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Assessment of the Safety and Effect of SAR425899 Versus Placebo for the Treatment of Non-alcoholic Fatty Liver Disease (Restore)

Primary Purpose

Non-alcoholic Steatohepatitis, Type 2 Diabetes Mellitus

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
SAR425899
Placebo
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-alcoholic Steatohepatitis

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria :

  • Non-diabetic or type 2 diabetes mellitus with confirmed non-alcoholic steatohepatitis.
  • Non-alcoholic fatty liver disease (NAFLD) activity score (NAS) >=4 with each of its components >=1.
  • Patients without Type 2 diabetes determined by HbA1c (glycated hemoglobin) <6.5% and Fasting Plasma Glucose (FPG) <7.0 mmol/L (<126 mg/dL).
  • Stable glycemic control (HbA1c <9.0%) and metabolic disorders managed with diet/exercise and/or stable dose metformin and/or sulphonylureas for at least 3 months prior to screening (type 2 diabetes patients).
  • Signed written informed consent form.

Exclusion criteria:

  • Diagnosis of type 1 diabetes mellitus.
  • Previous insulin use or use of insulin within the last 6 months, except for episode(s) of short-term treatment (<15 consecutive days) due to intercurrent illness.
  • Body Mass Index (BMI) <25 kg/m2 or >45.0 kg/m2.
  • Current participation in organized diet/weight reduction program or clinical trial of weight control (within the last 3 months prior to screening), or weight loss attempt, plans for major changes in physical activities or significant change in body weight in the 2 months prior to screening (significant change in body weight is defined as >=5% self-reported change within 6 months prior to randomization if a pre-existing liver biopsy sample was collected prior to screening period.
  • Current treatment with glucose-lowering agent(s) other than metformin or sulphonylureas, weight loss drugs including orlistat, systemic steroids, methotrexate, amiodarone, or Vitamin E.
  • Alcoholism (past or present) and/or average alcohol consumption per week >21 units (210 g) for males, >14 units (140 g) for females within the last 5 years.
  • Poorly controlled hypertension (resting systolic blood pressure (SBP) >160 mm Hg and/or resting diastolic blood pressure (DBP) >95 mm Hg) at screening.
  • Some liver diseases, pancreatic disease, liver transplantation and types of cancer.
  • Pregnant or breast-feeding women.
  • Women of childbearing potential (WOCBP) not protected by highly-effective method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy.
  • Male subjects, whose partners are able to become pregnant, who do not accept to use a condom during sexual intercourse from study inclusion up to 3 months after last dosing; or who are planning to donate sperm from study inclusion up to 3 months after last dosing.
  • Patients with coronary, carotid, or peripheral artery revascularization procedures planned during the screening or treatment phases of the protocol.
  • Patients with unstable heart conditions.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Placebo Comparator

    Placebo Comparator

    Arm Label

    SAR425899 (Low Dose)

    SAR425899 (High Dose)

    Placebo (Low Dose)

    Placebo (High Dose)

    Arm Description

    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.

    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.

    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.

    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.

    Outcomes

    Primary Outcome Measures

    Resolution of Non-alcoholic steatohepatitis (NASH)
    Percentage of participants with absence of hepatocyte ballooning (NAFLD - non-alcoholic fatty liver disease - activity score, NAS = 0) without worsening of fibrosis score at week 52. -

    Secondary Outcome Measures

    No hepatocyte ballooning, lobular inflammation score 0 or 1, without worsening of fibrosis
    Percentage of participants with absence of hepatocyte ballooning (NAS = 0), lobular inflammation NAS = 0 or 1, without worsening of fibrosis score at week 52.
    Change in overall NAFLD activity score (NAS)
    Change from baseline to week 52 in overall NAFLD activity score (NAS).
    Change in NAS individual components
    Change from baseline to week 52 in individual components of NAS (steatosis).
    Change in NAS individual components
    Change from baseline to week 52 in individual components of NAS (hepatocyte ballooning).
    Change in NAS individual components
    Change from baseline to week 52 in individual components of NAS (lobular inflammation).
    Change in fibrosis score
    Change from baseline to week 52 in fibrosis score.
    Major adverse cardiac events
    Number of patients with major cardiac events
    Change in Magnetic Resonance Imaging-determined Proton Density Fat Fraction (MRI-PDFF)
    Change from baseline to week 26 and to week 52 in MRI-PDFF-derived total liver fat, liver volume and fractional liver fat content.
    Improvement of fibrosis without worsening of hepatocyte ballooning component of NAS
    Percentage of participants with improvement of fibrosis by at least 1 stage without worsening of hepatocyte ballooning component of NAS at week 52
    Change in body weight
    Change from baseline to week 52 in body weight
    Change in waist circumference
    Change from baseline to week 52 in waist circumference
    Change in hip circumference
    Change from baseline to week 52 in hip circumference
    Change in waist to hip ratio
    Change from baseline to week 52 in waist to hip ratio
    Assessment of pharmacokinetic (PK) parameter: AUC0-24
    Area under the concentration-time curve from 0 to 24 hours (AUC0-24)
    Assessment of PK parameter: Cmax
    Observed maximum plasma concentration after administration (Cmax)
    Assessment of PK parameter: Ctrough
    Plasma concentration immediately prior to treatment administration during repeat dosing levels (Ctrough)

    Full Information

    First Posted
    February 13, 2018
    Last Updated
    April 5, 2022
    Sponsor
    Sanofi
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03437720
    Brief Title
    Assessment of the Safety and Effect of SAR425899 Versus Placebo for the Treatment of Non-alcoholic Fatty Liver Disease
    Acronym
    Restore
    Official Title
    A 52-week Double-blind, Randomized, Placebo-controlled, Phase 2 Study to Assess the Efficacy and Safety of SAR425899 for the Treatment of Non-alcoholic Steatohepatitis (NASH)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Sponsor decision to cancel TRIAL, not related to safety concern.
    Study Start Date
    May 23, 2019 (Anticipated)
    Primary Completion Date
    August 25, 2021 (Anticipated)
    Study Completion Date
    August 25, 2021 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sanofi

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Primary Objective: - To evaluate the dose response relationship of SAR425899 compared to placebo on resolution of non-alcoholic steatohepatitis (NASH) with no worsening of fibrosis in diabetic and non-diabetic patients with histopathologically-confirmed NASH. Secondary Objectives: To assess the effect of SAR425899 on overall non-alcoholic fatty liver disease (NAFLD) activity score (NAS), individual components of NAS (steatosis, hepatocyte ballooning, and lobular inflammation), and fibrosis score. To assess to the effect of SAR425899 on MRI-PDFF (Magnetic Resonance Imaging-determined Proton Density Fat Fraction) derived parameters (total liver fat, liver volume, and fractional liver fat content). To assess the effect of SAR425889 on body weight and waist/hip circumference ratio. To assess SAR425899 pharmacokinetics. To assess safety and tolerability of SAR425899.
    Detailed Description
    Study duration per participant will be approximately 64 weeks, consisting of up to 8 weeks screening plus 52 weeks treatment and 4 weeks post treatment follow-up.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Non-alcoholic Steatohepatitis, Type 2 Diabetes Mellitus

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    SAR425899 (Low Dose)
    Arm Type
    Experimental
    Arm Description
    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.
    Arm Title
    SAR425899 (High Dose)
    Arm Type
    Experimental
    Arm Description
    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.
    Arm Title
    Placebo (Low Dose)
    Arm Type
    Placebo Comparator
    Arm Description
    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.
    Arm Title
    Placebo (High Dose)
    Arm Type
    Placebo Comparator
    Arm Description
    Once daily dose with weekly dose escalations, if tolerated, until target dose is reached. From week 14 (Day 99) until week 52, no further dose adjustments are planned.
    Intervention Type
    Drug
    Intervention Name(s)
    SAR425899
    Intervention Description
    Pharmaceutical form: Solution for injection Route of administration: Subcutaneous injection
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Pharmaceutical form: Solution for injection Route of administration: Subcutaneous injection
    Primary Outcome Measure Information:
    Title
    Resolution of Non-alcoholic steatohepatitis (NASH)
    Description
    Percentage of participants with absence of hepatocyte ballooning (NAFLD - non-alcoholic fatty liver disease - activity score, NAS = 0) without worsening of fibrosis score at week 52. -
    Time Frame
    Week 52
    Secondary Outcome Measure Information:
    Title
    No hepatocyte ballooning, lobular inflammation score 0 or 1, without worsening of fibrosis
    Description
    Percentage of participants with absence of hepatocyte ballooning (NAS = 0), lobular inflammation NAS = 0 or 1, without worsening of fibrosis score at week 52.
    Time Frame
    Week 52
    Title
    Change in overall NAFLD activity score (NAS)
    Description
    Change from baseline to week 52 in overall NAFLD activity score (NAS).
    Time Frame
    Baseline to week 52
    Title
    Change in NAS individual components
    Description
    Change from baseline to week 52 in individual components of NAS (steatosis).
    Time Frame
    Baseline to week 52
    Title
    Change in NAS individual components
    Description
    Change from baseline to week 52 in individual components of NAS (hepatocyte ballooning).
    Time Frame
    Baseline to week 52
    Title
    Change in NAS individual components
    Description
    Change from baseline to week 52 in individual components of NAS (lobular inflammation).
    Time Frame
    Baseline to week 52
    Title
    Change in fibrosis score
    Description
    Change from baseline to week 52 in fibrosis score.
    Time Frame
    Baseline to week 52
    Title
    Major adverse cardiac events
    Description
    Number of patients with major cardiac events
    Time Frame
    Baseline to week 52
    Title
    Change in Magnetic Resonance Imaging-determined Proton Density Fat Fraction (MRI-PDFF)
    Description
    Change from baseline to week 26 and to week 52 in MRI-PDFF-derived total liver fat, liver volume and fractional liver fat content.
    Time Frame
    Baseline to week 26 and week 52
    Title
    Improvement of fibrosis without worsening of hepatocyte ballooning component of NAS
    Description
    Percentage of participants with improvement of fibrosis by at least 1 stage without worsening of hepatocyte ballooning component of NAS at week 52
    Time Frame
    Week 52
    Title
    Change in body weight
    Description
    Change from baseline to week 52 in body weight
    Time Frame
    Baseline to week 52
    Title
    Change in waist circumference
    Description
    Change from baseline to week 52 in waist circumference
    Time Frame
    Baseline to week 52
    Title
    Change in hip circumference
    Description
    Change from baseline to week 52 in hip circumference
    Time Frame
    Baseline to week 52
    Title
    Change in waist to hip ratio
    Description
    Change from baseline to week 52 in waist to hip ratio
    Time Frame
    Baseline to week 52
    Title
    Assessment of pharmacokinetic (PK) parameter: AUC0-24
    Description
    Area under the concentration-time curve from 0 to 24 hours (AUC0-24)
    Time Frame
    Week 52
    Title
    Assessment of PK parameter: Cmax
    Description
    Observed maximum plasma concentration after administration (Cmax)
    Time Frame
    Week 52
    Title
    Assessment of PK parameter: Ctrough
    Description
    Plasma concentration immediately prior to treatment administration during repeat dosing levels (Ctrough)
    Time Frame
    Baseline to week 52

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion criteria : Non-diabetic or type 2 diabetes mellitus with confirmed non-alcoholic steatohepatitis. Non-alcoholic fatty liver disease (NAFLD) activity score (NAS) >=4 with each of its components >=1. Patients without Type 2 diabetes determined by HbA1c (glycated hemoglobin) <6.5% and Fasting Plasma Glucose (FPG) <7.0 mmol/L (<126 mg/dL). Stable glycemic control (HbA1c <9.0%) and metabolic disorders managed with diet/exercise and/or stable dose metformin and/or sulphonylureas for at least 3 months prior to screening (type 2 diabetes patients). Signed written informed consent form. Exclusion criteria: Diagnosis of type 1 diabetes mellitus. Previous insulin use or use of insulin within the last 6 months, except for episode(s) of short-term treatment (<15 consecutive days) due to intercurrent illness. Body Mass Index (BMI) <25 kg/m2 or >45.0 kg/m2. Current participation in organized diet/weight reduction program or clinical trial of weight control (within the last 3 months prior to screening), or weight loss attempt, plans for major changes in physical activities or significant change in body weight in the 2 months prior to screening (significant change in body weight is defined as >=5% self-reported change within 6 months prior to randomization if a pre-existing liver biopsy sample was collected prior to screening period. Current treatment with glucose-lowering agent(s) other than metformin or sulphonylureas, weight loss drugs including orlistat, systemic steroids, methotrexate, amiodarone, or Vitamin E. Alcoholism (past or present) and/or average alcohol consumption per week >21 units (210 g) for males, >14 units (140 g) for females within the last 5 years. Poorly controlled hypertension (resting systolic blood pressure (SBP) >160 mm Hg and/or resting diastolic blood pressure (DBP) >95 mm Hg) at screening. Some liver diseases, pancreatic disease, liver transplantation and types of cancer. Pregnant or breast-feeding women. Women of childbearing potential (WOCBP) not protected by highly-effective method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy. Male subjects, whose partners are able to become pregnant, who do not accept to use a condom during sexual intercourse from study inclusion up to 3 months after last dosing; or who are planning to donate sperm from study inclusion up to 3 months after last dosing. Patients with coronary, carotid, or peripheral artery revascularization procedures planned during the screening or treatment phases of the protocol. Patients with unstable heart conditions. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Clinical Sciences & Operations
    Organizational Affiliation
    Sanofi
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

    Learn more about this trial

    Assessment of the Safety and Effect of SAR425899 Versus Placebo for the Treatment of Non-alcoholic Fatty Liver Disease

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