NCT01051219已完成3 期
A Randomised, Controlled Trial of Losartan as an Anti-fibrotic Agent in Non-alcoholic Steatohepatitis
Newcastle-upon-Tyne Hospitals NHS Trust10 个研究点 分布在 1 个国家目标入组 45 人开始时间: 2011年5月最近更新:
适应症
干预措施
试验速览
- 阶段
- 3 期
- 状态
- 已完成
- 发起方
- 入组人数
- 45
- 试验地点
- 10
- 主要终点
- The primary outcome will be change in Kleiner fibrosis score, [Kleiner DE et al Hepatology 2005], based on histological fibrosis stage (as judged by two independent blinded histopathologists from liver biopsies), from pre-treatment to end-of-study
研究概览
简要总结
This is a randomized, controlled trial to determine whether Losartan is effective at slowing down, halting or reversing liver fibrosis in patients with non-alcoholic steatohepatitis (NASH). Liver fibrosis is the accumulation of tough, fibrous scar tissue in the liver which occurs in patients with NASH. NASH resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage, which may lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to function properly.
Primary hypothesis:
That losartan is superior to placebo in reversing, slowing down or halting fibrosis in patients with non-alcoholic fatty liver disease, after 24 months of treatment.
Secondary hypothesis:
- That the safety profile of the angiotensin receptor blocker (losartan) in this patient population is acceptable
- That losartan can prevent clinical deterioration in non-alcoholic fatty liver disease
- That serum, radiological and histological markers of fibrosis correlate in these patients over a 24 month period
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults (both males and females, aged 18+) with steatohepatitis and fibrosis (Kleiner F1-F3), resulting from non-alcoholic fatty liver disease.
排除标准
- •Refusal or inability (lack of capacity) to give informed consent
- •Average alcohol ingestion >21 units/week (males) or >14 units/week (females)
- •History or presence of Type 1 diabetes mellitus
- •Haemoglobin A1C >15.0
- •Other causes of chronic liver disease or hepatic steatosis
- •Any contra-indication to liver biopsy
- •History of, or planned, gastrointestinal bypass surgery
- •Hepatocellular carcinoma
- •Previous liver transplantation
- •Recent significant weight loss (>5% total body weight within last 6 months)
- •Electrolyte disturbance: potassium level outside the normal (local) range
- •Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >10 x upper limit of normal (ULN) at screening
- •Recent (within 6 months of baseline liver biopsy and screening visit) or concomitant use of agent known to cause hepatic steatosis (corticosteroids, amiodarone, methotrexate, tamoxifen, tetracycline, high dose oestrogens, valproic acid), or concomitant use of pioglitazone, fluconazole, rifampicin or any drug contra-indicated in the Losartan SmPC
- •Introduction of metformin, glitazones, a GLP-1 agonist, Vitamin E or C, betaine, s-adenosyl methionine, ursodeoxycholic acid, silymarin, fibrate, pentoxifylline, orlistat, sibutramine or rimonabant within 3 months of baseline liver biopsy and screening visit
- •Intolerance of angiotensin receptor blockers (ARBs) or presence of multiple allergic reactions to drugs
- •Use of angiotensin-converting enzyme (ACE) inhibitor or ARB in previous year
- •Hypotension (systolic <100, diastolic <60)
- •Renal failure (Cr >130)
- •Participation in any clinical study of an investigational agent within 30 days or five half-lives of the investigational product, whichever is longer
- •Presence of clinically relevant cardiovascular, pulmonary, gastrointestinal, renal, hepatic, metabolic, haematological, neurological, psychiatric, systemic, ocular, gynaecologic or any acute infectious disease or signs of acute illness that, in the opinion of the investigator, might compromise the patient's safe participation in the trial
- •Presence or history of cancer within the past 5 years with exception of adequately treated localized basal cell carcinoma of the skin, in situ cervical carcinoma or solid malignancy surgically excised in toto without recurrence for five years
- •Women of child-bearing potential not protected by effective contraceptive method of birth control or surgical sterilization and/or who are unwilling or unable to be tested for pregnancy (Pregnancy status will be checked by serum pregnancy testing before initiation of study treatment and by urine pregnancy testing during the trial)
- •Known allergy or sensitivity to losartan or its excipients (microcrystalline cellulose [E460]; lactose monohydrate; pregelitanized maize starch; magnesium stearate [E572]; hydroxypropyl cellulose [E463]; hypromellose [E464])
研究组 & 干预措施
Losartan, daily medication
Active Comparator
50 milligrams Losartan to be taken orally daily
干预措施: Losartan (Drug)
Placebo
Placebo Comparator
A matched placebo will be given for patients to take once daily
干预措施: Losartan (Drug)
结局指标
主要结局
The primary outcome will be change in Kleiner fibrosis score, [Kleiner DE et al Hepatology 2005], based on histological fibrosis stage (as judged by two independent blinded histopathologists from liver biopsies), from pre-treatment to end-of-study
时间窗: trial entry, end of study (2 years)
次要结局
- Change in radiological (fibroscan) and serological (ELF) markers of fibrosis(trial entry, 48 weeks, 96 weeks)
- change in NAFLD activity score (NAS)(trial entry, end of study)
- comparison of "responder rate" - placebo versus intervention(trial entry, end of study)
研究者
研究点 (10)
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