A Study of TG103 Injection Combined With Metformin in Treatment of Type 2 Diabetes Mellitus

A Multicenter, Randomized, Open-label, Controlled Phase 3 Trial of TG103 Injection in Combination With Metformin in Subjects With Type 2 Diabetes Mellitus

This is a randomized, open-label, dulaglutide-controlled, multicenter Phase 3 trial to evaluate the efficacy, safety, and immunogenicity of different doses of TG103 injection in combination with metformin in subjects with type 2 diabetes with poor glycemic control treated with metformin monotherapy.

Study Overview

• Status: Completed
• Conditions: Type 2 Diabetes Mellitus
• Intervention / Treatment: Drug: TG103; Drug: Dulaglutide

• Study Type: Interventional
• Enrollment (Actual): 632
• Phase: Phase 3

Contacts and Locations

Study Locations

• China
  • Beijing Municipality
    • Beijing, Beijing Municipality, China, 100032
      • Peking University People's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Subjects have diagnosed with type 2 diabetes according to the Guidelines for prevention and treatment of type 2 diabetes in China (2020 Edition), T2DM was diagnosed at least 8 weeks before screening;
• Aged 18 to 75 years (inclusive), no gender limitation;
• Body Mass Index (BMI): 18.5≤BMI≤40;
• Received stable dose of metformin hydrochloride monotherapy for ≥8 weeks before screening and metformin dose ≥1500 mg/ day ;

• HbA1c must meet the following criteria:

  • Screening: 7.5% ≤ HbA1c ≤ 11.0% (Local laboratory)
  • Baseline: 7.0% ≤ HbA1c ≤ 10.5% (Central laboratory)
• Subjects of childbearing potential must use reliable methods of contraception throughout the study period and at least 3 months after the last dose to avoid pregnancy in female subjects or pregnancy in the male subject's partner;
• Willing and able to accurately use home glucose meter for self-glucose monitoring;
• Be able to understand and follow the trial procedure, voluntarily participate in the trial and sign the informed consent form.

Exclusion Criteria:

• Type 1 diabetes;
• Body weight change more than 5% within 1 month prior to screening;

• Received any of the following medications:

  1. Prior discontinuation of DPP-4 inhibitors or GLP-1 receptor agonists for efficacy, tolerability, and safety reasons;
  2. Systemic glucocorticoid and growth hormone,or other drugs affecting glucose metabolism have been used within 8 weeks before screening;
• History of ≥2 episodes of grade 3 hypoglycemia within 6 months prior to screening, or grade 3 hypoglycemia between screening to randomization;
• Acute complications of diabetes, such as diabetic ketoacidosis and hyperglycemic hyperosmolar status, occurred ≥1 time within 6 months prior to screening;
• Severe chronic complications of diabetes (e.g., proliferative diabetic retinopathy, severe diabetic neuropathy, diabetic foot, etc.) within 6 months prior to screening
• History of acute or chronic pancreatitis prior to screening;
• Subjects with clinically significant gastric emptying abnormalities (e.g., gastric outlet obstruction), severe chronic gastrointestinal diseases (e.g., gastroparesis, inflammatory bowel disease, or intestinal obstruction) within 6 months prior to screening, or who have undergone gastrointestinal surgery that affects gastric emptying;
• Any of the following cardiovascular events within 6 months prior to screening: decompensated cardiac insufficiency (NYHA class III or IV); history of unstable angina pectoris, myocardial infarction, coronary artery bypass grafting, or coronary stent implantation; or long QT syndrome or prolonged QTcF interval (QTcF: male >450 ms, female >470 ms) on 12-lead ECG; severe arrhythmias that are evaluated by the investigator to be inappropriate for participation in this clinical trial;
• Hemorrhagic stroke or acute ischemic stroke disease occurred within 6 months prior to screening;
• History of psychiatric diseases (such as depression, anxiety, etc.) during screening; or symptomatic gallbladder disease; or history of other diseases that may endanger the safety of the subject and that the investigator deems inappropriate for enrollment;
• Any type of malignant tumor treated or untreated within 5 years prior to screening (except for clinically cured basal cell carcinoma or carcinoma in situ);
• Severe infection within 4 weeks prior to screening, or refractory urinary tract or genital infection within 6 months prior to screening;
• Having a significant blood system disease (e.g., aplastic anemia, myelodysplastic syndrome) or any disease causing hemolysis or red blood cell instability (e.g., malaria) at screening;
• Subjects with thyroid dysfunction that cannot be controlled by a stable drug dose at screening, or with clinically significant abnormalities in thyroid function examination results requiring drug treatment at screening;
• Personal or family history of medullary thyroid cancer (MTC) or type 2 multiple endocrine tumor syndrome at screening;

• Any of the indicators meet the following criteria:

  • i. Systolic blood pressure ≥ 160mmHg or diastolic blood pressure ≥ 100mmHg at screening or before randomization;

  • ii. Laboratory tests show any of the following abnormalities:

    1. FPG≥13.9 mmol/L;
    2. ALT or AST≥2.5×ULN;
    3. Total bilirubin (TBiL) ≥2.0×ULN;
    4. Triglyceride >5.7 mmol/L;
    5. eGFR<45 mL/(min*1.73 m^2);
    6. Serum amylase and/or lipase ≥3×ULN;
    7. Hemoglobin <100 g/L;
    8. Calcitonin≥50 ng/L(pg/mL);

  • iii. Serological examination:

    1. Human immunodeficiency virus antibody or treponema pallidum antibody is positive;
    2. Hepatitis C antibody is positive, and HCV RNA was higher than the lower limit of the detection reference range;
    3. Hepatitis B surface antigen is positive, and the quantitative detection result of HBV DNA was higher than the lower limit of the detection reference range;
• Known allergy to the test drug, Dulaglutide, Empagliflozin, or related excipients;
• Subjects who have lost more than 400 mL blood due to blood donation or other reasons within 3 months prior to screening;
• Average alcohol intake more than 21 units of alcohol (male)/14 units of alcohol (female) per week within the 3 months prior to screening (1 unit ≈360 mL beer, or 45 mL spirits with 40% alcohol content, or 150 mL wine);
• Subject participated in any drug or medical device clinical study within 3 months prior to screening (except for screening failure);
• Pregnant or lactating female;
• Not suitable for this study in the investigator's opinion.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: TG103, 7.5 mg; TG103 (7.5 mg) will be administered via subcutaneous injection once a week in subjects with type 2 diabetes.	Drug: TG103; TG103 injection, 7.5mg, 15 mg, SC, once a week
Experimental: TG103, 15 mg; TG103 (15 mg) will be administered via subcutaneous injection once a week in subjects with type 2 diabetes.	Drug: TG103; TG103 injection, 7.5mg, 15 mg, SC, once a week
Experimental: Dulaglutide; Dulaglutide will be administered via subcutaneous injection once a week in subjects with type 2 diabetes.	Drug: Dulaglutide; Dulaglutide, SC, once a week

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Changes in glycosylated hemoglobin (HbA1c) from baseline at 28 weeks of treatment	Baseline through Week28

Secondary Outcome Measures

Outcome Measure	Time Frame
Changes in HbA1c from baseline at 52 weeks of treatment	Baseline through Week52
The percentage of HbA1c≤6.5% and the percentage of HbA1c≤7% at week 28 and 52	Week28 and 52
Change in fasting plasma glucose (FPG) from baseline at week 28 and 52	Baseline through Week28 and 52
Change in weight from baseline at week 28 and 52	Baseline through Week28 and 52
Change in 2h-postprandial plasma glucose (2h-PPG) from baseline at week 28 and 52	Baseline through Week28 and 52
Mean 7 point blood glucose curve from baseline at week 28 and 52. Change in mean postprandial blood glucose increment from baseline at week 28 and 52.	Baseline through Week28 and 52
Change in blood lipids (triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) from baseline at week 28 and 52.	Baseline through Week28 and 52
Proportion of subjects receiving remedial therapy at week 28 and 52	Week28 and 52
Incidence of adverse events	Week-2 through 52
Blood concentrations of TG103	Week 0, 4, 8,16, 28, 36, 44, 52 and 55
The occurrence of TG103 anti-drug antibodies (ADA) and neutralizing antibody (NAb).	Week 0, 4, 8,16, 28, 36, 44, 52 and 55

Collaborators and Investigators

• Sponsor: CSPC Baike (Shandong) Biopharmaceutical Co., Ltd.

Study record dates

Study Major Dates

• Study Start (Actual): April 8, 2024
• Primary Completion (Actual): February 3, 2026
• Study Completion (Actual): February 3, 2026

Study Registration Dates

• First Submitted: January 23, 2024
• First Submitted That Met QC Criteria: January 23, 2024
• First Posted (Actual): January 31, 2024

Study Record Updates

• Last Update Posted (Actual): April 3, 2026
• Last Update Submitted That Met QC Criteria: March 30, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Endocrine System Diseases; Metabolic Diseases; Glucose Metabolism Disorders; Diabetes Mellitus; Nutritional and Metabolic Diseases; Diabetes Mellitus, Type 2; Glucagon-Like Peptide-1 Receptor Agonists; Physiological Effects of Drugs; Hypoglycemic Agents; dulaglutide
• Other Study ID Numbers: SYSA1803-009

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No