Trial Outcomes & Findings for Treating Nonalcoholic Steatohepatitis (NASH) With Metformin (NCT NCT00063232)

NCT ID: NCT00063232

Last Updated: 2011-07-20

Results Overview

Patients under went liver biopsy, metabolic profiling and imaging studies before and at the end 48 weeks of metformin (2000 mg/day) therapy. The primary endpoint is a three point improvement in the histological NASH activity index with a decrease in at least two of the component scores and no worsening of fibrosis or increase in Mallory bodies.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

28 participants

Primary outcome timeframe

from baseline to 48 Weeks

Results posted on

2011-07-20

Participant Flow

28 adult patients with biopsy-proven NASH were enrolled in the study and 26 completed the 48 weeks of therapy and underwent follow-up metabolic testing, imaging and repeat liver biopsy. 2 patients dropped out were not included in analyses.

The two drop-outs included a 26-year-old woman who stopped therapy after 12 weeks because she had moved and her employment did not allow time for travel for outpatient visits and a 53-year-old woman who stopped therapy after 24 weeks because of desire to pursue other treatments.

Participant milestones

Participant milestones
Measure
Metformin
Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.
Overall Study
STARTED
26
Overall Study
COMPLETED
26
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Treating Nonalcoholic Steatohepatitis (NASH) With Metformin

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Metformin
n=26 Participants
Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.
Age Continuous
44 years
STANDARD_DEVIATION 14 • n=5 Participants
Sex: Female, Male
Female
13 Participants
n=5 Participants
Sex: Female, Male
Male
13 Participants
n=5 Participants
Race/Ethnicity, Customized
Non-Hispanic White
17 participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic White
4 participants
n=5 Participants
Race/Ethnicity, Customized
Asian
5 participants
n=5 Participants
Race/Ethnicity, Customized
African-American
0 participants
n=5 Participants
Region of Enrollment
United States
26 participants
n=5 Participants
Body Mass Index
Overweight (BMI=25-30 kg/m^2)
8 participants
n=5 Participants
Body Mass Index
Obese (BMI=30-40 kg/m^2)
13 participants
n=5 Participants
Body Mass Index
Severely Obese (BMI greater than 40 kg/m^2)
5 participants
n=5 Participants
Glucose tolerance
impaired
8 partcipants
n=5 Participants
Glucose tolerance
not impaired
18 partcipants
n=5 Participants
Diabetes
Yes
7 participants
n=5 Participants
Diabetes
No
19 participants
n=5 Participants

PRIMARY outcome

Timeframe: from baseline to 48 Weeks

Patients under went liver biopsy, metabolic profiling and imaging studies before and at the end 48 weeks of metformin (2000 mg/day) therapy. The primary endpoint is a three point improvement in the histological NASH activity index with a decrease in at least two of the component scores and no worsening of fibrosis or increase in Mallory bodies.

Outcome measures

Outcome measures
Measure
Metformin
n=26 Participants
Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.
Change in the Histological NASH Activity Index at 48 Weeks Compared With Baseline (Number of Participants in Each Change Category)
improved (reduced) by greater or equal to 3 points
9 participants
Change in the Histological NASH Activity Index at 48 Weeks Compared With Baseline (Number of Participants in Each Change Category)
improved (reduced) by 1-2 points
11 participants
Change in the Histological NASH Activity Index at 48 Weeks Compared With Baseline (Number of Participants in Each Change Category)
no change
5 participants
Change in the Histological NASH Activity Index at 48 Weeks Compared With Baseline (Number of Participants in Each Change Category)
worsen (increased)
1 participants

SECONDARY outcome

Timeframe: from baseline to 48 weeks

Alanine transaminase \<42 U/L is considered normal

Outcome measures

Outcome measures
Measure
Metformin
n=26 Participants
Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.
Change in Serum Alanine Aminotransferase (ALT) Levels From Baseline (Number of Participants in Each Change Category)
changed to normal from abnormal
9 participants
Change in Serum Alanine Aminotransferase (ALT) Levels From Baseline (Number of Participants in Each Change Category)
unchanged (normal at beginning)
4 participants
Change in Serum Alanine Aminotransferase (ALT) Levels From Baseline (Number of Participants in Each Change Category)
unchanged (abnormal at beginning)
12 participants
Change in Serum Alanine Aminotransferase (ALT) Levels From Baseline (Number of Participants in Each Change Category)
changed to abnormal from normal
1 participants

SECONDARY outcome

Timeframe: from baseline to 48 weeks

HOMA-IR is calculated from Fasting Glucose and Fasting Insulin

Outcome measures

Outcome measures
Measure
Metformin
n=26 Participants
Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.
Change in Insulin Sensitivity (Glucose Tolerance, Homeostatic Model Assessment of Insulin Resistence (HOMA-IR)) From Baseline
-3.3 unit
Standard Deviation 3.2

Adverse Events

Metformin

Serious events: 0 serious events
Other events: 21 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Metformin
n=26 participants at risk
Participants will undergo a complete medical examination, a series of lab tests, and a liver biopsy. They will then start taking a single 500-mg tablet of metformin once a day for 2 weeks, then the same dosage twice a day for 2 more weeks, if they tolerate the first dosage. The dosage will increase to 1,000 mg twice a day for the remaining 44 weeks of the study. After 1 year, participants will undergo a repeat medical examination and liver biopsy.
General disorders
Weight loss
80.8%
21/26 • Number of events 21

Additional Information

Jay Hoofnagle, M.D.

National Institute of Diabetes and Digestive and Kidney Diseases

Phone: 3014961333

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place