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RecruitingNCT04858412Updated Sep 25, 2026

Study of HMB-enriched Amino Acid Supplementation in Patients With Alcoholic Liver Disease and COVID-19

An interventional study of β-hydroxy β-methyl butyrate (HMB) enriched amino acid and Balanced amino acid in Alcoholic Liver Disease and COVID 19 Pneumonia, sponsored by The Cleveland Clinic. Recruiting at 1 site in United States. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2026-09-25.

Sponsored by The Cleveland Clinic · Not applicable, Interventional, and Basic science

From the registry’s dates

  • Started Apr 2021; still recruiting 5 years 7 months later.
Updated Sep 25, 2026Primary completion movedStudy completion movedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
21 Years and older
Sex
All
01

Study summary

Patients with COVID-19 and comorbidities including alcohol associated liver disease (ALD) are at risk for severe illness and abrupt or sudden clinical deterioration with ventilatory failure. â-hydroxy â-methyl butyrate (HMB), a non-nitrogenous leucine metabolite with anabolic properties, increases muscle mass and contractile function and enhances immune function. We aim to study the natural course of COVID-19 in patients with ALD and test whether HMB can affect ventilatory deterioration and improve short and long-term morbidity, mortality, and recovery from critical illness in symptomatic COVID-19 patients with ALD.

02

Conditions studied

  • Alcoholic Liver Disease
  • COVID 19 Pneumonia
03

In context

Liver Diseases, Alcoholic

73 studies on the registry are indexed under Liver Diseases, Alcoholic; 24 are open to participants now.

This study's planned enrollment of 48 is below the median of 85 across 43 interventional studies indexed under Liver Diseases, Alcoholic.

Browse Liver Diseases, Alcoholic studies →

Lead sponsor

The Cleveland Clinic is the lead sponsor of 831 studies on the registry; 119 are open to participants now.

Of its 90 completed or terminated interventional studies of FDA-regulated products, 73 (81%) have results posted.

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

04

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

A. Cases: Patients with ALD and COVID-19 pneumonia:

  1. Clinical, imaging, laboratory, and/or histological diagnosis of alcoholic cirrhosis and/or alcoholic hepatitis
  2. score 5-8, serum creatinine \<3, Model for End Stage Liver Disease score (MELD) \<25
  3. Diagnosis of COVID-19 pneumonia as defined by the WHO criteria: confirmed SARS-CoV-2 infection by PCR, evidence of bilateral pulmonary infiltrates on chest radiograph (CXR) or computed tomography (CT) and SpO2 \<93% or on oxygen supplement
  4. Age of 21 years or older

B. Controls: Patients without alcoholic liver disease (Non-ALD) and COVID-19 pneumonia:

  1. Diagnosis of COVID-19 pneumonia as defined by the WHO criteria: confirmed SARS-CoV-2 infection by PCR, evidence of bilateral pulmonary infiltrates on chest radiograph (CXR) or computed tomography (CT) and SpO2 \<93% or on oxygen supplement
  2. Age of 21 years or older

Exclusion Criteria: (Both Cases and Controls)

  1. Patients requiring active ventilator support
  2. Anticoagulant/antiplatelet therapy (for those in the arm, see Randomization schema. If clinically feasible, patients will be asked to hold their anticoagulants for the muscle biopsy after physician review),
  3. Recent gastrointestinal bleeding (\<3 months)
  4. Advanced organ diseases: congestive heart failure ( class 3 and 4), chronic obstructive pulmonary diseases () (GOLD stage 3 and 4), chronic kidney disease (Cr>3),
  5. Medications that alter muscle protein metabolism except systemic
  6. Pregnancy
  7. Unwillingness/ Inability to sign
Terms in these criteria, in plain language(8)

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.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

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.

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.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

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.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
48 participants (estimated)

Study arms

  • Active comparator
    HMB enriched amino acid arm

    The patients randomized to the HMB enriched amino acid (HMB/EAA) arm will be given HMB/EAA for 90 days.

    Dietary Supplement: β-hydroxy β-methyl butyrate (HMB) enriched amino acid

  • Placebo comparator
    Balanced amino acid arm

    The patients randomized to the Balanced amino acid (BAA) arm will be given BAA for 90 days.

    Dietary Supplement: Balanced amino acid

Interventions

  • β-hydroxy β-methyl butyrate (HMB) is a non-nitrogenous leucine metabolite with anabolic properties.

  • Dietary supplementBalanced amino acid

    Balanced amino acid is the balanced mixture of the various essential amino acids.

06

What researchers measure

Primary outcomes

  1. Change in skeletal muscle mass at Day 0 and Day 90

    Time frame: Baseline and Day 90

  2. Number of hospital admissions between Day 0 and Day 90

    Time frame: Baseline and Day 90

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it moved

Started Apr 2021 (actual). Primary completion is estimated for Dec 2028, 92 months after the start.

Since we started tracking on Sep 25, 2026, the dates moved once, on Sep 25, 2026: primary completion Dec 2026 → Dec 2028 and completion Dec 2026 → Dec 2028.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Apr 21, 2021
First posted
Apr 26, 2021
StartActual
Apr 1, 2021
Primary completionEst.
Dec 31, 2028was Dec 2026
CompletionEst.
Dec 31, 2028was Dec 2026
Last update
Sep 25, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
Dec 31, 2026→Dec 31, 2028
Sep 25, 2026
Study completion
Dec 31, 2026→Dec 31, 2028
Sep 25, 2026
Show all 1 update
  1. Sep 25, 2026
    Primary completion Dec 31, 2026→Dec 31, 2028
    Study completion Dec 31, 2026→Dec 31, 2028
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT04858412
Responsible party
Srinivasan Dasarathy (Staff, The Cleveland Clinic) — Principal investigator
First posted
Apr 26, 2021
Start date
Apr 1, 2021
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Sep 25, 2026

Study contacts

Annette Bellar, MSLA
Contact
bellara@ccf.org
216-445-0688
Alina Tuladhar, MPH
Contact
tuladha@ccf.org
216-445-6268
Srinivasan Dasarathy, MD
principal investigator · Staff

Oversight

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

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