Recruiting
Phase 3

Combination Therapies

Sponsor:

The University of Texas Health Science Center at San Antonio

Code:

NCT06246799

Conditions

Type 2 Diabetes (Adult Onset)

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Interventions

Tirzepatide

Pioglitazone

Sitagliptin

Metformin HCI XR

Study Details

Brief summary:

The primary purpose of this study is to evaluate the efficacy, durability, and mechanism of HbA1c reduction produced by the combination of pioglitazone plus tirzepatide compared to metformin plus sitagliptin in patients with recently diagnosed type 2 diabetes mellitus.

Conditions

Type 2 Diabetes (Adult Onset)

Study ID

NCT06246799

Start date

Nov 7, 2024

Status verified date

Mar, 2026

Completion date

Jun 30, 2029

Anticipated

Primary completion date

Apr 30, 2029

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Inclusion Criteria:

1. Ability of subject to understand and the willingness to sign a written informed consent document.
2. Males and females; Age 18-75 years
3. Recently (within 5 years) diagnosed Type 2 Diabetes Mellitus (T2DM) patients
4. Drug naïve or receiving metformin monotherapy
5. HbA1c >6.5% (no limit on upper HbA1c value);
6. Willingness to adhere to the investigational product regimen
7. Good general health
8. Stable body weight over the preceding 3 months
9. Agreement to adhere to Lifestyle Considerations throughout study duration.

Exclusion Criteria:

1. positive anti-GAD (antibodies to glutamic acid decarboxylase)
2. pregnancy or plan of becoming pregnant
3. evidence of proliferative diabetic retinopathy,
4. plasma creatinine >1.4 females or >1.5 males;
5. presence of congestive heart failure (CHF);
6. history of cancer (<5 years);
7. prior history of pancreatitis,
8. bladder cancer or family history of thyroid tumors;
9. presence of hematuria in the urine analysis.

Study Design

Enrollment

256 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Other

Interventions and Outcome Measures

Arms

experimental: Group IC

Tirzepatide starting at 2.5mg weekly titrated to 15mg weekly (2.5 month 1, 5mg month 2, 10mg month 3 and 15mg at month 4) with Pioglitazone beginning at 15mg daily and ending at 45mg daily (15mg month 1, 30mg month 2 and 45mg at month 3 onwards).

active comparator: Group II

Metformin starting at 1000mg XR daily and Sitagliptin 100mg daily at week 4, Metformin will be increased to 200mg.

active comparator: Group IA

Tirzepatide will be started at 2.5mg and increased to 15mg by month 4. At month 6, Pioglitazone will be added to the Tirzepatide, 15 mg daily.

active comparator: Group 1B

Pioglitazone will be started at 15mg and increased to 45 mg by month 3. At month 6, tirzepatide 2.5mg will be started and increased weekly as tolerated.

Interventions

Tirzepatide

Tirzepatide:Participants will be initiated on 2.5mg weekly and increase their dose to 5mg at week 4, 10mg at week 8 and 15mg at week 12 as tolerated.

Pioglitazone

Pioglitazone: Participants will begin therapy at 15mg daily for the first 4 weeks then increase dose to 30mg at week 4 and to 45 mg at week 8, as tolerated.

Sitagliptin

Sitagliptin: will be administered as a 100mg dose once daily.

Metformin HCI XR

Metformin will be administered at a dose of 1000mg for the first 4 weeks and then the dose increased to 2000mg.

Primary outcome measure

  • number of subjects achieving HbA1c <6.5% at 6 months (Efficacy) [ Time Frame: 6 months ]
  • Number of subjects failing to achieving HbA1c <6.5% Long-term [ Time Frame: month 60 ]

Central Contacts and Locations

Central contacts

Locations

University Health System Texas Diabetic Institute

Recruiting

San Antonio, Texas, United States, 78207

Contacts

Muhammad Abdul-Ghani, MD

210-567-2391abdulghani@uthscsa.edu

UT Health Science Center

Recruiting

San Antonio, Texas, United States, 78229

More Information

Sponsor

The University of Texas Health Science Center at San Antonio

Last update posted

Mar 10, 2026

Last verified

Mar, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by The University of Texas Health Science Center at San Antonio on 2026-03-10.