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This is a study to evaluate the efficacy and safety of Supaglutide injection in the treatment of type 2 diabetes patients with poor glycemic control after metformin treatment.
This trial includes dosage determination (Phase IIb) and efficacy confirmation stage(Phase III ). The primary outcome of the phase IIb period is to preliminarily evaluate the efficacy and safety of Supaglutide combined with metformin and to provide the recommended dosage for the Phase 3 period after 12-week treatment.
The primary outcome of the Phase III period is to evaluate the efficacy and safety of Supaglutide combined with metformin treatment after 24-week, double-blind treatment. The secondary outcome is to evaluate the efficacy and safety of Supaglutide combined with metformin during the 24-week, double-blinded plus 28-week, open-label treatment period.
This trial includes a 2-week screening period, a 4-week metformin titration and dose-stabilization period, a 4-week induction period, a 24-week double-blind treatment period and a 28-week open-label treatment period, followed by a 4-week follow-up period and a follow-up visit. We calculated that the sample size would need to be 632, including 120 subjects in the period of Phase IIb and 512 subjects in the period of Phase III. During the phase IIb period, subjects were randomly assigned to once-weekly subcutaneously injected Supaglutide 1mg plus metformin, 3mg plus metformin and placebo plus metformin at a ratio of 1:1:1.
When the number of participants who have completed the 12-week follow up reached 120, interim analyses will be performed and the results will be evaluated by Independent Data Monitoring Committee experts to determine the recommended phase 3 dosage.
During the phase III stage, subjects were randomly assigned 1:1 to the "recommended phase 3 dosage + metformin" group and the "placebo + metformin" group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| supaglutide RP3D dose+metformin | Experimental | Supaglutide Subcutaneous injection once a week for 52weeks,combined with metformin |
|
| placebo+metformin | Placebo Comparator | Placebo Subcutaneous injection once a week for 52weeks,,combined with metformin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| supaglutide injection+metformin | Biological | supaglutide subcutaneous injection under RP3D dose combined with metformin treatment |
|
| Measure | Description | Time Frame |
|---|---|---|
| HbA1c | The change in mean HbA1c concentrations (%)from baseline with Supaglutide versus placebo | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Measure | Description | Time Frame |
|---|---|---|
| fasting plasma glucose | Changes in fasting plasma glucose (mmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| HbA1c<7.0% and <6.5% | The proportion of participants who achieved HbA1c target (HbA1c<7.0% and <6.5% Patient percentage) |
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Inclusion Criteria:
6. without birth plan and voluntarily take effective contraceptive measures; 7. fully understood the study, signed the informed consentï¼›
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Weiping Jia, M.D,Ph.D | Shanghai 6th People's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Boai Hospital | Beijing | China | ||||
| Beijing Pinggu Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42103705 | Derived | Jia W, Gao F, Lu J, Cheng Z, Dong X, Shi X, Su X, Li L, Zhang W, Wang Y, Ma J, Li S, Wang H, Cheng L, Mao L, Jiang C, Li Q, Li X, Zheng X, Liu M, Sun J, Peng H, Pan H, Ling H, Jiang C, Song J, Zhang X, Zhang L, Liu Y, Zeng T, Zhao Y, Xu Y, Li Y, Bao Y, Zhou J, Wang Q. Efsubaglutide alfa added to metformin improves glycaemia with beta-cell functional responses in type 2 diabetes: a randomised, double-blind, placebo-controlled, two-stage adaptive phase 2b/3 trial (SUPER 2). Nat Commun. 2026 May 8. doi: 10.1038/s41467-026-72574-7. Online ahead of print. | |
| 40991141 |
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This clinical trial includes dosage determination (Phase IIb) and efficacy confirmation stage(Phase III ). During the phase IIb, subjects were randomly assigned to Supaglutide 1mg + metformin, Supaglutide 3mg + metformin and placebo + metformin according to a 1:1:1 ratio.
When 120 subjects complete the 12 weeks of follow-up, Interim analysis will be performed and the results be evaluated by IDMC to confirm the RP3D dose.
And then during the phase III, subjects were randomly assigned to Supaglutide RP3D + metformin, placebo + metformin group according to a 1:1 ratio.
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This includes a 24-week double-blind treatment period, followed by a 28-week open-label treatment period.
| placebo+metformin | Other | placebo subcutaneous injection combined with metformin treatment |
|
| 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Fasting insulin | Fasting insulin changes(pmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| fasting C-peptide | Fasting C-peptide changes (nmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| fasting glucagon | fasting glucagon changes (pg/ml) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Area under the curve of blood glucose | Area under the curve of blood glucose (AUC0-120min,mmol/L) during the multi-maneuvering target tracking | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Area under the curve of insulin | Area under the curve of insulin (AUC0-120min,pmol/L) during the MMTT | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Area under the curve of C-peptide | Area under the curve of C-peptide (AUC0-120min,nmol/L) during the MMTT | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Total cholesterol | Changes in total cholesterol (mmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| low density lipoprotein | Changes in low density lipoprotein (mmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| High density lipoprotein | Changes in high density lipoprotein (mmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| triglyceride | Changes in triglyceride(mmol/L) relative to baseline | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| weight | Weight change from baseline(kg) | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| salvage treatment | Percentage of subjects receiving salvage treatment(%) | 12 weeks for phase IIb; 24weeks and 52 weeks for phase III |
| Beijing |
| China |
| Emergency General Hospital | Beijing | China |
| Cangzhou Central Hospital | Cangzhou | China |
| Cangzhou Hospital of Integrated TCM-WM Hebei | Cangzhou | China |
| The Second Hospital of Jilin University | Changchun | China |
| First People's Hospital of Changde | Changde | China |
| Changsha Hopital Affiliated to Hunan University | Changsha | China |
| The Fourth Hospital of Changsha | Changsha | China |
| Chengdu Fifth People's Hospital | Chengdu | China |
| Chenzhou First People's Hospital | Chenzhou | China |
| Chongqing Ninth People's Hospital | Chongqing | China |
| Dalian Municipal Central Hospital | Dalian | China |
| Daqing People's Hospital | Daqing | China |
| Jilin Guowen Hospital | Gongzhuling | China |
| Handan First Hospital | Handan | China |
| The Fourth Affiliated Hospital of Harbin Medical University | Harbin | China |
| Heze Municipal Hospital | Heze | China |
| Huai'an First People's Hospital | Huai'an | China |
| Huai'an Second People's Hospital | Huai'an | China |
| Huizhou Central Hospital | Huizhou | China |
| Jilin People's Hospital | Jilin City | China |
| Jinan Central Hospital Affiliated to Shandong First Medical University | Jinan | China |
| Jincheng General Hospital | Jincheng | China |
| Jingzhou Central Hospital | Jingzhou | China |
| The Second Affiliated Hospital of Kunming Medical University | Kunming | China |
| The Second People's Hospital of Lianyungang | Lianyungang | China |
| Linfen People's Hospital | Linfen | China |
| First People's Hospital of Tancheng | Linyi | China |
| Liuzhou People's Hospital | Liuzhou | China |
| The First Affiliated Hospital of Henan University | Luoyang | China |
| Meihekou Central Hospital | Meihekou | China |
| Jiangxi Provincial People's Hospital | Nanchang | China |
| Nanjing First Hospital | Nanjing | China |
| Nanjing Jiangning Hospital | Nanjing | China |
| Sir Run Run Hospital of Nanjing Medical University | Nanjing | China |
| Nanyang First People's Hospital | Nanyang | China |
| Nanyang Second General Hospital | Nanyang | China |
| The First Affiliated Hospital of Nanyang Medical College | Nanyang | China |
| Puyang Oilfield General Hospital | Pujiang | China |
| The First Hospital of Qinhuangdao | Qinhuangdao | China |
| The First Hospital of Qiqihar | Qiqihar | China |
| Changhai Hospital | Shanghai | China |
| Huadong Hospital | Shanghai | China |
| Shanghai Pudong New Area People's Hospital | Shanghai | China |
| Shanghai Sixth People's Hospital Affiliated to Shanghai JiaoTong University | Shanghai | China |
| Shanghai Tongren Hospital | Shanghai | China |
| Siping Central Hospital | Siping | China |
| Second Hospital of Shanxi Medical University | Taiyuan | China |
| The Second Affiliated Hospital of Shandong First Medical University | Tanan | China |
| The Second Hospital of Tanjin Medical University | Tianjin | China |
| Tianjin Medical University General Hospital | Tianjing | China |
| Union Hospital of Tongji Medical College, Huazhong University of Science and Technology | Wuhan | China |
| Jiangyin People's Hospital | Wuxi | China |
| The Affiliated Hospital of Xuzhou Medical University | Xuzhou | China |
| Xuzhou Cancer Hospital | Xuzhou | China |
| The Second People's Hospital of Yibin | Yibin | China |
| Yichun People's Hospital | Yichun | China |
| Yiyang Central Hospital | Yiyang | China |
| The Second Affiliated Hospital of Zhengzhou University | Zhengzhou | China |
| First People's Hospital of Zunyi | Zunyi | China |
| Derived |
| Wang Q, Jiang F, Xu Y, Lei Y, Zhang L, Sun X. Exposure-Response Analysis of Efsubaglutide Alfa in Patients with Type 2 Diabetes Treated with Metformin. Clin Pharmacokinet. 2025 Dec;64(12):1799-1809. doi: 10.1007/s40262-025-01569-2. Epub 2025 Sep 24. |
| 39961992 | Derived | Lou YR, Xu YL, Xiong Y, Deng C, Wang Q. Population Pharmacokinetics of Efsubaglutide Alfa in Healthy Subjects and Subjects with Type 2 Diabetes. Clin Pharmacokinet. 2025 Apr;64(4):533-552. doi: 10.1007/s40262-025-01475-7. Epub 2025 Feb 17. |