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Study to Evaluate the Effect of Elafibranor on Hepatic Lipid Composition in Subjects With Nonalcoholic Fatty Liver (NAFL)

Primary Purpose

Non-Alcoholic Fatty Liver

Status
Terminated
Phase
Phase 2
Locations
Netherlands
Study Type
Interventional
Intervention
elafibranor 120mg
Placebo
Sponsored by
Genfit
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Alcoholic Fatty Liver focused on measuring Hepatic lipid composition, Elafibranor, Hepatic Glucose Production

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males or post-menopausal females aged from 40-75 years inclusive at first Screening Visit. (Post-menopausal defined as: subject should be surgically sterilized at least 6 months or no spontaneous menses for at least 1 year prior to screening)
  • Must provide signed written informed consent and agrees to comply with the study protocol.
  • Liver fat percentage ≥ 5 percent (as measured with Magnetic Resonance Spectroscopy)
  • 25.0 ≤ BMI ≤ 38.0 kg/m^2
  • Stable dietary habits and physical activity pattern (over 3 months prior to Screening Visit)
  • Subject agrees not to change dietary habits and physical activity pattern, to follow diet and lifestyle recommendations and not to consume or use illicit drugs during the study up to end of treatment.

Exclusion Criteria:

Medical history:

  • Documented weight loss of more than 5 percent during the 6-month period prior to Screening Visit
  • Contra-indications for magnetic resonance imaging / spectroscopy
  • Known history of Type 1 and 2 diabetes
  • Known chronic heart failure (Grade I to IV of New York Heart Association classification)
  • History of clinically significant acute cardiac event within 6 months prior to Screening Visit such as: stroke, transient ischemic attack, or coronary heart disease (angina pectoris, myocardial infarction, revascularization procedures)
  • Uncontrolled hypertension despite optimal antihypertensive therapy
  • Other well documented causes of chronic liver disease according to standard diagnostic procedures.
  • Symptoms of clinical depression
  • Other concurrent medical (e.g., immunological, neoplastic, endocrine, hematological, gastrointestinal or neurological) or psychiatric condition, which, in the opinion of the Investigator, would place the subject at increased risk, preclude obtaining voluntary consent/assent or compliance with required study procedures, or would confound the objectives of study
  • Known hypersensitivity to the investigation product or any of its formulation excipients

Concomitant medications and lifestyle:

  • Fibrates are not permitted from 8 weeks before Screening up to end of treatment. Subjects taking statins or ezetimibe prior to Screening Visit 1 may participate if the dose has been stable for 3 months prior to Screening Visit 1 and no dose adjustments are anticipated
  • Currently taking drugs that can induce steatosis/steatohepatitis including, but not restricted to: corticosteroids (parenteral & oral chronic administration only), amiodarone (Cordarone), tamoxifen (Nolvadex), and methotrexate (Rheumatrex, Trexall), which are not permitted 30 days prior to Screening and up to end of treatment
  • Subjects receiving thiazolidinediones (glitazones [pioglitazone, rosiglitazone])
  • Currently taking any medication that could interfere with study medication absorption, distribution, metabolism, or excretion or could lead to induction or inhibition of microsomal enzymes, e.g., indomethacin, which are not permitted from Randomization until end of treatment
  • Any medication use known to interfere with glucose homeostasis/metabolism
  • Smoking
  • Current or recent history (<5years) of significant alcohol consumption. For men, significant consumption is typically defined as higher than 30 g pure alcohol per day. For women, it is typically defined as higher than 20 g pure alcohol per day
  • Subjects who have donated blood or blood products within the previous month prior to screening or who plan to donate blood or blood products at any time during the trial and in the month following the end of the study
  • Is participating in any other study and have received any other investigational drug or device within 30 days prior to Screening or are taking part in a non-medication study which, in the opinion of the Investigator, would interfere with study compliance or outcome assessments
  • Subjects who cannot be contacted in case of emergency

In addition to the above criteria, subject should not present any of the following biological exclusion criteria:

  • Positive anti-human immunodeficiency virus (HIV) antibody
  • Positive hepatitis B surface antigen
  • Positive hepatitis C Virus (HCV) antibody
  • Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >5 x upper limit of normal (ULN)
  • Conjugated bilirubin > 1.50mg/dL due to altered hepatic function Note: Gilbert Disease subjects are allowed into the study
  • International normalized ratio >1.40 due to altered hepatic function
  • Platelet count <100,000/mm^3 due to portal hypertension
  • Serum creatinine levels >1.53 mg/dL in males and >1.24 mg/dL in females
  • Significant renal disease, including nephritic syndrome, chronic kidney disease (defined as subjects with markers of kidney damage or estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m^2)
  • Unexplained serum creatine phosphokinase (CPK) >2 x ULN. In case of explained elevated CPK >2 x ULN, the measurement can be repeated prior to Randomization. In this case, retest should be performed within 1 to 2 weeks after initial test. A CPK retest >2 x ULN leads to exclusion
  • Hemoglobin A1c (HbA1C) > 6.4% and/or fasting plasma glucose (FGP) > 126 mg/dl

Sites / Locations

  • NUTRIM School of Nutrition and Translational Research in Metabolism

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

elafibranor 120mg followed by placebo

placebo followed by elafibranor 120mg

Arm Description

Participants will first receive elafibranor 120mg for 6 weeks. After a washout period of 4-6 weeks, they will then receive placebo for 6 weeks

Participants will first receive placebo for 6 weeks. After a washout period of 4-6 weeks, they will then receive elafibranor 120mg for 6 weeks

Outcomes

Primary Outcome Measures

Change in relative amount of saturated fatty acids in the liver
Relative amount of saturated fatty acids (SFA) in the liver measured by Magnetic Resonance Spectroscopy (1H-MRS) at the end of 6 weeks treatment period

Secondary Outcome Measures

Change in hepatic insulin sensitivity
Hepatic insulin sensitivity measured by Hepatic Glucose Production (HGP) at the end of 6 weeks treatment period
Glucose homeostasis markers
Fasting glycemia
Glucose homeostasis markers
HbA1c
Glucose homeostasis markers
Fasting insulinemia
Glucose homeostasis markers
C-peptide
Glucose homeostasis markers
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index
Glucose homeostasis markers
Fructosamine
Lipid metabolism markers
Triglycerides (TG)
Lipid metabolism markers
Total cholesterol (TC)
Lipid metabolism markers
High density lipoprotein-cholesterol (HDL-C)
Lipid metabolism markers
Low density lipoprotein-cholesterol (LDL-C)
Lipid metabolism markers
Non-HDL-C
Lipid metabolism markers
Free fatty acid (FFA)
Inflammatory markers
High sensitivity C-reactive protein (hs-CRP)
Inflammatory markers
Fibrinogen
Inflammatory markers
Haptoglobin
Liver function
Alanine aminotransferase (ALT)
Liver function
Aspartate aminotransferase (AST)
Liver function
Gamma glutamyl transferase (GGT)
Liver function
Alkaline phosphatase (ALP)
Liver function
Total and conjugated bilirubin
Renal function
Creatinine
Renal function
Estimated glomerular filtration rate (using Modification of Diet in Renal Disease (MDRD) formula)
Renal function
Blood urea nitrogen
Renal function
Albumin
Renal function
Uric acid
Renal function
Total proteins
Body weight
Body Mass Index
Waist circumference
Incidence and severity of treatment emergent adverse events (TEAEs) and their relationship to study drug
Incidence of clinically meaningful changes from baseline in safety laboratory parameters, and vital signs

Full Information

First Posted
May 15, 2019
Last Updated
August 27, 2020
Sponsor
Genfit
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1. Study Identification

Unique Protocol Identification Number
NCT03953456
Brief Title
Study to Evaluate the Effect of Elafibranor on Hepatic Lipid Composition in Subjects With Nonalcoholic Fatty Liver (NAFL)
Official Title
A Double-Blind, Placebo-Controlled, Cross-over Phase II Study to Evaluate the Effect of a 6-week Elafibranor (120mg) Treatment Administered Once Daily on Hepatic Lipid Composition in Subjects With Nonalcoholic Fatty Liver (NAFL)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Terminated
Why Stopped
Continuation of the trial cannot serve a scientific purpose
Study Start Date
August 16, 2019 (Actual)
Primary Completion Date
March 11, 2020 (Actual)
Study Completion Date
July 14, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genfit

4. Oversight

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

5. Study Description

Brief Summary
This randomized, double-blind, cross-over (placebo or elafibranor [GFT505]) placebo-controlled study, will evaluate the effect on hepatic lipid composition and safety of elafibranor 120 mg quaque die (QD) versus placebo in an adult NAFL population after 6 weeks of treatment with a 4-week wash-out period. This study will achieve mechanistic information about the mode of action of Elafibranor on the (lipid) metabolism in the human fatty liver

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Alcoholic Fatty Liver
Keywords
Hepatic lipid composition, Elafibranor, Hepatic Glucose Production

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Model Description
Randomized, double-blind, cross-over (placebo or elafibranor [GFT505]) placebo-controlled study
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
The Investigator, subject, and study personnel will be blinded to the treatment. Identification numbers will be assigned to a subject at the Screening Visit. Upon completion of the Screening Visits, eligible subjects will be randomly assigned to Sequence Group A or Group B, defining the order of treatments.
Allocation
Randomized
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
elafibranor 120mg followed by placebo
Arm Type
Experimental
Arm Description
Participants will first receive elafibranor 120mg for 6 weeks. After a washout period of 4-6 weeks, they will then receive placebo for 6 weeks
Arm Title
placebo followed by elafibranor 120mg
Arm Type
Placebo Comparator
Arm Description
Participants will first receive placebo for 6 weeks. After a washout period of 4-6 weeks, they will then receive elafibranor 120mg for 6 weeks
Intervention Type
Drug
Intervention Name(s)
elafibranor 120mg
Other Intervention Name(s)
GFT505
Intervention Description
elafibranor 120mg is a coated tablet for oral administration, once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo is a coated tablet for oral administration, once daily
Primary Outcome Measure Information:
Title
Change in relative amount of saturated fatty acids in the liver
Description
Relative amount of saturated fatty acids (SFA) in the liver measured by Magnetic Resonance Spectroscopy (1H-MRS) at the end of 6 weeks treatment period
Time Frame
After 6 weeks
Secondary Outcome Measure Information:
Title
Change in hepatic insulin sensitivity
Description
Hepatic insulin sensitivity measured by Hepatic Glucose Production (HGP) at the end of 6 weeks treatment period
Time Frame
After 6 weeks
Title
Glucose homeostasis markers
Description
Fasting glycemia
Time Frame
After 6 weeks
Title
Glucose homeostasis markers
Description
HbA1c
Time Frame
After 6 weeks
Title
Glucose homeostasis markers
Description
Fasting insulinemia
Time Frame
After 6 weeks
Title
Glucose homeostasis markers
Description
C-peptide
Time Frame
After 6 weeks
Title
Glucose homeostasis markers
Description
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index
Time Frame
After 6 weeks
Title
Glucose homeostasis markers
Description
Fructosamine
Time Frame
After 6 weeks
Title
Lipid metabolism markers
Description
Triglycerides (TG)
Time Frame
After 6 weeks
Title
Lipid metabolism markers
Description
Total cholesterol (TC)
Time Frame
After 6 weeks
Title
Lipid metabolism markers
Description
High density lipoprotein-cholesterol (HDL-C)
Time Frame
After 6 weeks
Title
Lipid metabolism markers
Description
Low density lipoprotein-cholesterol (LDL-C)
Time Frame
After 6 weeks
Title
Lipid metabolism markers
Description
Non-HDL-C
Time Frame
After 6 weeks
Title
Lipid metabolism markers
Description
Free fatty acid (FFA)
Time Frame
After 6 weeks
Title
Inflammatory markers
Description
High sensitivity C-reactive protein (hs-CRP)
Time Frame
After 6 weeks
Title
Inflammatory markers
Description
Fibrinogen
Time Frame
After 6 weeks
Title
Inflammatory markers
Description
Haptoglobin
Time Frame
After 6 weeks
Title
Liver function
Description
Alanine aminotransferase (ALT)
Time Frame
After 6 weeks
Title
Liver function
Description
Aspartate aminotransferase (AST)
Time Frame
After 6 weeks
Title
Liver function
Description
Gamma glutamyl transferase (GGT)
Time Frame
After 6 weeks
Title
Liver function
Description
Alkaline phosphatase (ALP)
Time Frame
After 6 weeks
Title
Liver function
Description
Total and conjugated bilirubin
Time Frame
After 6 weeks
Title
Renal function
Description
Creatinine
Time Frame
After 6 weeks
Title
Renal function
Description
Estimated glomerular filtration rate (using Modification of Diet in Renal Disease (MDRD) formula)
Time Frame
After 6 weeks
Title
Renal function
Description
Blood urea nitrogen
Time Frame
After 6 weeks
Title
Renal function
Description
Albumin
Time Frame
After 6 weeks
Title
Renal function
Description
Uric acid
Time Frame
After 6 weeks
Title
Renal function
Description
Total proteins
Time Frame
After 6 weeks
Title
Body weight
Time Frame
After 6 weeks
Title
Body Mass Index
Time Frame
After 6 weeks
Title
Waist circumference
Time Frame
After 6 weeks
Title
Incidence and severity of treatment emergent adverse events (TEAEs) and their relationship to study drug
Time Frame
After 6 weeks
Title
Incidence of clinically meaningful changes from baseline in safety laboratory parameters, and vital signs
Time Frame
After 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or post-menopausal females aged from 40-75 years inclusive at first Screening Visit. (Post-menopausal defined as: subject should be surgically sterilized at least 6 months or no spontaneous menses for at least 1 year prior to screening) Must provide signed written informed consent and agrees to comply with the study protocol. Liver fat percentage ≥ 5 percent (as measured with Magnetic Resonance Spectroscopy) 25.0 ≤ BMI ≤ 38.0 kg/m^2 Stable dietary habits and physical activity pattern (over 3 months prior to Screening Visit) Subject agrees not to change dietary habits and physical activity pattern, to follow diet and lifestyle recommendations and not to consume or use illicit drugs during the study up to end of treatment. Exclusion Criteria: Medical history: Documented weight loss of more than 5 percent during the 6-month period prior to Screening Visit Contra-indications for magnetic resonance imaging / spectroscopy Known history of Type 1 and 2 diabetes Known chronic heart failure (Grade I to IV of New York Heart Association classification) History of clinically significant acute cardiac event within 6 months prior to Screening Visit such as: stroke, transient ischemic attack, or coronary heart disease (angina pectoris, myocardial infarction, revascularization procedures) Uncontrolled hypertension despite optimal antihypertensive therapy Other well documented causes of chronic liver disease according to standard diagnostic procedures. Symptoms of clinical depression Other concurrent medical (e.g., immunological, neoplastic, endocrine, hematological, gastrointestinal or neurological) or psychiatric condition, which, in the opinion of the Investigator, would place the subject at increased risk, preclude obtaining voluntary consent/assent or compliance with required study procedures, or would confound the objectives of study Known hypersensitivity to the investigation product or any of its formulation excipients Concomitant medications and lifestyle: Fibrates are not permitted from 8 weeks before Screening up to end of treatment. Subjects taking statins or ezetimibe prior to Screening Visit 1 may participate if the dose has been stable for 3 months prior to Screening Visit 1 and no dose adjustments are anticipated Currently taking drugs that can induce steatosis/steatohepatitis including, but not restricted to: corticosteroids (parenteral & oral chronic administration only), amiodarone (Cordarone), tamoxifen (Nolvadex), and methotrexate (Rheumatrex, Trexall), which are not permitted 30 days prior to Screening and up to end of treatment Subjects receiving thiazolidinediones (glitazones [pioglitazone, rosiglitazone]) Currently taking any medication that could interfere with study medication absorption, distribution, metabolism, or excretion or could lead to induction or inhibition of microsomal enzymes, e.g., indomethacin, which are not permitted from Randomization until end of treatment Any medication use known to interfere with glucose homeostasis/metabolism Smoking Current or recent history (<5years) of significant alcohol consumption. For men, significant consumption is typically defined as higher than 30 g pure alcohol per day. For women, it is typically defined as higher than 20 g pure alcohol per day Subjects who have donated blood or blood products within the previous month prior to screening or who plan to donate blood or blood products at any time during the trial and in the month following the end of the study Is participating in any other study and have received any other investigational drug or device within 30 days prior to Screening or are taking part in a non-medication study which, in the opinion of the Investigator, would interfere with study compliance or outcome assessments Subjects who cannot be contacted in case of emergency In addition to the above criteria, subject should not present any of the following biological exclusion criteria: Positive anti-human immunodeficiency virus (HIV) antibody Positive hepatitis B surface antigen Positive hepatitis C Virus (HCV) antibody Aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) >5 x upper limit of normal (ULN) Conjugated bilirubin > 1.50mg/dL due to altered hepatic function Note: Gilbert Disease subjects are allowed into the study International normalized ratio >1.40 due to altered hepatic function Platelet count <100,000/mm^3 due to portal hypertension Serum creatinine levels >1.53 mg/dL in males and >1.24 mg/dL in females Significant renal disease, including nephritic syndrome, chronic kidney disease (defined as subjects with markers of kidney damage or estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m^2) Unexplained serum creatine phosphokinase (CPK) >2 x ULN. In case of explained elevated CPK >2 x ULN, the measurement can be repeated prior to Randomization. In this case, retest should be performed within 1 to 2 weeks after initial test. A CPK retest >2 x ULN leads to exclusion Hemoglobin A1c (HbA1C) > 6.4% and/or fasting plasma glucose (FGP) > 126 mg/dl
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pascal Birman, MD
Organizational Affiliation
Genfit
Official's Role
Study Director
Facility Information:
Facility Name
NUTRIM School of Nutrition and Translational Research in Metabolism
City
Maastricht
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Study to Evaluate the Effect of Elafibranor on Hepatic Lipid Composition in Subjects With Nonalcoholic Fatty Liver (NAFL)

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