An Open-Label Study to Assess the Hepatic Protection Effect of SNP-612, in Patients With NAFLD
Primary Purpose
NASH - Nonalcoholic Steatohepatitis
Status
Terminated
Phase
Phase 2
Locations
Taiwan
Study Type
Interventional
Intervention
SNP-612 dose1
SNP-612 dose2
Sponsored by
About this trial
This is an interventional treatment trial for NASH - Nonalcoholic Steatohepatitis
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 agentagent administration.
Phenotypic diagnosis of NASH based on one or more of the following:
- Alanine aminotransferase (ALT) levels ≥ 1.5x upper limit of normal (ULN) on at least two occasions, seven or more days apart, prior to study agent administration
- ALT ≥ ULN on at least two occasions, seven or more days apart, prior to study agent administration AND body mass index (BMI) ≥ 25 AND diagnosis of Type 2 DM
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:
Subjects who meet any of the following criteria are not eligible to enter the study:
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 > ULN, or ALT or AST > 5 x ULN, or Alkaline phosphatase (ALP) > 2x 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-612 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.
- Pregnant or lactating
- Female of child-bearing potential who are not committed to taking reliable contraception during the participation of the study and at least 4 weeks after the end of the study treatment
Sites / Locations
- Tri-Service General Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
SNP-612 dose1
SNP-612 dose2
Arm Description
dose1 once a day orally for 12 weeks
dose2 once a day orally for 12 weeks
Outcomes
Primary Outcome Measures
Change in serum ALT
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Secondary Outcome Measures
Change in serum AST
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Change in serum Alk-P
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Change in serum γ-GT
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Change in GSP
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Change in liver fat content as measured by liver fat fraction (FF) with magnetic resonance imaging method.
A non-invasive method will be utilized to estimate liver fat content (%) by MRI calculated liver FF.
Change in serum CK-18 fragment levels
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Rate of AE/SAE
Rate of patients who experience AE/SAE at end of treatment
Rate of AEs leading to discontinuation at end of treatment
Rate of patients who experience AEs leading to discontinuation at end of treatment
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03868566
Brief Title
An Open-Label Study to Assess the Hepatic Protection Effect of SNP-612, in Patients With NAFLD
Official Title
An Open-Label Study to Assess the Hepatic Protection Effect of a Food Supplement Product, SNP-612, in Patients With Non-alcoholic Fatty Liver Disease
Study Type
Interventional
2. Study Status
Record Verification Date
January 2023
Overall Recruitment Status
Terminated
Why Stopped
recruitment difficulties due to Covid-19
Study Start Date
August 4, 2017 (Actual)
Primary Completion Date
September 22, 2021 (Actual)
Study Completion Date
October 19, 2021 (Actual)
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
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The primary objective of the study is to compare the changes in ALT to baseline among patients with non-alcoholic fatty liver disease (NAFLD) following the 3-month treatment of 3 different dosing regimens of SNP-612. The secondary objectives will be to compare the changes in other liver function tests, cytokeratin-18 (CK-18) fragment level and adverse event / serious adverse event rates.
Detailed Description
An open-label study will be conducted in medical centers around Taiwan. The objective of the study is to investigate the efficacy and safety of SNP-612 for the treatment of NAFLD.
Subjects who fulfill all the entry criteria and have written informed consent will be enrolled to the study. Considering a 10% drop-out rate, approximately 72 subjects will be enrolled in order to recruit 64 evaluable subject subjects to complete the enrollment.
Subjects will be administered the study agents 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 compared to baseline. With 64 evaluable patients, there will be an 80% chance of detecting a significant difference at a two sided 0.05 significance level.
Subjects who finish treatment or discontinue prematurely from the study for any reason after receiving one or more doses of study agent will be assessed for safety for 2 (±1) weeks after the last study agent 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
Experimental: SNP-612 dose1 Experimental: SNP-612 dose2
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
90 (Actual)
8. Arms, Groups, and Interventions
Arm Title
SNP-612 dose1
Arm Type
Experimental
Arm Description
dose1 once a day orally for 12 weeks
Arm Title
SNP-612 dose2
Arm Type
Experimental
Arm Description
dose2 once a day orally for 12 weeks
Intervention Type
Drug
Intervention Name(s)
SNP-612 dose1
Intervention Description
Subjects will take dose1 once a day orally for 12 weeks
Intervention Type
Drug
Intervention Name(s)
SNP-612 dose2
Intervention Description
Subjects will take dose2 once a day orally for 12 weeks
Primary Outcome Measure Information:
Title
Change in serum ALT
Description
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change in serum AST
Description
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Time Frame
12 weeks
Title
Change in serum Alk-P
Description
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Time Frame
12 weeks
Title
Change in serum γ-GT
Description
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Time Frame
12 weeks
Title
Change in GSP
Description
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Time Frame
12 weeks
Title
Change in liver fat content as measured by liver fat fraction (FF) with magnetic resonance imaging method.
Description
A non-invasive method will be utilized to estimate liver fat content (%) by MRI calculated liver FF.
Time Frame
12 weeks
Title
Change in serum CK-18 fragment levels
Description
A reduction from baseline (i.e. a negative percent value) indicates an improvement in condition
Time Frame
12 weeks
Title
Rate of AE/SAE
Description
Rate of patients who experience AE/SAE at end of treatment
Time Frame
12 weeks
Title
Rate of AEs leading to discontinuation at end of treatment
Description
Rate of patients who experience AEs leading to discontinuation at end of treatment
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
Change in serum at Week 12
Time Frame
12 weeks
Title
Low density lipoprotein
Description
Change in serum at Week 12
Time Frame
12 weeks
Title
Total cholesterol
Description
Change in serum at Week 12
Time Frame
12 weeks
Title
High density lipoprotein
Description
Change 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
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 agentagent administration.
Phenotypic diagnosis of NASH based on one or more of the following:
Alanine aminotransferase (ALT) levels ≥ 1.5x upper limit of normal (ULN) on at least two occasions, seven or more days apart, prior to study agent administration
ALT ≥ ULN on at least two occasions, seven or more days apart, prior to study agent administration AND body mass index (BMI) ≥ 25 AND diagnosis of Type 2 DM
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:
Subjects who meet any of the following criteria are not eligible to enter the study:
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 > ULN, or ALT or AST > 5 x ULN, or Alkaline phosphatase (ALP) > 2x 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-612 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.
Pregnant or lactating
Female of child-bearing potential who are not committed to taking reliable contraception during the participation of the study and at least 4 weeks after the end of the study treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yu-Lueng Shih, MD,PhD
Organizational Affiliation
Tri-Service General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tri-Service General Hospital
City
Taipei
ZIP/Postal Code
114
Country
Taiwan
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
An Open-Label Study to Assess the Hepatic Protection Effect of SNP-612, in Patients With NAFLD
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