The Efficacy of S-adenosyl Methionine (SAMe) Versus Pentoxiphylline in Patients With Non-alcoholic Steatohepatitis With Fibrosis

NCT02231333 | Completed

• 1 other identifier: ILBS-NASH-01
• Study Type: interventional
• Target: 122
• Locations: 1 country
• Sites: 1

Brief Summary

Nonalcoholic fatty liver disease is one the most commonly encountered conditions in a daily outpatient Hepatology clinic. Secondly our country is the diabetic capital of the world and so the incidence of NAFLD (Non Alcoholic Fatty Liver Disease) is expected to rise in the future. It is a spectrum of hepatic pathology, ranging from simple steatosis, steatohepatitis, to cirrhosis. Nonalcoholic steatohepatitis (NASH) is a more advanced form of disease where steatosis is accompanied by hepatocyte injury as well as infiltration of inflammatory cells. Approximately 10-20% of patients with NASH may progress to cirrhosis. NASH is felt to be a major etiology of cryptogenic cirrhosis. Around 6230 human studies out of which 49 RCTs have been done till date to define the appropriate treatment of nonalcoholic steatohepatitis. However, still a controversy and no recommended treatment available till date. Recently published PIVENS trial has shown that Vitamin E has proven benefit in NASH. Other trials have also shown that pentoxiphylline has shown benefit in the form of histological improvement and biochemical improvement in the form of liver enzymes. Role of SAMe has been studied in alcoholic liver disease and showed to improve in both biochemical and histological features. However the usefulness of SAMe in NAFLD is not known till now. Hence this study has been designed.

Conditions

Non-alcoholic Steatohepatitis

Outcome Measures

Primary Outcomes (2)

• Biochemical improvement in the form of AST/ALT

  1 Years

• Improvement in LSM (Liver Stiffness Measurement) & CAP (Controlled Attenuation Parameter)

  1 years

Secondary Outcomes (5)

• Metabolic response in form of anthropometry.

  1 Years

• Fasting lipid profiles

  1 Years

• Reduction in uric acid levels

  1 Years

• Reduction in pro- inflammatory cytokines

  1 Years

• Histological outcome in the form of improvement or non- progression in hepatocyte injury and fibrosis.

  1 years

Study Arms (2)

S-adenosylmethionine (SAMe)

EXPERIMENTAL

Drug: S-adenosylmethionine (SAMe)

pentoxiphylline (PTX)

ACTIVE COMPARATOR

Drug: pentoxiphylline (PTX)

Interventions

S-adenosylmethionine (SAMe) DRUG

S-adenosylmethionine (SAMe)

pentoxiphylline (PTX) DRUG

pentoxiphylline (PTX)

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 to 70 years
• Persistently abnormal ALT \>1.2 times upper limit of normal
• Histological evidence of NASH (Non alcoholic Steatohepatitis) on liver biopsy. The minimal criteria for diagnosis of NASH included the presence of lobular inflammation and fibrosis up to stage 3 as per Burnt stating.

You may not qualify if:

• Alcohol intake of more than 40gm / week with features suggestive chronic liver disease .
• Other known cause of chronic liver disease like Hepatitis B,C, autoimmune liver disease, Wilson's disease, alpha 1 antitrypsin deficiency and hemochromatosis, primary biliary cirrhosis, PSC (Primary Sclerosis Cholangitis).
• Patient on Medication like estrogens, amiodarone, MTx, tamoxifen, ATT (Antitubercular Treatment)
• Pregnancy or lactation
• Hypersensitivity to methylxanthines (e.g., caffeine, theophylline,)
• Recent retinal/cerebral hemorrhage
• Acute myocardial infarction or severe cardiac arrhythmias.
• Impaired renal function.

Sponsors & Collaborators

• Institute of Liver and Biliary Sciences, India: lead

Study Sites (1)

Institute of Liver & Biliary Sciences

New Delhi, National Capital Territory of Delhi, 110070, India

Location

MeSH Terms

Conditions

Non-alcoholic Fatty Liver Disease

Interventions

S-Adenosylmethionine

Condition Hierarchy (Ancestors)

Fatty Liver; Liver Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Methionine; Amino Acids, Sulfur; Sulfur Compounds; Organic Chemicals; Adenosine; Purine Nucleosides; Purines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds; Amino Acids; Amino Acids, Peptides, and Proteins; Nucleosides; Nucleic Acids, Nucleotides, and Nucleosides; Ribonucleosides

Study Officials

• Dr Devaraja R, MD

  Institute of Liver and Biliary Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 30, 2014
• First Posted: September 4, 2014
• Study Start: July 1, 2013
• Primary Completion: July 31, 2015
• Study Completion: July 31, 2015
• Last Updated: October 29, 2019

Record last verified: 2019-10

Locations

IN (1)