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- Ensaio Clínico 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
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Fase 2
Contactos e Locais
Contato de estudo
- Nome: Elizabeth Dedrick, BS
- Número de telefone: 469-602-2356
- E-mail: elizabeth.dedrick@utsouthwestern.edu
Estude backup de contato
- Nome: Shavonna Williams
- Número de telefone: 469-602-1926
- E-mail: shavonna.williams@utsouthwestern.edu
Locais de estudo
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California
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Los Angeles, California, Estados Unidos, 90032
- University of Southern California (USC)
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Contato:
- Jimena Estrada
- Número de telefone: 386-846-6139
- E-mail: jimenaes@usc.edu
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San Francisco, California, Estados Unidos, 94102
- Center of Substance Use and Health
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Contato:
- Xochitl Luna Marti
- Número de telefone: 628-217-6235
- E-mail: xochitl.lunamarti@sfdph.org
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Contato:
- Samantha Serrano
- E-mail: samantha.serrano@sfdph.org
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Oklahoma
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Tulsa, Oklahoma, Estados Unidos, 74136
- Oklahoma State University (OSU) Center for Health Services
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Contato:
- Katie Thompson, BS
- Número de telefone: 603-978-2208
- E-mail: kthompson@okstate.edu
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-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Quadruplicar
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: 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).
Outros nomes:
|
|
Comparador de Placebo: Placebo (Saline)
Eligible participants who are enrolled will receive once-weekly subcutaneous injections of saline for a 26-week period.
|
Eligible participants who are randomized to placebo group will receive once-weekly subcutaneous injections of saline for a 26-week period.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Treatment response
Prazo: 26 weeks
|
Proportion of participants who attain treatment response (≥6 of 8 urine drug screens (UDS) negative for methamphetamine in Weeks 23 to 26).
|
26 weeks
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Tolerability - stopping of treatment
Prazo: 26 weeks
|
Proportion of participants discontinuing or stopping treatment before Week 26 visit.
|
26 weeks
|
|
Current craving for methamphetamine
Prazo: 27 weeks
|
Severity score (range: 0-70) on stimulant craving questionnaire, higher score reflects more severe craving.
|
27 weeks
|
|
Early remission
Prazo: 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.
|
27 weeks
|
|
Safety - occurrence of serious adverse event
Prazo: 26 weeks
|
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
|
|
Reduction in self-reported use of methamphetamine
Prazo: 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.
|
26 weeks
|
|
Worst past-week craving for methamphetamine
Prazo: 27 weeks
|
Visual analog scale (VAS) for drug craving for methamphetamine, rated on 0-100, higher score indicates more severe craving
|
27 weeks
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Manish Jha, MBBS, University of Texas Southwestern Medical Center
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Transtornos Mentais, Desordem Mental
- Distúrbios induzidos quimicamente
- Transtornos Relacionados a Substâncias
- Aminoácidos, peptídeos e proteínas
- Proteínas
- Produtos químicos inorgânicos
- Compostos de cloro
- Receptor peptídeo 1 do tipo glucagon
- Receptores peptídicos semelhantes a glucagon
- Receptores, acoplado à proteína G.
- Receptores, superfície celular
- Proteínas da membrana
- Receptores, hormônio gastrointestinal
- Receptores, peptídeo
- Compostos de sódio
- Cloretos
- Ácido clorídrico
- Tirzepatide
- Cloreto de sódio
Outros números de identificação do estudo
- STU20260467
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Tipo de informação de suporte de compartilhamento de IPD
- PROTOCOLO DE ESTUDO
- SEIVA
- CIF
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