Antidiabetic Drugs for Steatotic Liver Disease

NCT ID: NCT03646292

Last Updated: 2025-03-05

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

51 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-06

Study Completion Date

2022-06-16

Brief Summary

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To investigate the synergic therapeutic effect of thiazolidinediones and SGLT2 inhibitor on metabolic dysfunction-associated steatotic liver disease, the effect of empagliflozin 10mg, pioglitazone 15mg monotherapy and combination therapy in patients with type 2 diabetes and steatotic liver disease will be compared and analyzed.

This study was designed to include a total of 60 patients (20 per subgroup) for randomized controlled trials with prospective, open label, randomized, single-institution clinical trials.

The drug will be maintained for a total of 24 weeks. The primary endpoint is the difference of liver fat change measured by MRI-PDFF in the largest possible polygonal region of interest encompassing both lobes of the liver between three groups.

Detailed Description

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Conditions

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MASLD - Metabolic Dysfunction-Associated Steatotic Liver Disease Type 2 Diabetes Digestive System Disease Liver Diseases Fatty Liver Metabolic Dysfunction-Associated Steatotic Liver Disease Non-Alcoholic Fatty Liver Disease Hypoglycemic Agents Physiological Effects of Drugs Sodium-Glucose Cotransporter 2 Inhibitors Pioglitazone Molecular Mechanisms of Pharmacological Action Empagliflozin Thiazolidinediones

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study will evaluate the efficacy in lowering liver fat and the safety of empagliflozin 10mg, pioglitazone 15mg, alone or in combination (empagliflozin 10mg/pioglitazone 15mg), over a 24-week period.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

open label

Study Groups

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Pioglitazone monotherapy

Pioglitazone 15mg 1T daily for 24 weeks

Group Type EXPERIMENTAL

Pioglitazone

Intervention Type DRUG

The investigators will compare the degree of liver fat before and after pioglitazone monotherapy.

Empagliflozin monotherapy

Empagliflozin 10mg 1T daily for 24 weeks

Group Type EXPERIMENTAL

Empagliflozin

Intervention Type DRUG

The investigators will compare the degree of liver fat before and after empagliflozin monotherapy.

Pioglitazone + Empagliflozin combination therapy

Pioglitazone 15mg 1T + Empagliflozin 10mg 1T combination daily for 24 weeks

Group Type EXPERIMENTAL

Combination of pioglitazone and empagliflozin

Intervention Type DRUG

The investigators will compare the degree of liver fat before and after pioglitazone and empagliflozin combination therapy.

Interventions

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Pioglitazone

The investigators will compare the degree of liver fat before and after pioglitazone monotherapy.

Intervention Type DRUG

Empagliflozin

The investigators will compare the degree of liver fat before and after empagliflozin monotherapy.

Intervention Type DRUG

Combination of pioglitazone and empagliflozin

The investigators will compare the degree of liver fat before and after pioglitazone and empagliflozin combination therapy.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Men and women aged 19 to 75 years
2. Individuals who are diagnosed with type 2 diabetes (HbA1c ≥ 7.5% and \< 11.0%) and treated with antidiabetic drugs excluding TZD and SGLT2i over the previous 12 weeks
3. Individuals diagnosed with steatotic liver disease as documented by abdominal ultrasonography within the previous year
4. Individuals who have voluntarily agreed in written form to participate in the clinical trial after hearing the explanation of this clinical trial
5. Individuals who understand the content of the clinical trial and are able to participate in the trial until the end of the clinical trial

Exclusion Criteria

1. Type 1 diabetes and gestational diabetes
2. Highly uncontrolled diabetes (HbA1c ≥ 11.0%)
3. Excessive alcohol intake (210 g and 140 g/week for men and women, respectively) within the previous 2 years
4. A history of taking thiazolidinedione or sodium-glucose cotransporter 2 inhibitor class medications within the last 12 weeks, or a history of discontinuing these medications due to severe side effects
5. Treatment with four or more classes of antidiabetic medications
6. Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma, within 24 weeks
7. Intake of drugs that can cause steatotic liver disease (amiodarone, methotrexate, tamoxifen, valproate, etc.)
8. Allergy or hypersensitivity to the study drugs or their constituents
9. Oral or parenteral chronic corticosteroid therapy (more than 14 consecutive days) that requires continual adjustments in corticosteroid dose for therapeutic purposes within 8 weeks
10. Galactosemia
11. Genetic disorders such as galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption
12. Malignant tumors currently undergoing treatment or progression
13. A history of substance abuse or alcohol intoxication within 12 weeks
14. Infection of human immunodeficiency virus
15. Severe infection
16. Pre- and post-operative status, or severe trauma
17. Cardiac failure within 24 weeks (class III to IV in the NYHA classification)
18. Acute cardiovascular event within 12 weeks (unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass grafting, or coronary intervention)
19. AAcute and chronic renal disease (estimated glomerular filtration rate \< 45 mL/min/1.73 m²) or dialysis
20. Pregnant or lactating women
21. Individuals whom the investigator determines to be unsuitable for participation in the clinical trial
Minimum Eligible Age

19 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Lee M, Hong S, Cho Y, Rhee H, Yu MH, Bae J, Lee YH, Lee BW, Kang ES, Cha BS. Synergistic benefit of thiazolidinedione and sodium-glucose cotransporter 2 inhibitor for metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: a 24-week, open-label, randomized controlled trial. BMC Med. 2025 May 7;23(1):266. doi: 10.1186/s12916-025-04017-x.

Reference Type DERIVED
PMID: 40336058 (View on PubMed)

Other Identifiers

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4-2018-0655

Identifier Type: -

Identifier Source: org_study_id

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