Does the novel drug decrease liver fat in subjects with NASH or NAFLD as compared to placebo
We propose to evaluate hepatic fat and hepatic fibrosis using magnetic resonance elastography (MRE) liver (pre vs. post). We will also establish glucose tolerance status by our established labeled oral glucose tolerance test (OGTT) (6,6 ²H2 glucose). Following baseline evaluation subjects with biopsy/MRE proven NASH will be randomized to one of two groups and treated either with active drug (AZ compound) or placebo for 12 weeks (plus or minus 1 week). Subjects with history suggestive of non-alcoholic fatty liver disease (NAFLD) or NASH will be invited to participate. If they meet criteria following initial screening they will be included in the study. OGTT, liver MRE will be repeated. Liver enzymes \[aspartate aminotransferase (AST), alanine aminotransferase (ALT),alkaline phosphatase (ALP)\] as well as other safety tests \[creatine phosphokinase (CPK), thyroid stimulating hormone (TSH), international normalized ratio (INR),total bilirubin\] will be measured before, monthly during therapy and at one month following therapy. Furthermore, we will also do the subgroup analysis in NASH/NAFLD subjects with and without diabetes to see the effect of the drug.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
93
AZ compound 800 mg/day for 12 weeks (plus or minus 1 week) in two divided doses morning (400 mg) and evening (400 mg).
Placebo 800 mg/day for 12 weeks (plus or minus 1 week) in two divided doses morning (400 mg) and evening (400 mg).
Yogesh Yadav
Charlottesville, Virginia, United States
Percentage Change in Hepatic Fat
Percentage Hepatic fat measured using Magnetic Resonance Imaging (Proton Density Fat Fraction). A cut-off of \<5% is used to distinguish between normal and fatty liver.
Time frame: baseline, approximately 12 weeks
Number of Participants With no Conversion of [13C] Cortisone to [13C] Cortisol
Hepatic conversion of \[13C\] cortisone to \[13C\] cortisol was assessed before and after the treatment in both groups using the triple tracer cortisol test.
Time frame: baseline, approximately 12 weeks
Liver Fibrosis Measured With MRE in kPa
Liver fibrosis will be measured with Magnetic Resonance Enterography (MRE) at baseline and then compared after \~12 weeks of treatment. A clinical cut-off of 2.93 kPa was used to classify the results as either normal or elevated liver stiffness. Change in Liver fibrosis (kPa) is compared in between the groups.
Time frame: baseline, approximately 12 weeks
Total Insulin Sensitivity (Si) and Hepatic Insulin Sensitivity (Si Liver)
Total insulin sensitivity (Si) and hepatic insulin sensitivity (Si liver) will be measured with an Oral glucose Tolerance test at baseline and after \~12 weeks of treatment.
Time frame: baseline, approximately 12 weeks
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