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Trial registered on ANZCTR
Registration number
ACTRN12624000111572
Ethics application status
Approved
Date submitted
23/12/2023
Date registered
8/02/2024
Date last updated
22/07/2024
Date data sharing statement initially provided
8/02/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Tirzepatide in Type 1 Diabetes: Cardiometabolic Effects
(TIRTLE)
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Scientific title
Assessing the cardiometabolic effects of tirzepatide in people with type 1 diabetes
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Secondary ID [1]
311091
0
None
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Universal Trial Number (UTN)
U1111-1301-2135
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Trial acronym
TIRTLE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 Diabetes
332244
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Condition category
Condition code
Metabolic and Endocrine
328959
328959
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
subcutaneous tirzepatide injection 2.5mg once weekly for 4 weeks, then 5.0mg once weekly (or maximum tolerated dose) for 12 weeks post initiation of treatment
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Intervention code [1]
327541
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Treatment: Drugs
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Comparator / control treatment
Placebo subcutaneous injection with matching titration schedule. Placebo injections are given as saline.
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Control group
Placebo
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Outcomes
Primary outcome [1]
336753
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Weight (kg)
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Assessment method [1]
336753
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Digital scale
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Timepoint [1]
336753
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [1]
429572
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Arterial stiffness
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Assessment method [1]
429572
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carotid femoral pulse wave velocity (assessed by applanation tonometry)
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Timepoint [1]
429572
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [2]
429573
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Heart rate
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Assessment method [2]
429573
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Digital sphygmomanometer
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Timepoint [2]
429573
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [3]
429574
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Blood pressure
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Assessment method [3]
429574
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Digital sphygmomanometer
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Timepoint [3]
429574
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [4]
429575
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waist:hip ratio
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Assessment method [4]
429575
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waist and hip measurement by tape measure
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Timepoint [4]
429575
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [5]
429576
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Fasting free fatty acids
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Assessment method [5]
429576
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Serum assay
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Timepoint [5]
429576
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [6]
429577
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Fasting lipid profile
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Assessment method [6]
429577
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Serum assay
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Timepoint [6]
429577
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [7]
429578
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Vascular inflammation
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Assessment method [7]
429578
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serum assay
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Timepoint [7]
429578
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [8]
429579
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high-sensitivity c-reactive protein
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Assessment method [8]
429579
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serum assay
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Timepoint [8]
429579
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [9]
429580
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liver function tests
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Assessment method [9]
429580
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serum assay
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Timepoint [9]
429580
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [10]
429581
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energy expenditure (fasting)
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Assessment method [10]
429581
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Indirect calorimetry
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Timepoint [10]
429581
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [11]
429584
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total fat mass
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Assessment method [11]
429584
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air-displacement plethysmography
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Timepoint [11]
429584
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment t
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Secondary outcome [12]
429585
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fat free mass
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Assessment method [12]
429585
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air-displacement plethysmography
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Timepoint [12]
429585
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [13]
429586
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time in range (3.9-10mmol/L)
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Assessment method [13]
429586
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continuous glucose monitoring
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Timepoint [13]
429586
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [14]
429587
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glycaemic variability (coefficient of variation)
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Assessment method [14]
429587
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continuous glucose monitoring
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Timepoint [14]
429587
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [15]
429588
0
time below range (<3.9mmol/L, <3.0mmol/L)
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Assessment method [15]
429588
0
continuous glucose monitoring
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Timepoint [15]
429588
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [16]
429589
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time above range (>10mmol/L, 13.9mmol/L)
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Assessment method [16]
429589
0
continuous glucose monitoring
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Timepoint [16]
429589
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [17]
429590
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mean glucose over 24 hours (mmol/L)
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Assessment method [17]
429590
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continuous glucose monitoring
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Timepoint [17]
429590
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [18]
429591
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mean overnight glucose (mmol/L between midnight to 0600AM)
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Assessment method [18]
429591
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continuous glucose monitoring
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Timepoint [18]
429591
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [19]
429592
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mean daytime glucose (0600AM to midnight)
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Assessment method [19]
429592
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continuous glucose monitoring
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Timepoint [19]
429592
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [20]
429593
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HbA1c
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Assessment method [20]
429593
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serum assay
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Timepoint [20]
429593
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [21]
429594
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total daily insulin dose (units)
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Assessment method [21]
429594
0
insulin dose diary or insulin pump report
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Timepoint [21]
429594
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [22]
429595
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basal insulin dose (units)
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Assessment method [22]
429595
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insulin dose diary or insulin pump report
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Timepoint [22]
429595
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [23]
429596
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bolus insulin dose
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Assessment method [23]
429596
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insulin dose diary or insulin pump report
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Timepoint [23]
429596
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [24]
429597
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fasting c-peptide
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Assessment method [24]
429597
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serum assay
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Timepoint [24]
429597
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [25]
429598
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fasting glucagon
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Assessment method [25]
429598
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serum assay
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Timepoint [25]
429598
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [26]
430824
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Arterial stiffness
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Assessment method [26]
430824
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Augmentation index (AIx) assessed by radial artery applanation tonometry,
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Timepoint [26]
430824
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [27]
437741
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Total body water
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Assessment method [27]
437741
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Bioelectrical impedance analysis
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Timepoint [27]
437741
0
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Secondary outcome [28]
437742
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Total body water
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Assessment method [28]
437742
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Bioelectrical impedance analysis
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Timepoint [28]
437742
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [29]
437743
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Diet patterns
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Assessment method [29]
437743
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Diet diary
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Timepoint [29]
437743
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [30]
437744
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Diet patterns
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Assessment method [30]
437744
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Diet diary
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Timepoint [30]
437744
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [31]
437745
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Eating behaviour
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Assessment method [31]
437745
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Validated questionnaire (TFEQ-r18)
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Timepoint [31]
437745
0
change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [32]
437746
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Eating behaviour
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Assessment method [32]
437746
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Validated questionnaire (TFEQ-r18)
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Timepoint [32]
437746
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Change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [33]
437747
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Gastrointestinal symptoms
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Assessment method [33]
437747
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Validated questionnaire (PAGISYM)
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Timepoint [33]
437747
0
Change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [34]
437748
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Gastrointestinal symptoms
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Assessment method [34]
437748
0
Validated questionnaire (PAGISYM)
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Timepoint [34]
437748
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [35]
437749
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Fasting GLP1 (glucagon-like peptide 1)
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Assessment method [35]
437749
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serum assay
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Timepoint [35]
437749
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change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Secondary outcome [36]
437750
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Fasting GLP1 (glucagon-like peptide 1)
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Assessment method [36]
437750
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serum assay
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Timepoint [36]
437750
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Change from baseline (taken prior to commencement of treatment) and after 12 weeks post commencement of treatment
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Eligibility
Key inclusion criteria
• age 18-60 years
• 2 years since diagnosis of type 1 diabetes
• BMI greater than or equal to 30 kg/m2
• Willingness to give written informed consent, participate and comply with the study.
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Minimum age
18
Years
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• treatment with a glucagon-like peptide-1 (GLP1) receptor agonist, or a sodium-glucose cotransporter 2 (SGLT2) inhibitor in the last 6 weeks
• treatment with glucocorticoids in the last 6 weeks
• previous bariatric surgery or planned during the trial period
• diabetic ketoacidosis or severe hypoglycaemia in the last 3 months
• eGFR <45 ml/min/1.73m2
• evidence of significant liver disease (known cirrhosis, LFTs > 3x upper limit of normal)
• known gastroparesis
• history of pancreatitis or cholecystitis
• pregnant, breastfeeding or female of childbearing potential not using adequate contraception
• coronary event or stroke in the last 3 months
• history of active proliferative diabetic retinopathy or macular oedema
• cognitive impairment or significant psychiatric illness which impairs ability to understand study requirements
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/05/2024
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Actual
14/05/2024
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Date of last participant enrolment
Anticipated
1/08/2024
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Actual
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Date of last data collection
Anticipated
31/12/2024
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Actual
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Sample size
Target
24
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Accrual to date
10
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
315350
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Charities/Societies/Foundations
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Name [1]
315350
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Philanothropic donations to Garvan Institute of Medical Research
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Address [1]
315350
0
384 Victoria St Darlinghurst
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Country [1]
315350
0
Australia
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Primary sponsor type
Other
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Name
Garvan Institute of Medical Research
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Address
384 Victoria St Darlinghurst
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Country
Australia
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Secondary sponsor category [1]
317411
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None
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Name [1]
317411
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Address [1]
317411
0
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Country [1]
317411
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314269
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St Vincent's Hospital Human Research Ethics Committee (HREC)
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Ethics committee address [1]
314269
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97-105 Boundary Street Darlinghurst NSW 2010
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Ethics committee country [1]
314269
0
Australia
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Date submitted for ethics approval [1]
314269
0
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Approval date [1]
314269
0
01/12/2023
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Ethics approval number [1]
314269
0
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Summary
Brief summary
Cardiovascular disease and its risk factors are prominent issues in T1D. There is a need to identify therapies that can address weight, glycaemia and other cardiometabolic indices in T1D. In T1D, whether tirzepatide, a dual gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist improves weight, glycaemia and cardiometabolic health has not been previously studied. The TIRTLE study is a randomised controlled clinical trial in adults with type 1 diabetes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
130998
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Dr Jennifer Snaith
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Address
130998
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Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
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Country
130998
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Australia
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Phone
130998
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+61491731769
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Fax
130998
0
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Email
130998
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[email protected]
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Contact person for public queries
Name
130999
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Ruth Frampton
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Address
130999
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Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
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Country
130999
0
Australia
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Phone
130999
0
+61491731769
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Fax
130999
0
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Email
130999
0
[email protected]
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Contact person for scientific queries
Name
131000
0
Jerry Greenfield
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Address
131000
0
Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
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Country
131000
0
Australia
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Phone
131000
0
+61 02 9295 8100
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Fax
131000
0
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Email
131000
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF