ClinicalTrials.gg
RecruitingNCT03472157NASHSURGUpdated Apr 22, 2026

A Randomized Controlled Study Evaluating Bariatric Surgery as a Treatment for Severe NASH With Advanced Liver Fibrosis in Non-severe Obese Patients

An interventional study of Lifestyle therapy and Bariatric surgery in Surgery, Obesity and NASH - Nonalcoholic Steatohepatitis, sponsored by University Hospital, Lille. Recruiting at 1 site in France. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-04-22.

Sponsored by University Hospital, Lille · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2018; still recruiting 8 years 4 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

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).

02

Conditions studied

  • Surgery
  • Obesity
  • NASH - Nonalcoholic Steatohepatitis
  • Cirrhosis

Keywords

  • Gastric bypass
  • Sleeve gastrectomy
  • Lifestyle therapy
  • NASH
  • Advanced fibrosis
  • Cirrhosis
03

In context

Obesity

11,522 studies on the registry are indexed under Obesity; 2,033 are open to participants now.

This study's planned enrollment of 100 is above the median of 67 across 9,006 interventional studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

University Hospital, Lille is the lead sponsor of 631 studies on the registry; 142 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Provide written and agree to comply to the study protocol prior to enrolment.
  • 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 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: > 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, ≤ 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 ) or using an efficient : 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

Exclusion criteria

Exclusion Criteria:

  • 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
  • \<125 000; TP \<80%; \<20 mmol / l; albumin \<35 g / L.
  • Other liver disease: alcohol consumption exceeding 20 g / day for women and 30g / day in men, , , CBP, CSP, hepatitis, hemochromatosis, Wilson's disease, alpha-1 antitrypsin.
  • Being processed Cancer (chemotherapy, radiotherapy or hormone therapy)
  • positive patients
  • Patients who had an acute cardiovascular episode, coronary Heart Disease (Angina pectoris, myocardial infarction, revascularization procedure), stroke or (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 classification).
  • Pregnant or breastfeeding women.
  • Simultaneous enrollment in another clinical trial.
  • Drug abuse within the past year.
  • Patient with 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
Terms in these criteria, in plain language(15)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Bariatric surgery

    Two different types of bariatric surgery can be proposed: laparoscopic Roux-en-Y Gastric Bypass or a Laparoscopic sleeve gastrectomy. Decision of the surgery type will be made according to surgical expertise, habits of investigation centers and the patient's desire. All patients receive nutritional support and therapeutic education adapted to recommendations bariatric surgery care.

    Procedure: Bariatric surgery

  • Active comparator
    Lifestyle therapy

    The group will received the medical standard treatment defined as lifestyle therapy combining diet with increased physical activity (standard treatment, control) (figure 1, design of study).

    Other: Lifestyle therapy

Interventions

  • OtherLifestyle therapy

    Lifestyle habits (caloric intake and exercise) + pedometer

  • ProcedureBariatric surgery

    Two different types of bariatric surgery can be proposed: laparoscopic Roux-en-Y Gastric Bypass or a Laparoscopic sleeve gastrectomy

06

What researchers measure

Primary outcomes

  1. Rate of disappearance of NASH without worsening of fibrosis grade

    Diagnosis of NASH on the liver biopsy

    Time frame: at 60 weeks after randomization

Secondary outcomes

  1. Change in the NAS (Nafld Activity Score) score

    NAS is a histological score established on the liver biopsy. The NAS ranges form 0 to 8. 8 is associated with the highest severity.

    Time frame: at 60 weeks after randomization

  2. Percentage of patients achieving at least a 2 point improvement in the NAS (≥2 points) without worsening of fibrosis grade

    NAS established on the liver biopsy

    Time frame: at 60 weeks after randomization

  3. Change in the Brunt fibrosis score,

    Brunt fibrosis is a histological score ranges from 0 to 4. The Brunt fibrosis score is established on the liver biopsy. It is the recommended score for the evaluation of fibrosis in NASH and NAFLD. On the scale, "0" is an absence of fibrosis, whereas "4" matches with cirrhosis.

    Time frame: at 60 weeks after randomization

  4. Change in the Metavir score

    METAVIR fibrosis score is established on the liver biopsy. METAVIR fibrosis is a histological score ranges from 0 to 4. This score is more discriminant than the Brunt score for the severe form of fibrosis that are included in this study.On the scale, "0" is an absence of fibrosis, whereas "4" matches with cirrhosis.

    Time frame: at 60 weeks after randomization

  5. Change in the fibrosis area

    computerized morphometry analysis of fibrosis area

    Time frame: at 60 weeks after randomization

  6. Change in the SF-36 quality of life score.

    SF-36 quality of life score

    Time frame: at 60 weeks after randomization

  7. Percentage of patients with at least one of the following complications

    complications: infection, thromboembolic complications, haemorrhage, rhabdomyolysis, hepatic decompensation and death

    Time frame: through study completion

  8. Percentage of patient achieving 5 and 10% of weight loss from randomization to end of treatment.

    Weight

    Time frame: at 60 weeks after randomization

  9. Change in aspartate transaminase (AST)

    AST is a liver enzyme, used for the biological liver test evaluation.

    Time frame: at 60 weeks after randomization

  10. Change in Alanine transaminase (ALT)

    ALT is a liver enzyme, used for the biological liver test evaluation.

    Time frame: at 60 weeks after randomization

  11. Change in total bilirubin

    Total bilirubin is a liver enzyme, used for the biological liver test evaluation.

    Time frame: at 60 weeks after randomization

  12. Change in GGT

    GGT (gamma glutamyl transferase) is a liver enzyme, used for the biological liver test evaluation. .

    Time frame: at 60 weeks after randomization

  13. Change in ALP

    Alkalin Phosphatase is a liver enzyme, used for the biological liver test evaluation.

    Time frame: at 60 weeks after randomization

  14. Change in INR (International Normalized Ratio)

    INR represents coagulation but also liver hepatocellular function.

    Time frame: at 60 weeks after randomization

  15. Change in Albumin

    Albumin is used a marker of nutrition and hepatocellular function

    Time frame: at 60 weeks after randomization

  16. Change in metabolic profile assessed by HOMA score

    HOMA is a score (scale) evaluating insulin resistance.

    Time frame: at 60 weeks after randomization

  17. Change in Fasting glucose

    fasting glucose is a marker of diabetes and insulin resistance

    Time frame: at 60 weeks after randomization

  18. Change in Glycated haemoglobin

    glycated haemoglobin is a surrogate marker for diabetes management and outcome.

    Time frame: at 60 weeks after randomization

  19. Change in HDL cholesterol

    HDL cholesterol is a biomarker for lipid metabolism and cardiovascular risk

    Time frame: at 60 weeks after randomization

  20. Change in serum triglycerides

    serum triglycerides is a biomarker for lipid metabolism and cardiovascular risk

    Time frame: at 60 weeks after randomization

  21. Change in LDL cholesterol

    LDL cholesterol is a biomarker for lipid metabolism and cardiovascular risk

    Time frame: at 60 weeks after randomization

  22. Change in total cholesterol.

    total cholesterol is a biomarker for lipid metabolism and cardiovascular risk

    Time frame: at 60 weeks after randomization

07

Study locations

1 of 1 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 22, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03472157
Collaborators
Ministry of Health, France
Responsible party
Sponsor
First posted
Mar 21, 2018
Start date
Jun 20, 2018
Primary completion
Jun 20, 2028 (estimated)
Completion
Jun 20, 2028 (estimated)
Last update
Apr 22, 2026

Study contacts

Philippe Mathurin, MD,PhD
Contact
philippe.mathurin@chru-lille.fr
3 20 44 53 21 ext. +33
Guillaume Lassailly, MD
Contact
guillaume.lassailly@chru-lille.fr
3 20 44 53 21 ext. +33
Philippe Mathurin, MD,PhD
principal investigator · University Hospital, Lille

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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