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This is a randomized, single blind study to determine whether AXA1125 or AXA1957, novel compositions of amino acids, are safe and well tolerated. Subjects have non-alcoholic fatty liver disease (NAFLD) and the study will also examine liver biology using blood tests and magnetic resonance imaging (MRI).
This was a 16-week, single-blind, randomized, placebo-controlled food study of the safety and tolerability of AXA1125 and AXA1957 in subjects with NAFLD.
Subjects signed an informed consent form and were screened for eligibility, per the inclusion and exclusion criteria below, up to 6 weeks before the start of the administration period. Subjects were randomized as soon as eligibility was confirmed.
Eligible subjects were randomized in a 2:2:2:1 ratio to receive either AXA1125 24 g twice daily (BID), AXA1957 20.3 g BID, AXA1957 13.5 g BID, or placebo 24 g BID. Randomization occurred via an interactive web response system after eligibility was confirmed and approximately 3 to 5 days prior to the Day 1 visit. Assigned study food product (AXA1125, AXA1957, or placebo) were shipped to the study site upon randomization of each subject.
Once randomization had occurred, subjects presented to the study site on Day 1 (Baseline/Visit 2) for their baseline assessments per the schedule of events. Study Day 1 was the beginning of the 16-week administration period.
Subjects returned to the study site at Week 1 (Visit 3), Week 2 (Visit 4), Week 4 (Visit 5), Week 8 (Visit 6), Week 12 (Visit 7), and Week 16 (Visit 8) to receive their study food product and/or to return any unused study food product, provide blood samples for biomarker and other laboratory testing, undergo liver imaging, and complete other study safety assessments per the schedule of events.
The Safety Follow-up Visit, which occurred approximately 2 weeks after the last visit in the administration period (ie, after the Week 16 visit or at the time of early termination), was the End of Study Visit (Visit 9).
There were 9 study visits in total, including the Screening and Follow-up Visits.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AXA1957 high dose | Active Comparator | AXA1957 20.3g |
|
| AXA1957 low dose | Active Comparator | AXA1957 13.5g |
|
| AXA1125 | Active Comparator | AXA1125 24g |
|
| Placebo | Placebo Comparator | Placebo 24g |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AXA1957 | Dietary Supplement | Amino acids, food study |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects With Incidence of Study Product Emergent Adverse Events (AEs) and Any Serious Adverse Events (SAEs) | Subjects received AXA1125 at 24 g twice daily ( BID), AXA1957 at 20.3 g BID or 13.5 g BID with Product related AEs and any SAEs up to 16 weeks | Baseline to week 16 |
| Measure | Description | Time Frame |
|---|---|---|
| Percent Change in Liver Fat as Assessed by MRI- Proton Density Fat Fraction (PDFF) | Relative Changes From Baseline in MRI-PDFF at Week 16 in Overall Subjects (Safety Analysis Population) | Baseline to week 16 |
| Change in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) |
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Key Inclusion Criteria:
Key Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stephen Harrison, MD | Pinnacle Clinical Research | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Institute for Liver Health LLC | Chandler | Arizona | 85224 | United States | ||
| The Institute for Liver Health LLC |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34382947 | Derived | Harrison SA, Baum SJ, Gunn NT, Younes ZH, Kohli A, Patil R, Koziel MJ, Chera H, Zhao J, Chakravarthy MV. Safety, Tolerability, and Biologic Activity of AXA1125 and AXA1957 in Subjects With Nonalcoholic Fatty Liver Disease. Am J Gastroenterol. 2021 Dec 1;116(12):2399-2409. doi: 10.14309/ajg.0000000000001375. |
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112 subjects signed consent and randomized. Ten subjects screen failed prior to day 1 dosing ( after signing consent) and the number of participants who started the study is 102 subjects.
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| ID | Title | Description |
|---|---|---|
| FG000 | AXA1957 High Dose | AXA1957 20.3g AXA1957: Amino acids, food study |
| FG001 | AXA1957 Low Dose | AXA1957 13.5g AXA1957: Amino acids, food study |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 1, 2019 | May 14, 2021 |
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| AXA1125 |
| Dietary Supplement |
Amino acids, food study |
|
| Placebo | Dietary Supplement | Amino acids, food study |
|
Absolute Changes From Baseline in HOMA-IR at Week 16 in Overall Subjects (Safety Analysis Population) |
| Baseline to week 16 |
| Change in Glucose Homeostasis | Absolute Changes From Baseline in HbA1c at Week 16 in Subjects with Diabetes (Safety Analysis Population) | Baseline to week 16 |
| Relative Change in Alanine Aminotransferase (ALT) | Relative Changes From Baseline in ALT at Week 16 in Overall Subjects (Safety Analysis Population) | Baseline to week 16 |
| Change in Aspartate Aminotransferase (AST) | Relative Changes From Baseline in AST at Week 16 in Overall Subjects (Safety Analysis Population) | Baseline to Week 16 |
| Tucson |
| Arizona |
| 85641 |
| United States |
| National Research Institute | Huntington Park | California | 90255 | United States |
| National Research Institute - Wilshire | Los Angeles | California | 90010 | United States |
| Catalina Research Institute, LLC | Montclair | California | 91762 | United States |
| National Research Institute - Panorama | Panorama City | California | 91402 | United States |
| Excel Medical Clinical Trials, LLC | Boca Raton | Florida | 33427 | United States |
| Florida Digestive Health Specialists | Lakewood Rch | Florida | 34202 | United States |
| Compass Research, LLC - Orlando | Orlando | Florida | 32789 | United States |
| Bioclinica Research | Orlando | Florida | 32806 | United States |
| Southern Therapy and Advanced Research LLC | Jackson | Mississippi | 39056 | United States |
| Kansas City Research Institute | Kansas City | Missouri | 64030 | United States |
| Gastro One | Germantown | Tennessee | 20874 | United States |
| Pinnacle Clinical Research | Austin | Texas | 73301 | United States |
| Liver Center of Texas | Dallas | Texas | 75234 | United States |
| Doctors Hospital at Renaissance, LLC | Edinburg | Texas | 78504 | United States |
| Texas Digestive Disease Consultants (TDDC) - Downtown Fort Worth | Fort Worth | Texas | 76104 | United States |
| Pinnacle Clinical Research | San Antonio | Texas | 78201 | United States |
| FG002 | AXA1125 | AXA1125 24g AXA1125: Amino acids, food study |
| FG003 | Placebo | Placebo 24g Placebo: Amino acids, food study |
| COMPLETED |
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| NOT COMPLETED |
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This is the safety analysis population
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| ID | Title | Description |
|---|---|---|
| BG000 | AXA1957 High Dose | AXA1957 20.3g AXA1957: Amino acids, food study |
| BG001 | AXA1957 Low Dose | AXA1957 13.5g AXA1957: Amino acids, food study |
| BG002 | AXA1125 | AXA1125 24g AXA1125: Amino acids, food study |
| BG003 | Placebo | Placebo 24g Placebo: Amino acids, food study |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
| ||||||||||||||||
| Type 2 diabetes mellitus status (T2DM) | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Subjects With Incidence of Study Product Emergent Adverse Events (AEs) and Any Serious Adverse Events (SAEs) | Subjects received AXA1125 at 24 g twice daily ( BID), AXA1957 at 20.3 g BID or 13.5 g BID with Product related AEs and any SAEs up to 16 weeks | Subjects received AXA1125 at 24 g BID, AXA1957 at 20.3 g BID or 13.5 g BID, or placebo for up to 16 weeks. | Posted | Number | participants | Baseline to week 16 |
|
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| |||||||||||||||||||||||||||||||||||
| Secondary | Percent Change in Liver Fat as Assessed by MRI- Proton Density Fat Fraction (PDFF) | Relative Changes From Baseline in MRI-PDFF at Week 16 in Overall Subjects (Safety Analysis Population) | Relative Changes From Baseline in MRI-PDFF at Week 16 in Overall Subjects (Safety Analysis Population) | Posted | Mean | Standard Deviation | percentage of change of MRI_PDFF | Baseline to week 16 |
|
| |||||||||||||||||||||||||||||||||||
| Secondary | Change in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) | Absolute Changes From Baseline in HOMA-IR at Week 16 in Overall Subjects (Safety Analysis Population) | Absolute Changes From Baseline in HOMA-IR at Week 16 in Overall Subjects (Safety Analysis Population) | Posted | Mean | Standard Deviation | percentage of change of HOM-IR | Baseline to week 16 |
|
| |||||||||||||||||||||||||||||||||||
| Secondary | Change in Glucose Homeostasis | Absolute Changes From Baseline in HbA1c at Week 16 in Subjects with Diabetes (Safety Analysis Population) | Absolute Changes From Baseline in HbA1c at Week 16 in Subjects with Diabetes (Safety Analysis Population) | Posted | Mean | Standard Deviation | change in HbA1c | Baseline to week 16 |
|
| |||||||||||||||||||||||||||||||||||
| Secondary | Relative Change in Alanine Aminotransferase (ALT) | Relative Changes From Baseline in ALT at Week 16 in Overall Subjects (Safety Analysis Population) | Relative Changes From Baseline in ALT at Week 16 in Overall Subjects (Safety Analysis Population) | Posted | Mean | Standard Deviation | percentage change of ALT | Baseline to week 16 |
|
| |||||||||||||||||||||||||||||||||||
| Secondary | Change in Aspartate Aminotransferase (AST) | Relative Changes From Baseline in AST at Week 16 in Overall Subjects (Safety Analysis Population) | Relative Changes From Baseline in AST at Week 16 in Overall Subjects (Safety Analysis Population) | Posted | Mean | Standard Deviation | percentage of AST from basline | Baseline to Week 16 |
|
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From the time of informed consent up to first administration of study product on Day 1, any untoward medical occurrence considered related to study procedures will be recorded as an AE. Adverse events that occur from the first administration of study product on Day 1 through the Follow-up Visit / Week 18 will be considered treatment-emergent AEs
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | AXA1957 High Dose | AXA1957 20.3g AXA1957: Amino acids, food study | 0 | 32 | 1 | 32 | 10 | 32 |
| EG001 | AXA1957 Low Dose | AXA1957 13.5g AXA1957: Amino acids, food study | 0 | 26 | 0 | 26 | 8 | 26 |
| EG002 | AXA1125 | AXA1125 24g AXA1125: Amino acids, food study | 0 | 29 | 1 | 29 | 13 | 29 |
| EG003 | Placebo | Placebo 24g Placebo: Amino acids, food study | 0 | 15 | 0 | 15 | 2 | 15 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| nephrolithiasis | Renal and urinary disorders | Systematic Assessment |
| ||
| laryngeal squamous cell carcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Upper respiratory tract infection | Infections and infestations | Systematic Assessment |
| ||
| Decreased appetite | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Headache | Nervous system disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Margaret Koziel, MD | Axcella Health, Inc | 8573202200 | clinicaltrials@axcellahealth.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Mar 9, 2020 | May 14, 2021 | SAP_001.pdf |
| ID | Term |
|---|---|
| D065626 | Non-alcoholic Fatty Liver Disease |
| ID | Term |
|---|---|
| D005234 | Fatty Liver |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| C000720464 | leucine, isoleucine, valine, arginine, glutamine, and N-acetylcysteine |
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| Male |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Any SAEs |
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| Counts |
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| Participants |
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| Participants |
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| Participants |
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| Participants |
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| Participants |
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