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Liver Cirrose Network Rosuvastatin Werkzaamheid en veiligheid voor cirrose in de Verenigde Staten (LCN RESCU)

Liver Cirrhosis Network (LCN) Rosuvastatine werkzaamheid en veiligheid voor cirrose in de Verenigde Staten (RESCU): een dubbelblinde, gerandomiseerde, placebogecontroleerde fase 2-studie

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.

Studie Overzicht

Gedetailleerde beschrijving

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).

Studietype

Ingrijpend

Inschrijving (Geschat)

260

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 75 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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)

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: 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.

Andere namen:
  • Rosuvastatine 20 mg
Placebo-vergelijker: 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.

Andere namen:
  • Rosuvastatine 20 mg

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Mean change in liver stiffness
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Time to disease progression
Tijdsspanne: 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
Tijdsspanne: 96 weeks

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

96 weeks
Time to development of ascites
Tijdsspanne: 96 weeks

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

96 weeks
Time to development of overt hepatic encephalopathy
Tijdsspanne: 96 weeks

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

96 weeks
Time to development of variceal bleed
Tijdsspanne: 96 weeks

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

96 weeks
Time to development of hepatocellular carcinoma
Tijdsspanne: 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)
Tijdsspanne: 96 weeks

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

96 weeks
Change in Child-Turcotte-Pugh score
Tijdsspanne: 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)
Tijdsspanne: 96 weeks

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

96 weeks
Change in liver stiffness via Magnetic Resonance Elastography
Tijdsspanne: 96 weeks

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

96 weeks
Change in Enhanced Liver Fibrosis test
Tijdsspanne: 96 weeks

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

96 weeks
Change in Fibrosis-4
Tijdsspanne: 96 weeks

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

96 weeks
Change in patient-reported quality of life scores
Tijdsspanne: 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
Tijdsspanne: 96 weeks

Count

96 weeks
Rate of serious adverse events
Tijdsspanne: 96 weeks

Count

96 weeks
Rate of adverse events of special interest
Tijdsspanne: 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
Tijdsspanne: 96 weeks

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

96 weeks
Time to new onset diabetes
Tijdsspanne: 96 weeks

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

96 weeks

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

7 december 2023

Primaire voltooiing (Geschat)

31 augustus 2029

Studie voltooiing (Geschat)

31 augustus 2029

Studieregistratiedata

Eerst ingediend

24 maart 2023

Eerst ingediend dat voldeed aan de QC-criteria

14 april 2023

Eerst geplaatst (Werkelijk)

27 april 2023

Updates van studierecords

Laatste update geplaatst (Werkelijk)

28 september 2026

Laatste update ingediend die voldeed aan QC-criteria

23 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

Beschrijving IPD-plan

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

IPD delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • ICF

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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