Pharmacokinetics of NRL972 in Patients With Nonalcoholic Steatohepatitis (NASH) and Non-Alcoholic Fatty Liver Disease (NAFLD)

Prospective Single-centre, Open-label Study to Assess the Pharmacokinetics of Cholyl-lysl-fluorescein (NRL972) in Patients With Clinical Evidence for Non-alcoholic Fatty Liver Disease (NAFLD): Supporting the Disease Staging Into Fatty Liver Disease Versus Non-alcoholic Steatohepatitis (NASH)

This study is to evaluate the predictive value of NRL972 pharmacokinetics in the diagnosis of steatohepatitis using fatty liver disease as the comparator group. In addition, the sensitivity and specificity of NRL972 pharmacokinetics as a diagnostic tool will be compared to results from the standard laboratory tests, elastography, tests of metabolic markers and serum fibrosis markers frequently used in the evaluation of clinically predicted NAFLD patients. Patients will be included if they have clinical evidence of fatty liver disease and have been referred to the clinic for a diagnostic work-up, including a liver biopsy, blood tests and scans of the liver.

Study Overview

• Status: Completed
• Conditions: Nonalcoholic Steatohepatitis; Non-Alcoholic Fatty Liver Disease
• Intervention / Treatment: Drug: NRL972

• Study Type: Interventional
• Enrollment (Actual): 125
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Durham, North Carolina, United States, 27710
      • Duke University Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Subjects meeting the following conditions will be eligible for enrollment:

• Males or females (females of non-child-bearing potential or of child-bearing potential while taking medically appropriate contraception)
• Any ethnicity
• Age: 18 to 80 years of age
• Clinical evidence of non-alcoholic liver disease requiring the conduct of a liver biopsy for the diagnosis of NAFLD and/or staging of disease severity
• Willing and able to provide informed consent

Exclusion Criteria:

Subjects fulfilling any of the following criteria will be excluded from enrollment:

General - all subjects

• Presence of acute or chronic viral hepatitis confirmed by serology
• Clinical signs of significant cholestasis
• Liver impairment due to space-occupying processes (e.g. carcinoma)
• Liver transplant recipient or patient scheduled for liver transplantation
• Clinically evident rapidly deteriorating hepatic function
• Significant bleeding diathesis
• Esophageal bleeding within the 8 weeks prior to study entry
• Presence of any contraindications for the conduct of the planned liver biopsy (e.g. allergy to lidocaine, coagulopathy with <100 x109/L thrombocytes and/or INR >1.3
• History of any allergic reaction to fluorescein
• Presence of any acute infection
• Previous participation in this trial
• Having received any investigational drug or treatment within 30 days prior to study entry or requiring a concurrent treatment with any other experimental drug or treatment
• Uncontrolled hypo- or hypertension (treated or untreated) with resting systolic blood pressure >160 or < 90 mmHg, diastolic blood pressure >95 or < 50 mmHg
• Clinically relevant abnormal laboratory values indicating end-stage renal, pulmonary or cardiac disease
• Known HIV infection
• Concurrent alcohol use of more than 14 drinks (140g ethanol) for men and 7 drinks (70g ethanol) for women per week (each drink is counted as 10g ethanol)
• History of drug or alcohol abuse within 2 months prior to dosing
• Use of prohibited medication (section 4.8)
• Donation of blood during the last 60 days or a history of blood loss exceeding 300 mL within the last 3 months
• Suspicion or evidence that the subject is not trustworthy and reliable
• Suspicion or evidence that the subject is not able to make a free consent or to understand the information in this regard
• Significant side effects prior to the liver biopsy (e.g. anxiety requiring pre-medication) or after the biopsy (e.g. pain requiring i.v. pain medication, bleeding re-quiring medical intervention)

General - all females

• Positive pregnancy test
• Pre-menopausal women not using appropriate contraception

Study Plan

How is the study designed?

Design Details

• Primary Purpose: DIAGNOSTIC
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: NRL972	Drug: NRL972; Single dose of 2 mg NRL972 administered intravenously. Total volume 5mL.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The primary efficacy variable is the NRL972 fractional retention ratio for 10 and 30 minutes post-dose (C30/C10) for different populations with NAFLD.	30 minutes post-dose

Secondary Outcome Measures

Outcome Measure	Time Frame
Approximate overall clearance and t½ within 60 minutes of dosing with NRL972. Cmax, AUC(0-∞), and mean residence time derived from a non-compartmental analysis.	60 minutes post-dose

Collaborators and Investigators

• Sponsor: Norgine
• Investigators: Principal Investigator: Manal F Abdelmalek, M.D., MPH, Duke University

Publications and helpful links

General Publications

• Glass O, Henao R, Patel K, Guy CD, Gruss HJ, Syn WK, Moylan CA, Streilein R, Hall R, Mae Diehl A, Abdelmalek MF. Serum Interleukin-8, Osteopontin, and Monocyte Chemoattractant Protein 1 Are Associated With Hepatic Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Hepatol Commun. 2018 Sep 21;2(11):1344-1355. doi: 10.1002/hep4.1237. eCollection 2018 Nov.

Study record dates

Study Major Dates

• Study Start: June 1, 2008
• Primary Completion (ACTUAL): March 1, 2010
• Study Completion (ACTUAL): November 1, 2011

Study Registration Dates

• First Submitted: November 19, 2008
• First Submitted That Met QC Criteria: November 19, 2008
• First Posted (ESTIMATE): November 20, 2008

Study Record Updates

• Last Update Posted (ESTIMATE): June 10, 2015
• Last Update Submitted That Met QC Criteria: June 9, 2015
• Last Verified: August 1, 2010

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Liver Diseases; Fatty Liver; Non-alcoholic Fatty Liver Disease
• Other Study ID Numbers: NRL972-01/2007 (FLD)