This is a Phase I/II open-label uncontrolled, prospective study to assess the clinical and biological effects of Deferasirox (ICL 670, Exjade®) in patients with NASH and increased iron storage / distribution of iron on liver function and liver histology. NASH is defined clinically and histologically by elevated liver enzymes, signs of hepatic steatosis on ultrasound and magnetic resonance imaging, impaired liver function as expressed by functional breath tests, and significantly altered liver histology. Patients will be treated in a phase I and phase II part for either 12 or 48 weeks. Both study parts have different endpoints: in phase I the side effect profile will be evaluated while in phase II the therapeutic response will be tested. Accordingly, measures will be different. Approximately 10 patients in phase I and 50 patients in phase II will be enrolled according to sample size calculations. The design is an "adaptive" Two-stage design, allowing to minimize the number of patients included into the trial as well as to introduce corrections for the second stage.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
5
Two dose escalating cohorts of oral administration in Phase I. Phase II: oral administration of the maximum tolerated dose.
Zollernalbklinikum
Balingen/Hechingen, Germany
Charité, Virchow Klinikum
Berlin, Germany
Klinikum der J. W. Goethe-Universität, Med. Klinik I
Frankfurt, Germany
Universitätsklinikum Halle, Klinik & Poliklinik für Innere Medizin I
Halle, Germany
Universitätsklinikum des Saarlandes
Homburg/Saar, Germany
Universitätsklinikum Magdeburg, Klinik für Gastroenterologie, Hepatologie und Infektiologie
Magdeburg, Germany
Universitätsklinikum Mainz, I. Medizinische Klinik und Poliklinik
Mainz, Germany
Universitätsklinikum Regensburg, Klinik und Poliklinik für Innere Med. I
Regensburg, Germany
Universitätsklinikum Tübingen, Medizinische Klinik IV
Tübingen, Germany
Safety and tolerability of deferasirox in all patients (Phase I)
Safety and tolerability assessments will consist of evaluating (serious) adverse events, laboratory parameters including hematology, chemistry; vital signs and physical examinations according to CTC.
Time frame: Phase I: 12 weeks of treatment
Changes in liver histology in all patients (Phase II)
A decrease in the NASH activity score (NAS) of ≥1 compared to baseline will be classified as response, an unchanged score or an increase in NAS will be judged as non-response.
Time frame: Phase II: 48 weeks of treatment
Phase I: e.g. changes in liver enzymes, serum ferritin, and hemoglobin levels
Time frame: Phase I: 12 weeks of treatment
Phase II: e.g. changes in MRI and histology based assessment of hepatic steatosis, fibrosis and iron content
Time frame: Phase II: 48 weeks of treatment
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