Non-alcoholic Steatohepatitis, Type2 Diabetes
Conditions
Brief summary
This study was designed to evaluate the effect of Nesinaact on non-alcoholic steatohepatitis through magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) and liver fibroscan in patients with type 2 diabetes. This is a prospective, open-label, single-arm, single-center clinical Study. After 24 weeks of Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment, the improvement of parameters estimated by MRI and liver fibroscan will be estimated.
Interventions
DRUGNesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment for 24 weeks
All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks. Patients who have not been prescribed any other anti-diabetic drugs at least for 12 weeks and whose HbA1c ranges from 6.5\ 8.5%, can be enrolled. If Patients has been prescribed metformin as monotherapy, they have to substitute metformin with nesinaact 25-15 for enrollment.
Sponsors
Yonsei University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Masking description
No masking is applied, as this is an open label study
Intervention model description
This is a prospective, open-label, single-arm, single-center clinical Study. All participants will be treated with Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) for 24 weeks.
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Male or female patients ages \>= 20 years 2. Patients diagnosed with non-alcoholic fatty liver disease (NAFLD). =\> Definition of NAFLD: CAP (Controlled attenuation parameter) \>= 250 dB/m 3. Diabetic patients who meet one of the following glycemic conditions: * Patients with glycated hemoglobin (HbA1c) ranging 6.5\ 8.5 % while not taking an antidiabetic for more than 12 weeks irrespective of duration of diabetes. * Patients with HbA1c ranging 6.5\ 9.0 % in screening while using metformin monotherapy for more than 8 weeks without changing the dose irrespective of duration of diabetes.
Exclusion criteria
1. Patients who meet the criteria for alcoholic liver disease whose alcohol intake for the recent tow years if above 210 g per week in men and above 140 g per week in women) 2. Patients with chronic hepatitis B, C, or type 1 diabetes, or secondary diabetes 3. Patients with history of acute or chronic metabolic acidosis and ketoacidosis, including diabetic ketoacidosis accompanied or not accompanied by coma 4. Patients who were administered an oral hypoglycemic agent or insulin other than metformin within 8 weeks prior ro screening, or are likely to be administered it during the study duration among patients receiving monotherapy. 5. Patients who had hypersensitivity to biguanide or glitazone in the past. 6. Patients who received oral or parenteral corticosteroid treatment chronically (for more than 14 consecutive days) within 8 weeks prior to screening 7. Patients wih past history of lactic acidosis 8. Patients with a genetic disorder, such as galactose intolerance, Lapp lactase deficiency or glucose-galactose impaired absorption, etc. 9. Patients wih malnutrition, starvation, weakness, (Including patients with severe infection), pituitary insufficiency or adrenal insufficiency 10. Patients who have been receiving radiotherapy or chemotherapy due to bladder cancer and other malignant tumor, or it is less than 2 years since the patients received it. 11. Patients with past history of bladder cancer 12. A patient with history of drug abuse or alcoholism in 12 weeks 13. A patient who has hear failure (NYHA class 3\ 4) or uncontrolled arrhythmia within 6 months 14. A patient who has acute cardiovascular disease within 12 weeks (including unstable angina, myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass, or coronary intervention) 15. A person who falls under one of the followings: 1\) A patient with serum creatinine level \>= 1.5 mg/dL in men and 1.4 mg/dL in women or a patient wih moderate to severe renal impairment (creatinine clearance: \< 50 ml/min) 2) An anemia patient with 10.5 g/dL of Hb level * A pregnant or nursing woman * A patient who does not consent to use a proper method of contraception during the study period only among women or men of childbearing age * A patient who has taken investigational drug in other clinical study within 4 weeks following informed consent * A person who may not participate in the study according to investigator's judgement * A person who cannot read the informed consent form (e.g: an illiterate, a foreigner, etc.)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| A degree of liver steatosis | 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment | Magnetic resonance imaging (MRI)-based proton density-fat fraction (MRI-PDFF) will be evaluated to confirm the improvement in liver steatosis. |
| A degree of liver fibrosis | 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment | In liver fibroscan, liver stiffness (kPa) as a marker of fibrosis and CAP (dB/m) as a marker of steatosis will be estimated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical glucometabolic parameters : HbA1c | 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment | HbA1c in % |
| Clinical glucometabolic parameters : Lipid parameters | 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment | Total cholesterol in mg/dL |
| Clinical glucometabolic parameters : Liver enzymes | 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment | AST in IU/L |
| Clinical glucometabolic parameters :Anthropometric parameters | 24 weeks after starting Nesinaact 25/15 (Alogliptin benzoate 25mg, pioglitazone hydrochloride 15mg) treatment | Blood pressure in mmHg |
Countries
South Korea
Outcome results
None listed