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Randomized Controlled Trial of Tirzepatide for Methamphetamine Use Disorder (T-STEM)

11 september 2026 uppdaterad av: Manish Jha, University of Texas Southwestern Medical Center

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:

  1. completing self-assessments
  2. undergo brief physical and review of medical and psychiatric history
  3. provide urine and blood samples
  4. medical management sessions
  5. weekly subcutaneous study medication injections

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

228

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

  • Förenta staterna
    • California
      • Los Angeles, California, Förenta staterna, 90032
        • University of Southern California (USC)
        • Kontakt:
      • San Francisco, California, Förenta staterna, 94102
    • Oklahoma
      • Tulsa, Oklahoma, Förenta staterna, 74136
        • Oklahoma State University (OSU) Center for Health Services
        • 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:

  • 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.

Studieplan

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

Hur är studien utformad?

Designdetaljer

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

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Tirzepatide
Eligible participants who are enrolled will receive once-weekly subcutaneous injections of tirzepatide for a 26-week period.
Läkemedel: Tirzepatide
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).
Andra namn:
  • Mounjaro
  • Zepbound
Placebo-jämförare: Placebo (Saline)
Eligible participants who are enrolled will receive once-weekly subcutaneous injections of saline for a 26-week period.
Läkemedel: Placebo (saline)
Eligible participants who are randomized to placebo group will receive once-weekly subcutaneous injections of saline for a 26-week period.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Treatment response
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Tolerability - stopping of treatment
Tidsram: 26 weeks
Proportion of participants discontinuing or stopping treatment before Week 26 visit.
26 weeks
Current craving for methamphetamine
Tidsram: 27 weeks
Severity score (range: 0-70) on stimulant craving questionnaire, higher score reflects more severe craving.
27 weeks
Early remission
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 27 weeks
Visual analog scale (VAS) for drug craving for methamphetamine, rated on 0-100, higher score indicates more severe craving
27 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University of Texas Southwestern Medical Center

Samarbetspartners

National Institute on Drug Abuse (NIDA)

Utredare

  • Huvudutredare: Manish Jha, MBBS, University of Texas Southwestern Medical Center

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 oktober 2026

Primärt slutförande (Beräknad)

1 juli 2031

Avslutad studie (Beräknad)

1 augusti 2031

Studieregistreringsdatum

Först inskickad

11 september 2026

Först inskickad som uppfyllde QC-kriterierna

11 september 2026

Första postat (Faktisk)

17 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

17 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

11 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • STU20260467

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

IPD data will be shared based on NIH Policy of Data Management and Sharing.

IPD-delning som stöder informationstyp

  • STUDY_PROTOCOL
  • SAV
  • ICF

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

produkt tillverkad i och exporterad från U.S.A.

Ja

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