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Investigation on Safety and Efficacy of Soybean Fermented Extract (MBS217) in Treating Patients With NAFLD

Primary Purpose

Non-Alcoholic Fatty Liver Disease

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
MBS217
Placebo
Sponsored by
National Taiwan University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Alcoholic Fatty Liver Disease

Eligibility Criteria

20 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male or female subjects aged between 20 and 70 years old. Serum ALT of the subject is between 40-200 U/L. The subject is diagnosed as NAFLD through FibroScan (CAP > 220 db/m). BMI of the subject is between 18.5-40 kg/m2. The subject is able to provide written informed consent by himself/herself and agrees to comply with all protocol requirements. The subject agrees to comply with the following two requirements: comply with all follow-up visit requirements according to the trial protocol. comply with all requirement regarding fecal samples collection, storage and delivery according to the trial protocol. If the subject is reproductive women, she should agree to take more than two ways of contraceptive methods. Exclusion Criteria: The subject is pregnant or lactating. The subject has received any antibiotic (excluding topical agents), antifungals or antivirals within 30 days prior to visit 1. The subject has received any steroids (excluding topical agents), immunosuppressant or anti-inflammation drugs within 14 days prior to visit 1. The subject has received probiotics or prebiotics 14 days prior to visit 1. The subject has received medication affecting evaluating indicators, including hepatitis and lipid metabolism related compounds, but excluding the following medicines: Statins, Fibrates, Silymarin, N-Acetyl Cystein, Thiazolidinediones, Metformin, Fibrate, Cholestyramine, Ezetimibe, Orlistat, SGLT2i and GLP1-RAs. The subject has a clinically significant, currently active or underlying diarrhea (loose stools more than three times in 24 hours) of infectious etiologies. The subject who has been diagnosed a severe/injury hepatic disease, acute/chronic viral hepatitis B, acute/chronic viral hepatitis C, human immunodeficiency virus infection, disease affecting liver function, active inflammatory bowel disease, gastric ulcer, chronic kidney disease, kidney function repairmen, chronic gut inflammatory disease, coronary artery disease with arterial stent surgery in half year, cancer, autoimmune disease, fasting glucose≥ 300 mg/dl, HbA1c>9%, or serum triglyceride≥ 500 mg/dl. The subject currently is participating in studies involving other investigational drugs, medical devices, functional foods, or cosmetic within 30 days prior to visit 1. The subject has participated in body weight control plan within 60 days prior to visit 1. The subject has an alcohol abuse problem. The subject has been aboard for 10 days within 60 days prior to visit 1, or plans to go aboard during this study. The subject has soybean allergy. The subject is vegetarian or special diet. The subject is considered by the investigator as not suitable for the trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    MBS-217

    Placebo

    Arm Description

    4 ml MBS-217 twice a day for 16 weeks

    4 ml MBS-217 placebo twice a day for 16 weeks

    Outcomes

    Primary Outcome Measures

    Changes in gut microbiota
    evaluated by fecal 16S rRNA gene sequencing
    Improvement of intrahepatic fibrosis
    evaluated by FibroScan
    Changes in hepatic steatosis composition
    evaluated by MRI-PDFF and MRI-MRS

    Secondary Outcome Measures

    Changes in FIB-4
    Fibrosis-4 (FIB-4) Index
    Changes in gut permeability
    evaluated by lactulose/mannitol ratio

    Full Information

    First Posted
    December 21, 2022
    Last Updated
    January 8, 2023
    Sponsor
    National Taiwan University Hospital
    Collaborators
    Taipei Medical University Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05686174
    Brief Title
    Investigation on Safety and Efficacy of Soybean Fermented Extract (MBS217) in Treating Patients With NAFLD
    Official Title
    Investigation on Safety and Efficacy of Soybean Fermented Extract (MBS217) in Treating Patients With Non-alcoholic Fatty Liver Disease: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Study in National Taiwan University Hospital
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    February 1, 2023 (Anticipated)
    Primary Completion Date
    April 30, 2024 (Anticipated)
    Study Completion Date
    December 31, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    National Taiwan University Hospital
    Collaborators
    Taipei Medical University Hospital

    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
    Investigators aimed to investigate the efficacy and safety of fermented soybean extract (MBS-217) in treating participants with Non-alcoholic fatty liver disease (NAFLD) in this study.
    Detailed Description
    Background: NAFLD is one of the most prevalent chronic liver diseases in Taiwan. NAFLD can progress to fibrosis, cirrhosis, and even liver cancer. Based on the current trend in epidemiology, fatty liver disease is forecasted to be the leading cause of liver transplantation by 2030. Since NAFLD imposes a significant medical burden and there is no approved medication for NAFLD, developing an effective therapy for improving NAFLD is undoubtedly an unmet need. Diet and gut microbiota play pivotal roles in NAFLD progress. The composition of the gut microbiota and gut barrier function is affected by dietary factors, which cause pathophysiological impacts on the liver through the immune and metabolic communications between gut and liver, which is coined as the "gut-liver axis." Therefore, intervention with dietary products from probiotics and prebiotics may be an opportunity to develop effective therapy against NAFLD. In fact, current evidence has shown that fermented soybean products can modulate hepatic lipid metabolism and possess potential prebiotic activities. Also, our preliminary data have shown that MBS217 supplementation has the effects of modulating gut microbiota and regulating the hepatic inflammatory-related immune response in both nonalcoholic steatohepatitis (NASH) mice and healthy adult subjects. Objective: Investigators aimed to investigate the efficacy and safety of MBS217 in treating participants with NAFLD in this study. The changes in other metabolic parameters, gut microbiome, metabolomics, and gut permeability will also be investigated. Methods: Using a block randomization with a block size of 2 in a 1:1 ratio, 30 eligible adult subjects aged 20-70 years diagnosed with NAFLD will be randomized to receive one of the following regimens. This study plans to enroll 30 eligible adult subjects aged 20-70 years diagnosed with NAFLD. Enrolled subjects will be randomly assigned to receive 4 mL of either MBS217 or placebo (1:1) treatment for 16 weeks and then followed for 8 weeks, with assessment for NAFLD-related parameters, gut microbiome, metabolomics, and gut permeability. Outcome analysis: The primary outcome is the improvement of hepatic steatosis, fibrosis, stiffness, and FIB-4 evaluated by FibroScan or MRI. The secondary outcomes are the frequency of adverse events, the overall NAFLD-related parameters, gut microbiota, metabolomics, and gut permeability.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Non-Alcoholic Fatty Liver Disease

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    30 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    MBS-217
    Arm Type
    Active Comparator
    Arm Description
    4 ml MBS-217 twice a day for 16 weeks
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    4 ml MBS-217 placebo twice a day for 16 weeks
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    MBS217
    Intervention Description
    Soybean Fermented Extract (MBS217)
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Placebo
    Intervention Description
    Without active ingredient
    Primary Outcome Measure Information:
    Title
    Changes in gut microbiota
    Description
    evaluated by fecal 16S rRNA gene sequencing
    Time Frame
    baseline to 8th, 12th, 16th and 24th weeks
    Title
    Improvement of intrahepatic fibrosis
    Description
    evaluated by FibroScan
    Time Frame
    baseline to 16th and 24th weeks
    Title
    Changes in hepatic steatosis composition
    Description
    evaluated by MRI-PDFF and MRI-MRS
    Time Frame
    baseline to 16th week
    Secondary Outcome Measure Information:
    Title
    Changes in FIB-4
    Description
    Fibrosis-4 (FIB-4) Index
    Time Frame
    baseline to 12th, 16th and 24th weeks
    Title
    Changes in gut permeability
    Description
    evaluated by lactulose/mannitol ratio
    Time Frame
    baseline to 16th week

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    20 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female subjects aged between 20 and 70 years old. Serum ALT of the subject is between 40-200 U/L. The subject is diagnosed as NAFLD through FibroScan (CAP > 220 db/m). BMI of the subject is between 18.5-40 kg/m2. The subject is able to provide written informed consent by himself/herself and agrees to comply with all protocol requirements. The subject agrees to comply with the following two requirements: comply with all follow-up visit requirements according to the trial protocol. comply with all requirement regarding fecal samples collection, storage and delivery according to the trial protocol. If the subject is reproductive women, she should agree to take more than two ways of contraceptive methods. Exclusion Criteria: The subject is pregnant or lactating. The subject has received any antibiotic (excluding topical agents), antifungals or antivirals within 30 days prior to visit 1. The subject has received any steroids (excluding topical agents), immunosuppressant or anti-inflammation drugs within 14 days prior to visit 1. The subject has received probiotics or prebiotics 14 days prior to visit 1. The subject has received medication affecting evaluating indicators, including hepatitis and lipid metabolism related compounds, but excluding the following medicines: Statins, Fibrates, Silymarin, N-Acetyl Cystein, Thiazolidinediones, Metformin, Fibrate, Cholestyramine, Ezetimibe, Orlistat, SGLT2i and GLP1-RAs. The subject has a clinically significant, currently active or underlying diarrhea (loose stools more than three times in 24 hours) of infectious etiologies. The subject who has been diagnosed a severe/injury hepatic disease, acute/chronic viral hepatitis B, acute/chronic viral hepatitis C, human immunodeficiency virus infection, disease affecting liver function, active inflammatory bowel disease, gastric ulcer, chronic kidney disease, kidney function repairmen, chronic gut inflammatory disease, coronary artery disease with arterial stent surgery in half year, cancer, autoimmune disease, fasting glucose≥ 300 mg/dl, HbA1c>9%, or serum triglyceride≥ 500 mg/dl. The subject currently is participating in studies involving other investigational drugs, medical devices, functional foods, or cosmetic within 30 days prior to visit 1. The subject has participated in body weight control plan within 60 days prior to visit 1. The subject has an alcohol abuse problem. The subject has been aboard for 10 days within 60 days prior to visit 1, or plans to go aboard during this study. The subject has soybean allergy. The subject is vegetarian or special diet. The subject is considered by the investigator as not suitable for the trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Wei-Kai Wu
    Phone
    +886233667316
    Email
    weikaiwu0115@gmail.com

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    Citations:
    PubMed Identifier
    33431715
    Citation
    Huang SC, Su HJ, Kao JH, Tseng TC, Yang HC, Su TH, Chen PJ, Liu CJ. Clinical and Histologic Features of Patients with Biopsy-Proven Metabolic Dysfunction-Associated Fatty Liver Disease. Gut Liver. 2021 May 15;15(3):451-458. doi: 10.5009/gnl20218.
    Results Reference
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