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Liver Cirrhosis Network Efficacia e sicurezza della rosuvastatina per la cirrosi negli Stati Uniti (LCN RESCU)

Liver Cirrhosis Network (LCN) Efficacia e sicurezza della rosuvastatina per la cirrosi negli Stati Uniti (RESCU): uno studio di fase 2 randomizzato in doppio cieco, controllato con placebo

This is a double-blind, phase 2 study to evaluate safety and efficacy of rosuvastatin in comparison to placebo after 2 years in patients with compensated cirrhosis.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

This study is a randomized, double-blind, placebo-controlled Phase 2 clinical trial, of 20mg of rosuvastatin by mouth, once daily. Participants will be randomized (1:1) to either once daily placebo or once daily rosuvastatin.

Patients meeting all eligibility criteria will be assigned to a randomization arm prior to initiation of a 4-week lead-in phase of the study. All participants will undergo a 4-week, open-label active run-in phase to evaluate initial safety and adherence to rosuvastatin. During this active run-phase, all participants will receive target dose rosuvastatin-- 20 mg daily. After the active run-in phase, all participants will continue with their pre-assigned randomization (1:1) treatment of rosuvastatin 20 mg daily or matching placebo.

The total duration of the study will be 96 weeks in the assigned treatment arm plus the 4-week lead-in period. The primary outcome will be the mean change in liver stiffness from the baseline measurement to the end of study liver stiffness, as measured by ultrasound-based vibration-controlled transient elastography (VCTE).

There are 10 participating clinical centers, and we anticipate a total of 260 patients will be recruited for the initial lead-in as we estimate 20% of participants may dropout after the lead-in (260 x 0.8 = 208 for randomization into the study drug treatment phase).

Tipo di studio

Interventistico

Iscrizione (Stimato)

260

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

    • California
      • La Jolla, California, Stati Uniti, 92035
        • Reclutamento
        • University of California San Diego NAFLD Research Center
        • Contatto:
      • Los Angeles, California, Stati Uniti, 90033
      • Los Angeles, California, Stati Uniti, 90033
      • San Francisco, California, Stati Uniti, 94143
      • San Francisco, California, Stati Uniti, 94110
        • Reclutamento
        • UCSF/Zuckerberg San Francisco General Hospital and Trauma Center
        • Contatto:
    • Florida
      • Miami, Florida, Stati Uniti, 33122
    • Michigan
      • Ann Arbor, Michigan, Stati Uniti, 48109
    • Minnesota
      • Rochester, Minnesota, Stati Uniti, 55901
    • New York
      • New York, New York, Stati Uniti, 10021
      • New York, New York, Stati Uniti, 10031
        • Reclutamento
        • Columbia University Iriving School of Medicine
        • Contatto:
    • North Carolina
      • Durham, North Carolina, Stati Uniti, 27710
    • Ohio
      • Cleveland, Ohio, Stati Uniti, 44192
        • Reclutamento
        • Cleveland Clinic
        • Contatto:
    • Virginia
      • Richmond, Virginia, Stati Uniti, 23298

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 75 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria

  1. Age 18-75 years

  2. Cirrhosis due to NAFLD, ALD, or chronic viral hepatitis (treated HBV or HCV)

  3. Clinical diagnosis of cirrhosis as defined by investigator confirmation and the following:

    a. At least one liver biopsy within 5 years prior to consent showing either: Metavir stage 4 fibrosis; Ishak Stage 5-6 fibrosis, OR b. At least 2 of the following: i. Evidence on imaging: Nodular liver with either splenomegaly or recanalized umbilical vein within the past 48 weeks ii. Liver stiffness: VCTE within 48 weeks prior to consent or during Screening ≥15.0 kPa or MRE within 48 weeks prior to consent or during Screening ≥5 kPa iii. Evidence of varices demonstrated on imaging or endoscopy within 3 years prior to consent or during Screening iv. Either: FIB-4>2.67 or platelets <150/mL within 6 months prior to consent or during Screening

  4. Two measures of VCTE: one at screening and one at the open-label dispense study visit, meeting the following criteria:

    1. The first measure must be ≥ 15.0 kPa.
    2. The two measures must be at least 2 hours apart and no more than 60 days apart from one another.
    3. The mean of two measurements must be ≥ 15.0 kPa.
    4. Additionally, both screening and open-label dispense liver stiffness measures must be ≤50 kPa
  5. Compensated defined by:

    1. Absence of ascites/hydrothorax, hepatic encephalopathy or variceal bleeding currently or in the last 48 weeks, as determined clinically by investigator.
    2. If prior history of decompensation, must be without current symptoms of decompensation and no longer requiring treatment of complications for the last 48 weeks, including the use of diuretics for the treatment of ascites, and/or rifaximin or lactulose for the treatment of hepatic encephalopathy. Use of non-selective beta blockers will be allowed.
    3. Child-Pugh score <8
  6. Provision of written informed consent. Exclusion Criteria

  1. Currently on a statin or any statin exposure within 24 weeks prior to consent.

  2. Known indication for statin therapy, defined as:

    1. Prior peripheral vascular, cardiovascular or cerebrovascular event for which statins are indicated for secondary prevention, OR
    2. Documented familial hypercholesterolemia, heterozygous familial hypercholesterolemia, OR
    3. Fasting LDL-C ≥ 190 mg/dL
  3. Myocardial infarction, Unstable angina, transient ischemic events, or stroke within 24 weeks of screening.

  4. Alcohol Use Disorder Identification Test (AUDIT) total score of ≥8 at screening.

  5. Patients with limitations in attending study visits.

  6. Prisoners.

  7. Known prior or current hepatocellular carcinoma (HCC) or cholangiocarcinoma.

  8. Known transjugular intrahepatic portosystemic shunt (TIPS), balloon retrograde transvenous obliteration (BRTO) or porto-systemic shunt surgery regardless of time of occurrence.

  9. Current (in past 24 weeks prior to consenting) use of medications known to cause hepatic fibrogenesis or confound endpoint assessment, defined as:

    1. amiodarone
    2. methotrexate
    3. warfarin
  10. Current (in past 24 weeks prior to consenting) use of medications which may increase risk for rosuvastatin-related myositis or DILI, defined as:

    1. fenofibrate

    2. erythromycin

    3. gemfibrozil

    4. niacin (500 mg or more)

    5. HIV protease inhibitors (darunivar, indinavir, nelfinavir, amprenavir)

    6. colchicine

    7. cyclosporin

    8. Additional medications that will be excluded:

      atazanavir/ritonavir capmatinib darolutamide dasabuvir/ombitasvir/paritaprevir/ritonavir ledipasvir/sofosbuvir elbasvir/grazoprevir erythromycin lopinavir/ritonavir regorafenib ritonavir, in any combination simeprevir sofbuvir/velpatasvir/voxilaprevir sofosbuvir/velpatasvir tafamidis tamoxifen teriflunomide

      *If exposure was for 7 or less days for one of these medications can consider enrollment after 28 days from final dose.

  11. Presence of portal or hepatic vein thrombosis

  12. Diagnosis of untreated hypothyroidism or on unstable treatment regimen for hypothyroidism

  13. Receiving an elemental diet or parenteral nutrition

  14. Chronic pancreatitis or pancreatic insufficiency

  15. Etiology of cirrhosis other than ALD, NAFLD, or viral hepatitis (excluded diagnoses include cryptogenic immune-mediated such as AIH, PSC and PBC, cardiac cirrhosis or Fontan-associated liver disease, A1AT, Wilson's disease, etc.)

  16. Conditions which may confound study outcome:

    a. Unstable or active inflammatory bowel disease b. Active infection c. Any malignant disease (other than squamous or basal cell carcinoma of the skin) within previous 3 years d. Prior solid organ or hematopoietic cell transplant e. Bariatric surgery in the last 24 weeks prior to consent or planned bariatric surgery within the next 96 weeks f. Current liver-unrelated end-stage organ failures such as end-stage renal disease on dialysis, stage 3-4 congestive heart failure (CHF), current chronic obstructive pulmonary disease (COPD) on home oxygen.

  17. Known current medical or psychiatric conditions which, in the opinion of the investigator, would make the participant unsuitable for the study for safety reasons or interfere with or prevent adherence to the protocol.

  18. The following laboratory abnormalities within 90 days of screening:

    a. Hemoglobin <10 g/dL b. Albumin <3.0 g/dL c. Prolonged international normalized ratio (INR) >1.5 d. Total bilirubin ≥ 2.0 mg/dl (unless due to Gilbert's syndrome or hemolysis as denoted by normal direct bilirubin fraction) e. Direct bilirubin ≥ 0.9 f. Uncontrolled diabetes (HbA1c ≥ 9.5%) within past 90 days.

  19. Kidney function abnormalities including:

    1. Dialysis
    2. Baseline eGFR < 30 cc/min with CKD-Epi equation
    3. Known nephrotic proteinuria, defined as 3g or greater of protein in 24-hour urine collection
  20. Recent (within 48 weeks) or present hepatic decompensation with ascites/hydrothorax, hepatic encephalopathy or variceal bleeding

  21. Untreated chronic hepatitis B or C infection

    1. HCV eligible for enrollment if HCV RNA negative at baseline or documentation of prior SVR12
    2. HBV eligible if an HBV DNA <100 IU/mL within the last 48 weeks and on treatment
  22. Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥ 200 U/L within the past 24 weeks or alkaline phosphatase (ALP) ≥ 300.

  23. Documented history of intolerance to statins

  24. Serious comorbid medical disease which in the investigator's opinion renders a life-expectancy less than 96 weeks

  25. Active illicit substance use (other than THC), including inhaled or injected drugs, in the 24 weeks prior to screening

  26. Pregnancy, planned pregnancy or breastfeeding

  27. Current participation in active medication treatment trials (within 24 weeks prior to randomization) or planned participation in active medication treatment trials simultaneous to participation in present trial.

  28. Significant existing muscle pain or tenderness or prior history of myasthenia gravis as determined by a site physician.

  29. Failure or inability to provide informed consent.

  30. East Asian Descent within one degree of relatedness (e.g., if the participant's parents are of East Asian descent)

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Quadruplicare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Active

Open-label lead-in period of 4 weeks on 20 mg rosuvastatin by mouth once daily, followed by a period of 96 weeks rosuvastatin 20 mg daily.

Patients meeting all eligibility criteria will be assigned to a randomization arm prior to initiation of a 4-week lead-in phase of the study. All participants will undergo a 4-week, open-label active run-in phase to evaluate initial safety and adherence to rosuvastatin. During this active run-phase, all participants will receive target dose rosuvastatin-- 20 mg daily . After the active run-in phase, all participants will continue with their pre-assigned randomization (1:1) treatment of rosuvastatin 20 mg daily or matching placebo.

Altri nomi:
  • Rosuvastatina 20 mg
Comparatore placebo: Placebo

Open-label lead-in period of 4 weeks on 20 mg rosuvastatin by mouth once daily, followed by a period of 96 weeks placebo.

Patients meeting all eligibility criteria will be assigned to a randomization arm prior to initiation of a 4-week lead-in phase of the study. All participants will undergo a 4-week, open-label active run-in phase to evaluate initial safety and adherence to rosuvastatin. During this active run-phase, all participants will receive target dose rosuvastatin-- 20 mg daily . After the active run-in phase, all participants will continue with their pre-assigned randomization (1:1) treatment of rosuvastatin 20 mg daily or matching placebo.

Altri nomi:
  • Rosuvastatina 20 mg

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Mean change in liver stiffness
Lasso di tempo: 96 weeks

Mean change in liver stiffness as measured in kilopascal with Vibration-Controlled Transient Elastography between study entry and week 96. Range: 2 to 75 kilopascal. Higher stiffness indicates increased disease progression

96 weeks

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Time to disease progression
Lasso di tempo: 96 weeks

Time to disease progression defined as time to development of decompensation event (ascites, hepatic encephalopathy, variceal bleed) or hepatocellular carcinoma. Analyzed as time-to-event; binary if low counts.

96 weeks
All-cause mortality
Lasso di tempo: 96 weeks

All-cause mortality: time-to-event, binary if low counts

96 weeks
Time to development of ascites
Lasso di tempo: 96 weeks

Ascites: time-to-event, binary if low counts

96 weeks
Time to development of overt hepatic encephalopathy
Lasso di tempo: 96 weeks

Time to development of overt hepatic encephalopathy: time-to-event, binary if low counts

96 weeks
Time to development of variceal bleed
Lasso di tempo: 96 weeks

Variceal bleed: time-to-event, binary if low counts

96 weeks
Time to development of hepatocellular carcinoma
Lasso di tempo: 96 weeks

Hepatocellular carcinoma: time-to-event, binary if low counts

96 weeks
Change in spleen stiffness as measured by Vibration-Controlled Transient Elastography (VCTE)
Lasso di tempo: 96 weeks

Units: kilopascal; Range: 5 to 100 kilopascal; higher stiffness indicates increased disease progression

96 weeks
Change in Child-Turcotte-Pugh score
Lasso di tempo: 96 weeks

Ordinal score from 5 to 15; higher score indicates further disease progression

96 weeks
Change in Model for End Stage Liver Disease - Sodium (MELD-Na)
Lasso di tempo: 96 weeks

Unitless; Range: 6-40; higher score indicates further disease progression

96 weeks
Change in liver stiffness via Magnetic Resonance Elastography
Lasso di tempo: 96 weeks

Units: kilopascal; Range: 0 to 20; higher stiffness indicates increased disease progression

96 weeks
Change in Enhanced Liver Fibrosis test
Lasso di tempo: 96 weeks

Unitless; Range: 5 to 11; Higher score is worse

96 weeks
Change in Fibrosis-4
Lasso di tempo: 96 weeks

Unitless; Range: 0 to 10; higher score indicates more stiffness

96 weeks
Change in patient-reported quality of life scores
Lasso di tempo: 96 weeks

Patient Reported Outcomes Measurement Information System (29-item version) Global Health T-Score: Population centered at 50 points, standard deviation of 10 (higher score signifies "better" health)

96 weeks
Rate of adverse events
Lasso di tempo: 96 weeks

Count

96 weeks
Rate of serious adverse events
Lasso di tempo: 96 weeks

Count

96 weeks
Rate of adverse events of special interest
Lasso di tempo: 96 weeks

Rate of adverse events of special interest (myopathy, drug-induced liver injury, cardiovascular events, cancer other than hepatocellular carcinoma, new onset diabetes as separate outcomes): Count

96 weeks
Time to cardiovascular events
Lasso di tempo: 96 weeks

Cardiovascular events: time-to-event, binary if low counts

96 weeks
Time to new onset diabetes
Lasso di tempo: 96 weeks

New onset diabetes: time-to-event, binary if low counts

96 weeks

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Abigail Smith, PhD, Northwestern University

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

7 dicembre 2023

Completamento primario (Stimato)

31 agosto 2029

Completamento dello studio (Stimato)

31 agosto 2029

Date di iscrizione allo studio

Primo inviato

24 marzo 2023

Primo inviato che soddisfa i criteri di controllo qualità

14 aprile 2023

Primo Inserito (Effettivo)

27 aprile 2023

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

28 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

23 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • Pro00070580
  • 5U24DK130164-04 (Sovvenzione/contratto NIH degli Stati Uniti)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano IPD

Dataset with National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Repository.

Tipo di informazioni di supporto alla condivisione IPD

  • STUDIO_PROTOCOLLO
  • ICF

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .