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CPAP · 1 trial · 2 indications
Cross-sectional analysis will be performed in NAFLD study participants from the Johns Hopkins (JH) Hepatology Clinic to examine the relationship between findings on liver biopsy and sleep apnea severity indices. The main predictor variable will be presence/severity of OSA and nocturnal oxyhemoglobin desaturation (assessed by T90%, time w/ oxyhemoglobin desaturation \< 90%; Delta SaO2 between baseline and minimal oxyhemoglobin saturation, and standard deviation of nocturnal SaO2). Our primary outcome will be NAFLD activity score on biopsy.
| Arm | Type | Description |
|---|---|---|
| CPAP | EXPERIMENTAL | Patients with moderate to severe apnea will be randomized to CPAP or deferred CPAP. Those in the CPAP group will be sent home with an autoset CPAP device, which they will be instructed to utilize for 4 months. The CPAP device will be set in the "auto mode" so that it will automatically adjust the pressure at night to eliminate upper airway obstruction during sleep. Criteria for OSA severity are specifically designed to target patients with nocturnal hypoxemia, which is hypothesized to contribute to NAFLD progression. According to the guidelines of the American Academy of Sleep Medicine, apnea will be defined as cessation of airflow for ≥ 10 sec. and hypopnea will be defined as decreased airflow for ≥ 10 sec. leading to oxyhemoglobin desaturation ≥ 4%. Mild, moderate and severe OSA will be diagnosed by an Apnea-Hypopnea Index (AHI) of 5-14.9, 15-29.9, and ≥ 30 events/hr, respectively. |
| Name | Type | Description |
|---|---|---|
| CPAP (ResMed S9 autoset CPAP) | DEVICE | A ResMed S9 autoset CPAP device will be utilized throughout the study. Throughout the study intervention period, subjects (for AHI\> 15) will be instructed to utilize their CPAP and adherence will be monitored using an automatic meter that is built into the CPAP device. |
Inclusion Criteria: * Age ≥ 21 * Diagnosis of NAFLD and BMI ≥ 30 or obesity with BMI \> 35 and \< 400lbs * No other cause of liver disease other than NAFLD (as assessed by patient and physician surveys detailed below, blood work and magnetic resonance imaging(MRI)) Exclusion Criteria: Both patien...
CPAP is being studied for use in Non Alcoholic Fatty Liver Disease (NAFLD), specifically in patients who also have obstructive sleep apnea. It is a continuous positive airway pressure therapy that is being evaluated for its effects on liver health in this population.
CPAP is developed by ResMed Inc., a company publicly traded under the ticker symbol RMD. ResMed is conducting clinical research to evaluate the therapy's potential in treating Non Alcoholic Fatty Liver Disease.
CPAP is in Phase 2 clinical development for Non Alcoholic Fatty Liver Disease. It has completed one Phase 2 trial, and the therapy remains investigational for this indication, meaning it is not yet approved for this use.
CPAP has one completed clinical trial, NCT01482065, titled "The Sleep, Liver Evaluation and Effective Pressure Study." This Phase 2 study enrolled 40 participants with Non Alcoholic Fatty Liver Disease and obstructive sleep apnea in the United States.
CPAP is not FDA approved for Non Alcoholic Fatty Liver Disease. It is an investigational therapy for this indication, currently in Phase 2 clinical development. The completed trial NCT01482065 provides data on its effects, but regulatory approval has not been granted.