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Saroglitazar Magnesium 4 mg in the Treatment of NAFLD in Women With PCOS (EVIDENCES VII)

Phase 2
Terminated
Conditions
Non-alcoholic Fatty Liver Disease in Women With PCOS
Interventions
Registration Number
NCT03617263
Lead Sponsor
Zydus Therapeutics Inc.
Brief Summary

This is a multicenter, phase 2A, randomized, double-blind, placebo-controlled study designed to evaluate the efficacy and safety of Saroglitazar Magnesium in women with well characterized PCOS.

Detailed Description

This is a multicenter, phase 2A, randomized, double-blind, placebo-controlled study designed to evaluate the efficacy and safety of Saroglitazar Magnesium in women with well characterized PCOS. \\

The study will be conducted over a period of up to 34 weeks and will include Screening (Days -28 to -7) Phase, a 24-week Treatment Phase following randomization on Day 1.

The primary endpoint of the study is change in hepatic fat content from baseline following 24 weeks of treatment as measured by MRI-PDFF.

Recruitment & Eligibility

Status
TERMINATED
Sex
Female
Target Recruitment
90
Inclusion Criteria
  • Females, 18 to 45 years of age.

  • Previously confirmed diagnosis of PCOS:

    1. oligo-and/or anovulation;
    2. hyperandrogenism (clinical and/or biochemical);
    3. polycystic ovary morphology on ultrasonography
  • Evidence of NAFLD within 6 months prior to the Screening Visit (Visit 1).

  • Alanine transaminase ≥ 38 U/L at Visit 1. Visit 2 ALT must not increase >30% from Visit 1.

  • Hepatic fat fraction ≥10% by MRI-PDFF.

  • Willingness to participate in the study.

  • Ability to understand and give informed consent for participation.

  • Woman who agrees to use the contraceptive methods.

Exclusion Criteria
  • Presence of other chronic liver diseases (hepatitis B or C, autoimmune hepatitis, cholestatic liver disease, Wilsons disease, hemochromatosis, etc.).
  • Average alcohol consumption ≥ 7 drinks per week for women in the 6 months prior to enrollment.
  • Clinical, imaging, or histological evidence of cirrhosis.
  • Patients who have used medications known to cause hepatic steatosis for more than 2 weeks in the past year.
  • Prior bariatric surgery.
  • Weight loss of more than 5% in the 3 months preceding screening.
  • Severe co-morbidities (e.g., advanced cardiac, renal, pulmonary, or psychiatric illness).
  • Known allergy, sensitivity or intolerance to Saroglitazar Magnesium, comparator or formulation ingredients.
  • Use of antidiabetic and lipid lowering medications if the dose is not stable for at least the 3 months preceding screening.
  • Intake of Vitamin E (>100 IU/day) or multivitamins containing Vitamin E (>100 IU/day) 3 months before enrollment.
  • Use of drugs with potential effect on NAFLD/NASH in the 3 months prior to screening.
  • Illicit substance abuse within the past 12 months.
  • Pregnant or breast feeding females.
  • Women with known Cushing syndrome or hyperprolactinemia.
  • Refusal or inability to comply with the requirements of the protocol, for any reason, including scheduled clinic visits and laboratory tests.
  • History of myopathies or evidence of active muscle diseases.
  • History or current significant cardiovascular disease.
  • History of malignancy.
  • History of bladder disease.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo tablet once daily in the morning before breakfast
Saroglitazar Magnesium 4 mgSaroglitazar Magnesium 4 mg TabletSaroglitazar Magnesium once daily in the morning before breakfast
Primary Outcome Measures
NameTimeMethod
Hepatic fat content24 weeks

Change in hepatic fat content from baseline following 24 weeks of treatment as measured by MRI-PDFF

Secondary Outcome Measures
NameTimeMethod
Insulin resistance12 and 24 weeks

Changes from baseline to week 12 and week 24 in insulin resistance as measured by HOMA

Liver fibrosis24 weeks

Changes from baseline to week 24 in fibrosis including CK-18, hs-CRP, and TNFα

MRI-derived measures of total liver fat index (It will be calculated as the product of liver volume and the liver mean proton-density fat fraction across all liver segments)24 weeks

Changes from baseline to week 24 in MRI-derived measures of total liver fat index

Area under Plasma concentration vs. time curve extrapolated to the infinity (AUC0-∞) after first dose (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Apparent Clearance [CL/F,ss] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Minimal or Trough plasma concentration [Cmin] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Fluctuation index (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Liver enzymes/LFTs12 and 24 weeks

Changes from baseline to week 12 and week 24 in liver enzymes/LFTs: ALT, AST, ALP,GGT, serum protein, albumin and total bilirubin.

Liver stiffness24 weeks

Changes from baseline to week 24 in liver stiffness measured by transient elastography/FibroScan

Waist circumference12 and 24 weeks

Changes from baseline to week 12 and week 24 in waist circumference

SHBG level12 and 24 weeks

Changes from baseline to week 12 and week 24 in SHBG level

Free androgen index ( Total testosterone level divided by the sex hormone binding globulin (SHBG) level, and then multiplying by a constant, usually 100. The concentrations of testosterone and SHBG are normally measured in nanomols per liter.12 and 24 weeks

Changes from baseline to week 12 and week 24 in free androgen index

Apparent Volume of distribution [Vd/F] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Peak Plasma concentration [Cmax,ss] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Markers of liver injury24 weeks

Changes from baseline to week 24 in markers of liver injury

Area under plasma concentration vs. time curve in a 24 h dosing interval (AUCtau) after last dose (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Accumulation index calculated as a ratio of AUCtau (last dose)/AUCtau (first dose) (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Controlled attenuation parameter24 weeks

Changes from baseline to week 24 in controlled attenuation parameter measured by transient elastography/ FibroScan

Lipid and lipoprotein levels12 and 24 weeks

Changes from baseline to week 12 and week 24 in lipid and lipoprotein levels: TG, TC, HDL, LDL, sdLDL, VLDL, apolipoprotein A and apolipoprotein B

Area under Plasma concentration vs. time curve till the last time point [AUC0-t] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Elimination rate constant [Kel] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Apparent Volume of distribution [Vd/F,ss] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

BMI12 and 24 weeks

Changes from baseline to week 12 and week 24 in BMI

MRI-derived measures of total liver volume (Liver volume will be calculated after complete segmentation by summing the liver surface area at each segmented slice, and then multiplying this sum by individual slice thickness, in millilitres [mL])24 weeks

Changes from baseline to week 24 in MRI-derived measures of total liver volume

Ovarian function12 and 24 weeks

Changes from baseline to week 12 and week 24 in ovarian function (Total testosterone, 17-hydroxyprogesterone, free testosterone, luteinizing hormone, follicle-stimulating hormone, LH-to-FSH ratio and estradiol)

Peak Plasma concentration [Cmax] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Time to reach peak Plasma concentration [Tmax] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Area under plasma concentration vs. time curve in a 24 h dosing interval (AUCtau) after first dose (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Elimination half-life [tHalf] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Apparent Clearance [CL/F] (For Single Dose)24 weeks

Pharmacokinetics of Saroglitazar following first dose

Time to reach peak Plasma concentration [Tmax,ss] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Elimination rate constant [Kel,ss] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Elimination half-life [thalf,ss] (For Multiple Dose)24 weeks

Pharmacokinetics of Saroglitazar following last dose

Trial Locations

Locations (19)

Zydus US002

🇺🇸

San Francisco, California, United States

Zydus US008

🇺🇸

Aurora, Colorado, United States

Zydus US005

🇺🇸

Chandler, Arizona, United States

Zydus US004

🇺🇸

Panorama City, California, United States

Zydus US010

🇺🇸

Miami, Florida, United States

Zydus US001

🇺🇸

Indianapolis, Indiana, United States

Zydus US011

🇺🇸

Morehead City, North Carolina, United States

Zydus US003

🇺🇸

Marion, Ohio, United States

Zydus US015

🇺🇸

Hershey, Pennsylvania, United States

Zydus US014

🇺🇸

Philadelphia, Pennsylvania, United States

Zydus US013

🇺🇸

Austin, Texas, United States

Zydus US007

🇺🇸

San Antonio, Texas, United States

Zydus US009

🇺🇸

San Antonio, Texas, United States

Zydus MX006

🇲🇽

Guadalajara, Jalisco, Mexico

Zydus MX001

🇲🇽

Monterrey, Nuevo León, Mexico

Zydus MX002

🇲🇽

Monterrey, Nuevo León, Mexico

Zydus MX005

🇲🇽

Culiacán, Sinaloa, Mexico

Zydus MX004

🇲🇽

Mérida, Yucatán, Mexico

Zydus MX003

🇲🇽

Ciudad de mexico, Mexico

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