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出境医 / 临床实验 / To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes

To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes

Study Description
Brief Summary:
This study was designed to evaluate the effect of Nesinaact on non-alcoholic steatohepatitis through magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) and liver fibroscan in patients with type 2 diabetes. This is a prospective, open-label, single-arm, single-center clinical Study. After 24 weeks of Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment, the improvement of parameters estimated by MRI and liver fibroscan will be estimated.

Condition or disease Intervention/treatment Phase
Non-alcoholic Steatohepatitis Type2 Diabetes Drug: Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks Phase 4

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: This is a prospective, open-label, single-arm, single-center clinical Study. All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks.
Masking: None (Open Label)
Masking Description: No masking is applied, as this is an open label study
Primary Purpose: Treatment
Official Title: To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes: A Prospective, Open-Label, Single-Arm, Single-Center Clinical Study
Actual Study Start Date : May 29, 2020
Estimated Primary Completion Date : December 2020
Estimated Study Completion Date : December 2020
Arms and Interventions
Arm Intervention/treatment
Experimental: 1
Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
Drug: Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks. Patients who have not been prescribed any other anti-diabetic drugs at least for 12 weeks and whose HbA1c ranges from 6.5~8.5%, can be enrolled. If Patients has been prescribed metformin as monotherapy, they have to substitute metformin with nesinaact 25-15 for enrollment.

Outcome Measures
Primary Outcome Measures :
  1. A degree of liver steatosis [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) will be evaluated to confirm the improvement in liver steatosis.

  2. A degree of liver fibrosis [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    In liver fibroscan, liver stiffness (kPa) as a marker of fibrosis and CAP (dB/m) as a marker of steatosis will be estimated.


Secondary Outcome Measures :
  1. Clinical glucometabolic parameters : HbA1c [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    HbA1c in %

  2. Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Total cholesterol in mg/dL

  3. Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Triglyceride in mg/dL

  4. Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    HDL-cholesterol in mg/dL

  5. Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    LDL-cholesterol in mg/dL

  6. Clinical glucometabolic parameters : Liver enzymes [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    AST in IU/L

  7. Clinical glucometabolic parameters : Liver enzymes [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    ALT in IU/L

  8. Clinical glucometabolic parameters :Anthropometric parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Blood pressure in mmHg

  9. Clinical glucometabolic parameters :Anthropometric parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Body weight in kilogram

  10. Clinical glucometabolic parameters :Anthropometric parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Body mass idex in kg/m2


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   20 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Male or female patients ages >= 20 years
  2. Patients diagnosed with non-alcoholic fatty liver disease (NAFLD).

    => Definition of NAFLD: CAP (Controlled attenuation parameter) >= 250 dB/m

  3. Diabetic patients who meet one of the following glycemic conditions:

    • Patients with glycated hemoglobin (HbA1c) ranging 6.5~8.5 % while not taking an antidiabetic for more than 12 weeks irrespective of duration of diabetes.
    • Patients with HbA1c ranging 6.5~9.0 % in screening while using metformin monotherapy for more than 8 weeks without changing the dose irrespective of duration of diabetes.

Exclusion Criteria:

  1. Patients who meet the criteria for alcoholic liver disease whose alcohol intake for the recent tow years if above 210 g per week in men and above 140 g per week in women)
  2. Patients with chronic hepatitis B, C, or type 1 diabetes, or secondary diabetes
  3. Patients with history of acute or chronic metabolic acidosis and ketoacidosis, including diabetic ketoacidosis accompanied or not accompanied by coma
  4. Patients who were administered an oral hypoglycemic agent or insulin other than metformin within 8 weeks prior ro screening, or are likely to be administered it during the study duration among patients receiving monotherapy.
  5. Patients who had hypersensitivity to biguanide or glitazone in the past.
  6. Patients who received oral or parenteral corticosteroid treatment chronically (for more than 14 consecutive days) within 8 weeks prior to screening
  7. Patients wih past history of lactic acidosis
  8. Patients with a genetic disorder, such as galactose intolerance, Lapp lactase deficiency or glucose-galactose impaired absorption, etc.
  9. Patients wih malnutrition, starvation, weakness, (Including patients with severe infection), pituitary insufficiency or adrenal insufficiency
  10. Patients who have been receiving radiotherapy or chemotherapy due to bladder cancer and other malignant tumor, or it is less than 2 years since the patients received it.
  11. Patients with past history of bladder cancer
  12. A patient with history of drug abuse or alcoholism in 12 weeks
  13. A patient who has hear failure (NYHA class 3~4) or uncontrolled arrhythmia within 6 months
  14. A patient who has acute cardiovascular disease within 12 weeks (including unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass, or coronary intervention)
  15. A person who falls under one of the followings:

1) A patient with serum creatinine level >= 1.5 mg/dL in men and 1.4 mg/dL in women or a patient wih moderate to severe renal impairment (creatinine clearance: < 50 ml/min) 2) An anemia patient with 10.5 g/dL of Hb level

  • A pregnant or nursing woman
  • A patient who does not consent to use a proper method of contraception during the study period only among women or men of childbearing age
  • A patient who has taken investigational drug in other clinical study within 4 weeks following informed consent
  • A person who may not participate in the study according to investigator's judgement
  • A person who cannot read the informed consent form (e.g: an illiterate, a foreigner, etc.)
Contacts and Locations

Locations
Layout table for location information
Korea, Republic of
Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine Recruiting
Seoul, Korea, Republic of
Contact: Kwang Joon Kim, MD, Ph.D    +82-2-2228-0960    PREPPIE@yuhs.ac   
Sponsors and Collaborators
Yonsei University
Tracking Information
First Submitted Date  ICMJE May 8, 2019
First Posted Date  ICMJE May 15, 2019
Last Update Posted Date October 9, 2020
Actual Study Start Date  ICMJE May 29, 2020
Estimated Primary Completion Date December 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 13, 2019)
  • A degree of liver steatosis [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) will be evaluated to confirm the improvement in liver steatosis.
  • A degree of liver fibrosis [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    In liver fibroscan, liver stiffness (kPa) as a marker of fibrosis and CAP (dB/m) as a marker of steatosis will be estimated.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: May 13, 2019)
  • Clinical glucometabolic parameters : HbA1c [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    HbA1c in %
  • Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Total cholesterol in mg/dL
  • Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Triglyceride in mg/dL
  • Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    HDL-cholesterol in mg/dL
  • Clinical glucometabolic parameters : Lipid parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    LDL-cholesterol in mg/dL
  • Clinical glucometabolic parameters : Liver enzymes [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    AST in IU/L
  • Clinical glucometabolic parameters : Liver enzymes [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    ALT in IU/L
  • Clinical glucometabolic parameters :Anthropometric parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Blood pressure in mmHg
  • Clinical glucometabolic parameters :Anthropometric parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Body weight in kilogram
  • Clinical glucometabolic parameters :Anthropometric parameters [ Time Frame: 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment ]
    Body mass idex in kg/m2
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes
Official Title  ICMJE To Evaluate the Effect of Nesinaact on Non-alcoholic Steatohepatitis Through MRI and Liver Fibroscan in Patients With Type 2 Diabetes: A Prospective, Open-Label, Single-Arm, Single-Center Clinical Study
Brief Summary This study was designed to evaluate the effect of Nesinaact on non-alcoholic steatohepatitis through magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) and liver fibroscan in patients with type 2 diabetes. This is a prospective, open-label, single-arm, single-center clinical Study. After 24 weeks of Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment, the improvement of parameters estimated by MRI and liver fibroscan will be estimated.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 4
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description:
This is a prospective, open-label, single-arm, single-center clinical Study. All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks.
Masking: None (Open Label)
Masking Description:
No masking is applied, as this is an open label study
Primary Purpose: Treatment
Condition  ICMJE
  • Non-alcoholic Steatohepatitis
  • Type2 Diabetes
Intervention  ICMJE Drug: Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks. Patients who have not been prescribed any other anti-diabetic drugs at least for 12 weeks and whose HbA1c ranges from 6.5~8.5%, can be enrolled. If Patients has been prescribed metformin as monotherapy, they have to substitute metformin with nesinaact 25-15 for enrollment.
Study Arms  ICMJE Experimental: 1
Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
Intervention: Drug: Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: May 13, 2019)
60
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE December 2020
Estimated Primary Completion Date December 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Male or female patients ages >= 20 years
  2. Patients diagnosed with non-alcoholic fatty liver disease (NAFLD).

    => Definition of NAFLD: CAP (Controlled attenuation parameter) >= 250 dB/m

  3. Diabetic patients who meet one of the following glycemic conditions:

    • Patients with glycated hemoglobin (HbA1c) ranging 6.5~8.5 % while not taking an antidiabetic for more than 12 weeks irrespective of duration of diabetes.
    • Patients with HbA1c ranging 6.5~9.0 % in screening while using metformin monotherapy for more than 8 weeks without changing the dose irrespective of duration of diabetes.

Exclusion Criteria:

  1. Patients who meet the criteria for alcoholic liver disease whose alcohol intake for the recent tow years if above 210 g per week in men and above 140 g per week in women)
  2. Patients with chronic hepatitis B, C, or type 1 diabetes, or secondary diabetes
  3. Patients with history of acute or chronic metabolic acidosis and ketoacidosis, including diabetic ketoacidosis accompanied or not accompanied by coma
  4. Patients who were administered an oral hypoglycemic agent or insulin other than metformin within 8 weeks prior ro screening, or are likely to be administered it during the study duration among patients receiving monotherapy.
  5. Patients who had hypersensitivity to biguanide or glitazone in the past.
  6. Patients who received oral or parenteral corticosteroid treatment chronically (for more than 14 consecutive days) within 8 weeks prior to screening
  7. Patients wih past history of lactic acidosis
  8. Patients with a genetic disorder, such as galactose intolerance, Lapp lactase deficiency or glucose-galactose impaired absorption, etc.
  9. Patients wih malnutrition, starvation, weakness, (Including patients with severe infection), pituitary insufficiency or adrenal insufficiency
  10. Patients who have been receiving radiotherapy or chemotherapy due to bladder cancer and other malignant tumor, or it is less than 2 years since the patients received it.
  11. Patients with past history of bladder cancer
  12. A patient with history of drug abuse or alcoholism in 12 weeks
  13. A patient who has hear failure (NYHA class 3~4) or uncontrolled arrhythmia within 6 months
  14. A patient who has acute cardiovascular disease within 12 weeks (including unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass, or coronary intervention)
  15. A person who falls under one of the followings:

1) A patient with serum creatinine level >= 1.5 mg/dL in men and 1.4 mg/dL in women or a patient wih moderate to severe renal impairment (creatinine clearance: < 50 ml/min) 2) An anemia patient with 10.5 g/dL of Hb level

  • A pregnant or nursing woman
  • A patient who does not consent to use a proper method of contraception during the study period only among women or men of childbearing age
  • A patient who has taken investigational drug in other clinical study within 4 weeks following informed consent
  • A person who may not participate in the study according to investigator's judgement
  • A person who cannot read the informed consent form (e.g: an illiterate, a foreigner, etc.)
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 20 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Listed Location Countries  ICMJE Korea, Republic of
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03950505
Other Study ID Numbers  ICMJE 4-2018-0203
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Yonsei University
Study Sponsor  ICMJE Yonsei University
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account Yonsei University
Verification Date October 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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