LiFT 2: Low-energy treatment in compensated cirrhosis

  • Research type

    Research Study

  • Full title

    Safety signals and potential efficacy of a low-energy total diet replacement programme with behavioural support to delay disease progression in compensated cirrhosis due to non-alcoholic fatty liver disease: a feasibility randomised controlled trial

  • IRAS ID

    307043

  • Contact name

    Dimitrios Koutoukidis

  • Contact email

    dimitrios.koutoukidis@phc.ox.ac.uk

  • Sponsor organisation

    University of Oxford / Research Governance, Ethics and Assurance team

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    The build-up of fat in the liver can cause inflammation and scarring. This condition is called compensated cirrhosis due to non-alcoholic fatty liver disease (CC-NAFLD). It may require liver transplant and increases the risk of early death. It affects about 200,000 UK adults, most of whom also have obesity.

    No drug exists to treat CC-NAFLD. Weight loss programmes might improve CC-NAFLD, but only if they lead to large weight loss. One programme that could achieve this is a low-energy diet with professional support. People eat only soups and shakes for 16 weeks (~860 calories/day). Then, slowly over the next 8 weeks, they start eating regular food. The support helps people stick to the programme and develop healthier eating habits. We know people lose weight rapidly and lower their heart disease risk. This may also treat CC-NAFLD, but a concern exists that rapid weight loss may worsen liver scarring. Here we will test the programme in a few people with detailed monitoring of the health of their liver to see if this concern is a reality.

    We will recruit 24 adults with CC-NAFLD and excess weight. A computer will decide at random if patients continue with their care as usual (n=8) or are offered the programme (n=16). We will see whether enough patients will take part, stick to the programme, and return for follow-ups. We will examine whether the treatment appears to be safe at 2, 4, 16, and 24 weeks with blood tests. If there are signs of worsening, we will stop the treatment. At the start of the programme and at 24 weeks, we will also do a detailed liver scan. We will monitor changes in weight and physical function.

    With this information, we will plan a large trial to test whether this programme can delay progression of CC-NAFLD.

  • REC name

    South Central - Oxford B Research Ethics Committee

  • REC reference

    21/SC/0408

  • Date of REC Opinion

    23 Dec 2021

  • REC opinion

    Further Information Favourable Opinion