Vitamin E Dosing Study (VEDS): A Dose Finding Study of Vitamin E for the Treatment of Adult NAFLD (VEDS)

  • STATUS
    Recruiting
  • End date
    Dec 28, 2024
  • participants needed
    200
  • sponsor
    National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Updated on 28 October 2022
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Summary

This is a multicenter, randomized, double masked, placebo-controlled, parallel treatment groups dosing trial of Vitamin E in adult nonalcoholic fatty liver disease (NAFLD).

Description

Adults age 18 years or older will be enrolled for 48 weeks and treated with 200 international units (IU), 400 IU, or 800 IU of Vitamin E or matching placebo for 24 weeks. The primary objective of the study is to determine the minimum effective dose of Vitamin E (d-alpha-tocopherol) based upon relative change in alanine aminotransferase (ALT) from baseline to 24 weeks.

Details
Condition Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis
Treatment Placebo, vitamin E
Clinical Study IdentifierNCT04801849
SponsorNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Last Modified on28 October 2022

Eligibility

 Yes No Not Sure

Inclusion Criteria

years of age or older as of the initial screening interview and provision of consent
FibroScan CAP>280 dB/m within 60 days prior to randomization
ALT ≥ 60 U/L within 30 days of randomization

Exclusion Criteria

Concurrent or prior use (within 90 days) of vitamin E supplements in excess of 40 IU/day
Current or history of significant alcohol consumption for a period of more than 3 consecutive months within 1 year prior to screening (significant alcohol consumption is defined as more than 20 g/day (~1.5 drinks/day) (> 10.5 drinks per week) in females and more than 30 g/day (~2 drinks/day) (>14 drinks per week) in males, respectively. One "standard" drink (or one alcoholic drink equivalent) contains roughly 14 grams of pure alcohol, which is found in: 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of distilled spirits)
Inability to reliably quantify alcohol consumption based upon local study physician judgment
Continued use of drugs historically associated with NAFLD (amiodarone, methotrexate, systemic glucocorticoids, tetracyclines, tamoxifen, estrogens at doses greater than those used for hormone replacement, anabolic steroids, valproic acid, and other known hepatotoxins) for more than 2 weeks in the 6 months prior to randomization
Current use of anticoagulation therapy (not including antiplatelet agents such as aspirin or clopidogrel)
Platelet count below 150,000 /mm3 within 90 days of randomization
History of condition(s) that cause increased risk of bleeding, including hemophilia A, hemophilia B, von Willebrand disease, or other clotting factor deficiencies
Prior or planned (during the study period) bariatric surgery (eg, gastroplasty, roux-en-Y gastric bypass)
Uncontrolled diabetes defined as HbA1c 9.5% or higher within 60 days prior to randomization
Clinical evidence of hepatic decompensation as defined by the presence of any of the following abnormalities
Serum albumin less than 3.2 g/dL
International Normalized Ratio (INR) greater than 1.3
Direct bilirubin greater than 1.0 mg/dL
History of esophageal varices, ascites or hepatic encephalopathy
Evidence of other forms of chronic liver disease
Hepatitis B as defined by presence of hepatitis B surface antigen (HBsAg)
Hepatitis C as defined by presence of hepatitis C virus (HCV) RNA
Evidence of ongoing autoimmune liver disease as defined by compatible liver histology
Primary biliary cirrhosis as defined by the presence of at least 2 of these criteria (i) Biochemical evidence of cholestasis based mainly on alkaline phosphatase elevation (ii) Presence of anti-mitochondrial antibody (AMA) (iii) Histologic evidence of nonsuppurative destructive cholangitis and destruction of interlobular bile ducts[1]
Primary sclerosing cholangitis
Known history of Wilson disease, alpha-1-antitrypsin liver disease, or hemochromatosis. Any other type of liver disease that is currently active other than NASH such as drug-induced liver disease, liver cancer, or bile duct obstruction
Serum alanine aminotransferase (ALT) greater than 400 U/L within 90 days of
randomization
Moderate or severe renal impairment (serum creatinine ≥ 2.0 mg/dL or eGFR < 60 mg/mL/1.73m2)
History of biliary diversion or evidence of current biliary obstruction
Known positivity for Human Immunodeficiency Virus (HIV) infection
Active, serious medical disease with likely life expectancy less than 5 years
Active substance abuse including inhaled or injection drugs in the year prior to screening
Pregnancy, planned pregnancy, potential for pregnancy and unwillingness to use ≥ 1 effective form(s) of birth control during the trial, breast feeding
Current use of medications that may impact the absorption of fat-soluble vitamins (i.e. orlistat or cholestyramine)
Pre-existing history of fat malabsorption
Males at high risk of prostate cancer, including
PSA >ULN at baseline
History of prostate cancer
Age 45 or older with a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65)
Age 40 or older with more than one first-degree relative who had prostate cancer at an early age (younger than age 65)
Participation in an IND trial in the 30 days before randomization
Any other condition which, in the opinion of the investigator, would impede compliance or hinder completion of the study, including inability to swallow treatment capsules
Failure or inability to give informed consent
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