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METabolic MODulation to Enhance Insulin Sensitivity and Mitochondrial Function in Type 1 Diabetes (MetMod-T1D) (MetMod-T1D)

10. september 2026 opdateret af: Petter Bjornstad, University of Washington
The study is a randomized, double-blind, parallel-group clinical trial to examine the effects of 24 weeks of oral AMX0035 (sodium phenylbutyrate + taurursodiol) versus placebo in 60 adults with Type 1 Diabetes (T1D) (n=30 per arm). Enrollment will be distributed equally between the University of Washington and Amsterdam University Medical Center/Diabetes Center Amsterdam. Participants will be recruited through diabetes research registries, local T1D clinics, and community outreach.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a randomized, double-blind, parallel-group clinical trial to evaluate the effects of 24 weeks of oral AMX0035 (sodium phenylbutyrate + taurursodiol) versus placebo in 60 adults with type 1 diabetes (T1D) (n=30 per arm). Following screening and baseline assessments, eligible participants will be randomized 1:1 to receive either AMX0035 or placebo, with stratification by sex and body mass index (≥30 vs. <30 kg/m2). Participants will undergo comprehensive metabolic phenotyping at baseline and 24 weeks, including hyperinsulinemic-euglycemic clamp studies, body composition imaging, continuous glucose monitoring, and tissue biopsies (skeletal muscle and adipose) for assessment of mitochondrial function and biological markers. Participants, clinicians administering the intervention, and laboratory personnel analyzing the samples will remain blinded to treatment assignments throughout the study.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

60

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Amanda Bard, MMS, MS, CCRC
  • Telefonnummer: 206-685-2069
  • E-mail: abard@uw.edu

Studiesteder

  • Forenede Stater
    • Washington
      • Seattle, Washington, Forenede Stater, 98109
        • Rekruttering
        • University of Washington Medicine Diabetes Institute (UWMDI)
        • Ledende efterforsker:
          • Petter Bjornstad, MD
        • Kontakt:
          • Amanda Bard, MMS, MS, CCRC
          • Telefonnummer: 206-685-2069
          • E-mail: abard@uw.edu
  • Holland
      • Amsterdam, Holland
        • Ikke rekrutterer endnu
        • Amsterdam UMC
        • Kontakt:
        • Ledende efterforsker:
          • Daniël van Raalte, MD, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Adults ≥18 years to <70 years of age with established T1D (duration ≥1 year)
  2. Currently on insulin therapy (multiple daily injections or insulin pump)
  3. HbA1c <9.5%
  4. BMI 18.5-40 kg/m2
  5. On stable dose of RASB or statin, if indicated
  6. Willing and able to comply with all study procedures

Exclusion Criteria:

  1. History of pancreatic disease (including pancreatitis) or pancreatic surgery
  2. History of cardiovascular disease or stroke within the past 6 months
  3. History of heart failure per New York Heart Association criteria
  4. History of severe edema or salt restriction requirement
  5. Biliary disease or pathologies that may alter enterohepatic circulation of bile acids
  6. Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m²
  7. Liver disease (ALT/AST >3x upper limit of normal [ULN]) or severe hepatic impairment (defined as Child-Pugh Class C)
  8. Pregnancy, breastfeeding, or planning pregnancy during the study period
  9. Known hypersensitivity to study drug components
  10. Abnormal baseline ECG
  11. Use of off label medications that affect insulin sensitivity within the past 1 month (e.g., metformin, GLP-1RA, SGLT2i, pioglitazone)
  12. Chronic use of anticoagulants
  13. Use of bile acid sequestering agents, inhibitors of bile acid transporters, bile acid derivatives, aluminum-based antacids, probenecid, pan-HDAC inhibitors, phase 2 metabolizing enzymes (e.g., uridine diphosphate glucuronosyl transferases), phase 1 metabolizing enzymes other than cytochrome P450 enzymes (CYPs), and OATP1B3
  14. Use of substrates of CYP2C9, Organic Anion transporter 1, P-glycoprotein, and Breast Cancer Resistance Protein
  15. History of severe hypoglycemia requiring assistance within the past 3 months
  16. History of diabetic ketoacidosis (DKA) within the past 3 months
  17. Personal or family history of breast cancer or ovarian cancer
  18. Current participation in another clinical trial
  19. Any condition(s) found by the study team and confirmed with the Investigator that make it unsafe to participate

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: AMX0035
Participants will be instructed to take one packet of AMX0035 daily for the first 2 weeks, followed by 1 packet twice a day (morning and evening) thereafter for ~6 months.
Medicin: AMX0035
AMX0035 sachets
Placebo komparator: Placebo
Participants will be instructed to take one packet of placebo daily for the first 2 weeks, followed by 1 packet twice a day (morning and evening) thereafter for ~6 months.
Medicin: Placebo
Placebo sachets

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in whole-body insulin sensitivity (M-value) measured by hyperinsulinemic-euglycemic clamp
Tidsramme: Baseline, 24 weeks

Evaluate the effect of 24 weeks of AMX0035 versus placebo on whole-body insulin sensitivity in T1D as assessed by gold-standard two-stage hyperinsulinemic-euglycemic clamp.

  • Two-stage hyperinsulinemic-euglycemic clamp studies will occur at baseline and 24 weeks.
  • Insulin sensitivity will be quantified using the M-value (glucose infusion rate), normalized to lean body mass measured by dual-energy X-ray absorptiometry (DXA) and insulin concentration.
Baseline, 24 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Changes in glycemic control
Tidsramme: Baseline, 24 weeks
Glycemic control will be evaluated via continuous glucose monitoring (CGM) and HbA1c.
Baseline, 24 weeks
Changes in body composition
Tidsramme: Baseline, 24 weeks
Body composition, including total, regional, visceral, and hepatic fat, will be quantified using DXA and multiparametric MRI.
Baseline, 24 weeks
Changes in immune and metabolic biomarkers
Tidsramme: Baseline, 24 weeks
  • Circulating and peripheral blood mononuclear cell (PBMC)-based biomarkers of inflammation and oxidative stress will be measured.
  • Associations between these biological markers and insulin sensitivity or glycemic metrics will be examined using multivariable models.
Baseline, 24 weeks
Changes in mitochondrial function
Tidsramme: Baseline, 24 weeks
Skeletal muscle and adipose tissue biopsies will be analyzed for ER stress, inflammation, and insulin signaling. Skeletal muscle tissue will also undergo assessment of mitochondrial function by ex vivo respiration.
Baseline, 24 weeks
Establish the safety and tolerability of AMX0035 in adults with T1D
Tidsramme: Duration of study
  • Adverse events including hypoglycemia, DKA, and changes in hepatic and renal function will be closely monitored throughout the study.
  • Tolerability will be assessed through participant-reported symptoms, including gastrointestinal side effects and study discontinuations.
  • An independent Data Safety Monitoring Board (DSMB) will periodically review unblinded safety data and provide guidance.
Duration of study

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Washington

Samarbejdspartnere

Breakthrough T1D

Efterforskere

  • Ledende efterforsker: Petter M Bjornstad, MD, University of Washington

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. december 2029

Studieafslutning (Anslået)

1. december 2029

Datoer for studieregistrering

Først indsendt

23. juni 2026

Først indsendt, der opfyldte QC-kriterier

9. juli 2026

Først opslået (Faktiske)

13. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • MetMod-T1D-AMX0035

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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