간경변증 네트워크 미국에서 간경변증에 대한 Rosuvastatin 효능 및 안전성 (LCN RESCU)
간경변증 네트워크(LCN) 미국 간경변증에 대한 로수바스타틴 효능 및 안전성(RESCU): 이중 맹검 무작위, 위약 대조 2상 연구
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.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
상세 설명
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).
연구 유형
연구 유형
등록 (추정된)
등록
단계
단계
- 2 단계
연락처 및 위치
연구 연락처
연구 연락처
- 이름: Crystal Santillanes, MS
- 전화번호: 312-503-5536
- 이메일: lcn@northwestern.edu
연구 연락처 백업
- 이름: Mary Beth Tull, MBA, CCRP
- 전화번호: 312-503-4746
- 이메일: mary.tull@northwestern.edu
연구 장소
-
-
California
-
La Jolla, California, 미국, 92035
- 모병
- University of California San Diego NAFLD Research Center
-
연락하다:
- Rohit Loomba
- 이메일: roloomba@health.ucsd.edu
-
Los Angeles, California, 미국, 90033
- 모병
- Keck Medical Center of USC
-
연락하다:
- Norah Terrault
- 이메일: norah.terrault@med.usc.edu
-
Los Angeles, California, 미국, 90033
- 모병
- LAC + USC Medical Center
-
연락하다:
- Norah Terrault
- 이메일: norah.terrault@med.usc.edu
-
San Francisco, California, 미국, 94143
- 모병
- UCSF Medical Center
-
연락하다:
- Bilal Hameed
- 이메일: bilal.hameed@ucsf.edu
-
San Francisco, California, 미국, 94110
- 모병
- UCSF/Zuckerberg San Francisco General Hospital and Trauma Center
-
연락하다:
- Mandana Khalili
- 이메일: Mandana.Khalili@ucsf.edu
-
-
Florida
-
Miami, Florida, 미국, 33122
- 모병
- University of Miami Health System
-
연락하다:
- David Goldberg
- 이메일: dsgoldberg@med.miami.edu
-
-
Michigan
-
Ann Arbor, Michigan, 미국, 48109
- 모병
- University of Michigan
-
연락하다:
- Elliot Tapper
- 이메일: etapper@med.umich.edu
-
-
Minnesota
-
Rochester, Minnesota, 미국, 55901
- 모병
- Mayo Clinic
-
연락하다:
- Doug A. Simonetto, MD
- 전화번호: (507) 284-2511
- 이메일: simonetto.douglas@mayo.edu
-
-
New York
-
New York, New York, 미국, 10021
- 모병
- New York Presbyterian/Weill Cornell
-
연락하다:
- Robert Brown
- 이메일: rsb2005@med.cornell.edu
-
New York, New York, 미국, 10031
- 모병
- Columbia University Iriving School of Medicine
-
연락하다:
- Elizabeth Verna
- 이메일: ev77@cumc.columbia.edu
-
-
North Carolina
-
Durham, North Carolina, 미국, 27710
- 모병
- Duke Liver Center
-
연락하다:
- Cynthia Ann Moylan, MD, MHS, MS
- 전화번호: 919-681-4044
- 이메일: cynthia.moylan@duke.edu
-
연락하다:
- Mariko Kopping
- 이메일: mariko.kopping@duke.edu
-
-
Ohio
-
Cleveland, Ohio, 미국, 44192
- 모병
- Cleveland Clinic
-
연락하다:
- Srinivasan Dasarathy
- 이메일: DASARAS@ccf.org
-
-
Virginia
-
Richmond, Virginia, 미국, 23298
- 모병
- Virginia Commonwealth University
-
연락하다:
- Arun Sanyal
- 이메일: arun.sanyal@vcuhealth.org
-
-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria
-
Age 18-75 years
-
Cirrhosis due to NAFLD, ALD, or chronic viral hepatitis (treated HBV or HCV)
-
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
-
Two measures of VCTE: one at screening and one at the open-label dispense study visit, meeting the following criteria:
- The first measure must be ≥ 15.0 kPa.
- The two measures must be at least 2 hours apart and no more than 60 days apart from one another.
- The mean of two measurements must be ≥ 15.0 kPa.
- Additionally, both screening and open-label dispense liver stiffness measures must be ≤50 kPa
-
Compensated defined by:
- Absence of ascites/hydrothorax, hepatic encephalopathy or variceal bleeding currently or in the last 48 weeks, as determined clinically by investigator.
- 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.
- Child-Pugh score <8
-
Provision of written informed consent. Exclusion Criteria
-
Currently on a statin or any statin exposure within 24 weeks prior to consent.
-
Known indication for statin therapy, defined as:
- Prior peripheral vascular, cardiovascular or cerebrovascular event for which statins are indicated for secondary prevention, OR
- Documented familial hypercholesterolemia, heterozygous familial hypercholesterolemia, OR
- Fasting LDL-C ≥ 190 mg/dL
-
Myocardial infarction, Unstable angina, transient ischemic events, or stroke within 24 weeks of screening.
-
Alcohol Use Disorder Identification Test (AUDIT) total score of ≥8 at screening.
-
Patients with limitations in attending study visits.
-
Prisoners.
-
Known prior or current hepatocellular carcinoma (HCC) or cholangiocarcinoma.
-
Known transjugular intrahepatic portosystemic shunt (TIPS), balloon retrograde transvenous obliteration (BRTO) or porto-systemic shunt surgery regardless of time of occurrence.
-
Current (in past 24 weeks prior to consenting) use of medications known to cause hepatic fibrogenesis or confound endpoint assessment, defined as:
- amiodarone
- methotrexate
- warfarin
-
Current (in past 24 weeks prior to consenting) use of medications which may increase risk for rosuvastatin-related myositis or DILI, defined as:
-
fenofibrate
-
erythromycin
-
gemfibrozil
-
niacin (500 mg or more)
-
HIV protease inhibitors (darunivar, indinavir, nelfinavir, amprenavir)
-
colchicine
-
cyclosporin
-
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.
-
-
Presence of portal or hepatic vein thrombosis
-
Diagnosis of untreated hypothyroidism or on unstable treatment regimen for hypothyroidism
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Receiving an elemental diet or parenteral nutrition
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Chronic pancreatitis or pancreatic insufficiency
-
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.)
-
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.
-
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.
-
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.
-
Kidney function abnormalities including:
- Dialysis
- Baseline eGFR < 30 cc/min with CKD-Epi equation
- Known nephrotic proteinuria, defined as 3g or greater of protein in 24-hour urine collection
-
Recent (within 48 weeks) or present hepatic decompensation with ascites/hydrothorax, hepatic encephalopathy or variceal bleeding
-
Untreated chronic hepatitis B or C infection
- HCV eligible for enrollment if HCV RNA negative at baseline or documentation of prior SVR12
- HBV eligible if an HBV DNA <100 IU/mL within the last 48 weeks and on treatment
-
Serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥ 200 U/L within the past 24 weeks or alkaline phosphatase (ALP) ≥ 300.
-
Documented history of intolerance to statins
-
Serious comorbid medical disease which in the investigator's opinion renders a life-expectancy less than 96 weeks
-
Active illicit substance use (other than THC), including inhaled or injected drugs, in the 24 weeks prior to screening
-
Pregnancy, planned pregnancy or breastfeeding
-
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.
-
Significant existing muscle pain or tenderness or prior history of myasthenia gravis as determined by a site physician.
-
Failure or inability to provide informed consent.
-
East Asian Descent within one degree of relatedness (e.g., if the participant's parents are of East Asian descent)
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 네 배로
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
실험적: 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.
다른 이름들:
|
|
위약 비교기: 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.
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Mean change in liver stiffness
기간: 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
|
2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Time to disease progression
기간: 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
기간: 96 weeks
|
All-cause mortality: time-to-event, binary if low counts |
96 weeks
|
|
Time to development of ascites
기간: 96 weeks
|
Ascites: time-to-event, binary if low counts |
96 weeks
|
|
Time to development of overt hepatic encephalopathy
기간: 96 weeks
|
Time to development of overt hepatic encephalopathy: time-to-event, binary if low counts |
96 weeks
|
|
Time to development of variceal bleed
기간: 96 weeks
|
Variceal bleed: time-to-event, binary if low counts |
96 weeks
|
|
Time to development of hepatocellular carcinoma
기간: 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)
기간: 96 weeks
|
Units: kilopascal; Range: 5 to 100 kilopascal; higher stiffness indicates increased disease progression |
96 weeks
|
|
Change in Child-Turcotte-Pugh score
기간: 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)
기간: 96 weeks
|
Unitless; Range: 6-40; higher score indicates further disease progression |
96 weeks
|
|
Change in liver stiffness via Magnetic Resonance Elastography
기간: 96 weeks
|
Units: kilopascal; Range: 0 to 20; higher stiffness indicates increased disease progression |
96 weeks
|
|
Change in Enhanced Liver Fibrosis test
기간: 96 weeks
|
Unitless; Range: 5 to 11; Higher score is worse |
96 weeks
|
|
Change in Fibrosis-4
기간: 96 weeks
|
Unitless; Range: 0 to 10; higher score indicates more stiffness |
96 weeks
|
|
Change in patient-reported quality of life scores
기간: 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
기간: 96 weeks
|
Count |
96 weeks
|
|
Rate of serious adverse events
기간: 96 weeks
|
Count |
96 weeks
|
|
Rate of adverse events of special interest
기간: 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
기간: 96 weeks
|
Cardiovascular events: time-to-event, binary if low counts |
96 weeks
|
|
Time to new onset diabetes
기간: 96 weeks
|
New onset diabetes: time-to-event, binary if low counts |
96 weeks
|
공동 작업자 및 조사자
스폰서
스폰서
협력자
협력자
수사관
수사관
- 수석 연구원: Abigail Smith, PhD, Northwestern University
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
기타 연구 ID 번호
- Pro00070580
- 5U24DK130164-04 (미국 NIH 보조금/계약)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
Dataset with National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Repository.
IPD 공유 지원 정보 유형
- 연구_프로토콜
- ICF
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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