Study of ADI-PEG 20 Versus Placebo in Subjects With NASH

NCT ID: NCT05842512

Last Updated: 2025-09-23

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-13

Study Completion Date

2028-01-31

Brief Summary

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Evaluate efficacy and safety of ADI-PEG 20 in patients with NASH

Detailed Description

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The safety of ADI-PEG 20 will be assessed during the study through the reporting of adverse events (AEs), clinical laboratory tests, electrocardiogram (ECG), vital sign assessments, body weight, and concomitant medication usage.

An external Data Safety and Monitoring Committee (DSMB) that consists of two hepatologists and a statistician will review the safety of the study. The DSMB will convene after 10 subjects (approximately 5 per treatment group) have completed the Week 4 assessments. The DSMB will receive all reports of serious adverse events (SAEs) and convene as needed to monitor for safety.

The primary efficacy will be assessed via the absolute change from baseline in hepatic fat fraction measured by MRI-PDFF at Week 24.

Conditions

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Nonalcoholic Steatohepatitis (NASH)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

To evaluate efficacy and safety of ADI-PEG 20 or Placebo in patients with NASH
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
This is a randomized, double-blind trial.

Study Groups

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Drug: ADI-PEG 20

Dose: 36 mg/m2 given weekly Route of Administration: Intramuscular (IM)

Group Type EXPERIMENTAL

ADI-PEG20

Intervention Type DRUG

Treatment for NASH

Drug: Placebo

Dose: 36 mg/m2 given weekly Route of Administration: Intramuscular (IM)

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Treatment for NASH

Interventions

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ADI-PEG20

Treatment for NASH

Intervention Type DRUG

Placebo

Treatment for NASH

Intervention Type OTHER

Other Intervention Names

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Pegargiminase

Eligibility Criteria

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Inclusion Criteria

1. Males and non-lactating, pregnancy test negative females between 18 - 80 years of age with biopsy proven F1 - F4 (compensated cirrhosis, Child-Pugh A, score ≤6) NASH. Limit F1 fibrosis to ≤ 20% of total subject population.
2. Willingness to use appropriate contraceptive measures throughout study treatment and for 90 days thereafter (see Appendix A).
3. Body mass index (BMI) \> 23 kg/m2
4. Must have confirmation of ≥ 5 % liver fat content on MRI-PDFF at screening.
5. Biopsy-proven NASH confirmed by a central pathologist. Must have had a liver biopsy either during the screening period or a historical biopsy conducted within the last 6 months prior to pre-screening with fibrosis stage 1 to 4 (F score, F1-F4) and a non-alcoholic fatty liver disease (NAFLD) activity score (NAS) of ≥ 4 with at least a score of 1 in each of the following NAS components:

1. Steatosis (scored 0 to 3),
2. Ballooning degeneration (scored 0 to 2), and
3. Lobular inflammation (scored 0 to 3).
6. Must have no evidence of worsening of ALT and AST (within 50%) measurements within 2 months prior to screening (-8 weeks) visits.
7. Screening laboratory parameters, as determined by the central laboratory:

1. Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min, as calculated by the Cockcroft- Gault equation;
2. HbA1c ≤ 9.5% (or serum fructosamine ≤ 381 μmol if HbA1c is unable to be resulted);
3. Hemoglobin ≥ 11 g/dL;
4. INR ≤ 1.3, unless due to therapeutic anticoagulation;
5. Direct bilirubin ≤ 0.5 mg/dL;
6. Total bilirubin ≤ 1.3 x upper limit of normal (ULN), unless due to an alternate etiology such as Gilbert's syndrome or hemolytic anemia;
7. Creatinine kinase \< 3 x ULN;
8. Platelet count ≥ 150,000/μL;
9. Serum triglyceride level ≤ 500 mg/dL;
10. ALT \< 6 x ULN;
11. AST \< 6 x ULN;
12. ALP \< 2 x ULN.
8. FibroScan® measurement \> 7.0 kPa and \< 20.0 kPa.
9. Subjects on non-insulin dependent diabetic, weight loss, or lipid-modifying medication(s) must be on stable dose(s) for at least 3 months prior to the diagnostic liver biopsy through randomization.
10. Subjects on vitamin E and pioglitazone must maintain a stable dosage before the diagnostic liver biopsy and during the study period.

Exclusion Criteria

1. Weight gain or loss \> 5% in the 3 months prior to randomization or \> 10% in the 6 months prior to screening.
2. Type 1 and insulin-dependent Type 2 diabetes.
3. Poorly controlled hypertension (blood pressure \[BP\] \> 160/100 mmHg).
4. Prior history of decompensated liver disease including ascites, hepatic encephalopathy (HE), or variceal bleeding.
5. Chronic hepatitis B virus (HBV) infection (hepatitis B surface antigen \[HBsAg\] positive.
6. Chronic hepatitis C virus (HCV) infection (HCV antibody \[Ab\] and HCV ribonucleic acid \[RNA\] positive). Subjects cured of HCV infection less than 1 year prior (based on date of RNA polymerase chain reaction \[PCR\] negative confirmation following conclusion of treatment) to the screening visit are not eligible.
7. Prior or planned (during the study period) bariatric surgery (e.g., gastroplasty, roux-en-Y gastric bypass), surgery reversal or removal of intragastric balloon \> 2 years prior to enrollment would be eligible.
8. Other causes of liver disease based on medical history and/or centralized review of liver histology, including but not limited to alcoholic liver disease, autoimmune disorders (e.g., primary biliary cholangitis \[PBC\], primary sclerosing cholangitis \[PSC\], autoimmune hepatitis), drug-induced hepatotoxicity, Wilson disease, clinically significant iron overload, or alpha-1-antitrypsin deficiency requiring treatment.
9. History of liver transplantation.
10. Subjects with primary cancer, including co-existent second malignancy, with the exception of primary solid tumor with no known active disease present in the opinion of the Investigator which will not affect subject outcome in the setting of current diagnosis.
11. Alcohol intake above an average limit of 2 drinks per day for women and 3 drinks per day for men. An alcoholic drink is defined as 12 ounces of regular beer, which is usually about 5% alcohol, 5 ounces of wine, which is typically about 12% alcohol, and 1.5 ounces of distilled spirits, which is about 40% alcohol.
12. Human immunodeficiency virus (HIV) infection.
13. Unstable cardiovascular disease in the 6 months prior to screening.
14. Life expectancy less than 2 years.
15. Use of any investigational medication within 30 days or within 5 half-lives of the investigational medication, whichever is longer, prior to screening and throughout the study is prohibited.
16. Subjects with a history of (12 months prior to baseline) or current use of prescription drugs associated with liver steatosis (e.g., methotrexate, amiodarone, high-dose estrogen, tamoxifen, systemic steroids, anabolic steroids, valproic acid) should be excluded. However, subjects currently using silymarin should maintain their current dosage throughout the trial period.
17. Contraindication of magnetic resonance imaging. These include but are not limited to devices or metal foreign bodies, such as Pacemaker, defibrillator or wires other than sternal wires, metallic foreign body in the eye, "triggerfish" contact lens, gastric reflux device, and insulin pumps.
18. MELD score \>12
19. Subjects with esophageal or gastric varices with recent bleeding episodes (within 1 year).
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Polaris Group

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John S Bomalaski

Role: STUDY_DIRECTOR

Polaris Group

Locations

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Ditmanson Medical Foundation Chiayi Christian Hospital;Chiayi Christian Hospital (CYCH)

Chiayi City, Taiwan, Taiwan

Site Status RECRUITING

Kaohsiung Medical University Chung-Ho Memorial Hospital(KMUH)

Kaohsiung, Taiwan, Taiwan

Site Status RECRUITING

E-Da Hospital (EDH)

Kaohsiung, Taiwan, Taiwan

Site Status RECRUITING

Chang Gung Medical Foundation-Kaohsiung (CGMF-KS)

Kaohsiung, Taiwan, Taiwan

Site Status RECRUITING

Chang Gung Medical Foundation-Keelung (CGMF-KL)

Keelung, Taiwan, Taiwan

Site Status RECRUITING

National Cheng Kung University Hospital (NCKUH)

Tainan City, Taiwan, Taiwan

Site Status RECRUITING

National Taiwan University Hospital (NTUH)

Taipei, Taiwan, Taiwan

Site Status RECRUITING

Taipei Veterans General Hospital (TPVGH)

Taipei, Taiwan, Taiwan

Site Status RECRUITING

Fu Jen Catholic University Hospital (FJCUH)

Taipei, Taiwan, Taiwan

Site Status RECRUITING

Chang Gung Medical Foundation-Linkou (CGMF-LK)

Taoyuan District, Taiwan, Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Silvia Lee

Role: CONTACT

02-2656-2727 ext. 142

Facility Contacts

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Perry Weng

Role: primary

886-5-276-5041 ext. 2535

Feng Yufeng

Role: primary

886-7-312-1101 ext. 6770

Chih-Wen Lin

Role: primary

886-7-6150011 ext. 251179

Sheng-Nan Lu

Role: primary

886-7-7317123 ext. 6161

Li-Wen Chen

Role: primary

886-2-24313131 ext. 6203

Ying Ru Lu

Role: primary

886-6-2353535 ext. 4220

Chun-Hui Fu

Role: primary

+886-2-23123456 ext. 66384

Ying-Luan Wang

Role: primary

886-958661767

Chi-Yang Chang

Role: primary

886-2-85128888 ext. 28880

Chau-Ting Yeh

Role: primary

886-3-3281200 ext. 8121

Other Identifiers

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POLARIS2023-001

Identifier Type: -

Identifier Source: org_study_id

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