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- Klinische proef NCT07825857
Randomized Controlled Trial of Tirzepatide for Methamphetamine Use Disorder (T-STEM)
This is a phase 2, randomized, double-blind, placebo-controlled, parallel-group trial evaluating the tolerability, safety, and preliminary efficacy of tirzepatide for the treatment of individuals with moderate or severe MtUD. The central hypothesis of the proposed research is that tirzepatide is a safe and potentially efficacious treatment of MtUD.
Participants will undergo study procedures over 32 weeks, including:
- completing self-assessments
- undergo brief physical and review of medical and psychiatric history
- provide urine and blood samples
- medical management sessions
- weekly subcutaneous study medication injections
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Methamphetamine use disorder (MtUD) affects over 1.5 million U.S. adults annually and has no FDA-approved treatments. Preclinical studies and observational data suggest that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may reduce stimulant use. Tirzepatide, a dual GLP-1/glucose-dependent insulinotropic peptide (GIP) receptor agonist approved for type 2 diabetes and weight management, has not been evaluated for MtUD in an adequately-powered randomized controlled trial. This Phase 2 double-blind, randomized controlled trial will enroll 228 adults with moderate or severe MtUD to receive weekly subcutaneous tirzepatide (2.5 mg/week titrated to 15 mg/week or maximally tolerated dose) or placebo for 26 weeks, followed by 6 weeks of follow-up. Safety will be monitored throughout.
The study aims are to: (1) assess tolerability (treatment discontinuation) and safety (serious adverse events) of tirzepatide; and (2) evaluate preliminary efficacy, including reduction in methamphetamine use (Timeline Follow-back), treatment response (≥6 of 8 UDS negative in weeks 23-26), and early remission (no longer meeting DSM-5 criteria at week 26). Secondary/exploratory aims include assessing reductions in methamphetamine craving and cravings for other substances.
Studietype
Inschrijving (Geschat)
Fase
- Fase 2
Contacten en locaties
Studiecontact
- Naam: Elizabeth Dedrick, BS
- Telefoonnummer: 469-602-2356
- E-mail: elizabeth.dedrick@utsouthwestern.edu
Studie Contact Back-up
- Naam: Shavonna Williams
- Telefoonnummer: 469-602-1926
- E-mail: shavonna.williams@utsouthwestern.edu
Studie Locaties
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California
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Los Angeles, California, Verenigde Staten, 90032
- University of Southern California (USC)
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Contact:
- Jimena Estrada
- Telefoonnummer: 386-846-6139
- E-mail: jimenaes@usc.edu
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San Francisco, California, Verenigde Staten, 94102
- Center of Substance Use and Health
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Contact:
- Xochitl Luna Marti
- Telefoonnummer: 628-217-6235
- E-mail: xochitl.lunamarti@sfdph.org
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Contact:
- Samantha Serrano
- E-mail: samantha.serrano@sfdph.org
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Oklahoma
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Tulsa, Oklahoma, Verenigde Staten, 74136
- Oklahoma State University (OSU) Center for Health Services
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Contact:
- Katie Thompson, BS
- Telefoonnummer: 603-978-2208
- E-mail: kthompson@okstate.edu
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- be aged 18 to 65 years;
- have moderate or severe methamphetamine use disorder;
- have active pattern of methamphetamine use;
- be interested in reducing or stopping methamphetamine use;
- be able and willing to provide informed consent, comply with all study procedures, and adhere to weekly study medication injections;
- be overweight or obese (body mass index ≥25 kg/m²); and
- (only for biological females) agree to use acceptable contraception and undergo urine pregnancy testing unless unable to become pregnant
Exclusion Criteria:
- report using any glucagon like peptide 1 receptor agonists (GLP-1RA, including tirzepatide), sulfonylureas, or insulin in the past 90 days;
- have a current eating disorder or severe alcohol or substance use disorder;
- have personal or family history of medullary thyroid carcinoma, history of multiple endocrine neoplasia type 2, or hypersensitivity, angioedema, or anaphylaxis to GLP-1RAs or tirzepatide;
- have Stage 3 or higher chronic kidney disease, inadequately controlled diabetes, history of diabetic retinopathy, any unstable or serious medical or psychiatric condition, or any other reason or clinical condition that may either interfere with study participation or make the study participation unsafe (per investigator judgement);
- are currently pregnant, breastfeeding, or planning pregnancy;
- have received an investigational drug within 30 days of informed consent;
- require psychiatric hospitalization;
- have recent suicidal or current homicidal ideation;
- are incarcerated or in court-mandated residential placement;
- have unsafe use of alcohol, benzodiazepines, sedative/hypnotics, or other substances; or
- have use of concurrent medications that may pose safety risks or interfere with study procedures.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Tirzepatide
Eligible participants who are enrolled will receive once-weekly subcutaneous injections of tirzepatide for a 26-week period.
|
Eligible participants who are randomized to treatment group will receive once-weekly subcutaneous injections of tirzepatide for a 26-week period.
Tirzepatide will start at 2.5 mg/week with planned dose increases every four weeks in 2.5 mg/week increments up to a maximum of 15 mg/week (or the maximally tolerated dose).
Andere namen:
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Placebo-vergelijker: Placebo (Saline)
Eligible participants who are enrolled will receive once-weekly subcutaneous injections of saline for a 26-week period.
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Eligible participants who are randomized to placebo group will receive once-weekly subcutaneous injections of saline for a 26-week period.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Treatment response
Tijdsspanne: 26 weeks
|
Proportion of participants who attain treatment response (≥6 of 8 urine drug screens (UDS) negative for methamphetamine in Weeks 23 to 26).
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26 weeks
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Tolerability - stopping of treatment
Tijdsspanne: 26 weeks
|
Proportion of participants discontinuing or stopping treatment before Week 26 visit.
|
26 weeks
|
|
Current craving for methamphetamine
Tijdsspanne: 27 weeks
|
Severity score (range: 0-70) on stimulant craving questionnaire, higher score reflects more severe craving.
|
27 weeks
|
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Early remission
Tijdsspanne: 27 weeks
|
Proportion of participants no longer meeting DSM-5 criteria for at least 3 months (criterion for craving permitted) at the Week 27 visit.
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27 weeks
|
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Safety - occurrence of serious adverse event
Tijdsspanne: 26 weeks
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Proportion of participants with the occurrence of serious adverse event any time on or after Week 1 visit that is deemed to be related to study drug.
|
26 weeks
|
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Reduction in self-reported use of methamphetamine
Tijdsspanne: 26 weeks
|
From first day of Week 1 to last day of Week 26, participant's use of methamphetamine will be recorded as a binary variable (yes/no), and compared across the two treatment arms.
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26 weeks
|
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Worst past-week craving for methamphetamine
Tijdsspanne: 27 weeks
|
Visual analog scale (VAS) for drug craving for methamphetamine, rated on 0-100, higher score indicates more severe craving
|
27 weeks
|
Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Manish Jha, MBBS, University of Texas Southwestern Medical Center
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Psychische aandoening
- Chemisch veroorzaakte aandoeningen
- Middelgerelateerde aandoeningen
- Aminozuren, peptiden en eiwitten
- Eiwitten
- Anorganische chemicaliën
- Chloorverbindingen
- Glucagon-achtige peptide-1-receptor
- Glucagon-achtige peptideceptoren
- Receptoren, G-eiwit gekoppeld
- Receptoren, celoppervlak
- Membraaneiwitten
- Receptoren, gastro -intestinaal hormoon
- Receptoren, peptide
- Natriumverbindingen
- Chloriden
- Zoutzuur
- Tirzepatide
- Natriumchloride
Andere studie-ID-nummers
- STU20260467
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
- ICF
Informatie over medicijnen en apparaten, studiedocumenten
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