MedPath

Simtuzumab (SIM, GS-6624) in the Treatment of Cirrhosis Due to NASH

Phase 2
Terminated
Conditions
Liver Fibrosis Due to NASH
Interventions
Biological: Placebo
Biological: SIM
Registration Number
NCT01672879
Lead Sponsor
Gilead Sciences
Brief Summary

The primary objective of this study is to evaluate the safety and efficacy of SIM (formerly referred to as GS-6624) in adults with compensated cirrhosis due to Non-Alcoholic Steatohepatitis (NASH). It will consist of 2 phases:

* Randomized Double-Blind Phase

* Open-Label Phase (optional)

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
259
Inclusion Criteria
  • Adults with cirrhosis of the liver defined as an Ishak fibrosis stage ≥ 5
  • Liver biopsy consistent with NASH or cryptogenic cirrhosis
  • Exclusion of other causes of liver disease including viral hepatitis and alcoholic liver disease
  • The liver biopsy sample must be determined to be adequate for evaluation by the Central pathologist
  • Must have aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 10 x the upper limit of the normal range (ULN)
  • Must have serum creatinine < 2.0 mg/dL
  • A negative serum pregnancy test is required for female subjects of childbearing potential
  • All sexually active female subjects of childbearing potential must agree to use a protocol recommended method of contraception during heterosexual intercourse throughout the study and for 90 days following the last dose of study medication
  • Lactating females must agree to discontinue nursing before starting study treatment
  • Male subjects, if not vasectomized, are required to use barrier contraception (condom plus spermicide) during heterosexual intercourse from the screening through the study completion and for 90 days following the last dose of study drug

Key

Exclusion Criteria
  • Pregnant or breast feeding
  • Any history of hepatic decompensation including ascites, hepatic encephalopathy or variceal bleeding
  • Weight reduction surgery in the past 5 year
  • Child-Pugh-Turcotte (CPT) score >7; Model for End-Stage Liver Disease (MELD) score > 12 and Body Mass Index (BMI) <18kg/m2
  • Positive for hepatitis C virus (HCV) RNA
  • Positive for HBsAg
  • Alcohol consumption greater than 21oz/week for males or 14oz/week for females
  • Positive urine screen for amphetamines, cocaine or opiates (i.e. heroin, morphine) at screening. Subjects on stable methadone or buprenorphine maintenance treatment for at least 6 months prior to screening may be included in the study. Subjects with a positive urine drug screen due to prescription opioid-based medication are eligible if the prescription and diagnosis are reviewed and approved by the investigator
  • Clinically significant cardiac disease
  • History of malignancy, other than non-melanomatous skin cancer, within 5 years prior to screening
  • Major surgical procedure within 30 days prior to screening or the presence of an open wound
  • Known hypersensitivity to the investigation product or any of its formulation excipients
  • History of bleeding diathesis within 6 months of screening
  • Unavailable for follow-up assessment or concern for subject's compliance with the protocol procedures;
  • Participation in an investigational trial of a drug or device within 30 days prior to screening
  • History of solid-organ transplant; poor venous access or requirement for permanent or semi-permanent central vein catheter such as portacath

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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboDuring the Randomized Double-Blind Phase, participants will receive placebo to match SIM administered via intravenous infusion every 2 weeks for up to 240 weeks. During the optional Open-Label Phase, participants will receive SIM 700 mg administered via intravenous infusion every 2 weeks for up to an additional 240 weeks.
SIM 700 mgSIMDuring the Randomized Double-Blind Phase, participants will receive SIM 700 mg via intravenous infusion every 2 weeks for up to 240 weeks. During the optional Open-Label Phase, participants will receive SIM 700 mg via intravenous infusion every 2 weeks for up to an additional 240 weeks.
PlaceboSIMDuring the Randomized Double-Blind Phase, participants will receive placebo to match SIM administered via intravenous infusion every 2 weeks for up to 240 weeks. During the optional Open-Label Phase, participants will receive SIM 700 mg administered via intravenous infusion every 2 weeks for up to an additional 240 weeks.
SIM 200 mgSIMDuring the Randomized Double-Blind Phase, participants will receive SIM 200 mg via intravenous infusion every 2 weeks for up to 240 weeks. During the optional Open-Label Phase, participants will receive SIM 700 mg via intravenous infusion every 2 weeks for up to an additional 240 weeks.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Hepatic Venous Pressure Gradient (HVPG)Baseline to Week 96
Event-Free Survival (EFS) Using Kaplan-MeierBaseline up to the time of clinical event or last dose date (maximum: 240 weeks in Blinded Phase); which ever occurred first

Event free survival (EFS) was the primary clinical efficacy endpoint and was assessed by time to first liver-related event or death, whichever occurs first. Liver-related events included any of the following:

* Liver transplantation

* Qualification for liver transplantation

* Model for End-Stage Liver Disease (MELD) ≥ 15

* Events indicative of hepatic decompensation

* Esophageal variceal bleeding

* Ascites

* Hepatic Encephalopathy

* ≥ 2 point increase in Child Pugh-Turcotte (CPT) score

* Newly diagnosed varices in a subject without prior varices

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (59)

Mayo Clinic Hospital

🇺🇸

Phoenix, Arizona, United States

Southern California Liver Centers

🇺🇸

Coronado, California, United States

University of California, San Diego (UCSD)

🇺🇸

San Diego, California, United States

University of California San Francisco (UCSF)

🇺🇸

San Francisco, California, United States

Indiana University School of Medicine, Division of Gastroenterology/Hepatology

🇺🇸

Indianapolis, Indiana, United States

University of Colorado, Denver

🇺🇸

Aurora, Colorado, United States

Tulane University

🇺🇸

New Orleans, Louisiana, United States

Mercy Medical Center

🇺🇸

Baltimore, Maryland, United States

Walter Reed National Military Medical Center

🇺🇸

Bethesda, Maryland, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Iowa Digestive Disease Center

🇺🇸

Clive, Iowa, United States

Saint Louis University Hospital

🇺🇸

Saint Louis, Missouri, United States

Minnnesota Gastroenterology, PA

🇺🇸

Saint Paul, Minnesota, United States

Lahey Clinic

🇺🇸

Burlington, Massachusetts, United States

State University Of New York at Buffalo

🇺🇸

Buffalo, New York, United States

North Shore University Health System

🇺🇸

Manhasset, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

New York University

🇺🇸

New York, New York, United States

University Hospitals Case Medical Center

🇺🇸

Cleveland, Ohio, United States

University of Pennsylvania Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

University Gastroenterology

🇺🇸

Providence, Rhode Island, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Methodist University Hospital

🇺🇸

Memphis, Tennessee, United States

Texas Clinical Research Institute

🇺🇸

Arlington, Texas, United States

Brooke Army Medical Center

🇺🇸

Fort Sam Houston, Texas, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Intermountain Transplant Center

🇺🇸

Murray, Utah, United States

University of Virginia Health Center

🇺🇸

Charlottesville, Virginia, United States

Bucheon St. Marys Hospital

🇺🇸

Richmond, Virginia, United States

Liver Institute of Virginia

🇺🇸

Newport News, Virginia, United States

Digestive and Liver Disease Specialists

🇺🇸

Norfolk, Virginia, United States

University of Washington

🇺🇸

Seattle, Washington, United States

University of Manitoba

🇨🇦

Winnipeg, Manitoba, Canada

Virginia Mason Medical Center

🇺🇸

Seattle, Washington, United States

Toronto Liver Centre

🇨🇦

Toronto, Ontario, Canada

Hospital Saint-Antoine

🇫🇷

Paris, France

Hôpital de la Croix Rousse

🇫🇷

Lyon, France

CHU Pitié-Salpêtrière

🇫🇷

Paris, France

Istituto Clinico Humanitas

🇮🇹

Rozzano, Milano, Italy

Fonds de Recherche Honoraires

🇫🇷

Strasbourg, France

Gastroenterologisch-Hepatologisches Zentrum Kiel

🇩🇪

Kiel, Germany

Eugastro Gmbh

🇩🇪

Leipzig, Germany

Azienda Ospedaliera Città della Salute e della Scienza di Torino

🇮🇹

Torino, Italy

Fundacion De Investigacion

🇵🇷

San Juan, Puerto Rico

Hospital Universitario Puerta de Hierro

🇪🇸

Majadahonda, Madrid, Spain

Royal Free Hospital, Pond Street

🇬🇧

London, United Kingdom

Hospital Vall D´Hebron

🇪🇸

Barcelona, Cataluna, Spain

King's College Hospital NHS Trust

🇬🇧

London, United Kingdom

Nottingham University Hospitals Queen's Medical Centre

🇬🇧

Nottingham, United Kingdom

Azienda Ospedaliero-Universitaria Policlinico di Modena

🇮🇹

Modena, Italy

Dalhousie University

🇨🇦

Halifax, Nova Scotia, Canada

University of Mississippi Medical Center

🇺🇸

Jackson, Michigan, United States

University of Miami

🇺🇸

Miami, Florida, United States

University of Louisville

🇺🇸

Louisville, Kentucky, United States

Tampa General Hospital

🇺🇸

Tampa, Florida, United States

St. Luke Episcopal Hospital

🇺🇸

Houston, Texas, United States

Alamo Clinical Research Associates

🇺🇸

San Antonio, Texas, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

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