A Phase 1 interventional study of Tirzepatide and Semaglutide in Diabetes Mellitus, Type 2, sponsored by Eli Lilly and Company. Completed at 2 sites in Germany. Open to participants aged 20 Years to 74 Years. Per ClinicalTrials.gov, last updated 2023-03-20.
Sponsored by Eli Lilly and Company · Phase 1, Interventional, and Basic science
This is a study for participants with type 2 diabetes mellitus. The main purpose of this study is to learn more about how tirzepatide, semaglutide and placebo affect the body's ability to respond to blood sugar levels after a meal. The study will last up to 40 weeks, including a 28-week treatment period.
9,589 studies on the registry are indexed under Diabetes Mellitus, Type 2; 1,332 are open to participants now.
This study's enrollment of 117 is above the median of 81 across 7,713 interventional studies indexed under Diabetes Mellitus, Type 2.
Browse Diabetes Mellitus, Type 2 studies →Eli Lilly and Company is the lead sponsor of 2,095 studies on the registry; 142 are open to participants now.
Of its 535 completed or terminated interventional studies of FDA-regulated products, 356 (67%) have results posted.
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Participants received 15 milligram (mg) tirzepatide administered subcutaneously (SC) once weekly for 28 weeks.
Drug: Tirzepatide
Participants received 1 mg Semaglutide administered SC once weekly for 28 weeks.
Drug: Semaglutide
Participants received Placebo administered SC once weekly for 28 weeks.
Drug: Placebo
Administered SC
Also known as: LY3298176
Administered SC
Administered SC
Change From Baseline in Total Clamp Disposition Index (cDI)
cDI is defined as the product of the M-value derived from the hyperinsulinemic euglycemic clamp over the last 30 minutes and total insulin secretion (ISR AUC0-120min) derived from the insulin secretion rate based on C-peptide using the using the deconvolution technique divided by the total glucose AUC0-120min from the hyperglycemic clamp portion of the study. Least squares (LS) mean was determined by analysis of covariance (ANCOVA) model for endpoint measures: log(Actual Measurement/Baseline) = log(Baseline) + Treatment (Type III sum of squares).
Time frame: Baseline, Week 28
Change From Baseline in Fasting Glucose
Fasting glucose is a test to determine sugar levels in blood sample after an overnight fast. Fasting glucose was measured prior to standardized mixed-meal tolerance tests (sMMTT). LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
Time frame: Baseline, Week 28
Change From Baseline in Postmeal Glucose
Total AUC from time zero to 240 minutes after start of the meal \[AUC0-240min\]) during sMMTT was evaluated. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares) and ANOVA model for baseline measures: Variable = Treatment (Type III sum of squares).
Time frame: Baseline, Week 28
Change From Baseline in Hemoglobin A1c (HbA1c)
HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. LS mean was determined by mixed model repeated measures; (MMRM) model for post-baseline measures: Variable = Baseline + Treatment + Time + Treatment\*Time (Type III sum of squares).
Time frame: Baseline, Week 28
Change From Baseline in Total Insulin Secretion Rate During the 120-Minute Hyperglycemic Clamp (ISR0-120min)
Total Insulin Secretion Rate During the 120-Minute Hyperglycemic Clamp (ISR0-120min) will be determined from C-peptide concentrations using the deconvolution technique. LS mean was determined by ANCOVA model for endpoint measures: log(Actual Measurement/Baseline) = log(Baseline) + Treatment (Type III sum of squares).
Time frame: Baseline and Week 28
Change From Baseline in Hyperinsulinemic Euglycemic Clamp M-value
Hyperinsulinemic euglycemic clamp M-value is calculated from glucose infusion rate (GIR) over the last 30 minutes, corresponding to steady-state (+150 to +180 minutes), corrected for urine loss and space. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
Time frame: Baseline, Week 28
Change From Baseline in Glucagon Concentration at Fasting
Glucagon concentration was measured prior to sMMTT. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
Time frame: Baseline and Week 28
Change From Baseline in Glucagon Concentration at Postmeal
Total AUC from time zero to 240 minutes after start of the meal \[AUC0-240min\]) during sMMTT. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
Time frame: Baseline and Week 28
Change From Baseline in Food Intake During Ad Libitum Meal
Ad libitum meal served buffet-style. Food intake was recorded during a 45 minute period. The sum of the caloric breakdown (carbohydrates, protein, and fats) was calculated from the respective nutritional information of the food items. LS mean was determined by MMRM model for post-baseline measures: Variable = Baseline + Treatment + Time + Treatment\*Time (Type III sum of squares).
Time frame: Baseline, Week 28
| Milestone | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Started | 45 | 44 | 28 |
| Completed | 41 | 43 | 24 |
| Not completed | 4 | 1 | 4 |
| Withdrew: Adverse event | 1 | 0 | 3 |
| Withdrew: Withdrawal by subject | 3 | 1 | 0 |
| Withdrew: Lost to follow-up | 0 | 0 | 1 |
cDI is defined as the product of the M-value derived from the hyperinsulinemic euglycemic clamp over the last 30 minutes and total insulin secretion (ISR AUC0-120min) derived from the insulin secretion rate based on C-peptide using the using the deconvolution technique divided by the total glucose AUC0-120min from the hyperglycemic clamp portion of the study. Least squares (LS) mean was determined by analysis of covariance (ANCOVA) model for endpoint measures: log(Actual Measurement/Baseline) = log(Baseline) + Treatment (Type III sum of squares).
| pmol*m-2*L*min-2*kg-1 | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Total Clamp Disposition Index (cDI) | 1.9 ± 0.16 | 1.1 ± 0.10 | 0.0 ± 0.03 |
Fasting glucose is a test to determine sugar levels in blood sample after an overnight fast. Fasting glucose was measured prior to standardized mixed-meal tolerance tests (sMMTT). LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
| milligrams per decilitre (mg/dL) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Fasting Glucose | -51.4 ± 2.30 | -42.4 ± 2.22 | -4.3 ± 2.98 |
Total AUC from time zero to 240 minutes after start of the meal \[AUC0-240min\]) during sMMTT was evaluated. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares) and ANOVA model for baseline measures: Variable = Treatment (Type III sum of squares).
| Milligrams per decilitre*minute | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Postmeal Glucose | -17414.0 ± 726.02 | 14236.9 ± 709.53 | 459.2 ± 947.50 |
HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. LS mean was determined by mixed model repeated measures; (MMRM) model for post-baseline measures: Variable = Baseline + Treatment + Time + Treatment\*Time (Type III sum of squares).
| % of HbA1c | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Hemoglobin A1c (HbA1c) | 2.05 ± 0.079 | -1.64 ± 0.078 | 0.29 ± 0.101 |
Total Insulin Secretion Rate During the 120-Minute Hyperglycemic Clamp (ISR0-120min) will be determined from C-peptide concentrations using the deconvolution technique. LS mean was determined by ANCOVA model for endpoint measures: log(Actual Measurement/Baseline) = log(Baseline) + Treatment (Type III sum of squares).
| pmol/min/m^2 | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Total Insulin Secretion Rate During the 120-Minute Hyperglycemic Clamp (ISR0-120min) | 388.6 ± 20.17 | 286.6 ± 15.82 | 7.4 ± 7.15 |
Hyperinsulinemic euglycemic clamp M-value is calculated from glucose infusion rate (GIR) over the last 30 minutes, corresponding to steady-state (+150 to +180 minutes), corrected for urine loss and space. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
| umol/min/kg [body weight] | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Hyperinsulinemic Euglycemic Clamp M-value | 19.2 ± 1.93 | 10.7 ± 1.99 | -0.6 ± 2.53 |
Glucagon concentration was measured prior to sMMTT. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
| picomoles per litre (pmol/L) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Glucagon Concentration at Fasting | -3.6 ± 0.55 | -2.8 ± 0.55 | 0.8 ± 0.75 |
Total AUC from time zero to 240 minutes after start of the meal \[AUC0-240min\]) during sMMTT. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline + Treatment (Type III sum of squares).
| (pmol/L)*min | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Glucagon Concentration at Postmeal | -843.6 ± 86.26 | -502.0 ± 87.33 | -205.9 ± 116.31 |
Ad libitum meal served buffet-style. Food intake was recorded during a 45 minute period. The sum of the caloric breakdown (carbohydrates, protein, and fats) was calculated from the respective nutritional information of the food items. LS mean was determined by MMRM model for post-baseline measures: Variable = Baseline + Treatment + Time + Treatment\*Time (Type III sum of squares).
| kilocalorie (kcal) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo |
|---|---|---|---|
| Change From Baseline in Food Intake During Ad Libitum Meal | -348.4 ± 34.59 | -284.1 ± 33.94 | -38.6 ± 45.17 |
Collected over Up to Week 32. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo | 0/28 (0%) | 2/28 (7.1%) | 18/28 (64.3%) |
| Semaglutide 1 mg | 0/44 (0%) | 0/44 (0%) | 43/44 (97.7%) |
| Tirzepatide 15 mg | 0/45 (0%) | 1/45 (2.2%) | 41/45 (91.1%) |
| Event | Placebo | Semaglutide 1 mg | Tirzepatide 15 mg |
|---|---|---|---|
| Acute myocardial infarctionCardiac disorders | 1/28 | 0/44 | 0/45 |
| Subacute pancreatitisGastrointestinal disorders | 1/28 | 0/44 | 0/45 |
| UreterolithiasisRenal and urinary disorders | 0/28 | 0/44 | 1/45 |
| Event | Placebo | Semaglutide 1 mg | Tirzepatide 15 mg |
|---|---|---|---|
| Decreased appetiteMetabolism and nutrition disorders | 7/28 | 31/44 | 27/45 |
| Injection site haematomaGeneral disorders | 12/28 | 12/44 | 12/45 |
| Early satietyGeneral disorders | 6/28 | 12/44 | 16/45 |
| DyspepsiaGastrointestinal disorders | 2/28 | 14/44 | 3/45 |
| DiarrhoeaGastrointestinal disorders | 6/28 | 13/44 | 9/45 |
| NauseaGastrointestinal disorders | 7/28 | 13/44 | 11/45 |
| FatigueGeneral disorders | 2/28 | 10/44 | 5/45 |
| ConstipationGastrointestinal disorders | 0/28 | 8/44 | 6/45 |
| EructationGastrointestinal disorders | 0/28 | 8/44 | 8/45 |
| NasopharyngitisInfections and infestations | 3/28 | 8/44 | 7/45 |
All randomized participants who received at least one dose of study drug.
| Age, Categorical(Participants) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 31 | 20 | 18 | 69 |
| >=65 years | 14 | 24 | 10 | 48 |
| Age, Continuous(years) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| Mean | 61.1 ± 7.1 | 63.7 ± 5.9 | 60.4 ± 7.6 | 61.9 ± 6.9 |
| Sex: Female, Male(Participants) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| Female | 14 | 10 | 7 | 31 |
| Male | 31 | 34 | 21 | 86 |
| Ethnicity (NIH/OMB)(Participants) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| Hispanic or Latino | 0 | 0 | 0 | 0 |
| Not Hispanic or Latino | 45 | 44 | 28 | 117 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 |
| Asian | 0 | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 |
| Black or African American | 1 | 0 | 0 | 1 |
| White | 44 | 44 | 28 | 116 |
| More than one race | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 |
| Region of Enrollment(Participants) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| Germany | 45 | 44 | 28 | 117 |
| HbA1c (%)(percentage) | Tirzepatide 15 mg | Semaglutide 1 mg | Placebo | Total |
|---|---|---|---|---|
| Mean | 7.83 ± 0.72 | 7.70 ± 0.60 | 7.90 ± 0.51 | 7.80 ± 0.63 |
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Studies of the drug tested here: Tirzepatide