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RESPONSE: Response to Seladelpar in Subjects With Primary Biliary Cholangitis (PBC) and an Inadequate Control to or an Intolerance to Ursodeoxycholic Acid (UDCA)

Phase 3
Completed
Conditions
Primary Biliary Cholangitis
Interventions
Registration Number
NCT04620733
Lead Sponsor
CymaBay Therapeutics, Inc.
Brief Summary

The purposes of this study are to evaluate the treatment effect of seladelpar on composite biochemical improvement in cholestasis markers based on ALP and total bilirubin and to evaluate the safety of seladelpar over 12 months of treatment compared to placebo.

The study also checked the effect of treatment on the symptoms of PBC, including pruritus.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
193
Inclusion Criteria
  • Must have given written informed consent (signed and dated) and any authorizations required by local law.

  • Male or female with a definitive diagnosis of primary biliary cholangitis (PBC).

  • Ursodeoxycholic acid (UDCA) for the past 12 months (stable dose for >3 months prior to screening) or intolerant to UDCA (last dose of UDCA >3 months prior to screening).

  • Laboratory parameters measured by the Central Laboratory at screening:

    • Alkaline phosphatase (ALP) ≥1.67× ULN (upper limit of normal)
    • Aspartate aminotransferase (AST) ≤3× ULN
    • Alanine aminotransferase (ALT) ≤3× ULN
    • Total bilirubin ≤2× ULN
    • Estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m^2 (calculated by the Modification of Diet in Renal Disease study equation).
    • International normalized ratio (INR) below 1.1× ULN (For individuals on anticoagulation therapy, INR must be maintained in the range required for prophylaxis for their specific disease).
    • Platelet count ≥100 ×10^3/µL.
  • Females of reproductive potential must use at least 1 barrier contraceptive and a second effective birth control method during the study and for at least 90 days after the last dose. Male individuals who are sexually active with female partners of reproductive potential must use barrier contraception, and their female partners must use a second effective birth control method during the study and for at least 90 days after the last dose.

Key

Exclusion Criteria
  • Previous exposure to seladelpar (MBX-8025).

  • A medical condition other than PBC that, in the investigator's opinion, would preclude full participation in the study (e.g., cancer) or confound its results (e.g., Paget's disease, any active infection).

  • Advanced PBC as defined by the Rotterdam criteria (albumin below the lower limit of normal and total bilirubin above 1.0 × ULN).

  • Presence of clinically important hepatic decompensation, including the following:

    • History of liver transplantation, current placement on liver transplantation list, or current Model for End-Stage Liver Disease (MELD) score ≥12. For individuals on anticoagulation medication, evaluation of the baseline INR, in concert with their current dose adjustments of their anticoagulant medication, will be taken into account when calculating the MELD score. This will be done in consultation with the medical monitor.
    • Complications of portal hypertension, including known esophageal varices, history of variceal bleeds or related interventions (e.g., transjugular intrahepatic portosystemic shunt placement), ascites, and hepatic encephalopathy.
    • Cirrhosis with complications, including history or presence of spontaneous bacterial peritonitis, hepatocellular carcinoma, or hepatorenal syndrome.
  • Other chronic liver diseases:

    • Current features of autoimmune hepatitis (AIH) as determined by the investigator based on immunoserology, liver biochemistry, or historic confirmed liver histology.
    • PSC determined by the presence of diagnostic cholangiographic findings.
    • History or clinical evidence of alcoholic liver disease.
    • History or clinical evidence of alpha-1-antitrypsin deficiency.
    • History of biopsy confirmed nonalcoholic steatohepatitis (NASH).
    • History or evidence of Gilbert's syndrome with elevated total bilirubin.
    • History or evidence of hemochromatosis.
    • Hepatitis B, defined as the presence of hepatitis B surface antigen.
    • Hepatitis C, defined as the presence of hepatitis C virus ribonucleic acid.
    • History, evidence, or high suspicion of hepatobiliary malignancy based on imaging, screening laboratory values, and/or clinical symptoms.
  • Known history of human immunodeficiency virus (HIV) or positive antibody test at screening

  • Clinically important alcohol consumption, defined as more than 2 drink units per day (equivalent to 20 g) in women and 3 drink units per day (equivalent to 30 g) in men, or inability to quantify alcohol intake reliably.

  • History of malignancy diagnosed or treated, actively or within 2 years, or ongoing evaluation for malignancy; localized treatment of squamous or noninvasive basal cell skin cancers and cervical carcinoma in situ is allowed if appropriately treated prior to screening.

  • Treatment with obeticholic acid (OCA) or fibrates (e.g., bezafibrate, fenofibrate, elafibranor, lanifibranor, pemafibrate, saroglitizar) 6 weeks prior to screening.

  • Treatment with colchicine, methotrexate, azathioprine, or long-term systemic corticosteroids (>2 weeks) during 2 months prior to screening

  • Treatment with anti-pruritic drugs (e.g., cholestyramine, naltrexone, rifampicin, sertraline, or any experimental approach) must be on a stable dose within 1 month prior to screening

  • Treatment with any other investigational therapy or device within 30 days or within 5 half-lives, whichever is longer, prior to screening

  • For females, pregnancy or breastfeeding.

  • Any other condition(s) that would compromise the safety of the individual or compromise the quality of the clinical study, as judged by the investigator.

  • Immunosuppressant therapies.

  • Other medications that effect liver or gastrointestinal (GI) functions, such as absorption of medications or the roux-en-y gastric bypass procedure, may be prohibited and should be discussed with the medical monitor on a case-by-case basis.

  • Active Coronavirus Disease-2019 (COVID-19) infection during Screening.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SeladelparSeladelpar 5 mgParticipants will receive seladelpar 10 mg (or 5 mg down-titrated, for those participants who met specific safety monitoring criteria or had tolerability issues), orally, once daily, for a duration of up to 12 months.
SeladelparSeladelpar 10 mgParticipants will receive seladelpar 10 mg (or 5 mg down-titrated, for those participants who met specific safety monitoring criteria or had tolerability issues), orally, once daily, for a duration of up to 12 months.
PlaceboPlaceboParticipants will receive placebo to match seladelpar, orally, once daily, for a duration of up to 12 months.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Response Criteria for the Composite Endpoint of ALP <1.67 × Upper Limit of Normal (ULN), ≥15% Reduction in ALP, and Total Bilirubin ≤ 1.0× ULN at Month 12Month 12

Percentages were rounded-off.

Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEsFirst dose date up to last dose plus 30 days (up to 13.4 months)

Percentages were rounded-off.

Percentage of Participants With Shift of ≥ 2 CTCAE Grades From Baseline in Treatment-emergent Laboratory Abnormalities Related to Hematology and Select Liver BiochemistryFirst dose date up to last dose (up to 13.4 months)

Treatment-emergent graded laboratory abnormalities were defined as values that increase at least 2 toxicity grade from baseline at any time post baseline. The laboratory abnormalities were graded using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), where Grade 1: mild, Grade 2: moderate, Grade 3: severe, Grade 4: potentially life-threatening laboratory abnormality.

The data is reported for shift of ≥ 2 grades from baseline in values for hematology and select liver biochemistry. Hematology includes parameters like RBCs, (erythrocytes), hemoglobin, hematocrit, platelets, WBC, WBC differentials (absolute and percentage) including basophils, neutrophils, lymphocytes, eosinophils, and monocytes, etc. Biochemistry included select liver function tests like blood bilirubin, gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase. Percentages were rounded-off.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Weekly Averaged Pruritus Numerical Rating Scale (NRS) in Participants With NRS ≥ 4 at Month 6Baseline, Month 6

Pruritus NRS is used to rate the intensity of the itching experienced by the participants in the past 24 hours from no itching to worst possible itching by selecting a number from 0 to 10 on Itch Scale. Zero means no itching and 10 means worst imaginable itching.

Percentage of Participants With ALP ≤1.0× ULN at Month 12Month 12

Percentages were rounded-off.

Trial Locations

Locations (134)

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Consultorio de la Doctora Maria Sarai Gonzalez Huezo

🇲🇽

Metepec, Mexico

UPMC Center for Liver Diseases

🇺🇸

Pittsburgh, Pennsylvania, United States

Digestive Healthcare of Georgia

🇺🇸

Atlanta, Georgia, United States

Mercy Medical Center

🇺🇸

Baltimore, Maryland, United States

University of Chicago Hospitals

🇺🇸

Chicago, Illinois, United States

University Health Network

🇨🇦

Toronto, Ontario, Canada

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

American Research Corporation at the Texas Liver Institute

🇺🇸

San Antonio, Texas, United States

Pinnacle Clinical Research, PLLC

🇺🇸

San Antonio, Texas, United States

Schiff Center for Liver Diseases/University of Miami

🇺🇸

Miami, Florida, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Universitätsklinikum des Saarlandes

🇩🇪

Homburg, Saarland, Germany

California Pacific Medical Center - Sutter Pacific Medical Foundation

🇺🇸

San Francisco, California, United States

Vanderbilt Digestive Disease Center

🇺🇸

Nashville, Tennessee, United States

DIM CliniaPrivada

🇦🇷

Ramos Mejía, Buenos Aires, Argentina

The Institute for Liver Health DBA Arizona Liver Health

🇺🇸

Chandler, Arizona, United States

Hospital Italiano de Buenos Aires

🇦🇷

Caba, Argentina

Somogy Megyei Kaposi Mor Oktato Korhaz

🇭🇺

Kaposvár, Hungary

Liver Unit

🇮🇱

Jerusalem, Israel

Fundeni Clinical Institute

🇷🇴

Bucharest, Romania

LLC Medical Company "Hepatolog"

🇷🇺

Samara, Russian Federation

University of Zurich, Gastroenterology and Hepatology

🇨🇭

Zürich, Switzerland

Queen's Medical Centre

🇬🇧

Nottingham, Nottinghamshire, United Kingdom

AZ Maria Middelares

🇧🇪

Gent, Oost-Vlaanderen, Belgium

Stavropol state medical university

🇷🇺

Stavropol, Russian Federation

University Hospitals Plymouth NHS Trust

🇬🇧

Plymouth, Devon, United Kingdom

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

Arkansas Diagnostic Center

🇺🇸

Little Rock, Arkansas, United States

Centro Clinico Mediterraneo

🇨🇱

La Serena, Coquimbo, Chile

Semmelweis Egyetem

🇭🇺

Budapest, Hungary

STAT Research S.A.

🇦🇷

Ciudad Autonoma de Buenos Aire, Buenos Aires, Argentina

CINME (Centro de Investigaciones Metabolicas)

🇦🇷

Buenos Aires, Argentina

CHU de Liège

🇧🇪

Liege, Liège, Belgium

Liver Disease Center, Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Uniwersyteckie Centrum Kliniczne Im.

🇵🇱

Katowice, Poland

The Royal Melbourne Hospital

🇦🇺

Parkville, Victoria, Australia

Centro Medico Dra. De Salvo

🇦🇷

Caba, Buenos Aires, Argentina

Hospital Italiano de La Plata

🇦🇷

La Plata, Buenos Aires, Argentina

Klinikum Wels-Grieskirchen GmbH, Abteilung Fur Innere Medizin I - Gastroenterologie

🇦🇹

Wels, Austria

UZ Antwerpen

🇧🇪

Edegem, Antwerpen, Belgium

Ippokrateio General Hospital of Athens

🇬🇷

Athens, Attiki, Greece

Institute for Digestive Tract & Liver Disease

🇮🇱

Tel Aviv, Israel

Portsmouth Hospitals NHS Trust

🇬🇧

Portsmouth, Hampshire, United Kingdom

State budget institution of healthcare of Moscow city "Moscow Clinical Scientific and Practical Centre n. a. A.S. Loginov" of Moscow City Healthcare, Department, Central Research Institute of Gastroenterology

🇷🇺

Moscow, Russian Federation

General University Hospital of Larissa Department of Medicine and Research Laboratory of internal rv1edicine, National Expertise Center of Greece in Autoimmune liver Diseases

🇬🇷

Larissa, Greece

Stanford University School of Medicine

🇺🇸

Palo Alto, California, United States

Covenant Metabolic Specialists, LLC

🇺🇸

Fort Myers, Florida, United States

California Liver Research Institute

🇺🇸

Pasadena, California, United States

University of California, Davis Medical Center

🇺🇸

Sacramento, California, United States

Florida Research Institute

🇺🇸

Lakewood Ranch, Florida, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Covenant Research and Clinics, LLC

🇺🇸

Sarasota, Florida, United States

Tulane University Health Sciences Center

🇺🇸

New Orleans, Louisiana, United States

MNGI Digestive Health, P.A.

🇺🇸

Maplewood, Minnesota, United States

Saint Louis University

🇺🇸

Saint Louis, Missouri, United States

NYU Langone Health / NYU Grossman School of Medicine

🇺🇸

New York, New York, United States

Weill Cornell Medical College

🇺🇸

New York, New York, United States

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

Care Access Research - Lumberton

🇺🇸

Lumberton, North Carolina, United States

Penn State Milton S Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Gastro One

🇺🇸

Germantown, Tennessee, United States

The Liver Institute at Methodist Dallas Medical Center

🇺🇸

Dallas, Texas, United States

Texas Digestive Disease Consultants dba GI Alliance

🇺🇸

Fort Hood, Texas, United States

University of Texas Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Liver Institute Northwest

🇺🇸

Seattle, Washington, United States

Bon Secours Richmond Community Hospital LLC

🇺🇸

Richmond, Virginia, United States

Concord Repatriation General Hospital

🇦🇺

Concord, New South Wales, Australia

Royal Brisbane & Women's Hospital

🇦🇺

Herston, Queensland, Australia

Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

London Health Sciences Centre

🇨🇦

London, Ontario, Canada

Universitaire Ziekenhuizen Leuven

🇧🇪

Leuven, Vlaams-Brabant, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Oost-Vlaanderen, Belgium

Toronto Digestive Disease Associates Inc

🇨🇦

Vaughan, Ontario, Canada

Clinical Research Chile SpA

🇨🇱

Valdivia, Los Ríos, Chile

Centro de Investigaciones Clínicas Vina del Mar

🇨🇱

Valparaíso, Chile

Fakultni nemocnice Ostrava- Interni a Kardiologicka Klinika, Oddeleni gastroenterologie, hepatologie a pankreatologie

🇨🇿

Ostrava, Czechia

Hvidovre Hospital

🇩🇰

Hvidovre, Denmark

CHU de Grenoble

🇫🇷

Grenoble, France

Aalborg Universitetshospital, Ambulatoriet for Medicinske Mave-Tarm Sygdomme

🇩🇰

Aalborg, Denmark

Hopital de la Croix-Rousse

🇫🇷

Lyon, France

Hopital Saint-Antoine - Service d'Hepato-Gastro-Enterologie -184, rue du Faubourg Saint-Antoine

🇫🇷

Paris, France

Universitätsklinikum Bonn

🇩🇪

Bonn, Nordrhein-Westfalen, Germany

Universitatsklinikum Frankfurt. Medizinische Klinik I

🇩🇪

Frankfurt am main, Germany

Ifi-Medizin GmbH

🇩🇪

Hamburg, Germany

Universitatsklinikum Erlangen, Medizinische Klinik I, Gastroenterologie

🇩🇪

Erlangen, Germany

Gastroenterologische Gemeinschaftspraxis

🇩🇪

Herne, Germany

Universitatsklinikum Leipzig

🇩🇪

Leipzig, Germany

Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona-Umberto I G.M. Lancisi G. Salesi

🇮🇹

Ancona, Italy

ASST di Monza

🇮🇹

Monza, MB, Italy

Azienda Ospedaliero Universitaria Careggi

🇮🇹

Firenze, Italy

Nuovo Ospedale Civile S. Agostino-Estense di Baggiovara

🇮🇹

Bologna, Italy

Azienda Ospedaliera Universita Padova

🇮🇹

Padova, Italy

Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone

🇮🇹

Palermo, Italy

Soon Chun Hyang University Hospital Bucheon

🇰🇷

Bucheon-si, Gyeonggido, Korea, Republic of

Seoul National University Bundang Hospital

🇰🇷

Gyeonggi-do, Korea, Republic of

Pusan National University Hospital

🇰🇷

Busan, Korea, Republic of

Inje University Busan Paik Hospital

🇰🇷

Busan, Busan Gwangyeogsi, Korea, Republic of

Kyungpook National University Hospital

🇰🇷

Daegu, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Consultorio Medico - Distrito Federal

🇲🇽

Ciudad de Mexico, Mexico

Severance Hospital Yonsei University Health System - PPDS

🇰🇷

Soeul, Korea, Republic of

Campeche No. 280, Int. 601 y 602, Col. Hipodromo, Cuauhtemoc

🇲🇽

Mexico City, Mexico

Hospital Universitario Dr. Jose Eleuterio González

🇲🇽

Monterrey, Mexico

Gastroenterology, Christchurch Hospital

🇳🇿

Christchurch, Canterbury, New Zealand

Gastroenterology Research Unit Dunedin Hospital

🇳🇿

Dunedin, Otago, New Zealand

ID Clinic Akradiusz Pisula

🇵🇱

Mysłowice, Poland

Clinic of High Medical Technologies n.a. N.I. Pirogov

🇷🇺

Saint Petersburg, Russian Federation

Federal State Autonomous Educational Institution of Higher Education "Peoples' Friendship University of Russia", Centre of Liver Studies

🇷🇺

Moscow, Russian Federation

Hospital Universitario German Trias i Pujol

🇪🇸

Badalona, Barcelona, Spain

Ulyanovsk Regional Clinical Hospital

🇷🇺

Ulyanovsk, Russian Federation

Hospital Universitario Margues de Valdecilla

🇪🇸

Santander, Cantabria, Spain

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitario Virgen de la Victoria

🇪🇸

Málaga, Malaga, Spain

Hospital Universitario Vall D'Hebron

🇪🇸

Barcelona, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Ankara Gazi University Faculty of Medicine Hospital

🇹🇷

Ankara, Turkey

Ankara Sehir Hastanesi

🇹🇷

Ankara, Turkey

Medical Center OK!Clinic+LLC International Institute of Clinical Research

🇺🇦

Kyiv, Ukraine

Ege University Medical Faculty

🇹🇷

İzmir, Turkey

Municipal Non-profit Enterprise "City Clinical Hospital #13" of Kharkiv City Council

🇺🇦

Kharkiv, Ukraine

Marmara University Pendik Training and Research Hospital

🇹🇷

Istanbul, Turkey

Bezmi Alem University

🇹🇷

Istanbul, Turkey

Gemini Clinical Trial Unit

🇬🇧

Oxford, Oxfordshire, United Kingdom

Barts Health NHS Trust, Royal London Hospital, Ambrose King Centre

🇬🇧

London, London, City Of, United Kingdom

University Hospitals Birmingham NHS Foundation Trust, Heritage Building (Queen Elizabeth Hospital)

🇬🇧

Birmingham, United Kingdom

Hull Royal Infirmary

🇬🇧

Hull, United Kingdom

Kings College Hospital

🇬🇧

London, United Kingdom

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Galen Hepatology

🇺🇸

Chattanooga, Tennessee, United States

Henry Ford Health System

🇺🇸

Novi, Michigan, United States

Southern Therapy and Advanced Research, LLC (STAR)

🇺🇸

Jackson, Mississippi, United States

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