A study on safety and efficacy of Elafibranor in Adult Participants with Primary Sclerosing Cholangitis (PSC)

Phase 1

• Conditions: Adults patients with Primary Sclerosing Cholangitis (PSC); MedDRA version: 20.1Level: LLTClassification code 10036732Term: Primary sclerosing cholangitisSystem Organ Class: 100000004871; Therapeutic area: Body processes [G] - Metabolic Phenomena [G03]

• Registration Number: EUCTR2022-002695-37-ES
• Lead Sponsor: Ipsen Bioscience, Inc.

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2023-01-10
• Last Update Posted: 20 February 2023

Recruitment & Eligibility

• Status: Authorised-recruitment may be ongoing or finished
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. Male or female participants must be 18 to 75 years of age inclusive, at the time of signing the informed consent.
2. Participants with a diagnosis of PSC as demonstrated by the presence of the following, and in the absence of apparent causes of secondary sclerosing cholangitis:
i) Historical evidence of an elevated ALP >ULN since at least 6 months prior to SV1.
ii) Cholangiogram (e.g. magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) with features compatible with large duct PSC.
3. ALP =1.5x ULN during screening (with variability =30% based on two values). The interval between the two consecutive measurements should beat least 2 weeks (and up to 4 weeks). The baseline value will be the average of all values obtained during screening plus the baseline visit measurement (obtained prior to treatment initiation).
• If the mean value of both ALP values is =1.5x ULN and the variability between values is =30%, the participant is eligible (even if one of the two values is <1.5x ULN).
• In cases where one of the two values is >1.5x ULN, but the mean value is <1.5x ULN, or if the variability between values is >30%, an additional value during screening may be obtained at least 2 weeks (and up to 4 weeks) after the previous measurement during screening.
• In cases where an additional value is checked, the participant will be eligible if the variability between the second and the third value is =30%, and the mean value of all ALP values during screening is =1.5x ULN.
• In cases of ineligibility, the candidate may be subsequently re-screened once at investigator’s discretion, and enrolled if stable qualifying values are demonstrated.
• All ALP values during screening should be analysed via the central laboratory.
4. Total bilirubin =2.0x ULN at SV1.
5. Participants taking UDCA who have:
i) Total daily dose =23 mg/kg/day.
ii) Minimum of 6 months of stable treatment prior to screening period and expected to remain on stable dose through the 12-week DBP.
iii) Minimum of 3 months off treatment prior to screening period if UDCA was recently discontinued.
6. For participants with IBD:
i) Participants with Crohn’s disease must be in remission based on the investigator’s clinical assessment and should be on stable treatment prior to randomisation and during screening.
ii) Participants with ulcerative colitis must be in remission or have low activity disease as per the judgement of the investigator and should be on stable treatment prior to randomisation and during screening.
iii) Current treatment for IBD is permitted, if the participant has been well controlled for =3 months prior to the screening period and is anticipated to remain on a stable dose of drugs for IBD treatment, including biologics, immunosuppressants, immunomodulators, or systemic corticosteroids. This provision regarding stability of IBD treatment applies to the following, among others:
• 5-aminosalicylic acid drugs.
• Azathioprine; 6-mercaptopurine; methotrexate.
• Budesonide (within recommended doses for management of IBD). In addition to oral formulation, topical application of budesonide (rectal foam or enema) is allowed.
• Other systemic corticosteroids.
• Biologics (e.g. anti-tumour necrosis factor or anti-integrin therapies).
• Other immunosuppressants or immunomodulators used for IBD treatment.
iv) Participants with IBD should have a colonoscopy performed within one year prio

Exclusion Criteria

1. History or presence of other concomitant chronic liver disease including:
a) ImmunoglobulinG 4 (IgG4) related sclerosing cholangitis, or IgG4 =4x ULN at SV1.
b) Small duct PSC.
c) Documented history of secondary sclerosing cholangitis.
d) Presence of hepatitis B surface antigen (HBsAg) at screening.
e) Hepatitis C virus (HCV) infection defined by positive anti-HCV antibody and positive HCV ribonucleic acid (RNA) (Note: Participants with positive anti-HCV antibody due to previously treated HCV infection, may be enrolled if a confirmatory HCV RNA is undetectable and sustained viral response has been documented).
f) PBC or positive anti-mitochondrial antibody.
g) Alcoholic liver disease.
h) Autoimmune hepatitis (AIH): Simplified Diagnostic Criteria of the IAIHG =6.
i) Presence of history of PSC-PBC or PSC-AIH overlap syndrome.
j) NASH.
k) Known history of alpha-1 antitrypsin deficiency.
2. Presence of percutaneous drain or bile duct stent at screening or within three months prior to screening.
3. History of bacterial cholangitis within 60 days prior to the screening period, or participant on antibiotics for prophylaxis of recurrent cholangitis.
4. History or any current suspicion of cholangiocarcinoma or elevated value of carbohydrate antigen 19-9 (CA19-9) >129 U/mL at SV1.
5. Alpha-fetoprotein (AFP) >20 ng/mL with 4-phase liver computerised tomography (CT) or magnetic resonance imaging (MRI) suggesting presence of liver cancer.
6. Participants with cirrhosis who are also classified as Child-Pugh B or C based on the Child-Pugh score. Participants with cirrhosis with Child-Pugh A score are allowed.
7. History of clinically significant hepatic decompensation, including:
a) History of liver transplantation, current placement on a liver transplant list, current model for end-stage liver disease (MELD)-Na score =12 due to hepatic impairment (MELD-Na will be calculated only when MELD >11).
b) Evidence of complications of cirrhosis, including hepatic decompensation or evidence of significant portal hypertension complications including presence of ascites requiring treatment; history or presence of spontaneous bacterial peritonitis; presence of hepatic encephalopathy grade 2 or higher per West-Haven criteria; history of oesophageal variceal bleeding or related interventions (e.g. oesophageal variceal banding, or transjugular intrahepatic portosystemic shunt placement).
c) Hepatorenal syndrome (type I or II).
8. Presence or history of hepatocellular carcinoma.
9. Medical conditions that may cause non-hepatic increases in ALP (e.g. Paget’s disease).
10. Medical conditions that may diminish life expectancy to <2 years, including known cancers.
11. Participant has a positive test for human immunodeficiency virus (HIV) type 1 or 2 at SV1, or participant is known to have tested positive for HIV.
12. Evidence of any other unstable or untreated clinically significant immunological, endocrine, neurological, gastrointestinal, haematologic, psychiatric diseases as evaluated by the investigator; other clinically significant conditions that are not well controlled.
13. Known malignancy or history of malignancy within the last 5 years, with the exception of local, successfully treated basal cell carcinoma or in-situ carcinoma of the uterine cervix.
14. Administration of the following medications are prohibited as specified below:
a) 3 months prior to the screening period: fibrates and glitazones.
b) 3 months prior to the screening period: cyclosporine, myc

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified