A randomized, double-blind study to assess the safety and efficacy of EDP-305 in subjects with liver-biopsy proven Non-Alcoholic Steatohepatitis (NASH)
The aim of this Phase 2b study aimed to evaluate safety and efficacy of the investigational novel FXR agonist, EDP-305, in a population of patients with liver biopsy proven NASH. This Phase 2b study aimed to evaluate the safety and efficacy of two doses of EDP-305 compared to placebo for the treatment of NASH in subjects with liver biopsy proven NASH. As suggested in the FDA guidance, this late stage Phase 2 study explored the effect of EDP-305/placebo treatment on histological endpoints. The patient population selected for inclusion in the study was designed to represent the target population for treatment. Specifically, in patients with liver disease, there is a significant overlap of NASH and various metabolic conditions including obesity and T2DM. In order to be reflective of the NASH population, these patients were not excluded from participation in this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
98
Proportion of Participants Who Achieve ≥1 Stage Improvement in Fibrosis Without Worsening of Steatohepatitis and/or Resolution of Steatohepatitis and no Worsening of Liver Fibrosis as Determined by Liver Biopsy
Proportion of participants who achieve ≥1 stage improvement in fibrosis without worsening of steatohepatitis and/or resolution of steatohepatitis and no worsening of liver fibrosis as determined by liver biopsy.
Time frame: Week 72
Change in 5D-itch Scale From Baseline
5D-itch scale, change from baseline at Week 12. Change from baseline for 5D-itch scale was analyzed using a restricted maximum likelihood-based mixed model repeated measures (MMRM) technique. The model included treatment, visit, treatment-by-visit interaction as fixed effects along with baseline NAS score and baseline score for 5D-itch scale as covariate. A multidimensional 5D-itch scale developed by Elman (Elman et al., 2010) indicated sum of 0-2 = score of 1, sum of 3-5 = score of 2, sum of 6-10 = score of 3, sum of 11-13 = score of 4, and sum of 14-16 = score of 5. The total 5D score was obtained by summing up the five domain scores and ranges between 5 (no pruritus) and 25 (most severe pruritus).
Time frame: Baseline, Week 12
Proportion of Participants With Improvement of Fibrosis by at Least 1 Stage and/or Resolution of NASH Without Worsening of Either as Determined by Liver Biopsy
Description of endpoint is Proportion of participants with improvement of fibrosis by at least 1 stage and/or resolution of NASH without worsening of either as determined by liver biopsy.
Time frame: Week 72
Proportion of Participants With no Worsening of Fibrosis Combined With no Worsening of NASH as Determined by Liver Biopsy
Proportion of participants with no worsening of fibrosis combined with no worsening of NASH as determined by liver biopsy.
Time frame: Week 72
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Arizona Liver Health
Chandler, Arizona, United States
The Institute of Liver Health
Glendale, Arizona, United States
Dignity Health DBA St. Joseph's Hospital and Medical Center
Phoenix, Arizona, United States
Del Sol Research Management LLC
Tucson, Arizona, United States
Rajeev Krishan, MD, Inc
Bakersfield, California, United States
eStudy Site
Chula Vista, California, United States
Southern California Research Center
Coronado, California, United States
St. Jude Hospital Yorba Linda DBA St. Joseph Heritage Healthcare
Fullerton, California, United States
National Institute of Clinical Research, Inc
Garden Grove, California, United States
eStudySite - La Mesa
La Mesa, California, United States
...and 71 more locations
Proportion of Participants With Resolution of Fibrosis as Determined by Liver Biopsy
Proportion of participants with resolution of fibrosis as determined by liver biopsy at Week 72.
Time frame: Week 72
Proportion of Participants With Improvement in Each Histologic Feature of NASH by at Least 1 Point as Determined by Liver Biopsy
Proportion of participants with improvement in each histologic feature of NASH by at least 1 point as determined by liver biopsy at Week 72.
Time frame: Week 72
Proportion of Participants With Improvement of Fibrosis by ≥ 2 Stages by Liver Biopsy
Proportion of participants with improvement of fibrosis by ≥ 2 stages by liver biopsy.
Time frame: Week 72
Proportion of Participants With Improvement in NAS by at Least 2 Points With no Worsening of Fibrosis as Determined by Liver Biopsy
Proportion of participants with improvement in NAS by at least 2 points with no worsening of fibrosis as determined by liver biopsy at Week 72.
Time frame: Week 72
Proportion of Participants With Improvement of Fibrosis and Resolution of NASH as a Composite Endpoint as Defined by Both Endpoints Being Met in the Same Participant
Proportion of participants with improvement of fibrosis and resolution of NASH as a composite endpoint as defined by both endpoints being met in the same participant at week 72.
Time frame: Baseline, Week 72
Proportion of Participants With Resolution of NASH and no Worsening of Liver Fibrosis
Proportion of participants with resolution of NASH and no worsening of liver fibrosis at Week 72.
Time frame: Week 72
Proportion of Participants With Histological Progression to Cirrhosis as Determined by Liver Biopsy
Proportion of participants with histological progression to cirrhosis as determined by liver biopsy at Week 72.
Time frame: Week 72
Participants With TEAEs Leading to Discontinuation
Treatment emergent adverse events (TEAEs) were defined as AEs occurring or worsening on or after the first dose of study drug until the last dose of study drug. TEAEs were regarded as leading to discontinuation if they led to discontinuation of the study drug.
Time frame: Day 1 to Week 72
Percentage Change of Fat in the Liver From Baseline
Percentage change of fat in the liver as assessed by magnetic resonance imaging proton density fat fraction (MRI PDFF) from Baseline to Week 12.
Time frame: Baseline, Week 12
Change in Liver Stiffness From Baseline
Change in liver stiffness by magnetic resonance elastography (MRE) in kilopascal (kPa) from Baseline at Week 12.
Time frame: Baseline, Week 12
Change in Triglycerides From Baseline
Change in Triglycerides from Baseline at Week 12.
Time frame: Baseline, Week 12
Change in Adiponectin From Baseline
Change in adiponectin from Baseline at Week 12.
Time frame: Baseline, Week 12
Plasma Concentration of EDP-305
Plasma concentration at second post dose (2-4 hours post dose) at Week 12.
Time frame: 2-4 hours post dose at Week 12
Change in VAS (Visual Analog Score) From Baseline
Change in VAS from Baseline at Week 12. Change from baseline was analyzed using a restricted maximum likelihood-based MMRM technique. Two separate scales were used to assess pruritus. An itch VAS was used to record the intensity of the pruritus by Furue (Furue et al., 2013). Scale referred to no pruritus (0 point) and the end of the scale to the most severe pruritus (10 points). If the VAS score was greater than zero (i.e. itch), a multidimensional 5D-itch scale developed by Elman (Elman et al., 2010) indicated sum of 0-2 = score of 1, sum of 3-5 = score of 2, sum of 6-10 = score of 3, sum of 11-13 = score of 4, and sum of 14-16 = score of 5. It was used to assess five different dimensions of pruritus within the last two weeks. The five dimensions assessed were duration, degree, direction, disability, and distribution. The total 5D itch score was obtained by summing up the five domain scores and ranges between 5 (no pruritus) and 25 (most severe pruritus).
Time frame: Baseline, Week 12
Change in Total Cholesterol From Baseline
Change in Total Cholesterol from Baseline to Week 12 versus placebo.
Time frame: Baseline, Week 12
Change in HDL From Baseline
Change in HDL from Baseline at week 12.
Time frame: Baseline, Week 12
Change in LDL From Baseline
Change in LDL From Baseline to Week 12.
Time frame: Baseline, Week 12