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RecruitingNCT06582329EARTHUpdated Oct 9, 2026

Effect of Alpha-1 Antitrypsin Supplementation on Alcohol-Associated Hepatitis

A Phase 2 interventional study of Alfa1 Antitrypsin in Alcohol-Associated Hepatitis, sponsored by Medical University Innsbruck. Recruiting at 1 site in Austria. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-09.

Sponsored by Medical University Innsbruck · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2025; still recruiting 1 year 4 months later.
Updated Oct 9, 2026Now RecruitingSite recruiting status changed+2 moreGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
16
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The trial is designed as a prospective, single center, open label, randomized controlled pilot study evaluating the effect of A1AT (Alpha 1 Antitrypsin) on inflammation in patients with severe AAH (alcohol-associated hepatitis).

The objective is to evaluate the safety and the effect of intravenous A1AT on the systemic inflammation in patients with severe AAH. The objectives also include the assessment of A1AT on clinical outcomes including the incidence of adverse events (AEs) and serious adverse events (SAEs) and the cytokine.

Read the detailed description

About 5-7 % of patients with alcohol-associated chronic liver disease transform into acute on chronic liver disease (ACLF) per year. In patients with underlying alcohol-associated liver disease (ALD) and active drinking, a sudden onset of jaundice, malaise, decompensated liver disease and coagulopathy i.e. alcohol-associated hepatitis (AAH) might develop. In its severe form, AAH is associated with development of ACLF and bacterial infections and this disease exhibits a high short-term mortality of 20 to 50% within 3 months. Treatment options are limited currently, for instance, the use of corticosteroids.

Alpha-1 Antitrypsin (A1AT) acts as an anti-inflammatory protein by inhibiting the generation of pro-inflammatory cytokines. The investigators recently showed protective effects of A1AT in a pre-clinical experimental model of ALD, resulting in decreased levels of pro-inflammatory cytokines, less steatosis and hepatic injury. The investigators also have recently found that cirrhotic patients with A1AT concentrations less than 120 mg/dL had a significantly increased risk for death/liver transplantation in a cohort of 130 patients with ALD cirrhosis. This finding was not only significant, but also independent of the MELD-Na score, indicating that in ALD A1AT is not only a marker of reduced hepatic synthetic function. Further, significantly higher ferritin and lower transferrin in the cohort of patients with low A1AT also indicate more severe inflammation. An interventional analysis in an established mouse model of ALD showed that A1AT supplementation mitigated inflammation and histological changes further indicating that low AAT (Alpha 1 Antitrypsin) is a driver and not the consequence of tissue damage in ALD. These data support the use of A1AT in humans with severe AAH.

As a pilot trial the study also aims to establish important preliminary data for future studies and design of larger trials aimed at formal evaluation of the effect of A1AT on clinical endpoints.

02

Conditions studied

  • Alcohol-Associated Hepatitis

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03

In context

Hepatitis

343 studies on the registry are indexed under Hepatitis; 51 are open to participants now.

This study's planned enrollment of 16 is below the median of 85 across 245 interventional studies indexed under Hepatitis.

Browse Hepatitis studies →

Lead sponsor

Medical University Innsbruck is the lead sponsor of 186 studies on the registry; 47 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
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. Male or female patient ≥18 years of age at time of consent.
  2. Severe AAH (Maddrey's discriminant function score ≥ 32) at screening.
  3. No ACLF or ACLF Grade 1 at screening.
  4. Daily average intake of >80 g (men)/>60 g (women) ethanol during the past 3 months (patient reported).
  5. Understands and agrees to comply with the study procedures and provides written as documented by signature.
  6. Outpatient or hospitalized patient not being on the Intensive Care Unit (ICU) at screening.

    Inclusion criterion 7 only applies to women of (WOCBP)

  7. Negative urine pregnancy test, not breastfeeding \& agreement to use highly-effective means of during the study. Allowed are sexual abstinence, vasectomized partners (˃3 months previously-vasectomy has to be confirmed by two negative semen analyses) or the consistent and correct use of an approved contraceptive method in accordance with the product label, for example: Barrier method (such as condoms, diaphragm, or cervical cap) used in conjunction with spermicide; intrauterine device; prescription hormonal contraceptive taken or administered via oral (pill), transdermal (patch), subdermal, or intramuscular (IM) route Inclusion criterion 8 only applies to male patients
  8. Male patients who are sexually active with female partners of childbearing potential must agree to use a condom with spermicide and to use one other approved method of highly effective contraception from the time of product administration for at least 90 days after the dose of investigational product and must refrain from sperm donation from Screening through at least 90 days following the last dose of investigational product.
  9. Ability to speak and read German to a level which allows fully comprehending the meaning of everything that is said and written.

Exclusion criteria

Exclusion Criteria:

  1. Uncontrolled Diabetes Mellitus type 1 or 2 (defined by > 10%).
  2. use .
  3. Viral hepatitis, hepatitis, infection, Wilson disease, hemochromatosis, toxic liver injury, Primary Biliary Cholangitis (PBC), Primary Sclerosing Cholangitis (PSC).
  4. Participation in another interventional clinical study within 6 months prior to screening and/or during trial participation.
  5. Presence of any active (other than non-melanoma skin cancer) which required treatment within the past 12 months.
  6. Chronic kidney disease receiving dialysis.
  7. Do Not Attempt Resuscitation (DNAR) order in place.
  8. IgA deficiency (IgA level \<7mg/dL) or known intolerance to A1AT.
  9. History of liver transplantation or currently listed for liver transplant.
Terms in these criteria, in plain language(10)

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

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.

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.

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.

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.

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.

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.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
16 participants (estimated)

Study arms

  • No intervention
    standard of care

    Standard of care Prednisolon 40mg will be administered over 4 weeks

  • Experimental
    Standard of care + Alpha 1 Antitrypsin

    In the experimental arm the participants will receive Prolastin 120 mg/kg bodyweight and Prednisolon 40 mg over a time period of 4 weeks

    Drug: Alfa1 Antitrypsin

Interventions

  • Participants will be treated intravenously with A1AT 120 mg/kg bodyweight once a week for 4 weeks (4 total infusions).

06

What researchers measure

Primary outcomes

  1. Serum concentration of IL-6 (interleukin-6) assessed at Visit 2 (Day 8+/-1) in the intervention (A1AT in combination with standard-of-care) and control group (standard-of-care).

    The effect on the serum IL-6 concentration assessed after 1 week will be assessed at Visit 2 (Day 8+/-1) in the intervention (A1AT in combination with standard-of-care) and control group (standard-of-care).

    Time frame: at visit 2

Secondary outcomes

  1. Serum A1AT concentration assessed at visit 5 (Day 29+/-3)

    Time frame: at visit 5 (Day 29+/-3)

  2. Incidence of Adverse Events (AEs) from the baseline visit (Day 1) to end of study visit (Day 90+/-7)

    Time frame: up to 3 months

  3. Incidence of Serious Adverse Events (SAEs) from the baseline visit (Day 1) through to end of study visit (Day 90+/-7)

    Time frame: up to 3 months

  4. Chronic Liver Disease Questionnaire (CLDQ) overall and subscale scores.

    The response of CLDQ results in 1 to 7 scales, ranging from "all the time" to "none of the time". Higher scores indicate the minimum frequency of symptoms and therefore a better HRQL

    Time frame: up to 3 months

  5. CLDQ-D overall and subscale scores

    The response of CLDQ results in 1 to 7 scales, ranging from "all the time" to "none of the time". Higher scores indicate the minimum frequency of symptoms and therefore a better HRQL.

    Time frame: up to 3 months

Other outcomes

  1. Model for end-stage liver disease (MELD)

    The Model for End-Stage Liver Disease (MELD) is a numerical scale, ranging from 6 (you are less sick) to 40 (you are gravely sick), used for liver transplant candidates

    Time frame: up to 3 months

  2. The MELD-sodium (MELD-Na)

    MELD-Na Score adds sodium to the MELD model for liver cirrhosis. The Model for End-Stage Liver Disease (MELD) is a numerical scale, ranging from 6 (you are less sick) to 40 (you are gravely sick), used for liver transplant

    Time frame: up to 3 months

  3. Child-Pugh-Turcotte

    The score employs five clinical measures of liver disease. Each measure is scored 1-3, with 3 indicating most severe derangement. Chronic liver disease is classified into Child-Pugh class A to C, employing the added score from above. 5-6 points class A, 79 points class B, 10-15 points class C. Class A with the best outcome, class C with the most severe.

    Time frame: up to 3 months

  4. CLIF (Chronic Liver Failure)-C-AD (acute decompensation)

    The CLIF-C acute decompensation (AD) score is used to predict prognosis of patients with acute decompensation of cirrhosis who do not have acute-on-chronic liver failure (ACLF).

    Time frame: up to 3 months

  5. CLIF-C-OF (organ function)

    Each organ system is scored on a scale to generate the overall CLIF-C OF score, ranging from 0 to 18. A higher CLIF-C OF score translates into a higher ACLF grade.

    Time frame: up to 3 months

  6. CLIF-SOFA (Sequential Organ Failure Assessment) score

    The CLIF-SOFA score is calculated on a scale from 0 to 4, whereas 4 means the worst outcome

    Time frame: up to 3 months

  7. Maddrey's discriminant function

    Prospective studies have shown that it is useful in predicting short term prognosis, especially mortality within 30 days. A value more than 32 implies poor outcome

    Time frame: up to 3 months

  8. Time to hospital discharge

    Time frame: up to 3 months

  9. Time to re-hospitalization

    Time frame: up to 3 months

  10. Time to ICU admission

    Time frame: up to 3 months

  11. Liver-specific survival and transplant-free survival at End of Study Visit

    Time frame: up to 3 months

  12. Serum concentrations of IL-6

    Time frame: up to 3 months

07

Study locations

1 of 1 sites recruiting
08

Updates

1 registry update since Sep 25, 2026
Status
Not yet recruiting→Recruiting
changed Oct 9, 2026
Sites
Medical University Innsbruck is now Recruiting
Oct 9, 2026
Start date
Apr 2025→Jun 18, 2025 (actual)
Oct 9, 2026
Primary completion
Jul 2025→Dec 2026
Oct 9, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • Medical University Innsbruck · Innsbruck, AustriaContact added •••0504
Oct 9, 2026
Show all 1 update
  1. Oct 9, 2026
    Not yet recruiting→Recruiting
    Medical University Innsbruck is now Recruiting
    Start date Apr 2025→Jun 18, 2025 (now actual)
    Primary completion Jul 2025→Dec 2026
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Medical University Innsbruck · Innsbruck, AustriaContact added •••0504
    + 3 other changes: verification date, oversight details and index terms

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 ↗

09

Registry details

Key details

Study ID
NCT06582329
Responsible party
Sponsor
First posted
Sep 3, 2024
Start date
Jun 18, 2025
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Oct 9, 2026

Oversight

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

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