Colesevelam Versus Placebo in the Treatment of Nonalcoholic Steatohepatitis

University of California, San Diego59 enrolled

Overview

The purpose of the study is to see if the drug colesevelam is a potential treatment for Nonalcoholic Steatohepatitis(NASH).

We plan to investigate the role of colesevelam, a bile-acid binding resin, in patients with NASH residing in the United States and assess liver fat changes during therapy using MRI of the liver. It can be hypothesized that colesevelam would lead to a greater improvement in insulin sensitivity and lipid profile compared with placebo and may lead to greater improvement in liver fat by MRI as compared to placebo. In this pilot study, we propose to randomize approximately 55 patients (1:1 ratio) to either colesevelam or placebo and treat them for 24-weeks to evaluate changes in baseline insulin sensitivity, serum biochemistry (ALT and AST), and liver fat by MRI during therapy. Liver histologic changes would also be examined as an exploratory outcome for future studies.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Nonalcoholic Steatohepatitis

Interventions

Colesevelam HclDRUG

3.75 gm/day (six 675 mg tablets)

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age at entry at least 18 years. 2. Serum alanine (ALT) or aspartate (AST) aminotransferase activities that are above the upper limits of normal. 19 or more in women and 30 or more in men. 3. Evidence of hepatic steatosis or liver fat (\>5%) by MRI. 4. Evidence of definite or suspected NASH 5. Written informed consent. Exclusion criteria: 1. Evidence of another form of liver disease. 2. History of excess alcohol ingestion. 3. Contraindications to liver biopsy. 4. Decompensated liver disease. 5. History of gastrointestinal bypass surgery or ingestion of drugs known to produce hepatic steatosis. 6. Recent initiation or change of anti-diabetic drugs. 7. Use of colesevelam or other agents in the same class. 8. Significant systemic or major illnesses other than liver disease that, in the opinion of the investigator would preclude treatment with colesevelam and adequate follow up. 9. Positive test for anti-HIV. 10. Active substance abuse, such as alcohol, inhaled or injection drugs within the previous one year. 11. Pregnancy or inability to practice adequate contraception in women of childbearing potential. 12. Evidence of hepatocellular carcinoma

Locations (2)

UCSD: Prevention Studies Clinic

La Jolla, California, United States

UCSD: Medical Center- Hillcrest

San Diego, California, United States

Outcomes

Primary Outcomes

The Primary Outcome Will be Improvement in Hepatic Steatosis by Liver MRI

To examine the efficacy of Colesevelam at 3.75 g/day orally versus placebo to decrease liver fat in patients with biopsy-proven nonalcoholic steatohepatitis.

Time frame: 24 weeks

Secondary Outcomes

Insulin Sensitivity as Determined by HOMA-IR

To examine the efficacy of Colesevelam at 3.75 g/day orally versus placebo to decrease HOMA-IR in patients with biopsy-proven nonalcoholic steatohepatitis.

Time frame: 24 weeks

Serum ALT and AST Values

To examine the efficacy of Colesevelam at 3.75 g/day orally versus placebo to decrease serum ALT and AST in patients with biopsy-proven nonalcoholic steatohepatitis.

Time frame: 24 weeks

Lipid Profiles

To examine the efficacy of Colesevelam at 3.75 g/day orally versus placebo to decrease improve the lipid profiles in patients with biopsy-proven nonalcoholic steatohepatitis.

Time frame: 24 weeks

Data from ClinicalTrials.gov

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