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Non Alcoholic Fatty LiverPhase 4NCT03222206

The Comparison of Effect Between Salsalate and Placebo in Osteoarthritis With Nonalcoholic Fatty Liver Disease

A Phase 4 study testing Salsalate in people with Non Alcoholic Fatty Liver and Osteo Arthritis, run by Korea University Guro Hospital at 1 site in South Korea.

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

This Study purpose to verify change of variety factors that the cause of nonalcoholic fatty liver disease and its process through salsalate injection to osteoarthritis patient who has non alcoholic fatty liver Read more about this study

Who is it for?
Ages 19 years and older
Conditions the study is for
Non Alcoholic Fatty Liver, Osteo Arthritis
What is being tested?
Salsalate
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
34 participants
Where
1 siteSouth Korea
Study dates
8 Nov 2017to 22 Feb 2019
Phase
Phase 4
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 19 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Osteoarthritis patient who has non alcoholic fatty liver
  • Standard of non alcoholic fatty liver diagnosis
  • Fatty liver on abdominal ultrasonography
  • Patient who has no evidence as hepatitis B, hepatitis C, immune hepatitis, metabolic hepatitis and other chronic hepatitis
  • Osteoarthritis patient who has never been treated

Who cannot join

  • Unsuitable on inclusion criteria
  • Thiazolidinedione injected patient for diabetes treatment or patient who has changed injected drug last 6 month
  • Patient who is treating nonsteroidal antiinflammatory drugs for osteoarthritis
  • Renal dysfunction : serum creatinine level 1.5mg/dl or creatinine clearance < 60ml/min
  • Anamnesis of gastrointestinal tract bleeding
  • Upper 5 times(200IU/l) the normality of Aspartate Transaminase(AST), Alanine Transaminase(ALT)
Show all 13Show fewer
  • Pregnant or Breastfeeding
  • Patient who has untreated malignant tumor
  • Liver transplantation patient
  • Patient who has liver function Child-Pugh B over
  • Patient who has serious disease that was estimated influence to study (e.g. Congestive heart failure, Kidney failure, Chronic pancreatitis, Malignant tumor)
  • Patients who has been injected immunomodulatory and immunosuppressant(inclusive universal corticosteroids) before 6 month enrollment or at present
  • Patient who was judged unsuitable for study by investigator

Trial locations and contacts

1 site in 1 country.

South Korea1 site
  • Korea University Guro Hospital

    Seoul, 08308

Other trials in South Korea

About this study

Official title: The Comparison of Effect Between Salsalate and Placebo in Osteoarthritis With Nonalcoholic Fatty Liver Disease: Investigator Initiated Randomized Placebo-controlled Double-blind, Pilot Study

This Study purpose to verify change of variety factors that the cause of nonalcoholic fatty liver disease and its process through salsalate injection to osteoarthritis patient who has non alcoholic fatty liver

Read the detailed description

Salsalate, the salicylic acid dimer that is one of anti-inflammatory and kind of salicylate. Aspirin(Acetylated salicylic) is known as nonsteroidal anti-inflammatory, also salsalate is widely used painkiller and anti-inflammatory without prescription in Europe and America through the long time and it was approved as osteoarthritis and rheumarthritis treatment in Korea. Especially salsalate is switched to salicylic acid(active metabolite) 15% rate lower than the same dose of aspirin (3.5g vs. 5g).

Salsalate is cyclooxygenase antagonist, it make anti-inflammatory effect by hinder creation of variety inflammatory induction factors like interleukin-6, Tumor Necrosis Factor (TNF)-alpha, C-reactive protein. This anti-inflammatory reaction is known to block Nuclear Factor(NF)-kappaB gene action by hinder action of IkappaB kinase. Also salsalate was reported it has positive effect to gluco metabolism as performed role of insulin-sensitizing. Therefore, the above mechanism of salsalate was expected that it can be had positive effect to metabolic disease like diabetes and obesity, and related studies are performed considerably at present.

There is no clinical trial for non alcoholic fatty acid related salsalate, and there was the animal study result that salsalate may reduce occurence of non alcoholic fatty acid and fibrosis by hinder non alcoholic fatty acid creation and inflammation mediation path.

Therefore, this Study purpose to verify change of variety factors that the cause of nonalcoholic fatty liver disease and its process through salsalate injection to osteoarthritis patient who has non alcoholic fatty liver

Being tested
Salsalate, Placebo
Keywords
Hepatokine, Adipokine, Saccharometabolism, Lipid metabolism
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.

  • SalsalateDrug

    Also called A03850041

    1. Medicate salsalate 2g/day after run-in period
    2. Check side effect after 1 month and Control dosage (2g/day or 3g/day)
    3. Check side effect after 2 month
  • PlaceboOther

    1. Medicate placebo 2g/day after run-in period
    2. Check side effect after 1 month and Control dosage (2g/day or 3g/day)
    3. Check side effect after 2 month
Study groups in NCT03222206
Study groupRoleWhat they receive
SalsalateExperimental17 patients received continuous medication with salsalate 2g/day after run-in period
Receives: Drug: Salsalate
PlaceboPlacebo comparator17 patients received continuous medication with Placebo 2g/day after run-in period
Receives: Other: Placebo

What is being measured

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

  1. Change of controlled attenuation parameter

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 8weeks

  2. Change of hepatokine as Fetuin-A

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 8weeks

  3. Change of pulse wave velocity

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 8weeks

  4. Change of adipokine as Adiponectin

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 8weeks

Secondary outcomes (13)
  1. Change of controlled attenuation parameter

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 4weeks

  2. Change of hepatokine as Fetuin-A

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 4weeks

  3. Change of pulse wave velocity

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 4weeks

  4. Change of adipokine as Adiponectin

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline and 4weeks

  5. Numerical value change of fatty liver index

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  6. Numerical value change of hepatic fibrosis as Nonalcoholic Fatty Liver Disease(NAFLD) fibrosis score

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  7. Change of saccharometabolic factors as Homeostasis Model Assessment(HOMA)-Insulin Resistance(IR), Homeostasis Model Assessment(HOMA)-B, Fasting glucose, Insulin, C-peptide, HbA1c, Glycated albumin

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  8. Change of lipid metabolic factors as Cholesterol, Triglyceride, LDL-cholesterol HDL-cholesterol and liver function test as Aspartate Transaminase(AST) and Alanine Transaminase(ALT)

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  9. Change of inflammatory factors as C Reactive Protein(CRP), Tumor Necrosis Factor(TNF)-a

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  10. Change of liver fibrosis factors as hyaluronic acid

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  11. Change of symptom of osteoarthritis as visual analog score for pain

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  12. Change of function of osteoarthritis as WOMAC (The Western Ontario and McMaster Universities Osteoarthritis Index)

    Estimation of salsalate single injection group and placebo injection group

    Measured: baseline, 4weeks and 8weeks

  13. Stability comparison like side effect

    Estimation with treatment-related adverse events as assessed by CTCAE v4.0

    Measured: Up to 2month

Timeline

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

  1. First posted19 Jul 2017
  2. Study start8 Nov 2017
  3. Primary completion22 Feb 2019
  4. Study completion22 Feb 2019

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Salsalate (2g/d), Place (2g/d)
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
34 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03222206
Sponsor's protocol ID
KUGH16353
Status last verified
Aug 2019
First submitted
8 Jul 2017
Last updated
22 Aug 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Bae JC, Cho YK, Lee WY, Seo HI, Rhee EJ, Park SE, Park CY, Oh KW, Sung KC, Kim BI. Impact of nonalcoholic fatty liver disease on insulin resistance in relation to HbA1c levels in nondiabetic subjects. Am J Gastroenterol. 2010 Nov;105(11):2389-95. doi: 10.1038/ajg.2010.275. Epub 2010 Jul 13.

    PubMed 20628364
  • Choi SY, Kim D, Kim HJ, Kang JH, Chung SJ, Park MJ, Kim YS, Kim CH, Choi SH, Kim W, Kim YJ, Yoon JH, Lee HS, Cho SH, Sung MW, Oh BH. The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans. Am J Gastroenterol. 2009 Aug;104(8):1953-60. doi: 10.1038/ajg.2009.238. Epub 2009 Jun 2.

    PubMed 19491838
  • Clark JM. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol. 2006 Mar;40 Suppl 1:S5-10. doi: 10.1097/01.mcg.0000168638.84840.ff.

    PubMed 16540768
  • Musso G, Cassader M, Gambino R. Diagnostic accuracy of adipose insulin resistance index and visceral adiposity index for progressive liver histology and cardiovascular risk in nonalcoholic fatty liver disease. Hepatology. 2012 Aug;56(2):788-9. doi: 10.1002/hep.25677. No abstract available.

    PubMed 22371327
  • Kim D, Choi SY, Park EH, Lee W, Kang JH, Kim W, Kim YJ, Yoon JH, Jeong SH, Lee DH, Lee HS, Larson J, Therneau TM, Kim WR. Nonalcoholic fatty liver disease is associated with coronary artery calcification. Hepatology. 2012 Aug;56(2):605-13. doi: 10.1002/hep.25593. Epub 2012 Jul 2.

    PubMed 22271511
  • Mahady SE, Webster AC, Walker S, Sanyal A, George J. The role of thiazolidinediones in non-alcoholic steatohepatitis - a systematic review and meta analysis. J Hepatol. 2011 Dec;55(6):1383-90. doi: 10.1016/j.jhep.2011.03.016. Epub 2011 Apr 14.

    PubMed 21703200
  • Aithal GP, Thomas JA, Kaye PV, Lawson A, Ryder SD, Spendlove I, Austin AS, Freeman JG, Morgan L, Webber J. Randomized, placebo-controlled trial of pioglitazone in nondiabetic subjects with nonalcoholic steatohepatitis. Gastroenterology. 2008 Oct;135(4):1176-84. doi: 10.1053/j.gastro.2008.06.047. Epub 2008 Jun 25.

    PubMed 18718471
  • Belfort R, Harrison SA, Brown K, Darland C, Finch J, Hardies J, Balas B, Gastaldelli A, Tio F, Pulcini J, Berria R, Ma JZ, Dwivedi S, Havranek R, Fincke C, DeFronzo R, Bannayan GA, Schenker S, Cusi K. A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med. 2006 Nov 30;355(22):2297-307. doi: 10.1056/NEJMoa060326.

    PubMed 17135584
  • Klein EA, Thompson IM Jr, Tangen CM, Crowley JJ, Lucia MS, Goodman PJ, Minasian LM, Ford LG, Parnes HL, Gaziano JM, Karp DD, Lieber MM, Walther PJ, Klotz L, Parsons JK, Chin JL, Darke AK, Lippman SM, Goodman GE, Meyskens FL Jr, Baker LH. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011 Oct 12;306(14):1549-56. doi: 10.1001/jama.2011.1437.

    PubMed 21990298
  • Kahn SE, Zinman B, Lachin JM, Haffner SM, Herman WH, Holman RR, Kravitz BG, Yu D, Heise MA, Aftring RP, Viberti G; Diabetes Outcome Progression Trial (ADOPT) Study Group. Rosiglitazone-associated fractures in type 2 diabetes: an Analysis from A Diabetes Outcome Progression Trial (ADOPT). Diabetes Care. 2008 May;31(5):845-51. doi: 10.2337/dc07-2270. Epub 2008 Jan 25.

    PubMed 18223031
  • Cohen A. Fecal blood loss and plasma salicylate study of salicylsalicylic acid and aspirin. J Clin Pharmacol. 1979 Apr;19(4):242-7. doi: 10.1002/j.1552-4604.1979.tb01658.x.

    PubMed 312297
  • Esser N, Paquot N, Scheen AJ. Anti-inflammatory agents to treat or prevent type 2 diabetes, metabolic syndrome and cardiovascular disease. Expert Opin Investig Drugs. 2015 Mar;24(3):283-307. doi: 10.1517/13543784.2015.974804. Epub 2014 Oct 25.

    PubMed 25345753
  • Ridker PM, Luscher TF. Anti-inflammatory therapies for cardiovascular disease. Eur Heart J. 2014 Jul 14;35(27):1782-91. doi: 10.1093/eurheartj/ehu203. Epub 2014 May 26.

    PubMed 24864079
  • Alderete TL, Sattler FR, Richey JM, Allayee H, Mittelman SD, Sheng X, Tucci J, Gyllenhammer LE, Grant EG, Goran MI. Salsalate treatment improves glycemia without altering adipose tissue in nondiabetic obese hispanics. Obesity (Silver Spring). 2015 Mar;23(3):543-51. doi: 10.1002/oby.20991. Epub 2015 Feb 3.

    PubMed 25644856
  • Pierce GL, Lesniewski LA, Lawson BR, Beske SD, Seals DR. Nuclear factor-kappaB activation contributes to vascular endothelial dysfunction via oxidative stress in overweight/obese middle-aged and older humans. Circulation. 2009 Mar 10;119(9):1284-92. doi: 10.1161/CIRCULATIONAHA.108.804294. Epub 2009 Feb 23.

    PubMed 19237660

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Salsalate in people with Non Alcoholic Fatty Liver and Osteo Arthritis, run by Korea University Guro Hospital at 1 site in South Korea.

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 5 inclusion and 13 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 22 Aug 2019. 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 South Korea. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Change of controlled attenuation parameter (time frame: baseline and 8weeks). The study lists 4 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 NCT03222206, which also lists 21 linked publications.

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 22 Aug 2019.

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