Type 2 Diabetes MellitusPhase 3SYMPHONY-2NCT06353347
Efficacy and Safety of Berberine Ursodeoxycholate (HTD1801) in Patients With Type 2 Diabetes Inadequately Controlled With Metformin
A Phase 3 study testing HTD1801 in people with Type 2 Diabetes Mellitus, run by Shenzhen HighTide Biopharmaceutical Ltd. at 64 sites in China.
Trial summary
The goal of this clinical study is to evaluate the efficacy and safety of berberine ursodeoxycholate (HTD1801) compared to placebo in patients with type 2 diabetes inadequately controlled with metformin. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Type 2 Diabetes Mellitus
- What is being tested?
- HTD1801
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 551 participants
- Where
- 64 sitesChina
- Study dates
- 13 Nov 2023to 30 Jul 2025
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Have been diagnosed with type 2 diabetes
- Received a stable dose of metformin monotherapy for at least 8 weeks prior to screening
- If used any glucose-lowering drugs other than metformin within the 8 weeks prior to screening such use was ≤7 days and was discontinued at least 4 weeks prior to screening
- Have HbA1c ≥7.5% to ≤11.0% (screening) and HbA1c ≥7.0% to ≤10.5% (pre-randomization)
- Have fasting plasma glucose ≤13.9 mmol/L (screening and pre-randomization)
- Have a body mass index ≥19.0 kg/m^2 to ≤35.0 kg/m^2
Who cannot join
- Have type 1 diabetes
- Have had any acute diabetic complications within 12 months prior to screening
- Have had any Grade 3 hypoglycemic event within 12 months prior to screening
- Have had proliferative retinopathy or macular degeneration, severe diabetic neuropathy, or diabetic foot
- Have been taking any weight loss medication or dietary supplement, have participated in a weight loss program, or have adhered to a special diet within 12 weeks prior to screening
- Have used insulin or an insulin analogue for more than 14 days within 12 months prior to screening
- Have used any hypoglycemic drug other than metformin during the 4-week run-in period prior to randomization
- Have had weight gain or loss ≥5% during the 4-week run-in period prior to randomization
Trial locations and contacts
64 sites in 1 country.
64 sites in 1 country
China64 sites
Baogang Hospital of Inner Mongolia
Baotou
Beijing Friendship Hospital, Capital Medical University
Beijing
Beijing Luhe Hospital Capital Medical University
Beijing
Beijing Pinggu Hospital
Beijing
Peking Union Medical College Hospital
Beijing
Peking University People's Hospital
Beijing
The Second Norman Bethune Hospital of Jilin University
Changchun
The First People's Hospital of Changde City
Changde
Hunan Provincial People's Hospital
Changsha
The Third Xiangya Hospital of Central South University
Changsha
Chongqing University Three Gorges Hospital
Chongqing
The Third People's Hospital of Datong
Datong
Nanfang Hospital, Southern Medical University
Guangzhou
Handan First Hospital
Handan
The Fourth Affiliated Hospital of Harbin Medical University
Harbin
Anhui Provincial Hospital
Hefei
The Second Hospital of Anhui Medical University
Hefei
Hengshui People's Hospital (Harrison International Peace Hospital)
Hengshui
Heze Municipal Hospital
Heze
Huai'an First People's Hospital
Huai'an
Huangshi Central Hospital
Huangshi
Huizhou Municipal Central Hospital
Huizhou
Huzhou Central Hospital
Huzhou
Jinan Central Hospital
Jinan
Jingzhou Central Hospital
Jingzhou
Jinzhou Central Hospital
Jinzhou
The First People's Hospital of Kashgar
Kashgar
Hebei Petro China Center Hospital
Langfang
Liaocheng People's Hospital
Liaocheng
The First Affiliated Hospital of Henan University of Science and Technology (Jinghua)
Luoyang
The First Affiliated Hospital of Henan University of Science and Technology (Kaiyuan)
Luoyang
Nanjing Drum Tower Hospital - The Affiliated Hospital of Nanjing University Medical School
Nanjing
Nanjing First Hospital
Nanjing
Nanjing Jiangning Hospital
Nanjing
Sir Run Run Hospital Nanjing Medical University
Nanjing
The Second Affiliated Hospital of Nanjing Medical University
Nanjing
The First People's Hospital of Nanning
Nanning
The First Affiliated Hospital of Nanyang Medical College
Nanyang
Panjin Liaohe Oilfield Gem Flower Hospital
Panjin
The First Hospital of Qiqihar
Qiqihar
Shanghai East Hospital of Tongji University
Shanghai
Shanghai Pudong New Area People's Hospital
Shanghai
Shengjing Hospital of China Medical University
Shenyang
The Sixth People's Hospital of Shenyang
Shenyang
Shenzhen People's Hospital
Shenzhen
The University of Hong Kong - Shenzhen Hospital
Shenzhen
Taihe Hospital
Shiyan
Siping City Central People's Hospital
Siping
The First Affiliated Hospital of Suzhou University
Suzhou
People's Hospital of Tianjin
Tianjin
Tonghua Central Hospital
Tonghua
The Central Hospital of Wuhan
Wuhan
Yijishan Hospital of Wannan Medical College
Wuhu
The First People's Hospital of Xiangtan City
Xiangtan
The Affiliated Hospital of Xuzhou Medical University
Xuzhou
Yanan University Affiliated Hospital
Yanan
Yueyang People's Hospital
Yueyang
Yuncheng Central Hospital
Yuncheng
The Second Affiliated Hospital of Zhengzhou University
Zhengzhou
Affiliated Hospital of Jiangsu University
Zhenjiang
Zhumadian Central Hospital
Zhumadian
Zhuzhou Central Hospital
Zhuzhou
Zibo Central Hospital
Zibo
The First People's Hospital of Zunyi
Zunyi
About this study
Official title: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 3 Study Evaluating the Efficacy and Safety of HTD1801 in Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Metformin
The goal of this clinical study is to evaluate the efficacy and safety of berberine ursodeoxycholate (HTD1801) compared to placebo in patients with type 2 diabetes inadequately controlled with metformin.
Read the detailed description
This Phase 3, randomized, double-blind, placebo-controlled study will evaluate the safety and efficacy of HTD1801 in two phases, a 24-week double-blind phase followed by a 28-week open-label extension. To ensure stabilization of glycemic control, eligible patients will first participate in a 4-week single-blind run-in period where investigators will provide guidance on lifestyle modifications, concomitant medications, and procedures for self-monitoring of blood glucose. Following this period, patient eligibility will be reassessed. Eligible patients will then be randomized 2:1 to receive HTD1801 1000 mg twice daily (BID) or placebo for 24 weeks.
Patients who complete the double-blind treatment phase will enter an open-label extension period where all patients will receive HTD1801 1000 mg BID for 28 weeks.
- Conditions
- Type 2 Diabetes Mellitus
- Being tested
- HTD1801, Placebo
- Medical subject headings
- Diabetes Mellitus, Type 2
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
HTD1801Drug
Also called berberine ursodeoxycholate
HTD1801 1000 mg administered orally BID as four capsules
PlaceboDrug
Matching placebo administered orally BID as four capsules
| Study group | Role | What they receive |
|---|---|---|
| HTD1801 | Experimental | Administered orally twice daily (BID) Receives: Drug: HTD1801 |
| Placebo | Placebo comparator | Administered orally BID Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Primary Endpoint: mean change in HbA1c
Mean change in HbA1c from baseline to Week 24
Measured: 24 Weeks
Secondary outcomes (6)
Double-blind (DB) Phase: mean change in fasting plasma glucose
Mean change in fasting plasma glucose from baseline to Week 24
Measured: 24 Weeks
DB Phase: mean change in 2-hour postprandial glucose
Mean change in 2-hour postprandial glucose from baseline to Week 24
Measured: 24 Weeks
DB Phase: proportion of patients achieving HbA1c <7.0%
Proportion of patients achieving HbA1c target value of <7.0% at Week 24
Measured: 24 Weeks
DB Phase: proportion of patients achieving HbA1c <6.5%
Proportion of patients achieving HbA1c target value of <6.5% at Week 24
Measured: 24 Weeks
DB Phase: mean change in insulin sensitivity (HOMA-IR)
Mean change in homeostatic model Assessment for insulin resistance (HOMA-IR) from baseline to Week 24
Measured: 24 Weeks
DB Phase: mean change in low-density lipoprotein cholesterol (LDL-C)
Mean change in LDL-C from baseline to Week 24
Measured: 24 Weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Apr 2024
- Study start13 Nov 2023
- Primary completion12 Dec 2024
- Study completion30 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Type 2 Diabetes MellitusStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 551 participants (actual)
Sponsor and investigators
- Lead sponsor
- Shenzhen HighTide Biopharmaceutical Ltd.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Kui Liu, MD, Study director, Shenzhen HighTide Biopharmaceutical Ltd.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06353347
- Sponsor's protocol ID
- HTD1801.PCT106
- Acronym
- SYMPHONY-2
- Status last verified
- Aug 2026
- First submitted
- 3 Apr 2024
- Last updated
- 11 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Ji L, Cheng Z, Ma J, Liu D, Zhang X, Dong X, Lin Y, Yang M, Gan S, Cai H, Wang X, Liu Y, Shi X, Liu K, MacConell L, Yu M, Liu L. HTD1801 in Combination with Metformin for Type 2 Diabetes. NEJM Evid. 2026 Jul;5(7):EVIDoa2500317. doi: 10.1056/EVIDoa2500317. Epub 2026 Jun 7.
PubMed 42251702
Study at a glance
From the registry record, last updated by the sponsor on 11 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 3 Study Evaluating the Efficacy and Safety of HTD1801 in Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Metformin
- ClinicalTrials.gov ID
- NCT06353347
- Acronym / sponsor ID
- SYMPHONY-2 / HTD1801.PCT106
- Conditions
- Type 2 Diabetes Mellitus
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 551 participants (actual)
- Lead sponsor
- Shenzhen HighTide Biopharmaceutical Ltd.Industry (pharma, biotech, devices)
- Study start
- 13 Nov 2023 (actual)
- Primary completion
- 12 Dec 2024 (actual)
- Study completion
- 30 Jul 2025 (actual)
- First posted
- 9 Apr 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical study is to evaluate the efficacy and safety of berberine ursodeoxycholate (HTD1801) compared to placebo in patients with type 2 diabetes inadequately controlled with metformin.
Detailed description
This Phase 3, randomized, double-blind, placebo-controlled study will evaluate the safety and efficacy of HTD1801 in two phases, a 24-week double-blind phase followed by a 28-week open-label extension. To ensure stabilization of glycemic control, eligible patients will first participate in a 4-week single-blind run-in period where investigators will provide guidance on lifestyle modifications, concomitant medications, and procedures for self-monitoring of blood glucose. Following this period, patient eligibility will be reassessed. Eligible patients will then be randomized 2:1 to receive HTD1801 1000 mg twice daily (BID) or placebo for 24 weeks.
Patients who complete the double-blind treatment phase will enter an open-label extension period where all patients will receive HTD1801 1000 mg BID for 28 weeks.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| HTD1801 | Experimental | Drug: HTD1801Administered orally twice daily (BID) |
| Placebo | Placebo comparator | Drug: PlaceboAdministered orally BID |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Have been diagnosed with type 2 diabetes
- Received a stable dose of metformin monotherapy for at least 8 weeks prior to screening
- If used any glucose-lowering drugs other than metformin within the 8 weeks prior to screening such use was ≤7 days and was discontinued at least 4 weeks prior to screening
- Have HbA1c ≥7.5% to ≤11.0% (screening) and HbA1c ≥7.0% to ≤10.5% (pre-randomization)
- Have fasting plasma glucose ≤13.9 mmol/L (screening and pre-randomization)
Key exclusion criteria (8 listed)
- Have type 1 diabetes
- Have had any acute diabetic complications within 12 months prior to screening
- Have had any Grade 3 hypoglycemic event within 12 months prior to screening
- Have had proliferative retinopathy or macular degeneration, severe diabetic neuropathy, or diabetic foot
- Have been taking any weight loss medication or dietary supplement, have participated in a weight loss program, or have adhered to a special diet within 12 weeks prior to screening
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| HTD1801Also: berberine ursodeoxycholateHTD1801 1000 mg administered orally BID as four capsules | Drug | HTD1801 |
| PlaceboMatching placebo administered orally BID as four capsules | Drug | Placebo |
Primary outcome
Primary Endpoint: mean change in HbA1c
Time frame: 24 Weeks
Mean change in HbA1c from baseline to Week 24
6 secondary outcomes
Double-blind (DB) Phase: mean change in fasting plasma glucose
Time frame: 24 Weeks
DB Phase: mean change in 2-hour postprandial glucose
Time frame: 24 Weeks
DB Phase: proportion of patients achieving HbA1c <7.0%
Time frame: 24 Weeks
DB Phase: proportion of patients achieving HbA1c <6.5%
Time frame: 24 Weeks
DB Phase: mean change in insulin sensitivity (HOMA-IR)
Time frame: 24 Weeks
DB Phase: mean change in low-density lipoprotein cholesterol (LDL-C)
Time frame: 24 Weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Aug 2026.
- Results publication: PubMed 42251702Ji L, Cheng Z, Ma J, Liu D, Zhang X, Dong X, Lin Y, Yang M, Gan S, Cai H, Wang X, Liu Y, Shi X, Liu K, MacConell L, Yu M, Liu L. HTD1801 in Combination with Metformin for Type 2 Diabetes. NEJM Evid. 2026 Jul;5(7):EVIDoa2500317. doi: 10.1056/EVIDoa2500317. Epub 2026 Jun 7.
- Individual participant dataSharing planned: No
Related trials for Type 2 Diabetes Mellitus
Not yet recruitingPhase 3
Efficacy and Safety of Once-Weekly SHR-3167 Compared With Once-Daily Insulin Glargine in Adults With Insulin-Naive Type 2 Diabetes
Type 2 Diabetes
Active, not recruiting
Digital Reinforcement of Motivational Interviewing Micro-Skills Among Primary Care Healthcare Professionals
Hypertension (Without Type 2 Diabetes Mellitus)
Recruiting
Investigating Vascular Properties of HEMI and SPG Signals in Individuals With or at Risk for Chronic Kidney Disease
Chronic Kidney Disease, Hypertension (HTN)
Not yet recruitingPhase 3
A Study to Evaluate the Effectiveness and Safety of the Drug AZD6234 for Managing Weight in Adults Who Are Obese or Overweight. These Participants May or May Not Also Have Type 2 Diabetes
Obesity, Overweight
Not yet recruiting
Impact of Endoscopic Sleeve Gastroplasty (ESG) in Obese Adults With Type 2 Diabetes (T2D)
Type 2 Diabetes Mellitus (T2D), Obesity (BMI>30)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kui Liu, MD study director
Shenzhen HighTide Biopharmaceutical Ltd.
64 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing HTD1801 in people with Type 2 Diabetes Mellitus, run by Shenzhen HighTide Biopharmaceutical Ltd. at 64 sites in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 64 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Primary Endpoint: mean change in HbA1c (time frame: 24 Weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06353347, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Aug 2026.