A Study to Test Whether Two Different Doses of Avenciguat Help People With Liver Cirrhosis and High Blood Pressure in the Portal Vein (Main Vessel Going to the Live
- Conditions
- Hypertension, Portal
- Interventions
- Drug: Avenciguat (BI 685509)Drug: Placebo matching Avenciguat (BI 685509)
- Registration Number
- NCT05161481
- Lead Sponsor
- Boehringer Ingelheim
- Brief Summary
This study is open to adults with liver cirrhosis and high blood pressure in the portal vein (main vessel going to the liver). The purpose of this study is to find out whether a medicine called Avenciguat helps people with this condition.
Participants are put into 3 groups randomly, which means by chance. Participants in 2 groups take different doses of Avenciguat as tablets twice a day. Participants in the placebo group take placebo as tablets twice a day. Placebo tablets look like Avenciguat tablets but do not contain any medicine.
Participants are in the study for about 8 months. During this time, they visit the study site about 14 times. At 3 of the visits, the doctors check the pressure in a liver vein. This is done with a catheter (a long thin tube) and gives information about the pressure in the portal vein. The change in blood pressure is then compared between the groups to see whether the treatment works.
The doctors also regularly check participants' health and take note of any unwanted effects.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 80
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Signed and dated written informed consent in accordance with International Council on Harmonisation-Good Clinical Practice (ICH-GCP) and local legislation prior to admission to the trial
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Male or female who is ≥ 18 (or who is of legal age in countries where that is greater than 18) and ≤ 75 years old at screening
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Clinical signs of Clinically Significant Portal Hypertension (CSPH) as described by either one of the points below. Each trial patient must have a gastroscopy during the screening period or within 6 months prior to screening.
- documented endoscopic proof of oesophageal varices and / or gastric varices at screening or within 6 months prior to screening
- documented endoscopic-treated oesophageal varices as preventative treatment
-
CSPH defined as baseline Hepatic Venous Pressure Gradient (HVPG) ≥ 10 mmHg, based on a local interpretation of the pressure tracing
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Diagnosis of compensated alcohol-related cirrhosis. Diagnosis must be based on histology (historical data is acceptable) or on clinical evidence of cirrhosis (e.g. platelet count < 150 x 10^9/L [150 x 10^3/µL], nodular liver surface on imaging or splenomegaly)
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Abstinence from significant alcohol misuse / abuse for a minimum of 2 months prior to screening, and the ability to abstain from alcohol throughout the trial (both evaluated based on Investigator judgement)
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Willing and able to undergo HVPG measurements per protocol (based on Investigator judgement)
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If receiving statins must be on a stable dose for at least 3 months prior to screening, with no planned dose change throughout the trial Further inclusion criteria apply.
- Previous clinically significant decompensation events (e.g. ascites [more than perihepatic ascites], Variceal Haemorrhage (VH) and / or apparent Hepatic Encephalopathy (HE))
- History of other forms of chronic liver disease (e.g. non-alcoholic steatohepatitis (NASH), Hepatitis B virus (HBV), untreated Hepatitis C Virus (HCV), autoimmune liver disease, primary biliary cholangitis, primary sclerosing cholangitis, Wilson's disease, haemachromatosis, alpha-1 antitrypsin (A1At) deficiency)
- Has received curative anti-viral therapy with direct-acting anti-virals within the last 2 years for HCV, or, if such treatment was > 2 years ago and there is no sustained virological response (SVR) at screening, or, must take curative anti-viral therapy with direct-acting anti-virals throughout the trial
- Alcohol-Related Liver Disease (ARLD) without adequate treatment (e.g. lifestyle modification) or with ongoing pathological drinking behaviour (misuse / abuse based on Investigator judgement)
- Must take, or wishes to continue the intake of, restricted concomitant therapy or any concomitant therapy considered likely (based on Investigator judgement) to interfere with the safe conduct of the trial
- Systolic Blood Pressure (SBP) < 100 mmHg and Diastolic Blood Pressure (DBP) < 70 mmHg at screening
- Model of End-stage Liver Disease (MELD) score of > 15 at screening, calculated by the central laboratory
- Hepatic impairment defined as a Child-Turcotte-Pugh score ≥ B8 at screening, calculated by the site, using central laboratory results Further exclusion criteria apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Avenciguat (BI 685509), dose group 2 Avenciguat (BI 685509) - Placebo Placebo matching Avenciguat (BI 685509) Placebo Avenciguat (BI 685509), dose group 1 Avenciguat (BI 685509) -
- Primary Outcome Measures
Name Time Method Percentage change in Hepatic Venous Pressure Gradient (HVPG) from baseline (measured in mmHg) after 24 weeks of treatment at baseline, at week 24
- Secondary Outcome Measures
Name Time Method Response defined as > 10% reduction from baseline HVPG (measured in mmHg) after 8 weeks of treatment at baseline, at week 8 Occurrence of Common Terminology Criteria for Adverse Events (CTCAE) grade 3 (or higher) hypotension or syncope based on Investigator judgement, during the first 8 weeks of the treatment period up to 8 weeks Occurrence of discontinuation due to hypotension or syncope during the 24 week treatment period up to 24 weeks Response defined as > 10% reduction from baseline HVPG (measured in mmHg) after 24 weeks of treatment at baseline, at week 24 Occurrence of discontinuation due to hypotension or syncope during the first 8 weeks of the treatment period up to 8 weeks Percentage change in HVPG from baseline (measured in mmHg) after 8 weeks of treatment at baseline, at week 8 Occurrence of one or more decompensation events (i.e. ascites, Variceal Haemorrhage (VH), and/or overt Hepatic Encephalopathy (HE)) during the 24 week treatment period up to 24 weeks Occurrence of CTCAE grade 3 (or higher) hypotension or syncope based on Investigator judgement, during the 24 week treatment period up to 24 weeks
Trial Locations
- Locations (45)
Kitasato University Hospital
🇯🇵Kanagawa, Sagamihara, Japan
Yokohama City University Hospital
🇯🇵Kanagawa, Yokohama, Japan
National Hospital Organization Yokohama Medical Center
🇯🇵Kanagawa, Yokohama, Japan
Osaka Metropolitan University Hospital
🇯🇵Osaka, Osaka, Japan
Soon Chun Hyang University Hospital Bucheon
🇰🇷Bucheon-si, Gyeonggi-do, Korea, Republic of
Yonsei University Wonju Severance Christian Hospital
🇰🇷Wonju-si, Gangwon State, Korea, Republic of
Leids Universitair Medisch Centrum (LUMC)
🇳🇱Leiden, Netherlands
ULS de Santa Maria, E.P.E
🇵🇹Lisboa, Portugal
Regional Institute of Gastroenterology Hepatology "Prof. Dr. O. Fodor"
🇷🇴Cluj-Napoca, Romania
Singapore General Hospital
🇸🇬Singapore, Singapore
Hospital Vall d'Hebron-Barcelona-47683
🇪🇸Barcelona, Spain
Hospital Ramón y Cajal
🇪🇸Madrid, Spain
Hospital Puerta de Hierro
🇪🇸Majadahonda, Spain
Ospedale Regionale di Lugano
🇨🇭Viganello, Switzerland
Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
St Mary's Hospital
🇬🇧London, United Kingdom
Queen Elizabeth Hospital Birmingham
🇬🇧Birmingham, United Kingdom
California Liver Research Institute
🇺🇸Pasadena, California, United States
Inland Empire Clinical Trials, LLC
🇺🇸Rialto, California, United States
Floridian Clinical Research-Miami Lakes-68368
🇺🇸Miami Lakes, Florida, United States
Northwell Health Center for Liver Disease
🇺🇸Manhasset, New York, United States
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
American Research Corporation at the Texas Liver Institute
🇺🇸San Antonio, Texas, United States
Hospital Italiano de Buenos Aires
🇦🇷Caba, Argentina
Medical University of Innsbruck
🇦🇹Innsbruck, Austria
AKH - Medical University of Vienna
🇦🇹Wien, Austria
Edegem - UNIV UZ Antwerpen
🇧🇪Edegem, Belgium
Centre Hospitalier de l'Universite de Montreal (CHUM)
🇨🇦Montreal, Quebec, Canada
Beijing Friendship Hospital
🇨🇳Beijing, China
Beijing Youan Hospital, Capital Medical University
🇨🇳Beijing, China
NanFang Hosptial
🇨🇳Guangzhou, China
The Affiliated Hospital of Hangzhou Normal University
🇨🇳Hangzhou, China
University Hospital Dubrava
🇭🇷Zagreb, Croatia
Hvidovre Hospital
🇩🇰Hvidovre, Denmark
HOP d'Angers
🇫🇷Angers, France
HOP Rangueil
🇫🇷Toulouse, France
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
🇩🇪Mainz, Germany
Universitätsklinikum Münster
🇩🇪Münster, Germany
St. Josefs-Hospital, Wiesbaden
🇩🇪Wiesbaden, Germany
Western Galilee Hospital
🇮🇱Nahariya, Israel
ASST Grande Ospedale Metropolitano Niguarda
🇮🇹Milano, Italy
Azienda Ospedaliera Policlinico di Modena
🇮🇹Modena, Italy
A.O. Univ. Policlinico "Paolo Giaccone"
🇮🇹Palermo, Italy
Poli Univ A. Gemelli
🇮🇹Roma, Italy
Shin-yurigaoka General Hospital
🇯🇵Kanagawa, Kawasaki, Japan