GLP-1 Agonists for Prevention of Recurrent Hypertriglyceridemic Acute Pancreatitis (RECAP-GLP1)

May 28, 2026 updated by: DONG WU, Peking Union Medical College Hospital

Effects of GLP-1 Agonists on Prevention of HTG-Induced Acute Pancreatitis Recurrence: Protocol for a Randomized Clinical Trial

Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is associated with a high risk of recurrence despite standard lipid-lowering therapy and lifestyle modification. The goal of this clinical trial is to evaluate whether GLP-1 receptor agonist therapy can reduce the recurrence of HTG-AP in adults with a history of HTG-AP and hypertriglyceridemia.

The main questions this study aims to answer are:

  • Whether GLP-1 receptor agonist therapy reduces the recurrence rate of HTG-AP.
  • Whether GLP-1 receptor agonist therapy improves triglyceride control, body weight, and metabolic parameters.
  • Whether GLP-1 receptor agonist therapy is safe and well tolerated in this patient population.

Researchers will compare GLP-1 receptor agonist therapy plus standard care with standard care alone to determine whether GLP-1 receptor agonist therapy provides additional benefit in preventing recurrent HTG-AP.

Participants will:

  • Receive either GLP-1 receptor agonist therapy plus standard care or standard care alone.
  • Undergo regular clinical follow-up visits and laboratory assessments.
  • Receive monitoring of triglyceride levels, recurrence events, metabolic outcomes, and adverse events during the study period.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

396

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Beijing Municipality
      • Beijing, Beijing Municipality, China, 100730
        • Peking Union Medical College Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria

  • Age ≥ 18 years old
  • Previous diagnosis of index HTG-AP (defined as AP with serum TG >1000 mg/dL or a serum TG level of 500-1000 mg/dL accompanied by chylous serum)36-38
  • Having HTG as the exclusive cause of AP
  • Time from discharge of index HTG-AP to recruitment between 4 weeks to 3 months, without AP-related symptoms between discharge and recruitment
  • Expression of the willingness to comply with lifestyle modification during the study period.
  • Clinically stable at the time of inclusion
  • The ability to understand the trial and completing it, as evaluated by the investigators.
  • Patients who may get pregnant should ensure using contraceptives for 20 months after inclusion Exclusion Criteria
  • History of malignancy in past 5 years
  • History of hypothyroidism, nephrotic syndrome, Cushing's syndrome or AIDS
  • History of chronic pancreatitis or pancreatic neoplasm
  • History of severe cardiovascular and pulmonary diseases, such as heart failure, coronary heart disease and chronic obstructive pulmonary disease.
  • Severe renal deficiency (glomerular filtration rate < 30 ml/min)
  • Severe hepatic deficiency (Child-Pugh Class B or C)
  • Previous pancreatic surgery
  • Recurrent AP due to pancreatic diverticulum
  • Recurrent AP due to known genetic mutations (eg. CFTR)
  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Current or prior diagnosis or suspected diagnosis of multiple endocrine neoplasia type 2 (MEN2)
  • Serious hypersensitivity reaction to semaglutide or any of the excipients in the investigational drug or placebo
  • Pregnancy
  • Breast-feeding

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Semaglutide
Participants receive once-weekly subcutaneous semaglutide for 18 months. Semaglutide is initiated at 0.25 mg weekly for 4 weeks and escalated to 0.5 mg weekly thereafter. Participants also receive standard-of-care management and lifestyle modification counseling, including low-fat diet, physical activity, weight management, smoking cessation, and alcohol limitation.
Drug: Semaglutide
Semaglutide is administered as a once-weekly subcutaneous injection for 18 months. Treatment is initiated at 0.25 mg once weekly for the first 4 weeks and escalated to 0.5 mg once weekly thereafter to improve tolerability.
Other Names:
  • Ozempic
  • Wegovy
Placebo Comparator: Placebo
Participants receive once-weekly matching placebo (normal saline) subcutaneous injections for 18 months following the same administration schedule as the experimental arm. Participants also receive standard-of-care management and lifestyle modification counseling, including low-fat diet, physical activity, weight management, smoking cessation, and alcohol limitation.
Drug: Placebo (Normal Saline)
Placebo consists of normal saline administered as a once-weekly subcutaneous injection following the same administration schedule as semaglutide for 18 months. Participants receive 0.25 mg-equivalent injection volume once weekly for the first 4 weeks followed by 0.5 mg-equivalent injection volume once weekly thereafter.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of participants with recurrent hypertriglyceridemia-induced acute pancreatitis
Time Frame: Within 18 months after randomization
Recurrent hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is defined as an episode of acute pancreatitis occurring at least 1 month after complete symptom resolution from the index episode, with serum triglycerides >1000 mg/dL or triglycerides 500-1000 mg/dL accompanied by chylous serum and no other identifiable cause of acute pancreatitis.
Within 18 months after randomization

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of recurrent hypertriglyceridemia-induced acute pancreatitis episodes
Time Frame: 18 months after randomization
Total number of recurrent HTG-AP episodes experienced by each participant during follow-up.
18 months after randomization
Change in fasting serum triglyceride level
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in fasting serum triglyceride concentration from baseline.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in PAN-PROMISE score
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in patient-reported outcomes measured using the PAN-PROMISE questionnaire. PAtieNt-rePoRted OutcoMe scale in acute pancreatItis, an international proSpEctive cohort study, (PAN-PROMISE scale) was designed and validated to evaluate the symptoms that cause the greatest discomfort and concern to patients with AP. They include pain, abdominal distension, difficulty eating, difficulty with bowel movements, nausea or vomiting, thirst, and weakness. Each symptom is scored (highest intensity in the last 24 hours) by the patient from 0 (none) to 10 (maximum possible intensity according to the patient's judgment), with a total score ranging from 0 to 70.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in lipid profile parameters
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Changes in total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) from baseline.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in glycemic parameters
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Changes in fasting serum glucose and hemoglobin A1C from baseline.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in anthropometric measures
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Changes in body weight, body mass index (BMI), and waist circumference from baseline.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in smoking
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Changes in self-reported smoking amount
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Change in alcohol consumption
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Changes in self-reported alcohol intake from baseline.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
MRI assessment of hepatic and pancreatic fat infiltration and pancreatic volume
Time Frame: Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Changes in MRI-based measurements of hepatic fat infiltration, pancreatic fat infiltration, and pancreatic volume from baseline.
Baseline, 1 month, 3 months, 6 months, 12 months, and 18 months
Incidence of metabolic and pancreatic complications
Time Frame: Within 18 months after randomization
Incidence of stress hyperglycemia, post-acute pancreatitis diabetes mellitus, abdominal obesity, or pancreatic exocrine insufficiency.
Within 18 months after randomization
Incidence of chronic pancreatitis
Time Frame: 18 months after randomization
Incidence of newly diagnosed chronic pancreatitis during follow-up.
18 months after randomization
Change in health-related quality of life
Time Frame: Baseline and 18 months after randomization
Change in EQ-VAS score from baseline. EQ VAS is a 0-100 scale where respondents are asked to indicate their overall health on the day they complete the questionnaire. It is a visual analog scale. The score ranges from 0 to 100 where 100 means the best health the patient can imagine, and 0 means the worst health the patient can imagine.
Baseline and 18 months after randomization
Pancreatitis-related unplanned readmission rate
Time Frame: 18 months after randomization
Rate of unplanned hospital readmissions related to pancreatitis.
18 months after randomization
All-cause mortality
Time Frame: 18 months after randomization
Death from any cause during study follow-up.
18 months after randomization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Peking Union Medical College Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 1, 2028

Study Completion (Estimated)

December 1, 2028

Study Registration Dates

First Submitted

May 14, 2026

First Submitted That Met QC Criteria

May 28, 2026

First Posted (Actual)

June 1, 2026

Study Record Updates

Last Update Posted (Actual)

June 1, 2026

Last Update Submitted That Met QC Criteria

May 28, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2026-RECAP-GLP1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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