Ixekizumab Diabetes Intervention Trial (I-DIT)

INCLUSION CRITERIA:

• Signed informed consent and expected cooperation of the patients for the treatmentand follow up must be obtained and documented according to ICH GCP, andnational/local regulations before trial activities are begun.

• Must be willing and capable of taking the study drugs and meet for tests and followup as described.

• Diagnosed Type 1 Diabetes (E10.9) within 100 days.

• First injection of insulin maximum 100 days prior to screening

• Aged 18-45 years old.

• Presence of antibodies at clinical practice or at screening to at least one of thefollowing antigens: insulin/IAA, GAD-65, IA-2 and ZnT8.

• Remaining stimulated peak C-peptide ≥ 0.20 nmol/L. If age 36-45 years, peakC-peptide should be <2.0 nmol/L.

• Male subjects agree to use a reliable method of birth control during the study

• Female subjects:

Participants of childbearing age or childbearing potential who are sexually active who test negative for pregnancy must be counseled and agree to use either 1 highly effective method of contraception or 2 acceptable methods of contraception combined for the duration of the study and for at least 12 weeks following the last dose of study drug or remain abstinent during the study and for at least 12 weeks following the last dose of study drug.

If the highly effective contraceptive methods are contraindicated or strictly declined by patient, acceptable birth control methods may be considered. These may include combination of both of the following methods:

• Male or female condom with spermicide

• Cap, diaphragm, or sponge with spermicide

1. Highly effective methods of contraception (use 1 form):

2. combined oral contraceptive pill and mini-pill

3. NuvaRing®

4. implantable contraceptives

5. injectable contraceptives (such as Depo-Provera®)

6. intrauterine device (such as Mirena® and ParaGard®)

7. contraceptive patch-ONLY women <198 pounds or 90 kg

8. abstinence from sex

9. vasectomy-for men in clinical studies

10. Effective methods of contraception (use 2 forms combined)

• male condom with spermicide

• female condom with spermicide

• diaphragm with spermicide

• cervical sponge

• cervical cap with spermicide

Females who are not of childbearing potential include those who have undergone or who have:

• female sterilization

• hysterectomy

• menopause

• Müllerian agenesis (Mayer-Rokitansky-Küster-Hauser syndrome [also referred to ascongenital absence of the uterus and vagina])

EXCLUSION CRITERIA:

• Contraindications to Ixekizumab.

• Treatment with any oral or injected glucose-lowering agents other than insulin.

• A history of haemolytic anaemia or significantly abnormal haematology/coagulationresults at screening.

• Participation in other clinical trials with a new chemical entity within theprevious 3 months.

• Subjects with severe obesity (BMI >35 kg/m2 if age 18-35 years and BMI >30 kg/m2 ifage 36-45).

• Subjects with other autoimmune disease, e.g. Mb Crohn, Ulcerative colitis, Gravesdisease, psoriasis, psoriasis arthritis and axial spondylarthrosis, except celiacdisease and hypothyroidism which do not need to be excluded for.

• Active serious or chronic infections (ie: in case patient had a serious infection (eg pneumonia, cellulitis), has been hospitalized, has received intravenousantibiotics for an infection within 12 weeks prior to screening visit, had a seriousbone or joint infection within 24 weeks before screening visit, has ever had aninfection of an artificial joint

• Known immunodeficiency or patient is immunocompromised to an extent thatparticipation in the study would pose and unacceptable risk to the patient

• Tuberculosis

• History of HIV, hepatitis B or C

• Active or recurrent fungal infection

• Subjects with myocardial infarction, stroke, unstable angina or heart failure last 6months

• Current clinically significant cardiac arrhythmias as verified by ECG

• Planned surgery during the treatment period of the study (except minor surgery onskin lesions, e.g., nevus)

• For female subjects: Positive pregnancy test, presently breast-feeding, orunwillingness to use effective contraceptive measures for the duration of the studyand 3- months after discontinuation.

• For male subjects: intent to procreate during the duration of the study or within 3months after discontinuation or unwillingness of their partner to use effectivecontraceptive measures for the duration of the study and 4 months afterdiscontinuation.

• Any history of malignancy the last 5 years except for completely resected squamousor basal cell carcinoma of the skin.

• Administration of live attenuated vaccine(s) (LAV) within 2 months of enrolment. Orintended use of LAV during the treatment period.

• The investigator judges that the clinical diagnosis of T1D set is incorrect oruncertain (needs to be confirmed by discussion with experienced diabetologist ifexcluding due to this criterion)

• Allergy against ingredients of the investigational products.

• Known allergy or hypersensitivity to any biologic therapy (active substance orexcipients) that would pose an unacceptable risk to the patient if participating inthe study

• Presence of serious disease or condition, which in the opinion of the investigatormakes the patient non-eligible for the study.

• Liver injury criteria: patients with active hepatobiliary diseases or at screeninghaving alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5times the upper limit of normal (>2.5 x ULN)

• Laboratory abnormalities at screening:

1. Neutrophil count < 1,500 cells/ μL (=1,5 *109 cells/ L)

2. Platelet count < 100,000 cells/ μL (= 100 *109 cells/ L)

3. Hemoglobin < 8.5 g/dL (= <85 g/L) (males) and <8g/dL (= <80 g/L) (women)