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Study of TVB-2640 in Subjects With Nonalcoholic Steatohepatitis (NASH)

Phase 2
Completed
Conditions
Metabolic Dysfunction-assocated Steatohepatitis/ Nonalcoholic Fatty Liver Disease
Interventions
Other: Placebo
Registration Number
NCT04906421
Lead Sponsor
Sagimet Biosciences Inc.
Brief Summary

This is a Phase 2, multi-center, double-blind, randomized, placebo-controlled study to evaluate the safety and efficacy on TVB-2640 in subjects with non-alcoholic steatohepatitis (NASH). Subjects will be randomly assigned toTVB-2640 or matching placebo PO QD for 52 weeks, with the first dose administered on Day 1.

Detailed Description

The indication nonalcoholic steatohepatitis \[NASH\]) is now referred to as metabolic dysfunction-associated steatohepatitis (MASH) and is characterized by hepatocyte necrosis, chronic inflammation, and resultant fibrosis formation.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
168
Inclusion Criteria
  • Must be willing and able to participate in the study and provide written informed consent.

  • Male and female adults ≥18 years of age on the date that written informed consent to take part in the study is provided.

  • Body mass index (BMI) ≥23 kg/m2 for Asians and ≥25 kg/m2 for other races.

  • Female subjects must be either:

    • Not of childbearing potential OR
    • Women of childbearing potential (WOCBP) must have a negative serum pregnancy (beta-human chorionic gonadotropin [β-HCG]) test during Screening, a negative urine pregnancy test within 24 hours before the first dose of study drug on Day 1, and must agree to perform urine home pregnancy tests monthly between study visits. WOCBP must not be breastfeeding, not plan to become pregnant during the study, and must use birth control.
  • Must have liver stiffness measurement ≥8.5 kPa measured by FibroScan and CAP score measured by FibroScan ≥280 dB/m during the Screening period.

  • Histologic confirmation of NASH: must have had prior liver biopsy within 180 days before randomization (randomization is within 24 hours of Baseline [Day1]) with fibrosis stage F2-F3 and a NAS of ≥4 with at least a score of 1 in each of the following NAS components: steatosis, ballooning degeneration, and lobular inflammation.

Exclusion Criteria
  • History of harmful alcohol intake for a period of more than 3 consecutive months within 1 year prior to Screening in the judgement of the Investigator.
  • Active substance abuse.
  • Gain or loss of >5% of body weight in the 6 months prior to Baseline (Day 1) or >10% of body weight in the 12 months prior to Screening.
  • Type 1 diabetes mellitus by history.
  • Positive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) test within 30 days before Baseline, history of hospitalization for coronavirus disease-2019 (COVID-19) ), or history of use of oxygen due to COVID-19) <6 months prior to the Screening visit date. Note that previous COVID-19 infection alone is not exclusionary and vaccination against SARS-CoV-2 is allowed. Infection and/or vaccination must be documented.
  • Uncontrolled T2DM, defined as HbA1c ≥9.5% at Screening.
  • Presence of cirrhosis on liver histology (stage 4 fibrosis), according to the judgement of the central reader, and/or cross sectional imaging evidence consistent with cirrhosis and/or portal hypertension.
  • Use of glucagon-like peptide-1 (GLP-1) agonists or a sodium-glucose co-transporter-2 (SGLT2) inhibitor, unless on a stable daily dose for at least 6 months prior to the Screening visit date, or on a complex oral anti-diabetic (OAD) regimen (3 or more OADs [except for a GLP-1 agonist or an SGLT2 inhibitor]), unless on a stable dose for at least 3 months prior to the Screening visit date.
  • Subjects with active or quiescent chronic liver disease of etiologies other than NASH (eg, viral or autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cholangitis, and 'autoimmune hepatitis-overlap' syndromes, hemochromatosis, Wilson's disease, alpha 1 antitrypsin deficiency, alcohol-related liver disease, drug-induced liver disease, and/or infiltrative conditions [eg, sarcoidosis]).
  • Current or historic clinically evident hepatic decompensation event (eg, ascites formation, variceal hemorrhage, hepatic encephalopathy).
  • Any subject who has sustained a clinically evident cardiovascular, cerebrovascular, and/or peripheral vascular event during the 12 months prior to anticipated Baseline (Day 1) visit date is not eligible for study participation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboSubjects will receive matching placebo PO QD for 52 weeks, with the first dose administered on Day 1.
TVB-2640 50 mgTVB-2640Subjects will receive TVB-2640 PO QD for 52 weeks, with the first dose administered on Day 1.
Primary Outcome Measures
NameTimeMethod
Histological Improvement in Nonalcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS) Without Worsening of Fibrosis (by NASH Clinical Research Network [CRN] Fibrosis Score).52 Weeks

Histological improvement is defined as ≥2 points improvement in NAS with ≥1 point improvement in ballooning or inflammation

Subjects With Resolution of Steatohepatitis and No Worsening of Liver Fibrosis by NASH CRN Fibrosis Score and Histological Improvement in NAS.52 Weeks

NASH resolution defined as absence of fatty liver disease or isolated or simple steatosis without steatohepatitis and a score of either 0 or 1 for inflammation, 0 for ballooning and any value for steatosis and no worsening of liver fibrosis (by NASH CRN fibrosis score). Histological improvement defined as ≥2 point improvement in NAS (with ≥1 point improvement in ballooning or inflammation).

Secondary Outcome Measures
NameTimeMethod
Proportion of Subjects Experiencing Fibrosis Improvement of ≥1 Stage by NASH CRN Score Without Worsening of Steatohepatitis52 Weeks

Proportion of subjects experiencing fibrosis improvement of ≥1 stage by NASH CRN score Without worsening of steatohepatitis (defined as no increase in NAS for ballooning, inflammation, or steatosis) at 52 weeks.

Proportion of Subjects Experiencing Resolution of Steatohepatitis and no Worsening of Liver Fibrosis (by NASH CRN Fibrosis Score)52 Weeks

Resolution of steatohepatitis is defined as absence of fatty liver disease or isolated or simple steatosis without steatohepatitis and a NAS of 0 or 1 for inflammation, 0 for ballooning, and any value for steatosis.

Proportion of Subjects With Improvement in Liver Fibrosis >=1 Stage by NASH CRN Fibrosis Score Without Worsening of Steatohepatitis at 52 Weeks OR Resolution of Steatohepatitis and No Worsening of Liver Fibrosis by NASH CRN Fibrosis Score52 Weeks

No increase in NAS for ballooning, inflammation or steatosis.

Proportion of MRI-PDFF ≥30% Responders.52 Weeks

MRI PDFF ≥30% responder is defined as a subject with ≥8% liver fat content at Baseline who achieves a relative reduction from Baseline in MRI-PDFF ≥30%.

Trial Locations

Locations (108)

North Alabama Health Research

🇺🇸

Huntsville, Alabama, United States

Digestive Health Research of Southern California

🇺🇸

Long Beach, California, United States

Catalina Research Institute, LLC

🇺🇸

Montclair, California, United States

San Marcus Research Clinic, Inc.

🇺🇸

Miami Lakes, Florida, United States

ACME Medical Specialties PLCC

🇺🇸

Lumberton, North Carolina, United States

WR-ClinSearch, LLC

🇺🇸

Chattanooga, Tennessee, United States

North Alabama GI Research Center

🇺🇸

Madison, Alabama, United States

GI Alliance Arizona Digestive Health-Sun City

🇺🇸

Sun City, Arizona, United States

ARcare Center for Clinical Research, LLC - Conway

🇺🇸

Conway, Arkansas, United States

Arkansas Diagnostic Center

🇺🇸

Little Rock, Arkansas, United States

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North Alabama Health Research
🇺🇸Huntsville, Alabama, United States

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