A Phase II, Open-Label, Multi-Center, Prospective, Randomized Study of LCP-Tacro Tablets vs. Azathioprine, in Combination With Corticosteroids, for the Treatment of Autoimmune Hepatitis
Overview
- Phase
- Phase 2
- Intervention
- LCP-Tacro (tacrolimus)
- Conditions
- Autoimmune Hepatitis
- Sponsor
- Veloxis Pharmaceuticals
- Enrollment
- 13
- Locations
- 12
- Primary Endpoint
- Biochemical Remission of (AIH) at Month 6.
- Status
- Terminated
- Last Updated
- 6 years ago
Overview
Brief Summary
An open-label, multi-center, prospective, randomized study to evaluate the efficacy, safety and tolerability of LCP-Tacro tablets given once daily vs. azathioprine, each in combination with prednisone, for the treatment of autoimmune hepatitis (AIH).
Detailed Description
An open-label, multi-center, prospective, randomized study to evaluate the efficacy, safety and tolerability of LCP-Tacro tablets given once daily vs. azathioprine for the treatment of autoimmune hepatitis (AIH). Patients with histologically confirmed chronic hepatitis who fulfill criteria established by the International Autoimmune Hepatitis Group (IAIHG) and Inclusion and Exclusion criteria will be enrolled after having signed an informed consent document. Up to 60 patients will be randomized (1:1) to receive treatment with LCP-Tacro + prednisone vs. azathioprine (AZA) + prednisone. * LCP-Tacro will be started at 2 mg once daily (q.d.) with weekly measurement of tacrolimus whole blood trough levels and adjustment of the daily dose of LCP-Tacro to achieve target tacrolimus levels of 3 - 6 ng/mL. Patients with histological evidence of cirrhosis and a Model for End-Stage Liver Disease (MELD) score ≤ 8 will commence LCP-Tacro at a fixed dose of 1 mg once daily, with subsequent dosage adjustments to maintain tacrolimus trough levels at 3 - 6 ng/mL. * AZA will be started at 50 - 100 mg (approximately 1 mg/kg) once daily (q.d.). Patients will also commence treatment with prednisone 30 mg/day for one week, then 20 mg/day for one week, then 15 mg/day for two weeks, then 10 mg/day through Month 6.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Men and women at least 18 years of age with a diagnosis of definite or probable AIH defined by the revised International Autoimmune Hepatitis Group (IAIHG) criteria
- •Elevation of serum ALT ≥ 1.5 times the upper limit of normal
- •Liver biopsy showing chronic hepatitis consistent with AIH
- •Patients able to swallow the study medication
- •Patients capable of understanding the purposes and risks of the study, who can give written informed consent and who are willing to participate in and comply with the study
- •Women of childbearing potential must have a negative serum pregnancy test within seven days prior to receiving study medication and agree to use contraceptive measures to avoid pregnancy during participation in the trial.
Exclusion Criteria
- •Patients with other concurrent liver disease
- •Patients with cirrhosis on liver biopsy with a MELD score \> 15
- •Patients with a history or presence of decompensated liver disease
- •Patients with serum creatinine ≥ 1.5 mg/dL prior to enrollment
- •Patients positive for HCV RNA or Hepatitis B surface antigen (HBsAg)
- •Patients with a history of alcohol intake \> 25 g/day within the past six months
- •Patients with TSH outside normal range accompanied by an abnormal T4
- •Patients with alpha-fetoprotein ≥ 20 ng/mL
- •Patients with severe anemia (hemoglobin \< 8 g/dL), leukopenia (WBC \< 4000/mm3), or thrombocytopenia (platelet count \< 100,000/mm3)
- •Patients with a history of recent exposure to hepatotoxic drugs
Arms & Interventions
LCP-Tacro
LCP-Tacro tablets(1,2,and 5mg tacrolimus)+ prednisone tablets(5mg)
Intervention: LCP-Tacro (tacrolimus)
Azathioprine
Azathioprine tablets(50mg)+ prednisone tablets(5mg)
Intervention: Azathioprine
Outcomes
Primary Outcomes
Biochemical Remission of (AIH) at Month 6.
Time Frame: 6 months
Percent of patients that achieve biochemical remission of (AIH) at Month 6 during treatment with LCP-Tacro + prednisone or azathioprine + prednisone. Biochemical remission is defined as ALT, total bilirubin and gamma globulin within normal limits.
Secondary Outcomes
- Biochemical Remission by Month 3.(3 months)
- Incomplete Response, Treatment Failure, or a Case of Relapse at 6 Months(6 months)