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A Study of Elafibranor in Adults With Primary Biliary Cholangitis and Inadequate Response or Intolerance to Ursodeoxycholic Acid.

Phase 3
Active, not recruiting
Conditions
Primary Biliary Cholangitis
Interventions
Other: Placebo
Registration Number
NCT06383403
Lead Sponsor
Ipsen
Brief Summary

The participants in this study will have confirmed PBC with inadequate response or intolerance to Ursodeoxycholic acid (UDCA), which is a medication used in the management and treatment of cholestatic liver disease.

Primary biliary cholangitis is a slowly progressive disease characterised by damage of the bile ducts in the liver, leading to a build-up of bile acids which causes further damage. The liver damage in PBC may lead to scarring (cirrhosis). PBC may also be associated with multiple symptoms.

Many patients with PBC may require a liver transplant or may die if the disease progresses and a liver transplant is not done. This study will compare a daily dose of elafibranor (the study drug) to a daily dose of placebo (a dummy treatment).

The main aim of this study is to determine if elafibranor is better than placebo in reducing ALP levels to a normal value. High ALP levels in the blood can indicate liver disease.

There will be three periods in this study: A screening period (up to 8 weeks) to assess whether the participant can take part; a treatment period (up to 52 weeks) where eligible participants will be grouped as per their blood ALP levels and randomly assigned to either receive elafibranor or placebo, and a follow-up period (4 weeks) where participants' health will be monitored.

Participants will be twice as likely to receive elafibranor than placebo (2:1 ratio).

Participants will undergo blood sampling, urine collections, physical examinations, clinical evaluations, electrocardiograms (ECG: recording of the electrical activity of heart), ultrasound examinations (a noninvasive test that passes a probe over skin to look at the bladder, urinary tract, and liver), and Fibroscan® examinations (a noninvasive test that passes a probe on skin to measure stiffness of the liver).

They will also be asked to fill in questionnaires. Each participant will be in this study for up to 64 weeks (15 months).

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
69
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants will take 1 placebo tablet per day orally before breakfast with a glass of water at approximately the same time each morning.
Elafibranor 80 mgElafibranorParticipants will take 1 tablet of elafibranor 80 mg per day orally before breakfast with a glass of water at approximately the same time each morning.
Primary Outcome Measures
NameTimeMethod
Percentage of participants with normalisation of Alkaline Phosphate (ALP) LevelsAt Week 52
Secondary Outcome Measures
NameTimeMethod
Change from baseline in ALP levelsFrom baseline to Week 4, Week 12, Week 24, Week 36 and Week 52
Change from baseline in PBC Worst Itch Numeric Rating Scale (NRS) scoreFrom baseline through Week 52

PBC Worst Itch Numeric Rating Scale (NRS) is a self-administered patient-reported outcome questionnaire that measures itch intensity. It asks participants to rate the intensity of their Worst Itch on an 11-point scale ranging from 0 (no itch) to 10 (Worst Itch imaginable): - once daily (24-hour recall period)

Percentage of participants with moderate to severe pruritus at baseline (i.e. score ≥4) with a clinically meaningful response in PBC Worst Itch NRSFrom baseline through Week 52

Defined as ≥1.8-point reduction from baseline

Percentage of participants developing clinically significant changes in Electrocardiogram (ECG) ReadingsFrom baseline until 4 weeks after the end of treatment (maximum duration of 52 weeks)

The clinical significance will be graded by the investigator.

Percentage of participants with normalisation of ALP and TB <0.7 × ULNAt Week 4, Week 12, Week 24, Week 36 and Week 52
Percentage of participants with normalisation of TB and ALP LevelsAt Week 4, Week 12, Week 24, Week 36 and Week 52
Change from baseline in 5-D itch scoreFrom baseline to Week 4, Week 24, and Week 52

Change from baseline in symptoms in terms of 5 domains: degree, duration, direction, disability and distribution. Patients rate their symptoms over the preceding 2-week period on a 1 to 5 scale, with 5 being the most affected.

Change from baseline in Patient Global Impression of Severity (PGI-S) scoresFrom baseline to Week 4, Week 24, and Week 52

Patient Global Impression of Severity (PGI-S) is a 1-item, 5-point scale designed to assess the participant's impression of itch severity over the past 7 days, at different time points during the study.

Percentage of participants developing clinically significant changes in laboratory parametersFrom baseline until 4 weeks after the end of treatment (maximum duration of 52 weeks)

The following laboratory parameters will be reported: blood chemistry, hematology and coagulation, liver tests and renal tests (including urinalysis). The clinical significance will be graded by the investigator.

Percentage of participants with normalisation of ALP LevelsFrom baseline to Week 4, Week 12, Week 24 and Week 36
Percentage of participants with normalisation of ALP Levels and ≥15% decrease from BaselineFrom baseline to Week 4, Week 12, Week 24, Week 36 and Week 52
Percentage of participants with ≥40% decrease from Baseline in ALP LevelsFrom baseline to Week 4, Week 12, Week 24, Week 36 and Week 52
Changes from baseline in Total Bilirubin (TB) LevelsFrom baseline to Week 4, Week 12, Week 24, Week 36 and Week 52
Percentage of participants with ALP <0.5 × Upper Limit of Normal (ULN)At Week 4, Week 12, Week 24, Week 36 and Week 52
Percentage of participants with TB <0.7 × ULNAt Week 4, Week 12, Week 24, Week 36 and Week 52
Percentage of participants with complete biochemical responseAt Week 4, Week 12, Week 24, Week 36 and Week 52

Defined as normal levels of TB, ALP, aminotransferases, albumin, and International normalised ratio (INR)

Change from baseline in PBC-40 Quality of Life (QoL) scoresFrom baseline to Week 4, Week 24, and Week 52

PBC-40 Quality of Life (QoL) assesses symptoms across six domains: fatigue, emotional, social, cognitive function, general symptoms and itch. Patients respond on a verbal response scale, depending on the section options range from 'never' / 'not at all' / 'strongly disagree' to 'always' / 'very much'/ 'strongly agree'. Five items (3/3 in the itch domain and 2/10 in the social domain) also include a 'does not apply' option. A score for each domain is provided (but a total score is not calculated), with each verbal response scale correlating to a score of 1-5 per item (0-5 on items with a 'does not apply' option) with 5 being the most affected. The PBC-40 has a 4-week recall period.

Percentage of participants experiencing Treatment- Emergent Adverse Events (TEAEs), treatment- related TEAEs, Serious Adverse Events (SAEs) and Adverse Events of Special Interest (AESIs).From baseline until 4 weeks after the end of treatment (maximum duration of 52 weeks)

An Adverse Event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. AESIs are AEs that may not be serious but are of special importance to a particular drug or class of drugs.

Patient Global Impression of Change (PGI-C) scoresAt Week 4, Week 24, and Week 52

Patient Global Impression of Change (PGI-C) is a 1-item, 5-point scale designed to assess the participant's impression of change in itch severity since the baseline visit

Change from baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 7a scoresFrom baseline to Week 4, Week 24, and Week 52

PROMIS Fatigue Short Form 7a scores consists of 7 items that measure both the experience of fatigue and the interference of fatigue on daily activities over the past week. Response options are on a 5-point Likert scale, ranging from 1 to 5. Scores can range from 7 to 35, with higher scores indicating greater fatigue.

Percentage of participants developing clinically significant changes in physical examinationFrom baseline until 4 weeks after the end of treatment (maximum duration of 52 weeks)

The clinical significance will be graded by the investigator.

Percentage of participants developing clinically significant changes in vital signsFrom baseline until 4 weeks after the end of treatment (maximum duration of 52 weeks)

The clinical significance will be graded by the investigator.

Trial Locations

Locations (60)

Institute for Clinical and Experimental Medicine - IKEM

🇨🇿

Prague, Czechia

Research Site s.r.o.

🇨🇿

Plzen, Czechia

Universitaetsklinikum Muenster

🇩🇪

Münster, Germany

Ospedale Policlinico San Martino - IRCCS

🇮🇹

Genova, Italy

Hepato-Gastroenterologie HK, s.r.o.

🇨🇿

Hradec Králové, Czechia

Southern California Research Center

🇺🇸

Coronado, California, United States

Topgraphy Health, Inc.

🇺🇸

Los Angeles, California, United States

University of California, Davis

🇺🇸

Sacramento, California, United States

Stanford University Medical Center

🇺🇸

Stanford, California, United States

Peak Gastroenterology Associates

🇺🇸

Colorado Springs, Colorado, United States

Rocky Mountain Gastroenterology

🇺🇸

Littleton, Colorado, United States

International Center for Research

🇺🇸

Tampa, Florida, United States

Delta Research Partners, LLC

🇺🇸

West Monroe, Louisiana, United States

University of Michigan Health System

🇺🇸

Ann Arbor, Michigan, United States

Huron Gastroenterology Associates - Center for Digestive Care

🇺🇸

Ypsilanti, Michigan, United States

South Denver Gastroenterology,P.C.

🇺🇸

Englewood, New Jersey, United States

Southwest Gastroenterology Associates, PC (SWGA)

🇺🇸

Albuquerque, New Mexico, United States

Northwell Health Center for Liver Disease and Transplantation

🇺🇸

Manhasset, New York, United States

Charlotte Gastroenterology & Hepatology, PLLC

🇺🇸

Charlotte, North Carolina, United States

Coastal Research Institute

🇺🇸

Fayetteville, North Carolina, United States

Gastroenterology Center of the Midsouth

🇺🇸

Cordova, Tennessee, United States

Methodist Transplant Physicians

🇺🇸

Dallas, Texas, United States

American Research Corporation at The Texas Liver Institute

🇺🇸

San Antonio, Texas, United States

American Research Corporation

🇺🇸

San Antonio, Texas, United States

Velocity Liver Institute NW

🇺🇸

Seattle, Washington, United States

Artroscan

🇨🇿

Ostrava, Czechia

Clinique Pasteur

🇫🇷

Toulouse, France

Universitatsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

Gastroenterologsiche Studiengesellschaft Herne

🇩🇪

Hemer, Germany

EUGASTRO GmbH

🇩🇪

Leipzig, Germany

Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone

🇮🇹

Palermo, Italy

Azienda Ospedaliero Universitaria Pisana

🇮🇹

Pisa, Italy

IRCCS Istituto clinico humanitas - Humanitas Mirasole spa

🇮🇹

Rozzano, Italy

Korea University Ansan Hospital

🇰🇷

Ansan si, Korea, Republic of

Keimyung University Dongsan Hospital

🇰🇷

Daegu, Korea, Republic of

Kyungpook National University Hospital (KNUH)

🇰🇷

Daegu, Korea, Republic of

Pusan National University Hospital (PNUH)

🇰🇷

Pusan, Korea, Republic of

CHA Bundang Medical Center, CHA University

🇰🇷

Seongnam-si, Korea, Republic of

Seoul National University Bundang Hospital (SNUBH)

🇰🇷

Seongnam-si, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

The Catholic University of Korea, Eunpyeong St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Krakowskie Centrum Medyczne Sp.z.o.o - FutureMeds

🇵🇱

Kraków, Poland

FutureMeds Warszawa Centrum

🇵🇱

Warsaw, Poland

Cluj County Clinical Emergency Hospital

🇷🇴

Cluj-Napoca, Romania

Gastromedica Srl

🇷🇴

Iaşi, Romania

Hospital Clinic i Provincial de Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Universitario Puerta de Hierro de Majadahonda

🇪🇸

Majadahonda, Spain

Institut d Investigacio i Innovacio Parc Tauli, Hospital Universitari Parc Tauli

🇪🇸

Sabadell, Spain

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Aberdeen Royal Infirmary NHS Grampian Grampian Health Board

🇬🇧

Aberdeen, United Kingdom

Bradford Royal Infirmary - Bradford Teaching Hospitals NHS Foundation

🇬🇧

Bradford, United Kingdom

Frimley Park Hospital - Frimley Health NHS Foundation Trust

🇬🇧

Frimley, United Kingdom

Queen Elizabeth University Hospital - Greater Glasgow Health Board

🇬🇧

Glasgow, United Kingdom

Hull Royal Infirmary - Hull University Teaching Hospitals NHS Trust

🇬🇧

Hull, United Kingdom

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

🇬🇧

London, United Kingdom

King's College Hospital

🇬🇧

London, United Kingdom

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