A Phase 2 Dose Ranging, Randomized, Double Blind, Placebo-Controlled Study Evaluating the Safety, Tolerability, Pharmacokinetics and Efficacy of EDP-305 in Subjects with Primary Biliary Cholangitis (PBC) with or without an Inadequate Response to Ursodeoxycholic Acid (UDCA)
- Conditions
- Primary Biliary Cholangitis10019654
- Registration Number
- NL-OMON48564
- Lead Sponsor
- Enanta Pharmaceuticals, Inc.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- Not specified
- Target Recruitment
- 5
Each subject must meet all of the following criteria to be enrolled into this study:
1. An informed consent document must be signed and dated by the subject
2. Male and female subjects of any ethnic origin between the ages of 18 and 75 years, inclusive
3. Male or female with a diagnosis of PBC by at least two of the following criteria:
* History of ALP above ULN for at least 6 months
* Positive Anti-Mitochondrial Antibodies (AMA) titers (>1/40 on immunofluorescence or M2 positive by enzyme linked immunosorbent assay [ELISA] or positive PBC-specific antinuclear antibodies [PBC-ANAb])
* Documented liver biopsy result consistent with PBC (with no cirrhosis)
4. For subjects with no documented liver biopsy performed within 2 years, subjects must undergo a transient elastography (Fibroscan) showing liver stiffness <14.0 kPA
5. Must be on a stable dose of UDCA 12-20 mg/kg/day for at least 6 months prior to Screening or intolerant of UDCA in the opinion of the Investigator (no UDCA for at least 12 weeks prior to Screening)
6. Alkaline Phosphatase (ALP) *1.67 × ULN and/or total bilirubin >ULN but <2 × ULN (<2.4 mg/dL)
7. Subjects must have Screening laboratory values for Hepatitis B surface antigen (HBsAg), anti-HCV antibodies and HCV RNA negative, and Human Immunodeficiency Virus (HIV) 1 and 2 antibodies (Ab) as seronegative. NOTE: Subjects previously infected by chronic hepatitis C and treated with direct acting antivirals (DAAs) with sustained virologic response (SVR) for at least 3 years will be allowed.
8. Female subjects of childbearing potential must agree to use two effective methods of contraception from the date of Screening until 90 days after the last dose of EDP-305. Effective methods of contraception are defined as:
* a condom for the male partner and at least one of the following for the female participant:
o Intrauterine device
o Oral, injectable, implantable, transdermal, or intravaginal hormonal contraceptive Note: The above does not apply to female subjects of non-childbearing potential (ie, physiologically incapable of becoming pregnant) defined as:
- has had a complete hysterectomy greater than or equal to 3 months prior to dosing or
- has had a bilateral oophorectomy (ovariectomy) or
- has had a bilateral tubal ligation or fallopian tube inserts or
- is postmenopausal (a demonstration of a total cessation of menses for *1 year with an FSH level of >35 mIU/mL).
9. All male participants who have not had a vasectomy must use effective contraception from Day -1 to 90 days after their last dose of study drug. Effective contraception is defined as a condom and spermicide for the male, or condom and at least one of the following for a female partner:
* Intrauterine device
* Oral, injectable, implantable, transdermal, or intravaginal hormonal contraceptive
* Be of non-childbearing potential
10. Male subjects must agree to refrain from sperm donation from the date of Screening until 90 days after their last dose of study drug
11. Screening body mass index (BMI) of *18 kg/m2
12. Subject must be willing and able to adhere to the assessments, visit schedule, prohibitions and restrictions, as described in this protocol
Subjects who meet any of the following criteria will be excluded from this study:
1. Laboratory Screening Results:
* AST >5 × ULN
* ALT >5 × ULN
* Patients with Gilbert*s syndrome will not be allowed due to interpretability of bilirubin levels
* Total white blood cells (WBC) <3000 cells/mm3
* Absolute neutrophil count (ANC) <1500 cells/mm3
* Platelet count <140,000/mm3
* Prothrombin time (international normalized ratio, INR) >1.2
* Serum creatinine >2 mg/dL or clearance creatinine <60 mL/min (based on Cockroft- Gault Method)
2. Suspected to have relevant nonalcoholic fatty liver disease (NAFLD) as based on the judgment of the Investigator at Screening
3. Known history of alpha-1-Antitrypsin deficiency
4. Use of immunosuppressants known to have an effect on the liver of patients with PBC (eg, colchicine, methotrexate, or azathioprine) in the 3 months preceding Screening.
5. Current use of fibrates, including fenofibrates. NOTE: Subjects who discontinued fibrates for at least 3 months before Screening can participate
6. Use of an experimental treatment for PBC within the past 6 months
7. Prior use and/or concomitant treatment with OCA
8. Use of experimental or unapproved drugs within 1 year of Screening
9. Any other condition(s) that would compromise the safety of the subject or compromise the quality of the clinical study, as judged by the Principal Investigator (PI)
10. Pregnant or nursing females
11. Recipients of liver or other organ transplantation or anticipated need for orthotropic organ transplantation in one year as determined by a Model for End-Stage Liver Disease (MELD) Score *15
12. Co-existing liver or biliary diseases, such as primary sclerosing cholangitis,
choledocholithiasis, acute or chronic hepatitis, autoimmune hepatitis, alcoholic liver disease, nonalcoholic steatohepatitis (NASH), acute infection of bile duct system or gall bladder, history of gastrointestinal bleeding (secondary to portal hypertension), cirrhosis, cholangiocarcinoma diagnosed or suspected liver cancers
13. Cirrhosis with or without complications, including history or presence of: spontaneous bacterial peritonitis, hepatocellular carcinoma
14. Hepatorenal syndrome (type I or II) or Screening serum creatinine >2 mg/dL (178 *mol/L)
15. Prior variceal hemorrhage, uncontrolled encephalopathy, Child-Pugh Class A, B and C, esophageal varices, or refractory ascites within the previous 6 months of Screening (defined as date informed consent signed)
16. Patients with a history of severe pruritus requiring current or prior systemic treatment (e.g., with BAS or rifampicin)
17. Medical conditions that may cause non-hepatic increases in ALP (e.g., Paget's disease)
18. Any condition possibly affecting drug absorption (eg, gastrectomy <3 years prior to Screening). NOTE: Subjects who have undergone gastric surgeries known to not affect drug absorption such as gastric band or gastric sleeve will be allowed if they are stable for at least 1 year prior to Screening.
19. History of regular alcohol consumption exceeding 14 drinks/week for females and
21 drinks/week for males within 6 months of Screening. One drink is defined as 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of hard liquor)
20. Participation in a clinical trial within 30 days prior to study drug administration
21. Clinically significant electrocardi
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <p>* Proportion of subjects with at least 20% reduction in ALP from pretreatment<br /><br>value or normalization of ALP at Week 12</p><br>
- Secondary Outcome Measures
Name Time Method