Comparison Between Efficacy of Trelagliptin and Sitagliptin in Type II Diabetic Patients

NCT ID: NCT07073768

Last Updated: 2025-07-18

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

ENROLLING_BY_INVITATION

Clinical Phase

PHASE3

Total Enrollment

126 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-01

Study Completion Date

2026-12-30

Brief Summary

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The goal of this clinical trial is to find out if a medicine called Trelagliptin works as well as another medicine called Sitagliptin to lower blood sugar levels in people with type 2 diabetes who have not reached their target sugar levels with metformin alone.

The main questions this study aims to answer are:

Does Trelagliptin lower average blood sugar levels (measured by HbA1c) as well as Sitagliptin over 3 months? Does Trelagliptin help reduce swings in blood sugar levels compared to Sitagliptin? Are people more likely to stick to taking Trelagliptin, which is taken once a week, than Sitagliptin, which is taken every day? How satisfied are people with their treatment when using Trelagliptin versus Sitagliptin?

Researchers will compare two groups:

One group will take Trelagliptin once a week for 3 months. The other group will take Sitagliptin once a day for 3 months.

Participants in the study will:

Answer questions about their health and how they feel about their diabetes treatment.

Have blood tests to measure blood sugar levels, including:

HbA1c (an average measure of blood sugar over 2-3 months) Fasting blood sugar levels Blood sugar levels two hours after breakfast Keep records of how often they take their medicine.

People can take part in this study if:

They have type 2 diabetes and are taking metformin but still have higher-than-desired blood sugar levels.

They are between certain blood sugar ranges (HbA1c higher than 6.5% but lower than 10%).

They are willing to give informed consent and follow study instructions.

People cannot take part if:

They have type 1 diabetes. They have certain serious health conditions, such as severe kidney disease, heart problems, cancer, or are pregnant.

They are already taking Trelagliptin or are in another clinical study. The study will take place at Khyber Teaching Hospital in Pakistan and will last about 3 months for each participant.

Detailed Description

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Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with significant microvascular and macrovascular complications. In many patients, blood sugar levels remain above target despite treatment with metformin, which is the usual first-line therapy. Additional treatments are often required to achieve optimal glycemic control.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral medications used in managing T2DM. They work by preventing the breakdown of incretin hormones, which help regulate insulin secretion and lower blood glucose levels. Most DPP-4 inhibitors, including sitagliptin, require daily dosing. Trelagliptin is a once-weekly DPP-4 inhibitor that has shown higher potency against the DPP-4 enzyme in preclinical and clinical studies. Trelagliptin is approved for use in Japan but has limited availability and data in other countries, including Pakistan.

This randomized controlled trial aims to compare the efficacy and patient experience of Trelagliptin and Sitagliptin in patients with T2DM who have not achieved glycemic targets with metformin alone. The study seeks to evaluate whether once-weekly Trelagliptin provides similar or superior glycemic control compared to once-daily Sitagliptin and whether it improves treatment adherence and patient satisfaction due to reduced dosing frequency.

Participants will be randomly assigned in a 1:1 ratio to either the Trelagliptin group or the Sitagliptin group. The Trelagliptin group will receive a once-weekly dose of 100 mg oral Trelagliptin for 3 months. The Sitagliptin group will receive 100 mg of oral Sitagliptin once daily for 3 months. Both groups will continue metformin therapy as previously prescribed.

Glycemic control will be assessed through measurements of HbA1c at baseline and after 3 months of treatment. Additional evaluations include fasting blood sugar (FBS) and two-hour post-breakfast random blood sugar (RBS) levels measured monthly. Participants will be asked to maintain a medication diary to record doses taken. Treatment adherence will be assessed through the diary entries and through participant interviews. Treatment satisfaction will be evaluated using the Diabetes Treatment Satisfaction Questionnaire (DTSQ).

The study will be conducted at the Department of Medicine, Khyber Teaching Hospital, Pakistan. Data will be collected and analyzed using standard statistical methods. The primary outcome is the change in HbA1c from baseline to 3 months. Secondary outcomes include changes in FBS and RBS levels, treatment adherence rates, and patient-reported treatment satisfaction.

This study is expected to generate valuable evidence on the efficacy and patient acceptability of Trelagliptin in a Pakistani population and may help inform clinical decision-making regarding once-weekly versus daily DPP-4 inhibitor therapy for T2DM.

Conditions

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Diabetes Mellitus Type 2 Glycemic Control for Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Trelagliptin Arm

A total of 63 participants will receive Trelagliptin 100 mg taken orally once weekly for 3 months. All participants will continue their background metformin therapy as previously prescribed. The study will assess changes in HbA1c, fasting blood sugar, postprandial blood sugar, treatment adherence, and patient satisfaction compared to Sitagliptin.

Group Type EXPERIMENTAL

Trelagliptin 100 mg

Intervention Type DRUG

Trelagliptin will be administered as oral tablets at a dose of 100 mg once weekly for 3 months. Participants will continue background metformin therapy as prescribed. Trelagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for type 2 diabetes mellitus and differs from daily DPP-4 inhibitors due to its longer duration of action, allowing weekly dosing.

Sitagliptin Arm

A total of 63 participants will receive Sitagliptin 100 mg taken orally once daily for 3 months. All participants will continue their background metformin therapy as previously prescribed. The study will assess changes in HbA1c, fasting blood sugar, postprandial blood sugar, treatment adherence, and patient satisfaction compared to Trelagliptin.

Group Type ACTIVE_COMPARATOR

Sitagliptin 100mg OD

Intervention Type DRUG

Sitagliptin will be administered as oral tablets at a dose of 100 mg once daily for 3 months. Participants will continue background metformin therapy as prescribed. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for type 2 diabetes mellitus and requires daily dosing.

Interventions

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Trelagliptin 100 mg

Trelagliptin will be administered as oral tablets at a dose of 100 mg once weekly for 3 months. Participants will continue background metformin therapy as prescribed. Trelagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for type 2 diabetes mellitus and differs from daily DPP-4 inhibitors due to its longer duration of action, allowing weekly dosing.

Intervention Type DRUG

Sitagliptin 100mg OD

Sitagliptin will be administered as oral tablets at a dose of 100 mg once daily for 3 months. Participants will continue background metformin therapy as prescribed. Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated for type 2 diabetes mellitus and requires daily dosing.

Intervention Type DRUG

Other Intervention Names

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SYR-472

Eligibility Criteria

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Inclusion Criteria

* • Type 2 Diabetic patients visiting Medical OPD

* Patients already maintaining lifestyle modifications and on metformin monotherapy, but not achieving target HbA1c levels.
* Patients who require treatment with a DPP-4 inhibitors
* Patients with baseline HbA1c \> 6.5% and \< 10%
* Patients willing to provide written informed consent prior to recruitment

Exclusion Criteria

* • Type 1 Diabetic Patients

* Patients already using Trelagliptin for type 2 diabetes
* Patients with severe renal impairment (eGFR \< 30ml/min/1.73m2 or on dialysis)
* Patients with Serious Heart disease or Cerebrovascular disease
* Patients with Serious Pancreatic or blood disease
* Patients with malignancy
* Patients with history of hypersensitivity to DPP-4 inhibitors
* Patients with history of gastrointestinal resection
* Pregnant, Breast feeding or planning to be pregnant patients
* Patients participating in other clinical studies
* Patients assessed as ineligible by researchers due to any other reason
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Khyber Medical College, Peshawar

OTHER

Sponsor Role lead

Responsible Party

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Dr Aliena Badshah

Assistant Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Aliena Badshah, MBBS, FCPS, MRCP

Role: PRINCIPAL_INVESTIGATOR

Khyber Teaching Hospital

Locations

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Khyber Teaching Hospital / Khyber Medical College

Peshawar, Khyber Pakhtunkhwa, Pakistan

Site Status

Countries

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Pakistan

References

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Inagaki N, Sano H, Seki Y, Kuroda S, Kaku K. Efficacy and safety of once-weekly oral trelagliptin switched from once-daily dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes mellitus: An open-label, phase 3 exploratory study. J Diabetes Investig. 2018 Mar;9(2):354-359. doi: 10.1111/jdi.12730. Epub 2017 Oct 30.

Reference Type BACKGROUND
PMID: 28836351 (View on PubMed)

Dutta D, Mohindra R, Surana V, Sharma M. Safety and efficacy of once weekly dipeptidyl-peptidase-4 inhibitor trelagliptin in type-2 diabetes: A meta-analysis. Diabetes Metab Syndr. 2022 Apr;16(4):102469. doi: 10.1016/j.dsx.2022.102469. Epub 2022 Mar 21.

Reference Type BACKGROUND
PMID: 35344848 (View on PubMed)

Diachenko SS. [Development of medical microbiology in the Ukraine]. Vrach Delo. 1988 May;(5):116-20. No abstract available. Russian.

Reference Type BACKGROUND
PMID: 3047982 (View on PubMed)

Deacon CF, Lebovitz HE. Comparative review of dipeptidyl peptidase-4 inhibitors and sulphonylureas. Diabetes Obes Metab. 2016 Apr;18(4):333-47. doi: 10.1111/dom.12610. Epub 2016 Jan 8.

Reference Type BACKGROUND
PMID: 26597596 (View on PubMed)

Kim HJ, Kim YS, Lee CB, Choi MG, Chang HJ, Kim SK, Yu JM, Kim TH, Lee JH, Ahn KJ, Min KW, Kyung EJ, Kim YK, Lee KW. Efficacy and Safety of Switching to Teneligliptin in Patients with Type 2 Diabetes Inadequately Controlled with Dipeptidyl Peptidase-4 Inhibitors: 52-Week Results from a Prospective Observational Study. Diabetes Ther. 2021 Nov;12(11):2907-2920. doi: 10.1007/s13300-021-01148-1. Epub 2021 Sep 18.

Reference Type BACKGROUND
PMID: 34536208 (View on PubMed)

Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000 Aug 12;321(7258):405-12. doi: 10.1136/bmj.321.7258.405.

Reference Type BACKGROUND
PMID: 10938048 (View on PubMed)

Grimshaw CE, Jennings A, Kamran R, Ueno H, Nishigaki N, Kosaka T, Tani A, Sano H, Kinugawa Y, Koumura E, Shi L, Takeuchi K. Trelagliptin (SYR-472, Zafatek), Novel Once-Weekly Treatment for Type 2 Diabetes, Inhibits Dipeptidyl Peptidase-4 (DPP-4) via a Non-Covalent Mechanism. PLoS One. 2016 Jun 21;11(6):e0157509. doi: 10.1371/journal.pone.0157509. eCollection 2016.

Reference Type BACKGROUND
PMID: 27328054 (View on PubMed)

Glenn JK, Hofmeister RW, Neikirk H, Wright H. Continuity of care in the referral process: an analysis of family physicians' expectations of consultants. J Fam Pract. 1983 Feb;16(2):329-34.

Reference Type BACKGROUND
PMID: 6822803 (View on PubMed)

Related Links

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Other Identifiers

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KhyberMC

Identifier Type: -

Identifier Source: org_study_id

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