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A Randomized, Double-Blind, Placebo Controlled Study to Assess the Efficacy and Safety of SNP-610 for the Treatment of Patients With Non-alcoholic Steatohepatitis

Primary Purpose

NASH - Nonalcoholic Steatohepatitis

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
SNP-610
Placebo Oral Tablet
Sponsored by
Sinew Pharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for NASH - Nonalcoholic Steatohepatitis

Eligibility Criteria

20 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age ≥ 20 years
  2. Body weight ≥ 54 kg
  3. Diagnosis of non-alcoholic steatohepatitis (NASH) as evidenced by imaging or other diagnostic assessments. Subject should have documented liver fat content ≥ 10.0 % as measured by MRI method prior to study drug administration.
  4. Alanine aminotransferase (ALT) levels ≥ 2.0x upper limit of normal (ULN) on at least two occasions, seven or more days apart, prior to study drug administration
  5. Have adequate organ functions as defined by the following examinations prior to the start of study treatment:

    1. Hematology: Hemoglobin ≥ 9 g/dL, a platelet count ≥ 100 x 10^9/L, and a white blood cell count ≥ 3.0 x 10^9/L
    2. Renal: creatinine clearance ≥ 90 mL/min (by Cockcroft-Gault equation), serum uric acid < 9.0 mg/dL
  6. Able to provide written informed consent, and understand and comply with the requirements of the study

Exclusion Criteria:

  1. Decompensated or severe liver disease as evidenced by one or more of the following:

    1. Confirmed cirrhosis or suspicion of cirrhosis
    2. Liver transplant
    3. Liver malignancy
    4. Ascites
    5. Bilirubin >2 x ULN, or ALT or AST > 10 x ULN
    6. Acute or chronic hepatitis A, B, C, HIV, or other liver diseases affecting liver function.

    Patients with cysts, hemangiomas, or similar abnormalities, are accepted.

  2. History or presence of alcohol abuse, defined as consumption of more than 210 mL of alcohol per week (the equivalent of 14 glasses of 120-mL wine or 14 cans of 350-mL beer), or other substance abuse within the prior two years
  3. Subjects who are unable to undergo an MRI scan.
  4. Subjects have electronically, magnetically and mechanically activated implanted devices, including but not limited to automatic cardioverter defibrillators, cardiac pacemakers, insulin pumps, metallic splinters in the eye, ferromagnetic haemostatic clips in central nervous systems or vascular vessels.
  5. Significant systemic or major illness other than liver disease, including auto-immune disease, coronary artery disease, cerebrovascular disease, malignant neoplasms, pulmonary disease, renal insufficiency, serious psychiatric disease, and/or other serious disease, that, in the opinion of the Investigator would preclude the subject from participating in and completing the study
  6. Documented history of serious allergic reaction to SNP-610 or any structurally related compounds
  7. Diabetic patients who have not maintained a stable dose of oral medication for hyperglycemia or have had more than 10 percent change in their insulin dose over the past two months
  8. Regular use of agents that are potent against hepatitis or affecting lipid metabolisms, including but not limited to HMGCoA reductase inhibitors (statins), fibrates, silymarin, N-acetylcysteine, or anti-TNF therapies.

    Note: refer to Section 6.5 Prohibited agents for details.

  9. Pregnant or lactating
  10. Female of child-bearing potential who are not committed to take reliable contraception during the participation of the study and at least 4 weeks after the end of the study treatment

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    test drug

    placebo

    Arm Description

    2 tabs of SNP-610

    2 tabs of placebo

    Outcomes

    Primary Outcome Measures

    Alanine aminotransferase
    Absolute change from baseline in serum alanine aminotransferase (ALT/GPT)

    Secondary Outcome Measures

    MRI liver FF
    Absolute change from baseline in liver fat content
    MRI liver FF
    Relative change from baseline in liver fat content
    Aspartate aminotransferase
    Change in serum level at 12 weeks
    Alkaline phosphatase
    Change in serum level at 12 weeks
    Gamma-glutamyl transpeptidase
    Change in serum level at 12 weeks
    Total bilirubin
    Change in serum level at 12 weeks
    Galactose single point
    Change in serum level at 12 weeks
    CK-18
    Change in serum level at 12 weeks

    Full Information

    First Posted
    March 6, 2018
    Last Updated
    April 28, 2023
    Sponsor
    Sinew Pharma Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03468556
    Brief Title
    A Randomized, Double-Blind, Placebo Controlled Study to Assess the Efficacy and Safety of SNP-610 for the Treatment of Patients With Non-alcoholic Steatohepatitis
    Official Title
    A Randomized, Double-Blind, Placebo Controlled Study to Assess the Efficacy and Safety of SNP-610 for the Treatment of Patients With Non-alcoholic Steatohepatitis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    March 1, 2024 (Anticipated)
    Primary Completion Date
    December 30, 2024 (Anticipated)
    Study Completion Date
    December 30, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sinew Pharma Inc.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The primary objective of the study is to compare the changes in serum ALT level among patients with non-alcoholic steatohepatitis (NASH) following 3-month treatment of 800 mg SNP-610 or the placebo. The secondary objectives will be to compare the changes in liver fat fraction, other liver function tests, cytokeratin-18 (CK-18) fragment level and adverse event / serious adverse event rates among the interventional and placebo arms.
    Detailed Description
    A randomized, double-blind, placebo controlled study will be conducted in medical centers around Taiwan. The objective of the study is to investigate the efficacy and safety of SNP-610 for the treatment of NASH, assuming the treatment efficacy of the investigational product is superior to the placebo control. Subjects who fulfill all the entry criteria and have written informed consent will be enrolled to the study. Eligible subjects will be randomized in a 1:1 ratio to receive study drug or placebo control. Considering a 10% drop-out rate, approximately 80 subjects will be enrolled in order to recruit 70 evaluable subjects, each arm will be at least 35 evaluable subjects to complete the enrollment. Subjects will be administered the test drugs or placebo oral daily for 3 months or until treatment terminates prematurely. Subjects will return to the study center for clinical evaluation once every 4 weeks throughout the treatment period. Clinical assessment procedures and laboratory tests including ultrasound imaging, hematology with differential, biochemistry, liver function panel, and urinalysis, will be performed at each study visit. The primary endpoint assessment will be the reduction of ALT at completion of Week 12 treatment. Subjects who finish treatment or discontinue prematurely from the study for any reason after receiving one or more doses of study drug will be assessed for safety for 2 (±1) weeks after the last study drug dose or longer in the case of any significant AE or abnormal biochemical or clinical finding. Each subject will participate in the study for approximately 14 weeks (including the enrollment/baseline visit, 3 routine monthly visits during treatment period, and 1 follow-up visit after 2 weeks of the end of treatment). It is assumed the study will include a 6 months enrollment period and a further 4 months to complete the follow-up for all enrolled patients.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    NASH - Nonalcoholic Steatohepatitis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    test drug
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Masking Description
    placebo
    Allocation
    Randomized
    Enrollment
    80 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    test drug
    Arm Type
    Experimental
    Arm Description
    2 tabs of SNP-610
    Arm Title
    placebo
    Arm Type
    Placebo Comparator
    Arm Description
    2 tabs of placebo
    Intervention Type
    Drug
    Intervention Name(s)
    SNP-610
    Intervention Description
    Subjects will take 2 tablets once a day orally for 12 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo Oral Tablet
    Intervention Description
    Subjects will take 2 tablets once a day orally for 12 weeks
    Primary Outcome Measure Information:
    Title
    Alanine aminotransferase
    Description
    Absolute change from baseline in serum alanine aminotransferase (ALT/GPT)
    Time Frame
    12 weeks
    Secondary Outcome Measure Information:
    Title
    MRI liver FF
    Description
    Absolute change from baseline in liver fat content
    Time Frame
    12 weeks
    Title
    MRI liver FF
    Description
    Relative change from baseline in liver fat content
    Time Frame
    12 weeks
    Title
    Aspartate aminotransferase
    Description
    Change in serum level at 12 weeks
    Time Frame
    12 weeks
    Title
    Alkaline phosphatase
    Description
    Change in serum level at 12 weeks
    Time Frame
    12 weeks
    Title
    Gamma-glutamyl transpeptidase
    Description
    Change in serum level at 12 weeks
    Time Frame
    12 weeks
    Title
    Total bilirubin
    Description
    Change in serum level at 12 weeks
    Time Frame
    12 weeks
    Title
    Galactose single point
    Description
    Change in serum level at 12 weeks
    Time Frame
    12 weeks
    Title
    CK-18
    Description
    Change in serum level at 12 weeks
    Time Frame
    12 weeks
    Other Pre-specified Outcome Measures:
    Title
    Insulin resistance
    Description
    Change in insulin resistance at Week 12
    Time Frame
    12 weeks
    Title
    Triglycerides
    Description
    Changes in serum at Week 12
    Time Frame
    12 weeks
    Title
    Low density lipoprotein
    Description
    Changes in serum at Week 12
    Time Frame
    12 weeks
    Title
    Total cholesterol
    Description
    Changes in serum at Week 12
    Time Frame
    12 weeks
    Title
    High density lipoprotein
    Description
    Changes in serum at Week 12
    Time Frame
    12 weeks
    Title
    Gene expression biomarkers
    Description
    Gene expression biomarkers (ACC1, Adfp, AOX, Cat, CCL20, CCR2, Cpt1α, CYP2E1, CYP4A11, CYP7A, Dgat1, Dgat2, FAS, Gapdh, Gpx1, Gpx2, Gpx3, Gpx4, GSS, Hadh, Ho1, HSL, IL-10, IL-1β, IL-6, iNOS, LCAD, NF-κB1, NF-κB2, Pparα, PPARβ/δ, PPARγ, SCD-1, Sod1, Sod2, Sod3, SREBP-1c, TGFβ, TLR4, TNFα, Ucp2, VLCAD, α-SMA, β-actin) related to NASH changes in blood at Week 12
    Time Frame
    12 weeks
    Title
    Rate of patients who experience AEs leading to discontinuation at end of treatment
    Time Frame
    12 weeks
    Title
    Rate of patients who experience AE/SAE at end of treatment
    Time Frame
    12 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    20 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age ≥ 20 years Body weight ≥ 54 kg Diagnosis of non-alcoholic steatohepatitis (NASH) as evidenced by imaging or other diagnostic assessments. Subject should have documented liver fat content ≥ 10.0 % as measured by MRI method prior to study drug administration. Alanine aminotransferase (ALT) levels ≥ 2.0x upper limit of normal (ULN) on at least two occasions, seven or more days apart, prior to study drug administration Have adequate organ functions as defined by the following examinations prior to the start of study treatment: Hematology: Hemoglobin ≥ 9 g/dL, a platelet count ≥ 100 x 10^9/L, and a white blood cell count ≥ 3.0 x 10^9/L Renal: creatinine clearance ≥ 90 mL/min (by Cockcroft-Gault equation), serum uric acid < 9.0 mg/dL Able to provide written informed consent, and understand and comply with the requirements of the study Exclusion Criteria: Decompensated or severe liver disease as evidenced by one or more of the following: Confirmed cirrhosis or suspicion of cirrhosis Liver transplant Liver malignancy Ascites Bilirubin >2 x ULN, or ALT or AST > 10 x ULN Acute or chronic hepatitis A, B, C, HIV, or other liver diseases affecting liver function. Patients with cysts, hemangiomas, or similar abnormalities, are accepted. History or presence of alcohol abuse, defined as consumption of more than 210 mL of alcohol per week (the equivalent of 14 glasses of 120-mL wine or 14 cans of 350-mL beer), or other substance abuse within the prior two years Subjects who are unable to undergo an MRI scan. Subjects have electronically, magnetically and mechanically activated implanted devices, including but not limited to automatic cardioverter defibrillators, cardiac pacemakers, insulin pumps, metallic splinters in the eye, ferromagnetic haemostatic clips in central nervous systems or vascular vessels. Significant systemic or major illness other than liver disease, including auto-immune disease, coronary artery disease, cerebrovascular disease, malignant neoplasms, pulmonary disease, renal insufficiency, serious psychiatric disease, and/or other serious disease, that, in the opinion of the Investigator would preclude the subject from participating in and completing the study Documented history of serious allergic reaction to SNP-610 or any structurally related compounds Diabetic patients who have not maintained a stable dose of oral medication for hyperglycemia or have had more than 10 percent change in their insulin dose over the past two months Regular use of agents that are potent against hepatitis or affecting lipid metabolisms, including but not limited to HMGCoA reductase inhibitors (statins), fibrates, silymarin, N-acetylcysteine, or anti-TNF therapies. Note: refer to Section 6.5 Prohibited agents for details. Pregnant or lactating Female of child-bearing potential who are not committed to take reliable contraception during the participation of the study and at least 4 weeks after the end of the study treatment
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Jia-Yu Hao, MS
    Phone
    +886-2788-5365
    Ext
    623
    Email
    ariel.hao@sinewpharma.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Chiao-Yi Tien, MS
    Phone
    +886-8792-3100
    Ext
    18863
    Email
    tcy@sinewpharma.com

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

    Learn more about this trial

    A Randomized, Double-Blind, Placebo Controlled Study to Assess the Efficacy and Safety of SNP-610 for the Treatment of Patients With Non-alcoholic Steatohepatitis

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