- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05071898
Pharmacogenetics of Response to GLP1R Agonists (PORT)
Overweight/obese otherwise healthy volunteers will be recruited from the Old Order Amish population in Lancaster County, PA. Lancaster County, PA. Pharmacodynamic responses to GLP1R agonist will be assessed by conducting frequently sampled intravenous glucose tolerance tests (FSIGT) both before and after semaglutide for six weeks. The proposal proposes two specific aims:
- Specific Aim #1. To identify genetic variants associated with effects of a GLP1R agonist to enhance glucose-stimulated first phase insulin secretion in the two FSIGTs (before and after administration of drug).
- Specific Aim #2. To identify genetic variants associated with the effect of a GLP1R agonist to accelerate the rate of glucose disappearance as assessed in the two FSIGTs (before and after administration of drug).
Genotyping will be conducted using a high-density array with comprehensive coverage of DNA sequence variants. In addition, the analysis will leverage a global imputation panel generated from 1,025 Amish individuals.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Overweight/obese otherwise healthy volunteers will be recruited from the Old Order Amish population in Lancaster County, PA. In order to assess pharmacodynamic responses, research participants will undergo two frequently sampled intravenous glucose tolerance tests (FSIGT). The first FSIGT will be conducted at baseline prior to administration of drug. The second FSIGT will be conducted after six weeks of treatment with semaglutide (0.25 mg/wk X 4 wks; 0.5 mg/sk X 2 wks). The proposal proposes two specific aims:
- Specific Aim #1. To identify genetic variants associated with effects of a GLP1R agonist to enhance glucose-stimulated first phase insulin secretion in the two FSIGTs (before and after administration of drug).
- Specific Aim #2. To identify genetic variants associated with the effect of a GLP1R agonist to accelerate the rate of glucose disappearance as assessed in the two FSIGTs (before and after administration of drug).
After being determined to be eligible and after having given informed consent, participants will undergo two frequently samples intravenous glucose tolerance tests conducted at two clinic visits as described below:
Visit #1 - Research participants will be transported to the Amish Research clinic in the fasting state (minimum of 8 hour, maximum of 24 hour fast) where height, weight, waist and hip measurements, and vital signs will be measured. Women of child-bearing potential will undergo a urine pregnancy test. An FSIVGTT will be conducted as follows: IV (intravenous) access will be established in both arms of the research participant, one for glucose infusion and the other for frequent blood sampling. NSS (normal saline solution) will be used to maintain patency of IV. Intravenous glucose (0.3 g/kg) will be infused over 2 min at time=0, and 31 blood samples will be obtained between -15 and +180 minutes. Approximately 180 ml (36 tsp.) of blood will be drawn. Upon completion of the FSIVGTT, the participant will be instructed in the self-administration of subcutaneous (s.c.) injection of semaglutide. The first dose of semaglutide .25mg will be administered at this time. The participant will be provided with a post-fasting meal.
Home self-administration of weekly semaglutide: The participant will self-administer s.c. semaglutide weekly for 5 weeks (.25 mg for weeks 2,3,4 and .5 mg for weeks 5,6) A research nurse may observe the participant self-administering the first home dose and will make additional home visits as needed to ensure successful self-injection. The participant will use the study provided scale to obtain and record daily weights in the morning before breakfast throughout the medication weeks.
Visit #2 - This visit will be scheduled within 1 week of the final (6th) dose of semaglutide +/- 5 days. The FSIVGTT will be conducted exactly as during the previous clinic visit.
Genotyping will be conducted using a high-density array with comprehensive coverage of DNA sequence variants. The project will leverage a global imputation panel generated from whole genome sequence data on ~ 100K subjects including 1,025 Amish individuals obtained through the NHLBI-sponsored Trans-Omics for Precision Medicine (TOPMed) program.
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Amber L Beitelshees, PharmD
- Phone Number: (410)706-0118
- Email: abeitels@som.umaryland.edu
Study Contact Backup
- Name: Simeon I Taylor, MD, PhD
- Phone Number: (410)706-6439
- Email: staylor2@som.umaryland.edu
Study Locations
-
-
Pennsylvania
-
Lancaster, Pennsylvania, United States, 17602
- Recruiting
- Amish Research Clinic
-
Contact:
- Susan Shaub, RN
- Phone Number: 717-392-4948
- Email: sshaub@som.umaryland.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- BMI greater than or equal to 27 kg/m2
- Of Amish Descent
Exclusion Criteria:
- Woman of childbearing age who is sexually active
- History of diabetes (HbA1c > 6.5% or random glucose >200 mg/dL)
- Known allergy to semaglutide
- Medical issues, which in the judgment of the research physician or PIs might increase the risk associated with participation in the study
- eGFR < 60 mL/min/1.73 sq. m.
- Hematocrit < 35%
- TSH < 0.4 o4 > 5.5
- AST or ALT in excess of 2X the upper limit of normal
- Unable to discontinue a drug, vitamin, or nutritional supplement, which in the judgment of the research physician or PIs might alter the response to semaglutide
- Personal or family history of medullary carcinoma of the thyroid or multiple endocrine neoplasia, type 2
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Open label administration of semaglutide
Semaglutide: 0.25 mg, sc, q.week for 4 weeks followed by 0.5 mg, sc, q.week for 2 weeks
|
Participants will receive subcutaneously injected semaglutide (0.25 mg/wk) for 4 weeks followed by semaglutide (0.5 mg/wk) for an additional two weeks.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
First phase insulin secretion
Time Frame: Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Area under the curve for plasma insulin levels measured at times between 0-10 min after administration of intravenous glucose (0.3 g/kg)
|
Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Second phase insulin secretion
Time Frame: Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Area under the curve for plasma insulin levels measured at times between 10-50 min after administration of intravenous glucose (0.3 g/kg)
|
Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Rate of glucose disappearance
Time Frame: Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Slope of the plot of log(glucose concentration) as a function of time.
This will be calculated based on a linear regression using data points between 25-50 minutes after administration of intravenous glucose (0.3 g/kg)
|
Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Weight loss
Time Frame: Assessed after completing 6 weeks of semaglutide therapy
|
This will be measured as the baseline weight in kg minus the weight after completing 6 weeks of semaglutide therapy.
|
Assessed after completing 6 weeks of semaglutide therapy
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Insulin sensitivity (Si)
Time Frame: Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Estimated using Bergman's minimal model
|
Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Glucose effectiveness (Sg)
Time Frame: Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Estimated using Bergman's minimal model
|
Measured both at baseline and after completing 6 weeks of semaglutide therapy
|
Collaborators and Investigators
Investigators
- Principal Investigator: Amber L Beitelshees, PharmD, University of Maryland, Baltimore
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HP00097563
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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