A Study of the Efficacy and Safety of CF102 in the Treatment of Non-Alcoholic Fatty Liver Disease
Primary Purpose
Non-alcoholic Steatohepatitis (NASH)
Status
Completed
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
CF102
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Non-alcoholic Steatohepatitis (NASH)
Eligibility Criteria
Inclusion Criteria:
- At least 18 years of age.
- Diagnosis of NAFLD by non-invasive determination of liver triglyceride concentration, as defined as triglyceride concentration ≥10.0% by NMRS.
At least 2 of the following:
- Obesity, defined as body mass index (BMI) of ≥25 and ≤40 kg/m2; or waist circumference >88 and <200 cm for women or >102 and <200 cm for men
- Type II diabetes mellitus, defined by the criteria of the American Diabetes Association (Appendix 1)
- Blood pressure of 130/85 or higher (either systolic or diastolic)
- Hypertriglyceridemia, defined as >150 mg/dL (>1.7 mmol/L)
- Reduced high-density lipoprotein (HDL) cholesterol, defined as <40 mg/dL (<1.04 mmol/L) in men or <50 mg/dL (<1.3 mmol/L) in women.
Acceptable hepatic metabolic and synthetic function, as indicated at Screening by:
- Serum albumin ≥3.5 gm/dL
- INR ≤1.2
- Serum total bilirubin ≤2.0 mg/dL.
- Absence of cirrhosis, defined as a Fibroscan score of ≤F4 and liver stiffness measurement (LSM) of 7 13 kPa.
The following laboratory values must be documented at Screening prior to initiation of study drug:
- Absolute neutrophil count >1.5x109/L
- Platelet count >100x109/L
- Serum creatinine <2.0 mg/dL.
- For women of childbearing potential, negative serum pregnancy test result (not pregnant or lactating).
- Understand and provide written informed consent to participate.
- Patients taking herbal supplements, homeopathic medications, or other alternative treatments, must be on a stable regimen for at least 6 months prior to randomization.
- Willing to comply with scheduled visits, treatment plans, laboratory assessments, and other study-related procedures.
Exclusion Criteria:
- Presence of ascites, hepatic encephalopathy, or other clinical evidence of cirrhosis.
- Other active acute or chronic liver disease, such as autoimmune hepatitis, hepatitis B, hepatitis C, alcoholic liver disease, or hepatocellular carcinoma at the time of Screening and randomization.
- Familial dyslipidemia.
- Weight loss of >5% within 6 months prior to Baseline.
- History of bariatric surgery within 5 years of Screening.
- Diabetes mellitus other than Type II.
- Daily alcohol intake >20 g/day for women and 30 g/day for men (on average per day), as per medical history.
- Treatment with the following anti-diabetic medications: DPP-4 inhibitor unless it was stopped 3 months before Screening, GLP-1 receptor agonists (such as Januvia [sitagliptin], Byetta [incretin], etc.) unless it was started at least 12 months and on stable dose at least 3 months prior to Screening.
- Metformin, fibrates, statins, insulin, or sulfonylurea unless the dose has been stabilized for the last 1 month prior to Screening.
- More than 7 days of treatment with valproic acid, tamoxifen, methotrexate, amiodarone, rifaximin, other antibiotics, or anti-cholinergic agents within 3 months prior to Screening.
- Uncontrolled or clinically unstable thyroid disease, in the judgment of the Principal Investigator.
- Seropositivity for markers of viral hepatitis or human immunodeficiency virus (HIV) at Screening.
- Uncontrolled arterial hypertension or congestive heart failure (New York Heart Association Classification 3 or 4).
- Angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism within 3 months prior to initiation of study drug.
- History of or ongoing cardiac dysrhythmias requiring treatment, atrial fibrillation of any grade, or persistent prolongation of the QTc (Fridericia) interval to >450 msec for males or >470 msec for females.
- Pregnant or lactating female.
- Women of childbearing potential, unless they agree to use dual contraceptive methods which, in the opinion of the Principal Investigator, are effective and adequate for that patient's circumstances while on study drug.
- Men who partner with a woman of childbearing potential, unless they agree to use effective, dual contraceptive methods (ie, a condom, with female partner using oral, injectable, or barrier method) while on study drug.
- Any severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study.
Sites / Locations
- Can-Fite Investigational Site #318
- Can-Fite Investigational Site #319
- Can-Fite Investigational Site #311
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Placebo Comparator
Active Comparator
Active Comparator
Arm Label
Placebo
CF102 12.5mg
CF102 25mg
Arm Description
Placebo tablets orally q12h
CF102 tablets orally q12h
CF102 tablets orally q12h
Outcomes
Primary Outcome Measures
Efficacy of CF102 as determined by change in serum alanine aminotransferase (ALT) levels
Mean percent change in serum alanine aminotransferase (ALT) levels
Efficacy of CF102 as determined by change in magnetic resonance imaging-determined hepatic steatosis
Percent change from Baseline in hepatic steatosis measured by magnetic resonance imaging-determined proton-density fat-fraction (MRI-PDFF)
Secondary Outcome Measures
Body weight in subjects with NAFLD
Change from baseline in body weight (kg)
Waist circumference in subjects with NAFLD
Change from baseline in waist circumference (cm)
HDL cholesterol levels in subjects with NAFLD
Change from baseline in serum triglyceride and HDL cholesterol levels (mg/dL)
Normalization of serum ALT levels in subjects with NAFLD
Proportion of all subjects whose serum ALT level normalizes
Serum aspartate aminotransaminase (AST) levels in subjects with NAFLD
Change from baseline in serum AST levels
Hemoglobin A1c levels and degree of insulin resistance
Change from baseline in Homeostasis Model Assessment (HOMA)
Pharmacokinetics (PK) of CF102 in this population
PK of CF102 will be assessed through steady state trough drug level
Peripheral blood expression of the A3 adenosine receptor (A3AR).
Change from baseline in A3 adenosine receptor (A3AR) expression level
Nature, frequency, and severity of adverse events in this patient population
Nature, frequency, and severity (by CTCAE or comparable scale) of adverse events
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02927314
Brief Title
A Study of the Efficacy and Safety of CF102 in the Treatment of Non-Alcoholic Fatty Liver Disease
Official Title
A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Dose-Finding Study of the Efficacy and Safety of CF102 in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH)
Study Type
Interventional
2. Study Status
Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
November 27, 2017 (Actual)
Primary Completion Date
March 1, 2020 (Actual)
Study Completion Date
March 1, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Can-Fite BioPharma
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
5. Study Description
Brief Summary
This is a multicenter, randomized, double-blind, placebo-controlled clinical trial in subjects with NAFLD and NASH.
Detailed Description
This is a multicenter, randomized, double-blind, placebo-controlled study in subjects with a diagnosis of NAFLD. Subjects will undergo Screening procedures during the 4 weeks preceding Baseline. Subjects will be randomly assigned in a 1:1:1 ratio to oral doses of CF102 12.5 mg BID, CF102 25 mg BID, or matching placebo BID for 12 weeks using a stratified randomization, with stratification by presence or absence of diabetes mellitus. Subjects will be evaluated regularly for safety, and indicators of efficacy will be measured at Baseline and Week 12. Subjects will return for a follow-up visit 4 weeks after completion of the last dose of study drug.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-alcoholic Steatohepatitis (NASH)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
60 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo tablets orally q12h
Arm Title
CF102 12.5mg
Arm Type
Active Comparator
Arm Description
CF102 tablets orally q12h
Arm Title
CF102 25mg
Arm Type
Active Comparator
Arm Description
CF102 tablets orally q12h
Intervention Type
Drug
Intervention Name(s)
CF102
Other Intervention Name(s)
Cl-IB-MECA
Intervention Description
orally q12h
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
orally q12h
Primary Outcome Measure Information:
Title
Efficacy of CF102 as determined by change in serum alanine aminotransferase (ALT) levels
Description
Mean percent change in serum alanine aminotransferase (ALT) levels
Time Frame
12 weeks
Title
Efficacy of CF102 as determined by change in magnetic resonance imaging-determined hepatic steatosis
Description
Percent change from Baseline in hepatic steatosis measured by magnetic resonance imaging-determined proton-density fat-fraction (MRI-PDFF)
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Body weight in subjects with NAFLD
Description
Change from baseline in body weight (kg)
Time Frame
12 weeks
Title
Waist circumference in subjects with NAFLD
Description
Change from baseline in waist circumference (cm)
Time Frame
12 weeks
Title
HDL cholesterol levels in subjects with NAFLD
Description
Change from baseline in serum triglyceride and HDL cholesterol levels (mg/dL)
Time Frame
12 weeks
Title
Normalization of serum ALT levels in subjects with NAFLD
Description
Proportion of all subjects whose serum ALT level normalizes
Time Frame
12 weeks
Title
Serum aspartate aminotransaminase (AST) levels in subjects with NAFLD
Description
Change from baseline in serum AST levels
Time Frame
12 weeks
Title
Hemoglobin A1c levels and degree of insulin resistance
Description
Change from baseline in Homeostasis Model Assessment (HOMA)
Time Frame
12 weeks
Title
Pharmacokinetics (PK) of CF102 in this population
Description
PK of CF102 will be assessed through steady state trough drug level
Time Frame
12 weeks
Title
Peripheral blood expression of the A3 adenosine receptor (A3AR).
Description
Change from baseline in A3 adenosine receptor (A3AR) expression level
Time Frame
12 weeks
Title
Nature, frequency, and severity of adverse events in this patient population
Description
Nature, frequency, and severity (by CTCAE or comparable scale) of adverse events
Time Frame
12 weeks
Other Pre-specified Outcome Measures:
Title
Serum adiponectin levels
Description
Change from baseline in serum adiponectin levels in subjects with NAFLD
Time Frame
12 weeks
Title
Serum leptin levels
Description
Change from baseline in serum leptin levels in subjects with NAFLD
Time Frame
12 weeks
Title
Serum alpha-2 macroglobulin levels
Description
Change from baseline in serum alpha-2 macroglobulin levels in subjects with NAFLD
Time Frame
12 weeks
Title
Serum apolipoprotein A1 levels
Description
Change from baseline in serum apolipoprotein A1 levels in subjects with NAFLD
Time Frame
12 weeks
Title
Serum haptoglobin levels
Description
Change from baseline in serum haptoglobin levels in subjects with NAFLD
Time Frame
12 weeks
Title
Serum C-reactive protein levels
Description
Change from baseline in serum C-reactive protein levels in subjects with NAFLD
Time Frame
12 weeks
Title
Liver stiffness
Description
Change from baseline in liver stiffness by FibroScan in subjects with NAFLD
Time Frame
12 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
At least 18 years of age.
Diagnosis of NAFLD by non-invasive determination of liver triglyceride concentration, as defined as triglyceride concentration ≥10.0% by NMRS.
At least 2 of the following:
Obesity, defined as body mass index (BMI) of ≥25 and ≤40 kg/m2; or waist circumference >88 and <200 cm for women or >102 and <200 cm for men
Type II diabetes mellitus, defined by the criteria of the American Diabetes Association (Appendix 1)
Blood pressure of 130/85 or higher (either systolic or diastolic)
Hypertriglyceridemia, defined as >150 mg/dL (>1.7 mmol/L)
Reduced high-density lipoprotein (HDL) cholesterol, defined as <40 mg/dL (<1.04 mmol/L) in men or <50 mg/dL (<1.3 mmol/L) in women.
Acceptable hepatic metabolic and synthetic function, as indicated at Screening by:
Serum albumin ≥3.5 gm/dL
INR ≤1.2
Serum total bilirubin ≤2.0 mg/dL.
Absence of cirrhosis, defined as a Fibroscan score of ≤F4 and liver stiffness measurement (LSM) of 7 13 kPa.
The following laboratory values must be documented at Screening prior to initiation of study drug:
Absolute neutrophil count >1.5x109/L
Platelet count >100x109/L
Serum creatinine <2.0 mg/dL.
For women of childbearing potential, negative serum pregnancy test result (not pregnant or lactating).
Understand and provide written informed consent to participate.
Patients taking herbal supplements, homeopathic medications, or other alternative treatments, must be on a stable regimen for at least 6 months prior to randomization.
Willing to comply with scheduled visits, treatment plans, laboratory assessments, and other study-related procedures.
Exclusion Criteria:
Presence of ascites, hepatic encephalopathy, or other clinical evidence of cirrhosis.
Other active acute or chronic liver disease, such as autoimmune hepatitis, hepatitis B, hepatitis C, alcoholic liver disease, or hepatocellular carcinoma at the time of Screening and randomization.
Familial dyslipidemia.
Weight loss of >5% within 6 months prior to Baseline.
History of bariatric surgery within 5 years of Screening.
Diabetes mellitus other than Type II.
Daily alcohol intake >20 g/day for women and 30 g/day for men (on average per day), as per medical history.
Treatment with the following anti-diabetic medications: DPP-4 inhibitor unless it was stopped 3 months before Screening, GLP-1 receptor agonists (such as Januvia [sitagliptin], Byetta [incretin], etc.) unless it was started at least 12 months and on stable dose at least 3 months prior to Screening.
Metformin, fibrates, statins, insulin, or sulfonylurea unless the dose has been stabilized for the last 1 month prior to Screening.
More than 7 days of treatment with valproic acid, tamoxifen, methotrexate, amiodarone, rifaximin, other antibiotics, or anti-cholinergic agents within 3 months prior to Screening.
Uncontrolled or clinically unstable thyroid disease, in the judgment of the Principal Investigator.
Seropositivity for markers of viral hepatitis or human immunodeficiency virus (HIV) at Screening.
Uncontrolled arterial hypertension or congestive heart failure (New York Heart Association Classification 3 or 4).
Angina, myocardial infarction, cerebrovascular accident, coronary/peripheral artery bypass graft surgery, transient ischemic attack, or pulmonary embolism within 3 months prior to initiation of study drug.
History of or ongoing cardiac dysrhythmias requiring treatment, atrial fibrillation of any grade, or persistent prolongation of the QTc (Fridericia) interval to >450 msec for males or >470 msec for females.
Pregnant or lactating female.
Women of childbearing potential, unless they agree to use dual contraceptive methods which, in the opinion of the Principal Investigator, are effective and adequate for that patient's circumstances while on study drug.
Men who partner with a woman of childbearing potential, unless they agree to use effective, dual contraceptive methods (ie, a condom, with female partner using oral, injectable, or barrier method) while on study drug.
Any severe, acute, or chronic medical or psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or study drug administration, may interfere with the informed consent process and/or with compliance with the requirements of the study, or may interfere with the interpretation of study results and, in the investigator's opinion, would make the patient inappropriate for entry into this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael H Silverman, MD
Organizational Affiliation
Can-Fite BioPharma Ltd
Official's Role
Study Director
Facility Information:
Facility Name
Can-Fite Investigational Site #318
City
Jerusalem
Country
Israel
Facility Name
Can-Fite Investigational Site #319
City
Nazareth
Country
Israel
Facility Name
Can-Fite Investigational Site #311
City
Petach Tikva
Country
Israel
12. IPD Sharing Statement
Citations:
PubMed Identifier
35092056
Citation
Muthiah MD, Siddiqui MS. Editorial: targeting aberrant hepatic inflammation for treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2022 Feb;55(4):483-484. doi: 10.1111/apt.16748. No abstract available.
Results Reference
derived
PubMed Identifier
34671996
Citation
Safadi R, Braun M, Francis A, Milgrom Y, Massarwa M, Hakimian D, Hazou W, Issachar A, Harpaz Z, Farbstein M, Itzhak I, Lev-Cohain N, Bareket-Samish A, Silverman MH, Fishman P. Randomised clinical trial: A phase 2 double-blind study of namodenoson in non-alcoholic fatty liver disease and steatohepatitis. Aliment Pharmacol Ther. 2021 Dec;54(11-12):1405-1415. doi: 10.1111/apt.16664. Epub 2021 Oct 20.
Results Reference
derived
Learn more about this trial
A Study of the Efficacy and Safety of CF102 in the Treatment of Non-Alcoholic Fatty Liver Disease
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