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Non Alcoholic Fatty Liver DiseasePhase 2NCT02941549

Safety And Efficacy Study Of Orally Administered Epeleuton In Patients With NAFLD

A Phase 2 study testing Epeleuton in people with Non Alcoholic Fatty Liver Disease, run by Afimmune at 16 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this randomised, double-blind, placebo-controlled, parallel group study is to assess the safety and efficacy of orally administered Epeleuton capsules versus placebo in the treatment of adult patients with Non Alcoholic Fatty Liver Disease (NAFLD) Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Non Alcoholic Fatty Liver Disease
What is being tested?
Epeleuton
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
96 participants
Where
16 sitesin 3 countries
Study dates
20 Dec 2016to 4 Mar 2019
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients diagnosed with NAFLD by the presence of hepatic steatosis on imaging or histology in the absence of any secondary causes.
  • Patients with an ALT ≥ 1.5 upper limit of normal (ULN) and < 5 ULN on two occasions 7 or more days apart during screening.
  • Patients with historical liver biopsy showing NASH and/or ≥ F1 fibrosis OR NFS ≥ -1.455 OR Fib- 4 ≥ 1.3 OR Fibroscan ≥8kPa within 3 months of screening.
  • Patients with a body mass index (BMI) between 25.0 and 40.0 kg/m² inclusive. Patients with a history of controlled obesity or controlled diabetes are allowed on the study.
  • Patients whose pre-study clinical laboratory findings do not interfere with their participation in the study, in the opinion of the Investigator.
  • Patients aged between 18 and 75 years inclusive.
  • Female patients and male patients with female partners of child bearing potential must use adequate contraception or have a sterilized partner for the duration of the study. Adequate contraception is defined as: systemic hormonal contraceptives; intrauterine device or barrier method of contraception in conjunction with spermicide; or agree to sexual abstinence, defined as a patient refraining from heterosexual intercourse during the entire period of risk associated with the study treatments and in line with their preferred and usual lifestyle. Hormonal contraceptives must be on a stable dose for at least one month before baseline.
  • Patients who are able to communicate well with the Investigator, to understand and comply with the requirements of the study, and understand and sign the written informed consent.

Who cannot join

  • Patients with an unstable metabolic condition such as weight change > 5% in the 3 months prior to inclusion.
  • Patients with medical/surgical history of gastric bypass surgery, orthotopic liver transplant (OLT) or listed for OLT.
  • Patients with uncontrolled diabetes mellitus type 2, i.e. HbA1c ≥ 9% (75 mmol/mol) at the time of screening.
  • Patients with decompensated or severe liver disease as evidenced by one or more of the following: confirmed cirrhosis or suspicion of cirrhosis, esophageal varices, ascites, suspicion of portal hypertension, hospitalization for liver disease within 60 days of screening, bilirubin ≥ 2 x ULN, or ALT or AST ≥ 5 x ULN. Patients with Gilbert's syndrome are eligible if the conjugated bilirubin is ≤ 1.5 x ULN.
  • Patients with inflammatory bowel disease that is either active or requiring medical therapy.
  • Patients with diagnosed or suspected autoimmune diseases such as systemic lupus erythematosus and/or rheumatoid arthritis.
Show all 18Show fewer
  • Patients with a history of or active non-liver malignancies other than curatively treated skin cancer (basal cell or squamous cell carcinomas).
  • Patients with a significant systemic or major illness other than liver disease, including coronary artery disease, cerebrovascular disease, pulmonary disease, renal insufficiency, serious psychiatric disease, respiratory or hypertensive disease, as well as diabetes and arthritis that, in the opinion of the Investigator, would preclude the patient from participating in and completing the study.
  • Patients requiring anti-diabetic treatment (including insulin sensitizing agents), and/or lipid lowering treatment, and who are not on a stable dose for at least 3 months prior to screening should be excluded. If patients are insulin dependent this treatment should have commenced at least 3 months prior to screening, however changes in dose are permitted.
  • Patients with known hypersensitivity to any ingredients of the study treatment.
  • Patients with a positive test for human immunodeficiency virus antibodies, Hepatitis B surface antigen or Hepatitis C antibodies at screening.
  • Patients with liver disease of other etiologies such as drug-induced, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, haemochromatosis, alpha-1 antitrypsin deficiency or Wilson's disease.
  • Patients with a significant history of drug/solvent abuse, in the opinion of the investigator.
  • Patients with a history of alcohol abuse in the opinion of the Investigator, or who currently drinks in excess of 21 units per week (males) or 14 units per week (females), whereby a unit consists of 10ml or 8mg of pure alcohol.
  • Patients who have used dietary supplements rich in omega-3 or omega-6 fatty acids in the 4 weeks prior to baseline.
  • Patients who have participated in any other clinical study with an investigational drug within 3 months before the first day of administration of study treatment.
  • Patients who are pregnant, planning pregnancy, breastfeeding and/or are unwilling to use adequate contraception (as specified in inclusion criterion 7) during the study.
  • Patients, in the opinion of the Investigator, not suitable to participate in the study.

Trial locations and contacts

16 sites in 3 countries.

16 sites in 3 countries

United Kingdom9 sites
  • UK Site 9

    Belfast

  • UK Site 1

    Birmingham, UK

  • UK Site 5

    Birmingham, UK

  • UK Site 8

    Liverpool

  • UK Site 6

    London, UK

  • UK Site 7

    Norwich, UK

  • UK Site 3

    Oxford, UK

  • UK Site 4

    Plymouth, UK

  • UK Site 2

    Portsmouth, UK

Other trials in United Kingdom

Ukraine4 sites
  • Ukraine Site 3

    Dnipro

  • Ukraine Site 1

    Kharkiv

  • Ukraine Site 2

    Kyiv

  • Ukraine Site 4

    Kyiv

Other trials in Ukraine

Georgia3 sites
  • Georgia Site 1

    Kutaisi

  • Georgia Site 2

    Kutaisi

  • Georgia Site 3

    Tbilisi

Other trials in Georgia

About this study

Official title: A Randomised, Double-Blind, Placebo-Controlled, Exploratory Phase IIa Study To Assess The Safety And Efficacy Of Orally Administered Epeleuton In NAFLD Patients.

The purpose of this randomised, double-blind, placebo-controlled, parallel group study is to assess the safety and efficacy of orally administered Epeleuton capsules versus placebo in the treatment of adult patients with Non Alcoholic Fatty Liver Disease (NAFLD)

Being tested
Placebo capsules, Epeleuton
Medical subject headings
Non-alcoholic Fatty Liver Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Placebo capsulesOther

  • EpeleutonDrug

Study groups in NCT02941549
Study groupRoleWhat they receive
PlaceboPlacebo comparator2 x placebo 500 mg capsules orally administered twice a day (4 capsules daily) for 16 weeks
Receives: Other: Placebo capsules
1000 mg EpeleutonExperimental1 x Epeleuton 500 mg capsule and 1 x placebo 500 mg capsule orally administered twice a day (4 capsules daily) for 16 weeks
Receives: Drug: Epeleuton
2000 mg EpeleutonExperimental2 x Epeleuton 500 mg capsules orally administered twice a day (4 capsules daily) for 16 weeks
Receives: Drug: Epeleuton

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Serum ALT (Alanine Aminotransferase) From Baseline to Week 16

    Change in serum ALT from baseline to Week 16 using ANCOVA.

    Measured: 16 Weeks

  2. Change in Liver Stiffness Measurements by Transient Elastography From Baseline to Week 16

    To evaluate change in liver stiffness measurements using Transient Elastography from baseline to Week 16 using FibroScan® 502 Touch model or equivalent.

    Measured: 16 Weeks

  3. Number of Treatment Emergent Adverse Events (TEAEs) in Each Treatment Group Leading to Treatment Discontinuation

    Subjects with at least 1 TEAE leading to treatment discontinuation

    Measured: 20 Weeks

Secondary outcomes (9)
  1. Change in Serum ALT (Alanine Aminotransferase) From Baseline to Weeks 2, 4, 8 and 12

    Change in serum ALT from baseline to weeks 2, 4, 8 and 12.

    Measured: 12 Weeks

  2. Change in AST (Aspartate Aminotransferase) From Baseline to Weeks 2, 4, 8, 12 and 16

    Change in serum AST from baseline to weeks 2, 4, 8, 12 and 16.

    Measured: 16 Weeks

  3. Change in AST:ALT Ratio From Baseline to Weeks 2, 4, 8, 12 and 16

    Change in AST: ALT ratio from baseline to weeks 2, 4, 8, 12 and 16.

    Measured: 16 Weeks

  4. Change in FIB-4 Index From Baseline to Week 16

    Change in FIB-4 Index from baseline to week 16. This index is based on age, platelet count, ALT level, and AST level and will be assessed at Baseline (Visit 2) and week 16 (Visit 10). FIB-4 was calculated using the following formula: FIB4 = (Age (years) x AST (U/L))/(Platelet count (10^9/L) x √ALT (U/L)). A decrease in FIB-4 represents a positive outcome. A FIB-4 Index of <1.45 indicates none to moderate fibrosis and an Index of >3.25 indicates advanced fibrosis.

    Measured: 16 Weeks

  5. Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Fibrosis Score (NFS) From Baseline to Week 16

    Change in NAFLD fibrosis score (NFS) from baseline to week 16. The NFS is based on age, hyperglycemia, BMI, platelet count, albumin level, and AST/ALT ratio. NFS was calculated using the following formula: NAFLD fibrosis score = -1.675 + 0.037 × age (years) + 0.094 × BMI (kg/m^2) + 1.13 × IFG/diabetes (yes = 1, no = 0) + 0.99 × AST/ALT ratio - 0.013 × platelet (×10^9/l) - 0.66 × albumin (g/dl). A decrease in NFS score represents a positive outcome. An NFS score of <-1.455 indicates no advanced fibrosis and a score of >0.676 indicates liver fibrosis.

    Measured: 16 Weeks

  6. Change in ELF (Enhanced Liver Fibrosis Score) From Baseline to Week 16

    Change in ELF from baseline to week 16. Enhanced Liver Fibrosis score is an extracellular matrix marker set consisting of tissue inhibitor of metalloproteinases 1 (TIMP-1), amino-terminal propeptide of type III procollagen (PIIINP) and hyaluronic acid (HA). A decrease in ELF score represents a positive outcome. The ELF score was calculated for the instrument based on the following equation: ELF score = 2.494 + 0.846 In (CHA) + 0.735 In (CPIIINP) + 0.391 In (CTIMP-1). An ELF score of less than 7.7 indicates no fibrosis. An ELF score greater than or equal to 9.8 indicates severe fibrosis. An ELF score of 11.3 or greater indicates cirrhosis.

    Measured: 16 Weeks

  7. Change in HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) From Baseline to Weeks 2, 4, 8, 12 and 16

    Change in HOMA-IR from baseline to weeks 2,4,8,12,16. Homeostatic model assessment for insulin resistance (HOMA-IR) was assessed as a measure of insulin resistance. HOMA-IR is calculated by multiplying fasting plasma insulin by fasting plasma glucose, then dividing by the constant 405. A decrease in HOMA-IR indicates a positive outcome. HOMA-IR values of greater than 1.9 indicates early insulin resistance and levels above 2.9 indicate significant insulin resistance.

    Measured: 16 Weeks

  8. Change in Adipo-IR (Adipose Tissue Insulin Resistance) From Baseline to Weeks 2, 4, 8, 12 and 16.

    Change in Adipo-IR from baseline to weeks 2, 4, 8, 12 and 16. Adipose tissue insulin resistance (Adipo-IR) was assessed as a measure of insulin resistance. Adipo- IR is calculated by multiplying fasting non-esterified fatty acids by fasting insulin. A decrease in Adipo-IR indicates a positive outcome.

    Measured: 16 Weeks

  9. Change in Hepatic Fat Measured by CAP (Controlled Attenuation Parameter) From Baseline to Week 16.

    Change in hepatic fat measured by CAP (controlled attenuation parameter) from baseline to week 16 using FibroScan® 502 Touch model or equivalent. CAP score is measured in decibels per meter (dB/m). A reduction in hepatic fat measured non-invasively by CAP indicates an improvement in hepatic steatosis. CAP scores range from 100 to 400dB/m. 0 to 237 dB/M indicates no hepatic steatosis, 238 to 260 dB/m indicates mild hepatic steatosis, 260 to 290 dB/m indicates moderate steatosis and a CAP score greater than 290 dB/m indicates severe steatosis.

    Measured: 16 Weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Oct 2016 (estimated)
  2. Study start20 Dec 2016
  3. Primary completion2 Jan 2019
  4. Study completion4 Mar 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
96 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02941549
Sponsor's protocol ID
DS102A-02
Other IDs
2016-000311-33, 2016
Status last verified
Sep 2022
First submitted
20 Oct 2016
Last updated
12 Oct 2022
Data monitoring committee
Yes

Publications

  • Climax J, Newsome PN, Hamza M, Weissbach M, Coughlan D, Sattar N, McGuire DK, Bhatt DL. Effects of Epeleuton, a Novel Synthetic Second-Generation n-3 Fatty Acid, on Non-Alcoholic Fatty Liver Disease, Triglycerides, Glycemic Control, and Cardiometabolic and Inflammatory Markers. J Am Heart Assoc. 2020 Aug 18;9(16):e016334. doi: 10.1161/JAHA.119.016334. Epub 2020 Aug 11.

    PubMed 32779505

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Epeleuton in people with Non Alcoholic Fatty Liver Disease, run by Afimmune at 16 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Oct 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in United Kingdom, Ukraine, Georgia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Apr 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Serum ALT (Alanine Aminotransferase) From Baseline to Week 16 (time frame: 16 Weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02941549, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Oct 2022.

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