AzTrials
AzTrials

Chronic Hepatitis bPhase 4NCT05147090

Effects of Empagliflozin on Fibrosis and Cirrhosis in Chronic Hepatitis B Patients

A Phase 4 study testing Empagliflozin 10 MG in people with Chronic Hepatitis b and NAFLD, run by The University of Hong Kong at 1 site in Hong Kong.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

Chronic hepatitis B (CHB) affects 257million individuals worldwide. In 2017, it caused around 39.7 million cases of cirrhosis and 0.4 million cirrhosis-related deaths in 2017. However, there is no specific treatment for liver fibrosis/cirrhosis. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Chronic Hepatitis b, NAFLD, Cirrhosis
What is being tested?
Empagliflozin 10 MG
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
106 participants
Where
1 siteHong Kong
Study dates
2 Jan 2022to 31 Dec 2027
Phase
Phase 4
Are there results?
Not yet: the study is under way

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
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients will be recruited if they have significant/advanced fibrosis or cirrhosis confirmed by MRE

Who cannot join

  • decompensated cirrhosis (variceal bleeding, ascites, hepatic hydrothorax, hepatic encephalopathy),
  • portal vein thrombosis,
  • alcohol intake >20g within last 2 years,
  • concurrent chronic liver disease (chronic hepatitis C infection, autoimmune hepatitis, Wilson's disease, hemochromatosis, primary biliary cholangitis, drug-induced),
  • history of malignancy including hepatocellular carcinoma (HCC),
  • pregnancy,
  • contraindications to empagliflozin (estimated glomerular filtration rate (eGFR) <45mL/min/1.73m2, recurrent genitourinary tract infections, gangrene, allergy),
  • contraindications to MRI (e.g., claustrophobia, implanted devices with ferromagnetic properties).

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • The University of Hong Kong/Queen Mary Hospital

    Hong Kong, Hong Kong, China, 852

Other trials in Hong Kong

About this study

Official title: Effects of Empagliflozin on Preventing Fibrosis and Cirrhosis Progression in Nucleos(t)Ide Analogue-treated Chronic Hepatitis B Patients With F2-F4 Fibrosis: a Randomized, Double-blind Placebo-controlled Trial

Chronic hepatitis B (CHB) affects 257million individuals worldwide. In 2017, it caused around 39.7 million cases of cirrhosis and 0.4 million cirrhosis-related deaths in 2017. However, there is no specific treatment for liver fibrosis/cirrhosis. Although nucleos(t)ide analogues (NAs) profoundly suppress viral replication, fibrosis/cirrhosis progression can still occur in NA-treated patients.

Sodium-glucose cotransporter type-2 (SGLT2) inhibitors are antidiabetic drugs that may prevent fibrosis/cirrhosis progression by reducing hepatic steatosis/inflammation, dampening renin-angiotensin aldosterone system (RAAS) activation, and reducing fluid retention, effects of which are independent of glycemic control. Clinical studies in diabetic patients show SGLT2 inhibitors reduce hepatis steatosis/inflammation, regress ascites (a cirrhotic complication), and improve liver function parameters and survival prognosis in terms of model for end-stage liver disease (MELD) score. There are currently no randomized controlled trials (RCTs) on role of SGLT2 inhibitors in preventing fibrosis/cirrhosis progression in CHB patients. Magnetic resonance elastography (MRE) and transient elastography (TE) are non-invasive techniques for liver stiffness measurement (LSM), although MRE is more accurate than TE.

Read more

The investigators propose a double-blind, randomized, placebo-controlled trial to compare effect of empagliflozin (an SGLT2 inhibitor) with placebo (1:1 ratio) in preventing fibrosis progression in both diabetic and non-diabetic NA-treated CHB patients with significant/advanced fibrosis or compensated cirrhosis. 108 patients will be randomly sampled from our pre-existing TE database. Empagliflozin 10mg daily will be given to treatment arm. Placebo pills will be manufactured identical in appearance to empagliflozin. Subjects will receive active or placebo pills for three years, and undergo clinical, anthropometric and laboratory assessments (at baseline, weeks 8, 16, and every 4 months thereafter). They will undergo LSM by TE at baseline, end of first, second and third year, and by MRE at baseline and end of third year. Primary outcome is difference in change to liver stiffness (measured by MRE) from baseline between the two groups at the end of third year.

The study results will determine whether SGLT2 inhibitors can prevent hepatic fibrosis/cirrhosis progression in NA-treated CHB patients.

Read the detailed description

Chronic hepatitis B (CHB) affects 257million individuals worldwide. In 2017, it caused around 39.7 million cases of cirrhosis and 0.4 million cirrhosis-related deaths in 2017. However, there is no specific treatment for liver fibrosis/cirrhosis. Although nucleos(t)ide analogues (NAs) profoundly suppress viral replication, fibrosis/cirrhosis progression can still occur in NA-treated patients.

Sodium-glucose cotransporter type-2 (SGLT2) inhibitors are antidiabetic drugs that may prevent fibrosis/cirrhosis progression by reducing hepatic steatosis/inflammation, dampening renin-angiotensin aldosterone system (RAAS) activation, and reducing fluid retention, effects of which are independent of glycemic control. Clinical studies in diabetic patients show SGLT2 inhibitors reduce hepatis steatosis/inflammation, regress ascites (a cirrhotic complication), and improve liver function parameters and survival prognosis in terms of model for end-stage liver disease (MELD) score. Our preliminary data from a territory-wide electronic healthcare database shows SGLT2 inhibitors were associated with 58% reduction in risk of cirrhosis development over three years among CHB patients with diabetes (n=9,502). There are currently no randomized controlled trials (RCTs) on role of SGLT2 inhibitors in preventing fibrosis/cirrhosis progression in CHB patients. Magnetic resonance elastography (MRE) and transient elastography (TE) are non-invasive techniques for liver stiffness measurement (LSM), although MRE is more accurate than TE.

The novelty of utilizing "drug repositioning" by changing role of SGLT2 inhibitors in treating diabetes mellitus (DM) to preventing fibrosis/cirrhosis progression in CHB deserves exploration. We propose a double-blind, randomized, placebo-controlled trial to compare effect of empagliflozin (an SLGT2 inhibitor) with placebo (1:1 ratio) in reducing liver stiffness in both diabetic and non-diabetic NA-treated CHB patients with significant/advanced fibrosis or compensated cirrhosis. 108 patients will be randomly sampled from our pre-existing TE database. Empagliflozin 10mg daily will be given to treatment arm. Placebo pills will be manufactured identical in appearance to empagliflozin. Subjects will receive active or placebo pills for three years, and undergo clinical, anthropometric and laboratory assessments (at baseline, weeks 8, 16, and every 4 months thereafter). They will undergo LSM by TE at baseline, end of first, second and third year, and by MRE at baseline and end of third year. Primary outcome is difference in change to liver stiffness (measured by MRE) from baseline between the two groups at the end of third year. Secondary outcomes are remission of advanced fibrosis/cirrhosis, progression of advanced fibrosis to cirrhosis, improvement of laboratory results (liver transaminases, ferritin, glucose, lipid profiles) and anthropometric measurements.

The study results will determine whether SGLT2 inhibitors can prevent hepatic fibrosis/cirrhosis progression in NA-treated CHB patients.

Being tested
Empagliflozin 10 MG, Placebo pills
Medical subject headings
Hepatitis B, Chronic, Non-alcoholic Fatty Liver Disease, Fibrosis, Liver Cirrhosis

What participants receive

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

  • Empagliflozin 10 MGDrug

    Also called empagliflozin

    Empagliflozin 10mg daily

  • Placebo pillsDrug

    Also called placebo

    Identical in appearance to empagliflozin 10mg daily

Study groups in NCT05147090
Study groupRoleWhat they receive
Empagliflozin groupActive comparatorEmpagliflozin 10mg daily for 156 weeks
Receives: Drug: Empagliflozin 10 MG
Placebo groupPlacebo comparatorPlacebo pills (identical in appearance to empagliflozin 10mg) daily for 156 weeks
Receives: Drug: Placebo pills

What is being measured

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

  1. Change in liver stiffness (measured by MRE)

    difference in change to liver stiffness from baseline between the two groups at the end of year 3 as measured by MRE

    Measured: week 156

Secondary outcomes (19)
  1. Remission of significant/advanced fibrosis and cirrhosis

    Remission of advanced fibrosis and cirrhosis (defined as a decrease in 1 fibrosis stage using MRE) at the end of year 3

    Measured: week 156

  2. Progression of significant/advanced fibrosis to cirrhosis (measured by MRE)

    Progression of significant/advanced fibrosis to cirrhosis (as defined by MRE) at the end of year 3

    Measured: week 156

  3. Progression to decompensated cirrhosis

    Progression to decompensated cirrhosis (ascites, variceal bleeding and/or hepatic encephalopathy) at the end of year 3

    Measured: week 156

  4. Change in liver stiffness (measured by transient elastography)

    Difference in serial changes to liver stiffness from baseline between the two groups (LSM measured by transient elastography)

    Measured: week 26, 52, 104 and 156

  5. Change in fat content (measured by transient elastography)

    Difference in serial changes to liver fat content from baseline between the two groups (CAP measured by transient elastography)

    Measured: week 26, 52, 104 and 156

  6. Changes of alanine aminotransferase (ALT)

    Changes of ALT at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  7. Changes of aspartate aminotransferase (AST)

    Changes of AST at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  8. Changes of alkaline phosphatase (ALP)

    Changes of ALP at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  9. Changes of gamma glutamyl transferase (GGT)

    Changes of GGT at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  10. Changes of fasting glucose

    Changes of fasting glucose at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  11. Changes of haemoglobin A1c (HbA1c)

    Changes of HbA1c at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  12. Changes of total cholesterol

    Changes of total cholesterol at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  13. Changes of low density lipoprotein (LDL)

    Changes of LDL at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  14. Changes of high density lipoprotein (HDL)

    Changes of HDL at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  15. Changes of body weight

    Changes of body weight at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  16. Changes of body mass index (BMI)

    Changes of BMI at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  17. Changes of waist circumference

    Changes of waist circumference at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  18. Changes of systolic blood pressure

    Changes of systolic blood pressure at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

  19. Changes of diastolic blood pressure

    Changes of diastolic blood pressure at week 26, 52, 104 and 156

    Measured: week 26, 52, 104 and 156

Timeline

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

  1. First posted7 Dec 2021
  2. Study start2 Jan 2022
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

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
Eligible subjects will be randomly allocated to either the empagliflozin group or placebo group (i.e. control group)
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
106 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05147090
Sponsor's protocol ID
UW-21023
Status last verified
Dec 2025
First submitted
22 Nov 2021
Last updated
30 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data (IPD) will be made available in the form of excel files upon request by other researchers

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Empagliflozin 10 MG in people with Chronic Hepatitis b and NAFLD, run by The University of Hong Kong at 1 site in Hong Kong.

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 1 inclusion and 8 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: under way, not looking for participants, as of the sponsor's last update on 30 Jan 2026. 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 Hong Kong. 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?

This study is still under way. Results are not available in the source record yet.

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 in liver stiffness (measured by MRE) (time frame: week 156). 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 30 Jan 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in