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THE FRENCH NATIONAL NAFLD COHORT (FRench pAtients With MEtabolic Steatosis) (FRAMES)

Primary Purpose

NAFLD, NASH, NASH - Nonalcoholic Steatohepatitis

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Biological specimens
Additional visit
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for NAFLD focused on measuring Cohort

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥18 years
  2. Patients with a confirmed diagnosis of NAFLD
  3. Patients affiliated to French social security
  4. Written informed consent signed by the patient

Exclusion Criteria:

  1. Refusal or inability (lack of capacity) to give informed consent.
  2. Average alcohol ingestion greater than 21/14 units/week (males/females) in the preceding 6 months or history of sustained excessive consumption of alcohol in past 5 years.
  3. History or presence of Type 1 diabetes mellitus.
  4. Presence of any other form of chronic liver disease except NAFLD
  5. Recent (within 12 months) or concomitant use of agents known to cause hepatic steatosis (long-term systemic corticosteroids [>10 days], amiodarone, methotrexate, tamoxifen, tetracycline, high dose oestrogens, valproic acid).
  6. Any contra-indication to liver biopsy.
  7. Recent (within 3 months) change in dose/regimen or introduction of Vitamin E (at a dose ≥400 IU/day), betaine, s-adenosyl methionine, ursodeoxycholic acid, silymarin or pentoxifylline.
  8. Non-French speaking/unable to access an interpreter.
  9. Patients judged by the investigator to be unsuitable for inclusion in the study (e.g. judged by the physician as unlikely to be compliant with the study protocol).
  10. Pregnant or breastfeeding women
  11. Patient under legal protection measure (tutorship or curatorship) and patient deprived of freedom

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Other

    Arm Label

    Patients

    Arm Description

    Patients with histologically confirmed NAFLD

    Outcomes

    Primary Outcome Measures

    Disease severity
    The disease severity defined by the fibrosis stage on liver biopsy according to the semi-quantitative histological classification of NASH CRN.

    Secondary Outcome Measures

    Ballooning grade
    Lobular inflammation
    Composite scores of Lobular inflammation (Ballooning and Inflammation)
    Steatohepatitis
    Presence or Absence
    Cirrhosis
    Cirrhosis defined by either : stage 4 of histological classification of fibrosis on liver biopsy or liver stiffness >14 kPa by elastometry
    Obesity
    Obesity defined by either : Increased waist circumference by ethnically adjusted criteria or BMI ≥25
    Type 2 diabetes
    Type 2 diabetes defined by Fasting glucose ≥100 mg/dL [5.6 mmol/L], HbA1c ≥48mmol/mol (6.5%) or previously diagnosed insulin resistance/type 2 diabetes mellitus (or on treatment).
    Dyslipidaemia
    Dyslipidaemia defined by fasting TG level ≥150 mg/dL [1.7mmol/L]; or fasting HDL <40 mg/dL [1.03 mmol/L] in males and <50 mg/dL [1.29 mmol/L] in females; or on treatment);
    Cardiovascular disease
    Cardiovascular disease defined by arterial hypertension (systolic BP ≥130 or diastolic BP ≥85 mmHg, or on antihypertensive treatment).
    Necroinflammation measured by the activities component of the SAF
    Necroinflammation measured by the activities component of the SAF classification : ranges 0 to 4 SAF : steatosis, activity, fibrosis
    Necroinflammation measured by the NAS score
    Necroinflammation measured by the NAS score : ranges from 0 to 8 NAS score : NAFLD Activity Score
    Fasting insulin
    Insulin sensitivity
    HOMA - %s

    Full Information

    First Posted
    February 24, 2021
    Last Updated
    June 7, 2021
    Sponsor
    Assistance Publique - Hôpitaux de Paris
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04925362
    Brief Title
    THE FRENCH NATIONAL NAFLD COHORT (FRench pAtients With MEtabolic Steatosis)
    Acronym
    FRAMES
    Official Title
    Identification of Clinical and Biological Factors Determining Disease Severity and Disease Progression in NAFLD: "THE FRENCH NATIONAL NAFLD COHORT" FRAMES (FRench pAtients With MEtabolic Steatosis)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2021
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 2021 (Anticipated)
    Primary Completion Date
    June 2036 (Anticipated)
    Study Completion Date
    June 2036 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Assistance Publique - Hôpitaux de Paris

    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
    The main objective of this cohort study is to determine genetic, clinical biologic and metabolic factors associated with patient heterogeneity in regards to severity of NAFLD at diagnosis as well as during the clinical course. at diagnosis, with the aim to better characterize patients of different severity and improve our understanding of clinical and histological heterogeneity at diagnosis during the clinical course to better understand and predict disease progression in terms notably of fibrosis progression and progression to cirrhosis
    Detailed Description
    Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome and is currently the most common cause of liver disease in many developed countries worldwide. The aim of the study is to improve the scientific knowledge on markers associated with disease severity and progression in NAFLD. The study is a multicentre French NAFLD cohort of well-characterized patients with biological samples covering the entire spectrum of NAFLD severity (steatosis, NASH, significant fibrosis, cirrhosis, hepatocellular carcinoma).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    NAFLD, NASH, NASH - Nonalcoholic Steatohepatitis, Fibrosis, Cirrhosis
    Keywords
    Cohort

    7. Study Design

    Primary Purpose
    Diagnostic
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    900 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Patients
    Arm Type
    Other
    Arm Description
    Patients with histologically confirmed NAFLD
    Intervention Type
    Other
    Intervention Name(s)
    Biological specimens
    Intervention Description
    Biological specimens are collected to better characterize patients of different severity and improve our understanding of clinical and histological heterogeneity at diagnosis : added for the research : blood, urine, stools collected for the research : liver tissue sample, if a liver biopsy is indicated for clinical reasons (standard of care)
    Intervention Type
    Other
    Intervention Name(s)
    Additional visit
    Intervention Description
    Visits if possible during standard care, otherwise added by the research (If necessary the annual visit will be added by research for the collection of biological samples)
    Primary Outcome Measure Information:
    Title
    Disease severity
    Description
    The disease severity defined by the fibrosis stage on liver biopsy according to the semi-quantitative histological classification of NASH CRN.
    Time Frame
    Change of the fibrosis stage from baseline to 10 years
    Secondary Outcome Measure Information:
    Title
    Ballooning grade
    Time Frame
    At baseline
    Title
    Lobular inflammation
    Description
    Composite scores of Lobular inflammation (Ballooning and Inflammation)
    Time Frame
    At baseline
    Title
    Steatohepatitis
    Description
    Presence or Absence
    Time Frame
    At baseline
    Title
    Cirrhosis
    Description
    Cirrhosis defined by either : stage 4 of histological classification of fibrosis on liver biopsy or liver stiffness >14 kPa by elastometry
    Time Frame
    Through study completion, an average of 10 years
    Title
    Obesity
    Description
    Obesity defined by either : Increased waist circumference by ethnically adjusted criteria or BMI ≥25
    Time Frame
    Change from baseline to 10 years
    Title
    Type 2 diabetes
    Description
    Type 2 diabetes defined by Fasting glucose ≥100 mg/dL [5.6 mmol/L], HbA1c ≥48mmol/mol (6.5%) or previously diagnosed insulin resistance/type 2 diabetes mellitus (or on treatment).
    Time Frame
    Change from baseline to 10 years
    Title
    Dyslipidaemia
    Description
    Dyslipidaemia defined by fasting TG level ≥150 mg/dL [1.7mmol/L]; or fasting HDL <40 mg/dL [1.03 mmol/L] in males and <50 mg/dL [1.29 mmol/L] in females; or on treatment);
    Time Frame
    Change from baseline to 10 years
    Title
    Cardiovascular disease
    Description
    Cardiovascular disease defined by arterial hypertension (systolic BP ≥130 or diastolic BP ≥85 mmHg, or on antihypertensive treatment).
    Time Frame
    Change from baseline to 10 years
    Title
    Necroinflammation measured by the activities component of the SAF
    Description
    Necroinflammation measured by the activities component of the SAF classification : ranges 0 to 4 SAF : steatosis, activity, fibrosis
    Time Frame
    Change from baseline to 10 years
    Title
    Necroinflammation measured by the NAS score
    Description
    Necroinflammation measured by the NAS score : ranges from 0 to 8 NAS score : NAFLD Activity Score
    Time Frame
    Change from baseline to 10 years
    Title
    Fasting insulin
    Time Frame
    Change from baseline to 10 years
    Title
    Insulin sensitivity
    Description
    HOMA - %s
    Time Frame
    Change from baseline to 10 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age ≥18 years Patients with a confirmed diagnosis of NAFLD Patients affiliated to French social security Written informed consent signed by the patient Exclusion Criteria: Refusal or inability (lack of capacity) to give informed consent. Average alcohol ingestion greater than 21/14 units/week (males/females) in the preceding 6 months or history of sustained excessive consumption of alcohol in past 5 years. History or presence of Type 1 diabetes mellitus. Presence of any other form of chronic liver disease except NAFLD Recent (within 12 months) or concomitant use of agents known to cause hepatic steatosis (long-term systemic corticosteroids [>10 days], amiodarone, methotrexate, tamoxifen, tetracycline, high dose oestrogens, valproic acid). Any contra-indication to liver biopsy. Recent (within 3 months) change in dose/regimen or introduction of Vitamin E (at a dose ≥400 IU/day), betaine, s-adenosyl methionine, ursodeoxycholic acid, silymarin or pentoxifylline. Non-French speaking/unable to access an interpreter. Patients judged by the investigator to be unsuitable for inclusion in the study (e.g. judged by the physician as unlikely to be compliant with the study protocol). Pregnant or breastfeeding women Patient under legal protection measure (tutorship or curatorship) and patient deprived of freedom
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Vlad RATZIU
    Phone
    0142161001
    Ext
    +33
    Email
    vlad.ratziu@aphp.fr
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Vlad RATZIU
    Organizational Affiliation
    Assistance Publique - Hôpitaux de Paris
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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