NCT06851962

Brief Summary

The goal of this clinical trial is to assess the efficacy of a pharmacogenetics-guided treatment, compared to standard optimized treatment, in patients with inadequately controlled type 2 diabetes. The main questions it aims to answer are:

  • Is the disease better controlled when the treatment prescribed is based on the participant's pharmacogenetic profile?
  • What medical problems do participants experience while taking the treatment? Participants will:
  • Take the treatment described according to the Summary of Product Characteristics (SmPC).
  • Visit the clinic once every 12 weeks for checkups and tests.
  • Keep a diary of their symptoms to inform the Investigator.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
504

participants targeted

Target at P75+ for phase_4 diabetes-mellitus-type-2

Timeline
1mo left

Started May 2025

Shorter than P25 for phase_4 diabetes-mellitus-type-2

Geographic Reach
1 country

3 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress87%
May 2025Jun 2026

First Submitted

Initial submission to the registry

January 30, 2025

Completed
29 days until next milestone

First Posted

Study publicly available on registry

February 28, 2025

Completed
3 months until next milestone

Study Start

First participant enrolled

May 26, 2025

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2026

Last Updated

February 23, 2026

Status Verified

February 1, 2026

Enrollment Period

1.1 years

First QC Date

January 30, 2025

Last Update Submit

February 20, 2026

Conditions

Keywords

PharmacogeneticsDiabetes type 2uncontrolled diabeteshyperglycemiahypoglycemiadyslipemiapersonalized medicinegenomicsPrecision Medicine

Outcome Measures

Primary Outcomes (1)

  • Comparison of HbA1c ≤7% goal at Week 24 between Pharmacogenetic-Guided and Standard Treatment in Type 2 Diabetes

    The primary objective is to compare the proportion of patients achieving HbA1c ≤7% at Week 24 between pharmacogenetic-guided treatment arm and standard treatment arm in subjects with insufficiently controlled type 2 diabetes. The null hypothesis is that the proportion of patients achieving this goal is equal in both the pharmacogenetic-guided and standard treatment groups.

    From baseline to the end of treatment at 24 weeks

Secondary Outcomes (1)

  • Comparison of Pharmacogenetic Markers and Treatment Response Pre-Randomization

    Before randomization to the end of treatment at 24 weeks

Other Outcomes (13)

  • Exploratory Objective (1): percentage of patients achieving the dyslipidemia goal (LDL colesterol/LDL-C <70 mg/dL or <55 mg/Dl) in patients with or without cardiovascular disease (CVD)

    From baseline to the end of treatment at 24 weeks

  • Exploratory Objective (3): percentage of patients achieving the goal of <140/90 mmHg systolic and diastolic pressure

    From baseline to the end of treatment at 24 weeks

  • Exploratory Objective (4): glucose-lowering drugs' adverse events

    From baseline to the end of treatment at 24 weeks

  • +10 more other outcomes

Study Arms (2)

Pharmacogenetic-guided treatment

EXPERIMENTAL

Patient treatment will be selected according to previously identified genetic variations. Study treatments and posology from enrollment to the end of treatment at Week 24 can be: 1. Metformin (daily dose 2000 mg). 2. GLP1 receptor analogs: dulaglutide and semaglutide. 3. SGLT2 inhibitors: empagliflozin, canagliflozin and dapagliflozin. 4. Pioglitazone. 5. DPP4 inhibitors: sitagliptin, vildagliptin and linagliptin. Or a combination of these drugs. Except of metformin, which 2000 mg is the daily dose stablished in this study, for the rest of treatment options, SmPCs guidelines of each treatment will be followed to stablished the daily dose.

Drug: MetforminDrug: DulaglutideDrug: Semaglutide 1.0 mgDrug: Empagliflozin (BI 10773)Drug: CanagliflozinDrug: DapagliflozinDrug: pioglitazoneDrug: SitagliptinDrug: Vildagliptin (Galvus)Drug: linagliptin

Standard treatment

ACTIVE COMPARATOR

Patient treatment will be selected according to clinical guidelines. Study treatments and posology from enrollment to the end of treatment at Week 24 can be: 1. Metformin (daily dose 2000 mg). 2. GLP1 receptor analogs: dulaglutide and semaglutide. 3. SGLT2 inhibitors: empagliflozin, canagliflozin and dapagliflozin. 4. Pioglitazone. 5. DPP4 inhibitors: sitagliptin, vildagliptin and linagliptin. Or a combination of these drugs. Except of metformin, which 2000 mg is the daily dose stablished in this study, for the rest of treatment options, SmPCs guidelines of each treatment will be followed to stablished the daily dose.

Drug: MetforminDrug: DulaglutideDrug: Semaglutide 1.0 mgDrug: Empagliflozin (BI 10773)Drug: CanagliflozinDrug: DapagliflozinDrug: pioglitazoneDrug: SitagliptinDrug: Vildagliptin (Galvus)Drug: linagliptin

Interventions

Metformin maximum daily dose 2000 mg

Pharmacogenetic-guided treatmentStandard treatment

Semaglutide

Pharmacogenetic-guided treatmentStandard treatment

Empagliflozin

Pharmacogenetic-guided treatmentStandard treatment

Canagliflozin

Pharmacogenetic-guided treatmentStandard treatment

Dapagliflozin

Pharmacogenetic-guided treatmentStandard treatment

Pioglitazone

Pharmacogenetic-guided treatmentStandard treatment

Sitagliptin

Pharmacogenetic-guided treatmentStandard treatment

vildagliptin

Pharmacogenetic-guided treatmentStandard treatment

linagliptin

Pharmacogenetic-guided treatmentStandard treatment

Dulaglutide

Pharmacogenetic-guided treatmentStandard treatment

Eligibility Criteria

Age40 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 40-70 years old, included.
  • Body Mass Index (BMI) between 25-40 kg/m².
  • Diagnosis of Type 2 Diabetes (T2D) according to the American Diabetes Association (ADA) criteria.
  • Patients with T2D insufficiently controlled (Hemoglobin A1c (HbA1c) 7-9.5%) with current (≥6 months) "standard of care" treatment, excluding the use of insulin.
  • The subject has provided written informed consent prior to any study-specific procedure.
  • Able and willing to comply with requested study visits and procedures.
  • Contraceptive measures, only for female participants:
  • A female participant is eligible to participate if she is not pregnant or breastfeeding, and one of the following conditions applies:
  • Is a woman of non-childbearing potential (WONCBP) OR
  • Is a woman of childbearing potential (WOCBP) and agrees to use a contraceptive method that is highly effective, with a failure rate of \<1%, during the study intervention period (to be effective before starting the intervention).
  • A WOCBP must have a negative urine pregnancy test before the first administration of study intervention.

You may not qualify if:

  • Treatment with insulin at the time of screening.
  • HbA1c \>9.5% at screening.
  • Treatment with more than 3 glucose-lowering drugs at the time of screening.
  • Chronic renal disease defined as estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73m² (many glucose-lowering drugs are not approved or require dosage adjustments for use in these patients) at the screening visit.
  • Hepatic insufficiency, which contraindicates the use of glucose-lowering drugs.
  • Currently receiving treatment in another investigational drug study, or less than 30 days since ending treatment in another investigational drug study.
  • Pregnancy or lactation.
  • Women of childbearing potential with no effective contraceptive methods.
  • New York Heart Association (NYHA) Class III or IV congestive heart failure.
  • Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures to the best of the subject and investigator's knowledge.
  • Subject is study staff directly involved with the study or is a family member of the investigational study staff.
  • Life expectancy predicted to be \<2 years.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Hospital Universitario Regional de Málaga

Málaga, 29010, Spain

Location

Hospital Clínico Universitario de Valencia

Valencia, 46010, Spain

Location

Hospital General Universitario de Valencia (HGUV)

Valencia, 46014, Spain

Location

MeSH Terms

Conditions

Diabetes Mellitus, Type 2HyperglycemiaHypoglycemia

Interventions

MetformindulaglutidesemaglutideempagliflozinCanagliflozindapagliflozinPioglitazoneSitagliptin PhosphateVildagliptinLinagliptin

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

BiguanidesGuanidinesAmidinesOrganic ChemicalsThiophenesSulfur CompoundsHeterocyclic Compounds, 1-RingHeterocyclic CompoundsGlucosidesGlycosidesCarbohydratesThiazolidinedionesThiazolesAzolesTriazolesPyrazinesNitrilesPyrrolidinesPurinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingQuinazolines

Study Officials

  • Sergio Martínez Hervás, Doctor

    Hospital Clínico Universitario de Valencia

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 30, 2025

First Posted

February 28, 2025

Study Start

May 26, 2025

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

June 30, 2026

Last Updated

February 23, 2026

Record last verified: 2026-02

Locations