MedPath

Phase 4 Study of Obeticholic Acid Evaluating Clinical Outcomes in Patients With Primary Biliary Cholangitis

Phase 4
Terminated
Conditions
Liver Cirrhosis, Biliary
Interventions
Drug: Obeticholic Acid (OCA)
Drug: Placebo
Registration Number
NCT02308111
Lead Sponsor
Intercept Pharmaceuticals
Brief Summary

Primary Biliary Cholangitis (PBC) is a serious, life-threatening, bile acid related liver disease of unknown cause. Without treatment, it frequently progresses to liver fibrosis and eventual cirrhosis requiring liver transplantation or resulting in death. The investigational drug, Obeticholic Acid (OCA) is a modified bile acid and FXR agonist that is derived from the primary human bile acid chenodeoxycholic acid. The key mechanisms of action of OCA, including its choleretic, anti-inflammatory, and anti-fibrotic properties, underlie its hepatoprotective effects and result in attenuation of injury and improved liver function in a cholestatic liver disease such as PBC. The study will assess the effect of OCA compared to placebo, combined with stable standard care, on clinical outcomes in PBC participants.

Detailed Description

This Phase 4, double-blind, randomized, placebo-controlled, multicenter study is being undertaken at up to 170 sites internationally to evaluate the effect of OCA on clinical outcomes in 428 participants with PBC. The study will include a screening period of up to 8 weeks, requiring two clinic visits. Eligible participants will be randomly allocated (1:1) to treatment with either OCA 5 mg or matching placebo tablets, taken orally once daily for the majority of participants; dose and frequency will be modified for participants with cirrhosis and classified as Child-Pugh (CP) B or C. Randomization will be stratified by standard treatment with UDCA (yes/no) and baseline liver function. The treatment period involves clinic visits approximately every 3 months. At the 3 month visit or any study visit thereafter, if study treatment is tolerated, participants' dose should be titrated per protocol in a blinded manner eg for participants who are non-cirrhotic or classified as CP A and randomized to OCA, they should receive the maximum daily dose of 10 mg OCA, those on placebo continue to receive placebo. Subsequently, daily dosage may return to 5 mg if necessary for these participants who are non-cirrhotic or classified as CP A, but should be increased to 10 mg if possible, based on tolerability and clinical judgment. Safety and tolerability will be assessed by monitoring adverse events and vital signs, and blood and urine testing. The study is event driven and total duration will be determined by the time required to accrue approximately 127 primary endpoint events, estimated to be approximately 10 years. Participants are expected to have a minimum follow-up time of approximately 6 years.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
334
Inclusion Criteria
  1. Definite or probable PBC diagnosis (consistent with American Association for the Study of Liver Diseases [AASLD] and the European Association for the Study of the Liver [EASL] practice guidelines; Lindor 2009; EASL 2009), as demonstrated by the presence of ≥2 of the following 3 diagnostic factors:

    • History of elevated Alkaline phosphatase levels for at least 6 months
    • Positive antimitochondrial antibody (AMA) titer or if AMA negative or in low titer (<1:80) PBC-specific antibodies (anti-GP210 and/or anti-SP100 and/or antibodies against the major M2 components [PDC-E2, 2-oxo-glutaric acid dehydrogenase complex])
    • Liver biopsy consistent with PBC
  2. A mean total bilirubin >ULN and ≤5x ULN and/or a mean ALP >3x ULN

  3. Either is not taking UDCA (no UDCA dose in the past 3 months) or has been taking UDCA for at least 12 months with a stable dose for ≥3 months prior to Day 0

Exclusion Criteria
  1. History or presence of other concomitant liver diseases including:

    • Hepatitis C virus infection
    • Active Hepatitis B infection; however, subjects who have seroconverted (hepatitis B surface antigen and hepatitis B e antigen negative) may be included in this study after consultation with the medical monitor
    • Primary sclerosing cholangitis (PSC)
    • Alcoholic liver disease
    • Definite autoimmune liver disease or overlap hepatitis
    • Nonalcoholic steatohepatitis (NASH)
    • Gilbert's Syndrome
  2. Presence of clinical complications of PBC or clinically significant hepatic decompensation, including:

    • History of liver transplant, current placement on a liver transplant list, or current Model of End Stage Liver Disease (MELD) score >12. Subjects who are placed on a transplant list despite a relatively early disease stage (for example per regional guidelines) may be eligible as long as they do not meet any of the other exclusion criteria

    • Cirrhosis with complications, including history (within the past 12 months) or presence of:

      • Variceal bleed
      • Uncontrolled ascites
      • Encephalopathy
      • Spontaneous bacterial peritonitis
    • Known or suspected HCC

    • Prior transjugular intrahepatic portosystemic shunt procedure

    • Hepatorenal syndrome (type I or II) or screening (Visit 1 or 2) serum creatinine >2 mg/dL (178 μmol/L)

  3. Mean total bilirubin >5x ULN

  4. Subjects who have undergone gastric bypass procedures (gastric lap band is acceptable) or ileal resection or plan to undergo either of these procedures

  5. Other medical conditions that may diminish life expectancy, including known cancers (except carcinomas in situ or other stable, relatively benign conditions)

  6. If female: plans to become pregnant, known pregnancy or a positive urine pregnancy test (confirmed by a positive serum pregnancy test), or lactating

  7. Known history of human immunodeficiency virus infection

  8. Medical conditions that may cause nonhepatic increases in ALP (eg, Paget's disease or fractures within 3 months)

  9. Other clinically significant medical conditions that are not well controlled or for which medication needs are anticipated to change during the study

  10. History of alcohol abuse or other substance abuse within 1 year prior to Day 0

  11. Participation in another investigational product, biologic, or medical device study within 30 days prior to Screening. Participation in a previous study of OCA is allowed with 3 months washout prior to enrollment in this study

  12. Mental instability or incompetence, such that the validity of informed consent or ability to be compliant with the study is uncertain

  13. History of known or suspected clinically significant hypersensitivity to OCA or any of its components

  14. UDCA naïve (unless contraindicated)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Obeticholic Acid (OCA) 5 mg to 10 mgObeticholic Acid (OCA)Obeticholic Acid (OCA) 5 mg for a minimum 3 months and then titrating up to a maximum 10 mg for the remainder of the trial (based on tolerability and CP Score).
PlaceboPlacebo-
Primary Outcome Measures
NameTimeMethod
Time to the First Occurrence of Composite EndpointTime to first occurrence from date of randomization until the time to accrue approximately 127 primary endpoint events (up to 7 years)

To assess the effect of OCA, compared to placebo in conjunction with the established local standard of care, on clinical outcomes in participants with PBC as measured by time to the first occurrence of any of the following adjudicated events, derived as a composite event endpoint of death, liver transplant, model of end-stage liver disease (MELD) ≥15, uncontrolled ascites, or hospitalization for new onset or recurrence of variceal bleed, hepatic encephalopathy (as defined by a West Haven score of \>=2), or spontaneous bacterial peritonitis. The clinical events distribution was estimated using the Kaplan-Meier methodology. Point estimates and 95% confidence intervals (CIs) for the clinical events distribution percentiles (25th and 50th) are provided.

Time to the First Occurrence of Primary Clinical Event (Expanded Endpoint)Time to first occurrence from date of randomization until the time to accrue approximately 127 primary endpoint events (up to 7 years)

Primary clinical outcome event is the first occurrence of the following events: death, liver transplant, MELD score \>=15 (MELD-Na score \>=12 baseline), MELD-Na score \>=15 (MELD-Na score \<12 baseline), hospitalization for new onset or recurrence of variceal bleed, hepatic encephalopathy, spontaneous bacterial peritonitis (confirmed by diagnostic paracentesis), or bacterial empyema, uncontrolled or refractory ascites (requiring large volume paracentesis), portal hypertension syndromes, progression to decompensated liver disease, and progression to clinical evidence of portal hypertension without decompensation (for participants without decompensation or clinical evidence of portal hypertension at baseline). 71 endpoint events were observed in the OCA arm, and 80 were observed in the Placebo arm. The clinical events distribution was estimated using the Kaplan-Meier methodology. Point estimates and 95% CIs for the clinical events distribution percentiles (25th and 50th) are provided.

Secondary Outcome Measures
NameTimeMethod
Time To First Occurrence Of Severe Decompensating Events of Expanded Composite EndpointTime to first occurrence from date of randomization until the date of first documented progression or date of death from any cause, whichever came first (up to 7 years)

The first occurrence of the key secondary clinical event refers to the first occurrence of the following events: death, liver transplant, MELD-Na score \>=15 if MELD-Na\< 12 at baseline, MELD score \>=15 if MELD-Na \>=12 at baseline, uncontrolled or refractory ascites, portal hypertension syndromes (hepatorenal syndrome, portopulmonary syndrome, hepatopulmonary syndrome) or hospitalization for new onset or recurrence of variceal bleed, hepatic encephalopathy, spontaneous bacterial peritonitis, or bacterial empyema. The clinical events distribution was estimated using the Kaplan-Meier methodology. Point estimates and 95% CIs for the clinical events distribution percentiles (25th and 50th) are provided.

Time To Liver Transplant Or Death (All-cause)Time to first occurrence from date of randomization until the date of first documented liver transplant or date of death from any cause (up to 7 years)

The effect of OCA compared to placebo on time to liver transplant or death (all-cause) was assessed. The events distribution was estimated using the Kaplan-Meier methodology. Point estimates and 95% CIs for the clinical events distribution percentiles (25th and 50th) are provided.

Time to First Occurrence of Fatal Event (All-Cause)Time to first occurrence from date of randomization until the date of death from any cause (up to 7 years)

The results represent the ratio of OCA to placebo. The fatal events distribution was estimated using the Kaplan-Meier methodology. Point estimates and 95% CIs for the fatal events distribution percentiles (25th and 50th) are provided

Time to First Occurrence of Liver TransplantTime to first occurrence from date of randomization until the date of first documented liver transplant or date of death from any cause (up to 5 years)

The effect of OCA compared to placebo on time to occurrence of a liver transplant was assessed. The results represented the ratio of OCA to placebo. A hazard ratio \<1 indicated an advantage for OCA. The event of interest was summarized through Cumulative Incidence Function (CIF) estimate at 5 years.

Time to First Occurrence of Hospitalization Due to Hepatic EventsTime to first occurrence from date of randomization until the date of hospitalization, liver transplant or death from any cause, whichever came first (up to 5 years)

Hospitalization events include new onset or recurrent variceal bleed, hepatic encephalopathy (as defined by a West Haven score of \>=2), spontaneous bacterial peritonitis (confirmed by diagnostic paracentesis OR presence of \>250/mm\^3 polymorph leucocytes \[PMNs\] in the ascitic fluid), bacterial empyema is confirmed by diagnostic thoracentesis OR presence of \>250/mm\^3 PMNs in the pleural fluid. The event of interest was summarized through CIF estimate at 5 years.

Change From Baseline To Month 72 Of Cytokeratin-18 (CK-18)Baseline up to Month 72

Markers of inflammation, which include CK-18, were assessed.

Time to First Occurrence of Uncontrolled or Refractory AscitesTime to first occurrence from date of randomization until the date of first documented uncontrolled or refractory ascites, liver transplant or date of death from any cause, whichever came first (up to 5 years)

Uncontrolled or refractory ascites are defined as diuretic-resistant ascites requiring large-volume paracentesis. The effect of OCA compared to placebo on time to the first occurrence of uncontrolled or refractory ascites was assessed. The event of interest was summarized through CIF estimate at 5 years.

Time to First Occurrence of MELD Score ≥15Time to first occurrence from date of randomization until the date of first documented MELD Score ≥15, liver transplant or date of death from any cause, whichever came first (up to 5 years)

The MELD score is useful in assessing participants with significant decompensation. The MELD score is now used by the United Network for Organ Sharing in the United States and Eurotransplants to manage organ allocation for liver transplantation. The MELD score is derived from the participant's serum total bilirubin, serum creatinine, and International Normalized Ratio (INR), as appropriate, to predict survival. The MELD score ranges from 6 to 40. The higher the score, the more likely a participant will receive a liver from a deceased donor when an organ becomes available. The event of interest was summarized through CIF estimate at 5 years.

Time To Development Of Varix/VaricesTime to first occurrence from date of randomization until the date of first documented development of varix/varices, liver transplant or death from any cause, whichever came first (up to 5 years)

The effect of OCA compared to placebo on time to development of varix/varices was assessed. The event of interest was summarized through CIF estimate at 5 years.

Time To Liver-Related DeathTime to first occurrence from date of randomization until the date of first liver-related or non-liver- related death, whichever came first (up to 5 years)

The effect of OCA compared to placebo on time to liver-related death was assessed. The event of interest was summarized through CIF estimate at 5 years.

Time To Liver-Related Death Or Liver TransplantTime to first occurrence from date of randomization until the date of liver transplant, liver-related death or non-liver-related death from any cause, whichever came first (up to 5 years)

The effect of OCA compared to placebo on time to liver-related death or liver transplant was assessed. The event of interest was summarized through CIF estimate at 5 years.

Time To Liver-Related Death, Liver Transplant, Or MELD Score ≥15Time to first occurrence from date of randomization until the date of liver transplant, liver-related death, non-liver-related death from any cause or MELD Score ≥15, whichever came first (up to 5 years)

The effect of OCA compared to placebo on time to liver-related death, liver transplant, or MELD Score ≥15 was assessed. The MELD score is useful in assessing participants with significant decompensation. The MELD score is now used by the United Network for Organ Sharing in the United States and Eurotransplants to manage organ allocation for liver transplantation. The MELD score is derived from the participant's serum total bilirubin, serum creatinine, and INR, as appropriate, to predict survival. The MELD score ranges from 6 to 40. The higher the score, the more likely a participant will receive a liver from a deceased donor when an organ becomes available. The event of interest was summarized through CIF estimate at 5 years.

Progression To Cirrhosis (for Noncirrhotic Subjects at Baseline)Time to first occurrence from date of randomization until the date of cirrhosis, liver transplant or death from any cause, whichever came first (up to 5 years)

When a participant is identified as noncirrhotic at the Baseline and exhibited any signs or symptoms associated with progression to cirrhosis, the participant was assessed by Fibroscan® TE where available. The event of interest was summarized through CIF estimate at 5 years.

Time To Occurrence Of Hepatocellular Carcinoma (HCC)Time to first occurrence from date of randomization until the date of HCC diagnosis, liver transplant or death from any cause, whichever came first (up to 5 years)

The effect of OCA compared to placebo on time to occurrence of HCC was assessed. The event of interest was summarized through CIF estimate at 5 years.

Change From Baseline To Month 24 Of Total BilirubinBaseline up to Month 24

Liver biochemistry, which includes total bilirubin, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using mixed model repeated measures (MMRM), including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 24 Of Direct BilirubinBaseline up to Month 24

Liver biochemistry, which includes direct bilirubin, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 72 Of 7α-hydroxy-4-cholesten-3-one (C4)Baseline up to Month 72

Markers of hepatic fibrosis, which include C4, were assessed.

Change From Baseline To Month 24 Of Aspartate Aminotransferase (AST)Baseline up to Month 24

Liver biochemistry, which includes AST, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 24 Of Alanine Aminotransferase (ALT)Baseline up to Month 24

Liver biochemistry, which includes ALT, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 24 Of Alkaline Phosphatase (ALP)Baseline up to Month 24

Liver biochemistry, which includes ALP, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 24 Of Gamma-glutamyl Transferase (GGT)Baseline up to Month 24

Liver biochemistry, which includes GGT, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 24 Of AlbuminBaseline up to Month 24

Liver biochemistry, which includes albumin, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 24 Of INRBaseline up to Month 24

The coagulation test, which includes INR, was assessed to evaluate biochemical triggers that would prompt an immediate reevaluation of participants for potential hepatic injury or hepatic decompensation. INR is the ratio of tested prothrombin time to normal prothrombin time, to a power designated the international sensitivity index (ISI). INR normal range is 0.8 to 1.2 (female and male). Analysis was performed using MMRM, including treatment group, time, treatment group by time interaction, and randomization stratification factors as entered in the IWRS as fixed effects and baseline values as a covariate.

Change From Baseline To Month 72 Of MELD ScoreBaseline up to Month 72

The MELD score is useful in assessing participants with significant decompensation. The MELD score is now used by the United Network for Organ Sharing in the United States and Eurotransplants to manage organ allocation for liver transplantation. The MELD score is derived from the participant's serum total bilirubin, serum creatinine, and INR, as appropriate, to predict survival. The MELD score ranges from 6 to 40. The higher the score, the more likely a participant will receive a liver from a deceased donor when an organ becomes available.

Change From Baseline To Month 72 Of MELD-Na ScoreBaseline up to Month 72

The MELD-Na score is another useful predictor in assessing participants with significant decompensation. The MELD-Na took into account the effect of serum sodium as a reflection of renal function and hypothetically may improve the accuracy of the model score. The MELD-Na score is derived from the participant's serum total bilirubin, serum creatinine, INR, and serum sodium, as appropriate, to predict survival. The MELD-Na score ranges from 6 to 40. The higher the score, the more likely a participant will receive a liver from a deceased donor when an organ becomes available.

Change From Baseline To Month 72 Of CPSBaseline up to Month 72

Child-Pugh Score (Pugh 1973, Lucey 1997) was calculated and reported within the electronic data capture (EDC) system based on data entered into the CRF by adding the scores from the 5 factors and could have ranged from 5 to15. A total score of 5 to 6 was considered Grade A (mild, well-compensated disease); 7 to 9 was Grade B (moderate, significant functional compromise); and 10 and above was Grade C (severe, decompensated disease).

Change From Baseline To Month 72 Of Mayo Risk Score (MRS)Baseline up to Month 72

Mayo Risk Score (MRS) was calculated and reported within the EDC system. Calculation of MRS included Investigator assessment of peripheral edema and the use of diuretic therapy, which was assessed during the adverse event and concomitant medicine review at the scheduled visits and entered into the CRF, as well as total bilirubin, albumin, and prothrombin time results obtained from the central laboratory data. There is no maximum and minimum range of score but an increase in the MRS represents an increase in the risk of death.

Change From Baseline To Month 72 Of Immunoglobulin-M (IgM)Baseline up to Month 72

Markers of inflammation, which include IgM, were assessed.

Change From Baseline To Month 72 Of C-reactive Protein (CRP)Baseline up to Month 72

Markers of inflammation, which include CRP, were assessed.

Change From Baseline To Month 72 Of Tumor Necrosis Factor-α (TNF-α)Baseline up to Month 72

Markers of inflammation, which include TNF-α, were assessed.

Change From Baseline To Month 72 Of Fibroblast Growth Factor-19 (FGF-19)Baseline up to Month 72

Markers of hepatic fibrosis, which include FGF-19, were assessed.

Change From Baseline To Month 72 Of Enhanced Liver Fibrosis (ELF)Baseline up to Month 72

Liver fibrosis was assessed using ELF test. The ELF test assessed: hyaluronic acid, procollagen3 N-terminal peptide, and a tissue inhibitor of metalloproteinase 1. The ELF test is a composite score: \< 7.7: no to mild fibrosis; ≥ 7.7 - \< 9.8: Moderate fibrosis; ≥ 9.8 - \< 11.3: Severe fibrosis; ≥ 11.3: Cirrhosis. A negative change from Baseline suggests decreased fibrosis.

Change From Baseline To Month 72 Of Liver Stiffness - Transient ElastographyBaseline up to Month 72

Hepatic stiffness was measured using non-invasive transient Elastography with Fibroscan® TE device.

PK Population: Ctrough Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)Baseline up to the last IP dose plus 30 days and prior to commercial OCA initiation date (up to 7 years)

An adverse event (AE) was defined as any unfavorable and unintended sign (for example, including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product or procedure, whether or not considered related to the medicinal product or procedure, which occurred during the course of the clinical study. TEAEs were defined as AEs that occurred on or after the date and time of study drug administration, or those that first occurred before dosing but worsened in frequency or severity after study drug administration. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

Pharmacokinetic (PK) Population: Fasting Trough Concentrations Of OCA By Dose RegimenMonths 3, 6, 9, 12, 24, 36, 48, and 60

The fasting trough PK concentrations of OCA of different dose regimens taken throughout the study are reported.

PK Population: Serial Concentration of OCA By Dose RegimenMonth 9

In Month 9, blood samples were collected at predose, 0.5 h, 0.75 h, 1 h, 1.5 h, 2 h, 2.5 h, 3 h, 4h, 5 h, and 6 h and PK serial concentrations at different dose regimen are reported.

PK Population: Area Under The Concentration-Time Curve (AUC) From 0 to 6 Hours Post-dose (AUC0-6h) Of Participants Who Received 5 mg QD OCA and With CP Score=Non-Cirrhotic (NC)Month 9

In Month 9, blood samples were collected at predose, 0.5h, 0.75 h, 1 h, 1.5 h, 2 h, 2.5 h, 3 h, 4h, 5 h, and 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=NC.

PK Population: AUC From 0 to 24 Hours Post-dose (AUC0-24h) Of Participants Who Received 5 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose, 0.5h, 0.75 h, 1 h, 1.5 h, 2 h, 2.5 h, 3 h, 4h, 5 h, and 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=NC.

PK Population: Maximum Observed Concentration (Cmax) Of Participants Who Received 5mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=NC.

PK Population: Time to Cmax (Tmax) Of Participants Who Received 5mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=NC.

PK Population: Metabolite to Parent Ratio of AUC0-6h (MRAUC) Of Participants Who Received 5mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=NC.

PK Population: Metabolite to Parent Ratio of Cmax (MRCmax) Of Participants Who Received 5mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=NC.

PK Population: AUC0-24h Of Participants Who Received 10 mg QD OCA and With CPS Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: MRCmax Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: AUC0-6h Of Participants Who Received 5 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: AUC0-24h Of Participants Who Received 5 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: Cmax Of Participants Who Received 5mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: Tmax Of Participants Who Received 5mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: Concentration at 24 Hours Post-dose (Ctrough) Of Participants Who Received 5mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: MRAUC Of Participants Who Received 5mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: MRCmax Of Participants Who Received 5mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=A.

PK Population: Ctrough Of Participants Who Received 5mg QD OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with CP Score=B.

PK Population: AUC0-6h Of Participants Who Received 5 mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC.

PK Population: AUC0-24h Of Participants Who Received 5 mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC

PK Population: Cmax Of Participants Who Received 5mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC.

PK Population: Tmax Of Participants Who Received 5mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC.

PK Population: AUC0-6h Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: Tmax Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: MRCmax Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

PK Population: Ctrough Of Participants Who Received 5mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC.

PK Population: Cmax Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: Ctrough Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: MRAUC Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: MRAUC Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

PK Population: AUC0-24h Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: Cmax Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: Tmax Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: Ctrough Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: MRAUC Of Participants Who Received 5mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC.

PK Population: MRCmax Of Participants Who Received 5mg QOD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with CP Score=NC.

PK Population: AUC0-24h Of Participants Who Received 10 mg QD OCA and With CP Score=NCMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QOD OCA with CP Score=NC.

PK Population: Cmax Of Participants Who Received 10 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: Tmax Of Participants Who Received 10 mg QD OCA and With CPS Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: Ctrough Of Participants Who Received 10 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: MRAUC Of Participants Who Received 10 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: AUC0-6h Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B.

PK Population: Tmax Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B.

PK Population: Ctrough Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B.

PK Population: MRAUC Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B

PK Population: AUC0-6h Of Participants Who Received 10 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: MRCmax Of Participants Who Received 10 mg QD OCA and With CP Score=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with CP Score=A.

PK Population: AUC0-24h Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B.

PK Population: Cmax Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B.

PK Population: MRCmax Of Participants Who Received 10 mg Q2W OCA and With CP Score=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with CP Score=B.

PK Population: AUC0-6h Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

PK Population: Tmax Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

PK Population: AUC0-6h Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: MRAUC Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: MRCmax Of Participants Who Received 5 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=B.

PK Population: AUC0-6h Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: AUC0-24h Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: Cmax Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: Tmax Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: Ctrough Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: MRAUC Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: AUC0-24h Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

PK Population: Cmax Of Participants Who Received 5 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QD OCA with MELD Category=A.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 10 mg QD OCAMonths 6, 9, 12, 24, 36, and 60

The trough concentration of OCA in the cirrhotic participants who received 10 mg QD OCA was reported.

PK Population: AUC0-6h Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: MRCmax Of Participants Who Received 5 mg QOD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 5 mg QOD OCA with MELD Category=A.

PK Population: AUC0-6h Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A.

PK Population: AUC0-24h Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A.

PK Population: Cmax Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A

PK Population: Tmax Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A.

PK Population: Ctrough Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A.

PK Population: MRAUC Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A.

PK Population: MRCmax Of Participants Who Received 10 mg QD OCA and With MELD Category=AMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=A.

PK Population: AUC0-24h Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: Cmax Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: Tmax Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: Ctrough Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: MRAUC Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: MRCmax Of Participants Who Received 10 mg QD OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg QD OCA with MELD Category=B.

PK Population: AUC0-6h Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: AUC0-24h Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: Cmax Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: Tmax Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: Ctrough Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: MRAUC Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: MRCmax Of Participants Who Received 10 mg Q2W OCA and With MELD Category=BMonth 9

In Month 9, blood samples were collected at predose to 6 h for PK analysis in participants who received 10 mg Q2W OCA with MELD Category=B.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 5 mg QD OCAMonths 3, 6, 12, 24, and 48

The trough concentration of OCA in the cirrhotic participants who received 5 mg QD OCA was reported.

PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 5 mg QD OCAMonths 3, 6, 9, 12, and 24

The trough concentration of OCA in the non-cirrhotic participants who received 5 mg QD OCA was reported.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 5 mg QOD OCAMonths 6, 12, and 24

The trough concentration of OCA in the cirrhotic participants who received 5 mg QOD OCA was reported.

PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 5 mg QOD OCAMonths 3, 6, and 12

The trough concentration of OCA in the non-cirrhotic participants who received 5 mg QOD OCA was reported.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 5 mg QW OCAMonths 6 and 12

The trough concentration of OCA in the cirrhotic participants who received 5 mg QW OCA was reported.

PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 5 mg QW OCAMonth 12

In Month 12, the trough concentration of OCA in the non-cirrhotic participants who received 5 QW QOD OCA was reported.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 5 mg Q2W OCAMonths 6, 24, 36 and 48

The trough concentration of OCA in the cirrhotic participants who received 5 mg Q2W OCA was reported.

PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 5 mg Q2W OCAMonths 3, 6, 12, 24, 36, and 48

The trough concentration of OCA in the non-cirrhotic participants who received 5 Q2W QOD OCA was reported.

PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 10 mg QD OCAMonths 6, 9, 12, 24, and 36

The trough concentration of OCA in the non-cirrhotic participants who received 10 QD QOD OCA was reported.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 10 mg QOD OCAMonths 3, 6, 9, 12, 24, 36, 48, and 60
PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 10 mg QOD OCAMonth 12

In Month 12, the trough concentration of OCA in the non-cirrhotic participants who received 10 mg QOD OCA was reported.

PK Population: Trough Concentrations Of Cirrhotic Participants Who Received 10 mg Q2W OCAMonth 6

In Month 6, the trough concentration of OCA in the cirrhotic participants who received 10 mg Q2W OCA was reported.

PK Population: Trough Concentrations Of Non-Cirrhotic Participants Who Received 10 mg Q2W OCAMonth 6

In Month 6, the trough concentration of OCA in the non-cirrhotic participants who received 10 mg Q2W OCA was reported.

Trial Locations

Locations (180)

Mercy Medical Center

🇺🇸

Baltimore, Maryland, United States

Gastrointestinal Specialists of Georgia

🇺🇸

Marietta, Georgia, United States

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

Flinders Medical Centre

🇦🇺

Adelaide, South Australia, Australia

Department of Gastroenterology and Hepatology, Royal Adelaide Hospital

🇦🇺

Adelaide, South Australia, Australia

St. Vincent's Hospital Melbourne

🇦🇺

Fitzroy, Victoria, Australia

Northwestern University Feinberg School of Medicine

🇺🇸

Chicago, Illinois, United States

Hospital das Clinicas da Universidade Federal de Minas Gerais (UFMG)

🇧🇷

Belo Horizonte,, Minas Gerais, Brazil

Shaare Zedek Medical Center

🇮🇱

Jerusalem, Israel

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Mayo Clinic Arizona

🇺🇸

Phoenix, Arizona, United States

Schiff Center for Liver Diseases/University of Miami

🇺🇸

Miami, Florida, United States

Indianapolis Gastroenterology Research Foundation

🇺🇸

Indianapolis, Indiana, United States

Quality Medical Research, PLLC

🇺🇸

Nashville, Tennessee, United States

UT Health The University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

Baylor College of Medicine - Advanced Liver Therapies

🇺🇸

Houston, Texas, United States

American Research Corporation at Texas Liver Institute

🇺🇸

San Antonio, Texas, United States

Azienda Socio-Sanitarla Territoriale (ASST) Santi Paolo e Carlo

🇮🇹

Milano, Italy

Azienda Socio Sanitaria Territoriale (ASST) di Monza

🇮🇹

Monza, Italy

Università Politecnica delle Marche - Azienda Ospedaliero

🇮🇹

Ancona, Italy

Policlinico Universitario Agostino Gemelli - Universita Cattolica del Sacro Cuore

🇮🇹

Rome, Italy

Nzoz Vitamed

🇵🇱

Bydgoszcz, Kujawsko-Pomorskie, Poland

Medical University of Warsaw Samodzielny Publiczny Centralny Szpital Kliniczny w Warszawie (SPCSK in Warsaw

🇵🇱

Warsaw, Masovia, Poland

Amsterdam University Medical Centre (AMC)

🇳🇱

Amsterdam, Netherlands

NZ Liver Transplant Unit, Auckland Hospital

🇳🇿

Grafton, Auckland, New Zealand

Wojewodzki Szpital Specjalistyczny im. J. Gromkowskiego, Pierwszy Oddzial Chorob Zakaznych

🇵🇱

Wroclaw, Lover Silesia, Poland

Dep. Of Gastroenterology UM Lublin

🇵🇱

Lublin, Poland

Centro Hospitalar Lisboa Norte, EPE - Hospital de Santa Maria

🇵🇹

Lisbon, Portugal

Hospital Universitario Marqués De Valdecilla

🇪🇸

Santander, Cantabria, Spain

Inselspital, University Of Bern, UVCM, DMLL

🇨🇭

Bern, Switzerland

University Hospitals Bristol NHS Foundation Trust

🇬🇧

Bristol, Avon, United Kingdom

Ege University School of Medicine Gastroenterology Dept.

🇹🇷

Izmir, Turkey

Plymouth Hospitals NHS Trust, Derriford Hospital

🇬🇧

Plymouth, Devon, United Kingdom

Forth Valley Royal Hospital

🇬🇧

Larbert, Scotland, United Kingdom

Cambrigde University Hospitals NHS Foundation Trust

🇬🇧

Cambridge, United Kingdom

University Hospitals Birmingham NHS Foundation Trust

🇬🇧

Birmingham, West Midlands, United Kingdom

The Royal Free Hospital

🇬🇧

London, United Kingdom

London Health Sciences Centre-University Hospital

🇨🇦

London, Ontario, Canada

Inland Empire Liver Foundation

🇺🇸

Rialto, California, United States

University of California Davis, Davis Medical Center

🇺🇸

Sacramento, California, United States

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Piedmont Atlanta Hospital

🇺🇸

Atlanta, Georgia, United States

Henry Ford Health System

🇺🇸

Novi, Michigan, United States

Hospital De Clinicas University Of Buenos Aires

🇦🇷

Buenos Aires, Argentina

Stanford University

🇺🇸

Stanford, California, United States

Clinical Research Centers of America

🇺🇸

Murray, Utah, United States

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Brooke Army Medical Center

🇺🇸

Fort Sam Houston, Texas, United States

Southern Therapy and Advanced Research (STAR)

🇺🇸

Jackson, Mississippi, United States

Indiana University

🇺🇸

Indianapolis, Indiana, United States

Kansas City Research Institute

🇺🇸

Kansas City, Missouri, United States

Centro De Hepatología

🇦🇷

La Plata, Buenos Aires, Argentina

Swedish Organ Transplant & Liver Center

🇺🇸

Seattle, Washington, United States

Baylor Scott and White Research Institute

🇺🇸

Fort Worth, Texas, United States

Hospital Privado Universitario de Cordoba S.A.

🇦🇷

Córdoba, Cordoba, Argentina

Department of Gastroenterology & Hepatology, Nepean Hospital

🇦🇺

Kingswood, New South Wales, Australia

University Hospital Antwerp

🇧🇪

Edegem, Antwerp, Belgium

Hospital de Gastroenterologia Dr. Carlos Bonorino Udaondo

🇦🇷

Ciudad Autónoma de Buenos Aires, Argentina

Cepec Huufma

🇧🇷

Sao Luis, Maranhao, Brazil

Instituto Goiano de Gastroenterologia

🇧🇷

Goiânia, Goias, Brazil

Hospital Universitario Professor Edgard Santos

🇧🇷

Bahia, Salvador, Brazil

Instituto Hospital de Base do Distrito Federal-IHBDF

🇧🇷

Brasilia, Distrito Federal Brazil, Brazil

Hospital de Clinicas de Porto Alegre

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Cub Hôpital Erasme

🇧🇪

Bruxelles, Belgium

University Hospital Ghent

🇧🇪

Ghent, Belgium

Hospital Sao Rafael

🇧🇷

São Salvador, Bahia, Brazil

University of Calgary Liver Unit (Heritage Medical Research Clinic)

🇨🇦

Calgary, Alberta, Canada

Medicinsk klinik for mave, tarm-og leversygdomme

🇩🇰

København Ø, Denmark

Odense University Hospital Afdeling for medicinske mave-tarmsygdomme S

🇩🇰

Odense, Denmark

University Of Manitoba, Health Sciences Centre

🇨🇦

Winnipeg, Manitoba, Canada

St. Ivan Rilsky University Hospital

🇧🇬

Sofia, Bulgaria

East Tallinn Central Hospital Gastroenterology Center

🇪🇪

Tallinn, Harju, Estonia

Tartu University Hospital

🇪🇪

Tartu, Estonia

Helsinki University Central Hospital

🇫🇮

Helsinki, Finland

CHRU Hôpital HURIEZ

🇫🇷

Lille, France

Chu De Bordeaux - Hôpital Haut Lévêque

🇫🇷

Pessac Cedex, France

AOU Policlinico Sant' Orsola Malpighi

🇮🇹

Bologna, Italy

Hadassah Hebrew University Medical Center

🇮🇱

Jerusalem, Nazareth Elit, Israel

Hospital Vall d'Hebron

🇪🇸

Barcelona, Spain

La Fe, Hospital ( Valence )

🇪🇸

Valence, Spain

Klinikum der Johann-Wolfgang Goethe, Universitaet Frankfurt am Main

🇩🇪

Frankfurt am Main, Hessen, Germany

Universität Leipzig KöR, Medizinische Fakultät

🇩🇪

Leipzig, Germany

Rabin Medical Center

🇮🇱

Petach Tikva, Israel

Sourasky Tel-Aviv Medical Center

🇮🇱

Tel-Aviv, Israel

Gastroenterology, Christchurch Hospital

🇳🇿

Christchurch, Canterbury, New Zealand

Hospital Universitario Austral

🇦🇷

Presidente Derqui, Buenos Aires, Argentina

Dim Clínica Privada

🇦🇷

Ramos Mejía, Buenos Aires, Argentina

Hospital Italiano de Buenos Aires

🇦🇷

Ciudad Autónoma de Buenos Aires, Argentina

Univeritatsklinikum Hamburg Eppendorf, Medizinische Klinik und Poliklinik

🇩🇪

Hamburg, Germany

University of Munich, LMU Klinikum Grosshadern

🇩🇪

Munich, Germany

University of Colorado Denver and Hospital

🇺🇸

Aurora, Colorado, United States

UF Hepatology Research at CTRB

🇺🇸

Gainesville, Florida, United States

UMass Medical School

🇺🇸

Worcester, Massachusetts, United States

Tulane University Medical Center

🇺🇸

New Orleans, Louisiana, United States

University of Louisville, Medical Dental Complex

🇺🇸

Louisville, Kentucky, United States

Minnesota Gastroenterology, P.A.

🇺🇸

Saint Paul, Minnesota, United States

Saint Louis University Gastroenterology & Hepatology

🇺🇸

Saint Louis, Missouri, United States

Saint Joseph's Regional Medical Center

🇺🇸

Paterson, New Jersey, United States

Mount Sinai Beth Israel

🇺🇸

New York, New York, United States

Weill Cornell Medical College

🇺🇸

New York, New York, United States

Hospital of the University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

The Liver Institute at Methodist Dallas Medical Center

🇺🇸

Dallas, Texas, United States

Texas Digestive Disease Consultants

🇺🇸

Southlake, Texas, United States

UT Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

McGuire DVAMC

🇺🇸

Richmond, Virginia, United States

CIPREC - Centro de Investigacion y Prevencion Cardiovascular S.A.

🇦🇷

Buenos Aires, Argentina

Centrol Integral de Gastroenterologia

🇦🇷

Buenos Aires, Argentina

Hospital Aleman

🇦🇷

Ciudad Autónoma de Buenos Aires, Argentina

Hospital Britanico De Buenos Aires

🇦🇷

Ciudad Autónoma de Buenos Aires, Argentina

AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital

🇦🇺

Camperdown, New South Wales, Australia

Fiona Stanley Hospital, Gastroenterology Department

🇦🇺

Murdoch, Western Australia, Australia

Austin Hospital

🇦🇺

Heidelberg, Victoria, Australia

Gallipoli Medical Research Foundation

🇦🇺

Brisbane, Queensland, Australia

Box Hill Hospital

🇦🇺

Box Hill, Victoria, Australia

AKH, Medical University of Vienna

🇦🇹

Vienna, Austria

Uz Leuven

🇧🇪

Leuven, Vlaams-Brabant, Belgium

Gastrocentro/ Universidade Estadual de Campinas (UNICAMP)

🇧🇷

Sao Paulo, Campinas, Brazil

Gastrocentro. Unidad Estadual de CAmpinas UNICAMP

🇧🇷

Campinas, Sao Paulo, Brazil

Universidade Federal do Estado do Rio de Janeiro - Hospital Universitario Gaffree e Guinle/HUGG/UNIRIO

🇧🇷

Rio de Janeiro, Brazil

Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo-HCFMUSP

🇧🇷

Sao Paulo, Brazil

University Health Network, Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

Chum

🇨🇦

Montreal, Quebec, Canada

Aarhus University Hospital Department of Hepatology and Gastroenterology

🇩🇰

Aarhus, Aarhus C, Denmark

Hospital Saint-Antoine, A.P.-H.P.

🇫🇷

Paris Cedex 12, Paris, France

Medizinische Hochschule Hannover, Klinik für Gastroenterologie, Hepatologie und Endokrinologie

🇩🇪

Hannover, Lower Saxony, Germany

CHARITÉ, Campus Virchow Klinikum

🇩🇪

Berlin, Germany

Friedrich-Alexander-Uniersitat Erlangen

🇩🇪

Erlangen, QLD, Germany

Universitaetsklinikum Heidelberg Medizinische Universitaetsklinik

🇩🇪

Heidelberg, Germany

Queen Mary Hospital

🇭🇰

Hong Kong, Pokfulam, Hong Kong

Humanity & Health Research Centre

🇭🇰

Hong Kong, Hong Kong

Szent János Hospital

🇭🇺

Budapest, Hungary

Békés Megyei Kozponti Korhaz - Dr. Rethy Pal Tagkorhaz

🇭🇺

Bekescsaba, Hungary

University Of Debrecen, Department Of Medicine, Division Of Gastroenterology

🇭🇺

Debrecen, Hungary

Rambam Health Care Campus

🇮🇱

Haifa, Israel

Soroka Medical Center

🇮🇱

Beer Sheva, Israel

Azienda Ospedaliero - Universitaria di Cagliari - Centro per lo Studio delle Malattie del Fegato

🇮🇹

Monserrato, Cagliari, Italy

Sheba Medical Center

🇮🇱

Ramat-Gan, Israel

Azienda Ospedaliero Universitaria Careggi Universita di Firenze

🇮🇹

Florence, Italy

Azienda Ospedaliero Universitaria Sant´ Orsola Malpighi

🇮🇹

Bologna, Italy

AOU Ospedale Civile S. Agostino Estense - UO Medicina Metabolica

🇮🇹

Modena, Italy

AOU Policlinico Paolo Giaccone - Di.Bi.M.I.S

🇮🇹

Palermo, Italy

Azienda Ospedaliero - Universita di Padova

🇮🇹

Padova, Italy

Inje University Busan Paik Hospital

🇰🇷

Busan, Busanjin-gu, Korea, Republic of

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

Gangnam Severance Hospital

🇰🇷

Seoul, Gangnam-gu, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Jongno-Gu, Korea, Republic of

Vilnius University Hospital Santaros klinikos

🇱🇹

Vilnius, Lithuania

Pusan National University Hospital

🇰🇷

Busan, Seo-gu, Korea, Republic of

Radboud UMC

🇳🇱

Nijmegen, Gelderland, Netherlands

Vrije Universiteit Medisch Centrum (VUMC)

🇳🇱

Amsterdam, Noord-Holland, Netherlands

Departamento De Gastroenterologia. Instituto Nacional De Ciencias Medicas Y Nutricion Salvador Zubiran

🇲🇽

Mexico City, DF, Mexico

Erasmus Mc

🇳🇱

Rotterdam, Zuid Holland, Netherlands

Clinic For Gastroenterology And Hepatology Clinical Center Of Serbia

🇷🇸

Belgrade, Serbia

Clinical Hospital Centre Zvezdara

🇷🇸

Belgrade, Serbia

Oddział Gastr. I Hepat. Uniwersyteckie Centrum Kliniczne Im. Prof. K. Gibińskiego Sum

🇵🇱

Katowice, Silesia, Poland

Hospital Universitario Puerta De Hierro Majadahonda

🇪🇸

Majadahonda, Madrid, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Virgen De La Victoria University Hospital

🇪🇸

Málaga, Spain

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Sahlgrenska Universitetssjukhuset

🇸🇪

Gothenburg, Sweden

Karolinska University Hospital

🇸🇪

Stockholm, Huddinge, Sweden

Ankara University School of Medicine Gastroenterology Dept.

🇹🇷

Ankara, Turkey

Kantonsspital St. Gallen, Clinic for Gastroeterologie and Hepatologie

🇨🇭

St. Gallen, Switzerland

Gartnavel General Hospital

🇬🇧

Glasgow, Lanarkshire, United Kingdom

Institute of Cellular Medicine

🇬🇧

Newcastle Upon Tyne, Tyne And Wear, United Kingdom

Nottingham University Hospital Nhs Trust

🇬🇧

Nottingham, United Kingdom

Hospital of Lithuanian University of Health Sciences, Kauno klinikos

🇱🇹

Kaunas, Lithuania

Consultorio Médico de la Dra Alma Laura Ladrón de Guevara Cetina

🇲🇽

Mexico City, DF, Mexico

Turku University Central Hospital, Gastroenterology Outpatient Clinic

🇫🇮

Turku,, Finland

Emory University Hospital

🇺🇸

Atlanta, Georgia, United States

Centro De Investigaciones Clínicas Viña Del Mar

🇨🇱

Viña Del Mar, V Región, Chile

Medica Sur, S.A.B. de C.V.

🇲🇽

Ciudad de mexico, Ciudad De Mexico,, Mexico

Centrum Onkologii - Instytut im. Marii Skłodowskiej - Curie, Klinika Gastroenterologii Onkologicznej

🇵🇱

Warsaw, Mazovia, Poland

USZ, Klinik für Gastroenterologie und Hepatologie

🇨🇭

Zurich, Switzerland

Hospital Provincial del Centenario

🇦🇷

Rosario, Santa Fe, Argentina

University of Alberta, Walter C. Mackenzie Health Sciences Centre (WMC)

🇨🇦

Edmonton, Alberta, Canada

University Medical Center Utrecht

🇳🇱

Utrecht, Netherlands

Prince Of Wales Hospital

🇭🇰

Hong Kong, Shatin, Hong Kong

Tuen Mun Hospital

🇭🇰

Hong Kong, Tuen Mun, New Territories, Hong Kong

Alice Ho Miu Ling Nethersole Hospital

🇭🇰

Hong Kong, Hong Kong

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