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Non-alcoholic Fatty Liver DiseaseNUTRAFASTNCT02369536

Efficacy of a Natural Components Mixture in the Treatment of Non Alcoholic Fatty Liver Disease (NAFLD)

A study testing nutraceutical mixture in people with Non-alcoholic Fatty Liver Disease, run by Neuromed IRCCS at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study is to provide clinical data to support the effectiveness of a mixture of ingredients of natural origin, suitably selected and packaged, in the protection from liver damage, in subjects with NAFLD. Read more about this study

Who is it for?
Ages 18 to 80 yearsHealthy volunteers can take part
Conditions the study is for
Non-alcoholic Fatty Liver Disease
What is being tested?
nutraceutical mixture
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
126 participants
Where
1 siteItaly
Study dates
18 Aug 2015to 15 Sep 2016
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • subjects with non alcoholic fatty liver disease (NAFLD)
  • presenting ultrasonographic abnormalities of steatosic liver (hyperechogenic parenchyma)
  • with plasma levels greater than normal (ranges of each recruiting center) for at least one of the following parameters (aspartate aminotransferase AST, alanine aminotransferase ALT, γ -glutamyltranspeptidase γ-GT).

Who cannot join

  • history of alcohol abuse
  • use of drugs associated with the development of hepatic steatosis
  • malnutrition
  • alcoholic chronic liver disease
  • chronic liver disease of different etiology (autoimmune disease, primary biliary cirrhosis, primary sclerosing cholangitis, hereditary hemochromatosis, Wilson's disease, deficits of alpha-1 antitrypsin, celiac disease)
  • severe renal, cardiac or respiratory insufficiency
Show all 9Show fewer
  • malignant tumors
  • intolerance to any component of the active ingredients of the formulation
  • women who are pregnant or have planned the pregnancy within three months and women who are breast-feeding.

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • IRCCS Neuromed

    Pozzilli, Isernia, 86077

Other trials in Italy

About this study

Official title: Clinical Trial on the Efficacy of a Natural Components Mixture in the Treatment of Non Alcoholic Fatty Liver Disease (NAFLD)

The objective of this study is to provide clinical data to support the effectiveness of a mixture of ingredients of natural origin, suitably selected and packaged, in the protection from liver damage, in subjects with NAFLD.

Study design: double-blind, randomized, multicentre trial, placebo-controlled on two parallel groups.

Read more

The study participants are healthy volunteers, since they do not have nor had any liver-related clinical symptom, but simply laboratory (plasma levels greater than normal for at least one of the liver parameters -aspartate aminotransferase AST, alanine aminotransferase ALT or γ -glutamyltranspeptidase γ-GT) or instrumental (ultrasonographic abnormalities of steatosic liver) tests altered as compared to normal ranges.

Three months treatment with the nutraceutical mixture or placebo. Outcomes tested before and at the end of treatment - 3 months).

Read the detailed description

A correct hepatic function is highly relevant from the epidemiological point of view. In Italy, Non Alcoholic Fatty Liver Disease - NAFLD - has a prevalence of 20-25% in the adult population, with peaks of 50-70% within obese and type-2 diabetes populations: it is the most frequent cause of hematic changes in cytonecrosis enzymes, and can explain about 90% of asymptomatic high levels of transaminases. NAFLD natural history is associated with an increase of cerebro and cardiovascular risk, in both healthy subjects and diabetic patients.

Its prevention and treatment are of great interest, in particular dietary and nutraceutical interventions are the object of innovative research. It is also known that about 65% of subjects with hepatic dysfunction consume plant extracts, like silymarin from Cardo marianum. A recent trial showed an improvement of the hepatic function in subjects with NAFLD treated with silybin, combined with phosphatidylcholine and vitamin E. These findings provide valuable information on new therapeutic strategies, but warrant further investigation. For no natural substance a health claim related to liver function was in fact approved by the European Food Safety Authority (EFSA). The only exception is constituted by the food sources of choline, for which the maintenance of normal hepatic function has been claimed.

The objective of this study is to provide clinical data to support the effectiveness of a mixture of ingredients of natural origin, suitably selected and packaged, in the protection from liver damage, in subjects with NAFLD.

Treatment: subjects will be randomized to receive the nutraceutical formulation or placebo for three months, in the amount of two capsules (about 800 mg each) a day, at one time.

All subjects, after signing a written informed consent to participation in the study, will receive appropriate recomendations about diet and physical exercise.

A clinic visit, with collection of the patient clinical and pharmacological history and recording of any adverse event, liver ultrasound, measurement of weight and height and calculation of BMI, measure of arterial blood pressure, collection of a sample of venous blood, under fasting conditions, for hematochemical tests, will be made at the baseline (T0); all examinations and tests (except liver ultrasound) will be repeated after three months of treatment (T1).

Primary end-points of the study: hematic levels of hepatic enzymes: ALT, AST and γ-GT.

Secondary end-points of the study:

  1. Hepatic function: direct and indirect bilirubin;
  2. Inflammation markers: C Reactive Protein (CRP), interleukin (IL)-6, IL-1β, IL-8, IL-10, Receptor for Advanced Glycation End Products (RAGE), Advanced Glycation End Products (AGE), insulin-like growth factor-1 (IGF-1)
  3. Haemostatic function: Factor VII, fibrinogen, thrombin generation with and without thrombomodulin, antithrombin (AT), tissue-type Plasminogen Activator (t-PA), Plasminogen Activator Inhibitor-1(PAI-1), thrombin activatable fibrinolysis inhibitor (TAFI) and activated TAFI (TAFIa), plasmin-antiplasmin complex, plasma fibrinolytic capacity;
  4. Metabolic syndrome parameters: glycemia, triglycerides, HDL cholesterol, insulin e insulin-resistance (HOMA-IR homeostasis model assessment-estimated insulin resistance), adiponectin;
  5. Apoptosis parameters: total cytokeratin-18 (M65 antigene), M30 and M65/M65ED, soluble fas and soluble fas ligand.

A weekly food diary will be administered to each subject before and at the end of the treatment, to highlight any possible change of dietary habits during the study.

In addition, for all subjects the NAFLD Fibrosis Score (NFS), a composite score of prognostic value for the conversion of NAFDL into fibrotic hepatitis and for the disease severity, will be calculated. This score includes age, body mass index, platelet count, albumin, relationship between AST and ALT, and presence of diabetes. A sub-analysis will be done to evaluate the efficacy of the treatment with the synergistic blend of ingredients in subjects with high, as compared to those with low NFS.

Sample size calculation: Establishing Alpha = 0.05 and Β = 80%, the number of 150 people (75 per treatment arm) will evaluate differences between the two groups (T1 to T0) equal to 46% of the standard deviation of the mean of the two liver function parameters selected (primary end-points), in particular, differences over 11.5 for ALT (17% of the average), 7.1 for AST (17% of the average) or 13.8 for γ-GT (19% of the average). This calculation also includes a drop-out of 10% of the sample enrolled in the study.

Compliance to treatment will be monitored by counting the capsules returned in the box at the end of treatment.

Being tested
nutraceutical mixture, placebo
Keywords
NAFLD, nutraceutical mixture
Medical subject headings
Non-alcoholic Fatty Liver Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • nutraceutical mixtureDietary supplement

    Lifestyle counseling, administration of a nutraceutical mixture: fish oil 70% DHA (docosahexaenoic acid), phosphatidylcholine concentrated in sunflower oil, silymarin, choline bitartrate, curcumin, D-α-tocopherol; choline (82,5 mg, corresponding to 15% of the average intake of 550 mg per day in an adult man)

  • placeboDietary supplement

    Lifestyle counseling, administration of a placebo, containing only choline, at the same low concentration of the active mixture

Study groups in NCT02369536
Study groupRoleWhat they receive
nutraceutical mixtureActive comparatorLifestyle counseling plus three month administration of nutraceutical mixture (2 soft gelatin capsules of 800 mg per day)
Receives: Dietary Supplement: nutraceutical mixture
placeboPlacebo comparatorLifestyle counseling plus three month administration of placebo formulation (2 soft gelatin capsules of 800 mg per day)
Receives: Dietary Supplement: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hematic Levels of Hepatic Enzymes AST

    hematic levels of hepatic enzyme: aspartate aminotransferase (AST)

    Measured: before and at the end of treatment (three months)

  2. Hematic Levels of Hepatic Enzymes ALT

    hematic levels of hepatic enzyme: alanine aminotransferase (ALT)

    Measured: before and at the end of treatment (three months)

  3. Hematic Levels of Hepatic Enzymes GGT

    hematic levels of hepatic enzyme: gamma-glutamyl transpeptidase (GGT)

    Measured: before and at the end of treatment (three months)

Secondary outcomes (5)
  1. Plasma Levels of Hepatic Enzymes

    hematic levels of direct bilirubin

    Measured: before and at the end of treatment (three months)

  2. Levels of Circulating Inflammation Marker

    Levels of circulating Inflammation marker: C Reactive Protein (CRP)

    Measured: before and at the end of treatment (three months)

  3. Measures of the Haemostatic Function

    Tissue-type Plasminogen Activator (t-PA) levels in plasma

    Measured: before and at the end of treatment (three months)

  4. Measures of the Haemostatic Function

    Plasminogen Activator Inihibitor (PAI-1) levels in plasma

    Measured: before and at the end of treatment (three months)

  5. Measures of the Haemostatic Function

    Thrombin activatable fibrinolysis inhibitor (TAFI) levels in plasma

    Measured: before and at the end of treatment (three months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Feb 2015 (estimated)
  2. Study start18 Aug 2015
  3. Primary completion15 Sep 2016
  4. Study completion15 Sep 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
126 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02369536
Sponsor's protocol ID
Neuromed-Nutrafast-PON2015
Acronym
NUTRAFAST
Status last verified
Jan 2022
First submitted
17 Feb 2015
Last updated
12 Jan 2022
Data monitoring committee
No
Individual data sharing
No

Publications

  • Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ; American Association for the Study of Liver Diseases; American College of Gastroenterology; American Gastroenterological Association. The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol. 2012 Jun;107(6):811-26. doi: 10.1038/ajg.2012.128. No abstract available.

    PubMed 22641309

Questions about this trial

What is this clinical trial studying?

A study testing nutraceutical mixture in people with Non-alcoholic Fatty Liver Disease, run by Neuromed IRCCS at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Feb 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hematic Levels of Hepatic Enzymes AST (time frame: before and at the end of treatment (three months)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02369536, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jan 2022.

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