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Bile Acid DiarrheaPhase 4BASTANCT07042165

Treatment of Bile Acid Diarrhoea With Atorvastatin

A Phase 4 study testing Atorvastatin in people with Bile Acid Diarrhea and Bile Acid Malabsorption, run by Asger Lund, MD at 1 site in Denmark.

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

Bile acid diarrhoea (BAD) is a socially debilitating disease with stomach pain, high stool frequency, urgency, and faecal incontinence as the main symptoms. Studies estimate that 1-2% of the population suffers from the disease. There is an unmet need for more treatment options in patients suffering from BAD. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bile Acid Diarrhea, Bile Acid Malabsorption
What is being tested?
Atorvastatin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
1 siteDenmark
Study dates
15 Oct 2025to 27 Oct 2026
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • age 18 years or above
  • Self-identification as White
  • Confirmed moderate-severe bile acid diarrhoea with a SeHCAT test result of ≤ 10 %
  • Reported number of average daily stools ≥ 3 stools per day
  • Reported number of average daily watery (6 or 7 on the Bristol Stool Chart) stools ≥ 1 stools per day(30)
  • Informed and written consent

Who cannot join

  • Unwillingness to pause any of the following medications during the trial: bile acid sequestrants, morphine medication, liraglutide or anti-constipation medication (e.g., lactulose, laxoberal, magnesia)
  • Unwillingness to pause any anti-diarrhoea medication (e.g., imodium) from 3 days before initiation of each stool diary until after the respective visit
  • If regularly administering psyllium or metformin, unwillingness to agree to a stable dose of psyllium or metformin throughout the trial
  • Concomitant use of any drug in the GLP-1 receptor agonist drug class with the exception of paused liraglutide, see above
  • Concomitant use of any kind of insulin medication
  • Planned major changes in food consumption throughout the trial, including planned weight loss attempts
Show all 27Show fewer
  • Prior use of any statin within the recent 6 months
  • Intake of larger quantities of grapefruit juice during trial participation, at the discretion of the investigator
  • History of/present hepatobiliary disorder (except for simple metabolic dysfunction-associated fatty liver disease) and/or alanine aminotransferase and/or serum aspartate aminotransferase ≥ 3 times upper limit of normal
  • Crohn's disease, ulcerative colitis, celiac disease or lactose intolerance
  • Previous intestinal resection or major intra-abdominal surgery incl. stoma (cholecystectomy and appendectomy not included)
  • Nephropathy with estimated glomerular filtration rate < 45 ml/min/1,73 m2
  • Plasma level of creatine kinase ≥ 5 times the upper limit of normal
  • A recent stroke or transient ischemic attack (within 6 months)
  • Any treatment or condition requiring acute or subacute medical or surgical intervention
  • Hypothyroidism or hyperthyroidism, if not well regulated, at the discretion of the investigator
  • Active or recent (within 6 months) clinically significant malignant disease (non-melanoma skin cancer not included), at the discretion of the investigator
  • Alcohol consumption exceeding 12 units/week for women or 18 units/week for men, respectively. These thresholds are based on the limits of the European Association for the Study of the Liver
  • Drug abuse, at the discretion of the investigator
  • Fertile women not using any of the following contraceptive methods for the duration of the trial until at least 5 days after end of trial: Hormonal (tablet/pill, depot injection of progesterone, subdermal gestagen implantation, hormone intrauterine devices (IUD), hormonal vaginal ring or transdermal hormonal patch) associated with inhibition of ovulation, chemical (copper IUD), sterilisation, vasectomised partner with a confirmatory test, or sexual abstinence per the investigator's discretion
  • Pregnant or nursing women
  • Known or suspected hypersensitivity to atorvastatin or any of the additives in the tablet
  • Receipt of any investigational drug within 30 days prior to visit 0
  • Concomitant treatment with any of the following (topical administration not included): ciclosporin, telithromycin, clarithromycin, delavirdin, stiripentol, ketoconazol, voriconazol, itraconazol, posaconazol, letermovir, ritonavir, lopinavir, atazanavir, indinavir, darunavir, bocepravir, telaprevir, elbasvir/grazoprevir, ledipasvir/sofosbuvir, erythromycin, niacin, ezetimibe, fusidic acid, gemfibrozil, colchicine, digoxin, warfarin
  • Unable to speak or understand Danish or mental incapacity that preclude adequate understanding or cooperation or unwillingness to comply with trial requirements
  • Active participation in any other clinical intervention trial (observational studies not included)
  • Other concomitant disease or treatment that according to the investigator's assessment makes the person unsuitable for study participation

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Center for Clinical Metabolic Research, Gentofte Hospital

    Hellerup, 2900

Other trials in Denmark

About this study

Official title: Treatment of Bile Acid Diarrhoea With Atorvastatin (BASTA): A Randomised, Double-Blind, Placebo-Controlled, Crossover, Investigator-Initiated Trial

Bile acid diarrhoea (BAD) is a socially debilitating disease with stomach pain, high stool frequency, urgency, and faecal incontinence as the main symptoms. Studies estimate that 1-2% of the population suffers from the disease.

There is an unmet need for more treatment options in patients suffering from BAD.

The investigators hypothesise that atorvastatin treatment lowers bile acid synthesis in patients with bile acid diarrhoea. The investigators will investigate this hypothesis in the current study, BASTA, which is a Randomised, Double-Blind, Placebo-Controlled, Crossover, Proof of Concept, Investigator-Initiated, Trial.

Read the detailed description

Bile acid diarrhoea (BAD) is a socially debilitating disease with stomach pain, high stool frequency, urgency, and faecal incontinence as the main symptoms. Studies estimate that 1-2% of the population suffers from the disease.

Bile acids are synthesised from cholesterol in hepatocytes through a tightly regulated enzymatic process and then excreted to the gut lumen in response to food ingestion. In a healthy individual 95 % of the bile acids are recycled in the enterohepatic circulation in a tightly regulated process. BAD symptoms arise due to a pathological spill-over of bile acids to the colon.

Currently, individuals with BAD are typically treated with bile acids sequestrants. However, only about 2/3 patients experience an improvement in their symptoms on this treatment. Thus, the possibility of yet another tool in the toolbox is compelling.

Statins are used by millions of patients world-wide to reduce their risk of cardiovascular morbidity and mortality and are considered safe with overall mild and benign adverse effects. Statins lower the intracellular levels of cholesterol in hepatocytes. As such, atorvastatin could potentially reduce the bile acid production in individuals with BAD leading to a reduction or normalisation of the amount of bile acids secreted to the intestinal lumen and entering the colon. Unpublished results from the investigators' group show a 43 % reduction of serum C4, a biomarker of bile acid synthesis which can also be used to diagnose BAD, in healthy, young men, who were treated with atorvastatin for 14 days (7 days of 40 mg atorvastatin once daily followed by 7 days of 80 mg atorvastatin once daily) compared to placebo treatment.

The investigators hypothesise that atorvastatin treatment lowers bile acid synthesis in patients with bile acid diarrhoea.

The current study aims to investigate whether atorvastatin treatment lowers the synthesis of bile acids, measured via the well-known bile acid synthesis marker C4, in a dose-response manner in patients with severe bile acid diarrhoea. The investigators expect the reduction of bile acid synthesis to lead to a reduction in bile acid diarrhoea symptoms since the pathophysiology of the disease is a spill-over of bile acids to the colon. Specifically, the primary endpoint is the reduction in percentage of C4 at the end of the 80 mg treatment period compared to placebo. Additionally, the investigators will investigate the effect of atorvastatin treatment in patients with severe bile acid diarrhoea on symptoms, hepatobiliary markers, metabolic markers, glycaemic control markers, stool samples and safety.

Being tested
Atorvastatin, Placebo
Keywords
Bile Acid Diarrhea, Bile Acid Malabsorption, Atorvastatin, Randomised, Placebo, 7-alpha-C4, Crossover, Double-blind, Investigator-initiated, Proof of concept

What participants receive

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

  • AtorvastatinDrug

    Participants will be orally administering one tablet daily of 40 mg Atorvastatin for two weeks followed by two tablets daily for two weeks (totalling 80 mg daily).

  • PlaceboDrug

    Placebo tablets are manufactored by the Central Pharmacy of the Capital Region of Denmark and are identical to the IMP except with the active ingredient (atorvastatin) omitted. Participants will be orally administering one tablet daily for two weeks followed by two tablets daily for two weeks.

Study groups in NCT07042165
Study groupRoleWhat they receive
PlaceboPlacebo comparatorPlacebo tablets are manufactored by the Central Pharmacy of the Capital Region of Denmark and are identical to the IMP except with the active ingredient (atorvastatin) omitted. Participants will be administering one tablet for two weeks followed by two tablets for two weeks. Then four weeks of washout before entering the atorvastatin arm (crossover).
Receives: Drug: Placebo
AtorvastatinExperimental40 mg Atorvastatin tablets are manufactored by the Central Pharmacy of the Capital Region of Denmark and are identical to the placebo tablets except containing the active ingredient (atorvastatin). Participants will be administering one tablet for two weeks followed by two tablets for two weeks (80 mg atorvastatin). Then four weeks of washout before entering the placebo arm (crossover).
Receives: Drug: Atorvastatin

What is being measured

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

  1. Reduction in bile acid synthesis measured via 7alpha-Hydroxy-4-cholesten-3-on (C4)

    Ratio of geometric mean concentration of 7alpha-Hydroxy-4-cholesten-3-on (C4) at the end of the 80 mg atorvastatin treatment period compared to the end of the placebo treatment period.

    Measured: The end of week 4 and the end of week 12.

Secondary outcomes (11)
  1. Reduction in bile acid synthesis measured via C4

    Difference in mean concentration of 7alpha-Hydroxy-4-cholesten-3-on (C4) in μg/L at the end of the 80 mg atorvastatin treatment period compared to the end of the placebo treatment period.

    Measured: The end of week 4 and the end of week 12.

  2. Reduction in BAD symptoms measured via a stool diary.

    Difference in mean daily stools during the last week of the 80 mg atorvastatin treatment period compared to the last week of the placebo treatment period as assessed by a 7-day stool diary

    Measured: Week 4 and week 12.

  3. A reduction in BAD symptoms measured via a stool diary.

    Difference in mean daily watery stools during the last week of the 80 mg atorvastatin treatment period compared to the last week of the placebo treatment period as assessed by the total watery (6 or 7 on the Bristol Stool Chart) stools in a 7-day stool diary

    Measured: Week 4 and week 12.

  4. Symptom severity measured via IBS-SSS

    Difference in symptom severity measured via a danish translation of the validated questionnaire Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS).

    The answers are on a scale of 0-500, where a higher score indicates worse symptoms.

    Measured: The end of week 4 and the end of week 12.

  5. Reduction in bile acid synthesis measured via C4.

    Proportion of patients with a reduction of 7alpha-Hydroxy-4-cholesten-3-on (C4) below 31 μg/L (%)

    Measured: The end of week 4 and the end of week 12.

  6. Reduction in bile acid synthesis measured via C4

    Proportion of patients with a reduction of 7alpha-Hydroxy-4-cholesten-3-on (C4) below 46 μg/L (%)

    Measured: The end of week 4 and the end of week 12.

  7. Bile acid metabolism measured via FGF-19

    Fibroblast growth factor 19 (FGF-19) (pg/mL)

    Measured: The end of week 4 and the end of week 12.

  8. Bile acid metabolism measured via blood levels of total bile acids

    Blood levels of total bile acids (μmol/L)

    Measured: The end of week 4 and the end of week 12.

  9. Cholesterol metabolism

    Total cholesterol (mmol/L)

    Measured: The end of week 4 and the end of week 12.

  10. Cholesterol metabolism

    Low-density lipoprotein (LDL) cholesterol (mmol/L)

    Measured: The end of week 4 and the end of week 12.

  11. Bile acid levels measured in stool samples

    Stool sample levels of total bile acids (μmol/g)

    Measured: The end of week 4 and the end of week 12.

Timeline

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

  1. First posted27 Jun 2025
  2. Study start15 Oct 2025
  3. Primary completion27 Oct 2026
  4. Study completion27 Oct 2026

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
Crossover
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07042165
Sponsor's protocol ID
EU trial no. 2025-521856-47-00
Acronym
BASTA
Status last verified
Oct 2026
First submitted
5 Jun 2025
Last updated
30 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Lynggaard MB, Olsen SS, Forman JL, Karhus ML, Gluud LL, Lund AB, Ellegaard AM. BASTA trial: protocol for a randomised, double-blind, placebo-controlled, crossover trial investigating the effects of atorvastatin on bile acid diarrhoea. BMJ Open. 2026 Jul 28;16(7):e119827. doi: 10.1136/bmjopen-2026-119827.

    PubMed 42521312

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Atorvastatin in people with Bile Acid Diarrhea and Bile Acid Malabsorption, run by Asger Lund, MD at 1 site in Denmark.

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 6 inclusion and 27 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 30 Oct 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 Denmark. 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?

Reduction in bile acid synthesis measured via 7alpha-Hydroxy-4-cholesten-3-on (C4) (time frame: The end of week 4 and the end of week 12.). 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 NCT07042165, which also lists 1 linked publication.

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 Oct 2026.

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