線維症を伴う非アルコール性脂肪性肝炎の治療のためのサログリタザールマグネシウム (NASH)
非アルコール性脂肪性肝炎および線維症の被験者におけるサログリタザールマグネシウムの有効性と安全性を評価するための第2b相、前向き、多施設、無作為化、二重盲検、プラセボ対照試験
Saroglitazar Magnesium for the Treatment of Nonalcoholic Steatohepatitis
調査の概要
状態
条件
詳細な説明
A Phase 2b, Prospective, Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate Efficacy and Safety of Saroglitazar Magnesium in Subjects with Nonalcoholic Steatohepatitis and Fibrosis.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
-
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Alabama
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Birmingham、Alabama、アメリカ、35294
- Zydus US032
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Homewood、Alabama、アメリカ、35209
- Zydus US079
-
-
Arizona
-
Phoenix、Arizona、アメリカ、85013
- Zydus US047
-
Tucson、Arizona、アメリカ、85712
- Zydus US025
-
Tucson、Arizona、アメリカ、85712
- Zydus US087
-
Tucson、Arizona、アメリカ、85724
- Zydus US029
-
-
California
-
Chula Vista、California、アメリカ、91911
- Zydus US118
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Fresno、California、アメリカ、93720
- Zydus US041
-
Gardena、California、アメリカ、90247
- Zydus US111
-
Huntington Park、California、アメリカ、90255
- Zydus US013
-
La Jolla、California、アメリカ、92037
- Zydus US065
-
Lancaster、California、アメリカ、93534
- Zydus US094
-
Long Beach、California、アメリカ、90808
- Zydus US080
-
Long Beach、California、アメリカ、90815
- Zydus US090
-
Los Angeles、California、アメリカ、90027
- Zydus US022
-
Los Angeles、California、アメリカ、90033
- Zydus US062
-
Murrieta、California、アメリカ、92563
- Zydus US023
-
Orange、California、アメリカ、92868
- Zydus US052
-
Panorama City、California、アメリカ、91402
- Zydus US012
-
-
Colorado
-
Aurora、Colorado、アメリカ、80045
- Zydus US039
-
-
Florida
-
Clearwater、Florida、アメリカ、33761
- Zydus US122
-
Fort Myers、Florida、アメリカ、33907
- Zydus US057
-
Hallandale、Florida、アメリカ、33009
- Zydus US108
-
Hialeah Gardens、Florida、アメリカ、33016
- Zydus US096
-
Lakeland、Florida、アメリカ、33803
- Zydus US003
-
Lakewood Rch、Florida、アメリカ、34211
- Zydus US016
-
Largo、Florida、アメリカ、33777
- Zydus US125
-
Maitland、Florida、アメリカ、32751
- Zydus US001
-
Maitland、Florida、アメリカ、32751
- Zydus US124
-
Miami、Florida、アメリカ、33014
- Zydus US007
-
Miami、Florida、アメリカ、33135
- Zydus US024
-
Miami、Florida、アメリカ、33136
- Zydus US034
-
Miami、Florida、アメリカ、33136
- Zydus US038
-
Miami、Florida、アメリカ、33155
- Zydus US121
-
Miami、Florida、アメリカ、33173
- Zydus US054
-
Miami Lakes、Florida、アメリカ、33016
- Zydus US098
-
Naples、Florida、アメリカ、34102
- Zydus US099
-
Ocala、Florida、アメリカ、34471
- Zydus US081
-
Orlando、Florida、アメリカ、32806
- Zydus US085
-
Port Orange、Florida、アメリカ、32127
- Zydus US104
-
Winter Park、Florida、アメリカ、32789
- Zydus US004
-
-
Georgia
-
Dalton、Georgia、アメリカ、30720
- Zydus US107
-
Gainesville、Georgia、アメリカ、30501
- Zydus US113
-
Marietta、Georgia、アメリカ、30060
- Zydus US114
-
Savannah、Georgia、アメリカ、31406
- Zydus US119
-
-
Indiana
-
Indianapolis、Indiana、アメリカ、46202
- Zydus US020
-
-
Iowa
-
West Des Moines、Iowa、アメリカ、50652
- Zydus US100
-
-
Kansas
-
Kansas City、Kansas、アメリカ、66160
- Zydus US049
-
-
Louisiana
-
Houma、Louisiana、アメリカ、70363
- Zydus US071
-
Marrero、Louisiana、アメリカ、70072
- Zydus US014
-
West Monroe、Louisiana、アメリカ、71291
- Zydus US123
-
-
Massachusetts
-
Boston、Massachusetts、アメリカ、02215
- Zydus US017
-
-
Michigan
-
Chesterfield、Michigan、アメリカ、48047
- Zydus US092
-
Wyoming、Michigan、アメリカ、49519
- Zydus US019
-
-
Minnesota
-
Saint Paul、Minnesota、アメリカ、55101
- Zydus US115
-
-
Missouri
-
Columbia、Missouri、アメリカ、65201
- Zydus US074
-
Kansas City、Missouri、アメリカ、64131
- Zydus US120
-
-
Nevada
-
Reno、Nevada、アメリカ、89511
- Zydus US116
-
-
New Jersey
-
Sparta、New Jersey、アメリカ、07871
- Zydus US077
-
-
New York
-
Manhasset、New York、アメリカ、11030
- Zydus US069
-
New York、New York、アメリカ、10033
- Zydus US066
-
-
North Carolina
-
Asheville、North Carolina、アメリカ、28801
- Zydus US018
-
Charlotte、North Carolina、アメリカ、28204
- Zydus US027
-
-
Ohio
-
Cincinnati、Ohio、アメリカ、45044
- Zydus US010
-
Cincinnati、Ohio、アメリカ、45267-0595
- Zydus US009
-
Cleveland、Ohio、アメリカ、44109
- Zydus US035
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Springboro、Ohio、アメリカ、45066
- Zydus US072
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Pennsylvania
-
Hershey、Pennsylvania、アメリカ、17033
- Zydus US060
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Philadelphia、Pennsylvania、アメリカ、19141
- Zydus US053
-
-
South Carolina
-
Charleston、South Carolina、アメリカ、29401
- Zydus US015
-
Charleston、South Carolina、アメリカ、29425
- Zydus US030
-
Columbia、South Carolina、アメリカ、29204
- Zydus US073
-
Greenwood、South Carolina、アメリカ、29646
- Zydus US075
-
Summerville、South Carolina、アメリカ、29485
- Zydus US112
-
-
Tennessee
-
Hermitage、Tennessee、アメリカ、37067
- Zydus US011
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Nashville、Tennessee、アメリカ、37232
- Zydus US028
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Texas
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Arlington、Texas、アメリカ、76012
- Zydus US002
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Austin、Texas、アメリカ、78745
- Zydus US051
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Austin、Texas、アメリカ、78757
- Zydus US101
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Bellaire、Texas、アメリカ、77401
- Zydus US089
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Brownsville、Texas、アメリカ、78520
- Zydus US105
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Edinburg、Texas、アメリカ、78539
- Zydus US095
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Edinburg、Texas、アメリカ、78539
- Zydus US106
-
Fort Worth、Texas、アメリカ、76104
- Zydus US061
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Houston、Texas、アメリカ、77030
- Zydus US067
-
Houston、Texas、アメリカ、77030
- Zydus US109
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Houston、Texas、アメリカ、77058
- Zydus US005
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Houston、Texas、アメリカ、77079
- Zydus US110
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Katy、Texas、アメリカ、77084
- Zydus US117
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San Antonio、Texas、アメリカ、78215
- Zydus US031
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San Antonio、Texas、アメリカ、78222
- Zydus US103
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San Antonio、Texas、アメリカ、78229
- Zydus US036
-
San Antonio、Texas、アメリカ、78229
- Zydus US102
-
San Antonio、Texas、アメリカ、78234
- Zydus US043
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San Antonio、Texas、アメリカ、78240
- Zydus US008
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Waco、Texas、アメリカ、76712
- Zydus US078
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Wichita Falls、Texas、アメリカ、76301
- Zydus US076
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Utah
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Ogden、Utah、アメリカ、84405
- Zydus US088
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Virginia
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Manassas、Virginia、アメリカ、20110
- Zydus US070
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Richmond、Virginia、アメリカ、23236
- Zydus US082
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Richmond、Virginia、アメリカ、23298
- Zydus US021
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-
-
-
-
Buenos Aires、アルゼンチン、B1629ODT
- Zydus AR004
-
CABA、アルゼンチン、C1056ABJ
- Zydus AR001
-
CABA、アルゼンチン、C1180AAX
- Zydus AR013
-
CABA、アルゼンチン、C1199ABB
- Zydus AR007
-
CABA、アルゼンチン、C1221ADC
- Zydus AR006
-
CABA、アルゼンチン、C1264AAA
- Zydus AR005
-
CABA、アルゼンチン、C1425AGC
- Zydus AR008
-
CABA、アルゼンチン、C1426ABP
- Zydus AR012
-
CABA、アルゼンチン、CP143CKE
- Zydus AR003
-
Mar del Plata、アルゼンチン、B7600
- Zydus AR009
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Mar del Plata、アルゼンチン
- Zydus AR011
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Ramos Mejía、アルゼンチン
- Zydus AR002
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Rosario、アルゼンチン、S2002KDS
- Zydus AR010
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-
-
-
-
Adana、トルコ(Türkiye)、01240
- Zydus TR003
-
Ankara、トルコ(Türkiye)、06230
- Zydus TR002
-
Ankara、トルコ(Türkiye)、06800
- Zydus TR001
-
Bursa、トルコ(Türkiye)、16059
- Zydus TR004
-
Gaziantep、トルコ(Türkiye)、27310
- Zydus TR005
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Istanbul、トルコ(Türkiye)、34093
- Zydus TR009
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Istanbul、トルコ(Türkiye)、34760
- Zydus TR008
-
Izmir、トルコ(Türkiye)、35100
- Zydus TR007
-
Izmir、トルコ(Türkiye)、35150
- Zydus TR006
-
Kayseri、トルコ(Türkiye)、38039
- Zydus TR011
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Kocaeli、トルコ(Türkiye)、41000
- Zydus TR010
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Mersin、トルコ(Türkiye)、33110
- Zydus TR012
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Rize、トルコ(Türkiye)、53020
- Zydus TR013
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Trabzon、トルコ(Türkiye)、61080
- Zydus TR014
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Puerto Rico
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San Juan、Puerto Rico、プエルトリコ、00927
- Zydus US097
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Males or females, between 18 and 75 years of age, both inclusive at screening.
- BMI ≤45 kg/m²
- Histological confirmation of NASH with liver fibrosis by central pathologist on a diagnostic liver biopsy with a NAS ≥4 with at least one-point score in each of the three components of the NAFLD activity score [NAS] (steatosis scored 0-3, ballooning degeneration scored 0-2, and lobular inflammation scored 0-3) and NASH by pattern recognition Note: The biopsy must not have been performed more than 24 weeks before randomization.
- The subjects must have a stable body weight (no more than 5% change) between the time of biopsy and randomization.
- Fibrosis stage 2 and 3, according to the NASH CRN fibrosis staging, reported by central pathologist.
- If the subjects have type 2 diabetes mellitus, then it must be moderately controlled with HbA1c ≤ 9.5% and on a stable dose of permitted anti-diabetic medication for at least 90 days before screening until randomization.
- If the subjects are taking vitamin E > 400 IU/day, then it must be on a stable dose for at least 24 weeks prior to screening or, if a historical biopsy is used, at least 24 weeks prior to baseline liver biopsy until randomization.
- Must provide written informed consent and agree to comply with the trial protocol.
Exclusion Criteria:
-
Consumption of >2 units of alcohol per day (>14 units per week) if male and >1 units of alcohol per day (>7 units per week) if female for at least 12 consecutive weeks within 5 years before screening (Note: 1 unit = 12 ounces of beer, 4 ounces of wine or 1 ounce of spirits/hard liquor)
-
History or presence of other concomitant liver diseases at screening:
- Chronic hepatitis B (HBV) or hepatitis C virus (HCV) infection (However, If the subject has been treated for the HCV infection and has been cured at least 5 years from screening, such subjects can be enrolled in the study)
- Primary biliary cholangitis (PBC)
- Primary sclerosing cholangitis (PSC)
- Definite autoimmune liver disease or overlap syndrome
- Alcoholic liver disease
- Hemochromatosis
- Wilsons disease
- Alpha-1 antitrypsin deficiency
-
Subject with known cirrhosis, either based on histology, clinical criteria or any non-invasive diagnostic modality, within 24 weeks prior to the randomization.
-
Evidence of portal hypertension (low platelet count, esophageal varices, ascites, history of hepatic encephalopathy, splenomegaly) at screening.
-
Treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs), sodium glucose cotransporter- 2 (SGLT-2) inhibitors, and dipeptidyl peptidase 4 inhibitors (gliptins) unless stable for 120 days prior to screening or, if a historical biopsy is used, from 120 days prior to baseline liver biopsy until randomization.
-
Use of concurrent medications prior to screening including:
- Anti-NASH therapy(s) including S-adenosyl methionine (SAMe), ursodeoxycholic acid (UDCA), and obeticholic acid in the period from 90 days prior to screening or, if a historical biopsy is used, from 90 days prior to baseline liver biopsy until randomization. For resmetirom; 120 days prior to screening or if a historical biopsy is used, from 120 days prior to baseline liver biopsy until randomization.
- Antidiabetic mediation which may impact NASH histology including thiazolidinediones (pioglitazone, rosiglitazone) in the period from 90 days prior to screening or, if a historical biopsy is used, from 90 days prior to baseline liver biopsy until randomization.
- Immune modulatory agents including anti-TNF-α therapies (infliximab, adalimumab, etanercept) or anti-integrin therapy (namixilab) in the period from 28 days prior to screening or if a historical biopsy is used from 28 days prior to baseline liver biopsy until randomization.
- Any treatment or anticipated initiation (intended use for more than 14 consecutive days) of medications known to have an effect on steatosis (e.g. treatment with corticosteroids [topical and inhaled are allowed]), methotrexate, tamoxifen, valproic acid, amiodarone or tetracycline, estrogens in doses higher than used in oral contraceptives, vitamin A, L-asparaginase, valproate, chloroquine, or antiretroviral drugs in the period from 28 days prior to screening or, if a historical biopsy is used, from 28 days prior to baseline liver biopsy until randomization.
- Treatment with orlistat, zonisamide, topiramate, phentermine, lorcaserin, bupropion, or naltrexone alone, or in combination or any other medication, that could promote weight loss, in the opinion of the investigator, in the period from 28 days prior to screening or if a historical biopsy is used from 28 days prior to baseline liver biopsy until randomization.
-
Changing doses of statins (simvastatin, pitavastatin, pravastatin, atorvastatin, fluvastatin, lovastatin, rosuvastatin) or fibrates (clofibrate, Fenofibrate) in the 90 days preceding screening until randomization.
-
Use of drugs that are known CYP2C8 inhibitors/substrate in the 28 days preceding screening until randomization.
-
History of liver transplant
-
Any weight reduction surgery in the 2 years prior to screening or planned during the study (weight reduction surgery is disallowed during the study), and malabsorptive weight loss surgery (Rouxen-Y or distal gastric bypass) at any time prior to screening.
Note: Lap banding, if the band has been removed >6 months before baseline liver biopsy, or intragastric balloon, if the balloon has been removed > 6 months before baseline liver biopsy, is allowed.
-
Type 1 diabetes mellitus
-
History of stomach or intestinal surgery or resection within the six months prior to screening that would potentially alter absorption and/or excretion of orally administered drugs as judged by the investigator.
-
Unstable cardiovascular disease, including:
- unstable angina, (i.e., new or worsening symptoms of coronary heart disease) in the 90 days before screening and throughout the screening period; acute coronary syndrome in the 24 weeks before screening and throughout the screening period;
- acute myocardial infarction in the 90 days before screening and throughout the screening period; or heart failure of New York Heart Association class (III - IV), worsening congestive heart failure, or coronary artery intervention, in the 24 weeks before screening and throughout the screening period.
- history of unstable cardiac dysrhythmias
- uncontrolled hypertension at screening
- stroke or transient ischemic attack in the 24 weeks before screening
-
History of myopathies or evidence of active muscle disease demonstrated by CPK ≥ 5 times ULN at screening.
-
For subjects with elevated baseline ALT, AST, or ALP; ALT, AST, or ALP exceeding by more than 50% at Visit 2 reading compared to Visit 1 Note: If the ALT, AST or ALP values at Visit 2 exceed by more than 50% from Visit 1, then a third value will be measured to assess for the trend. If the third value shows continued increase ≥ 10%, then subject is considered ineligible for randomization.
-
Any of the following laboratory values at screening:
- Hemoglobin <9 g/dL
- WBC count <2.5 × 103/µL
- Neutrophil count <1.5 × 103/µL
- Platelets <140 × 103/µL [if low platelet count is due to reasons other than liver disease as assessed by a hematologist, participants may be eligible if the platelet count is > 75 x 103/µL] as per investigator's discretion]
- INR ≥ 1.3 (in the absence of anticoagulants)
- Total bilirubin > ULN except in Gilbert's syndrome. In subjects with known Gilbert's syndrome, direct bilirubin > 2 x ULN
- Albumin <3.5 g/dL
- eGFR <60 mL/min/1.73 m2
- ALP ≥ 2x ULN
- ALT or AST ≥ 250 U/L
-
Participation in any other therapeutic clinical study and on active treatment in the past 90 days of the screening.
-
History of benign or malignant bladder tumors, and/or hematuria or has current hematuria except due to a urinary tract infection.
-
History of malignancy in the past 5 years and/or active neoplasm with the exception of resolved superficial nonmelanoma skin cancer.
-
Known allergy, sensitivity or intolerance to the study drug, comparator or formulation ingredients.
-
Pregnancy-related exclusions, including:
- Pregnant/lactating female (including positive pregnancy test at screening)
- Pregnancy should be avoided by male and female participants either by true abstinence or the use of an acceptable effective contraceptive measures for the duration of the study and for at least 1 month after the end of the study treatment
-
History or other evidence of severe illness or any other conditions that would make the subject, in the opinion of the investigator, unsuitable for the study (such as poorly controlled psychiatric disease, HIV, coronary artery disease or active gastrointestinal conditions that might interfere with drug absorption)
-
Receiving an elemental diet or parenteral nutrition.
-
Chronic pancreatitis or pancreatic insufficiency.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Saroglitazar Magnesium 2 mg
Saroglitazar Magnesium 2 mg tablet orally administered once daily in the morning before breakfast without food, for the duration of treatment. |
Patients randomly assigned to this group will receive Saroglitazar Magnesium 2 mg tablet orally once daily in the morning before breakfast without food, for the duration of treatment.
他の名前:
|
|
実験的:Saroglitazar Magnesium 4 mg
Saroglitazar Magnesium 4 mg tablet orally administered once daily in the morning before breakfast without food, for the duration of treatment. |
Patients randomly assigned to this group will receive Saroglitazar Magnesium 4 mg tablet orally once daily in the morning before breakfast without food, for the duration of treatment.
他の名前:
|
|
プラセボコンパレーター:Placebo
Placebo tablet orally administered once daily in the morning before breakfast without food, for the duration of treatment. |
Patients randomly assigned to this group will receive Placebo tablet orally once daily in the morning before breakfast without food, for the duration of treatment.
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Resolution of steatohepatitis with no worsening of fibrosis
時間枠:52 Weeks/EOT
|
Resolution of steatohepatitis is defined as absent fatty liver disease or isolated or simple steatosis without steatohepatitis and a NAS of 0-1 for inflammation, 0 for ballooning, and any value for Steatosis |
52 Weeks/EOT
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Improvement in liver fibrosis with no increase in NAS for ballooning, inflammation or steatosis
時間枠:Week 52/EOT
|
Proportion of subjects achieving improvement in liver fibrosis (reduction of at least one stage) with no increase in NAS for ballooning, inflammation or steatosis |
Week 52/EOT
|
|
2 points improvement in NAS
時間枠:Week 52/EOT
|
Proportion of subjects with at least 2 points improvement in NAS at Week 52/EOT with at least 1-point improvement in either ballooning or inflammation and no worsening of liver fibrosis |
Week 52/EOT
|
|
Improvement in steatosis, ballooning, inflammation and fibrosis from liver biopsy
時間枠:Week 52/EOT
|
Proportion of subjects with ≥1 point improvement in steatosis, ballooning, inflammation and fibrosis |
Week 52/EOT
|
|
Decrease in SAF score on liver biopsy
時間枠:Week 52/EOT
|
Proportion of subjects with decrease in SAF score ≥2 combining hepatocellular inflammation and ballooning without worsening of fibrosis |
Week 52/EOT
|
|
Histological score changes in steatosis, ballooning, inflammation, and fibrosis
時間枠:Week 52/EOT
|
Change from baseline in steatosis, ballooning, inflammation, and fibrosis |
Week 52/EOT
|
|
Change in liver enzyme parameters including (ALT, AST, ALP, GGT, total bilirubin, albumin)
時間枠:Week 52/EOT
|
Change from baseline in liver enzyme parameters (ALT, AST, ALP, GGT, total bilirubin, albumin) |
Week 52/EOT
|
|
Change in non-invasive markers of steatosis
時間枠:Week 52/EOT
|
Change from baseline in non-invasive markers of steatosis (Enhanced Liver Fibrosis [ELF] test, Fibrosis 4 [FIB 4], APRI [AST to Platelet Ratio Index], NFS [NAFLD Fibrosis Score], PRO-C3) |
Week 52/EOT
|
|
Change in n lipid parameters including (TG, LDLC, TC, HDL-C, non-HDL-C, VLDL-C
時間枠:Week 52/EOT
|
Change from baseline in lipid parameters (TG, LDLC, TC, HDL-C, non-HDL-C, VLDL-C) |
Week 52/EOT
|
|
Change in body weight (any change from baseline)
時間枠:Week 52/EOT
|
Change from baseline in body weight |
Week 52/EOT
|
|
Change in insulin resistance marker, HOMA-IR
時間枠:Week 52/EOT
|
Change from baseline in insulin resistance marker (HOMA-IR) |
Week 52/EOT
|
|
Change in inflammatory markers including (CK-18 [M30], IL-6, CRP)
時間枠:Week 52/EOT
|
Change from baseline in inflammatory markers (CK-18 [M30], IL-6, CRP) |
Week 52/EOT
|
|
Change in glucose homeostasis markers including (HbA1c, FPG)
時間枠:Week 52/EOT
|
Change from baseline in glucose homeostasis markers (HbA1c, FPG) |
Week 52/EOT
|
協力者と研究者
スポンサー
捜査官
- スタディディレクター:Deven V. Parmar, MD, FCP、Zydus Therapeutics Inc.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- SARO.20.002
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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