Efficacy of Simvastatin in Alcoholic Liver Fibrosis

Alcohol Abuse Clinical Trial

— SIMFIB  

Official title:

Efficacy of Simvastatin in Reducing Liver Fibrosis in Patients With Advanced Fibrosis Due to Alcohol: Randomized, Double-blind, Placebo-controlled Clinical Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04971577
• Other study ID #: SIMFIB
• Status: Recruiting
• Phase: Phase 2/Phase 3
• Start date: February 22, 2022
• Est. completion date: January 2025

Study information

• Verified date: September 2023
• Source: Fundacion Clinic per a la Recerca Biomédica
• Contact: Gratacos
• Phone: 34 932275400
• Email: acruceta[@]recerca.clinic.cat
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Evaluate the efficacy of simvastatin in reducing liver fibrosis in patients with advanced fibrosis due to alcohol

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 90
• Est. completion date: January 2025
• Est. primary completion date: March 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Age = 18 years

2. Chronic alcohol-related liver disease according to international guidelines (EASL, European Association for the Study of the Liver) and with data of significant liver fibrosis obtained in the diagnostic biopsy at the beginning of the study or in the last biopsy of the patient within 6 months prior to randomization. Significant liver fibrosis is defined by a score on the Ishak fibrosis scale of between 3 and 6.

3. Patients in the compensated chronic liver disease phase defined by the absence of clinical decompensations at the time of entering the study, with or without data of portal hypertension.

4. Women of childbearing potential must have a negative urine pregnancy test prior to study enrollment and agree to use highly effective contraceptive methods (combined oral pill, injectable or implanted contraceptive, intrauterine device / hormone delivery system intrauterine) during the study.

Exclusion Criteria:

1. Patients receiving statins or fibrates.

2. Patients with other etiologies of liver disease in addition to alcohol: hepatitis C, hepatitis B, autoimmune hepatitis, Wilson's disease, or hemochromatosis.

3. Patients in whom hepatitis C has been cured with antivirals in the 2 years prior to inclusion in the study.

4. Patients with a CK elevation of 50% or more above the upper limit of normal at the time of study inclusion.

5. Gastrointestinal bleeding due to portal hypertension within 12 months prior to inclusion in the study.

6. Clinical hepatic encephalopathy, defined as grade II-IV hepatic encephalopathy, in the 12 months prior to inclusion in the study.

7. Patients in need of diuretic treatment in the previous 12 months to control ascites or hydrothorax.

8. Spontaneous bacterial peritonitis within 12 months prior to study enrollment.

9. Hepatocellular carcinoma of any stage.

10. Patients with known muscle disease.

11. Patients with previous rhabdomyolysis.

12. Patients being treated with strong CYP3A4 enzyme inhibitors (see section 5.2:

Concomitant drugs, not allowed and allowed).

13. Patients being treated with drugs with possible interactions with simvastatin (see section 5.2: Concomitant drugs, not allowed and allowed).

14. Patients with a history of significant extrahepatic disease with poor short-term prognosis, including New York Heart Association Grade III / V congestive heart failure, GOLD COPD> 2, chronic kidney disease with serum creatinine> 2mg / dL or under therapy of kidney replacement.

15. Patients with extrahepatic malignancies, including solid tumors and hematologic malignancies.

16. Patients with a history or increased risk of intestinal obstruction.

17. Pregnancy or breastfeeding.

18. Patients included in other clinical trials during the previous month.

19. Patients with mental disabilities, language barriers, poor social support or any other reason considered by the researcher as essential for adequate understanding, cooperation or compliance with the study.

20. Presence of data on alcoholic hepatitis in liver biopsy upon inclusion.

21. Patients with contraindications for statins.

22. Known hypersensitivity to simvastatin.

23. Refusal to sign the informed consent

Related Conditions & MeSH terms

• Alcohol Abuse
• Alcoholism
• Fibrosis
• Liver Cirrhosis
• Liver Fibrosis

Intervention

Drug:
• Simvastatin 40mg
participants will receive a capsule containing 4 tablets simvastatin 10 mg (40 mg total) every 24 hours at night

Locations

Country	Name	City	State
Spain	Jordi Gratacos	Barcelona

Sponsors (1)

Lead Sponsor	Collaborator
Anna Cruceta

Country where clinical trial is conducted

Spain, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change from baseline biopsy in histological fibrosis Ishak score (0-4 range. higher scores mean a worse result)	Change from range baseline biopsy in histological fibrosis score measured through the Ishak scale at 18 months.	18 months