This is a two part Phase IIa/b multicentre, randomised, double-blind, placebo-controlled, parallel group dose-ranging study to assess the efficacy, safety, and tolerability of the combination of zibotentan and dapagliflozin, and dapagliflozin monotherapy versus placebo in participants with cirrhosis with features of portal hypertension.
Part A will assess the efficacy, safety, and tolerability of the combination of B mg zibotentan and 10 mg dapagliflozin versus placebo in participants with Child-Pugh A cirrhosis with features of portal hypertension and with no history of decompensation events. If the safety profile is determined to be acceptable at the conclusion of Part A, Part B will investigate efficacy, safety, and tolerability of A mg, B mg, or C mg zibotentan combined with 10 mg dapagliflozin and of 10 mg dapagliflozin monotherapy versus placebo in participants with cirrhosis with features of portal hypertension. Part B will include a broader range of Child- Pugh A and Child-Pugh B cirrhosis participants, including those with more severe disease, a history of decompensation events, or current ascites. The study will be conducted in approximately 30 to 45 study centres in North America, Asia, and Europe.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
TRIPLE
Enrollment
205
placebo capsule (matching zibotentan capsule) placebo tablet (matching dapagliflozin tablet)
zibotentan capsule dapagliflozin tablet
placebo capsule (matching zibotentan capsule) placebo tablet (matching dapagliflozin tablet)
Absolute Change in HVPG From Baseline to Week 6, Part A
Absolute change in Hepatic venous pressure gradient from baseline to week 6.
Time frame: From Baseline to Week 6
Absolute Change in HVPG From Baseline to Week 6, Part B
Absolute change in Hepatic venous pressure gradient from baseline to week 6.
Time frame: From Baseline to Week 6
HVPG Percentage Change From Baseline to Week 6, Part A
Hepatic venous pressure gradient percentage change from baseline to week 6, Part A.
Time frame: From Baseline to Week 6
HVPG Percentage Change From Baseline to Week 6, Part B
Hepatic venous pressure gradient percentage change from baseline to week 6, Part B.
Time frame: From baseline to week 6
Number of Participants With HVPG Response at Week 6, Part A
A HVPG responder is defined as a subject having \<10 mmHg at week 6 if baseline HVPG \>=10 or a reduction of \>=1.5 mmHg from baseline to week 6. n: Number of subjects in analysis. N: Number of subjects per treatment group.
Time frame: From baseline to week 6
Number of Participants With HVPG Response at Week 6, Part B
A HVPG responder in Part B is defined as a subject having at least 20% decrease or a reduction to or below 12 mmHg if baseline HVPG \> 12 mmHG from baseline to Week 6.
Time frame: From baseline to Week 6
Change in Body Weight (kg) Over Time Course of Study, Part A
The analysis is performed using MMRM. The model includes the continuous covariate of the Baseline measurements as the fixed effect covariate and fixed categorical effects of treatment group, visit, and treatmentby-visit interaction.
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placebo capsule (matching zibotentan capsule) dapagliflozin tablet
zibotentan capsule dapagliflozin tablet
zibotentan capsule dapagliflozin tablet
zibotentan capsule dapagliflozin tablet
Research Site
Birmingham, Alabama, United States
Research Site
Pasadena, California, United States
Research Site
San Francisco, California, United States
Research Site
West Hollywood, California, United States
Research Site
Rochester, Minnesota, United States
Research Site
The Bronx, New York, United States
Research Site
Charleston, South Carolina, United States
Research Site
Dallas, Texas, United States
Research Site
Charlottesville, Virginia, United States
Research Site
Richmond, Virginia, United States
...and 40 more locations
Time frame: From baseline to Week 6
Change in Body Weight (kg) Over Time Course of Study, Part B
The analysis is performed using MMRM. The model includes the continuous covariate of the Baseline measurements as the fixed effect covariate and fixed categorical effects of treatment group, visit, and treatmentby-visit interaction.
Time frame: From baseline to Week 6 and Week 16
Change in Total Dosage of Loop-diuretic Equivalents Use From Baseline to Week 6, Part A
Change in total dosage of loop-diuretic equivalents use from baseline to Week 6, Part A. A loop-diuretic equivalent is based on 40 mg furosemide = 1 mg bumetanide = 20 mg torsemide = 50 mg ethacrynic acid.
Time frame: From baseline to Week 6
Change in Total Dosage of Loop-diuretic Equivalents Use From Baseline to Week 6 and Week 16, Part B
Change in total dosage of loop-diuretic equivalents use from baseline to Week 6, Part B. A loop-diuretic equivalent is based on 40 mg furosemide = 1 mg bumetanide = 20 mg torsemide = 50 mg ethacrynic acid.
Time frame: From Baseline to Week 6 and Week 16
Change in Total Body Water From Baseline to Week 6, Part A
Change in total body water from baseline to Week 6, Part A. The analysis is performed using MMRM.
Time frame: From Baseline to Week 6
Change in Total Body Water From Baseline to Week 6 and Week 16, Part B
Change in total body water from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM.
Time frame: From Baseline to Week 6 and Week 16
Change in Extracellular Water From Baseline to Week 6, Part A
Change in extracellular water from baseline to Week 6, Part A. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass.
Time frame: From baseline to Week 6
Change in Extracellular Water From Baseline to Week 6 and Week 16, Part B
Change in extracellular water from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass.
Time frame: From Baseline to Week 6 and to Week 16
Change in Intracellular Water From Baseline to Week 6, Part A
Change in intracellular water from Baseline to Week 6, Part A. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass.
Time frame: From Baseline to Week 6
Change in Intracellular Water From Baseline to Week 6 and Week 16, Part B
Change in intracellular water from Baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass.
Time frame: From Baseline to Week 6 and Week 16
Change in Total Body Fat Mass From Baseline to Week 6, Part A
Change in total body fat mass from Baseline to Week 6, Part A. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass.
Time frame: From baseline to Week 6
Change in Total Body Fat Mass From Baseline to Week 6 and Week 16, Part B
Change in total body fat mass from Baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass.
Time frame: From Baseline to Week 6 and Week 16
Change in Systolic Blood Pressure From Baseline to Week 6, Part A
Change in systolic blood pressure from baseline to Week 6, Part A. The analysis is performed using MMRM.
Time frame: From Baseline to Week 6
Change in Systolic Blood Pressure From Baseline to Week 6 and Week 16, Part B
Change in systolic blood pressure from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM.
Time frame: From baseline to Week 6 and Week 16
Change in Diastolic Blood Pressure From Baseline to Week 6, Part A
Change in diastolic blood pressure from baseline to Week 6, Part A. The analysis is performed using MMRM.
Time frame: From Baseline to Week 6
Change in Diastolic Blood Pressure From Baseline to Week 6 and Week 16, Part B
Change in diastolic blood pressure from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM.
Time frame: From baseline to Week 6 and Week 16