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
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 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
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
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
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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
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