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The Effect of Dulaglutide as an Adjuvant Therapy on Cognitive Function in Bipolar Disorder Patients With Obesity

Not Applicable
Recruiting
Conditions
Bipolar Disorder
Obesity
Cognition
Interventions
Registration Number
NCT06331286
Lead Sponsor
First Affiliated Hospital of Zhejiang University
Brief Summary

The primary objective of this study is to investigate the effect of dulaglutide adjuvant treatment in patients with bipolar disorder with obesity, in addition to exploring the effect of GLP-1RA on cognition of bipolar disorder.

Detailed Description

3. Characteristics, composition, mechanism of action and research scope of research drugs 3.1 Dulaglutide Injection has been approved for marketing by the National Medical Products Administration (NMPA S20190022). Dulaglutide is a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist with a half-life of up to 4-7 days and supports once-weekly subcutaneous administration at a dose of 0.75 mg.

The study included 60 patients (aged 18 to 65 years) with bipolar disorder with obesity who met the diagnostic criteria for bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), fifth edition.Eligible patients were randomly assigned (1:1) to 24-week treatment with dulaglutide injection (n=30) or diet and exercise guidance treatment (n=30), followed up at period of enrollment as baseline and at the end of 2th, 4th,8th ,12th ,16th and 24th weeks. Adverse events were recorded.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria

a. Patients (or their legal representatives/guardians) sign off-label medication and informed consent; b. 16≤ age≤ 65 years old, gender is not limited; c. Patients in the stable phase who meet the diagnostic criteria for DSM-V bipolar disorder using a short-form international neuropsychiatric interview and have kept their current medication unchanged for at least 2 months after enrollment; Body mass index (BMI) ≥28 kg/m2 ;e. Young's Mania Scale (YMRS) ≤6 points; f. HAMD-24<8 points; Han Chinese; Completed compulsory education at or above junior high school;

Exclusion Criteria

Subjects related: a. Patients who have undergone ECT therapy within 3 months; b. Have a hearing problem (inability to hear or understand the examiner's speech under normal conversation); c. Pregnant, lactating women or planning to become pregnant; d. Those who are allergic to the study drug.

Lesion-related: a. History of loss of consciousness due to cerebral organic disease or head trauma; b. Patients with any significant or unstable history of cardiovascular, respiratory, neurological (including epilepsy or significant cerebrovascular disease), renal, hepatic, or immune diseases, including inflammatory bowel disease, thyroid cancer, acute pancreatitis, etc., who are taking sulfonylurea drugs, anti-inflammatory or immunological agents, etc., especially those with a personal history or family history of medullary thyroid cancer (MTC) or 2 Patients with multiple endocrine neoplasia syndrome (MEN 2); c. Known, clinically significant laboratory markers or ECG abnormalities; Has any disease, liver disease, or renal disease that may alter the absorption, metabolism, or excretion of the study drug; d. Those with severe suicidal ideation and behavior or MARDS ≥ 30 points.

Exclusion criteria related to concomitant medications: a. chronic use of anticholinergics; b. history of psychoactive substance abuse and dependence;

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
dulaglutide injection treatment groupdulaglutide injection0.75mg Subcutaneous injection once a week for 24 weeks
diet and exercise guidance treatmentdulaglutide injectiondiet and exercise guidance treatment for 24 weeks
Primary Outcome Measures
NameTimeMethod
Concentration of triglyceride in bloodBaseline, the end of Week 12 and the end of Week 24

To analysis whether concentration of triglyceride in blood show any significant trend with time changes.

weightBaseline, the end of Week 12 and the end of Week 24

To analysis whether weight shows any significant trend with time changes.

Concentration of blood glucose in bloodBaseline, the end of Week 12 and the end of Week 24

To analysis whether concentration of blood glucose in blood show any significant trend with time changes.

Concentration of total cholesterol in bloodBaseline, the end of Week 12 and the end of Week 24

To analysis whether concentration of total cholesterol in blood show any significant trend with time changes.

Concentration of high density lipoprotein in bloodBaseline, the end of Week 12 and the end of Week 24

To analysis whether concentration of high density lipoprotein in blood show any significant trend with time changes.

Concentration of low density lipoprotein in bloodBaseline, the end of Week 12 and the end of Week 24

To analysis whether concentration of low density lipoprotein in blood show any significant trend with time changes.

CBCT test resultsBaseline, the end of Week 12 and the end of Week 24

CBCT is a tool to measure cognitive function. It includes 4 dimensions: wire test, symbol encoding, continuous operation, and digital breadth.The wired test reflects the dimension of the speed of patient information processing. Symbolic coding reflects the patient's information processing speed, attention, working memory, reasoning, and problem-solving dimensions.

Continuous manipulation reflects the patient's attention Dimension. The numerical breadth reflects the patient's working memory dimension.The basic information of the completion of each assessment and the completion of each assessment are calculated by the Chinese population norm model T-score, Deficit value, and extent and dimension of damage. Reflected in each assessment and the percentiles of neurocognitive function in the Chinese population.

Secondary Outcome Measures
NameTimeMethod
17-item Hamilton Depression Rating Scale (HAM-D17) ScoreTime Frame: Baseline, the end of Week 2, 4, 8,12,16 and 24

HAM-D17 has been the gold standard for the assessment of depression. The score needs to be based on clinical interviews, and the time frame of the assessment is usually the situation in the previous week. Most items use a 5-point scale of 0 to 4. The standard of each level is: 0 indicates none, 1 indicates mild, 2 indicates moderate, 3 indicates severe, and 4 indicates extremely severe. A few items adopt the 3-level scoring method with 0\~2 points, and the grading standard is: 0 indicates none, 1 indicates mild to moderate and 2 indicates severe.

Treatment Emergent Symptom Scale (TESS) ScoreTime Frame: Baseline, the end of Week 2, 4, 8,12,16 and 24

Treatment Emergent Symptom Scale was developed by The National Institute of Mental Health (NIMH) in the USA in 1973. It is a safety assessment tool after treatment of psychiatric diseases. Evaluation is based on patient reports, physical examination results, and laboratory reports, and some items should also be consulted with the patient's family. Severity item is scored from 0 (not present) to 4 (severe). Higher scores represent a more severe condition.

Trial Locations

Locations (1)

Department of Psychiatry, First Affiliated Hospital of Zhejiang University

🇨🇳

Hangzhou, Zhejiang, China

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