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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2016 ; 11
(3
): e0150733
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
A Proof of Concept, Phase II Randomized European Trial, on the Efficacy of
ALF-5755, a Novel Extracellular Matrix-Targeted Antioxidant in Patients with
Acute Liver Diseases
#MMPMID26983031
Nalpas B
; Ichaï P
; Jamot L
; Carbonell N
; Rudler M
; Mathurin P
; Durand F
; Gerken G
; Manns M
; Trautwein C
; Larrey D
; Radenne S
; Duvoux C
; Leroy V
; Bernuau J
; Faivre J
; Moniaux N
; Bréchot C
; Amouyal G
; Amouyal P
; Samuel D
PLoS One
2016[]; 11
(3
): e0150733
PMID26983031
show ga
OBJECTIVE: No efficient medical treatment is available for severe acute hepatitis
(SAH) except N-acetylcysteine for acetaminophen-induced acute liver failure. The
human C-type lectin Reg3?, referred to as ALF-5755, improved survival in an
animal model of acute liver failure and was well tolerated in a phase 1 trial in
humans. We performed a phase 2a trial of ALF5755 in non-acetaminophen induced
SAH. DESIGN: double-blind, randomized, placebo-controlled study. The primary
end-point was the improvement in the coagulation protein synthesis assessed by
the change of Prothrombin (PR) during the 72 hours following treatment initiation
calculated as PRH0 minus PRH72 divided by 72 (PR slope H0H72). Intention to treat
(ITT) and per-protocol (PP) analysis of the entire group and the Hepatitis B
virus (HBV)/AIH (auto-immune hepatitis) sub-group were done separately. RESULTS:
57 patients were included. Twenty-eight received ALF-5755, 29 the placebo.
Etiologies were: Hepatitis A (n = 10), HBV (n = 13), AIH (n = 9), drug-induced (n
= 8), other (n = 17). On the whole group, nor the PR slope H0H72 (0.18±0.31 vs
0.25±0.32), nor the transplant-free survival rate at day 21 (75 vs 86%) differed
between groups. Conversely, in the HBV-AIH subgroup, in which ALF was more
severe, PR slope H0-H72 was higher in the ALF-5755 arm, the difference being
significant in PP analysis (0.048±0.066 vs -0.040±0.099, p = 0.04); the median
length of hospitalization was lower in the ALF-5755 group (8 vs 14 days, p =
0.02). CONCLUSION: ALF-5755 was not efficient in a ITT analysis performed on the
whole sample; however it led to a significant, although moderate, clinical
benefit in a PP analysis of the sub-group of patients with HBV or AIH related
SAH. As HBV is the major cause of SAH in Asia and Africa and AIH a growing cause,
this study emphasizes the need to pursuit the evaluation of this novel medical
treatment of SAH. TRIAL REGISTRATION: ClinicalTrials.gov NCT01318525.
|Acute Disease
[MESH]
|Adult
[MESH]
|Antigens, Neoplasm/adverse effects/pharmacology/*therapeutic use
[MESH]
|Antioxidants/pharmacokinetics/pharmacology/*therapeutic use
[MESH]
|Area Under Curve
[MESH]
|Biomarkers, Tumor/adverse effects/pharmacokinetics/pharmacology/*therapeutic use
[MESH]