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Fatty LiverPhase 2NCT05984745

Effect of CoQ10 on the Outcome of MAFLD Patients

A Phase 2 study testing Coenzyme Q10 Forte® capsules in people with Fatty Liver and NAFLD, run by Ain Shams University at 1 site in Egypt.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

So far there has been no universal treatment for MAFLD since it has a complex etiology that involves ethnic, genetic, metabolic and environmental factors. However, therapeutic life changes including: diet, weight loss, and physical activity remain the cornerstone of treatment and is recommended by both American and… Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Fatty Liver, NAFLD
What is being tested?
Coenzyme Q10 Forte® capsules
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteEgypt
Study dates
31 Oct 2023to Dec 2025
Phase
Phase 2
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

  • All study subjects and prior to consenting to the ICF, laboratory and imaging work-up will be evaluated for the presence of three out of five criteria for metabolic dysregulation in the context of metabolic -dysfunction associated fatty liver disease (MAFLD):
  • Waist circumference (WC) ≥ 102/88 cm for men and women respectively.
  • HDL cholesterol <40 mg/dl in men and <50 mg/dl in women or on specific drug therapy.
  • Plasma Triglycerides ≥ 150 mg/dl or on specific drug therapy.
  • Blood pressure ≥130 and/or ≥ 85 or on specific anti-hypertensive therapy.
  • Fasting blood glucose ≥ 100 mg/dl or on specific anti hyperglycemic therapy
Show all 13Show fewer
  • Patients who agree to sign an informed consent
  • Adult patients >18 years old.
  • Males and females
  • Willing to comply with procedures and follow up
  • Elevated serum transaminases (1-4 times the ULN)
  • Imaging evidence of fatty liver:
  • pelviabdominal ultrasound and Fibro- CAP study

Who cannot join

  • Pregnancy or lactating
  • Physical or mental abnormalities
  • HCV infection
  • HBV infection
  • Anaemia
  • Thrombocytopenia
Show all 18Show fewer
  • Haematological malignancies
  • Ongoing alcoholism (Male: >30g/day, Female: >20g/day)
  • Patients with renal failure
  • Autoimmune hepatitis
  • Celiac disease
  • Wilson's disease
  • Hemochromatosis
  • Drugs: Tamoxifen, Valproic acid, Amiodarone, Methotrexate, Steroids, Anticoagulants, All anti-oxidative stress agents, Cos, IUD
  • Chronic use of systematically immunosuppressive agent or drugs that can affect liver profile.
  • Hypo/Hyper-thyroidism
  • Bypass surgeries
  • TPN (Total Parenteral Nutrition)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Egypt1 site, 1 recruiting
  • National Hepatology and tropical medicine research institute

    Cairo

    23642494 ext. 02, info@nhtmri.org

    Recruiting

Other trials in Egypt

About this study

Official title: Effect of Coenzyme Q10 on the Outcome of Metabolic Dysfunction-Associated Fatty Liver Disease Patients

So far there has been no universal treatment for MAFLD since it has a complex etiology that involves ethnic, genetic, metabolic and environmental factors. However, therapeutic life changes including: diet, weight loss, and physical activity remain the cornerstone of treatment and is recommended by both American and European associations.

Inflammatory biomarkers, such as tumor necrosis factor-alpha, and adipokines play key roles in the pathogenesis of MAFLD, hence, the anti-inflammatory and antioxidant effects of coenzyme Q10 especially at high doses that have not been tested are hypothesized to have a beneficial role in improving the systemic inflammation and biochemical variables.

This study is conducted to test this hypothesis

Read the detailed description

The liver disease with the most continuously rising prevalence rates is metabolic-dysfunction associated fatty liver disease (MAFLD), making us arrive at a conclusion that it might be the liver disease epidemic of the 21st century. It is increasingly diagnosed in many developed and developing countries and is considered the most common cause of chronic liver disease among patients with type 2 diabetes mellitus (T2DM). By 2030, it will be the leading cause for hepatocellular carcinoma (HCC) related liver transplantation (LTx) in western countries.

A number of studies have suggested that metabolic associated co-morbidities, such as obesity, type 2 DM, CVD, dyslipidemia, hypertension, metabolic syndrome, hypothyroidism, OSAS, PCOS are major risk factors for MAFLD.

It encompasses a wide spectrum of histological pattern, ranging from simple steatosis to steatohepatitis, fibrosis and cirrhosis.

The global prevalence of MAFLD is currently estimated to be 25%, but the highest rates are reported from the Middle East 31.8% and South America 30.5%, followed by Asia 27.4%, the USA 24% and Europe 23.7%, whereas MAFLD is less common in Africa 13.5%.

Coenzyme Q10 (CoQ10) or ubiquinone is a lipid-soluble and vitamin-like compound, which acts as a pivotal cofactor in the mitochondrial respiratory chain in addition to its role as a natural scavenger of free radicals. It is synthesized by cells of the body and also found in abundance in the human diet. Recent evidence suggests that CoQ10 supplementation might be useful in improving and preventing pathological conditions such as metabolic syndrome, hypertension, diabetes, liver diseases, and insulin resistance Because of its antioxidant activity, it seems that CoQ10 can prevent activation of the inflammatory signaling pathway. Many studies have shown that administration of CoQ10 reduced hepatic oxidative stress and inflammation. Also, other studies observed that CoQ10 supplementation reduced TNF-α production and serum levels of liver aminotransferase and decreased NF-kB expression. In addition, a previously published study showed that a dose of 100 mg/day of CoQ10 for 4 weeks can improve serum AST levels, total antioxidant capacity and waist circumference, but it had a non-significant effect on insulin resistance and MDA levels. The same result was found in the study by Esfahani et al. reporting improvement in AST and ALT concentrations and lower grades of portal inflammation and hepatocellular liver necrosis in thioacetamide-induced liver damage in rats. Yet, some contradicting results were reported by Hodgson et al. were they found a non-significant reduction in body weight after CoQ10 supplementation in patients with T2DM. These contradictions were addressed by Faresi et al. where they tested the effect of the same oral dose of CoQ10 used by Farhangi et al. for 12 weeks, where it had beneficial effects on serum levels of TNF-a, hs-CRP, hepatic enzymes, adiponectin, and NAFLD grades as well as near-significant changes in serum leptin among patients with NAFLD. However, serum IL-6 levels and AAR remained unchanged after CoQ10 supplementation.

Till this day, only a few small studies tried to investigate the effect of CoQ10 administration on the degree of steatosis in MAFLD patients and their results failed to show a clear effect, due to the conflicting and limited data. Hence, this encouraged us to study the efficacy and tolerability of a higher dose of CoQ10 especially that it can be safely administered up to a dose of 1200 mg/day. In addition, CoQ10 showed promising effects in previous studies, so the general recommendation was to study its effect in a larger study population, for longer periods.

Conditions
Fatty Liver, NAFLD
Being tested
Coenzyme Q10 Forte® capsules
Keywords
Coenzyme Q10, Liver steatosis, TNF alpha, Fatty Liver, Inflammation, MAFLD, CoQ10, Ubiquinone, Liver Disease
Medical subject headings
Fatty Liver, Non-alcoholic Fatty Liver Disease, Inflammation, Liver Diseases

What participants receive

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

  • Coenzyme Q10 Forte® capsulesDrug

    Coenzyme Q10 in the form of soft gelatin capsules, each capsule containing 100 mg

Study groups in NCT05984745
Study groupRoleWhat they receive
Control groupNo interventionPatients will receive the standard conventional care which is mainly therapeutic life changes
Test GroupExperimentalPatients will receive Coenzyme Q10 Forte® (MEPACO Pharmaceutical Company, Cairo, Egypt) capsules in a dose of 100 mg twice per day 1 capsule every 12 hours for twelve weeks, in addition to the standard conventional care.
Receives: Drug: Coenzyme Q10 Forte® capsules

What is being measured

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

  1. Change in liver steatosis degree

    Improvement in steatosis degree will be assessed using Fibro-CAP scoring measured in decibels per meter (dB/m) and ranges from 100-400, where 238 to 260 dB/m represents 11-33% fatty change in the liver, 260 to 290 dB/m represents 34-66% fatty change in the liver and > 290 dB/m represents almost 67% or more fatty change in the liver.

    Measured: Baseline and at 12 weeks

Secondary outcomes (5)
  1. Change in serum levels of tumor necrosis factor-alpha (TNF-α) 3 months post treatment with Coenzyme Q10

    TNF-α levels will be assessed in serum

    Measured: Baseline and at 12 weeks

  2. Change in serum levels of cytokeratin-18 (CK-18) 3 months post treatment with Coenzyme Q10

    CK-18 levels will be assessed in serum

    Measured: Baseline and at 12 weeks

  3. Change in serum levels of liver transaminases (AST and ALT) 3 months post treatment with Coenzyme Q10

    Levels of alanine transaminase (ALT) and aspartate aminotransferase (AST) will be measured in serum where normal serum ALT is 7-56 U/L and normal serum AST is 0 to 35 U/L.

    Measured: Baseline and at 12 weeks

  4. Study the drug's effect on kidney functions by measuring serum creatinine levels

    Serum creatinine levels will be measured where the normal range is 0.74 to 1.35 mg/dL (61.9 to 114.9 µmol/L) for men and 0.59 to 1.04 mg/dL (53 to 97.2 µmol/L) for women

    Measured: Baseline and at 12 weeks

  5. Change in the quality of life of MAFLD patients

    Quality of life will be assessed using the Chronic Liver Disease (CLD) questionnaire

    Measured: Baseline and at 12 weeks

Timeline

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

  1. First posted9 Aug 2023
  2. Study start31 Oct 2023
  3. Primary completionJul 2025 (estimated)
  4. Study completionDec 2025 (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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05984745
Sponsor's protocol ID
CoQ10 in MAFLD Patients
Status last verified
Mar 2025
First submitted
1 Aug 2023
Last updated
26 Mar 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, George J, Bugianesi E. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018 Jan;15(1):11-20. doi: 10.1038/nrgastro.2017.109. Epub 2017 Sep 20.

    PubMed 28930295
  • McPherson S, Hardy T, Henderson E, Burt AD, Day CP, Anstee QM. Evidence of NAFLD progression from steatosis to fibrosing-steatohepatitis using paired biopsies: implications for prognosis and clinical management. J Hepatol. 2015 May;62(5):1148-55. doi: 10.1016/j.jhep.2014.11.034. Epub 2014 Dec 1.

    PubMed 25477264
  • Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84. doi: 10.1002/hep.28431. Epub 2016 Feb 22.

    PubMed 26707365
  • Alam MA, Rahman MM. Mitochondrial dysfunction in obesity: potential benefit and mechanism of Co-enzyme Q10 supplementation in metabolic syndrome. J Diabetes Metab Disord. 2014 May 23;13:60. doi: 10.1186/2251-6581-13-60. eCollection 2014.

    PubMed 24932457
  • Fuller B, Smith D, Howerton A, Kern D. Anti-inflammatory effects of CoQ10 and colorless carotenoids. J Cosmet Dermatol. 2006 Mar;5(1):30-8. doi: 10.1111/j.1473-2165.2006.00220.x.

    PubMed 17173569
  • Sohet FM, Neyrinck AM, Pachikian BD, de Backer FC, Bindels LB, Niklowitz P, Menke T, Cani PD, Delzenne NM. Coenzyme Q10 supplementation lowers hepatic oxidative stress and inflammation associated with diet-induced obesity in mice. Biochem Pharmacol. 2009 Dec 1;78(11):1391-400. doi: 10.1016/j.bcp.2009.07.008. Epub 2009 Jul 23.

    PubMed 19632207
  • Bravo E, Palleschi S, Rossi B, Napolitano M, Tiano L, D'Amore E, Botham KM. Coenzyme Q metabolism is disturbed in high fat diet-induced non-alcoholic fatty liver disease in rats. Int J Mol Sci. 2012;13(2):1644-1657. doi: 10.3390/ijms13021644. Epub 2012 Feb 2.

    PubMed 22408414
  • Ashkani Esfahani S, Esmaeilzadeh E, Bagheri F, Emami Y, Farjam M. The effect of co-enzyme q10 on acute liver damage in rats, a biochemical and pathological study. Hepat Mon. 2013 Aug 27;13(8):e13685. doi: 10.5812/hepatmon.13685. eCollection 2013. No abstract available.

    PubMed 24130601
  • Farsi F, Mohammadshahi M, Alavinejad P, Rezazadeh A, Zarei M, Engali KA. Functions of Coenzyme Q10 Supplementation on Liver Enzymes, Markers of Systemic Inflammation, and Adipokines in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. J Am Coll Nutr. 2016 May-Jun;35(4):346-53. doi: 10.1080/07315724.2015.1021057. Epub 2015 Jul 9.

    PubMed 26156412
  • Vrentzos E, Ikonomidis I, Pavlidis G, Katogiannis K, Korakas E, Kountouri A, Pliouta L, Michalopoulou E, Pelekanou E, Boumpas D, Lambadiari V. Six-month supplementation with high dose coenzyme Q10 improves liver steatosis, endothelial, vascular and myocardial function in patients with metabolic-dysfunction associated steatotic liver disease: a randomized double-blind, placebo-controlled trial. Cardiovasc Diabetol. 2024 Jul 10;23(1):245. doi: 10.1186/s12933-024-02326-8.

    PubMed 38987784
  • Allen AM, Therneau TM, Larson JJ, Coward A, Somers VK, Kamath PS. Nonalcoholic fatty liver disease incidence and impact on metabolic burden and death: A 20 year-community study. Hepatology. 2018 May;67(5):1726-1736. doi: 10.1002/hep.29546. Epub 2018 Mar 23.

    PubMed 28941364

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Coenzyme Q10 Forte® capsules in people with Fatty Liver and NAFLD, run by Ain Shams University at 1 site in Egypt.

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 13 inclusion and 18 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: looking for participants now, as of the sponsor's last update on 26 Mar 2025. 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 Egypt. 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?

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?

Contact Mariam Seif (+201112720114, mariam.talaat@pharma.asu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in liver steatosis degree (time frame: Baseline and at 12 weeks). 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 NCT05984745, which also lists 11 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 26 Mar 2025.

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