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Trial registered on ANZCTR
Registration number
ACTRN12624001278527p
Ethics application status
Submitted, not yet approved
Date submitted
12/09/2024
Date registered
18/10/2024
Date last updated
18/10/2024
Date data sharing statement initially provided
18/10/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of tirzepatide on asthma control in obese asthmatics
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Scientific title
Effect of tirzepatide on asthma control in obese asthmatics aged 16 years and over: A phase III randomised double blinded placebo control trial
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Secondary ID [1]
312956
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Asthma
335128
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Obesity
335203
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Metabolic Syndrome
335204
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Condition category
Condition code
Respiratory
331628
331628
0
0
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Asthma
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Metabolic and Endocrine
331629
331629
0
0
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Metabolic disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Tirzepatide 2.5mg administered subcutaneously weekly
First dose administered under supervision, all subsequent doses to be self-administered
Assessment for tolerability at 4 weeks
If no grade 2 or 3 side effects, then dose escalation by 2.5mg to;
5mg administered subcutaneously weekly
Assessment at 4 weeks as above
Dose escalation will occur in a similar fashion, every 4 weeks until a maximum dose of 10mg is achieved
Assessment of compliance completed monthly with either phone or face-to-face assessment. Trial participants will be asked directly regarding medical compliance. Any noncompliance will be recorded by the clinical trial officer.
Total duration of treatment will be 36 weeks
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Intervention code [1]
329489
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Treatment: Drugs
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Comparator / control treatment
Placebo as a subcutaneous injection of 0.9% normal saline.
Syringe will be visually exactly the same as the active drug syringe.
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Control group
Placebo
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Outcomes
Primary outcome [1]
339362
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Asthma control
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Assessment method [1]
339362
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Change in Asthma Control Questionnaire (ACQ6) at 36 weeks
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Timepoint [1]
339362
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ACQ6 will be taken at baseline, week 16, and at week 36 (end of trial)
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Secondary outcome [1]
439653
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Weight change
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Assessment method [1]
439653
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Measure on digital scales recorded in kilograms
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Timepoint [1]
439653
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Collected at baseline, week 16 post baseline and at 36 weeks post baseline
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Secondary outcome [2]
439654
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Blood pressure recorded in mmHg
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Assessment method [2]
439654
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Sphygmomanometer
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Timepoint [2]
439654
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Collected at baseline, week 16 post baseline and at 36 weeks post baseline
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Secondary outcome [3]
439655
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Urine metabolomics - exploratory outcome measure
A range of inflammatory and nutritional metabolites
Recorded as a composite outcome
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Assessment method [3]
439655
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Urine sample 50mL collected and frozen, stored in a biobank
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Timepoint [3]
439655
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [4]
439656
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Adiponectin
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Assessment method [4]
439656
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Serum blood test
Assessed with bioplex assay
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Timepoint [4]
439656
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [5]
439657
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Leptin
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Assessment method [5]
439657
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Serum blood test
Assessed with bioplex assay
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Timepoint [5]
439657
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [6]
439658
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Insulin
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Assessment method [6]
439658
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Serum blood test
Commercially run lab test
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Timepoint [6]
439658
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [7]
439659
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Fasting blood glucose
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Assessment method [7]
439659
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Serum blood test
Commercially run lab test
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Timepoint [7]
439659
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [8]
439660
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HbA1c - glycated haemoglobin
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Assessment method [8]
439660
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Serum blood test
Commercially run lab test
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Timepoint [8]
439660
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [9]
439661
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Serum myeloperoxidase (MPO)
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Assessment method [9]
439661
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Serum blood test
Assessed with bioplex assay
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Timepoint [9]
439661
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [10]
439856
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Calprotectin
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Assessment method [10]
439856
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Serum blood test
Assessed with bioplex assay
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Timepoint [10]
439856
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [11]
439857
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Interleukin 10 - IL-10
Assessed with bioplex assay
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Assessment method [11]
439857
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Serum blood test
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Timepoint [11]
439857
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [12]
439858
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Interleukin 6 - IL-6
Assessed with bioplex assay
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Assessment method [12]
439858
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Serum blood test
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Timepoint [12]
439858
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [13]
439859
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interleukin - IL-33
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Assessment method [13]
439859
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Serum blood test
Assessed with bioplex assay
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Timepoint [13]
439859
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [14]
439860
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Soluble IL-6 receptor
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Assessment method [14]
439860
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Serum blood test
Assessed with bioplex assay
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Timepoint [14]
439860
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [15]
439861
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TNF- alpha - tumor necrosis factor alpha
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Assessment method [15]
439861
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Serum blood test
Assessed with bioplex assay
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Timepoint [15]
439861
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [16]
439862
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AQLQ – Asthma quality of life questionnaire
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Assessment method [16]
439862
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AQLQ Questionnaire
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Timepoint [16]
439862
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Collected at baseline, at 16 weeks post baseline and at 36 weeks post baseline
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Secondary outcome [17]
439863
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HADS – Hospital anxiety and depression score as a composite outcome
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Assessment method [17]
439863
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HADS Questionnaire
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Timepoint [17]
439863
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Collected at baseline, at 16 weeks post baseline and at 36 weeks post baseline
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Secondary outcome [18]
439864
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GSRS – gastrointestinal symptom rating scale
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Assessment method [18]
439864
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GSRS Questionnaire
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Timepoint [18]
439864
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Collected at baseline, at 16 weeks post baseline and at 36 weeks post baseline
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Secondary outcome [19]
439865
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ESS - Epworth sleepiness score
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Assessment method [19]
439865
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ESS Questionnaire
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Timepoint [19]
439865
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Collected at baseline, at 16 weeks post baseline and at 36 weeks post baseline
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Secondary outcome [20]
439866
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Food frequency questionnaire Australian Eating Survey
(https://australianeatingsurvey.com.au/ )
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Assessment method [20]
439866
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Australian Eating Survey - Questionnaire
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Timepoint [20]
439866
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [21]
439867
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Exploratory outcome - Stool sample for microbiome assessment
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Assessment method [21]
439867
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Stool sample
16S RNA gene sequencing performed on stool sample
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Timepoint [21]
439867
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [22]
439868
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Exploratory outcome - record device physical activity in steps (if available)
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Assessment method [22]
439868
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Smart watch or smart phone
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Timepoint [22]
439868
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Collected at baseline (3 months retrospective data extracted) and at 36 weeks post baseline (3 months retrospective data extracted)
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Secondary outcome [23]
439869
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Optional Investigation and exploratory outcome
Airway microscopy, culture and sensitivity - as a composite outcome
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Assessment method [23]
439869
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Bronchoscopy to collect saline wash - RML
25 mls of normal saline collected during bronchoscopy procedure from right middle lobe
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Timepoint [23]
439869
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [24]
439870
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Optional Investigation and exploratory outcome
Airway IL-5
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Assessment method [24]
439870
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Bronchoscopy used to collect a airway wash from the right middle lobe
25 ml saline to be collected - assessed with bioplex assay
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Timepoint [24]
439870
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [25]
439871
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Optional Investigation and exploratory outcome
Airway GLP-1 receptor quantitative assessment
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Assessment method [25]
439871
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Bronchoscopy used to collect saline wash from right middle lobe and also large airway tissue biopsy
PCR methods to detect GLP – 1 receptor presence and quantity
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Timepoint [25]
439871
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [26]
439872
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Optional Investigation and exploratory outcome - composite outcome
Airway - cell differential - eosinophils, macrophages, neutrophils, lymphocytes
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Assessment method [26]
439872
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Bronchoscopy used to collect 25 ml saline wash from right middle lobe
Expressed as a percentage relative to each other and in absolute numbers
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Timepoint [26]
439872
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [27]
439873
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Optional Investigation and exploratory outcome
Airway sub mucosal eosinophil assessment
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Assessment method [27]
439873
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Bronchoscopy obtained biopsy of large airway wall
Tissue sample collected
Processed into paraffin embedded formalin fixed specimens
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Timepoint [27]
439873
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [28]
439874
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Optional Investigation and exploratory outcome
Subcutaneous adipose tissue biopsy for assessment of tissue inflammation and metabolism
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Assessment method [28]
439874
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Peri umbiliacal superficial subcutaneous fat biopsy obtained with 4 mm punch biopsy
Inflammatory gene assessment using nano string plates
The process will allow for a broad screen of genes associated with inflammation and metabolism - reported as a composite outcome measure
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Timepoint [28]
439874
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [29]
439875
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Optional Investigation and exploratory outcome measure - composite outcome
Subcutaneous adipose tissue biopsy looking at immune cells including eosinophils lymphocytes and macrophages
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Assessment method [29]
439875
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Peri umbiliacal superficial subcutaneous fat biopsy obtained with 4 mm punch biopsy
Immunohistochemistry assessment allowing confirmation of cell type
Additional assessment with microscopy processed into paraffin embedded formalin fixed specimens
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Timepoint [29]
439875
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [30]
439876
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Lung function changes - spirometry
Assessment of severity of any airflow obstruction
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Assessment method [30]
439876
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FEV1 - forced expiratory volume in 1 second in litres
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Timepoint [30]
439876
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [31]
439877
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Lung function assessment - spirometry
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Assessment method [31]
439877
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FVC - forced vital capacity in litres
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Timepoint [31]
439877
0
Collected at baseline and at 36 weeks post baseline
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Secondary outcome [32]
439878
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Lung function assessment - spirometry
Assessment for airway obstruction
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Assessment method [32]
439878
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FEV1/FVC expressed as a ratio
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Timepoint [32]
439878
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [33]
439879
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Lung function
Assessment for airway inflammation assessment
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Assessment method [33]
439879
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FeNO - fraction of inspired nitric oxide
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Timepoint [33]
439879
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Collected at baseline and at 36 weeks post baseline
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Secondary outcome [34]
439880
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Lung function exploratory outcome
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Assessment method [34]
439880
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Forced oscillation technique (FOT)
Expressed as resistance relative to frequency
Paired with conventional spirometry
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Timepoint [34]
439880
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Collected at baseline and at 36 weeks post baseline
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Eligibility
Key inclusion criteria
All patients
>16 years and over
Physician diagnosed asthma
Mild / moderate / severe
Partially controlled asthma (ACQ6 > 0.75)
BMI > 30
Able and willing to consent
Speak and understand English
Be able to attend study appointments
Agree to have blood tests, lung function, participate in questionnaires and food diary
Willing for us to access their smart devices for activity assessment
Willing to use contraception if women of childbearing age
Being treated with optimised guideline based conventional asthma care as per global initiative for asthma guidelines (GINA)
Can be on all standard of care asthma treatment including advanced therapies
Stratification for metabolic syndrome
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Minimum age
16
Years
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Maximum age
80
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
Exclusion criteria
Unable / unwilling to consent
Currently using a glucagon like peptide - one (GLP-1) agonist
Regular use of illicit substances
Contraindication or intolerance to glucagon like peptide - one (GLP-1) agonists treatment in the past
Specific for glucagon like peptide - one (GLP-1) agonists
Patients with type 1 diabetes
Taking insulin for type 2 diabetes mellitus (T2DM)
Taking sulphonylurea
History of acute pancreatitis
Pregnancy or plans of becoming pregnant
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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)
Randomisation will be conducted by the research pharmacy off site using a predetermined electronic randomising program integrated with drug preparation and delivery
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
For the primary outcome of change in ACQ6 between baseline and 36 weeks, group sizes of 20 (treatment) and 20 (Placebo) would achieve 80% power to detect an effect size (Cohen’s d = mean/SD) of 0.91 (large effect size) using a two-sample t-test and choosing an alpha of 0.05.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/06/2025
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Actual
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Date of last participant enrolment
Anticipated
28/12/2026
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Actual
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Date of last data collection
Anticipated
6/09/2027
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Mater Hospital Brisbane - South Brisbane
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Recruitment postcode(s) [1]
43166
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
317387
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Charities/Societies/Foundations
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Name [1]
317387
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Betty McGrath Seeding Grant
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Address [1]
317387
0
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Country [1]
317387
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Australia
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Funding source category [2]
317453
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Hospital
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Name [2]
317453
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Mater respiratiry, infectious disease and oncology clinical trials unit
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Address [2]
317453
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Country [2]
317453
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Australia
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Primary sponsor type
Hospital
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Name
Mater Hospital
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Address
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Country
Australia
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Secondary sponsor category [1]
319679
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University
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Name [1]
319679
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University of Queensland
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Address [1]
319679
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Country [1]
319679
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
316115
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Mater Misericordiae Ltd Human Research Ethics Committee
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Ethics committee address [1]
316115
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http://www.materresearch.org.au/about-us/human-research-ethics-and-governance/human-research-ethics
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Ethics committee country [1]
316115
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Australia
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Date submitted for ethics approval [1]
316115
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17/09/2024
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Approval date [1]
316115
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Ethics approval number [1]
316115
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Summary
Brief summary
This study is seeking to investigate the commercially available and TGA approved drug Tirzepatide in obese asthmatics with uncontrolled symptoms. The trial will be a pilot phase 3 placebo controlled randomised trial. The trial is seeking to determine if this drug improves asthma symptoms over a 36 week period in the setting of weight loss. Furthermore, secondary and exploratory outcome measures are seeking to determine how these benefits, if they are observed, can be explained. For example it might not just be about weight loss that improves asthma symptoms. Maybe other changes in the bodies inflammatory pathways can explain any improved symptoms observed in asthmatics. It's very important for doctors to understand how drugs work as this allows improved prescribing practices and improves the ability to identify patients who are most likely to benefit from any drug intervention.
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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
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Dr Adrian Barnett
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Address
136838
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Mater Hospital South Brisbane, Raymond Terrace, Queensland, 4101
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Country
136838
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Australia
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Phone
136838
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+61 0410415414
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Fax
136838
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Email
136838
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[email protected]
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Contact person for public queries
Name
136839
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Adrian Barnett
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Address
136839
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Mater Hospital South Brisbane, Raymond Terrace, Queensland, 4101
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Country
136839
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Australia
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Phone
136839
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+61 0410415414
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Fax
136839
0
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Email
136839
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[email protected]
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Contact person for scientific queries
Name
136840
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Adrian Barnett
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Address
136840
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Mater Hospital South Brisbane, Raymond Terrace, Queensland, 4101
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Country
136840
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Australia
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Phone
136840
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+61 0410415414
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Fax
136840
0
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Email
136840
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