Effect of Add-on SGLT2i, TZD, or Combination Therapy in Type 2 Diabetes Patients on DPP4 Inhibitors

NCT07108985 | Not Yet Recruiting Phase 4

• 1 other identifier: 4-2025-0720
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

This clinical trial investigates the effects of adding different diabetes medications to patients with type 2 diabetes who are currently being treated with DPP4 inhibitors. The study evaluates three treatment strategies: SGLT2 inhibitor monotherapy, TZD monotherapy, and a combination of both SGLT2 inhibitor and TZD. Participants will be randomly assigned to one of four groups, including a control group continuing DPP4 inhibitor alone. The primary objective is to assess changes in blood sugar control, specifically HbA1c levels, after 12 and 24 weeks of treatment. Secondary outcomes include changes in fasting and postprandial glucose, insulin, C-peptide, lipid profiles (total cholesterol, triglycerides, HDL-C, LDL-C), body composition (muscle mass, visceral fat, subcutaneous fat), and insulin resistance indicators such as HOMA-IR, HOMA-beta, and Insulinogenic Index. Eligible participants are adults aged 19 to 75 years with type 2 diabetes who have been on stable doses of DPP4 inhibitors, with or without metformin or sulfonylurea, for at least 8 weeks. Individuals with recent use of SGLT2 inhibitors or TZDs, significant organ dysfunction, or other exclusion criteria will not be enrolled. The study is open-label and multicenter, conducted at four hospitals in Korea. All medications used in the trial are provided by the sponsor. Participants will receive lifestyle counseling throughout the study period, including guidance on diet and exercise. Safety monitoring will be conducted regularly, and adverse events will be documented and managed according to protocol.

Conditions

Diabetes Mellitus, Type 2; Hyperglycemia; Insulin Resistance

Outcome Measures

Primary Outcomes (1)

• change in HbA1c levels

  To assess the change in HbA1c levels at 12 and 24 weeks after administration of the investigational drugs, by comparing pre- and post-treatment values within each group and between groups.

  At 12 and 24 weeks after initiation of the investigational drug

Study Arms (4)

A

EXPERIMENTAL

Sitagliptin 100 mg

Drug: Sitagliptin 100 mg

B

EXPERIMENTAL

Sitagliptin 100 mg + Dapagliflozin 10 mg

Drug: Sitagliptin 100 mg + Dapagliflozin 10 mg

C

EXPERIMENTAL

Sitagliptin 100 mg + Lobeglitazone 0.5 mg

Drug: Sitagliptin 100 mg + Dapagliflozin 10 mg

D

EXPERIMENTAL

Sitagliptin 100 mg + Dapagliflozin 10 mg + Lobeglitazone 0.5 mg

Drug: Sitagliptin 100 mg + Dapagliflozin 10 mg + Lobeglitazone 0.5 mg

Interventions

Sitagliptin 100 mg DRUG

Sitagliptin 100 mg, taken once daily for 24 weeks.

A

Sitagliptin 100 mg + Dapagliflozin 10 mg DRUG

Sitagliptin 100 mg + Dapagliflozin 10 mg, taken once daily for 24 weeks.

B

Sitagliptin 100 mg + Dapagliflozin 10 mg + Lobeglitazone 0.5 mg DRUG

Sitagliptin 100 mg + Dapagliflozin 10 mg + Lobeglitazone 0.5 mg, taken once daily for 24 weeks.

D

Eligibility Criteria

• Age: 19 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged between 19 and 75 years at the time of providing written informed consent.
• Diagnosed with type 2 diabetes mellitus and having an HbA1c level between 7.5% and 11.0%.
• Receiving DPP4 inhibitor monotherapy or combination therapy with metformin and/or sulfonylurea for at least 8 weeks without dose adjustment.
• Provided written informed consent voluntarily after receiving a full explanation of the study.
• Considered capable of understanding the study procedures and cooperating throughout the study period until completion.

You may not qualify if:

• Patients with diabetes other than type 2 diabetes, including type 1 diabetes or gestational diabetes.
• Use of TZD or SGLT2 inhibitors within the past 8 weeks, or history of discontinuation due to serious adverse reactions.
• Currently receiving four or more antidiabetic medications.
• History of diabetic ketoacidosis (with or without coma) or acute/chronic metabolic acidosis within the past 24 weeks.
• Known allergy or hypersensitivity to the investigational drugs or their components.
• Chronic use (more than 14 consecutive days) of oral or parenteral corticosteroids within 8 weeks prior to screening, with ongoing need for dose adjustment.
• Genetic disorders such as galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption.
• Active or progressive malignant tumors requiring treatment.
• History of drug abuse or alcohol dependence within the past 12 weeks.
• HIV infection.
• Severe infections, perioperative status, or major trauma.
• History of heart failure classified as NYHA class III or IV within the past 24 weeks.
• History of acute cardiovascular events within the past 12 weeks (e.g., unstable angina, myocardial infarction, transient ischemic attack, stroke, coronary artery bypass grafting, or coronary intervention).
• Renal failure or chronic kidney disease with eGFR \< 25 mL/min/1.73m² or undergoing dialysis.
• Active bladder cancer or history of bladder cancer.

Sponsors & Collaborators

• Yonsei University: lead

Study Sites (1)

Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea

Seoul, 03722, South Korea

Location

MeSH Terms

Conditions

Diabetes Mellitus, Type 2; Hyperglycemia; Insulin Resistance

Interventions

Sitagliptin Phosphate; dapagliflozin; lobeglitazone

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Hyperinsulinism

Intervention Hierarchy (Ancestors)

Triazoles; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Pyrazines

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 31, 2025
• First Posted: August 7, 2025
• Study Start: September 1, 2025
• Primary Completion (Estimated): September 1, 2029
• Study Completion (Estimated): August 31, 2030
• Last Updated: August 7, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

KR (1)