Pinnacle Clinical Research
San Antonio, Texas, 78229, United States
NCT Number: NCT03656068
To evaluate the safety and tolerability of Nitazoxanide (NTZ) 500mg Twice Daily (BID) after 24 weeks of treatment in patients with NASH induced Stage 2 or Stage 3 fibrosis
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Notify Me18 year–75 year
All sexes
Interventional
Phase 2
San Antonio, Texas, 78229, United States
Based on the anti-fibrotic properties demonstrated in the animal models of fibrosis, this proof of concept clinical study aims at evaluating NTZ in patients with non-alcoholic steatohepatitis (NASH) and fibrosis stage 2 and 3. Although NTZ has been evaluated in liver disease populations up to 60 weeks, this is the first study evaluating NTZ treatment in a population with NASH induced stage 2 and 3 fibrosis. The aim of this study is to evaluate the safety and tolerability of NTZ 500 mg BID after 24 weeks of treatment in this population.
This proof of concept study will also evaluate the anti-fibrotic effect of NTZ as a secondary objective.
The methods of evaluation of fibrosis will include an innovative method of metabolic labeling.This approach is based on the concept that liver status can be determined by measuring the ratio of newly synthesized/pre-existing proteins.The turn-over rate of newly synthesized collagen and proteins represents the hepatic fibrogenic disease activity. Patients will be given "heavy water" to drink. Heavy water contains D20, deuterium being a stable isotope of hydrogen. Mass spectrometry is used to identify individual proteins and to quantify the ratio of labeled protein to total protein. The results are expressed as fractional synthesis rate of these proteins (FSR). This method has been previously published (Decaris et al, 2017).
Other non-invasive methods will be used to evaluate the liver stiffness changes after NTZ treatment: Magnetic Resonance Elastography (MRE) and FibroScan®.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Patients will receive 500mg of Nitazoxanide BID daily for 24 weeks
Other names: NTZ
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of treatment-emergent adverse events (TEAEs).
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of study drug-related treatment-emergent adverse events (TEAEs).
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of serious adverse events (SAEs).
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of study drug-related serious adverse events (SAEs).
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of deaths due to adverse events (AEs).
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of adverse events (AEs) leading to withdrawal from study or study drug.
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by assessing the occurrence of study drug-related adverse events (AEs) leading to withdrawal from study or study drug
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by performing clinical laboratory evaluations. Changes in clinical laboratory evaluations were considered clinically significant or not as per Investigator judgment.
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by measuring vital signs. Changes in vital signs were considered clinically significant or not as per Investigator judgement
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by performing electrocardiograms (ECGs). Changes in ECGs parameters were considered clinically significant or not as per Investigator judgement.
Time frame: 28 weeks
To assess the safety and tolerability of NTZ after 24 weeks of treatment by conducting physical examinations. Changes in physical examinations were considered clinically significant or not as per Investigator judgement.
Time frame: From baseline to end of treatment (Visit 10, Week 24 or early termination)
Change in Lumican Fractional Synthesis Rate (FSR) from baseline to end of treatment evaluated through the use of deuterated water.
Lumican is a marker indicative of hepatic fibrogenesis with its turnover assessed by Fractional Synthesis Rate (FSR). This innovative method of metabolic labelling is based on the concept that liver status could be determined by measuring the ratio of newly synthesized/pre-existing proteins. The turnover rate of newly synthesized collagen and proteins represents the hepatic fibrogenic disease activity.
Patients were given "heavy water" to drink. Heavy water contains D20, deuterium being a stable isotope of hydrogen. Mass spectrometry was used to identify individual proteins and to quantify the ratio of labeled protein to total protein.
Time frame: From baseline to end of treatment (Visit 10, Week 24 or early termination)
Percent Change in Lumican FSR from baseline to end of treatment evaluated through the use of deuterated water.
Lumican is a marker indicative of hepatic fibrogenesis with its turnover assessed by Fractional Synthesis Rate (FSR). This innovative method of metabolic labelling is based on the concept that liver status could be determined by measuring the ratio of newly synthesized/pre-existing proteins. The turnover rate of newly synthesized collagen and proteins represents the hepatic fibrogenic disease activity.
Patients were given "heavy water" to drink. Heavy water contains D20, deuterium being a stable isotope of hydrogen. Mass spectrometry was used to identify individual proteins and to quantify the ratio of labeled protein to total protein.
Time frame: From baseline to end of treatment (Visit 10, Week 24 or early termination)
Change in transforming growth factor beta-induced-protein (TGFBI) Fractional Synthesis Rate (FSR) from baseline to end of treatment evaluated through the use of deuterated water.
TGFBI is a marker indicative of hepatic fibrogenesis with its turnover assessed by FSR.
This innovative method of metabolic labelling is based on the concept that liver status could be determined by measuring the ratio of newly synthesized/pre-existing proteins. The turnover rate of newly synthesized collagen and proteins represents the hepatic fibrogenic disease activity.
Patients were given "heavy water" to drink. Heavy water contains D20, deuterium being a stable isotope of hydrogen. Mass spectrometry was used to identify individual proteins and to quantify the ratio of labeled protein to total protein. The results were expressed as FSR of these proteins.
Time frame: From baseline to end of treatment (Visit 10, Week 24 or early termination)
Percent Change in transforming growth factor beta-induced protein (TGFBI) FSR from baseline to end of treatment evaluated through the use of deuterated water.
TGFBI is a marker indicative of hepatic fibrogenesis with its turnover assessed by Fractional Synthesis Rate (FSR).
This innovative method of metabolic labelling is based on the concept that liver status could be determined by measuring the ratio of newly synthesized/pre-existing proteins. The turnover rate of newly synthesized collagen and proteins represents the hepatic fibrogenic disease activity.
Patients were given "heavy water" to drink. Heavy water contains D20, deuterium being a stable isotope of hydrogen. Mass spectrometry was used to identify individual proteins and to quantify the ratio of labeled protein to total protein. The results were expressed as FSR of these proteins.
Time frame: 24 weeks
FibroScan is a specialized ultrasound machine that measures fibrosis (scarring) and steatosis (fatty change) in the liver. It was required that each subject's FibroScan® assessments be done with the same type of probe at each study visit.
The CAP score is a measurement of fatty change in the liver, naming the steatosis grade. The CAP score is measured in decibels per meter (dB/m). It ranges from 100 to 400 dB/m. 100 to 237 dB/M indicates no hepatic steatosis, 238 to 260 dB/m indicates mild hepatic steatosis (steatosis S1), 260 to 290 dB/m indicates moderate steatosis (steatosis S2), and a CAP score greater than 290 dB/m indicates severe steatosis (steatosis S3).
Time frame: 24 weeks
FibroScan is a specialized ultrasound machine that measures fibrosis (scarring) and steatosis (fatty change) in the liver. It was required that each subject's FibroScan® assessments be done with the same type of probe at each study visit.
The CAP score is a measurement of fatty change in the liver, naming the steatosis grade.The CAP score is measured in decibels per meter (dB/m). It ranges from 100 to 400 dB/m. 100 to 237 dB/M indicates no hepatic steatosis, 238 to 260 dB/m indicates mild hepatic steatosis (steatosis S1), 260 to 290 dB/m indicates moderate steatosis (steatosis S2), and a CAP score greater than 290 dB/m indicates severe steatosis (steatosis S3).
Time frame: 24 weeks
FibroScan is a specialized ultrasound machine that measures fibrosis (scarring) and steatosis (fatty change) in the liver. It was required that each subject's FibroScan® assessments be done with the same type of probe at each study visit.
The fibrosis result is measured in kilopascals (kPa) It's normally between 2 and 6 kPa indicating the abscence of abscence of fibrosis (F0) or a potential fibrosis of stage 1 (F1). The highest possible result is 75 kPa indicating advanced liver fibrosis of stage 4 (F4).
Time frame: 24 weeks
FibroScan is a specialized ultrasound machine that measures fibrosis (scarring) and steatosis (fatty change) in the liver. It was required that each subject's FibroScan® assessments be done with the same type of probe at each study visit.
The fibrosis result is measured in kilopascals (kPa) It's normally between 2 and 6 kPa indicating the abscence of abscence of fibrosis (F0) or a potential fibrosis of stage 1 (F1). The highest possible result is 75 kPa indicating advanced liver fibrosis of stage 4 (F4).
Time frame: 12 weeks
Liver stiffness was assessed by MRE. It was recommended that each subject's radiological assessment was performed using the same procedure for each study visit.
Time frame: 12 weeks
Liver stiffness was assessed by MRE. It was recommended that each subject's radiological assessment was performed using the same procedure for each study visit.
Time frame: 24 weeks
Liver stiffness was assessed by MRE. It was recommended that each subject's radiological assessment was performed using the same procedure for each study visit.
Time frame: 24 weeks
Liver stiffness was assessed by MRE. It was recommended that each subject's radiological assessment was performed using the same procedure for each study visit.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples. ELF score is a continuous (not a categorical) variable with < 9.8 indicative of low risk of progression to cirrhosis and >=9.8 to >11.3 indicative of mid-risk and >=11.30 indicative of higher risk
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples. ELF score is a continuous (not a categorical) variable with < 9.8 indicative of low risk of progression to cirrhosis and >=9.8 to >11.3 indicative of mid-risk and >=11.30 indicative of higher risk.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples. ELF score is a continuous (not a categorical) variable with < 9.8 indicative of low risk of progression to cirrhosis and >=9.8 to >11.3 indicative of mid-risk and >=11.30 indicative of higher risk.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples. ELF score is a continuous (not a categorical) variable with < 9.8 indicative of low risk of progression to cirrhosis and >=9.8 to >11.3 indicative of mid-risk and >=11.30 indicative of higher risk.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
The Full Analysis Set consisted of all patients who met the eligibility criteria and enrolled into the study (Visit 1 Day 1).
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 24 weeks
Non-invasive Fibrosis Biomarkers were assessed in blood samples.
Time frame: 12 weeks
NAFLD NFS : < -1.5 for low probability of fibrosis, > -1.5 to < 0.67 for intermediate probability of fibrosis, and > 0.67 for high probability of fibrosis.
Time frame: 12 weeks
NAFLD NFS : < -1.5 for low probability of fibrosis, > -1.5 to < 0.67 for intermediate probability of fibrosis, and > 0.67 for high probability of fibrosis.
Time frame: 24 weeks
NAFLD NFS : < -1.5 for low probability of fibrosis, > -1.5 to < 0.67 for intermediate probability of fibrosis, and > 0.67 for high probability of fibrosis.
Time frame: 24 weeks
NAFLD NFS : < -1.5 for low probability of fibrosis, > -1.5 to < 0.67 for intermediate probability of fibrosis, and > 0.67 for high probability of fibrosis.
Time frame: 12 weeks
Fibrosis-4 score : FIB4 < 1.3 is not consistent with F3-F6 disease. FIB4 of 1.3 to <2.67 is indeterminate for F3-F6 disease. > 2.67 is consistent F3 to F6.
Time frame: 12 weeks
Fibrosis-4 score : FIB4 < 1.3 is not consistent with F3-F6 disease. FIB4 of 1.3 to <2.67 is indeterminate for F3-F6 disease. > 2.67 is consistent F3 to F6.
Time frame: 24 weeks
Fibrosis-4 score : FIB4 < 1.3 is not consistent with F3-F6 disease. FIB4 of 1.3 to <2.67 is indeterminate for F3-F6 disease. > 2.67 is consistent F3 to F6.
Time frame: 24 weeks
Fibrosis-4 score : FIB4 < 1.3 is not consistent with F3-F6 disease. FIB4 of 1.3 to <2.67 is indeterminate for F3-F6 disease. > 2.67 is consistent F3 to F6.
Pinnacle Clinical Research, PLLC
Other
A Monocentric, Open-Label, Proof of Concept Study to Evaluate the Safety and Efficacy of Nitazoxanide at 500mg Twice Daily on Collagen Turnover in Plasma in NASH Patients With Fibrosis Stage 2 or 3
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.
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