The cause of PSC is unknown.To date, there is no treatment besides liver transplantation proven to improve PSC prognosis. However, there is a clear medical unmet need yet for patients with PSC, due to risks and complications of liver transplantation. This is a two-part, Phase 2b, randomized, double-blind, placebo-controlled study designed to assess the efficacy and safety of HK-660S in patients with PSC. The primary objective is to evaluate the effects of HK-660S on serum ALP improvement (reduction of 20% or more) over 12 weeks of treatment in patients with PSC.
This is a two-part, Phase 2b, randomized, double-blind, placebo-controlled study designed to assess the efficacy and safety of HK-660S in patients with PSC. After subjects voluntarily consent in writing to participate in the clinical study, subjects who meet the inclusion/exclusion criteria will be evaluated through a screening period. The screening period should not, as far as possible, exceed a maximum of 5 weeks including the washout period. Based on the screening results at Visit 1, subjects suitable for participation in this clinical study will be selected. In Part A, 6 subjects will be assigned to 200 mg HK-660S twice a day for 12 weeks. After Visit 2, subjects will visit the study center at Week 4 (Visit 3), Week 8 (Visit 4), Week 12 (Visit 5 / End of Treatment), and Week 16 (Visit 6 / Follow-up) to assess the efficacy and safety (excluding MRCP at Visit 6). Enrollment will be staggered, with the first two subjects enrolled and monitored for the initial 4-week treatment period. Interim safety data from these initial two subjects will be reviewed by the Sponsor and medical monitor to assess any significant safety concerns. If no such concerns are identified, enrollment of the remaining four subjects will proceed. Safety data from the first 4-week treatment in all 6 subjects will be reviewed by the SRC, which will decide on the initiation of Part B. In Part B, 99 subjects will be randomly assigned in a 1:1:1 ratio into one of three groups: 100 mg HK-660S, 200 mg HK-660S, or placebo to take two tablets (1 active and 1 placebo tablets, 2 active tablets, or 2 placebo tablets) twice a day for 12 weeks. After Visit 2, subjects will visit the study center at Week 4 (Visit 3), Week 8 (Visit 4), Week 12 (Visit 5 / End of Treatment), and Week 16 (Visit 6 / Follow-up) to assess the efficacy and safety (excluding MRCP at Visit 6). The study period for each subject is approximately 21 weeks including up to 5-week screening period, 12-week treatment period, and 4-week follow-up period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
105
Administered orally
Administered orally
Administered orally
Percentage of subjects who show improvement of ALP
The improvement of ALP is defined as 20% or more ALP reduction
Time frame: 12 weeks from baseline
Percentage of subjects who show improvement of severity of PSC
The improvement of severity is defined as a decrease of -1 or more in the MRCP Anali score
Time frame: 12 weeks from baseline
Percentage of subjects who show improvement of bile duct strictures in MRCP
Defined as improvement (absence or improvement) in at least one of bile strictures, dilatation or bile ductal wall thickening and enhancement based on the IPSCSG (International Primary Sclerosing Cholangitis Study Group) MRI Reporting Guideline.
Time frame: 12 weeks from baseline
Percentage of subjects who show 50% or more reduction of ALP
Time frame: 12 weeks from baseline
Percentage of subjects who show ALP normalization or partial normalization (< 1.5 x ULN)
Time frame: 12 weeks from baseline
Percentage of subjects who show improvement of severity of fibrosis in FibroScan
Time frame: 12 weeks from baseline
Change of fibrosis score in FibroScan
Time frame: 12 weeks from baseline
Percentage of subjects who show improvement of severity of liver fibrosis in Enhanced Liver Fibrosis (ELF) score
Time frame: 12 weeks from baseline
Change of ELF score
Time frame: 12 weeks from baseline
Change of pruritus score
Time frame: 4, 8, and 12 weeks from baseline
Change of serum C4 (7α-hydroxy-4-cholesten-3-one) level
Time frame: 12 weeks from baseline
Change of ALP level
Time frame: 4, 8, and 12 weeks from baseline
Change of ALT, AST, GGT, and bilirubin levels
Time frame: 4, 8, and 12 weeks from baseline
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