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Clinical Trial to Investigate the Anti-oxidant Activity of Heptex in Patients With Apparent Risk Factors of NASH (PHYLLANTEX)

Primary Purpose

Nonalcoholic Steatohepatitis

Status
Completed
Phase
Phase 2
Locations
Egypt
Study Type
Interventional
Intervention
Heptex
Rice bran
Sponsored by
Natural Wellness Egypt
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Nonalcoholic Steatohepatitis focused on measuring NASH

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female aged between 18 and 65 years.
  2. Both male and female patients who have childbearing potential must agree to practice an acceptable method of birth control during the study and for at least 6 months after the cessation of treatment; such contraceptive methods must include at least one barrier method.
  3. Controlled Attenuation Parameter (CAP)-confirmed hepatic steatosis.
  4. Patients with elevated serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels but less than 2.5 times the upper limit of the normal range.
  5. Liver fibrosis stage F1-F2 as diagnosed by the FibroScan liver stiffness measurement of 5-10 kPa.
  6. Liver condition according the following criteria;

    • Serum albumin > 3 g/dl
    • INR < 2
    • No ascites on ultrasound
    • No documented or suspected hepatic encephalopathy
  7. Willing to stop any other liver support and hepatoprotective medications throughout study duration.
  8. Able and willing to provide written informed consent.
  9. Able and willing to complete all study visits and procedures, including compliance with the requirements and restrictions listed in the consentform.

Exclusion Criteria:

  1. Pregnant or lactating women.
  2. Patients with BMI > 40 Kg/m2 or BMI < 18.5 Kg/m2.
  3. Serum creatinine > 1.5 x ULN OR creatinine clearance (GFR) < 60 mL/minute.
  4. Platelet count < 75,000/mm3.
  5. Uncontrolled diabetes mellitus as evident by HbA1c ≥ 8.5%.
  6. Patients who are currently receiving Thiazolidinediones.
  7. Patients with ischemic heart disease (IHD).
  8. History of parenteral nutrition.
  9. History of liver transplant.
  10. Viral hepatitis, drug-induced liver injury, metabolic liver disease or auto-immune liver disease.
  11. Liver cancer or serum alpha-fetoprotein (AFP) >100ng/ml. Patients with an AFP between 50 and 100ng/ml may be included as long as a liver ultrasound within 3 months of screening, or at screening, shows no evidence of potential hepatocellular cancer.
  12. Use of drugs known to induce steatosis (valproate, amiodarone or prednisone) or to affect body weight and carbohydrate metabolism.
  13. Use of drugs known to alter liver enzymes.
  14. Allergy or allergic history to any of the drug components.
  15. History of alcohol abuse as assessed by the investigator within the past 2 years, or an alcohol use pattern that may interfere with the patient's study compliance. Patients must have abstained from alcohol for at least 6 months prior to study start.
  16. Patients with history of clinically-significant illness or any other major medical disorder that may interfere with subject treatment, assessment, or compliance with the protocol.
  17. Receipt of an investigational drug within 6 months prior to screening, or active enrolment in another investigational medication or device trial.
  18. Patients with any chronic illness or prior treatment which in the opinion of the investigator should preclude participation in the trial.
  19. Inability to understand and cooperate with the investigators or to give valid consent.

Sites / Locations

  • National Hepatology & Tropical Medicine Research Instistute
  • Tropical Medicine Department, Faculty of Medicine, Ain Shams University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Placebo

Heptex-low dose

Heptex-high dose

Arm Description

Placebo (Rice bran) in 2 capsules size 1, administered PO TID on empty stomach with plenty of water.

Low dose The contents of one capsule of Heptex is equally distributed and inserted into 2 capsules size 1, administered PO TID on empty stomach with plenty of water.

High dose The contents of two capsule of Heptex is equally distributed and inserted into 2 capsules size 1, administered PO TID on empty stomach with plenty of water.

Outcomes

Primary Outcome Measures

explore the anti-oxidant activity of Heptex
assessed by the change in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in patients with apparent risk factors of NASH.

Secondary Outcome Measures

explore the hepatoprotective effect of Heptex
assessed by the change in Fibrosis score (F0 to F1: 2 to 7 kPa, F2: 7.5 to 10 kPa, F3: 10 to 14 kPa, F4: 14 kPa or higher) and by the occurrence of hepatic complications.

Full Information

First Posted
May 15, 2019
Last Updated
April 18, 2022
Sponsor
Natural Wellness Egypt
Collaborators
Ain Shams University, National Hepatology & Tropical Medicine Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT05343780
Brief Title
Clinical Trial to Investigate the Anti-oxidant Activity of Heptex in Patients With Apparent Risk Factors of NASH
Acronym
PHYLLANTEX
Official Title
A Phase II, Randomized, Double Blind, Placebo-Controlled Clinical Trial to Investigate the Anti-oxidant Activity of Heptex in Patients With Apparent Risk Factors of Nonalcoholic Steatohepatitis (NASH)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
May 8, 2019 (Actual)
Primary Completion Date
February 21, 2022 (Actual)
Study Completion Date
February 21, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Natural Wellness Egypt
Collaborators
Ain Shams University, National Hepatology & Tropical Medicine Research Institute

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
A Phase II, Randomized, Double Blind, Placebo-Controlled Clinical Trial to Investigate the Anti-oxidant Activity of Heptex in Patients with Apparent Risk Factors of Nonalcoholic Steatohepatitis (NASH)
Detailed Description
This is a phase II, randomized, double blind placebo-controlled, three-arm, parallel-group, intervention clinical trial evaluating anti-oxidant activity of Heptex; a herbal medicinal product of Aerial Parts of Phyllanthus niruri (Dukung Anak) and Fruits of Silybum marianum (Milk Thistle) in patients with apparent risk factors of NASH.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nonalcoholic Steatohepatitis
Keywords
NASH

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Masking Description
Double blinded
Allocation
Randomized
Enrollment
142 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo (Rice bran) in 2 capsules size 1, administered PO TID on empty stomach with plenty of water.
Arm Title
Heptex-low dose
Arm Type
Experimental
Arm Description
Low dose The contents of one capsule of Heptex is equally distributed and inserted into 2 capsules size 1, administered PO TID on empty stomach with plenty of water.
Arm Title
Heptex-high dose
Arm Type
Experimental
Arm Description
High dose The contents of two capsule of Heptex is equally distributed and inserted into 2 capsules size 1, administered PO TID on empty stomach with plenty of water.
Intervention Type
Drug
Intervention Name(s)
Heptex
Intervention Description
Dukung Anak 200 mg + Milk thistle 100 mg
Intervention Type
Other
Intervention Name(s)
Rice bran
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
explore the anti-oxidant activity of Heptex
Description
assessed by the change in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in patients with apparent risk factors of NASH.
Time Frame
36 weeks
Secondary Outcome Measure Information:
Title
explore the hepatoprotective effect of Heptex
Description
assessed by the change in Fibrosis score (F0 to F1: 2 to 7 kPa, F2: 7.5 to 10 kPa, F3: 10 to 14 kPa, F4: 14 kPa or higher) and by the occurrence of hepatic complications.
Time Frame
36 weeks
Other Pre-specified Outcome Measures:
Title
To explore the lipid-lowering effect of Heptex
Description
To explore the lipid-lowering effect of Heptex as assessed by the change in lipid profile.
Time Frame
36 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female aged between 18 and 65 years. Both male and female patients who have childbearing potential must agree to practice an acceptable method of birth control during the study and for at least 6 months after the cessation of treatment; such contraceptive methods must include at least one barrier method. Controlled Attenuation Parameter (CAP)-confirmed hepatic steatosis. Patients with elevated serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels but less than 2.5 times the upper limit of the normal range. Liver fibrosis stage F1-F2 as diagnosed by the FibroScan liver stiffness measurement of 5-10 kPa. Liver condition according the following criteria; Serum albumin > 3 g/dl INR < 2 No ascites on ultrasound No documented or suspected hepatic encephalopathy Willing to stop any other liver support and hepatoprotective medications throughout study duration. Able and willing to provide written informed consent. Able and willing to complete all study visits and procedures, including compliance with the requirements and restrictions listed in the consentform. Exclusion Criteria: Pregnant or lactating women. Patients with BMI > 40 Kg/m2 or BMI < 18.5 Kg/m2. Serum creatinine > 1.5 x ULN OR creatinine clearance (GFR) < 60 mL/minute. Platelet count < 75,000/mm3. Uncontrolled diabetes mellitus as evident by HbA1c ≥ 8.5%. Patients who are currently receiving Thiazolidinediones. Patients with ischemic heart disease (IHD). History of parenteral nutrition. History of liver transplant. Viral hepatitis, drug-induced liver injury, metabolic liver disease or auto-immune liver disease. Liver cancer or serum alpha-fetoprotein (AFP) >100ng/ml. Patients with an AFP between 50 and 100ng/ml may be included as long as a liver ultrasound within 3 months of screening, or at screening, shows no evidence of potential hepatocellular cancer. Use of drugs known to induce steatosis (valproate, amiodarone or prednisone) or to affect body weight and carbohydrate metabolism. Use of drugs known to alter liver enzymes. Allergy or allergic history to any of the drug components. History of alcohol abuse as assessed by the investigator within the past 2 years, or an alcohol use pattern that may interfere with the patient's study compliance. Patients must have abstained from alcohol for at least 6 months prior to study start. Patients with history of clinically-significant illness or any other major medical disorder that may interfere with subject treatment, assessment, or compliance with the protocol. Receipt of an investigational drug within 6 months prior to screening, or active enrolment in another investigational medication or device trial. Patients with any chronic illness or prior treatment which in the opinion of the investigator should preclude participation in the trial. Inability to understand and cooperate with the investigators or to give valid consent.
Facility Information:
Facility Name
National Hepatology & Tropical Medicine Research Instistute
City
Cairo
Country
Egypt
Facility Name
Tropical Medicine Department, Faculty of Medicine, Ain Shams University
City
Cairo
Country
Egypt

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Clinical Trial to Investigate the Anti-oxidant Activity of Heptex in Patients With Apparent Risk Factors of NASH

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