HIV InfectionsPhase 2NCT04216589
Study of Semaglutide for Non-Alcoholic Fatty Liver Disease (NAFLD), a Metabolic Syndrome With Insulin Resistance, Increased Hepatic Lipids, and Increased Cardiovascular Disease Risk (The SLIM LIVER Study)
A Phase 2 study testing Semaglutide in people with HIV Infections and Non-Alcoholic Fatty Liver Disease, run by National Institute of Allergy and Infectious Diseases (NIAID) at 9 sites in 2 countries.
Trial summary
The purpose of this study was to evaluate the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- HIV Infections, Non-Alcoholic Fatty Liver Disease
- What is being tested?
- Semaglutide
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 51 participants
- Where
- 9 sitesin 2 countries
- Study dates
- 19 Feb 2021to 15 Sep 2023
- Phase
- Phase 2
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- HIV-1 infection, documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 antigen, plasma HIV-1 RNA viral load.
- NOTE: The term "licensed" refers to a US Food and Drug Administration (FDA)-approved kit, which is required for all investigational new drug (IND) studies, or for sites located in countries other than the United States, a kit that has been certified or licensed by an oversight body within that country and validated internally. Non-US sites are encouraged to use US FDA-approved methods for IND studies.
- WHO (World Health Organization) and CDC (Centers for Disease Control and Prevention) guidelines mandate that confirmation of the initial test result must use a test that is different from the one used for the initial assessment. A reactive initial rapid test should be confirmed by either another type of rapid assay or an E/CIA that is based on a different antigen preparation and/or different test principle (e.g., indirect versus competitive), or a Western blot or a plasma HIV-1 RNA viral load.
- Two separate reports of HIV-1 RNA measurements <50 copies/mL, and no HIV-1 RNA measurement >500 copies/mL, during the 48 weeks prior to entry. One of the HIV-1 RNA values must be the screening visit value, and the other value obtained between 24 and 48 weeks prior to entry.
- NOTE: All values must have been reported from a US laboratory that has a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent, or at any network-approved non-US laboratory that is Virology Quality Assurance (VQA) certified.
- No change in antiretroviral therapy (ART) in the 24 weeks prior to entry.
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- NOTE A: Modifications of ART formulation (e.g., from standard formulation to fixed dose combination or single tablet regimen) will be permitted.
- NOTE B: Within-class substitutions are not permitted.
- No plan to change ART for the study duration.
- Within 30 days prior to pre-entry, a minimum WC measurement of ≥95 cm for individuals assigned male sex at birth or ≥94 cm for individuals assigned female sex at birth.
- NOTE: For transgender study participants, sites should use the parameter that matches sex assigned at birth.
- At least one of the following drawn within 30 days prior to pre-entry by any US laboratory that has a CLIA certification or its equivalent, or at any network-approved non-US laboratory that operates in accordance with Good Clinical Laboratory Practices (GCLP) and participates in appropriate external quality assurance programs:
- Fasting plasma glucose 100-125 mg/dL (refer to the study protocol for a definition of fasting).
- HbA1c between ≥5.7 and <6.5%
- Homeostatic model assessment of insulin resistance (HOMA-IR) >3.0 (Refer to calculator: https://www.mdcalc.com/homa-ir-homeostatic-model-assessment-insulin-resistance)
- Documentation of negative hepatitis A virus (HAV) immunoglobulin M (IgM) or HAV vaccination prior to study entry.
- NOTE: If documentation is not available prior to screening, this should be obtained through routine clinical care within 30 days prior to entry.
- Hepatic fat content (i.e., IHTG) ≥5%, as determined by liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF) within 14 days prior to entry (and between 1-30 days after screening).
- NOTE: Refer to the study protocol for more details.
- CD4+ T-cell count ≥200 cells/mm^3 within 30 days prior to pre-entry (may be from standard of care) at any US laboratory that has a CLIA certification or its equivalent, or at any network-approved non-US laboratory that is Immunology Quality Assurance (IQA) certified.
- The following laboratory values obtained within 30 days prior to pre-entry by any US laboratory that has a CLIA certification or its equivalent, or at any network-approved non-US laboratory that operates in accordance with GCLP and participates in appropriate external quality assurance programs:
- Absolute neutrophil count (ANC) >750 cells/mm^3
- Hemoglobin >10 g/dL for individuals assigned male at birth and >9 g/dL for individuals assigned female at birth
- Creatinine clearance (CrCl) ≥50 mL/min, as calculated by the CKD-Epi equation.
- NOTE: Please refer to A5371 protocol-specific web page (PSWP) for the website link to calculate CrCl using the CKD-Epi calculator.
- NOTE: Calculations will be done without using cystatin C. Please refer to the A5371 Manual of Operating Procedures (MOPS) for further details.
- Aspartate aminotransferase (AST) (SGOT) ≤3 x ULN on at least two measurements, with at least one within 30 days prior to pre-entry. Participants must also have no evidence of AST >3 x ULN within the 3 months prior to entry, from routine clinical monitoring, if available. If no additional monitoring is available in the 3 months prior to entry, additional testing should be obtained within the screening interval (2-4 weeks apart) to ensure stability.
- Alanine aminotransferase (ALT) (SGPT) ≤3 x ULN on at least two measurements, with at least one within 30 days prior to pre-entry. Participants must also have no evidence of ALT >3 x ULN within the 3 months prior to entry, from routine clinical monitoring, if available. If no additional monitoring is available in the 3 months prior to entry, additional testing should be obtained within the screening interval (2-4 weeks apart) to ensure stability.
- Fasting triglyceride level ≤500 mg/dL.
- NOTE A: See the study protocol for a definition of fasting.
- NOTE B: If level is >500 mg/dL, level may be rechecked within the screening window.
- For individuals taking daily medications with anti-inflammatory properties, including but not limited to, statins and chronic corticosteroids (inhaled corticosteroids exempt), the doses must be stable as determined by the site investigator for ≥3 months prior to study entry, and the individual should have no active plans to change dosing during the study period.
- For individuals taking daily lipid-lowering medications (such as statins, fibrates, niacin, fish oil), the doses must be stable as determined by the site investigator for ≥3 months prior to study entry, and the individual should have no active plans to change dosing during the study period.
- NOTE: Lipid-lowering equivalents for niacin and fish oil are ≥1 g and ≥3 g daily, respectively.
- Ability and willingness of participant to provide informed consent
- Willingness and ability to use auto-inject pen weekly for 24 weeks.
- Willingness and ability to undergo MRI scans.
- NOTE: Anxiolytics will not be provided through the study but may be provided at site expense.
- For persons able to become pregnant, a negative serum or urine pregnancy test (urine test must have a sensitivity of <25 mIU/mL) both 1) at screening (within 30 days prior to pre-entry MRI) and 2) within 3 days before or at entry (prior to registration into study) by any US clinic or laboratory that has a CLIA certification or its equivalent, or is using a point of care (POC)/ CLIA-waived test, or at any network-approved non-US laboratory or clinic that operates in accordance with Good Clinical Laboratory Practices (GCLP) and participates in appropriate external quality assurance programs.
- NOTE: Individuals able to become pregnant are defined as individuals who have reached menarche and who have not been post-menopausal for at least 24 consecutive months (i.e., have had menses within the preceding 24 months), and have not undergone surgical sterilization such as hysterectomy, bilateral oophorectomy, tubal ligation, or salpingectomy.
- If participating in sexual activity that could lead to the participant becoming pregnant, the participant must agree to use contraception while on study drug (24 weeks) and for 2 months following the last dose of study drug. At least one of the following must be used:
- Intrauterine device (IUD)
- Hormone-based contraceptive
- Partner sterilization (i.e., vasectomy) and is the sole partner for the participant.
- NOTE: Participant self-report of partner sterilization is acceptable.
- For individuals taking Vitamin E (any dose), the dose must be stable as determined by the site investigator for more than 1 year prior to entry.
- Willingness to be contacted by telephone or e-mail by study staff throughout the study.
Who cannot join
- Known active hepatitis C virus (HCV) infection, defined as a detectable HCV RNA within 24 weeks prior to study entry.
- NOTE A: Individuals with HCV RNA below the limit of quantitation for >24 weeks prior to study entry are eligible, i.e., individuals who have been treated for hepatitis C are eligible if they have completed therapy >24 weeks prior to study entry, and/or individuals who spontaneously cleared hepatitis C virus are eligible as long as they have had undetectable HCV RNA for >24 weeks. HCV RNA testing is not provided by the study.
- NOTE B: If HCV antibody testing has not been performed in the 5 years prior to screening and the participant does not have history of cured HCV infection, HCV antibody testing should be repeated at screening. If screening HCV antibody is positive or reactive, the individual is not eligible and should be referred for clinical evaluation through routine care.
- Active/chronic hepatitis B (HBV), defined as a positive hepatitis B surface antigen (HBsAg) at screening.
- NOTE A: HBsAg testing is only required at screening if HBV laboratory results are not available within the last 5 years prior to screening and individual does not have documented immunity.
- NOTE B: If HBsAg positive, individual is not eligible and should be referred for clinical evaluation through routine care.
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- Known active severe delayed gastric emptying, as determined by the site investigator.
- Gain or loss of >5% body weight within 12 weeks prior to study entry.
- NOTE: Self-report recall is acceptable.
- Any plans to change diet or exercise regimen significantly, except for the adoption of study provided suggestions for diet and exercise, within the study period.
- NOTE: "Significantly" refers to intent to join a weight-loss program such as Weight Watchers, or start a specific diet (such as ketogenic or very low carbohydrate).
- Known acute or chronic liver disease with cirrhosis or portal hypertension.
- History of liver transplant.
- Breastfeeding or plans to become pregnant.
- Current diagnosis of diabetes mellitus or current use of diabetes medications, or a laboratory measurement of hemoglobin A1c ≥6.5% at screening.
- NOTE: Stable use of metformin (i.e., for ≥12 weeks) for indication other than diabetes (e.g., polycystic ovarian syndrome or pre-diabetes/impaired fasting glucose) may be permitted with approval of the Clinical Management Committee (CMC).
- Known retinopathy (excluding remote history of cotton wool spots).
- Personal or family (first-degree relative) history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2).
- Untreated, poorly controlled, or previously undiagnosed thyroid disease defined as the presence of abnormal thyroid-stimulating hormone (TSH) at screening with no clear explanation.
- Unexplained hypercalcemia corrected for albumin that is >10.5 mg/dL at screening. Please refer to the A5371 MOPS for the calculation.
- Use of any immunomodulatory (including prednisone equivalent of ≥10 mg), HIV vaccine, investigational therapy, or TNF-α therapy within 3 months prior to study entry.
- Use of human growth hormone, tesamorelin, supraphysiologic testosterone to achieve therapeutic blood levels, or any use of other anabolic steroids within 3 months prior to study entry or plans to start these while on study.
- NOTE: Chronic, stable hormone replacement therapy ≥3 months prior to entry in men with diagnosed hypogonadism or transgender person on masculinizing hormonal therapy is permitted.
- Use of estrogens or progesterones at supraphysiologic doses within 3 months prior to study entry.
- NOTE: Stable doses used for contraception, post-menopausal hormone replacement or feminizing hormone therapy for transgender persons ≥3 months prior to entry is permitted.
- Known allergy/sensitivity or any hypersensitivity to components of study drug or its formulation.
- Current serious illness requiring systemic treatment and/or hospitalization.
- NOTE: The individual can be rescreened when they complete therapy or are clinically stable as determined by the site investigator.
- Use of GLP-1 agonists within 24 weeks prior to study entry.
- Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
- Excessive consumption of alcohol of ≥3 months within 90 days prior to screening, defined as:
- Consuming ≥5 alcoholic drinks for men or consuming ≥4 alcoholic drinks for women during a single occasion (i.e., at the same time or within a couple of hours of each other), or
- ≥3 drinks on 4 or more days of the week on average for men or ≥2 drinks on 4 or more days of the week on average for women.
- NOTE: For transgender study participants, sites should use the parameter that matches sex assigned at birth.
- Known chronic pancreatitis or more than one episode of pancreatitis ever in the past.
- Inability to keep study product at 36°F to 46°F (2°C to 8°C) prior to first use, or to maintain the study product at a controlled room temperature between 59°F and 86°F (15°C to 30°C) following first use.
- Intent to use any medication likely to cause significant changes in weight during the study period.
- NOTE: Refer to the study protocol for a list of medications in this category.
- Use of stavudine within 12 months prior to study entry.
- Prior bariatric surgery (e.g., lap band, gastric sleeve, or Roux-en-Y bypass surgery) or major gastric surgery or plans to undergo weight reduction surgery while on study.
- Individuals with any metal, implantable devices (e.g., pacemakers, prosthetics), or shrapnel, per standard MRI exclusion criteria.
- Any condition that the site investigator believes would make the individual unsuitable for participation.
Trial locations and contacts
9 sites in 2 countries.
9 sites in 2 countries
United States8 sites
University of Colorado Hospital CRS (Site ID: 6101)
Aurora, Colorado, 80045
Johns Hopkins University CRS
Baltimore, Maryland, 21287
Alabama CRS (Site ID: 31788)
Birmingham, Alabama, 35294
Massachusetts General Hospital CRS (MGH CRS) (Site ID: 101)
Boston, Massachusetts, 02114
Cincinnati Clinical Research Site (Site ID: 2401)
Cincinnati, Ohio, 45267-0405
Ohio State University CRS (Site ID: 2301)
Columbus, Ohio, 43210
Houston AIDS Research Team CRS (Site ID: 31473)
Houston, Texas, 77009
University of Washington AIDS CRS (Site ID: 1401)
Seattle, Washington, 98104-9929
Brazil1 site
Instituto de Pesquisa Clinica Evandro Chagas (IPEC) CRS (Site ID: 12101)
Rio de Janeiro, 21040-360
About this study
Official title: A Single-Arm, Open-Label, Pilot Study of Semaglutide for Non-Alcoholic Fatty Liver Disease (NAFLD), a Metabolic Syndrome With Insulin Resistance, Increased Hepatic Lipids, and Increased Cardiovascular Disease Risk (The SLIM LIVER Study)
The purpose of this study was to evaluate the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis.
Read the detailed description
This study evaluated the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis.
All participants received semaglutide subcutaneously once weekly for 24 weeks, followed by 24 weeks of observation off of the study drug. IHTG was quantified by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) evaluations at two time points during the study.
Participants attended several study visits through Week 48. Participants completed food diaries, adherence and strength assessments, and report on hypoglycemia, vision changes, physical activity, diet, quality of life, and acceptability of study drug. Blood was collected at all visits and stool samples at two visits.
Participants remained on their non-study-provided antiretroviral therapy (ART) throughout the study.
- Conditions
- HIV Infections, Non-Alcoholic Fatty Liver Disease
- Being tested
- Semaglutide
- Keywords
- NAFLD, HIV, semaglutide
- Medical subject headings
- HIV Infections, Non-alcoholic Fatty Liver Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SemaglutideDrug
Administered subcutaneously
| Study group | Role | What they receive |
|---|---|---|
| Semaglutide | Experimental | All participants received a dose of 0.25 mg of semaglutide weekly starting at study entry, followed by 0.5 mg weekly starting at Week 2, and then 1.0 mg weekly from Weeks 4 through 24. Receives: Drug: Semaglutide |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change (Absolute) in IHTG (%)
The absolute change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit.
Measured: Measured at pre-entry and Week 24
Secondary outcomes (24)
Change (Percent) in IHTG (%)
The percentage change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit. The percentage change is defined as IHTC % at week 24 minus IHTC % at pre-entry, then divided by IHTC % at pre-entry, then multiplied by 100.
Measured: Measured at pre-entry and Week 24
Level of IHTG (%)
Intra-hepatic triglyceride content (%) at Week 24 (<5% vs. >=5%). All participants were >=5% at pre-entry.
Measured: Measured at Week 24
Occurrence of Premature Discontinuation of Study Treatment
Premature study treatment discontinuation prior to the Week 24 visit.
Measured: Measured through Week 24
Occurrence of Grade ≥3 Adverse Event That is Related to Study Treatment
Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Adverse events are graded on a scale from 1-5: 1=mild, 2=moderate, 3=severe, 4=life-threatening, 5=death.
Measured: Measured through Week 24
Change (Absolute) in Body Mass Index (BMI)
The absolute change in body mass index from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Body Mass Index (BMI)
The absolute change in body mass index from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured from Week 0 to Week 12
Change (Absolute) in Body Weight
The absolute change in body weight from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Body Weight
The absolute change in body weight from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Minimum Waist Circumference (WC)
The absolute change in minimum WC from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Minimum Waist Circumference (WC)
The absolute change in minimum WC from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Insulin Resistance (HOMA-IR)
The absolute change in HOMA-IR from the study entry (Week 0) visit to the Week 24 visit.
HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a method used to estimate how well your body responds to insulin.
HOMA-IR is caluclated with the following formula:
(fasting glucose in mmol/L x fasting insulin in mIU/mL)/22.5
A higher HOMA-IR score indicates a greater likelihood of insulin resistance.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Insulin Resistance (HOMA-IR)
The absolute change in HOMA-IR from the study entry (Week 0) visit to the Week 12 visit.
HOMA-IR (Homeostatic Model Assessment of Insulin Resistanc) is a method used to estimate how well your body responds to insulin.
HOMA-IR is caluclated with the following formula:
(fasting glucose in mmol/L x fasting insulin in mIU/mL)/22.5 A higher HOMA-IR score indicates a greater likelihood of insulin resistance.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Hemoglobin A1C (HbA1c)
The absolute change in HbA1c from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Glucose
The absolute change in fasting glucose from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Glucose
The absolute change in fasting glucose from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Fasting Total Cholesterol
The absolute change in fasting total cholesterol from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Total Cholesterol
The absolute change in fasting total cholesterol from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Fasting LDL Cholesterol
The absolute change in fasting LDL cholesterol from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Fasting LDL Cholesterol
The absolute change in fasting LDL cholesterol from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Fasting HDL Cholesterol
The absolute change in fasting HDL cholesterol from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Fasting HDL Cholesterol
The absolute change in fasting HDL cholesterol from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Change (Absolute) in Fasting Triglycerides
The absolute change in fasting triglycerides from the study entry (Week 0) visit to the Week 24 visit.
Measured: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Triglycerides
The absolute change in fasting triglycerides from the study entry (Week 0) visit to the Week 12 visit.
Measured: Measured at Week 0 and Week 12
Presence of Metabolic Syndrome
Metabolic syndrome is defined as having ≥3 of the following: increased minimum WC (>=40 inches for male sex at birth; >=35 inches for female sex at birth), increased fasting triglyceride level (>150 mg/dL or taking lipid-lowering medication), reduced fasting HDL cholesterol (<40 mg/dL for male sex at birth; <50 mg/dL for female sex at birth), increased blood pressure (>=135/85 mmHg or taking BP medication), and increased fasting glucose (>100 mg/dL or taking glucose-lowering medication).
Measured: Measured at Weeks 0, 12 and 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jan 2020
- Study start19 Feb 2021
- Primary completion16 Mar 2023
- Study completion15 Sep 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for HIV InfectionsStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The 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
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 51 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Kristine Erlandson, MD, MS, Study chair, University of Colorado Hospital CRSJordan E. Lake, MD, MSc, Study chair, Houston AIDS Research Team CRS
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04216589
- Sponsor's protocol ID
- ACTG A5371
- Other IDs
- 38453
- Status last verified
- Sep 2024
- First submitted
- 30 Dec 2019
- Last updated
- 1 Oct 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Individual participant data that underlie results in the publication, after deidentification.
Publications
Corley MJ, Pang APS, Kitch DW, Kantor A, Sattler F, Belaunzaran-Zamudio PF, Brown TT, Landay A, Lake JE, Erlandson KM. Pilot study of epigenetic aging and treatment response to semaglutide in the SLIM LIVER study. NPJ Aging. 2026 Apr 21;12(1):88. doi: 10.1038/s41514-026-00383-9.
PubMed 42014432Erlandson KM, Kitch DW, Kantor A, Belaunzaran-Zamudio PF, Brown TT, Fichtenbaum CJ, Heath SL, Sattler FR, Lake JE. The Bounce-back Effect: What Happens After Cessation of Low-dose Semaglutide in People With HIV. Clin Infect Dis. 2026 Mar 17;82(3):e544-e548. doi: 10.1093/cid/ciaf652.
PubMed 41299212Corley M, Pang A, Kitch D, Kantor A, Sattler F, Belaunzaran-Zamudio P, Brown T, Landay A, Lake J, Erlandson K. Epigenetic Aging and Treatment Response to Semaglutide in the SLIM LIVER Study. Res Sq [Preprint]. 2025 Oct 1:rs.3.rs-7697256. doi: 10.21203/rs.3.rs-7697256/v1.
PubMed 41256006Ditzenberger GL, Lake JE, Kitch DW, Kantor A, Muthupillai R, Moser C, Belaunzaran-Zamudio PF, Brown TT, Corey K, Landay AL, Avihingsanon A, Sattler FR, Erlandson KM. Effects of Semaglutide on Muscle Structure and Function in the SLIM LIVER Study. Clin Infect Dis. 2025 Feb 24;80(2):389-396. doi: 10.1093/cid/ciae384.
PubMed 39046173
Study at a glance
From the registry record, last updated by the sponsor on 1 Oct 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Single-Arm, Open-Label, Pilot Study of Semaglutide for Non-Alcoholic Fatty Liver Disease (NAFLD), a Metabolic Syndrome With Insulin Resistance, Increased Hepatic Lipids, and Increased Cardiovascular Disease Risk (The SLIM LIVER Study)
- ClinicalTrials.gov ID
- NCT04216589
- Acronym / sponsor ID
- ACTG A5371
- Conditions
- HIV Infections, Non-Alcoholic Fatty Liver Disease
- Keywords
- NAFLD, HIV, semaglutide
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 51 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Collaborators
- The University of Texas Health Science Center, Houston
- Study start
- 19 Feb 2021 (actual)
- Primary completion
- 16 Mar 2023 (actual)
- Study completion
- 15 Sep 2023 (actual)
- First posted
- 2 Jan 2020 (actual)
- Results
- Posted 17 May 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study was to evaluate the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis.
Detailed description
This study evaluated the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis.
All participants received semaglutide subcutaneously once weekly for 24 weeks, followed by 24 weeks of observation off of the study drug. IHTG was quantified by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) evaluations at two time points during the study.
Participants attended several study visits through Week 48. Participants completed food diaries, adherence and strength assessments, and report on hypoglycemia, vision changes, physical activity, diet, quality of life, and acceptability of study drug. Blood was collected at all visits and stool samples at two visits.
Participants remained on their non-study-provided antiretroviral therapy (ART) throughout the study.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Semaglutide | Experimental | Drug: SemaglutideAll participants received a dose of 0.25 mg of semaglutide weekly starting at study entry, followed by 0.5 mg weekly starting at Week 2, and then 1.0 mg weekly from Weeks 4 through 24. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (47 listed)
- HIV-1 infection, documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 antigen, plasma HIV-1 RNA viral load.
- Two separate reports of HIV-1 RNA measurements <50 copies/mL, and no HIV-1 RNA measurement >500 copies/mL, during the 48 weeks prior to entry. One of the HIV-1 RNA values must be the screening visit value, and the other value obtained between 24 and 48 weeks prior to entry.
- No change in antiretroviral therapy (ART) in the 24 weeks prior to entry.
- No plan to change ART for the study duration.
- Within 30 days prior to pre-entry, a minimum WC measurement of ≥95 cm for individuals assigned male sex at birth or ≥94 cm for individuals assigned female sex at birth.
Key exclusion criteria (42 listed)
- Known active hepatitis C virus (HCV) infection, defined as a detectable HCV RNA within 24 weeks prior to study entry.
- Active/chronic hepatitis B (HBV), defined as a positive hepatitis B surface antigen (HBsAg) at screening.
- Known active severe delayed gastric emptying, as determined by the site investigator.
- Gain or loss of >5% body weight within 12 weeks prior to study entry.
- Any plans to change diet or exercise regimen significantly, except for the adoption of study provided suggestions for diet and exercise, within the study period.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SemaglutideAdministered subcutaneously | Drug | Semaglutide |
Primary outcome
Change (Absolute) in IHTG (%)
Time frame: Measured at pre-entry and Week 24
The absolute change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit.
24 secondary outcomes
Change (Percent) in IHTG (%)
Time frame: Measured at pre-entry and Week 24
Level of IHTG (%)
Time frame: Measured at Week 24
Occurrence of Premature Discontinuation of Study Treatment
Time frame: Measured through Week 24
Occurrence of Grade ≥3 Adverse Event That is Related to Study Treatment
Time frame: Measured through Week 24
Change (Absolute) in Body Mass Index (BMI)
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Body Mass Index (BMI)
Time frame: Measured from Week 0 to Week 12
Change (Absolute) in Body Weight
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Body Weight
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Minimum Waist Circumference (WC)
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Minimum Waist Circumference (WC)
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Insulin Resistance (HOMA-IR)
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Insulin Resistance (HOMA-IR)
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Hemoglobin A1C (HbA1c)
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Glucose
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Glucose
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Fasting Total Cholesterol
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Total Cholesterol
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Fasting LDL Cholesterol
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Fasting LDL Cholesterol
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Fasting HDL Cholesterol
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Fasting HDL Cholesterol
Time frame: Measured at Week 0 and Week 12
Change (Absolute) in Fasting Triglycerides
Time frame: Measured at Week 0 and Week 24
Change (Absolute) in Fasting Triglycerides
Time frame: Measured at Week 0 and Week 12
Presence of Metabolic Syndrome
Time frame: Measured at Weeks 0, 12 and 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Oct 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 42014432Corley MJ, Pang APS, Kitch DW, Kantor A, Sattler F, Belaunzaran-Zamudio PF, Brown TT, Landay A, Lake JE, Erlandson KM. Pilot study of epigenetic aging and treatment response to semaglutide in the SLIM LIVER study. NPJ Aging. 2026 Apr 21;12(1):88. doi: 10.1038/s41514-026-00383-9.
- Derived from this study: PubMed 41299212Erlandson KM, Kitch DW, Kantor A, Belaunzaran-Zamudio PF, Brown TT, Fichtenbaum CJ, Heath SL, Sattler FR, Lake JE. The Bounce-back Effect: What Happens After Cessation of Low-dose Semaglutide in People With HIV. Clin Infect Dis. 2026 Mar 17;82(3):e544-e548. doi: 10.1093/cid/ciaf652.
- Derived from this study: PubMed 41256006Corley M, Pang A, Kitch D, Kantor A, Sattler F, Belaunzaran-Zamudio P, Brown T, Landay A, Lake J, Erlandson K. Epigenetic Aging and Treatment Response to Semaglutide in the SLIM LIVER Study. Res Sq [Preprint]. 2025 Oct 1:rs.3.rs-7697256. doi: 10.21203/rs.3.rs-7697256/v1.
- Derived from this study: PubMed 39046173Ditzenberger GL, Lake JE, Kitch DW, Kantor A, Muthupillai R, Moser C, Belaunzaran-Zamudio PF, Brown TT, Corey K, Landay AL, Avihingsanon A, Sattler FR, Erlandson KM. Effects of Semaglutide on Muscle Structure and Function in the SLIM LIVER Study. Clin Infect Dis. 2025 Feb 24;80(2):389-396. doi: 10.1093/cid/ciae384.
- The Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017.Link provided by the sponsor.
- Manual for Expedited Reporting of Adverse Events to DAIDS (DAIDS EAE Manual), Version 2.0, January 2010.Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. Individual participant data that underlie results in the publication, after deidentification.
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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.
Kristine Erlandson, MD, MS study chair
University of Colorado Hospital CRS
Jordan E. Lake, MD, MSc study chair
Houston AIDS Research Team CRS
9 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Semaglutide in people with HIV Infections and Non-Alcoholic Fatty Liver Disease, run by National Institute of Allergy and Infectious Diseases (NIAID) at 9 sites in 2 countries.
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 47 inclusion and 42 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 1 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 9 sites in United States, Brazil. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 17 May 2024). 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?
Change (Absolute) in IHTG (%) (time frame: Measured at pre-entry and Week 24). 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 NCT04216589, which also lists 4 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 1 Oct 2024.