This is a phase 2A, single center, open-label, single-arm, 24-week study to evaluate the safety, tolerability and efficacy of Saroglitazar Magnesium 4 mg in liver transplant recipients with NAFLD.
This is a phase 2A, single center, open-label, single-arm, 24-week study to evaluate the safety, tolerability and efficacy of Saroglitazar Magnesium 4 mg in liver transplant recipients with NAFLD. The study will be conducted over a period of up to 33 weeks and will include 5 weeks screening, a 24 week treatment period and 4 week follow-up period. The primary end point of the study is to assess the safety of Saroglitazar Magnesium 4 mg in liver transplant recipients with NAFLD over 24 weeks of treatment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Saroglitazar magnesium 4 mg tablet once daily (OD) in the morning 60 minutes before breakfast without food
Virginia Commonwealth University
Richmond, Virginia, United States
Number of Participants With Adverse Events Assessed by CTCAE
Safety measured by adverse events, vital signs, physical exams, body weight, electrocardiograms (ECGs) and lab results (including hematology, chemistry and urinalysis)
Time frame: 24 weeks
Hepatic Fat
Changes in hepatic fat as determined by MRI-PDFF from baseline to end-of-treatment (EOT)
Time frame: Baseline and week 24
Liver Stiffness
Changes in Liver stiffness as determined by MRE from baseline to end-of-treatment (EOT) Liver stiffness is a measure of a mechanical property of tissue (stiffness). This can be measured non-invasively by MR elastography, a technique that involves applying an external vibration to the abdomen and measuring the progression of shear waves through the underlying liver using MRI.
Time frame: Baseline and Week 24
Frequently Sampled Intravenous Glucose Tolerance Test (Insulin Resistance Marker)
Changes in frequently sampled intravenous glucose tolerance test (FSIVGTT) from baseline to EOT
Time frame: Baseline and Week 24
Glycosylated Hemoglobin (Insulin Resistance Marker)
Changes in glycosylated hemoglobin (HbA1c) from baseline to EOT
Time frame: Baseline and Week 24
Fructosamine (Insulin Resistance Marker)
Changes in fructosamine from baseline to EOT
Time frame: Baseline and Week 24
Serum Liver Enzymes
Changes in serum liver enzymes from baseline to EOT
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Time frame: Baseline and Week 24
Serum Liver Enzymes; Bilirubin
Changes in bilirubin from baseline to EOT
Time frame: Baseline and Week 24
Serum Lipids
Changes in serum lipids from baseline to EOT
Time frame: Baseline and Week 24
Small Dense Low-density Lipoprotein (Atherogenic Lipoprotein)
Changes in small dense low-density lipoprotein (sdLDL) from baseline to EOT
Time frame: Baseline and Week 24
LDL Size (Atherogenic Lipoprotein)
Changes in LDL size from baseline to EOT
Time frame: Baseline and Week 24
LDL Concentration (Atherogenic Lipoprotein)
Changes in LDL concentration from baseline to EOT
Time frame: Baseline and Week 24
Very Low-density Lipoprotein (Atherogenic Lipoprotein)
Changes in subtypes of very low-density lipoprotein (VLDL) from baseline to EOT
Time frame: Baseline and Week 24
Very Low-density Lipoprotein Chylomicron Triglyceride (Atherogenic Lipoprotein)
Changes in VLDL chylomicron triglyceride from baseline to EOT
Time frame: Baseline and Week 24
High-density Lipoprotein (Atherogenic Lipoprotein)
Changes in high-density lipoprotein (HDL) from baseline to EOT
Time frame: Baseline and Week 24
Change in Metabolic Flexibility; Time to Peak RQ
Metabolic flexibility was measured via a whole room calorimeter (i.e. respiration chamber). The CO2 production and O2 consumption were recorded every minute for a total of 18 hours while study participants were in the respiration chamber on baseline and Week 24. Metabolic flexibility was quantified by measuring whole-body CO2 production relative to O2 consumption or respiratory quotient (RQ). The RQ oscillates between 0.7 and 1.0, which is indicative of either predominantly fatty acid or carbohydrate oxidation, respectively. The time to maximal carbohydrate consumption is measured by the time it takes to reach peak RQ after a standardized meal, whereas maximal carbohydrate consumption is measured at the peak of RQ vs. time curve. Next, the transition from maximal carbohydrate consumption to maximal fatty acid consumption is measured from peak RQ to lowest RQ. Finally, fasting biofuel utilization is measured in the fasting state and represents predominantly fatty acid oxidation.
Time frame: Baseline and Week 24
Quality of Life (SF-36 Health Survey)
Change in Quality of life score from baseline to EOT 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 the worst health status
Time frame: Baseline and Week 24
Peak Plasma Concentration [Cmax]
Pharmacokinetics of Saroglitazar following first and last dose.
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Time to Reach Peak Plasma Concentration [Tmax]
Pharmacokinetics of Saroglitazar following first and last dose
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Area Under Plasma Concentration vs. Time Curve Till the Last Time Point [AUC0-t]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 visit at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Area Under Plasma Concentration vs. Time Curve Extrapolated to the Infinity [AUC0-∞]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 visit at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Area Under Plasma Concentration vs. Time Curve in a 24 h Dosing Interval [AUCtau]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Elimination Rate Constant [λz]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Elimination Half-life [t1/2]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Apparent Volume of Distribution [Vd/F]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 (Baseline) and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Apparent Clearance [CL/F]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Minimal or Trough Plasma Concentration [Cmin]
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Week 24 visit at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Accumulation Index Calculated as a Ratio of AUCtau (Last Dose)/AUCtau (First Dose)
Pharmacokinetics of Saroglitazar
Time frame: PK Sampling time points: Day 1 and Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose
Fluctuation Index
Fluctuation index is the peak trough fluctuation within complete dosing interval at steady state, calculated as PTF (%) = (\[Cmax - Cmin\]/Cav ) multiplied by 100
Time frame: PK Sampling time points: Week 24 visits at pre-dose (0), 0.5, 1.0, 2, 3, 4, 6, 8, 10 and 24-hour post-dose