A Study of HTD1801 in Adults With Nonalcoholic Steatohepatitis (NASH) and Type 2 Diabetes Mellitus (T2DM)
Primary Purpose
Fatty Liver, Nonalcoholic, NAFLD, Nonalcoholic Fatty Liver Disease
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HTD1801
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Fatty Liver, Nonalcoholic
Eligibility Criteria
Inclusion Criteria:
- Clinical diagnosis of NASH as assessed by MRI
- Clinically documented diagnosis of T2DM
- Body mass index (BMI) >25 kg/m2
Exclusion Criteria:
- Liver disease unrelated to NASH
- Poorly controlled T2DM or Type 1 Diabetes Mellitus
- History of alcohol or substance abuse or dependence
- Inability to undergo MRI for any reason
- History of significant cardiovascular disease
Sites / Locations
- Institute for Liver Health
- Institute for Liver Health
- Adobe Clinical Research
- National Research Institute
- Excel Medical Clinical Trials
- Florida Research Institute
- Compass Research
- Kansas City Research Institute
- Cumberland Research Associates
- Gastro One
- Digestive Health Research
- Pinnacle Clinical Research
- Doctors Hospital at Renaissance
- Pinnacle Clinical Research
- Texas Digestive Disease Consultants
- Harborview Medical Center
- University of Washington Medical Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Placebo Comparator
Arm Label
500mg HTD1801, bid
1000mg HTD1801, bid
placebo, bid
Arm Description
Outcomes
Primary Outcome Measures
Absolute Change in Liver Fat Content (LFC) as Measured by MRI-PDFF
The primary endpoint was the absolute change in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Secondary Outcome Measures
Change in Fasting Glucose
Change in fasting glucose from Baseline to Week 18 .
Changes in Hemoglobin A1c
Changes in HbA1c from Baseline to Week 18.
Proportion of Subjects Who Achieved ≥ 30% Relative Reduction in LFC as Measured by MRI-PDFF
Proportion of subjects who achieved ≥ 30% relative reduction in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Relative Change in LFC as Measured by MRI-PDFF
Relative change in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Number of Subjects Who Normalized LFC to <5% as Measured by MRI-PDFF
Number of subjects who normalized liver fat content (LFC) to <5% as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) at Week 18.
Number of Subjects Who Achieved ≥5% Absolute Reduction in Liver Fat Content (LFC) as Measured by MRI-PDFF
Number of subjects who achieved ≥5% absolute reduction in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Change in HOMA-IR
Change in homeostasis model assessment-estimated insulin resistance (HOMA-IR) from Baseline to Week 18. The higher the HOMA-IR score, the more insulin resistant a person is. Values of <1 are considered optimal while values >2.9 indicate significant insulin resistance.
Change in LDL-c
Change in low-density lipoprotein cholesterol (LDL-c) from Baseline to Week 18.
Change in Serum Triglycerides
Change in serum triglycerides from Baseline to Week 18.
Change in HDL-c
Change in high-density lipoprotein cholesterol (HDL-c) from Baseline to Week 18.
Change in AST
Absolute change in aspartate aminotransferase (AST) from Baseline to Week 18.
Change in ALT
Absolute change in alanine aminotransferase (ALT) from Baseline to Week 18.
Proportion of Subjects With Elevated ALT at Baseline Who Normalized ALT at Week 18
Proportion of subjects with elevated alanine aminotransferase (ALT) at Baseline who normalized ALT at Week 18.
Change in Pro-Peptide of Type III Collagen (Pro-C3)
Change in Pro-C3 from Baseline to Week 18 for subjects with elevated Pro-C3 at Baseline.
Change in ELF Score
Change in the enhanced liver fibrosis (ELF) score. The ELF score is calculated using a published algorithm combining the values of a set of extracellular matrix markers, including TIMP-1, PIIINP, and HA. The ELF score has been reported to show good correlations with fibrosis stages in chronic liver disease, with higher ELF scores associated with higher fibrosis stages. The ELF score is hence used as a prognostic marker for disease progression: ELF score < 9.8 : Low risk of progression, ELF score 9.8 to < 11.3 : Moderate risk of progression and ELF score > = 11.3 : High risk of progression.
Change in TIMP-1
Change in tissue inhibitor of metalloproteinases 1 (TIMP-1) from Baseline to Week 18.
Change in PIIINP
Change in N-terminal pro-peptide of type III collagen (PIIINP) from Baseline to Week 18.
Change in HA
Change in hyaluronic acid (HA) from Baseline to Week 18.
Change in Total Bile Acids
Changes in total bile acids from Baseline to Week 18.
Change in FGF19
Change in fibroblast growth factor 19 (FGF19) from Baseline to Week 18
Number of Participants Reporting an Adverse Events From Baseline Through Week 18
AEs were mapped to MedDRA version 20.1 preferred term (PT) and system organ class (SOC). If the subject experienced multiple events that mapped to a single preferred term, the greatest severity grade according to CTCAE Version 4.0, and strongest investigator assessment of relation to study medication was assigned to the preferred term. If an event had a missing severity or relationship, it was classified as having the highest severity and/or strongest relationship to study medication. The occurrence of TEAEs was summarized by treatment group by SOC, PT, and severity. Separate summaries of treatment-emergent serious adverse events (SAEs), TEAEs related to study drug, severe or life threatening TEAEs, and TEAEs leading to the discontinuation of study treatment were generated. Additionally, the occurrence of liver-specific AEs was summarized by treatment group. All reported adverse events were listed for individual subjects showing verbatim term, PT and SOC.
Full Information
NCT ID
NCT03656744
First Posted
August 30, 2018
Last Updated
November 30, 2021
Sponsor
HighTide Biopharma Pty Ltd
1. Study Identification
Unique Protocol Identification Number
NCT03656744
Brief Title
A Study of HTD1801 in Adults With Nonalcoholic Steatohepatitis (NASH) and Type 2 Diabetes Mellitus (T2DM)
Official Title
A Proof-of-Concept and Dose-Ranging Study Investigating the Efficacy and Safety of HTD1801 in Adults With NASH and T2DM
Study Type
Interventional
2. Study Status
Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
November 26, 2018 (Actual)
Primary Completion Date
February 7, 2020 (Actual)
Study Completion Date
March 9, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
HighTide Biopharma Pty Ltd
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Randomized, double-blind, placebo-controlled, parallel-group study comparing multiple doses of HTD1801 to placebo.
Detailed Description
This 18-week randomized, double-blind, parallel-group, proof of concept (POC), dose-ranging study compared multiple doses of HTD1801 to placebo in a 1:1:1 ratio. Since accumulation of hepatic fat is considered the "first hit" in the pathogenesis of NASH (Adams and Angulo 2006), change in liver fat content (LFC) by magnetic resonance imaging estimated proton density fat fraction (MRI-PDFF) is an appropriate primary endpoint and is consistent with that used in other recent Phase 2 POC studies in NASH (Harrison et al., 2018, Madrigal Pharmaceuticals 2018).
The Harrison et al., 2018, Madrigal Pharmaceuticals 2018 study showed clinically meaningful absolute and relative reductions in LFC assessed by MRI-PDFF over 12-week treatment periods thus, it was considered that an 18 week HTD1801 treatment period would therefore be adequate to assess the study's primary endpoint and to maximize collection of exposure and safety related data.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fatty Liver, Nonalcoholic, NAFLD, Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis, Digestive System Diseases, Type 2 Diabetes Mellitus (T2DM)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
101 (Actual)
8. Arms, Groups, and Interventions
Arm Title
500mg HTD1801, bid
Arm Type
Experimental
Arm Title
1000mg HTD1801, bid
Arm Type
Experimental
Arm Title
placebo, bid
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
HTD1801
Intervention Description
HTD1801 tablets, 250mg
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
tablets manufactured to mimic HTD1801 tablets
Primary Outcome Measure Information:
Title
Absolute Change in Liver Fat Content (LFC) as Measured by MRI-PDFF
Description
The primary endpoint was the absolute change in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Time Frame
Baseline through study Week 18
Secondary Outcome Measure Information:
Title
Change in Fasting Glucose
Description
Change in fasting glucose from Baseline to Week 18 .
Time Frame
Baseline through study Week 18
Title
Changes in Hemoglobin A1c
Description
Changes in HbA1c from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Proportion of Subjects Who Achieved ≥ 30% Relative Reduction in LFC as Measured by MRI-PDFF
Description
Proportion of subjects who achieved ≥ 30% relative reduction in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Relative Change in LFC as Measured by MRI-PDFF
Description
Relative change in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Number of Subjects Who Normalized LFC to <5% as Measured by MRI-PDFF
Description
Number of subjects who normalized liver fat content (LFC) to <5% as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) at Week 18.
Time Frame
Baseline through study Week 18
Title
Number of Subjects Who Achieved ≥5% Absolute Reduction in Liver Fat Content (LFC) as Measured by MRI-PDFF
Description
Number of subjects who achieved ≥5% absolute reduction in liver fat content (LFC) as measured by magnetic resonance imaging derived proton density fat fraction (MRI-PDFF) from Baseline to Week 18.
Time Frame
Baseline through study Week 18
Title
Change in HOMA-IR
Description
Change in homeostasis model assessment-estimated insulin resistance (HOMA-IR) from Baseline to Week 18. The higher the HOMA-IR score, the more insulin resistant a person is. Values of <1 are considered optimal while values >2.9 indicate significant insulin resistance.
Time Frame
Baseline through study week 18
Title
Change in LDL-c
Description
Change in low-density lipoprotein cholesterol (LDL-c) from Baseline to Week 18.
Time Frame
Baseline visit through study week 18
Title
Change in Serum Triglycerides
Description
Change in serum triglycerides from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in HDL-c
Description
Change in high-density lipoprotein cholesterol (HDL-c) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in AST
Description
Absolute change in aspartate aminotransferase (AST) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in ALT
Description
Absolute change in alanine aminotransferase (ALT) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Proportion of Subjects With Elevated ALT at Baseline Who Normalized ALT at Week 18
Description
Proportion of subjects with elevated alanine aminotransferase (ALT) at Baseline who normalized ALT at Week 18.
Time Frame
Baseline through study week 18
Title
Change in Pro-Peptide of Type III Collagen (Pro-C3)
Description
Change in Pro-C3 from Baseline to Week 18 for subjects with elevated Pro-C3 at Baseline.
Time Frame
Baseline through study week 18
Title
Change in ELF Score
Description
Change in the enhanced liver fibrosis (ELF) score. The ELF score is calculated using a published algorithm combining the values of a set of extracellular matrix markers, including TIMP-1, PIIINP, and HA. The ELF score has been reported to show good correlations with fibrosis stages in chronic liver disease, with higher ELF scores associated with higher fibrosis stages. The ELF score is hence used as a prognostic marker for disease progression: ELF score < 9.8 : Low risk of progression, ELF score 9.8 to < 11.3 : Moderate risk of progression and ELF score > = 11.3 : High risk of progression.
Time Frame
Baseline through study week 18
Title
Change in TIMP-1
Description
Change in tissue inhibitor of metalloproteinases 1 (TIMP-1) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in PIIINP
Description
Change in N-terminal pro-peptide of type III collagen (PIIINP) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in HA
Description
Change in hyaluronic acid (HA) from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in Total Bile Acids
Description
Changes in total bile acids from Baseline to Week 18.
Time Frame
Baseline through study week 18
Title
Change in FGF19
Description
Change in fibroblast growth factor 19 (FGF19) from Baseline to Week 18
Time Frame
Baseline through study week 18
Title
Number of Participants Reporting an Adverse Events From Baseline Through Week 18
Description
AEs were mapped to MedDRA version 20.1 preferred term (PT) and system organ class (SOC). If the subject experienced multiple events that mapped to a single preferred term, the greatest severity grade according to CTCAE Version 4.0, and strongest investigator assessment of relation to study medication was assigned to the preferred term. If an event had a missing severity or relationship, it was classified as having the highest severity and/or strongest relationship to study medication. The occurrence of TEAEs was summarized by treatment group by SOC, PT, and severity. Separate summaries of treatment-emergent serious adverse events (SAEs), TEAEs related to study drug, severe or life threatening TEAEs, and TEAEs leading to the discontinuation of study treatment were generated. Additionally, the occurrence of liver-specific AEs was summarized by treatment group. All reported adverse events were listed for individual subjects showing verbatim term, PT and SOC.
Time Frame
Adverse events were collected from the time the subject signed the informed consent form through the date of the last visit for a specific subject, that is, approximately 24 weeks in total for a completed subject.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Clinical diagnosis of NASH as assessed by MRI
Clinically documented diagnosis of T2DM
Body mass index (BMI) >25 kg/m2
Exclusion Criteria:
Liver disease unrelated to NASH
Poorly controlled T2DM or Type 1 Diabetes Mellitus
History of alcohol or substance abuse or dependence
Inability to undergo MRI for any reason
History of significant cardiovascular disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adrian Di Bisceglie, MD,FACP,FAASLD
Organizational Affiliation
HighTide Therapeutics USA, LLC
Official's Role
Study Director
Facility Information:
Facility Name
Institute for Liver Health
City
Chandler
State/Province
Arizona
ZIP/Postal Code
85224
Country
United States
Facility Name
Institute for Liver Health
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85711
Country
United States
Facility Name
Adobe Clinical Research
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
National Research Institute
City
Panorama City
State/Province
California
ZIP/Postal Code
91402
Country
United States
Facility Name
Excel Medical Clinical Trials
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33434
Country
United States
Facility Name
Florida Research Institute
City
Lakewood Ranch
State/Province
Florida
ZIP/Postal Code
34211
Country
United States
Facility Name
Compass Research
City
Orlando
State/Province
Florida
ZIP/Postal Code
32806
Country
United States
Facility Name
Kansas City Research Institute
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64131
Country
United States
Facility Name
Cumberland Research Associates
City
Fayetteville
State/Province
North Carolina
ZIP/Postal Code
28304
Country
United States
Facility Name
Gastro One
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138
Country
United States
Facility Name
Digestive Health Research
City
Hermitage
State/Province
Tennessee
ZIP/Postal Code
37076
Country
United States
Facility Name
Pinnacle Clinical Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78746
Country
United States
Facility Name
Doctors Hospital at Renaissance
City
Edinburg
State/Province
Texas
ZIP/Postal Code
78539
Country
United States
Facility Name
Pinnacle Clinical Research
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Texas Digestive Disease Consultants
City
Southlake
State/Province
Texas
ZIP/Postal Code
76092
Country
United States
Facility Name
Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Facility Name
University of Washington Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
34535644
Citation
Harrison SA, Gunn N, Neff GW, Kohli A, Liu L, Flyer A, Goldkind L, Di Bisceglie AM. A phase 2, proof of concept, randomised controlled trial of berberine ursodeoxycholate in patients with presumed non-alcoholic steatohepatitis and type 2 diabetes. Nat Commun. 2021 Sep 17;12(1):5503. doi: 10.1038/s41467-021-25701-5.
Results Reference
derived
Learn more about this trial
A Study of HTD1801 in Adults With Nonalcoholic Steatohepatitis (NASH) and Type 2 Diabetes Mellitus (T2DM)
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