IBAT Inhibitor A4250 for Cholestatic Pruritus

Biliary Cirrhosis, Primary Clinical Trial

Official title:

An Exploratory, Phase IIa Study to Demonstrate the Safety and Efficacy of A4250 in Patients With Primary Biliary Cirrhosis and Cholestatic Pruritus

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT02360852
• Other study ID #: A4250 PBC Pruritus
• Status: Terminated
• Phase: Phase 2
• First received: January 14, 2015
• Last updated: February 21, 2017
• Start date: January 2015
• Est. completion date: October 2016

Study information

• Verified date: February 2017
• Source: Sahlgrenska University Hospital, Sweden
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study will evaluate the safety, tolerability and influence on itching, bile acids and liver enzyme changes in patients with PBC (Primary Biliary Cirrhosis) treated with A4250

Description:

A4250PBCpruritus (EudraCT 2014-004070-42) is an open-label exploratory study.

The primary objective of this study is to assess the safety and tolerability of A4250, 1.5 - 3 mg orally during a four-week treatment period, in patients with PBC and cholestatic pruritus, as determined by the occurrence of treatment-emergent serious adverse events (SAEs).

Other safety objectives of this study include assessment of the safety and tolerability of A4250 during a four-week treatment period, as determined by the occurrence of treatment-emergent adverse events (AEs) and changes in other safety parameters including liver and kidney function tests and vital signs.

Exploratory efficacy objectives of this study are to demonstrate the efficacy of A4250 orally on pruritus variables and on QoL and lysophosphatidic acid formation as well as evaluation of changes in pharmacodynamic parameters of bile acid metabolism such as serum and fecal bile acids, C4 and fibroblast growth factor 19 (FGF19) assessments and assessment of surrogate markers of cholestatic liver disease such as alkaline phosphatase, transaminases and bilirubin.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 9
• Est. completion date: October 2016
• Est. primary completion date: October 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Major Inclusion Criteria:

• Diagnosis of PBC or PBC-Autoimmune hepatitis overlap as established according to American Association for the Study of Liver Diseases/European Association for the Study of Liver (AASLD/EASL) definitions. Definite or probable PBC diagnosis, as demonstrated by the presence of = 2 of the following 3 diagnostic factors:

• History of elevated alkaline phosphatase (ALP) levels (>1.67 ULN) for at least 6 months prior to Day 1

• Positive antimitochondrial antibodies (AMA) titer or if AMA negative or in low titer (<1:80) PBC specific antibodies (anti-GP210 and/or anti-SP100 and/or antibodies against the major M2 components (PDC-E2, 2-oxo-glutaric acid dehydrogenase complex)

• Liver biopsy consistent with PBC;

• Ursodeoxycholic acid (UDCA) non-responders defined as >6 months of UDCA and at the time of enrolment a serum ALP >1.67 ULN;

• Laboratory markers of cholestasis identified within 3 months of Visit 1;

• Treatment with cholestyramine at a dose >4g BID or colestipol > 5mg for at least 3 months;

• The patient has a VAS-Itch of at least 30 mm during the day before baseline (Visit 2);

• The patient is a male or non-pregnant female =18 years of age and =80 years of age with body mass index (BMI) =18.5 but <35 kg/m2;

Major Exclusion Criteria:

• Any condition that, in the opinion of the Investigator constitutes a risk for the patient or a contraindication for participation and completion of the study, or could interfere with study objectives, conduct, or evaluations;

• Jaundice of extrahepatic origin;

• The patient has a structural abnormality of the GI tract;

• The patient has a known, active, clinically significant acute or chronic infection, or any major episode of infection requiring hospitalization or treatment with parenteral anti infectives within 4 weeks of treatment start (study day 1) or completion of oral anti-infective treatment within 2 weeks prior to start of screening period;

• The patient has unexplained and clinically significant GI alarm signals (e.g., lower GI bleeding or heme-positive stool, iron-deficiency anaemia, unexplained weight loss) or systemic signs of infection or colitis;

Related Conditions & MeSH terms

• Biliary Cirrhosis, Primary
• Fibrosis
• Liver Cirrhosis
• Liver Cirrhosis, Biliary
• Pruritus

Intervention

Drug:
• A4250
A4250 once daily

Locations

Country	Name	City	State
Sweden	Sahlgrenska Academy	Göteborg

Sponsors (2)

Lead Sponsor	Collaborator
Sahlgrenska University Hospital, Sweden	Albireo

Country where clinical trial is conducted

Sweden, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	•Safety and Tolerability assessed by the occurrence of treatment-emergent SAEs during the four weeks of treatment with A4250		4 weeks
Secondary	Safety laboratory measurements	Changes in safety laboratory test results (including hematology, clinical chemistry and urinalysis) from baseline to Day 28 of A4250 treatment	4 weeks
Secondary	VAS-Itch	Change in VAS-Itch (most severe itch during last 24 hrs) during the fourth treatment week of A4250	4 weeks
Secondary	Itching scale	Change in PBC40	Four weeks
Secondary	Bile acid evaluation	Change in serum and fecal bile acids (BAs)	Four weeks
Secondary	Liver biochemistry	Change in ALP	Four weeks