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Digoxin for Fatty Liver Disease (CODIN Trial)

Phase 2
Waitlist Available
Led By Bubu A Banini, MD, PhD
Research Sponsored by Yale University
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Biopsy-confirmed non-alcoholic steatohepatitis (NASH) as defined by the NASH clinical research network (NASH CRN) histological scoring system, with non-alcoholic fatty liver disease score (NAS) ≥4 and with a score ≥1 for each of the three components (steatosis, hepatocellular ballooning, and lobular inflammation) on a liver biopsy performed within 6 months of screening
Be older than 18 years old
Must not have
History or clinical evidence of cirrhosis or portal hypertension
Liver-related: Documented causes of chronic liver disease other than NASH
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 24 weeks

Summary

"This trial aims to find a new treatment for a liver condition called NASH, which affects many Americans. Current treatment involves lifestyle changes like weight loss and managing other health conditions. There is a need for

Who is the study for?
This trial is for individuals with a severe type of fatty liver disease called NASH, which can lead to fibrosis and cirrhosis. Participants should be looking for new treatments beyond lifestyle changes and management of related conditions like high blood pressure or diabetes.
What is being tested?
The CODIN trial is testing whether the heart medication digoxin can help treat NASH by protecting the liver and reducing fibrosis. Patients will either receive digoxin or a placebo (a pill without any active drug) to compare effects.
What are the potential side effects?
While low doses of oral digoxin have shown no adverse side effects in preliminary studies, potential side effects may include nausea, dizziness, irregular heartbeat, and other symptoms associated with its use in heart conditions.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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My liver biopsy confirms I have NASH with a NAS score of 4 or higher.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I have a history of cirrhosis or signs of high blood pressure in the liver.
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My chronic liver disease is not due to NASH.
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My heart rate was below 60 bpm at my first or second visit.
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I have a history of serious heart rhythm problems without a pacemaker.
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I understand and can follow the study's procedures.
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I have been diagnosed with severe aortic valve disease.
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I haven't had cancer, except for skin cancer or early-stage cancer, in the last 5 years.
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I am pregnant, breastfeeding, planning to become pregnant, or not using birth control.
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I consume less than the daily alcohol limit.
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I haven't taken drugs that affect liver fat for 30 days before signing consent or a liver biopsy.
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I have a history of an extra electrical pathway in my heart (like Wolf-Parkinson-White syndrome).
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I have been diagnosed with permanent atrial fibrillation.
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I am currently taking heart or muscle-related medications, calcium supplements, or disulfiram.
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My kidney function is severely reduced.
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I am currently taking calcium supplements, teriparatide, succinylcholine, or disulfiram.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~24 weeks
This trial's timeline: 3 weeks for screening, Varies for treatment, and 24 weeks for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Resolution of nonalcoholic steatohepatitis (NASH) without worsening of fibrosis
Secondary study objectives
Change in Magnetic resonance elastography (MRE)
Change in alanine aminotransferase (ALT)
Change in aspartate aminotransferase (AST)
+6 more

Side effects data

From 2018 Phase 4 trial • 178 Patients • NCT03136068
2%
hemmorhage
1%
pregnancy labor
1%
fever
1%
cramping
1%
severe nausea
1%
vomiting
100%
80%
60%
40%
20%
0%
Study treatment Arm
Digoxin
Placebo

Trial Design

3Treatment groups
Experimental Treatment
Placebo Group
Group I: Digoxin (weight-based)Experimental Treatment1 Intervention
Digoxin (weight-based) taken orally once daily. In the weight-based digoxin arm, the intervention will be oral digoxin 0.15mcg/kg/day.
Group II: Digoxin (titration-based)Experimental Treatment1 Intervention
Digoxin (titration-based) taken orally once daily. In this arm, the intervention will be administered dosed by weight and renal function using a well-studied digoxin nomogram.
Group III: PlaceboPlacebo Group1 Intervention
Placebo, taken orally once daily
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Digoxin
2017
Completed Phase 4
~670

Find a Location

Who is running the clinical trial?

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)NIH
2,432 Previous Clinical Trials
4,323,097 Total Patients Enrolled
50 Trials studying Non-alcoholic Fatty Liver Disease
9,554 Patients Enrolled for Non-alcoholic Fatty Liver Disease
Yale UniversityLead Sponsor
1,912 Previous Clinical Trials
3,039,328 Total Patients Enrolled
6 Trials studying Non-alcoholic Fatty Liver Disease
719 Patients Enrolled for Non-alcoholic Fatty Liver Disease
Bubu A Banini, MD, PhDPrincipal InvestigatorYale School of Medicine
~96 spots leftby Dec 2028