A Phase 2 interventional study of Icosabutate and Placebo in Non Alcoholic Steatohepatitis (NASH), sponsored by NorthSea Therapeutics B.V.. Completed at 39 sites in 2 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-02-28.
Sponsored by NorthSea Therapeutics B.V. · Phase 2, Interventional, and Treatment
A Phase 2b study to evaluate the efficacy of different doses of NST-4016 on the resolution of NASH without worsening of fibrosis
This is a 62 week (including screening and follow-up), multicenter, randomized, double blind, placebo-controlled, parallel group study in male and female patients with a histological diagnosis of NASH. The study includes a screening period, double blind treatment period, and post-treatment follow up
1,451 studies on the registry are indexed under Fatty Liver; 292 are open to participants now.
This study's enrollment of 280 is above the median of 60 across 1,003 interventional studies indexed under Fatty Liver.
Browse Fatty Liver studies →NorthSea Therapeutics B.V. is the lead sponsor of 7 studies on the registry; 1 is open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Placebo oral capsules taken one daily for 52 weeks
Drug: Placebo
Icosabutate 300mg oral capsule taken once daily for 52 weeks
Drug: Icosabutate
Icosabutate 600mg oral capsules taken once daily for 52 weeks
Drug: Icosabutate
Icosabutate oral capsule once daily
Also known as: NST-4016
Matching placebo oral capsule
Percentage of Patients With Resolution of NASH, Defined as Disappearance of Ballooning (Score = 0) With Lobular Inflammation Score 0 or 1, With no Worsening of Fibrosis.
Time frame: 52 weeks
Percentage of Patients With Fibrosis Improvement, Defined as Greater Than or Equal to 1 Stage of Fibrosis Improvement and no Worsening of Steatohepatitis (Inflammation/Ballooning).
Time frame: 52 weeks
Percentage of Patients With Fibrosis Improvement, Defined as Greater Than or Equal to 1 Stage of Fibrosis Improvement.
Time frame: 52 weeks
Changes in the Liver Enzymes Aspartate Aminotransferase (AST)U/L, Alanine Aminotransferase ( ALT)U/L and Gamma Glutamyl Transferase (GGT) U/L From Baseline
Time frame: 52 weeks
Change in Bilirubin Micromol/L From Baseline
Time frame: 52 weeks
Change From Baseline in Inflammation Marker hsCRP
Time frame: 52 weeks
Change From Baseline in Fibrosis Activity Marker Pro-C3
Time frame: 52 weeks
Change From Baseline in Fibrosis Activity Marker Enhanced Liver Fibrosis (ELF) Test
ELF is a blood test that measures liver fibrosis by analyzing three markers in the blood: Hyaluronic acid (HA), Procollagen III amino-terminal peptide (PIIINP), and Tissue inhibitor of matrix metalloproteinase 1 (TIMP-1). The higher the score the higher the levels of markers in the blood. ELF score = 2.278 + 0.851 × ln(HA) + 0.751 × ln(PIIINP) + 0.394 × ln(TIMP-1). As the score is a composite measure of the levels of three markers in the blood, there is not a finite range for this parameter.
Time frame: 52 weeks
Change From Baseline in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)
HOMA-IR is a measure of insulin resistance and metabolic status. The higher the score, the higher the level of insulin resistance. HOMA-IR = fasting glucose \[mmol/L)\] × fasting insulin \[mIU/L\]/22.5. As HOMA-IR is a composite score using 2 parameters, it does not have a finite range.
Time frame: 52 weeks
Change From Baseline in Composite Disease Activity Score (Composite NASH Score of Inflammation, Ballooning, Fibrosis)
The disease activity score can range from 0 to 8 and is calculated by the sum of scores of steatosis (0-3), lobular inflammation (0-3) and hepatocyte ballooning (0-2). The higher the score the more severe the disease.
Time frame: 52 weeks
Change From Baseline in Nonalcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)
A histological scoring system that assesses a liver biopsy and gives scores for steatosis (0-3), lobular inflammation (0-3), and hepatocyte ballooning (0-2) giving a total score of (0-8). The higher the score the more severe the disease
Time frame: 52 weeks
Changes in Individual Histological Scores for Steatosis, Ballooning, Inflammation, and Fibrosis From Baseline
Changes in scores for the individual component parts of the Nonalcoholic fatty liver disease (NAFLD) activity score (NAS) as judged by a pathologist examining sections from a liver biopsy; steatosis (range 0-3), lobular inflammation (range 0-3), and hepatocyte ballooning (range 0-2) In all cases a higher number denotes more severe disease activity
Time frame: 52 weeks
Change From Baseline in Magnetic Resonance Imaging-Proton Density-Fat Fraction (MRI-PDFF)
MRI-PDFF is a quantitative imaging biomarker that measures the fat fraction of tissue by correcting factors influencing magnetic resonance signal intensity.
Time frame: 52 weeks
| Milestone | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Started | 92 | 93 | 95 |
| Safety population | 91 | 92 | 95 |
| Itt | 91 | 92 | 95 |
| Mitt | 75 | 76 | 77 |
| 3-panel mitt | 75 | 76 | 77 |
| Completed | 79 | 78 | 78 |
| Not completed | 13 | 15 | 17 |
| Withdrew: Withdrawal by subject | 4 | 5 | 6 |
| Withdrew: Adverse event | 3 | 2 | 8 |
| Withdrew: Lost to follow-up | 2 | 5 | 3 |
| Withdrew: Protocol violation | 1 | 1 | 0 |
| Withdrew: Death | 1 | 0 | 0 |
| Withdrew: Physician decision | 0 | 1 | 0 |
| Withdrew: Pregnancy | 1 | 0 | 0 |
| Withdrew: Requirement of prohibited concomitant medication | 1 | 0 | 0 |
| Withdrew: Reason not recorded | 0 | 1 | 0 |
| percentage of participants | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Percentage of Patients With Resolution of NASH, Defined as Disappearance of Ballooning (Score = 0) With Lobular Inflammation Score 0 or 1, With no Worsening of Fibrosis. | 8.7 | 17.3 | 20.8 |
| percentage of participants | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Percentage of Patients With Fibrosis Improvement, Defined as Greater Than or Equal to 1 Stage of Fibrosis Improvement and no Worsening of Steatohepatitis (Inflammation/Ballooning). | 13.0 | 26.9 | 24.5 |
| percentage of participants | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Percentage of Patients With Fibrosis Improvement, Defined as Greater Than or Equal to 1 Stage of Fibrosis Improvement. | 13.0 | 30.8 | 28.3 |
| U/L | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Aspartate Aminotransferase | -8.2 ± 3.18 | -14.9 ± 3.46 | -18.5 ± 3.13 |
| Alanine Aminotransferase | -9.8 ± 3.73 | -27.9 ± 4.05 | -30.1 ± 3.65 |
| Gamma Glutamyl Transferase | -5.1 ± 5.41 | -27.9 ± 5.75 | -32.7 ± 5.26 |
| micromol/L | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change in Bilirubin Micromol/L From Baseline | 0.56 ± 0.332 | -1.11 ± 0.362 | -1.49 ± 0.325 |
| mg/L | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Inflammation Marker hsCRP | 1.089 ± 0.8095 | -1.297 ± 0.8953 | -3.382 ± 0.7978 |
| micrograms/L | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Fibrosis Activity Marker Pro-C3 | -4.33 ± 2.830 | -3.68 ± 3.023 | -11.76 ± 2.762 |
ELF is a blood test that measures liver fibrosis by analyzing three markers in the blood: Hyaluronic acid (HA), Procollagen III amino-terminal peptide (PIIINP), and Tissue inhibitor of matrix metalloproteinase 1 (TIMP-1). The higher the score the higher the levels of markers in the blood. ELF score = 2.278 + 0.851 × ln(HA) + 0.751 × ln(PIIINP) + 0.394 × ln(TIMP-1). As the score is a composite measure of the levels of three markers in the blood, there is not a finite range for this parameter.
| score | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Fibrosis Activity Marker Enhanced Liver Fibrosis (ELF) Test | -0.051 ± 0.0993 | -0.125 ± 0.1087 | -0.370 ± 0.0983 |
HOMA-IR is a measure of insulin resistance and metabolic status. The higher the score, the higher the level of insulin resistance. HOMA-IR = fasting glucose \[mmol/L)\] × fasting insulin \[mIU/L\]/22.5. As HOMA-IR is a composite score using 2 parameters, it does not have a finite range.
| score | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) | 0.609 ± 1.3453 | -2.810 ± 1.4733 | -3.794 ± 1.3203 |
The disease activity score can range from 0 to 8 and is calculated by the sum of scores of steatosis (0-3), lobular inflammation (0-3) and hepatocyte ballooning (0-2). The higher the score the more severe the disease.
| score on a scale | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Composite Disease Activity Score (Composite NASH Score of Inflammation, Ballooning, Fibrosis) | -0.2 ± 1.68 | -0.7 ± 1.84 | -0.9 ± 1.56 |
A histological scoring system that assesses a liver biopsy and gives scores for steatosis (0-3), lobular inflammation (0-3), and hepatocyte ballooning (0-2) giving a total score of (0-8). The higher the score the more severe the disease
| score on a scale | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Nonalcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS) | -0.9 ± 1.36 | -0.9 ± 1.51 | -1.3 ± 1.65 |
Changes in scores for the individual component parts of the Nonalcoholic fatty liver disease (NAFLD) activity score (NAS) as judged by a pathologist examining sections from a liver biopsy; steatosis (range 0-3), lobular inflammation (range 0-3), and hepatocyte ballooning (range 0-2) In all cases a higher number denotes more severe disease activity
| score on a scale | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Steatosis grade | -0.4 ± 0.62 | -0.2 ± 0.65 | -0.4 ± 0.81 |
| Lobular inflammation score | -0.2 ± 0.62 | -0.4 ± 0.67 | -0.5 ± 0.61 |
| Hepatocyte ballooning score | -0.3 ± 0.79 | -0.3 ± 0.84 | -0.4 ± 0.78 |
MRI-PDFF is a quantitative imaging biomarker that measures the fat fraction of tissue by correcting factors influencing magnetic resonance signal intensity.
| Percentage of fat | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| Change From Baseline in Magnetic Resonance Imaging-Proton Density-Fat Fraction (MRI-PDFF) | -4.37 ± 7.185 | -1.33 ± 5.356 | -0.95 ± 8.206 |
Collected over AEs, which included clinical laboratory test variables, were monitored and documented from the time the patient signed the ICF until Visit 10 (Week 54) or the Early Termination visit (if applicable).. Non-serious events are listed at a 3% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo | 1/91 (1.1%) | 4/91 (4.4%) | 82/91 (90.1%) |
| Icosabutate 300mg | 0/92 (0%) | 5/92 (5.4%) | 80/92 (87%) |
| Icosabutate 600mg | 1/95 (1.1%) | 8/95 (8.4%) | 80/95 (84.2%) |
| Event | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| CellulitisInfections and infestations | 0/91 | 0/92 | 2/95 |
| Coronavirus infectionInfections and infestations | 1/91 | 1/92 | 0/95 |
| Transient ischemic attackNervous system disorders | 1/91 | 0/92 | 1/95 |
| Post-procedural hematomaInjury, poisoning and procedural complications | 1/91 | 0/92 | 0/95 |
| Bladder transitional cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/91 | 0/92 | 0/95 |
| Abdominal painGastrointestinal disorders | 0/91 | 1/92 | 0/95 |
| DiarrheaGastrointestinal disorders | 0/91 | 1/92 | 0/95 |
| Intra-abdominal hematomaInfections and infestations | 0/91 | 1/92 | 0/95 |
| Food allergyImmune system disorders | 0/91 | 1/92 | 0/95 |
| DiverticulitisInfections and infestations | 0/91 | 0/92 | 1/95 |
| Event | Placebo | Icosabutate 300mg | Icosabutate 600mg |
|---|---|---|---|
| NauseaGastrointestinal disorders | 4/91 | 13/92 | 22/95 |
| DiarrheaGastrointestinal disorders | 13/91 | 13/92 | 15/95 |
| Urinary tract infectionGastrointestinal disorders | 8/91 | 13/92 | 9/95 |
| Coronavirus infectionInfections and infestations | 11/91 | 10/92 | 6/95 |
| Abdominal pain upperGastrointestinal disorders | 3/91 | 5/92 | 9/95 |
| ConstipationGastrointestinal disorders | 7/91 | 0/92 | 7/95 |
| HeadacheNervous system disorders | 7/91 | 4/92 | 6/95 |
| Type 2 diabetes mellitusMetabolism and nutrition disorders | 6/91 | 7/92 | 3/95 |
| Abdominal painGastrointestinal disorders | 6/91 | 5/92 | 3/95 |
| Diabetes mellitusMetabolism and nutrition disorders | 6/91 | 3/92 | 4/95 |
The Modified Intent-To-Treat (mITT) Population is used for the baseline analysis population as this was the primary population for efficacy analysis. The mITT Population included all patients from the ITT Population who had valid baseline and Week 52 (or ET, if applicable) liver biopsy measurements; a valid Week 52/ET liver biopsy was defined as a liver biopsy that had occurred within 90 days of last dose/Week 52 visit.
| Age, Continuous(years) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| Mean | 54.0 ± 11.15 | 53.3 ± 10.52 | 51.8 ± 10.26 | 53.0 ± 10.64 |
| Sex: Female, Male(Participants) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| Female | 52 | 55 | 51 | 158 |
| Male | 23 | 21 | 26 | 70 |
| Ethnicity (NIH/OMB)(Participants) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| Hispanic or Latino | 32 | 31 | 29 | 92 |
| Not Hispanic or Latino | 42 | 44 | 45 | 131 |
| Unknown or Not Reported | 1 | 1 | 3 | 5 |
| Race (NIH/OMB)(Participants) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 2 | 0 | 1 | 3 |
| Asian | 0 | 1 | 0 | 1 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 |
| Black or African American | 1 | 2 | 5 | 8 |
| White | 72 | 72 | 71 | 215 |
| More than one race | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 1 | 0 | 1 |
| Body mass index(kg/m^2) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| Mean | 35.94 ± 6.230 | 36.73 ± 5.732 | 37.32 ± 6.047 | 36.67 ± 6.006 |
| Alcohol use(Participants) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| Current | 44 | 40 | 40 | 124 |
| Former | 10 | 8 | 12 | 30 |
| Never | 20 | 28 | 25 | 73 |
| Missing | 1 | 0 | 0 | 1 |
| Type 2 Diabetes status(Participants) | Placebo | Icosabutate 300mg | Icosabutate 600mg | Total |
|---|---|---|---|---|
| Diabetic | 35 | 40 | 39 | 114 |
| Non-diabetic | 40 | 36 | 38 | 114 |
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NorthSea Therapeutics B.V.