Triple Therapy in T1DM

NCT ID: NCT03899402

Last Updated: 2025-04-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-01

Study Completion Date

2026-03-31

Brief Summary

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To assess whether the addition of dapagliflozin to semaglutide and insulin (triple therapy) improves glycemic control in patients with type 1 diabetes compared with semaglutide and insulin (dual therapy) and insulin only (standard) treatment.

Detailed Description

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This will be a 52 week study for type 1 diabetics looking into the effect of semaglutide and dapagliflozin on HbA1c and glycemic control.

Conditions

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Type 1 Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This will be a two-center, randomized, open-label then double-blind, parallel group, placebo and standard of care controlled prospective study in type 1 diabetes.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
This will be a two-center, randomized, open-label then double-blind, parallel group, placebo and standard of care controlled prospective study in type 1 diabetes.

Study Groups

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Control

Standard of care insulin will be used as an active comparator arm for 1/3 of patients (38 patients) for the entire duration of the study.

Group Type ACTIVE_COMPARATOR

Insulin

Intervention Type DRUG

Standard of care insulin for pump or injection and serves as a control

Dual Therapy

Once a week injection of Semaglutide (a GLP-1 receptor agonist) in addition to standard of care insulin for the first six months in 2/3 of patients (76 patients). Semaglutide is a clear, colorless solution that contains 2 mg of semaglutide in a 1.5 mL (1.34 mg/mL) pre-filled, disposable, single-patient-use pen injector. Semaglutide will be started at the 0.25 mg dose for the first two weeks, then increased to 0.5 mg at week 2, and then yet again increased to 1.0 mg at week 4.

Group Type EXPERIMENTAL

Insulin

Intervention Type DRUG

Standard of care insulin for pump or injection and serves as a control

Semaglutide

Intervention Type DRUG

Injectable weekly GLP-1RA given as open label experimental drug

Triple therapy

Once a day oral pill (green, plain, diamond shaped film coated 5 mg tablet) of Dapagliflozin (an SGLT-2 inhibitor) added to once a week injection of semaglutide and standard of care insulin in the second 6 months of 1/2 of the dual therapy arm (1/3 of total patients (38 patients)). Dapagliflozin will be started at 5 mg for one week, and then increased to 10 mg for the remainder of the study

Group Type EXPERIMENTAL

Insulin

Intervention Type DRUG

Standard of care insulin for pump or injection and serves as a control

Semaglutide

Intervention Type DRUG

Injectable weekly GLP-1RA given as open label experimental drug

Dapagliflozin

Intervention Type DRUG

Oral daily SGLT2 Inhibitor given as experimental drug

Triple therapy control

Once a day oral pill (green, plain, diamond shaped film coated 5 mg tablet) of the Placebo form of Dapagliflozin added to once a week injection of semaglutide and standard of care insulin in the second 6 months of 1/2 of the dual therapy arm (1/3 of total patients (38 patients)).

Group Type PLACEBO_COMPARATOR

Insulin

Intervention Type DRUG

Standard of care insulin for pump or injection and serves as a control

Semaglutide

Intervention Type DRUG

Injectable weekly GLP-1RA given as open label experimental drug

Placebo to Dapagliflozin

Intervention Type DRUG

Placebo to Dapagliflozin given as a control to the experimental drug

Interventions

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Insulin

Standard of care insulin for pump or injection and serves as a control

Intervention Type DRUG

Semaglutide

Injectable weekly GLP-1RA given as open label experimental drug

Intervention Type DRUG

Dapagliflozin

Oral daily SGLT2 Inhibitor given as experimental drug

Intervention Type DRUG

Placebo to Dapagliflozin

Placebo to Dapagliflozin given as a control to the experimental drug

Intervention Type DRUG

Other Intervention Names

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Ozempic Farxigo

Eligibility Criteria

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Inclusion Criteria

1. Type 1 Diabetes for at least 1 year on staple use of continuous subcutaneous insulin infusion (CSII) or multiple daily (four or more) injections (MDI) of insulin for last 3 months.
2. C-peptide \<0.23 nM
3. Minimum dose of insulin in Units/kg at entry: 0.5 U/kg for MDI and 0.4 U/kg for CSII
4. Regularly measuring blood sugars four or more times daily.
5. HbA1c of \>7.5%.
6. Well versed in CHO counting\*
7. Age 18-70 years.
8. BMI ≥25 kg/m2.

Exclusion Criteria

1. Type 1 diabetes for less than 12 months, type 2 diabetes, chronic pancreatitis, MODY
2. Previous use of any agent other than insulin for treatment of diabetes in the last 3 months.
3. History of diabetic ketoacidosis (DKA) requiring medical intervention (e.g., emergency room visit and/or hospitalization) within 3 month prior to the screening visit
4. Frequent episodes of severe hypoglycemia as defined by more than one episode requiring medical assistance, emergency care (paramedics or emergency room care), and/or glucagon therapy administered by a third-party individual within 1 month prior to the screening visit
5. Symptoms of poorly controlled diabetes that would preclude participation in this trial
6. Subjects on a commercial weight loss program with ongoing weight loss, or on an intensive exercise program
7. History of bariatric surgery or lap-band procedure within 12 months prior to screening
8. History of Addison's disease or chronic adrenal insufficiency
9. History of diabetes insipidus
10. Hepatic disease or cirrhosis with Aspartate Aminotransferase (AST) \> 3X Upper limit of normal (ULN) and/or Alanine aminotransferase (ALT) \> 3X ULN
11. Serum Total Bilirubin \> 2X ULN unless exclusively caused by Gilbert's Syndrome
12. Hemoglobin \< 11.0 g/dL (110 g/L) for men; hemoglobin \< 10.0 g/dL (100 g/L) for women.
13. Coronary event or procedure (myocardial infarction, unstable angina, coronary artery bypass, surgery or coronary angioplasty) in the previous 3 months or patients with congestive heart failure.
14. ESRD on hemodialysis; and or e-GFR \< 60 ml/min/1.73m2
15. HIV or Hepatitis B/C positive status
16. Any other life-threatening, noncardiac disease
17. History of pancreatitis
18. Women who are pregnant or women of childbearing potential who are not using adequate contraception or who are breast feeding
19. Inability to give informed consent
20. History of gastroparesis
21. History of medullary thyroid carcinoma or MEN 2 syndrome
22. History of serious hypersensitivity reaction to these agents
23. Painful gallstones
24. Alcoholism
25. Hypertriglyceridemia (\>500 mg/dl)
26. Recurrent genital mycotic infection.
27. Hypovolemic patients or with chronic renal insufficiency.
28. Patients with any malignancy except treated in situ malignancy and basal cell carcinoma of the skin
29. Unexplained hematuria
30. Patients with a history of diabetic retinopathy
31. Use of an investigational agent or therapeutic regimen within 30 days of study
32. Participation in any other concurrent interventional clinical trial
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Glasgow

OTHER

Sponsor Role collaborator

Juvenile Diabetes Research Foundation

OTHER

Sponsor Role collaborator

State University of New York at Buffalo

OTHER

Sponsor Role lead

Responsible Party

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paresh Dandona

SUNY Distinguished Professor, Head of Endocrinology, Diabetes, and Metabolism, State University of New York

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Husam Ghanim, PhD

Role: STUDY_DIRECTOR

State University of NY at Buffalo

Locations

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Diabetes and Endocrinology Research Center of WNY

Williamsville, New York, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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1987

Identifier Type: OTHER

Identifier Source: secondary_id

STUDY00002775

Identifier Type: -

Identifier Source: org_study_id

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