Trial Against INtractable Type 2 Diabetes (CAPTAIN-T2D)

NCT ID: NCT07296484

Last Updated: 2025-12-23

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

1500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-31

Study Completion Date

2028-06-30

Brief Summary

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CAPTAIN-T2D will take place in two parts. Part 1 (Screening) will evaluate patients with type 2 diabetes and elevated cortisol risk factors for trial eligibility and the presence of elevated cortisol. Participants deemed eligible from Part 1 will be randomized to either clofutriben or placebo in the double-blind (participant and investigator), dose-ranging, interventional Part 2 (Treatment).

Detailed Description

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CAPTAIN-T2D is a two-part, multicenter, randomized, double-blind, parallel group, placebo- controlled trial of the 11-hydroxysteroid dehydrogenase type 1 (HSD-1) inhibitor clofutriben. The primary objectives of this trial are to characterize the relationship of clofutriben dose to improved glycemic control, and to identify one or more doses suitable for Phase 3 evaluation, in patients with T2D and elevated cortisol.

The trial consists of two parts.

Part 1 (Screening) will last between approximately 5 to 9 weeks for most participants. The screening period duration allows for (sequentially) initial eligibility screen, dexamethasone suppression test, and further eligibility assessments.

During Part 2 (Treatment), participants will be randomized to placebo or one of four clofutriben doses. Part 2 will last 24 weeks with a follow-up phone call 4 weeks after the last dose of trial medication.

Conditions

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Type 2 Diabetes Cortisol Excess

Keywords

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hypercortisolism Cortisol excess elevated cortisol

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Dose 1

clofutriben .2 mg oral tablet daily

Group Type EXPERIMENTAL

clofutriben

Intervention Type DRUG

HSD-1 inhibitor

Dose 2

clofutriben 2mg oral tablet daily

Group Type EXPERIMENTAL

clofutriben

Intervention Type DRUG

HSD-1 inhibitor

Dose 3

clofutriben 6mg oral tablet daily

Group Type EXPERIMENTAL

clofutriben

Intervention Type DRUG

HSD-1 inhibitor

Dose 4

clofutriben 12 mg oral tablet daily

Group Type EXPERIMENTAL

clofutriben

Intervention Type DRUG

HSD-1 inhibitor

placebo

placebo control oral tablet daily

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo

Interventions

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clofutriben

HSD-1 inhibitor

Intervention Type DRUG

Placebo

Placebo

Intervention Type DRUG

Other Intervention Names

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SPI-62 ASP3662

Eligibility Criteria

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Inclusion Criteria

* From Screening 1

* Age at least 18 years.
* HbA1c ≥7.5% documented within 3 months prior to Screening 1. (The historical HbA1c value must have been obtained after at least 2 months on the current \[as of Screening 1\] regimen).
* Treatment with stable and adequate doses of ≥2 injectable or oral ADMs. (An ADM will be deemed stable if the dose has been the same for at least 3 months prior to Screening 1 and without change between Screening 1 and Day 1) (An ADM dose will be deemed adequate if it is at or above the maximal labelled dose, or a sub-maximal, but not starting, dose if limited by tolerability (confer with MM if less than half-maximal dose).
* Adequate total daily insulin is defined as at least 0.3 units/kg/day. Insulin dose will be deemed stable with adjustments of up to 20% total daily dose during the 3 months prior to Screening 1 or between Screening 1 and Day 1.
* Use of insulin pumps or insulin brand changes (e.g., due to insurance change or shortage) are to be discussed with the MM.
* At least one of the following

* ≥3 stable and adequate ADMs;
* diabetes complication (retinopathy, nephropathy, neuropathy, atherosclerotic heart disease);
* hypertension requiring ≥2 adequately dosed AHMs;
* adequately dosed basal or basal plus prandial insulin in addition to at least 1 other ADM; and
* adequately dosed incretin agonist (a single or combination agent counts as one ADM) in addition to at least 1 other ADM;
* evidence or history of osteoporosis or non-traumatic fracture (e.g., vertebral body compression);
* or established diagnosis of a neoplastic (non-malignant) source of hypercortisolism and have failed, are ineligible for, or declined surgery.

At DST • Post-DST cortisol level \>1.8 µg/dL and serum dexamethasone ≥140 ng/dL. Patients with an established diagnosis of neoplastic hypercortisolism do not require a DST.

At Screening 2

* HbA1c ≥7.5% at Screening 2. At Day 1
* No change in, or initiation of, medications for hypertension within 1 month prior to Day 1.

Exclusion Criteria

* New-onset diabetes (onset \<1 year in the past).
* Unwillingness to maintain with current glucose-lowering regimen during the trial.
* Unwillingness to adjust, add, replace, or discontinue current or other glucose-lowering medications during the trial as directed by the investigator.
* Unwillingness to comply with CGM or other trial procedures.
* Investigator considers the patient will otherwise be unwilling or unable to complete the trial.
* Night-shift worker or otherwise habitually awake from 23:00 to 07:00 h.
* Evidence for significant hypoglycemia while on their current diabetic treatment regimen(This includes episodes of symptomatic Level 3 hypoglycemia requiring external assistance for recovery, or CGM-documented prolonged \[\>15 min\] or repeated episodes of either Level 2 hypoglycemia leading to \>1%, or Level 1 hypoglycemia leading to \>4%, in "time below range" within 3 months prior to Screening 1 or between Screening 1 and Day 1).
* Any of the following in medical history:

* Type 1 diabetes mellitus (T1D), latent autoimmune diabetes in adults (LADA), or familial forms of maturity-onset diabetes of the young (MODY);
* A hemoglobinopathy or other condition which may interfere with measurement of HbA1c (e.g., sickle cell disease HbSS or other variants HbEE thalassemia, hemolytic anemia, recent blood transfusion);
* Hypersensitivity or severe reaction to dexamethasone;
* Pheochromocytoma, or suspicion thereof;
* Anorexia, or other eating disorder;
* Glucocorticoid resistance;
* Multiple sclerosis;
* Significant hepatic impairment (e.g., Child-Pugh Class B or C);
* Idiopathic thrombocytopenic purpura;
* Untreated or inadequately controlled moderate-to-severe sleep apnea (apnea-hypopnea index ≥15). (Patients whose condition has been well controlled with Continuous Positive Airway Pressure (CPAP) use for at least 3 months prior to Screening 1 are not excluded. Patients with a STOP-BANG score 5-8 should be referred for a sleep study outside the trial and may rescreen if found not to have moderate-to-severe sleep apnea);
* Current alcohol consumption \>14 units/week or \>4 units in a single day for males, or \>7 units/week or \>3 units in a single day for females. (Patients with a CAGE score 2-4 should be evaluated further outside the trial and may be rescreened if found not to have an alcohol \[or other substance\] use disorder);
* Untreated or inadequately controlled major depressive disorder, generalized anxiety disorder, bipolar disorder, post-traumatic stress disorder, or schizophrenia.(Patients whose condition has been well controlled with stable medical therapy, or has been asymptomatic, for at least 3 months prior to Screening 1 are not excluded); or
* Any other medical condition (including malignancy) that is likely to interfere with trial assessments or the patient's ability to complete the trial.
* Any of the following in medication history:
* Any of the excluded medications listed in Section 6.9;
* Any investigational drug within 4 weeks or within less than five times the drug's half-life, whichever is longer, prior to Screening 1 or between Screening 1 and Day 1;
* Woman of childbearing potential (WOCBP) not willing to adhere to highly effective contraception or strict abstinence for the duration of the trial and for 90 days post completion/discontinuation; and
* Pregnancy (including a positive urine test) or current breast feeding.

From Screening 2

• Prior probability of undiagnosed endogenous Cushing syndrome based on either of:

* wo morning serum cortisol values after dexamethasone suppression \>5.0 mcg/dL together with plasma dexamethasone \>140 ng/mL; or
* a morning serum cortisol value after dexamethasone suppression \>1.8 mcg/dL, together with plasma dexamethasone \>140 ng/mL and any one of the following that is not attributable to an etiology other than endogenous Cushing's syndrome:
* supraclavicular/dorsocervical fat accumulation;
* irounding of the face (especially compared with prior photos);
* skin changes (violaceous striae, skin thinning, or excessive bruising);
* proximal muscle weakness on exam; or
* history of deep vein thrombosis/pulmonary embolism.
* Plans for, or medically unable to forego, treatment for endogenous Cushing syndrome or ACS within the next 8 months. (For clarity, patients with EnCS or ACS, not having such treatment plans, and medically able to forego treatment for 8 months may enroll if otherwise eligible).
* Severe, poorly controlled hypertension (mean systolic BP \>160 mmHg or mean diastolic BP \>100 mmHg) at Screening 2 or between Screening 2 and Day 1, including by at-home monitoring. (Such patients will be eligible to rescreen for Part 2 when they restore BP \<160/100 mmHg for 1 month on a new stable medication regimen).
* Positive urine screen for recreational drugs (except tetrahydrocannabinol (THC)).
* Glomerular filtration rate (GFR) (determined using Chronic Kidney Disease Epidemiology Collaboration \[CKD-EPI\]) \<45 mL/min/1.73 m².
* Poorly controlled hyperthyroidism/hypothyroidism (confirmed by TSH or Free thyroxine \[fT4\]).
* Liver enzymes \>3 × upper limit of normal (ULN) (alanine aminotransferase (ALT) or aspartate aminotransferase (AST) or bilirubin \>1.5 × ULN.(excepting benign conditions such as Gilbert's)
* Known hypersensitivity to clofutriben or to any of the product
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sparrow Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Arizona Clinical Trials - Pecos

Chandler, Arizona, United States

Site Status NOT_YET_RECRUITING

Arizona Clinical Trials - Broadway

Tucson, Arizona, United States

Site Status NOT_YET_RECRUITING

Ark Clinical Research - Fountain Valley

Fountain Valley, California, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Huntington Park

Huntington Park, California, United States

Site Status RECRUITING

Velocity Clinical Research - Gardena

La Mesa, California, United States

Site Status RECRUITING

Ark Clinical Research - Long Beach

Long Beach, California, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Los Angeles

Los Angeles, California, United States

Site Status RECRUITING

Amicis Research Center- Nordhoff

Northridge, California, United States

Site Status RECRUITING

The Center for Diabetes and Endocrine Care

Fort Lauderdale, Florida, United States

Site Status RECRUITING

Admed Research LLC

Miami, Florida, United States

Site Status NOT_YET_RECRUITING

Progressive Medical Research

Port Orange, Florida, United States

Site Status RECRUITING

IACT Health-Brookstone Centre Pkwy

Columbus, Georgia, United States

Site Status NOT_YET_RECRUITING

Chicago Clinical Research Institute

Chicago, Illinois, United States

Site Status RECRUITING

Velocity Clinical Research, Sioux City

Sioux City, Iowa, United States

Site Status RECRUITING

Iowa Diabetes and Endocrinology Research Center

West Des Moines, Iowa, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Lafayette

Lafayette, Louisiana, United States

Site Status NOT_YET_RECRUITING

NOLA Care Clinical Research

Metairie, Louisiana, United States

Site Status NOT_YET_RECRUITING

Tulane University School of Medicine

New Orleans, Louisiana, United States

Site Status NOT_YET_RECRUITING

Medstar Health Research Institute

Olney, Maryland, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Rockville

Rockville, Maryland, United States

Site Status RECRUITING

Oakland Medical Research Center

Troy, Michigan, United States

Site Status RECRUITING

Velocity Clinical Research, Lincoln

Lincoln, Nebraska, United States

Site Status RECRUITING

Velocity Clinical Research, Omaha

Omaha, Nebraska, United States

Site Status RECRUITING

Palm Research Center, Inc.

Las Vegas, Nevada, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Binghamton

Binghamton, New York, United States

Site Status RECRUITING

Endocrine Associates of Long Island, P.C.

Smithtown, New York, United States

Site Status NOT_YET_RECRUITING

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status NOT_YET_RECRUITING

Physicians East

Greenville, North Carolina, United States

Site Status NOT_YET_RECRUITING

Centricity Research LR Morehead City NC

Morehead City, North Carolina, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Cincinnati, Mt. Auburn

Cincinnati, Ohio, United States

Site Status RECRUITING

Velocity Clinical Research, New Smyrna Beach

Cincinnati, Ohio, United States

Site Status RECRUITING

Velocity Clinical Research - Cincinnati, Blue Ash

Cincinnati, Ohio, United States

Site Status RECRUITING

Endocrinology Associates, Inc

Columbus, Ohio, United States

Site Status RECRUITING

Remington Davis, Inc

Columbus, Ohio, United States

Site Status RECRUITING

Velocity Clinical Research, Austin

Austin, Texas, United States

Site Status RECRUITING

Juno Research, LLC

Houston, Texas, United States

Site Status RECRUITING

Radiance Clinical Research

Lampasas, Texas, United States

Site Status RECRUITING

Texas Diabetes & Endocrinology, P.A. - Round Rock

Round Rock, Texas, United States

Site Status RECRUITING

Elevate Clinical Research

Seabrook, Texas, United States

Site Status RECRUITING

Texas Valley Clinical Research, LLC

Weslaco, Texas, United States

Site Status NOT_YET_RECRUITING

Wasatch Clinical Research, LLC

Salt Lake City, Utah, United States

Site Status NOT_YET_RECRUITING

Velocity Clinical Research, Salt Lake City

West Jordan, Utah, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Kurt Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Veronica Clinical Research Manager

Role: primary

Marie Study Coordinator

Role: primary

Nora Clinical Research Manager

Role: primary

Manognya Clinical Research Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Juliejo (Julie) Clinical Research Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Kurt Manager

Role: primary

Edward Clinical Research Manager

Role: primary

Tsunami Clinical Research Manager

Role: primary

Kurt Manager

Role: primary

Lian manager

Role: primary

Lauren Clinical Research Manager

Role: primary

Olivia Clinical Research Manager

Role: primary

Olga Clinical Research Manager

Role: primary

Kurt Clinical Research Manager

Role: primary

Other Identifiers

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SPI-62-CL-2006

Identifier Type: -

Identifier Source: org_study_id