- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04250259
SAMe Trial for Patients With Alcoholic Cirrhosis
A Multi-center, Randomized, Placebo-controlled Trial of S-Adenosylmethionine (SAMe) in Patients With Alcoholic Cirrhosis
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Kristina Chandler, BS
- Phone Number: (317) 988-4733
- Email: krimhick@iu.edu
Study Contact Backup
- Name: Maggie Hesler, BS
- Phone Number: (317) 988-4545
- Email: mshesler@iu.edu
Study Locations
-
-
California
-
Los Angeles, California, United States, 90048
- Recruiting
- Cedars-Sinai Medical Center
-
Contact:
- Brandon Love
- Phone Number: 310-423-9917
- Email: brandon.love@cshs.org
-
Sub-Investigator:
- Shelly Lu, MD
-
-
Indiana
-
Indianapolis, Indiana, United States, 46202
- Recruiting
- Indiana University Hospital
-
Principal Investigator:
- Suthat Liangpunsakul, MD
-
Contact:
- Kristina Chandler, BS
- Phone Number: 317-988-4733
- Email: krimhick@iu.edu
-
Contact:
- Maggie Hesler, BS
- Phone Number: 3179884545
- Email: mshesler@iu.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria for patients with alcoholic cirrhosis
- Evidence of cirrhosis as per clinical signs and/or noninvasive transient elastography (Fibroscan®), computed tomography, magnetic resonance imaging including MRI elastography compatible with cirrhosis and/or histopathology by biopsy and
- subjects with clinical presentation either in Child Class A or B at the time of enrollment
- individuals 18 to 70 years old and may or may not consume alcohol during study.
Inclusion criteria for healthy control :
) individuals 18 to 70 years old (2) able to provide informed consent (3) subjects do not consume any alcohol or those who drink < 50 grams per day on average in women and < 80 grams per day on average in men (4) subjects are healthy without underlying acute or chronic medical conditions.
Exclusion criteria for patients with alcoholic cirrhosis
- Active infection as evidenced by positive urine culture, blood culture, or pneumonia,
- Known co-existing infection with hepatitis C, hepatitis B, or HIV
- Significant systemic or major illness including chronic obstructive pulmonary disease, congestive heart failure, and renal failure that in the opinion of the Investigator would preclude the patient from participating in and completing the study
- Gastrointestinal bleeding within the prior 28 days3
- Participation in another investigational drug, biologic, or medical device trial within 30 days prior to screening
- Women who are pregnant, may become pregnant, or nursing
- Presence of any other disease or condition that is interfering with the absorption, distribution, metabolism, or excretion of SAMe such as those with gastric bypass surgery
- Subjects with history of/diagnosis of hepatocellular carcinoma
- Members from the same family of study participant. This is based on the recent paper on the non-random sampling in randomized controlled trials4. We acknowledge that if we assign family members to identical treatment, randomization would not be totally correct; but if properly randomized, there is a chance that the members of the family might mix the pills. To avoid this issue and maintain the integrity of randomized blinded fashion, we will not include members from the same family into the study
- Subjects with psychiatric illnesses such as bipolar disorders as SAMe may interfere with the levels of anti-psychotic drugs and
- Subjects who are immunocompromised
Exclusion criteria for all healthy control participants:
- subjects with an active and serious medical disease
- subjects with an infectious disease
- consume any alcohol within 3 months before the study
- subjects with localized or systemic infection
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo
Alcoholic Cirrhosis on placebo
|
2 tablets of placebo in the morning before breakfast and one tablet of placebo in the evening before dinner for 24 months
|
Experimental: 1,200 mg SAMe
SAMe supplement (SAMe 400 mg tablet), 2 tablets in the morning before breakfast and one tablet in the evening before dinner (a total dose of 1,200 mg daily) for 24 months
|
SAMe supplement (SAMe 400 mg tablet), 2 tablets in the morning before breakfast and one tablet in the evening before dinner (a total dose of 1,200 mg daily) for 24 months
|
No Intervention: Non-drinking Controls
Non-drinking healthy controls
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SAMe supplement's effect on all-cause mortality
Time Frame: Baseline to end of 24 months
|
The hypothesis is that SAMe supplement will improve liver function in patients with alcoholic liver disease.
The improvement in liver function will lead to the reduction in all-cause mortality in patients with alcoholic cirrhosis in those who receive SAMe supplement when compared to those receiving placebo.
|
Baseline to end of 24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SAMe supplement's effect on intestinal permeability function, as defined by serum lipopolysaccharides (LPS)
Time Frame: baseline to end of 24 months
|
The function of intestinal permeability will be evaluated by testing serum lipopolysaccharides (LPS) in patients who receive SAMe compared to those who receive placebo.
Lipopolysaccharides (LPS) are large molecules consisting of a lipid and a polysaccharide that are bacterial toxins.
|
baseline to end of 24 months
|
SAMe supplement's effect on cellular oxidative stress and/or endoplasmic reticulum (ER) stress, as defined by mitochondrial DNA
Time Frame: baseline to 24 months
|
Cellular oxidative stress and/or endoplasmic reticulum (ER) stress will be evaluated by measuring the levels of mitochondrial DNA in the blood of patients who receive SAMe compared to those who receive placebo.
|
baseline to 24 months
|
SAMe supplement's effect on liver deuteriation
Time Frame: baseline to 24 months
|
determining Proportion of subjects undergoing liver transplantation in patients who receive SAMe compared to those who receive placebo
|
baseline to 24 months
|
SAMe supplement's effect on liver developing cancer
Time Frame: baseline to 24 months
|
Proportion of subjects developing new onset hepatocellular carcinoma in patients who receive SAMe compared to those who receive placebo
|
baseline to 24 months
|
SAMe supplement's effect on infections of the liver
Time Frame: baseline to 24 months
|
Proportion of subjects with infection/sepsis (other than SBP) in patients who receive SAMe compared to those who receive placebo
|
baseline to 24 months
|
SAMe supplement's effect on other parts of the body
Time Frame: baseline to 24 months
|
capture safety-related endpoints by determining proportion of patients with nausea and emesis, proportion of subjects with unexplained diarrhea in patients receive SAMe compared to those who receive placebo.
|
baseline to 24 months
|
SAMe supplement's effects on intestinal permeability function, as defined by soluble(s) CD14
Time Frame: baseline to 24 months
|
The function of intestinal permeability will be evaluated by testing soluble(s) CD14 in patients who receive SAMe compared to those who receive placebo.
sCD14 either appears after shedding of mCD14 (48 kDa) or is directly secreted from intracellular vesicles (56 kDa).
|
baseline to 24 months
|
SAMe supplement's effects on intestinal permeability function, as defined by soluble(s) CD163
Time Frame: baseline to 24 months
|
The function of intestinal permeability will be evaluated by testing soluble(s) CD163 in patients who receive SAMe compared to those who receive placebo.
CD163 is an endocytic receptor for haptoglobin-hemoglobin complexes and is expressed solely on macrophages and monocytes.
As a result of ectodomain shedding, the extracellular portion of CD163 circulates in blood as a soluble protein (sCD163).
|
baseline to 24 months
|
SAMe supplement's effects on cellular oxidative stress and/or endoplasmic reticulum (ER) stress, as defined by cytochrome P450 2E1 levels
Time Frame: baseline to 24 months
|
Levels of cellular oxidative stress and/or endoplasmic reticulum (ER) stress will be evaluated by measuring the levels of cytochrome P450 2E1 (CYP2E1) enriched microparticles in patients who receive SAMe compared to those who receive placebo.CYP2E1 is a member of the cytochrome P450 mixed-function oxidase system, which is involved in the metabolism of xenobiotics in the body.
|
baseline to 24 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Exploratory outcome - identify who will improve their liver functions by taking the SAMe supplement amongst those that have been diagnosed with alcoholic cirrhosis (Child-Pugh score of A or B).
Time Frame: baseline to 24 months
|
The metabolic profiling of the serum and urine will be collected by those in the study who received the SAMe supplement and will be used as the surrogates for this prediction.
|
baseline to 24 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Suthat Liangpunsakul, MD, Indiana University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- SAMe Trial
- 5U01AA026817-04 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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