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To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes

Primary Purpose

Non-alcoholic Steatohepatitis, Type2 Diabetes

Status
Unknown status
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
Sponsored by
Yonsei University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-alcoholic Steatohepatitis

Eligibility Criteria

20 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients ages >= 20 years
  2. Patients diagnosed with non-alcoholic fatty liver disease (NAFLD).

    => Definition of NAFLD: CAP (Controlled attenuation parameter) >= 250 dB/m

  3. Diabetic patients who meet one of the following glycemic conditions:

    • Patients with glycated hemoglobin (HbA1c) ranging 6.5~8.5 % while not taking an antidiabetic for more than 12 weeks irrespective of duration of diabetes.
    • Patients with HbA1c ranging 6.5~9.0 % in screening while using metformin monotherapy for more than 8 weeks without changing the dose irrespective of duration of diabetes.

Exclusion Criteria:

  1. Patients who meet the criteria for alcoholic liver disease whose alcohol intake for the recent tow years if above 210 g per week in men and above 140 g per week in women)
  2. Patients with chronic hepatitis B, C, or type 1 diabetes, or secondary diabetes
  3. Patients with history of acute or chronic metabolic acidosis and ketoacidosis, including diabetic ketoacidosis accompanied or not accompanied by coma
  4. Patients who were administered an oral hypoglycemic agent or insulin other than metformin within 8 weeks prior ro screening, or are likely to be administered it during the study duration among patients receiving monotherapy.
  5. Patients who had hypersensitivity to biguanide or glitazone in the past.
  6. Patients who received oral or parenteral corticosteroid treatment chronically (for more than 14 consecutive days) within 8 weeks prior to screening
  7. Patients wih past history of lactic acidosis
  8. Patients with a genetic disorder, such as galactose intolerance, Lapp lactase deficiency or glucose-galactose impaired absorption, etc.
  9. Patients wih malnutrition, starvation, weakness, (Including patients with severe infection), pituitary insufficiency or adrenal insufficiency
  10. Patients who have been receiving radiotherapy or chemotherapy due to bladder cancer and other malignant tumor, or it is less than 2 years since the patients received it.
  11. Patients with past history of bladder cancer
  12. A patient with history of drug abuse or alcoholism in 12 weeks
  13. A patient who has hear failure (NYHA class 3~4) or uncontrolled arrhythmia within 6 months
  14. A patient who has acute cardiovascular disease within 12 weeks (including unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass, or coronary intervention)
  15. A person who falls under one of the followings:

1) A patient with serum creatinine level >= 1.5 mg/dL in men and 1.4 mg/dL in women or a patient wih moderate to severe renal impairment (creatinine clearance: < 50 ml/min) 2) An anemia patient with 10.5 g/dL of Hb level

  • A pregnant or nursing woman
  • A patient who does not consent to use a proper method of contraception during the study period only among women or men of childbearing age
  • A patient who has taken investigational drug in other clinical study within 4 weeks following informed consent
  • A person who may not participate in the study according to investigator's judgement
  • A person who cannot read the informed consent form (e.g: an illiterate, a foreigner, etc.)

Sites / Locations

  • Division of Geriatrics, Department of Internal Medicine, Yonsei University College of MedicineRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks

Outcomes

Primary Outcome Measures

A degree of liver steatosis
Magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) will be evaluated to confirm the improvement in liver steatosis.
A degree of liver fibrosis
In liver fibroscan, liver stiffness (kPa) as a marker of fibrosis and CAP (dB/m) as a marker of steatosis will be estimated.

Secondary Outcome Measures

Clinical glucometabolic parameters : HbA1c
HbA1c in %
Clinical glucometabolic parameters : Lipid parameters
Total cholesterol in mg/dL
Clinical glucometabolic parameters : Lipid parameters
Triglyceride in mg/dL
Clinical glucometabolic parameters : Lipid parameters
HDL-cholesterol in mg/dL
Clinical glucometabolic parameters : Lipid parameters
LDL-cholesterol in mg/dL
Clinical glucometabolic parameters : Liver enzymes
AST in IU/L
Clinical glucometabolic parameters : Liver enzymes
ALT in IU/L
Clinical glucometabolic parameters :Anthropometric parameters
Blood pressure in mmHg
Clinical glucometabolic parameters :Anthropometric parameters
Body weight in kilogram
Clinical glucometabolic parameters :Anthropometric parameters
Body mass idex in kg/m2

Full Information

First Posted
May 8, 2019
Last Updated
October 8, 2020
Sponsor
Yonsei University
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1. Study Identification

Unique Protocol Identification Number
NCT03950505
Brief Title
To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes
Official Title
To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes: A Prospective, Open-Label, Single-Arm, Single-Center Clinical Study
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Unknown status
Study Start Date
May 29, 2020 (Actual)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Yonsei University

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
This study was designed to evaluate the effect of Nesinaact on non-alcoholic steatohepatitis through magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) and liver fibroscan in patients with type 2 diabetes. This is a prospective, open-label, single-arm, single-center clinical Study. After 24 weeks of Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment, the improvement of parameters estimated by MRI and liver fibroscan will be estimated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-alcoholic Steatohepatitis, Type2 Diabetes

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Model Description
This is a prospective, open-label, single-arm, single-center clinical Study. All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks.
Masking
None (Open Label)
Masking Description
No masking is applied, as this is an open label study
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
Intervention Type
Drug
Intervention Name(s)
Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
Intervention Description
All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks. Patients who have not been prescribed any other anti-diabetic drugs at least for 12 weeks and whose HbA1c ranges from 6.5~8.5%, can be enrolled. If Patients has been prescribed metformin as monotherapy, they have to substitute metformin with nesinaact 25-15 for enrollment.
Primary Outcome Measure Information:
Title
A degree of liver steatosis
Description
Magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) will be evaluated to confirm the improvement in liver steatosis.
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
A degree of liver fibrosis
Description
In liver fibroscan, liver stiffness (kPa) as a marker of fibrosis and CAP (dB/m) as a marker of steatosis will be estimated.
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Secondary Outcome Measure Information:
Title
Clinical glucometabolic parameters : HbA1c
Description
HbA1c in %
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters : Lipid parameters
Description
Total cholesterol in mg/dL
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters : Lipid parameters
Description
Triglyceride in mg/dL
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters : Lipid parameters
Description
HDL-cholesterol in mg/dL
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters : Lipid parameters
Description
LDL-cholesterol in mg/dL
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters : Liver enzymes
Description
AST in IU/L
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters : Liver enzymes
Description
ALT in IU/L
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters :Anthropometric parameters
Description
Blood pressure in mmHg
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters :Anthropometric parameters
Description
Body weight in kilogram
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment
Title
Clinical glucometabolic parameters :Anthropometric parameters
Description
Body mass idex in kg/m2
Time Frame
24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients ages >= 20 years Patients diagnosed with non-alcoholic fatty liver disease (NAFLD). => Definition of NAFLD: CAP (Controlled attenuation parameter) >= 250 dB/m Diabetic patients who meet one of the following glycemic conditions: Patients with glycated hemoglobin (HbA1c) ranging 6.5~8.5 % while not taking an antidiabetic for more than 12 weeks irrespective of duration of diabetes. Patients with HbA1c ranging 6.5~9.0 % in screening while using metformin monotherapy for more than 8 weeks without changing the dose irrespective of duration of diabetes. Exclusion Criteria: Patients who meet the criteria for alcoholic liver disease whose alcohol intake for the recent tow years if above 210 g per week in men and above 140 g per week in women) Patients with chronic hepatitis B, C, or type 1 diabetes, or secondary diabetes Patients with history of acute or chronic metabolic acidosis and ketoacidosis, including diabetic ketoacidosis accompanied or not accompanied by coma Patients who were administered an oral hypoglycemic agent or insulin other than metformin within 8 weeks prior ro screening, or are likely to be administered it during the study duration among patients receiving monotherapy. Patients who had hypersensitivity to biguanide or glitazone in the past. Patients who received oral or parenteral corticosteroid treatment chronically (for more than 14 consecutive days) within 8 weeks prior to screening Patients wih past history of lactic acidosis Patients with a genetic disorder, such as galactose intolerance, Lapp lactase deficiency or glucose-galactose impaired absorption, etc. Patients wih malnutrition, starvation, weakness, (Including patients with severe infection), pituitary insufficiency or adrenal insufficiency Patients who have been receiving radiotherapy or chemotherapy due to bladder cancer and other malignant tumor, or it is less than 2 years since the patients received it. Patients with past history of bladder cancer A patient with history of drug abuse or alcoholism in 12 weeks A patient who has hear failure (NYHA class 3~4) or uncontrolled arrhythmia within 6 months A patient who has acute cardiovascular disease within 12 weeks (including unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass, or coronary intervention) A person who falls under one of the followings: 1) A patient with serum creatinine level >= 1.5 mg/dL in men and 1.4 mg/dL in women or a patient wih moderate to severe renal impairment (creatinine clearance: < 50 ml/min) 2) An anemia patient with 10.5 g/dL of Hb level A pregnant or nursing woman A patient who does not consent to use a proper method of contraception during the study period only among women or men of childbearing age A patient who has taken investigational drug in other clinical study within 4 weeks following informed consent A person who may not participate in the study according to investigator's judgement A person who cannot read the informed consent form (e.g: an illiterate, a foreigner, etc.)
Facility Information:
Facility Name
Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kwang Joon Kim, MD, Ph.D
Phone
+82-2-2228-0960
Email
PREPPIE@yuhs.ac

12. IPD Sharing Statement

Learn more about this trial

To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes

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