Study of HMB-enriched Amino Acid Supplementation in Patients With Alcoholic Liver Disease and COVID-19

Last updated: January 8, 2025
Sponsor: The Cleveland Clinic
Overall Status: Active - Recruiting

Phase

N/A

Condition

Liver Disease

Primary Biliary Cholangitis

Liver Disorders

Treatment

β-hydroxy β-methyl butyrate (HMB) enriched amino acid

Balanced amino acid

Clinical Study ID

NCT04858412
20-1194
  • Ages > 21
  • All Genders

Study Summary

Patients with COVID-19 and comorbidities including alcohol associated liver disease (ALD) are at risk for severe illness and abrupt or sudden clinical deterioration with ventilatory failure. â-hydroxy â-methyl butyrate (HMB), a non-nitrogenous leucine metabolite with anabolic properties, increases muscle mass and contractile function and enhances immune function. We aim to study the natural course of COVID-19 in patients with ALD and test whether HMB can affect ventilatory deterioration and improve short and long-term morbidity, mortality, and recovery from critical illness in symptomatic COVID-19 patients with ALD.

Eligibility Criteria

Inclusion

Inclusion Criteria:

A. Cases: Patients with ALD and COVID-19 pneumonia:

  1. Clinical, imaging, laboratory, and/or histological diagnosis of alcoholic cirrhosisand/or alcoholic hepatitis

  2. Child Pugh score 5-8, serum creatinine <3, Model for End Stage Liver Disease score (MELD) <25

  3. Diagnosis of COVID-19 pneumonia as defined by the WHO criteria: confirmed SARS-CoV-2infection by PCR, evidence of bilateral pulmonary infiltrates on chest radiograph (CXR) or computed tomography (CT) and SpO2 <93% or on oxygen supplement

  4. Age of 21 years or older

B. Controls: Patients without alcoholic liver disease (Non-ALD) and COVID-19 pneumonia:

  1. Diagnosis of COVID-19 pneumonia as defined by the WHO criteria: confirmed SARS-CoV-2infection by PCR, evidence of bilateral pulmonary infiltrates on chest radiograph (CXR) or computed tomography (CT) and SpO2 <93% or on oxygen supplement

  2. Age of 21 years or older

Exclusion

Exclusion Criteria: (Both Cases and Controls)

  1. Patients requiring active ventilator support

  2. Anticoagulant/antiplatelet therapy (for those in the biopsy arm, see Randomizationschema. If clinically feasible, patients will be asked to hold their anticoagulantsfor the muscle biopsy after physician review),

  3. Recent gastrointestinal bleeding (<3 months)

  4. Advanced organ diseases: congestive heart failure (NYHA class 3 and 4), chronicobstructive pulmonary diseases (COPD) (GOLD stage 3 and 4), chronic kidney disease (Cr>3), metastatic malignancy

  5. Medications that alter muscle protein metabolism except systemic corticosteroids

  6. Pregnancy

  7. Unwillingness/ Inability to sign informed consent

Study Design

Total Participants: 48
Treatment Group(s): 2
Primary Treatment: β-hydroxy β-methyl butyrate (HMB) enriched amino acid
Phase:
Study Start date:
April 01, 2021
Estimated Completion Date:
December 31, 2026

Connect with a study center

  • Cleveland Clinic Foundation

    Cleveland, Ohio 44195
    United States

    Active - Recruiting

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