Cells of Monocytic Origin as Surrogate Markers for Individual Drug Effects and Hepatotoxicity

NCT ID: NCT02353455

Last Updated: 2019-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-03-31

Study Completion Date

2022-08-31

Brief Summary

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Drug metabolism in the liver is subject to large fluctuations (differences between women and men, people of different ethnic backgrounds, children and adults). These large differences are responsible for very different drug effects and side-effects (and especially liver damage caused by drugs) between individuals. Recent scientific findings suggest that blood derived cells can be used to model individual effects of drugs on the liver reflect inter-individual differences. Since liver damage caused by drugs is a diagnosis of exclusion, the aforementioned cells can be used to identify patients that show higher sensitivity to hepatotoxic side-effects and - in case several drugs are involved - identify the causal agent or possible interactions.

Detailed Description

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Drug-induced liver injury (DILI), especially its idiosyncratic for is often an unpredictable complication of drug therapy. Until now it is very challenging to predict occurrence, severity and outcome of DILI. Previous data provide evidence that cells from peripheral blood may reflect hepatocellular damage (Fannin RD, Hepatology. 2010). Own research could show that peripheral monocytes are capable to obtain several hepatocyte-like functions while maintaining individual characteristics of the donor, especially cytochrome P450 metabolism (Benesic, Gerbes, et al, Lab Invest 2012). This study investigates the effects of potentially hepatotoxic drugs on cells generated from patient blood in comparison to the clinical presentation. Its aim is the evaluation of in vitro tests using monocyte derived cells for diagnosis and exclusion of DILI and the potential to use the patient derived-cells for mechanistic investigations of DILI. 4 groups are investigated: 1) donors without liver disease 2) patients who will start a therapy with DILI-potential; 3) DILI patients; 4) patients with liver injuries other than DILI.

Patient history and clinical data are obtained and a single blood sample will be collected after informed consent.

Conditions

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Drug-induced Disorder of Liver Adverse Reaction to Drug

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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healthy

donors/patients without liver disease, with and without ongoing drug therapy including buffy coat samples of healthy blood / thrombocyte donors.

After pseudonymisation a detailed history and clinical data are obtained and blood sampling will be performed . Buffy coats are obtained anonymously.

Blood sampling

Intervention Type PROCEDURE

In each group a blood sample of approximately 50 mL will be obtained upon study inclusion.

prior to therapy

History will be obtained and blood sampling will be performed in patients in whom a drug therapy with a drug with DILI potential is planned.

Blood sampling

Intervention Type PROCEDURE

In each group a blood sample of approximately 50 mL will be obtained upon study inclusion.

iDILI

Patients with clinical suspicion of idiosyncratic drug-induced liver injury. After pseudonymisation a detailed history and clinical data are obtained and blood sampling will be performed.

Blood sampling

Intervention Type PROCEDURE

In each group a blood sample of approximately 50 mL will be obtained upon study inclusion.

non DILI

Patients with other forms of liver injury. After pseudonymisation a detailed history and clinical data are obtained and blood sampling will be performed.

Blood sampling

Intervention Type PROCEDURE

In each group a blood sample of approximately 50 mL will be obtained upon study inclusion.

Interventions

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Blood sampling

In each group a blood sample of approximately 50 mL will be obtained upon study inclusion.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 2 years
* Informed consent given by the patient or in case of inability to give informed consent informed consent of the legally nominated consultee

Exclusion Criteria

* Anemia requiring blood transfusion
* acute or chronic hepatitis B, C or human immunodeficiency virus infection
* lack of informed consent
Minimum Eligible Age

2 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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MetaHeps GmbH

UNKNOWN

Sponsor Role collaborator

Andreas Benesic, MD

OTHER

Sponsor Role lead

Responsible Party

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Andreas Benesic, MD

Dr. med.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Alexander L Gerbes, Prof. MD

Role: PRINCIPAL_INVESTIGATOR

Liver Center Munich®, Internal Medicine II, Ludwig-Maximilians University Hospital, Campus Grosshadern, Munich; Marchioninistr. 15; D81377 Munich, Germany

Locations

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Gastroenterology, Alfred Health

Melbourne, Victoria, Australia

Site Status RECRUITING

Liver Center Munich®, Department of Internal Medicine II, LMU University Hospital, Campus Grosshadern

Munich, Bavaria, Germany

Site Status RECRUITING

Chinese University of Hong Kong

Hong Kong, , Hong Kong

Site Status RECRUITING

Department of Gastroenterology and Hepatology Nagoya University School of Medicine

Nagoya, , Japan

Site Status RECRUITING

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine

Seoul, , South Korea

Site Status RECRUITING

Countries

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Australia Germany Hong Kong Japan South Korea

Central Contacts

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Andreas Benesic, MD

Role: CONTACT

+49 89 44007 ext. 3130

Facility Contacts

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Joanne Mitchell, CTC

Role: primary

(03) 9076 2583

Andreas Benesic, MD

Role: primary

+49 89 44007 ext. 3130

Peter Tse

Role: primary

Masatoshi Ishigami, MD

Role: primary

+81-52-744-2190

Han Ah Lee, Ass Prof

Role: primary

References

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Russo MW, Galanko JA, Shrestha R, Fried MW, Watkins P. Liver transplantation for acute liver failure from drug induced liver injury in the United States. Liver Transpl. 2004 Aug;10(8):1018-23. doi: 10.1002/lt.20204.

Reference Type BACKGROUND
PMID: 15390328 (View on PubMed)

Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, Yang H, Rochon J; Drug Induced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology. 2008 Dec;135(6):1924-34, 1934.e1-4. doi: 10.1053/j.gastro.2008.09.011. Epub 2008 Sep 17.

Reference Type BACKGROUND
PMID: 18955056 (View on PubMed)

Watkins PB, Seeff LB. Drug-induced liver injury: summary of a single topic clinical research conference. Hepatology. 2006 Mar;43(3):618-31. doi: 10.1002/hep.21095.

Reference Type BACKGROUND
PMID: 16496329 (View on PubMed)

Chalasani N, Bjornsson E. Risk factors for idiosyncratic drug-induced liver injury. Gastroenterology. 2010 Jun;138(7):2246-59. doi: 10.1053/j.gastro.2010.04.001. Epub 2010 Apr 12.

Reference Type BACKGROUND
PMID: 20394749 (View on PubMed)

Lee WM. Drug-induced hepatotoxicity. N Engl J Med. 2003 Jul 31;349(5):474-85. doi: 10.1056/NEJMra021844. No abstract available.

Reference Type BACKGROUND
PMID: 12890847 (View on PubMed)

Bell LN, Chalasani N. Epidemiology of idiosyncratic drug-induced liver injury. Semin Liver Dis. 2009 Nov;29(4):337-47. doi: 10.1055/s-0029-1240002. Epub 2009 Oct 13.

Reference Type BACKGROUND
PMID: 19826967 (View on PubMed)

Zimmerman HJ. Drug-induced liver disease. Drugs. 1978 Jul;16(1):25-45. doi: 10.2165/00003495-197816010-00002.

Reference Type BACKGROUND
PMID: 352664 (View on PubMed)

Lee WM, Senior JR. Recognizing drug-induced liver injury: current problems, possible solutions. Toxicol Pathol. 2005;33(1):155-64. doi: 10.1080/01926230590522356.

Reference Type BACKGROUND
PMID: 15805067 (View on PubMed)

Fannin RD, Russo M, O'Connell TM, Gerrish K, Winnike JH, Macdonald J, Newton J, Malik S, Sieber SO, Parker J, Shah R, Zhou T, Watkins PB, Paules RS. Acetaminophen dosing of humans results in blood transcriptome and metabolome changes consistent with impaired oxidative phosphorylation. Hepatology. 2010 Jan;51(1):227-36. doi: 10.1002/hep.23330.

Reference Type BACKGROUND
PMID: 19918972 (View on PubMed)

Benesic A, Rahm NL, Ernst S, Gerbes AL. Human monocyte-derived cells with individual hepatocyte characteristics: a novel tool for personalized in vitro studies. Lab Invest. 2012 Jun;92(6):926-36. doi: 10.1038/labinvest.2012.64. Epub 2012 Apr 2.

Reference Type BACKGROUND
PMID: 22469698 (View on PubMed)

Weber S, Erhardt F, Allgeier J, Saka D, Donga N, Neumann J, Lange CM, Gerbes AL. Drug-Induced Liver Injury Caused by Metamizole: Identification of a Characteristic Injury Pattern. Liver Int. 2025 Mar;45(3):e70012. doi: 10.1111/liv.70012.

Reference Type DERIVED
PMID: 39912769 (View on PubMed)

Weber S, Benesic A, Neumann J, Gerbes AL. Liver Injury Associated with Metamizole Exposure: Features of an Underestimated Adverse Event. Drug Saf. 2021 Jun;44(6):669-680. doi: 10.1007/s40264-021-01049-z. Epub 2021 Feb 27.

Reference Type DERIVED
PMID: 33638811 (View on PubMed)

Benesic A, Jalal K, Gerbes AL. Drug-Drug Combinations Can Enhance Toxicity as Shown by Monocyte-Derived Hepatocyte-like Cells From Patients With Idiosyncratic Drug-Induced Liver Injury. Toxicol Sci. 2019 Oct 1;171(2):296-302. doi: 10.1093/toxsci/kfz156.

Reference Type DERIVED
PMID: 31407002 (View on PubMed)

Benesic A, Rotter I, Dragoi D, Weber S, Leitl A, Buchholtz ML, Gerbes AL. Development and Validation of a Test to Identify Drugs That Cause Idiosyncratic Drug-Induced Liver Injury. Clin Gastroenterol Hepatol. 2018 Sep;16(9):1488-1494.e5. doi: 10.1016/j.cgh.2018.04.049. Epub 2018 Apr 30.

Reference Type DERIVED
PMID: 29723689 (View on PubMed)

Benesic A, Leitl A, Gerbes AL. Monocyte-derived hepatocyte-like cells for causality assessment of idiosyncratic drug-induced liver injury. Gut. 2016 Sep;65(9):1555-63. doi: 10.1136/gutjnl-2015-309528. Epub 2015 Jun 4.

Reference Type DERIVED
PMID: 26045135 (View on PubMed)

Related Links

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Other Identifiers

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055-13

Identifier Type: -

Identifier Source: org_study_id

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