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A study to compare norursodeoxycholic acid with placebo in the treatment of primary sclerosing cholangitis

Phase 1
Conditions
Primary Sclerosing Cholangitis (PSC) is a slowly progressing chronic cholestatic liver disease of assumed autoimmune, but finally unidentified etiology, characterized by a chronic inflammatory and fibro-obliterative destruction of extra-, and intrahepatic bile ducts. The disease is characterized by diffuse inflammation, fibrosis, and strictures of the intra- and/or extrahepatic bile ducts with an impaired biliary secretion of potentially aggressive bile fluid often leading to cirrhosis.
MedDRA version: 20.1 Level: LLT Classification code 10036732 Term: Primary sclerosing cholangitis System Organ Class: 100000004871
Therapeutic area: Diseases [C] - Digestive System Diseases [C06]
Registration Number
EUCTR2016-003367-19-FR
Lead Sponsor
Dr. Falk Pharma GmbH
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
Not specified
Target Recruitment
300
Inclusion Criteria

1. Signed informed consent.
2. Males or females.
3. Verified PSC.
4. Liver biopsy available.
5. If pre-treated with ursodeoxycholic acid (UDCA), then stable UDCA dose for = 3 months prior to baseline and must not have exceeded 20 mg/kg/d.
6. Alkaline Phosphatase > 1.5 x upper limit of normal (ULN) at baseline.
7. PSC patients with or without Inflammatory Bowel Disease (IBD; patients without a definite diagnostic exclusion of IBD need a colonoscopy with segmental biopsy prior to the baseline visit)
8. Women of child-bearing potential, i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile, who are sexually active have to apply a highly effective method of birth control with a low failure rate (i.e., less than 1% per year) when used constantly and correctly such as combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal or transdermal), progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable or implantable), intrauterine device (IUD), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion, vasectomized partner, or sexual abstinence, throughout the treatment period and for four weeks following the last dose of study treatment. Hormonal methods other than levonorgestrel containing devices or medroxyprogesterone injections should be supplemented with use of a male condom. Women of non-childbearing potential may be included if surgically sterile or post-menopausal for at least 2 years. The investigator is responsible for determining whether the patient has this adequate birth control for study participation.
Are the trial subjects under 18? yes
Number of subjects for this age range: 50
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 200
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 50

Exclusion Criteria

1. History or presence of other concomitant liver diseases
4. Secondary causes of Sclerosing Cholangitis.
11. Total bilirubin > 4.0 mg/dl (> 68 µmol/L) at screening or baseline.
13. Any known relevant infectious disease (e.g., active tuberculosis, AIDS defining diseases).14. Abnormal renal function.
15. Thyroid-stimulating hormone (TSH) > ULN at screening.
17. Any active malignant disease.
18. Known intolerance/hypersensitivity to study drug, or drugs of similar chemical structure or pharmacological profile.
19. Well-founded doubt about the patient’s cooperation.
20. Existing or intended pregnancy or breast-feeding.
21. Participation in another clinical trial within the last 30 days.
22. Patients who have an absolute contraindication for liver biopsy.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: To show the superiority of norursodeoxycholic acid (norUDCA) compared to placebo in the treatment of Primary Sclerosing Cholangitis (PSC) with regard to prevention of disease progression.;<br> Secondary Objective: To study safety and tolerability (Adverse Events, laboratory parameters) of norUDCA,<br> To assess quality of life.<br> ;<br> Primary end point(s): Partial normalization of s-ALP and no worsening of disease stage.<br> <br> ;Timepoint(s) of evaluation of this end point: Visit 2 and Visit 14
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): Secondary endpoints with regard to liver stiffness, fibrosis stage, liver histology, s-ALP levels, dominant strictures, quality of life;Timepoint(s) of evaluation of this end point: week 96
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