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RecruitingNCT05842512Updated Sep 23, 2025

Study of ADI-PEG 20 Versus Placebo in Subjects With NASH

A Phase 2 interventional study of ADI-PEG20 and Placebo in Nonalcoholic Steatohepatitis (NASH), sponsored by Polaris Group. Recruiting at 10 sites in Taiwan. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2025-09-23.

Sponsored by Polaris Group · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2023; still recruiting 3 years 1 month later.
Phase
Phase 2
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Evaluate efficacy and safety of ADI-PEG 20 in patients with NASH

Read the detailed description

The safety of ADI-PEG 20 will be assessed during the study through the reporting of adverse events (AEs), clinical laboratory tests, electrocardiogram (ECG), vital sign assessments, body weight, and concomitant medication usage.

An external Data Safety and Monitoring Committee (DSMB) that consists of two hepatologists and a statistician will review the safety of the study. The DSMB will convene after 10 subjects (approximately 5 per treatment group) have completed the Week 4 assessments. The DSMB will receive all reports of serious adverse events (SAEs) and convene as needed to monitor for safety.

The primary efficacy will be assessed via the absolute change from baseline in hepatic fat fraction measured by MRI-PDFF at Week 24.

02

Conditions studied

  • Nonalcoholic Steatohepatitis (NASH)

Keywords

  • Nonalcoholic Steatohepatitis (NASH)
  • Arginine
  • Arginine Deiminase
  • ADI-PEG 20
  • Pegargiminase
03

In context

Non-alcoholic Fatty Liver Disease

1,617 studies on the registry are indexed under Non-alcoholic Fatty Liver Disease; 324 are open to participants now.

This study's planned enrollment of 60 is close to the median of 60 across 1,176 interventional studies indexed under Non-alcoholic Fatty Liver Disease.

Browse Non-alcoholic Fatty Liver Disease studies →

Lead sponsor

Polaris Group is the lead sponsor of 20 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 80 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

  1. Males and non-lactating, pregnancy test negative females between 18 - 80 years of age with proven F1 - F4 (compensated cirrhosis, A, score ≤6) NASH. Limit F1 fibrosis to ≤ 20% of total subject population.
  2. Willingness to use appropriate measures throughout study treatment and for 90 days thereafter (see Appendix A).
  3. (BMI) > 23 kg/m2
  4. Must have confirmation of ≥ 5 % liver fat content on MRI-PDFF at screening.
  5. Biopsy-proven NASH confirmed by a central pathologist. Must have had a liver biopsy either during the screening period or a historical biopsy conducted within the last 6 months prior to pre-screening with fibrosis stage 1 to 4 (F score, F1-F4) and a non-alcoholic fatty liver disease (NAFLD) activity score (NAS) of ≥ 4 with at least a score of 1 in each of the following NAS components:

    1. Steatosis (scored 0 to 3),
    2. Ballooning degeneration (scored 0 to 2), and
    3. Lobular inflammation (scored 0 to 3).
  6. Must have no evidence of worsening of and AST (within 50%) measurements within 2 months prior to screening (-8 weeks) visits.
  7. Screening laboratory parameters, as determined by the central laboratory:

    1. Estimated (eGFR) ≥ 60 mL/min, as calculated by the equation;
    2. ≤ 9.5% (or serum fructosamine ≤ 381 μmol if HbA1c is unable to be resulted);
    3. ≥ 11 g/dL;
    4. ≤ 1.3, unless due to therapeutic anticoagulation;
    5. Direct ≤ 0.5 mg/dL;
    6. Total bilirubin ≤ 1.3 x (ULN), unless due to an alternate etiology such as Gilbert's syndrome or hemolytic anemia;
    7. Creatinine kinase \< 3 x ULN;
    8. count ≥ 150,000/μL;
    9. Serum triglyceride level ≤ 500 mg/dL;
    10. ALT \< 6 x ULN;
    11. AST \< 6 x ULN;
    12. ALP \< 2 x ULN.
  8. FibroScan® measurement > 7.0 kPa and \< 20.0 kPa.
  9. Subjects on non-insulin dependent diabetic, weight loss, or lipid-modifying medication(s) must be on stable dose(s) for at least 3 months prior to the diagnostic liver biopsy through randomization.
  10. Subjects on vitamin E and pioglitazone must maintain a stable dosage before the diagnostic liver biopsy and during the study period.

Exclusion criteria

Exclusion Criteria:

  1. Weight gain or loss > 5% in the 3 months prior to randomization or > 10% in the 6 months prior to screening.
  2. Type 1 and insulin-dependent Type 2 diabetes.
  3. Poorly controlled hypertension (blood pressure [BP] > 160/100 mmHg).
  4. Prior history of decompensated liver disease including ascites, hepatic encephalopathy (HE), or variceal bleeding.
  5. Chronic virus (HBV) infection (hepatitis B surface antigen [HBsAg] positive.
  6. Chronic virus (HCV) infection (HCV antibody [Ab] and HCV ribonucleic acid [RNA] positive). Subjects cured of HCV infection less than 1 year prior (based on date of RNA polymerase chain reaction [PCR] negative confirmation following conclusion of treatment) to the screening visit are not eligible.
  7. Prior or planned (during the study period) bariatric surgery (e.g., gastroplasty, roux-en-Y gastric bypass), surgery reversal or removal of intragastric balloon > 2 years prior to enrollment would be eligible.
  8. Other causes of liver disease based on medical history and/or centralized review of liver histology, including but not limited to alcoholic liver disease, disorders (e.g., primary biliary cholangitis [PBC], primary sclerosing cholangitis [PSC], autoimmune hepatitis), drug-induced hepatotoxicity, Wilson disease, iron overload, or alpha-1-antitrypsin deficiency requiring treatment.
  9. History of liver transplantation.
  10. Subjects with primary cancer, including co-existent second , with the exception of primary solid tumor with no known active disease present in the opinion of the Investigator which will not affect subject outcome in the setting of current diagnosis.
  11. Alcohol intake above an average limit of 2 drinks per day for women and 3 drinks per day for men. An alcoholic drink is defined as 12 ounces of regular beer, which is usually about 5% alcohol, 5 ounces of wine, which is typically about 12% alcohol, and 1.5 ounces of distilled spirits, which is about 40% alcohol.
  12. (HIV) infection.
  13. Unstable cardiovascular disease in the 6 months prior to screening.
  14. less than 2 years.
  15. Use of any medication within 30 days or within 5 half-lives of the investigational medication, whichever is longer, prior to screening and throughout the study is prohibited.
  16. Subjects with a history of (12 months prior to baseline) or current use of prescription drugs associated with liver steatosis (e.g., methotrexate, amiodarone, high-dose estrogen, tamoxifen, systemic , anabolic steroids, valproic acid) should be excluded. However, subjects currently using silymarin should maintain their current dosage throughout the trial period.
  17. of magnetic resonance imaging. These include but are not limited to devices or metal foreign bodies, such as Pacemaker, defibrillator or wires other than sternal wires, metallic foreign body in the eye, "triggerfish" contact lens, gastric reflux device, and insulin pumps.
  18. MELD score >12
  19. Subjects with esophageal or gastric varices with recent bleeding episodes (within 1 year).
Terms in these criteria, in plain language(23)

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.

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.

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.

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.

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.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

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.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

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.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

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.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

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
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Drug: ADI-PEG 20

    Dose: 36 mg/m2 given weekly Route of Administration: Intramuscular (IM)

    Drug: ADI-PEG20

  • Placebo comparator
    Drug: Placebo

    Dose: 36 mg/m2 given weekly Route of Administration: Intramuscular (IM)

    Other: Placebo

Interventions

  • Treatment for NASH

    Also known as: Pegargiminase

  • OtherPlacebo

    Treatment for NASH

06

What researchers measure

Primary outcomes

  1. Determine Efficacy of ADI-PEG 20 vs Placebo in the treatment of fatty liver as assessed by change in hepatic fat fraction

    Evaluate absolute change from baseline in hepatic fat fraction assessed by Magnetic Resonance Imaging - Proton Density Fat Fraction (MRI-PDFF) at Week 24

    Time frame: 24 Weeks

Secondary outcomes

  1. Assess the Efficacy of ADI-PEG 20 vs Placebo reflected in the percent change from baseline in hepatic fat fraction at week 24

    Evaluate percent change from baseline in hepatic fat fraction assessed by MRI-PDFF at Week 24

    Time frame: 24 Weeks

  2. Assess the safety of ADI-PEG 20 in subjects with NASH

    Evaluate the change from baseline in ALT at Weeks 12 and 24.

    Time frame: 24 Weeks

  3. Assess the safety and tolerability of ADI-PEG 20 in subjects with NASH

    Laboratory tests and clinical adverse events

    Time frame: 24 Weeks

07

Study locations

10 of 10 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 23, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05842512
Lead sponsor
Polaris Group
Responsible party
Sponsor
First posted
May 6, 2023
Start date
Sep 13, 2023
Primary completion
Dec 31, 2027 (estimated)
Completion
Jan 31, 2028 (estimated)
Last update
Sep 23, 2025

Study contacts

Silvia Lee
Contact
silvialee@polarispharma.com
02-2656-2727 ext. 142
John S Bomalaski
study director · Polaris Group

Oversight

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

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Studies of the drug tested here: Pegargiminase

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