Dihydroartemisinin for MAFLD

A Single-Arm, Proof-of-Concept Study of Dihydroartemisinin in Adults With Metabolic Associated Fatty Liver Disease

Brief Summary

Purpose:

This is a proof-of-concept clinical trial to evaluate whether Dihydroartemisinin (DHA), a medication commonly used to treat malaria, can effectively reduce liver fat in adults with Metabolic Associated Fatty Liver Disease (MAFLD). The study will also rigorously assess the safety and tolerability of DHA in this specific patient population.

Study Design:

This is a single-center, open-label, single-arm study. All qualified participants will receive the investigational treatment, with each individual serving as their own baseline control to measure pre- and post-treatment changes. To minimize lifestyle-related confounding factors, all participants will receive standardized dietary and physical activity counseling at baseline and will be instructed to strictly maintain their established lifestyle routines throughout the study period.

Participants:

The study plans to enroll approximately 30 adult patients (ages 18 to 45 years) formally diagnosed with MAFLD. MAFLD is defined by the presence of excessive hepatic fat accumulation concurrent with specific metabolic dysfunctions, such as overweight/obesity, hypertension, elevated blood sugar, or dyslipidemia.

Intervention:

Participants will be administered oral Dihydroartemisinin tablets at a dose of 20 mg three times daily (TID) for a continuous duration of 12 weeks. Upon completion of the intervention, participants will enter a 12-week observational follow-up period to monitor the durability of the treatment effects and long-term safety.

Main Things We Will Measure (Outcomes):

Primary Outcome: Absolute change in liver fat content from baseline to the end of the 12-week treatment, quantitatively assessed by the gold-standard MRI Proton Density Fat Fraction (MRI-PDFF).

Secondary Outcomes: Changes in supplementary non-invasive liver fat assessments (including Ultrasound-derived Fat Fraction [UDFF] and FibroScan Controlled Attenuation Parameter [CAP]), as well as changes in body weight, blood pressure, heart rate, and routine laboratory safety panels (e.g., comprehensive liver and kidney function tests).

Study Overview

• Status: Recruiting
• Conditions: MAFLD
• Intervention / Treatment: Drug: Dihydroartemisinin

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Phase 2; Phase 1

Contacts and Locations

• Study Contact: Name: Xuehao Wang, Doctor; Phone Number: 86-025-68303211; Email: Wangxh@njmu.edu.cn

Study Locations

• China
  • Jiangsu
    • Nanjing, Jiangsu, China
      • Recruiting
      • The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029
      • Contact: Xuehao Wang; Phone Number: 86-025-68303211; Email: wangxh@njmu.edu.cn

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Aged 18-45 years (inclusive), any gender.

Meets the diagnostic criteria for Metabolic Associated Fatty Liver Disease (MAFLD), requiring both of the following:

Evidence of hepatic steatosis (at least one of the following):

Imaging: Ultrasound, CT, or MRI-PDFF showing liver fat content ≥5%.

Liver biopsy: Histologically confirmed steatosis ≥5% (within 6 months prior to enrollment).

FibroScan: Controlled Attenuation Parameter (CAP) ≥248 dB/m.

Evidence of metabolic dysfunction (at least one of the following):

Overweight/Obesity: BMI ≥24 kg/m² or waist circumference ≥90 cm (male) / ≥85 cm (female).

Elevated blood pressure/Hypertension: Blood pressure ≥130/85 mmHg, or on antihypertensive medication.

Pre-diabetes or Type 2 Diabetes: Fasting blood glucose ≥6.1 mmol/L, or 2-hour post-load glucose ≥7.8 mmol/L, or HbA1c ≥5.7%, or history of T2DM, or HOMA-IR ≥2.5.

Elevated blood triglycerides: Fasting serum TG ≥1.70 mmol/L, or on lipid-lowering medication.

Reduced HDL-cholesterol: Serum HDL ≤1.0 mmol/L (male) / ≤1.3 mmol/L (female), or on lipid-lowering medication.

Participants on glucose-, blood pressure-, or lipid-lowering medications must have been on a stable dose for at least 3 months prior to screening.

All participants must have stable body weight (defined as weight loss or gain not exceeding 5% within 3 months prior to screening and from screening to enrollment).

Voluntary participation, willingness to cooperate with follow-up, and signed informed consent.

Exclusion Criteria:

Liver function impairment (defined as any one of ALT, AST, GGT, ALP exceeding 2 times the upper limit of normal (ULN) and/or bilirubin exceeding 1.5 times ULN).

Long-term use (exceeding 2 weeks) of drugs known to cause hepatic steatosis or fibrosis (e.g., glucocorticoids, valproate, methotrexate, tamoxifen, amiodarone, oral vitamin E) within the past year.

Excessive alcohol consumption: weekly ethanol intake ≥210 g (male) or ≥140 g (female).

Positive for Hepatitis B surface antigen (HBsAg) or Hepatitis C virus antibody (HCV-Ab).

Specific liver diseases that can cause fatty liver (e.g., autoimmune hepatitis, Wilson's disease) or other specific conditions (e.g., total parenteral nutrition, inflammatory bowel disease, celiac disease, hypothyroidism, Cushing's syndrome, abetalipoproteinemia, lipodystrophic diabetes, Mauriac syndrome).

History of leukopenia or agranulocytosis.

History of bariatric surgery within the past 2 years.

Pregnant, planning pregnancy, or lactating women.

History of malignancy, cardiovascular disease, chronic kidney disease, decompensated cirrhosis (e.g., ascites, variceal bleeding, hepatic encephalopathy, hepatorenal syndrome), or liver transplantation.

Use of any category of antibiotics within 2 weeks prior to enrollment.

Considered by the clinical investigator to be unsuitable for participation in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dihydroartemisinin Treatment Arm; All enrolled participants will receive the investigational intervention: oral Dihydroartemisinin tablets at a dose of 20 mg three times daily (TID) for 12 weeks. The drug is provided as 20mg tablets (Manufacturer: Beijing Fuyuan Pharmaceutical Co., Ltd.). This is followed by a 12-week post-treatment observational follow-up period.	Drug: Dihydroartemisinin; Oral Dihydroartemisinin tablets at a dose of 20 mg three times daily (TID) for 12 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Liver Fat Content Measured by MRI Proton Density Fat Fraction (MRI-PDFF)	Absolute change in liver fat percentage (%) from baseline to the end of treatment, as assessed by MRI-PDFF	Baseline (Week 0) to End of Treatment (Week 12)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Controlled Attenuation Parameter (CAP)	Absolute change in Controlled Attenuation Parameter (CAP, measured in dB/m) from baseline, as assessed by FibroScan.	Baseline (Week 0), End of Treatment (Week 12), End of Follow-up (Week 24)
Change in Liver Fat Content Measured by Ultrasound-derived Fat Fraction (UDFF)	Absolute change in liver fat percentage (%) from baseline to the end of 12-week treatment, as quantitatively assessed by Ultrasound-derived Fat Fraction (UDFF).	Baseline (Week 0) to End of Treatment (Week 12)
Change in Body Weight	Absolute change in body weight (kg) from baseline.	Baseline (Week 0), End of Treatment (Week 12), End of Follow-up (Week 24)

Collaborators and Investigators

• Sponsor: The First Affiliated Hospital with Nanjing Medical University

Study record dates

Study Major Dates

• Study Start (Actual): March 30, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: June 25, 2026
• First Submitted That Met QC Criteria: June 25, 2026
• First Posted (Actual): July 1, 2026

Study Record Updates

• Last Update Posted (Actual): July 1, 2026
• Last Update Submitted That Met QC Criteria: June 25, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: artenimol
• Other Study ID Numbers: 2026-SR-149

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No