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Trial registered on ANZCTR
Registration number
ACTRN12615000874516
Ethics application status
Approved
Date submitted
28/07/2015
Date registered
21/08/2015
Date last updated
3/11/2020
Date data sharing statement initially provided
17/06/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pathophysiology and treatment of nonalcoholic fatty liver disease (NAFLD): Effects of bariatric surgery
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Scientific title
Efficacy of bariatric surgery for the treatment of NAFLD in obese patients
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Secondary ID [1]
287163
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Nil
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Universal Trial Number (UTN)
U1111-1173-0844
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obesity
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Non-alcoholic fatty liver disease
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Bariatric Surgery
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Condition category
Condition code
Diet and Nutrition
296008
296008
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0
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Obesity
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Oral and Gastrointestinal
296009
296009
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Surgery
296125
296125
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Bariatric Surgery:
- Laparoscopic adjustable gastric banding [approximately 1 hour]
- sleeve gastrectomy (laparoscopic or open) [approximately 1-2 hours]
- gastric bypass (laparoscopic or open) [approximately 2-3 hours]
- BPD [approximately 2-3 hours]
Choice of bariatric surgery will be at patient and clinician discretion.
Liver biopsy and adipose tissue biopsy will be taken during the operation.
- Liver biopsy may sometimes be taken by the surgeon if there is obvious liver disease macroscopically, or pre-operative suspicion. It is not routine for all patients.
- Adipose tissue biopsy is not part of routine clinical care and is taken for research purposes only.
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Intervention code [1]
292438
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Treatment: Surgery
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Comparator / control treatment
No control treatment
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Changes in liver histology with surgically induced weight loss (comparison of baseline liver biopsy with follow-up liver biopsy)
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Assessment method [1]
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Timepoint [1]
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1 year
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Secondary outcome [1]
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Changes in immune cell infiltrate and expression of TNFSF14/LIGHT (immune cell related marker) in NASH with weight loss (as investigated via immunohistochemistry of liver).
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Assessment method [1]
316553
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Timepoint [1]
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1 year
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Eligibility
Key inclusion criteria
Patients >17 years undergoing bariatric surgery and any of:
- AST or ALT > 0.5 upper limit normal
- GGT > upper limit normal
- Abnormal transient elastography
- Abnormal ultrasound suggesting NAFLD
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Other cause of liver disease
Past or current excessive ETOH
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Consecutive patients undergoing bariatric surgery who meet inclusion criteria will be invited to participate.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The sample size has been powered to observe a difference in mean NALFD activity score of 0.90, based on previous data of histological changes in paired liver biopsies [Mathurin et al, 2009]. In this study, the pre-operative mean NAS was 1.97 +/- 1.33, and post-operative mean NAS was 1.07 +/- 1.26. This created an effect size of 0.694. The G*power 3.1 program was used to calculated the power with alpha error of 0.05 and power of 0.90. Two tailed t-test using differences between the mean was used. The determined sample size calculated was 24 patients.
To account for 75% of patients consenting to further biopsy, we would need 36 patients with NASH. With a 25-50% incidence of NASH in the obese, we would be aiming for approximately 100 patients.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
22/06/2015
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Actual
29/06/2015
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Date of last participant enrolment
Anticipated
30/05/2016
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Actual
4/12/2016
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Date of last data collection
Anticipated
27/01/2020
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Actual
5/08/2019
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Sample size
Target
100
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Accrual to date
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Final
190
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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The Alfred Research Trust
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Address [1]
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99 Commercial Road
Prahran
Victoria, 3181
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Country [1]
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Australia
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Funding source category [2]
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University
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Name [2]
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Centre for Obesity Research and Education, Monash University
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Address [2]
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Level 6, The Alfred Centre
99 Commercial Road
Prahran,
Victoria, 3181
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Country [2]
291733
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Australia
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Primary sponsor type
University
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Name
Centre for Obesity Research and Education, Monash University
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Address
Level 6, The Alfred Centre
99 Commercial Road
Prahran,
Victoria, 3181
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Department of Gastroenterology and Department of Upper Gastrointestinal Surgery, The Alfred Hospital
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Address [1]
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99 Commercial Road,
Prahran
Victoria 3181
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Country [1]
290407
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293254
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The Alfred Hospital HREC
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Ethics committee address [1]
293254
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99 Commercial Road Prahran Victoria 3181
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Ethics committee country [1]
293254
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Australia
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Date submitted for ethics approval [1]
293254
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Approval date [1]
293254
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09/06/2015
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Ethics approval number [1]
293254
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195/15
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Ethics committee name [2]
293255
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Monash University HREC
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Ethics committee address [2]
293255
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Monash University Room 111, Chancellery Building E 24 Sports Walk, Clayton Campus Wellington Road, Clayton, VICTORIA, 3800
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Ethics committee country [2]
293255
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Australia
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Date submitted for ethics approval [2]
293255
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Approval date [2]
293255
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17/06/2015
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Ethics approval number [2]
293255
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CF15/2419-2015000971
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Summary
Brief summary
This is a prospective cohort study for patients undergoing bariatric surgery who have risk factors for NAFLD, to investigate the impact of surgical weight loss on the liver. Patients who are already scheduled for bariatric surgery who fit criteria for likely NAFLD will be recruited from The Alfred Hospital, to undergo an intraoperative liver and adipose tissue biopsy. Patients with significant liver disease on initial biopsy (NAFLD activity score (NAS) greater than 4 or fibrosis score greater than F1) will be offered a follow-up liver biopsy at 12-months post-operatively. Liver tissues will be investigated for markers that may indicate disease prognosis and underlying pathophysiology, particularly immune cell markers.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Geraldine Ooi
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Address
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Centre for Obesity Research and Education, Monash University
Level 6, The Alfred Centre
99 Commercial Road, Prahran
Victoria, 3181
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Country
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Australia
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Phone
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+613 9903 0725
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Geraldine Ooi
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Address
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Centre for Obesity Research and Education, Monash University
Level 6, The Alfred Centre
99 Commercial Road, Prahran
Victoria, 3181
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Country
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Australia
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Phone
59107
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+613 9903 0725
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Fax
59107
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Email
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[email protected]
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Contact person for scientific queries
Name
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Geraldine Ooi
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Address
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Centre for Obesity Research and Education, Monash University
Level 6, The Alfred Centre
99 Commercial Road, Prahran
Victoria, 3181
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Country
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Australia
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Phone
59108
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+613 9903 0725
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Fax
59108
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Email
59108
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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