Emricasan, a Caspase Inhibitor, for Evaluation in Subjects With Non-Alcoholic Steatohepatitis (NASH) Fibrosis

NCT ID: NCT02686762

Last Updated: 2019-08-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

318 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-26

Study Completion Date

2019-02-28

Brief Summary

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This is a multicenter, double-blind, randomized, placebo-controlled trial involving subjects with a diagnosis of "definite NASH" with fibrosis (excluding cirrhosis) as determined by the central histopathologist. Upon successful screening, subjects will be randomized to receive either emricasan 50 mg BID or emricasan 5 mg BID or matching placebo BID.

Detailed Description

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Conditions

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Non-alcoholic Steatohepatitis Fibrosis Liver Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Emricasan (5 mg)

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with emricasan (5 mg) twice a day.

Group Type ACTIVE_COMPARATOR

Emricasan (5 mg)

Intervention Type DRUG

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with emricasan (5 mg) twice a day.

Emricasan (50 mg)

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with emricasan (50 mg) twice a day.

Group Type ACTIVE_COMPARATOR

Emricasan (50 mg)

Intervention Type DRUG

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with emricasan (50 mg) twice a day.

Matching Placebo

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with a matching placebo twice a day.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with a matching placebo twice a day.

Interventions

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Emricasan (5 mg)

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with emricasan (5 mg) twice a day.

Intervention Type DRUG

Emricasan (50 mg)

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with emricasan (50 mg) twice a day.

Intervention Type DRUG

Placebo

Subjects with Non-alcoholic Steatohepatitis (NASH) Fibrosis will be administered orally with a matching placebo twice a day.

Intervention Type DRUG

Other Intervention Names

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IDN-6556 IDN-6556

Eligibility Criteria

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Inclusion Criteria

1. Male or female subjects 18 years or older, able to provide written informed consent, and able to understand and willing to comply with the requirements of the study
2. Histological evidence of definite NASH based on NASH CLinical Research Network (CRN) criteria, as confirmed by the central histopathologist, on a liver biopsy obtained no more than 6 months prior to Day 1
3. NAFLD Activity Score (NAS) of 4 or greater with a score of at least 1 in each component of the NAS (steatosis scored 0-3, lobular inflammation scored 0-3, ballooning scored 0-2)
4. Fibrosis stage 1 (limited to 20% of subjects), stage 2, or stage 3 using the NASH CRN Histologic Scoring System

a. Subjects with fibrosis stage 1 must also have diabetes mellitus or metabolic syndrome
5. Willingness to utilize effective contraception (for both males and females of childbearing potential) from Screening to 4 weeks after the last dose of study drug
6. If on vitamin E or pioglitazone, subjects must have been on a stable dose for at least 3 months prior to the biopsy (whether historical or qualifying biopsy)

Exclusion Criteria

1. Current or history of significant alcohol consumption, defined as more than 20 g/day for females and more than 30 g/day in males on average, or inability to reliably quantify alcohol consumption based on investigator's judgement
2. Use of the following drugs (which may have potential hepatotoxic effects) within 6 months prior to Day 1: amiodarone, methotrexate, tamoxifen, valproic acid, estrogens at doses greater than those used for hormone replacement or contraception, anabolic steroids, or systemic glucocorticoids for more than 4 weeks at doses greater than replacement doses
3. Uncontrolled diabetes (HbA1c ≥9%) within 60 days prior to Day 1
4. Presence of cirrhosis on liver biopsy (fibrosis stage 4 based on the central histopathologist reading)
5. Hepatitis and fibrosis more likely related to etiologies other than NASH such as:

1. alcoholic steatohepatitis
2. autoimmune hepatitis
3. hepatitis B virus (HBV) infection
4. hepatitis C virus (HCV) infection
5. primary biliary cirrhosis
6. primary sclerosing cholangitis
7. Wilson's disease
8. alpha-1-antitrypsin deficiency
9. hemochromatosis or iron overload
10. drug-induced liver disease
11. other biliary liver disease
6. ALT or AST \>5 times upper limit of normal (ULN) or total bilirubin \>1.5 times ULN during screening (unless subject has elevated total bilirubin due to Gilbert's as documented in the medical records)
7. Alpha-fetoprotein \>200 ng/mL
8. Hemoglobin \<10 g/dL
9. White blood cell count \<2.0 x 10\^3/mm3
10. Estimated creatinine clearance \<30 mL/min
11. Current use of the following medications that are considered significant inhibitors of OATP1B1 and OATP1B3 transporters: atazanavir, cyclosporine, eltrombopag, gemfibrozil, indinavir, lopinavir, ritonavir, rifampin, saquinavir, simeprevir, telaprevir, tipranovir, or some combination of these medications
12. Symptoms of biliary colic, e.g. due to symptomatic gallstones, within the last 6 months, unless resolved following cholecystectomy
13. Inability to safely obtain a liver biopsy
14. Known human immunodeficiency virus (HIV) infection
15. Weight loss ≥ 10% within 6 months of Day 1
16. Use of controlled substances (including inhaled or injected drugs) or non-prescribed use of prescription drugs within 1 year of screening to the point of interfering with the subject's ability to comply with study procedures and study drug administration in the investigator's judgement
17. History of or active malignancies, other than those successfully treated with curative intent and believed to be cured
18. Significant systemic or major illness other than liver disease that in the opinion of the investigator would preclude the subject from participating in and completing the study, including but not limited to acute coronary syndrome or stroke within 6 months of screening or major surgery within 3 months of screening
19. History or presence of clinically concerning cardiac arrhythmias, or prolongation of Screening (pre-treatment) QTcF interval \>480 milliseconds (msec)
20. Prior or planned (during the time frame of the study) bariatric surgery
21. If female: planned or known pregnancy, positive urine or serum pregnancy test, or lactating/breastfeeding
22. Previous treatment with emricasan or active investigational medication in a clinical trial within 6 months prior to Day 1
23. Prior liver transplant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Conatus Pharmaceuticals Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean L Chan, MD

Role: STUDY_CHAIR

Conatus Pharmaceuticals Inc.

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

University of Arizona Clinical and Translational Sciences Research Center

Tucson, Arizona, United States

Site Status

Preferred Research Partners, Inc.

Little Rock, Arkansas, United States

Site Status

Fresno Clinical Research Center

Freestone, California, United States

Site Status

UCLA The Pfleger Liver Institute

Los Angeles, California, United States

Site Status

Gastrointestinal Biosciences

Los Angeles, California, United States

Site Status

Surinder Singh Saini, M.D., Inc.

Newport Beach, California, United States

Site Status

California Liver Research Institute

Pasadena, California, United States

Site Status

Inland Empire Liver Foundation

Rialto, California, United States

Site Status

University of California Davis Medical Center

Sacramento, California, United States

Site Status

University of California San Diego Medical Center

San Diego, California, United States

Site Status

Cedars Sinai Medical Center

West Hollywood, California, United States

Site Status

Yale University School of Medicine

New Haven, Connecticut, United States

Site Status

Sibley Memorial Hospital

Washington D.C., District of Columbia, United States

Site Status

Howard University

Washington D.C., District of Columbia, United States

Site Status

UF Hepatology Research at CTRB

Gainesville, Florida, United States

Site Status

Florida Digestive Health Specialist

Lakewood Rch, Florida, United States

Site Status

Miami Veterans Administration Healthcare System

Miami, Florida, United States

Site Status

University of Miami/Schiff Center for Liver Diseases

Miami, Florida, United States

Site Status

Florida Hospital Orlando Transplant Institute

Orlando, Florida, United States

Site Status

Tampa General Medical Group

Tampa, Florida, United States

Site Status

iResearch Atlanta LLC

Decatur, Georgia, United States

Site Status

Gastrointestinal Specialists of Georgia

Marietta, Georgia, United States

Site Status

Northwestern Memorial Hospital

Chicago, Illinois, United States

Site Status

Rush University Medical Center

Chicago, Illinois, United States

Site Status

The University of Chicago Medical Center

Chicago, Illinois, United States

Site Status

Aquiant Research

New Albany, Indiana, United States

Site Status

Iowa Digestive Disease Center, P.C

Clive, Iowa, United States

Site Status

UnityPoint Clinic Center For Liver Disease

Des Moines, Iowa, United States

Site Status

University of Louisville

Louisville, Kentucky, United States

Site Status

Ochsner Clinic Foundation

New Orleans, Louisiana, United States

Site Status

Louisiana Research Center, LLC

Shreveport, Louisiana, United States

Site Status

Mercy Medical Center

Baltimore, Maryland, United States

Site Status

Walter Reed National Military Medical Center

Bethesda, Maryland, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Lahey Clinic Medical Center

Burlington, Massachusetts, United States

Site Status

Henry Ford Health System

Detroit, Michigan, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Kansas City VA Medical Center

Kansas City, Missouri, United States

Site Status

Kansas City Research Institute

Kansas City, Missouri, United States

Site Status

Washington University School of Medicine-Infectious Disease Clinical Research Unit

St Louis, Missouri, United States

Site Status

Doctors Office Center

Newark, New Jersey, United States

Site Status

State University of New York

Buffalo, New York, United States

Site Status

Northwell Health, Inc.

Manhasset, New York, United States

Site Status

Mount Sinai Beth Israel Medical Center

New York, New York, United States

Site Status

NYU Langone Medical Center

New York, New York, United States

Site Status

Columbia University Medical Center (CUMC)

New York, New York, United States

Site Status

Weill Cornell Medical College

New York, New York, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

Asheville Gastroenterology Associates, PA

Asheville, North Carolina, United States

Site Status

Carolinas Healthcare System, Center for Liver Disease

Charlotte, North Carolina, United States

Site Status

Duke University Medical Center, Duke South Clinics

Durham, North Carolina, United States

Site Status

Rex Healthcare

Raleigh, North Carolina, United States

Site Status

Consultants for Clinical Research

Cincinnati, Ohio, United States

Site Status

University Hospitals Case Medical Center

Cleveland, Ohio, United States

Site Status

Options Health Research, LLC

Tulsa, Oklahoma, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Albert Einstein Medical Center

Philadelphia, Pennsylvania, United States

Site Status

University Gastroenterology

Providence, Rhode Island, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

PMG Research at Charleston

Charleston, South Carolina, United States

Site Status

ClinSearch, LLC

Chattanooga, Tennessee, United States

Site Status

Gastro One

Germantown, Tennessee, United States

Site Status

Methodist University Hospital

Memphis, Tennessee, United States

Site Status

Vanderbilt University Medical Center - Digestive Disease Center

Nashville, Tennessee, United States

Site Status

Texas Clinical Research Institute

Arlington, Texas, United States

Site Status

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

Baylor All Saints Medical Center

Fort Worth, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Liver Associates of Texas, P.A.

Houston, Texas, United States

Site Status

Research Specialists of Texas

Houston, Texas, United States

Site Status

Pinnacle Clinical Research, PLLC

Live Oak, Texas, United States

Site Status

American Research Corporation at the Texas Liver Institue

San Antonio, Texas, United States

Site Status

Brooke Army Medical Center

San Antonio, Texas, United States

Site Status

University of Utah Health Sciences Center

Salt Lake City, Utah, United States

Site Status

University of Vermont

Burlington, Vermont, United States

Site Status

Bon Secours Richmond Health System

Newport News, Virginia, United States

Site Status

Digestive and Liver Disease Specialists

Norfolk, Virginia, United States

Site Status

McGuire VA Medical Center

Richmond, Virginia, United States

Site Status

University of Washington Harborview Medical Center

Seattle, Washington, United States

Site Status

Universitätsklinikum der RWTH Aachen

Aachen, North Rhine-Westphalia, Germany

Site Status

Universitätsklinikum Bonn

Bönning, North Rhine-Westphalia, Germany

Site Status

Universitätsklinikum Münster

Münster, North Rhine-Westphalia, Germany

Site Status

Charité - Universitätsmedizin Berlin

Berlin, , Germany

Site Status

Universitätsklinikum Freiburg

Freiburg im Breisgau, , Germany

Site Status

Universitätsklinikum Hamburg Eppendorf

Hamburg, , Germany

Site Status

Medizinische Hochschule Hannover

Hanover, , Germany

Site Status

Eugastro GmbH

Leipzig, , Germany

Site Status

Universitätsmedizin der Johannes Gutenberg-Universität Mainz

Mainz, , Germany

Site Status

Hospital Universitario Vall d'Hebron

Barcelona, , Spain

Site Status

Hospital Clinic de Barcelona

Barcelona, , Spain

Site Status

Hospital Universitario de Donostia

Donostia / San Sebastian, , Spain

Site Status

Hospital Universitario de La Princesa

Madrid, , Spain

Site Status

Hospital General Universitario Gregorio Marañon

Madrid, , Spain

Site Status

Hospital Universitario Ramon y Cajal

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Hospital Universitario Puerta de Hierro - Majadahonda

Majadahonda, , Spain

Site Status

Hospital Universitario Marques de Valdecilla

Santander, , Spain

Site Status

Hospital Clinico Universitario de Valencia

Valencia, , Spain

Site Status

Hospital General Universitario de Valencia

Valencia, , Spain

Site Status

Countries

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United States Germany Spain

References

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Harrison SA, Goodman Z, Jabbar A, Vemulapalli R, Younes ZH, Freilich B, Sheikh MY, Schattenberg JM, Kayali Z, Zivony A, Sheikh A, Garcia-Samaniego J, Satapathy SK, Therapondos G, Mena E, Schuppan D, Robinson J, Chan JL, Hagerty DT, Sanyal AJ. A randomized, placebo-controlled trial of emricasan in patients with NASH and F1-F3 fibrosis. J Hepatol. 2020 May;72(5):816-827. doi: 10.1016/j.jhep.2019.11.024. Epub 2019 Dec 27.

Reference Type DERIVED
PMID: 31887369 (View on PubMed)

Other Identifiers

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IDN-6556-12

Identifier Type: -

Identifier Source: org_study_id

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