Informations générales (source: ClinicalTrials.gov)
Prospective Multicentric, Open Label, Randomized Clinical Trial of Superiority, With Two Arms, Comparing Bariatric Surgery to the Recommended Medical Treatment for NASH (NASHSURG)
Interventional
N/A
University Hospital, Lille (Voir sur ClinicalTrials)
juin 2018
mars 2026
29 juin 2024
The aim of the study is to demonstrate the superiority of bariatric surgery on the
disappearance of NASH without worsening of fibrosis in comparison to medical standard
treatment in obese patients (35 kg/m² > BMI ≥ 30 kg/m²) with NASH complicated of advanced
fibrosis (F3 and F4 fibrosis grade according to Brunt score).
Etablissements
| Les établissements d'Île-de-France ayant mis à jour leurs données Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| CHI DE CRETEIL | Isabelle ROSA | 29/03/2024 01:29:53 | Contacter | ||
| Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
| Hôpital Claude Huriez, CHRU - Lille - France | Contact (sur clinicalTrials) | ||||
Critères
Tous
Inclusion Criteria:
- Provide written informed consent and agree to comply to the study protocol prior to
enrolment.
- BMI and Brunt Fibriosis score:
- For F3 fibrosis patients: 35>BMI≥ 30kg/m² ; Fibroscan ≥ 9kPa or FibrometreVM
≥0.526 predicting a F3 fibrosis score grade within 1 month before inclusion or
F3 fibrosis score grade diagnosed by hepatic biopsy performed before inclusion.
- For F4 fibrosis patients: 50>BMI≥ 30kg/m² ; Fibroscan ≥ 15kPa predicting a F4
fibrosis score grade within 1 month before inclusion or F4 fibrosis score grade
diagnosed by hepatic biopsy performed before inclusion.
- Fibroscan ≥ 9kPa or FibrometreVM ≥0.526 predicting a F3 or F4 fibrosis score grade
within 1 month before inclusion Or F3 or F4 fibrosis score grade diagnosed by
hepatic biopsy performed before inclusion.
- Patient should agree to have one liver biopsy during the screening period (before
randomization, the randomization will be permitted after at least a second reading
performed by pathologist of CHRU Lille to confirm the histological diagnosis of NASH
with advanced fibrosis (F3-F4)) for the diagnosis purpose (if no histological biopsy
within 1 month before inclusion is available) and one at the end of the treatment
period for assessment of the treatment effects.
- For patients with cirrhosis, patients must fulfil all the following criteria:
Platelets > 125 000, PT > 80 %, Albumin > 35 g/L, MELD score at inclusion < 9, CPT
score < 6, No history of previous decompensation, No oesophageal varices
(endoscopy), No vascular shunt, ASA score ≤ III, Alcohol consumption lower than
20g/day for women and 30g/day for men.
- For hypertensive patients, hypertension must be controlled by stable dose of
anti-hypertensive medication for at least 2 months prior to screening (and the
stable dose can be maintained throughout the study).
- Female participating in the study must be either of non-child bearing (surgically
sterilized at 6 month prior to screening or postmenopausal) or using an efficient
contraception: hormonal contraception (including patch, contraceptive ring etc)
intra-uterine device or other mechanical contraception
- Patient agrees to come to the study visits within the protocol-specified delay
- Provide written informed consent and agree to comply to the study protocol prior to
enrolment.
- BMI and Brunt Fibriosis score:
- For F3 fibrosis patients: 35>BMI≥ 30kg/m² ; Fibroscan ≥ 9kPa or FibrometreVM
≥0.526 predicting a F3 fibrosis score grade within 1 month before inclusion or
F3 fibrosis score grade diagnosed by hepatic biopsy performed before inclusion.
- For F4 fibrosis patients: 50>BMI≥ 30kg/m² ; Fibroscan ≥ 15kPa predicting a F4
fibrosis score grade within 1 month before inclusion or F4 fibrosis score grade
diagnosed by hepatic biopsy performed before inclusion.
- Fibroscan ≥ 9kPa or FibrometreVM ≥0.526 predicting a F3 or F4 fibrosis score grade
within 1 month before inclusion Or F3 or F4 fibrosis score grade diagnosed by
hepatic biopsy performed before inclusion.
- Patient should agree to have one liver biopsy during the screening period (before
randomization, the randomization will be permitted after at least a second reading
performed by pathologist of CHRU Lille to confirm the histological diagnosis of NASH
with advanced fibrosis (F3-F4)) for the diagnosis purpose (if no histological biopsy
within 1 month before inclusion is available) and one at the end of the treatment
period for assessment of the treatment effects.
- For patients with cirrhosis, patients must fulfil all the following criteria:
Platelets > 125 000, PT > 80 %, Albumin > 35 g/L, MELD score at inclusion < 9, CPT
score < 6, No history of previous decompensation, No oesophageal varices
(endoscopy), No vascular shunt, ASA score ≤ III, Alcohol consumption lower than
20g/day for women and 30g/day for men.
- For hypertensive patients, hypertension must be controlled by stable dose of
anti-hypertensive medication for at least 2 months prior to screening (and the
stable dose can be maintained throughout the study).
- Female participating in the study must be either of non-child bearing (surgically
sterilized at 6 month prior to screening or postmenopausal) or using an efficient
contraception: hormonal contraception (including patch, contraceptive ring etc)
intra-uterine device or other mechanical contraception
- Patient agrees to come to the study visits within the protocol-specified delay
- Previous history of bariatric surgery (except gastric ring removed for more than 3
years).
- Decompensated cirrhosis (MELD> 7 CPT score> 5, previous history of decompensation
(encephalopathy, ascites, jaundice, varicose vein rupture)
- Hepatocellular carcinoma
- Platelets <125 000; TP <80%; bilirubin <20 mmol / l; albumin <35 g / L.
- Other liver disease: alcohol consumption exceeding 20 g / day for women and 30g /
day in men, HBV, HCV, CBP, CSP, autoimmune hepatitis, hemochromatosis, Wilson's
disease, alpha-1 antitrypsin.
- Being processed Cancer (chemotherapy, radiotherapy or hormone therapy)
- HIV positive patients
- Patients who had an acute cardiovascular episode, coronary Heart Disease (Angina
pectoris, myocardial infarction, revascularization procedure), stroke or TIA
(Transient Ischemic Attack) within the 6 months prior to screening Recent
cardiovascular events (stroke, myocardial infarcts, etc...) in the past 6 months.
- Severe chronic respiratory disease.
- Severe chronic cardiac insufficiency (grade III and IV of NYHA classification).
- Pregnant or breastfeeding women.
- Simultaneous enrollment in another clinical trial.
- Drug abuse within the past year.
- Patient with contra-indication for bariatric surgery
- Gastic Banding, Biliopancreatic diversion and all the new bariatric surgery
techniques are forbidden because the study design allow only the laparoscopic sleeve
gastrectomy or laparoscopic Roux-en-Y gastric Bypaass.
- History of cancer, except:
- Patients considered in remission for at least 5 years after onset of treatment.
- Patients Treated and believed to be cured basal or squamous cell carcinoma of
the skin or resected carcinoma of the cervix