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

28 maj 2026 uppdaterad av: 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.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Beräknad)

396

Fas

  • Fas 4

Kontakter och platser

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Studiekontakt

Studieorter

    • Beijing Municipality
      • Beijing, Beijing Municipality, Kina, 100730
        • Peking Union Medical College Hospital
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
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.
Andra namn:
  • Ozempisk
  • Wegovy
Placebo-jämförare: 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.
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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Proportion of participants with recurrent hypertriglyceridemia-induced acute pancreatitis
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of recurrent hypertriglyceridemia-induced acute pancreatitis episodes
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 18 months after randomization
Incidence of newly diagnosed chronic pancreatitis during follow-up.
18 months after randomization
Change in health-related quality of life
Tidsram: 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
Tidsram: 18 months after randomization
Rate of unplanned hospital readmissions related to pancreatitis.
18 months after randomization
All-cause mortality
Tidsram: 18 months after randomization
Death from any cause during study follow-up.
18 months after randomization

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Studieavstämningsdatum

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Studera stora datum

Studiestart (Beräknad)

1 september 2026

Primärt slutförande (Beräknad)

1 september 2028

Avslutad studie (Beräknad)

1 december 2028

Studieregistreringsdatum

Först inskickad

14 maj 2026

Först inskickad som uppfyllde QC-kriterierna

28 maj 2026

Första postat (Faktisk)

1 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

1 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

28 maj 2026

Senast verifierad

1 maj 2026

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