Nonalcoholic Fatty Liver DiseaseNCT02717000
NASH: Non-invasive Diagnostic Markers and Imaging
An observational study of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis, run by Maastricht University Medical Center.
Trial summary
Rationale: Non-alcoholic fatty liver disease (NAFLD) is the most widespread liver disorder in Western society (prevalence 20-30%). It is strongly associated with overweight and obesity. The majority of patients have simple steatosis. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis
- How many people
- 110 participants
- Where
- No sites listed yet
- Study dates
- Apr 2016to Dec 2017
- Phase
- Observational
- Are there results?
- None posted in the registry
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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Subjects with proven NAFLD by histology or NAFLD proven by imaging, who are undergoing surgery (i.e. bariatric surgery or cholecystectomy) will be asked to participate in this study. Furthermore, all subjects have to be between 18 and 65 years old.
Who may be able to join
- NAFLD proven by imaging
- Age 18-65 years
Who cannot join
- Incompetent to understand and/or sign the informed consent.
- Ethanol consumption exceeding more than 14 standard beverages per week for males and more than 7 standard beverages per week for female.
- Causes for secondary hepatic fat accumulation such as significant alcohol consumption, medications, Wilson's disease, viral infections, starvation or parenteral nutrition, among others, and conditions associated with microvesicular steatosis
- Not willing to be informed about unexpected findings by MRI and histopathologic evaluation of liver biopsy
- Unwilling to collect biosamples.
- Pregnancy and breastfeeding.
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- Diagnosis of liver cirrhosis and/or hepatocellular carcinoma.
- Current diagnosis of extrahepatic malignancie(s) or prior diagnosis within last 5 years.
- Diagnosis of chronic inflammatory disease (i.e. inflammatory bowel disease, rheumatoid arthritis, inflammatory lung disease, severe infectious diseases), other than NAFLD/NASH
- Chronic use of immunosuppressants (e.g. biologicals, prednisolone, azathioprine)
About this study
Official title: Non-invasive Diagnosis of Non-alcoholic Steatohepatitis in Patients With Non-alcoholic Fatty Liver Disease Using Markers and Imaging Techniques
Rationale:
Non-alcoholic fatty liver disease (NAFLD) is the most widespread liver disorder in Western society (prevalence 20-30%). It is strongly associated with overweight and obesity. The majority of patients have simple steatosis. However, in about 15-30% of the subjects, a chronic inflammatory state develops that is referred to as non-alcoholic steatohepatitis (NASH), which leads to an overall increase in morbidity and mortality due to the progression to fibrosis, cirrhosis and in some cases, hepatocellular carcinoma (HCC). The term NAFLD comprises both simple steatosis and NASH. Most patients with NAFLD have no or few, mainly aspecific symptoms; and generally there is a silent progression of simple steatosis to NASH and in the end, liver-related morbidity and mortality.
Read more
To date, liver biopsy is the most sensitive test for detecting and staging NAFLD, and is the only reliable method for differentiating between NASH and simple steatosis. However, the procedure of obtaining a liver biopsy is invasive and associated with patient discomfort, significant complications and high costs. In addition, liver biopsy is prone to sampling error and inter- and intra-observer variability, due to the small size of liver biopsy samples. This method is therefore not suitable for screening large numbers of subjects at risk, or for follow-up of patients with NASH over time. Hence, only subjects at high risk (usually based upon elevated aminotransferase levels, which is not specific for the presence of NASH) are biopsied, leading to an underestimation of NASH prevalence and undertreatment. Further insight into disease mechanisms and risk factors for NAFLD and in particular NASH is warranted, to enable early diagnosis, adequate therapy and preventive measures to improve health status of these individuals. Accurate and less invasive methods to evaluate NASH, and NAFLD, are urgently needed.
Objective: The primary objective of this study is to establish non-invasive tools (e.g. biomarkers and imaging) to accurately diagnose patients with NASH. The secondary objective is to show an association between the levels of identified markers and disease severity.
Study design:
Eligible subjects will be included via the outpatient clinics Zuyderland in Heerlen, the Catharina hospital in Eindhoven and MUMC+ in Maastricht. A subset of eligible subjects has undergone a liver biopsy for clinical reasons. It is estimated that about 85% of subjects will be asked to undergo a biopsy for study purposes only. Liver biopsies for study purposes will be performed during a surgical procedure, e.g. bariatric surgery or cholecystectomy.
Blood, faeces and exhaled air will be collected and a FibroScan (+CAP) will be performed during a study visit. An MRI will be performed, to estimate the degree of steatosis. Furthermore, anthropometric data (weight, height, abdominal and waist circumference and blood pressure (BP)) will be collected.
The participants in the group undergoing liver biopsy during bariatric surgery will be asked permission to be approached for follow-up measurements 3 months post-surgery. As they will lose weight, which is associated with improvement of hepatic steatosis, this enables assessment of possible changes over time. A routine follow-up visit post-surgery will take place after 3 months. The follow-up measurements will be combined with this visit, minimizing the burden for the participant. The measurements will consist of blood, faeces and exhaled air collection and a FibroScan (+CAP) will be performed during a study visit. Furthermore, weight, height, BP and abdominal and waist circumference will be measured.
Study population:
Subjects with proven NAFLD by histology or NAFLD proven by imaging, who are undergoing surgery (i.e. bariatric surgery or cholecystectomy) will be asked to participate in this study. Furthermore, all subjects have to be between 18 and 65 years old.
Main study parameters/endpoints:
Non-invasive tool based on biomarkers and imaging to diagnose NASH.
- 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.
| Study group | Role | What they receive |
|---|---|---|
| NASH | Not described | |
| No NASH | Not described |
What is being measured
The primary outcome is the main question the study is designed to answer.
Non-invasive tool to diagnose NASH (based on imaging (TE/MRI) an markers (biochemical, volatile organic compounds)
Measured: once enough evaluable patients are recruited, an average of 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Mar 2016 (estimated)
- Study startApr 2016
- Primary completionOct 2017 (estimated)
- Study completionDec 2017 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Nonalcoholic Fatty Liver DiseaseStudies of the same condition, open and under way.
- More trials run by Maastricht University Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 110 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Maastricht University Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- Zuyderland Medical Centre
- Responsible party
- Principal investigator, Ger Koek, Maastricht University Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02717000
- Sponsor's protocol ID
- 15-T-167
- Status last verified
- Mar 2016
- First submitted
- 15 Mar 2016
- Last updated
- 23 Mar 2016
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Mar 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Non-invasive Diagnosis of Non-alcoholic Steatohepatitis in Patients With Non-alcoholic Fatty Liver Disease Using Markers and Imaging Techniques
- ClinicalTrials.gov ID
- NCT02717000
- Acronym / sponsor ID
- 15-T-167
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 110 participants (estimated)
- Lead sponsor
- Maastricht University Medical CenterUniversity, hospital or other
- Collaborators
- Zuyderland Medical Centre
- Study start
- Apr 2016
- Primary completion
- Oct 2017 (estimated)
- Study completion
- Dec 2017 (estimated)
- First posted
- 23 Mar 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Rationale:
Non-alcoholic fatty liver disease (NAFLD) is the most widespread liver disorder in Western society (prevalence 20-30%). It is strongly associated with overweight and obesity. The majority of patients have simple steatosis. However, in about 15-30% of the subjects, a chronic inflammatory state develops that is referred to as non-alcoholic steatohepatitis (NASH), which leads to an overall increase in morbidity and mortality due to the progression to fibrosis, cirrhosis and in some cases, hepatocellular carcinoma (HCC). The term NAFLD comprises both simple steatosis and NASH. Most patients with NAFLD have no or few, mainly aspecific symptoms; and generally there is a silent progression of simple steatosis to NASH and in the end, liver-related morbidity and mortality.
To date, liver biopsy is the most sensitive test for detecting and staging NAFLD, and is the only reliable method for differentiating between NASH and simple steatosis. However, the procedure of obtaining a liver biopsy is invasive and associated with patient discomfort, significant complications and high costs. In addition, liver biopsy is prone to sampling error and inter- and intra-observer variability, due to the small size of liver biopsy samples. This method is therefore not suitable for screening large numbers of subjects at risk, or for follow-up of patients with NASH over time. Hence, only subjects at high risk (usually based upon elevated aminotransferase levels, which is not specific for the presence of NASH) are biopsied, leading to an underestimation of NASH prevalence and undertreatment. Further insight into disease mechanisms and risk factors for NAFLD and in particular NASH is warranted, to enable early diagnosis, adequate therapy and preventive measures to improve health status of these individuals. Accurate and less invasive methods to evaluate NASH, and NAFLD, are urgently needed.
Objective: The primary objective of this study is to establish non-invasive tools (e.g. biomarkers and imaging) to accurately diagnose patients with NASH. The secondary objective is to show an association between the levels of identified markers and disease severity.
Study design:
Eligible subjects will be included via the outpatient clinics Zuyderland in Heerlen, the Catharina hospital in Eindhoven and MUMC+ in Maastricht. A subset of eligible subjects has undergone a liver biopsy for clinical reasons. It is estimated that about 85% of subjects will be asked to undergo a biopsy for study purposes only. Liver biopsies for study purposes will be performed during a surgical procedure, e.g. bariatric surgery or cholecystectomy.
Blood, faeces and exhaled air will be collected and a FibroScan (+CAP) will be performed during a study visit. An MRI will be performed, to estimate the degree of steatosis. Furthermore, anthropometric data (weight, height, abdominal and waist circumference and blood pressure (BP)) will be collected.
The participants in the group undergoing liver biopsy during bariatric surgery will be asked permission to be approached for follow-up measurements 3 months post-surgery. As they will lose weight, which is associated with improvement of hepatic steatosis, this enables assessment of possible changes over time. A routine follow-up visit post-surgery will take place after 3 months. The follow-up measurements will be combined with this visit, minimizing the burden for the participant. The measurements will consist of blood, faeces and exhaled air collection and a FibroScan (+CAP) will be performed during a study visit. Furthermore, weight, height, BP and abdominal and waist circumference will be measured.
Study population:
Subjects with proven NAFLD by histology or NAFLD proven by imaging, who are undergoing surgery (i.e. bariatric surgery or cholecystectomy) will be asked to participate in this study. Furthermore, all subjects have to be between 18 and 65 years old.
Main study parameters/endpoints:
Non-invasive tool based on biomarkers and imaging to diagnose NASH.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| NASH | – | – |
| No NASH | – | – |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Subjects with proven NAFLD by histology or NAFLD proven by imaging, who are undergoing surgery (i.e. bariatric surgery or cholecystectomy) will be asked to participate in this study. Furthermore, all subjects have to be between 18 and 65 years old.
Key inclusion criteria (2 listed)
- NAFLD proven by imaging
- Age 18-65 years
Key exclusion criteria (10 listed)
- Incompetent to understand and/or sign the informed consent.
- Ethanol consumption exceeding more than 14 standard beverages per week for males and more than 7 standard beverages per week for female.
- Causes for secondary hepatic fat accumulation such as significant alcohol consumption, medications, Wilson's disease, viral infections, starvation or parenteral nutrition, among others, and conditions associated with microvesicular steatosis
- Not willing to be informed about unexpected findings by MRI and histopathologic evaluation of liver biopsy
- Unwilling to collect biosamples.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Non-invasive tool to diagnose NASH (based on imaging (TE/MRI) an markers (biochemical, volatile organic compounds)
Time frame: once enough evaluable patients are recruited, an average of 1 year
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Mar 2016.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis, run by Maastricht University Medical Center.
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 2 inclusion and 10 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: status not confirmed, as of the sponsor's last update on 23 Mar 2016. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. 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?
Results are not available in the source record.
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?
Non-invasive tool to diagnose NASH (based on imaging (TE/MRI) an markers (biochemical, volatile organic compounds) (time frame: once enough evaluable patients are recruited, an average of 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 23 Mar 2016.