Trial Outcomes & Findings for Open Label Study to Evaluate Safety and Efficacy of LUM001 in Patients With Primary Sclerosing Cholangitis (NCT NCT02061540)

NCT ID: NCT02061540

Last Updated: 2019-03-29

Results Overview

An Adverse Event (AE) was defined as any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding, for example), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE was considered to be related to the investigational drug product. TEAEs were AEs with a start date on or after the first dose of investigational product and started prior to the last dose of investigational product plus 14 days.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

27 participants

Primary outcome timeframe

From start of study drug administration until Week 18

Results posted on

2019-03-29

Participant Flow

The study was conducted in 8 centers in Great Britain, Canada, and the United States between 22 April 2014 and 12 February 2016.

A total of 37 participants were screened, of them 27 participants were enrolled in the study.

Participant milestones

Participant milestones
Measure
Maralixibat (LUM001)
Participants received LUM001 tablet orally once daily at a dose of 0.5 milligram (mg) during Week 1; 1 mg during Week 2; 2.5 mg during Week 3; 5 mg during Week 4; 7.5 mg during Week 5; 10 mg during Week 6 followed by stable dosing of 10 mg for 8 weeks.
Overall Study
STARTED
27
Overall Study
Down-Titrated on LUM001 During the Study
5
Overall Study
COMPLETED
23
Overall Study
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Maralixibat (LUM001)
Participants received LUM001 tablet orally once daily at a dose of 0.5 milligram (mg) during Week 1; 1 mg during Week 2; 2.5 mg during Week 3; 5 mg during Week 4; 7.5 mg during Week 5; 10 mg during Week 6 followed by stable dosing of 10 mg for 8 weeks.
Overall Study
Adverse Event
2
Overall Study
Withdrawal by Subject
2

Baseline Characteristics

Open Label Study to Evaluate Safety and Efficacy of LUM001 in Patients With Primary Sclerosing Cholangitis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Maralixibat (LUM001)
n=27 Participants
Participants received LUM001 tablet orally once daily at a dose of 0.5 milligram (mg) during Week 1; 1 mg during Week 2; 2.5 mg during Week 3; 5 mg during Week 4; 7.5 mg during Week 5; 10 mg during Week 6 followed by stable dosing of 10 mg for 8 weeks.
Age, Continuous
43.7 Years
STANDARD_DEVIATION 11.35 • n=5 Participants
Sex: Female, Male
Female
9 Participants
n=5 Participants
Sex: Female, Male
Male
18 Participants
n=5 Participants

PRIMARY outcome

Timeframe: From start of study drug administration until Week 18

Population: Safety population included all participants who received at least 1 dose of the investigational product.

An Adverse Event (AE) was defined as any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding, for example), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE was considered to be related to the investigational drug product. TEAEs were AEs with a start date on or after the first dose of investigational product and started prior to the last dose of investigational product plus 14 days.

Outcome measures

Outcome measures
Measure
Maralixibat (LUM001) 1 mg
n=1 Participants
Participants received LUM001 tablet orally once daily at a dose of 1 mg during Week 2 of the treatment period.
Maralixibat (LUM001) 2.5 mg
n=2 Participants
Participants received LUM001 tablet orally once daily at a dose of 2.5 mg during Week 3 of the treatment period.
Maralixibat (LUM001) 5 mg
n=2 Participants
Participants received LUM001 tablet orally once daily at a dose of 5 mg during Week 4 of the treatment period.
Maralixibat (LUM001) 7.5 mg
n=1 Participants
Participants received LUM001 tablet orally once daily at a dose of 7.5 mg during Week 5 of the treatment period.
Maralixibat (LUM001) 10 mg
n=21 Participants
Participants received LUM001 tablet orally once daily at a dose of 10 mg during Week 6 of the treatment period followed by stable dosing of 10 mg for 8 weeks.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
1 participant
2 participant
2 participant
1 participant
19 participant

PRIMARY outcome

Timeframe: Baseline, Week 14

Population: Modified intent-to-treat (mITT) population included all participants who received at least 1 dose of investigational product and had at least 1 post baseline serum bile acid laboratory assessment.

Serum bile acid levels were evaluated using blood samples collected.

Outcome measures

Outcome measures
Measure
Maralixibat (LUM001) 1 mg
n=27 Participants
Participants received LUM001 tablet orally once daily at a dose of 1 mg during Week 2 of the treatment period.
Maralixibat (LUM001) 2.5 mg
Participants received LUM001 tablet orally once daily at a dose of 2.5 mg during Week 3 of the treatment period.
Maralixibat (LUM001) 5 mg
Participants received LUM001 tablet orally once daily at a dose of 5 mg during Week 4 of the treatment period.
Maralixibat (LUM001) 7.5 mg
Participants received LUM001 tablet orally once daily at a dose of 7.5 mg during Week 5 of the treatment period.
Maralixibat (LUM001) 10 mg
Participants received LUM001 tablet orally once daily at a dose of 10 mg during Week 6 of the treatment period followed by stable dosing of 10 mg for 8 weeks.
Change From Baseline in Fasting Serum Bile Acid Level at Week 14
Baseline
38.941 micromoles per liter
Standard Deviation 38.6614
Change From Baseline in Fasting Serum Bile Acid Level at Week 14
Change From Baseline
-14.841 micromoles per liter
Standard Deviation 31.3709

SECONDARY outcome

Timeframe: Baseline, Week 14

Population: mITT population included all participants who received at least 1 dose of investigational product and had at least 1 post baseline serum bile acid laboratory assessment.

Levels of liver enzymes such as Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP) in serum were evaluated.

Outcome measures

Outcome measures
Measure
Maralixibat (LUM001) 1 mg
n=27 Participants
Participants received LUM001 tablet orally once daily at a dose of 1 mg during Week 2 of the treatment period.
Maralixibat (LUM001) 2.5 mg
Participants received LUM001 tablet orally once daily at a dose of 2.5 mg during Week 3 of the treatment period.
Maralixibat (LUM001) 5 mg
Participants received LUM001 tablet orally once daily at a dose of 5 mg during Week 4 of the treatment period.
Maralixibat (LUM001) 7.5 mg
Participants received LUM001 tablet orally once daily at a dose of 7.5 mg during Week 5 of the treatment period.
Maralixibat (LUM001) 10 mg
Participants received LUM001 tablet orally once daily at a dose of 10 mg during Week 6 of the treatment period followed by stable dosing of 10 mg for 8 weeks.
Change From Baseline in Liver Enzyme Levels in Serum
ALP: Baseline
471.6 units per liter (U/L)
Standard Deviation 316.93
Change From Baseline in Liver Enzyme Levels in Serum
ALT: Baseline
108.5 units per liter (U/L)
Standard Deviation 78.95
Change From Baseline in Liver Enzyme Levels in Serum
ALT: Change From Baseline
10.5 units per liter (U/L)
Standard Deviation 63.07
Change From Baseline in Liver Enzyme Levels in Serum
AST: Baseline
88.3 units per liter (U/L)
Standard Deviation 43.70
Change From Baseline in Liver Enzyme Levels in Serum
AST: Change From Baseline
11.7 units per liter (U/L)
Standard Deviation 34.14
Change From Baseline in Liver Enzyme Levels in Serum
ALP: Change From Baseline
36.7 units per liter (U/L)
Standard Deviation 170.87

SECONDARY outcome

Timeframe: Baseline, Week 14

Population: mITT population included all participants who received at least 1 dose of investigational product and had at least 1 post baseline serum bile acid laboratory assessment.

Total Bilirubin and Direct (Conjugated) Bilirubin levels were evaluated.

Outcome measures

Outcome measures
Measure
Maralixibat (LUM001) 1 mg
n=27 Participants
Participants received LUM001 tablet orally once daily at a dose of 1 mg during Week 2 of the treatment period.
Maralixibat (LUM001) 2.5 mg
Participants received LUM001 tablet orally once daily at a dose of 2.5 mg during Week 3 of the treatment period.
Maralixibat (LUM001) 5 mg
Participants received LUM001 tablet orally once daily at a dose of 5 mg during Week 4 of the treatment period.
Maralixibat (LUM001) 7.5 mg
Participants received LUM001 tablet orally once daily at a dose of 7.5 mg during Week 5 of the treatment period.
Maralixibat (LUM001) 10 mg
Participants received LUM001 tablet orally once daily at a dose of 10 mg during Week 6 of the treatment period followed by stable dosing of 10 mg for 8 weeks.
Change From Baseline in Bilirubin Levels at Week 14
Total Bilirubin Level: Baseline
1.22 milligram per deciliter (mg/dL)
Standard Deviation 0.775
Change From Baseline in Bilirubin Levels at Week 14
Total Bilirubin Level: Change From Baseline
0.24 milligram per deciliter (mg/dL)
Standard Deviation 0.666
Change From Baseline in Bilirubin Levels at Week 14
Conjugated Bilirubin Level: Baseline
0.60 milligram per deciliter (mg/dL)
Standard Deviation 0.510
Change From Baseline in Bilirubin Levels at Week 14
Conjugated Bilirubin Level: Change From Baseline
0.19 milligram per deciliter (mg/dL)
Standard Deviation 0.450

SECONDARY outcome

Timeframe: Baseline, Week 14

Population: mITT population included all participants who received at least 1 dose of investigational product and had at least 1 post baseline serum bile acid laboratory assessment.

The Adult ItchRO instrument was completed twice daily using an electronic diary (eDiary). Each morning and evening score had a range from 0-10, with the higher score indicating increasing itch severity. The following was used for assessing the Adult ItchRO daily score: The score which represented the most severe itching for the day (morning or evening) was taken for each day as the daily score (maximum daily score of 10); If only 1 of the 2 scores was available for the day, the score that was available was used as the daily score; If both the morning and the evening scores were missing, the score was considered missing for the day.

Outcome measures

Outcome measures
Measure
Maralixibat (LUM001) 1 mg
n=27 Participants
Participants received LUM001 tablet orally once daily at a dose of 1 mg during Week 2 of the treatment period.
Maralixibat (LUM001) 2.5 mg
Participants received LUM001 tablet orally once daily at a dose of 2.5 mg during Week 3 of the treatment period.
Maralixibat (LUM001) 5 mg
Participants received LUM001 tablet orally once daily at a dose of 5 mg during Week 4 of the treatment period.
Maralixibat (LUM001) 7.5 mg
Participants received LUM001 tablet orally once daily at a dose of 7.5 mg during Week 5 of the treatment period.
Maralixibat (LUM001) 10 mg
Participants received LUM001 tablet orally once daily at a dose of 10 mg during Week 6 of the treatment period followed by stable dosing of 10 mg for 8 weeks.
Change From Baseline in Pruritus as Measured by Adult Itch Reported Outcome (ItchRO) Weekly Sum Score
Baseline
15.00 units on scale
Standard Deviation 18.735
Change From Baseline in Pruritus as Measured by Adult Itch Reported Outcome (ItchRO) Weekly Sum Score
Change From Baseline
-7.67 units on scale
Standard Deviation 16.326

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, Week 14

Population: mITT population included all participants who received at least 1 dose of investigational product and had at least 1 post baseline serum bile acid laboratory assessment.

Total cholesterol (TC) level and low density lipoprotein cholesterol (LDLC) level were considered as biochemical markers of cholestasis.

Outcome measures

Outcome measures
Measure
Maralixibat (LUM001) 1 mg
n=27 Participants
Participants received LUM001 tablet orally once daily at a dose of 1 mg during Week 2 of the treatment period.
Maralixibat (LUM001) 2.5 mg
Participants received LUM001 tablet orally once daily at a dose of 2.5 mg during Week 3 of the treatment period.
Maralixibat (LUM001) 5 mg
Participants received LUM001 tablet orally once daily at a dose of 5 mg during Week 4 of the treatment period.
Maralixibat (LUM001) 7.5 mg
Participants received LUM001 tablet orally once daily at a dose of 7.5 mg during Week 5 of the treatment period.
Maralixibat (LUM001) 10 mg
Participants received LUM001 tablet orally once daily at a dose of 10 mg during Week 6 of the treatment period followed by stable dosing of 10 mg for 8 weeks.
Change From Baseline for Other Biochemical Markers of Cholestasis: Total Cholesterol, Low Density Lipoprotein Cholesterol
TC Level: Baseline
213.0 mg/dL
Standard Deviation 50.62
Change From Baseline for Other Biochemical Markers of Cholestasis: Total Cholesterol, Low Density Lipoprotein Cholesterol
TC Level: Change From Baseline
-21.2 mg/dL
Standard Deviation 25.46
Change From Baseline for Other Biochemical Markers of Cholestasis: Total Cholesterol, Low Density Lipoprotein Cholesterol
LDLC Level: Baseline
121.4 mg/dL
Standard Deviation 40.52
Change From Baseline for Other Biochemical Markers of Cholestasis: Total Cholesterol, Low Density Lipoprotein Cholesterol
LDLC Level: Change From Baseline
-16.3 mg/dL
Standard Deviation 17.64

Adverse Events

Maralixibat (LUM001)

Serious events: 4 serious events
Other events: 25 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Maralixibat (LUM001)
n=27 participants at risk
Participants received LUM001 tablet orally once daily at a dose of 0.5 milligram (mg) during Week 1; 1 mg during Week 2; 2.5 mg during Week 3; 5 mg during Week 4; 7.5 mg during Week 5; 10 mg during Week 6 followed by stable dosing of 10 mg for 8 weeks.
Gastrointestinal disorders
Melaena
3.7%
1/27 • Number of events 1 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Upper gastrointestinal haemorrhage
3.7%
1/27 • Number of events 1 • From start of study drug administration up to follow up (Week 18)
Infections and infestations
Appendicitis
3.7%
1/27 • Number of events 1 • From start of study drug administration up to follow up (Week 18)
Injury, poisoning and procedural complications
Joint dislocation
3.7%
1/27 • Number of events 1 • From start of study drug administration up to follow up (Week 18)
Hepatobiliary disorders
Cholangitis
3.7%
1/27 • Number of events 1 • From start of study drug administration up to follow up (Week 18)

Other adverse events

Other adverse events
Measure
Maralixibat (LUM001)
n=27 participants at risk
Participants received LUM001 tablet orally once daily at a dose of 0.5 milligram (mg) during Week 1; 1 mg during Week 2; 2.5 mg during Week 3; 5 mg during Week 4; 7.5 mg during Week 5; 10 mg during Week 6 followed by stable dosing of 10 mg for 8 weeks.
Musculoskeletal and connective tissue disorders
Arthralgia
11.1%
3/27 • Number of events 9 • From start of study drug administration up to follow up (Week 18)
Musculoskeletal and connective tissue disorders
Muscle spasms
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Musculoskeletal and connective tissue disorders
Neck pain
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Abdominal discomfort
11.1%
3/27 • Number of events 4 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Abdominal distension
14.8%
4/27 • Number of events 5 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Abdominal pain
29.6%
8/27 • Number of events 8 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Abdominal pain upper
7.4%
2/27 • Number of events 4 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Diarrhoea
51.9%
14/27 • Number of events 27 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Frequent bowel movements
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Gastrointestinal disorders
Nausea
33.3%
9/27 • Number of events 12 • From start of study drug administration up to follow up (Week 18)
General disorders
Asthenia
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
General disorders
Fatigue
14.8%
4/27 • Number of events 4 • From start of study drug administration up to follow up (Week 18)
General disorders
Pyrexia
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Infections and infestations
Nasopharyngitis
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Hepatobiliary disorders
Cholangitis
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Hepatobiliary disorders
Hepatomegaly
7.4%
2/27 • Number of events 2 • From start of study drug administration up to follow up (Week 18)
Nervous system disorders
Headache
22.2%
6/27 • Number of events 7 • From start of study drug administration up to follow up (Week 18)

Additional Information

Study Physician

Mirum

Phone: 1 650-667-4085

Results disclosure agreements

  • Principal investigator is a sponsor employee If a multicenter publication is not submitted within twelve (12) months after conclusion, abandonment or termination of the Study at all sites, or after Sponsor confirms there shall be no multicenter Study publication, the Institution and/or such Principal Investigator may publish the results from the Institution site individually.
  • Publication restrictions are in place

Restriction type: OTHER