Skip to main content
OpenTrials
Not Yet Recruiting

NCT Number: NCT06946628

New Triple Therapy in Newly Diagnosed Type 2 Diabetes

The goal of this clinical trial is to learn the efficany of combination therapy with semaglutide, empagliflozin and pioglitazone versus standard therapy in newly diagnosed type 2 diabetes. The main objectives to achieve are:

1. To compare efficacy of the triple combination therapy against standard therapy in achieving type 2 diabetes remission in patients newly diagnosed with T2DM. 2. To compare the effects on β-cell function and glycemic control of the triple combination therapy against standard therapy in patients newly diagnosed with T2DM

Researchers will compare drug new triple combination therapy with semaglutide, empagliflozin, and pioglitazone to standard therapy (metformin-based treatment) to see if new triple combination therapy works better in achieving type 2 diabetes remission .

Participants will:

1. Take new triple combination therapy or a standard therapy every day for 6 months 2. Visit the clinic once every 0.5-1 month for checkups and tests 3. Keep a diary of their fingertip blood glucose and adverse events

Not Yet Recruiting

Trial opening soon.

Get Notified

Key information

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

The First Affiliated Hospital of Sun Yat-sen University

Guangzhou, Guangdong, 510080, China

Location contact

Hai Li, MD, PHD

CONTACT

[email protected]

+86-15920362668

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female, 18 years≤age≤75 years at the time of signing informed consent.
  • Newly diagnosed with type 2 diabetes, or diagnosed within 1 years according to the WHO diagnostic criteria.
  • Individuals who had not received previous antidiabetic therapy, or had not received antidiabetic therapy within 3 months prior to screening, or had not received antidiabetic therapy for more than 3 consecutive months or a combined total of more than 3 months in the past 2 years.
  • 6.5%≤HbA1c≤9.0% at screening confirmed by central laboratory analysis.
  • BMI≥24 kg/m2.

Exclusion criteria

  • Individuals with type 1 diabetes or special types of diabetes.
  • Allergy or intolerance to investigational drugs.
  • Estimated Glomerular Filtration Rate (eGFR) <20 mL/min/1.73 m².
  • Individuals with heart failure in New York Heart Association [NYHA] class III or IV in the 6 months prior to randomization.
  • History of bladder cancer or hematuria.
  • History of Multiple Endocrine Neoplasia Type 2 (MEN 2) or relevant family history.
  • History or family history of Medullary Thyroid Carcinoma (MTC), or susceptibility to MTC due to hereditary conditions.
  • History of fasting blood glucose≥13.9 mmol/L or the necessity for insulin use due to severe infection, diabetic foot, etc.
  • History of acute diabetic complications: including diabetic ketoacidosis, hyperglycemic hyperosmolar state, lactic acidosis.
  • Severe diabetic microvascular complications: proliferative retinopathy, or urinary AER>300mg/g, or urinary protein positive, quantitative >0.5g/24h.
  • Uncontrolled painful diabetic neuropathy and significant diabetic autonomic neuropathy.
  • Severe diabetic macrovascular complications: myocardial infarction, stroke or hospitalization for unstable angina and/or transient ischemic attack and/or peripheral arterial disease required for vascular intervention or amputation within the 12 months prior to screening.
  • Blood pressure persistently higher than 180/110 mmHg and not controllable to ≤160/100 mmHg within 1 week.
  • Alanine Aminotransferase (ALT) ≥2.5 times the upper normal limit, total bilirubin ≥1.5 times the upper normal limit.
  • Hemoglobin <100g/L or requiring regular blood transfusion.
  • Use of medicines potentially affecting blood glucose for more than 1 week cumulatively in the past 12 weeks, such as corticosteroids, growth hormone analogs, estrogen/progestogen, high-dose diuretics, antipsychotic drugs, etc.
  • Participation in another trial involving medicine therapy within the past 3 months.
  • Expected lifespan less than 2 years as per the investigator's clinical judgment, e.g., but not limited to malignancy.
  • Pregnant or lactating females, or females of childbearing potential who cannot or are unwilling to use adequate contraception.
  • Deemed unsuitable for participation in this clinical trial at the discretion of the investigator.

Treatment and study plan

Group A (triple combination therapy group)

Drug
  • Initiate with Semaglutide 0.25 mg once weekly (qw) + Empagliflozin 10 mg once daily (qd) + Pioglitazone 15 mg once daily (qd); 2) After 1 month, if blood glucose is not controlled, adjust to Semaglutide 0.5 mg qw + Empagliflozin 20 mg qd + Pioglitazone 30 mg qd. If Semaglutide is well-tolerated, increase to 1 mg qw after 1 week; 3)If blood glucose remains uncontrolled after 1 month, add basal insulin therapy.

Group B (standard therapy group)

Drug

metformin-based treatment is recommended when not contraindicated. 1).Initiate with Metformin monotherapy, titrate to the target dose of 1000 mg twice daily (bid) within 1 month or to the maximum tolerated dose (if Metformin is not tolerated, switch to Linagliptin 5 mg qd); 2) After 1 month, if blood glucose is not controlled, add a second antidiabetic drug, Empagliflozin 20 mg qd; 3) After another month, if blood glucose remains uncontrolled, add Semaglutide 0.25 mg qw, then increase to 0.5 mg qw after 1 month. If well-tolerated, increase to 1.0 mg qw after 1 week; 4) If blood glucose remains uncontrolled after 1 month, add basal insulin therapy.

Primary outcomes

  1. Diabetic remission rate

    Time frame: 6 months after discontinuation of medication

    Diabetic remission rate at 6 months after discontinuation of medication (percentage of patients with HbA1c <6.5% at 6 months after discontinuation of medication)

Secondary outcomes

  1. Diabetic remission rate

    Time frame: 3 and 12 months after discontinuation of medication

    Diabetic remission rate at 3 and 12 months after discontinuation of medication and the time of diabetic remission

  2. Time required to achieve glycemic goal

    Time frame: 6 months of medication

    The time required to achieve glycemic goal(FBG <6.1mmol/L, 2h PPG <8.0mmol/L or HbA1c<6.5%)

  3. EQ-5D-5L questionnaires, quality of life

    Time frame: At baseline, at 6 months of medication treatment, and at 3, 6, and 12 months after discontinuation of medication

    EQ-5D-5L questionnaires, assessment of quality of life. The EQ-5D-5L essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).

    The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.

    The EQ VAS records the patient's self-rated health on a vertical visual analogue scale where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. The VAS can be used as a quantitative measure of health outcome that reflects the patient's own judgement.

  4. Incremental cost per additional remission

    Time frame: 6 months after discontinuation of medication

    Incremental cost per additional remission at 6 months after discontinuation of medication

  5. HbA1c

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    HbA1c level at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  6. Blood glucose level

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    Fasting and 2-hour postprandial blood glucose level at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  7. Blood insulin level

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    Fasting and 2-hour postprandial insulin level at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  8. Blood C-peptide level

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    Fasting and 2-hour postprandial C-peptide level at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  9. Pancreatic β-cell function

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    HOMA-B at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  10. Insulin resistance

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    HOMA-IR at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  11. Weight changes

    Time frame: baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

    Weight at baseline, at 6 months of medication, and at 3, 6, and 12 months after discontinuation of medication

  12. Time in range (TIR)

    Time frame: At baseline, at 6 months of medication treatment, and at 6 months after discontinuation of medication

    Time within the target blood glucose range (3.9-10.0 mmol/L)

  13. Incremental cost per additional improvement in Time in Range (TIR)

    Time frame: 6 months of medication treatment, and at 6 months after discontinuation of medication

    Incremental cost per additional improvement in Time in Range (TIR) at 6 months of medication treatment, and at 6 months after discontinuation of medication

  14. Incremental cost per QALY gained

    Time frame: at baseline, at 6 months of medication treatment, and at 3, 6, and 12 months after discontinuation of medication

    Incremental cost per QALY gained, derived from EQ-5D-5L assessments at baseline, at 6 months of medication treatment, and at 3, 6, and 12 months after discontinuation of medication

Study contacts

Contact information is provided by the study sponsor or research team.

Hai Li, MD, PHD

CONTACT

[email protected]

+86-15920362668

Sponsors and collaborators

Lead sponsor

Sun Yat-sen University

Other

Registry information

Official study title

Combination Therapy With Semaglutide, Empagliflozin and Pioglitazone Versus Standard Therapy in Newly Diagnosed Type 2 Diabetes: a Multi-center Randomized Controlled Trial

Important dates

Study start
2025
Primary completion
2028
Study completion
2030
First posted
Apr 27, 2025
Registry last updated
Apr 27, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.