This is a randomized, double-blind, placebo-controlled study in up to 104 patients with a diagnosis of Non-alcoholic fatty Liver disease (NAFLD) and/or Non-alcoholic steatohepatitis (NASH). The study will be conducted over a period of up to 22 weeks and will include an optional Prescreening, Screening (Days -35 to -7) Phase, a 16-week Treatment Phase following randomization on Day 1. Patients will be randomly assigned in a ratio of 1:1:1:1 to receive Saroglitazar Magnesium 1mg or 2 mg or 4 mg or matching placebo once daily in the morning before breakfast for 16 Weeks. The primary endpoint of the study is percentage change from baseline in serum Alanine transaminase (ALT) levels at Week 16 in the Saroglitazar Magnesium groups as compared to the placebo group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
106
Patients randomly assigned to this group will receive Saroglitazar magnesium 1 mg tablet orally once daily for 16 weeks.
Patients randomly assigned to this group will receive Saroglitazar magnesium 2 mg tablet orally once daily for 16 weeks.
Patients randomly assigned to this group will receive Saroglitazar magnesium 4 mg tablet orally once daily for 16 weeks.
Patients randomly assigned to this group will receive placebo tablet orally once daily for 16 weeks.
Precision Research
Chula Vista, California, United States
Cedars-Sinai Medical Center
Los Angeles, California, United States
Catalina Research Institute
Montclair, California, United States
California liver research institute
Pasadena, California, United States
Precision Research
San Diego, California, United States
University of Florida
Gainesville, Florida, United States
Schiff Center for Liver Diseases/University of Miami
Miami, Florida, United States
Avail Clinical Research
Orange City, Florida, United States
Indiana University
Indianapolis, Indiana, United States
Mercy Medical Center
Baltimore, Maryland, United States
...and 8 more locations
Percentage Change From Baseline in Serum Alanine Aminotransferase (ALT) Levels at Week 16
Percentage change from baseline in serum ALT levels at Week 16 in the Saroglitazar Magnesium groups as compared to the placebo group
Time frame: Baseline and Week 16
Change in Liver Fat Content as Measured by Magnetic Resonance Imaging-derived Proton Density-fat Fraction (MRI-PDFF)
Change in liver fat content as measured by magnetic resonance imaging-derived proton in Saroglitazar Magnesium groups as compared to the placebo group
Time frame: Baseline and Week 16
Proportion of Patients With Sustain Decrease in Serum ALT Levels
Proportion of patients with sustain decrease in serum ALT levels in Saroglitazar Magnesium groups as compared to the placebo group
Time frame: Week 16
Changes in Cytokeratin-18
Changes in cytokeratin-18 in Saroglitazar Magnesium groups as compared to the placebo group
Time frame: baseline and Week 16
Changes in Enhanced Liver Fibrosis
Changes in enhanced liver fibrosis in Saroglitazar Magnesium groups as compared to the placebo group The ELF Score is a liver fibrosis score that is calculated by use of an algorithm: ELF score score = -7.412 + (ln(HA)\*0.681) + (ln(P3NP)\*0.775) + (ln(TIMP1)\*0.494). HA=hyaluronic acid concentration P3NP=procollagen 3 amino terminal peptide concentration TIMP1=tissue inhibitor matrix metalloproteinase 1 concentration. All are measured in serum. The ELF score has been reported to show good correlations with fibrosis stages in chronic liver disease, with higher ELF scores associated with higher fibrosis stages. The ELF score is hence used as a prognostic marker for disease progression: ELF score \< 9.8 : Low risk of progression, ELF score 9.8 to \< 11.3 : Moderate risk of progression and ELF score \> = 11.3 : High risk of progression
Time frame: baseline and Week 16
Change in Aspartate Aminotransferase-to-platelet Ratio Index
Change in aspartate aminotransferase-to-platelet ratio index in Saroglitazar Magnesium groups as compared to the placebo group APRI was calculated as (\[AST level/AST upper limit of normal\]/ \[Platelet count 1\^09/L\]) ×100, where AST is aspartate aminotransferase. The aspartate transaminase to platelet ratio index (APRI) is used to assess the risk of liver fibrosis. Higher APRI score represents a higher risk of liver fibrosis
Time frame: Baseline and Week 16
Pharmacokinetics of Saroglitazar Magnesium: Maximum Plasma Concentration (Cmax)
Maximum plasma concentration (Cmax) of Saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 7 (Week 16)
Time to Reach Maximum Plasma Concentration (Tmax)
Time to reach maximum plasma concentration (Tmax) of saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 7 (Week 16)
Terminal Half-life (t1/2)
Terminal Half-life (t1/2) of saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 7 (Week 16)
Area Under the Curve From the Time of Dosing to the Last Measurable Concentration (AUC0-t)
Area under the curve from the time of dosing to the last measurable concentration for saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 3 (Week 0)
Area Under the Curve From the Time of Dosing to the Infinity (AUC 0-inf)
Area under the curve from the time of dosing to the infinity (AUC 0-inf) for Saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 3 (Week 0)
Elimination Rate Constant (λz)
Elimination rate constant (λz) for saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 7 (Week 16)
Apparent Volume of Distribution (Vd/F)
Apparent volume of distribution (Vd/F) for Saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 7 (Week 16)
Apparent Clearance (CL/F)
Apparent clearance (CL/F) for Saroglitazar
Time frame: PK sampling timepoints: Pre-dose (0.0), 0.5, 1.0, 2.0, 3.0, 4.0, 6.0, 8.0, 10.0, and 24 hours post-dose of Visit 7 (Week 16)
Change in Quality of Life Assessed by the Short-Form 36 Health Survey
Quality of life will be assessed by the Short-Form 36 Health Survey The SF-36 is a multi-purpose, short-form health survey with 36 questions. It yields an 8-scale profile of functional health and well-being scores (domains) as well as psychometrically based physical and mental health summary measures. The SF-36 taps 8 health concepts: physical functioning, bodily pain, physical role functioning, emotional role functioning, emotional well-being, social functioning, vitality, and general health perceptions. The 8 scales are further summarized to 2 distinct higher-ordered clusters: the PCS and mental composite t-score (MCS). The range for all 8 domains as well as for the composite t-scores is from 0 to 100 with 100 as best possible health status and 0 as worst health status.
Time frame: baseline and 16 Week
Safety and Tolerability of Saroglitazar Magnesium
Number of participants with adverse events
Time frame: Baseline to Week 17
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