Study to Evaluate the Safety and Efficacy of Selonsertib, Firsocostat, Cilofexor, and Combinations in Participants With Bridging Fibrosis or Compensated Cirrhosis Due to Nonalcoholic Steatohepatitis (NASH)

NCT ID: NCT03449446

Last Updated: 2020-12-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

395 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-21

Study Completion Date

2019-11-19

Brief Summary

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The primary objectives of this study are:

* To assess the safety and tolerability of selonsertib (SEL), firsocostat (FIR) and cilofexor (CILO), administered alone or in combination, in participants with bridging fibrosis or compensated cirrhosis due to NASH
* To evaluate changes in liver fibrosis, without worsening of NASH

Detailed Description

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Conditions

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Nonalcoholic Steatohepatitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Selonsertib (SEL)

Participants will receive SEL + placebo to match firsocostat 20 mg tablet + placebo to match cilofexor 30 mg tablet orally once daily for 48 weeks.

Group Type EXPERIMENTAL

SEL

Intervention Type DRUG

18 mg tablet administered orally once daily without regard to food

Placebo to match FIR

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Placebo to match CILO

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Firsocostat (FIR)

Participants will receive placebo to match SEL 18 mg tablet + FIR + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.

Group Type EXPERIMENTAL

FIR

Intervention Type DRUG

20 mg tablet administered orally once daily without regard to food

Placebo to match CILO

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Placebo to match SEL

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Cilofexor (CILO)

Participants will receive placebo to match SEL 18 mg tablet + placebo to match FIR 20 mg tablet + CILO orally once daily for 48 weeks.

Group Type EXPERIMENTAL

CILO

Intervention Type DRUG

30 mg tablet administered orally once daily without regard to food

Placebo to match FIR

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Placebo to match SEL

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Selonsertib (SEL) + Firsocostat (FIR)

Participants will receive SEL + FIR + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.

Group Type EXPERIMENTAL

SEL

Intervention Type DRUG

18 mg tablet administered orally once daily without regard to food

FIR

Intervention Type DRUG

20 mg tablet administered orally once daily without regard to food

Placebo to match CILO

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Selonsertib (SEL) + Cilofexor (CILO)

Participants will receive SEL + placebo to match FIR 20 mg tablet + CILO orally once daily for 48 weeks.

Group Type EXPERIMENTAL

SEL

Intervention Type DRUG

18 mg tablet administered orally once daily without regard to food

CILO

Intervention Type DRUG

30 mg tablet administered orally once daily without regard to food

Placebo to match FIR

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Firsocostat (FIR) + Cilofexor (CILO)

Participants will receive placebo to match SEL 18 mg tablet + FIR + CILO orally once daily for 48 weeks.

Group Type EXPERIMENTAL

FIR

Intervention Type DRUG

20 mg tablet administered orally once daily without regard to food

CILO

Intervention Type DRUG

30 mg tablet administered orally once daily without regard to food

Placebo to match SEL

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Placebo

Participants will receive placebo to match SEL 18 mg + placebo to match FIR 20 mg tablet + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.

Group Type EXPERIMENTAL

Placebo to match FIR

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Placebo to match CILO

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Placebo to match SEL

Intervention Type DRUG

Tablet administered orally once daily without regard to food

Interventions

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SEL

18 mg tablet administered orally once daily without regard to food

Intervention Type DRUG

FIR

20 mg tablet administered orally once daily without regard to food

Intervention Type DRUG

CILO

30 mg tablet administered orally once daily without regard to food

Intervention Type DRUG

Placebo to match FIR

Tablet administered orally once daily without regard to food

Intervention Type DRUG

Placebo to match CILO

Tablet administered orally once daily without regard to food

Intervention Type DRUG

Placebo to match SEL

Tablet administered orally once daily without regard to food

Intervention Type DRUG

Other Intervention Names

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GS-0976 GS-9674

Eligibility Criteria

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Inclusion Criteria

* Liver biopsy consistent with NASH and F3 or F4 in the opinion of the central reader
* In participants who have never had a liver biopsy, liver stiffness by FibroScan® ≥ 14.0 kPa and Enhanced Liver Fibrosis (ELF™) Test score ≥ 9.8 at Screening
* Screening laboratory parameters, as determined by the central laboratory:

* Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min, as calculated by the Cockcroft-Gault equation
* Hemoglobin A1c (HbA1c) ≤ 9.5%
* Alanine aminotransferase (ALT) \< 5 x Upper Limits of Normal (ULN)
* Platelet count ≥ 125,000/μL

Exclusion Criteria

* Prior history of decompensated liver disease including ascites, hepatic encephalopathy, or variceal bleeding
* Child-Pugh (CP) score \> 6 at Screening, unless due to an alternative etiology such as Gilbert's syndrome or therapeutic anticoagulation
* Model for End-Stage Liver Disease (MELD) score \> 12 at Screening, unless due to an alternate etiology such as therapeutic anticoagulation
* Other causes of liver disease based on medical history and/or centralized review of liver histology, including but not limited to: alcoholic liver disease, hepatitis B, hepatitis C, autoimmune disorders (eg, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis), drug-induced hepatotoxicity, Wilson disease, clinically significant iron overload, or alpha-1-antitrypsin deficiency requiring treatment
* History of liver transplantation
* Current or prior history of hepatocellular carcinoma
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gilead Sciences

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gilead Study Director

Role: STUDY_DIRECTOR

Gilead Sciences

Locations

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The Institute for Liver Health

Chandler, Arizona, United States

Site Status

Mayo Clinic Arizona, Mayo Clinic Hospital

Phoenix, Arizona, United States

Site Status

Liver Wellness Center

Little Rock, Arkansas, United States

Site Status

Arkansas Gastroenterology

North Little Rock, Arkansas, United States

Site Status

eStudySite

Chula Vista, California, United States

Site Status

Southern California Liver Center

Coronado, California, United States

Site Status

Fresno Clinical Research Center

Fresno, California, United States

Site Status

UCSD NAFLD Clinical Research Center

La Jolla, California, United States

Site Status

Ruane Clinical Research Group Inc.

Los Angeles, California, United States

Site Status

Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

California Liver Research Institute

Pasadena, California, United States

Site Status

Huntington Medical Research Institutes Liver Center

Pasadena, California, United States

Site Status

Inland Empire Liver Foundation

Rialto, California, United States

Site Status

University of California, Davis Medical Center (study visits)

Sacramento, California, United States

Site Status

Medical Associates Research Group

San Diego, California, United States

Site Status

South Denver Gastroenterology, PC

Englewood, Colorado, United States

Site Status

Integrity Clinical Research

Doral, Florida, United States

Site Status

UF Hepatology Research at CTRB

Gainesville, Florida, United States

Site Status

Schiff Center for Liver Diseases/University of Miami

Miami, Florida, United States

Site Status

IMIC Inc

Miami, Florida, United States

Site Status

Genoma Research Group

Miami, Florida, United States

Site Status

Florida Research Institute

Tampa, Florida, United States

Site Status

Digestive Healthcare of Georgia

Atlanta, Georgia, United States

Site Status

Piedmont Hospital

Atlanta, Georgia, United States

Site Status

Gastrointestinal Diseases Research

Columbus, Georgia, United States

Site Status

Gastrointestinal Specialists of Georgia

Marietta, Georgia, United States

Site Status

Northwestern University; Feinberg School of Medicine

Chicago, Illinois, United States

Site Status

Indianapolis Gastroenterology Research Foundation

Indianapolis, Indiana, United States

Site Status

Iowa Digestive Disease Center, P.C.

Clive, Iowa, United States

Site Status

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Delta Research Partners, LLC

Bastrop, Louisiana, United States

Site Status

Tulane University

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

Digestive Disease Associates, PA

Catonsville, Maryland, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Henry Ford Health Systems

Detroit, Michigan, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Southern Therapy and Advanced Research (STAR) LLC

Ridgeland, Mississippi, United States

Site Status

Saint Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

Saint Louis University

St Louis, Missouri, United States

Site Status

Jubilee Clinical Research, Inc.

Las Vegas, Nevada, United States

Site Status

Rutgers New Jersey Medical School- Doctors Office Center

Newark, New Jersey, United States

Site Status

Sandra Atlas Bass Center for Liver Diseases and Transplantation

Manhasset, New York, United States

Site Status

Icahn School of Medicine at Mount Sinai Beth Israel

New York, New York, United States

Site Status

Concorde Medical Group, PLLC

New York, New York, United States

Site Status

NYU Langone Health

New York, New York, United States

Site Status

Weill Cornell Medical College

New York, New York, United States

Site Status

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

Carolinas Healthcare System Center for Liver Disease and Transplant

Charlotte, North Carolina, United States

Site Status

Duke University Medical Center, Duke South Clinics

Durham, North Carolina, United States

Site Status

Cumberland Research Associates, LLC

Fayetteville, North Carolina, United States

Site Status

Consultants for Clinical Research wed

Cincinnati, Ohio, United States

Site Status

Hospital of the University of Pennsylvania- Perelman Center for Advanced Medicine

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status

UPMC - Center for Liver Diseases at the Thomas E. Starlz Institute

Pittsburgh, Pennsylvania, United States

Site Status

VA Pittsburgh Healthcare System

Pittsburgh, Pennsylvania, United States

Site Status

University Gastroenterology

Providence, Rhode Island, United States

Site Status

Medical University of South Carolina (Liver Biopsy)

Charleston, South Carolina, United States

Site Status

GHS Gastroenterology and Liver Center

Greenville, South Carolina, United States

Site Status

Gastro One

Germantown, Tennessee, United States

Site Status

Quality Medical Research, PLLC

Nashville, Tennessee, United States

Site Status

Texas Clinical Research Institute, LLC

Arlington, Texas, United States

Site Status

Pinnacle Clinical Research, PLLC

Austin, Texas, United States

Site Status

Austin Center for Clinical Research

Austin, Texas, United States

Site Status

The Liver Institute at Methodist Dallas Medical Center

Dallas, Texas, United States

Site Status

University of Texas Southwestern Medical Center Internal Medicine Digestive and Liver Diseases Clinical Trials

Dallas, Texas, United States

Site Status

Baylor College of Medicine - Advanced Liver Therapies

Houston, Texas, United States

Site Status

Houston Methodist Hospital

Houston, Texas, United States

Site Status

Pinnacle Clinical Research

Live Oak, Texas, United States

Site Status

American Research Corporation at Texas Liver Institute

San Antonio, Texas, United States

Site Status

Intermountain Liver Disease and Transplant Center

Murray, Utah, United States

Site Status

University of Utah Hospital

Salt Lake City, Utah, United States

Site Status

University of Virginia Medical Center

Charlottesville, Virginia, United States

Site Status

California Pacific Medical Center - Sutter Pacific Medical Foundation San Francisco Center for Liver Disease Dept. of Transplant

Falls Church, Virginia, United States

Site Status

Digestive and Liver Disease Specialists

Norfolk, Virginia, United States

Site Status

Bon Secours Richmond Community Hospital, Inc. d/b/a Bon Secours Liver Institute of Richmond

Richmond, Virginia, United States

Site Status

McGuire DVAMC

Richmond, Virginia, United States

Site Status

Virginia Mason Medical Center

Seattle, Washington, United States

Site Status

Swedish Organ Transplant and Liver Center

Seattle, Washington, United States

Site Status

Royal Brisbane & Women's Hospital

Herston, Queensland, Australia

Site Status

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status

Monash Health, Monash Medical Centre

Clayton, Victoria, Australia

Site Status

St Vincent's Hospital Melbourne

Fitzroy, Victoria, Australia

Site Status

Melbourne Health, Royal Melbourne Hospital

Parkville, Victoria, Australia

Site Status

Sir Charles Gairdner Hospital

Nedlands, Western Australia, Australia

Site Status

Royal Perth Hospital

Perth, Western Australia, Australia

Site Status

Royal Prince Alfred Hospital

Camperdown, , Australia

Site Status

St Vincent's Hospital Sydney

Darlinghurst, , Australia

Site Status

Austin Health

Heidelberg, , Australia

Site Status

The Alfred Hospital, Alfred Health

Melbourne, , Australia

Site Status

Westmead Hospital

Westmead, , Australia

Site Status

William Osler Health System-Brampton Civic Hospital

Brampton, , Canada

Site Status

University of Calgary Liver Unit (Heritage Medical Research Clinic)

Calgary, , Canada

Site Status

Chronic Viral Illness Service McGill University Health Centre (MUHC)/ Royal Victoria Hospital

Montreal, , Canada

Site Status

Toronto General Hospital

Toronto, , Canada

Site Status

Toronto Liver Centre

Toronto, , Canada

Site Status

Prince of Wales Hospital

Shatin, , Hong Kong

Site Status

Auckland City Hospital

Auckland, , New Zealand

Site Status

Fundacion de Investigacion de Diego

San Juan, , Puerto Rico

Site Status

Countries

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United States Australia Canada Hong Kong New Zealand Puerto Rico

References

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Loomba R, et al. Safety and efficacy of combination therapies including cilofexor/firsocostat in patients with bridging fibrosis and cirrhosis due to NASH: Results of the Phase 2b ATLAS trial [accepted for oral presentation]. European Association for the Study of the Liver (EASL); 2020; Virtual.

Reference Type RESULT

Loomba R, Alkhouri N, Strasser S, Wong VWS, Schall RA, McColgan B, et al. Clinical utility and application of non-invasive tests of fibrosis in the selection of patients with advanced fibrosis due to NASH in the Phase 2 ATLAS trial (Poster SAT-315). EASL; 2019; Vienna, Austria.

Reference Type RESULT

Loomba R, Alkhouri N, Patel K, Zhang J, McColgan BJ, Djedjos S, et al. Validation of Cutoffs for Controlled Attenuation Parameter with MRI-Proton Density Fat Fraction (PDFF) as a Reference Standard in Subjects with Nonalcoholic Steatohepatitis (NASH) Across Multiple Randomized, Controlled Trials (Poster 1727). American Association for the Study of Liver Diseases (AASLD); 2019; Boston, MA, USA.

Reference Type RESULT

Loomba R, Alkhouri N, Noureddin M, Zhang J, McColgan BJ, Djedjos S, et al. Validation of the Diagnostic Accuracy of Magnetic Resonance Elastography (MRE) for the Detection of Advanced Fibrosis Due to Nash Across Multiple Phase 2 and 3 Clinical Trials (Poster 1728). AASLD; 2019; Boston, MA, USA.

Reference Type RESULT

Alkhouri N, Strasser SI, Wong VWS, Aguilar R, Chuang J, Huss R, et al. Alcohol use is Underreported in Clinical Trials of NASH: Baseline Alcohol Biomarkers from a Phase 2 Clinical Trial (Poster 1765). AASLD; 2019; Boston, MA, USA.

Reference Type RESULT

Loomba R, Noureddin M, Kowdley KV, Kohli A, Sheikh A, Neff G, Bhandari BR, Gunn N, Caldwell SH, Goodman Z, Wapinski I, Resnick M, Beck AH, Ding D, Jia C, Chuang JC, Huss RS, Chung C, Subramanian GM, Myers RP, Patel K, Borg BB, Ghalib R, Kabler H, Poulos J, Younes Z, Elkhashab M, Hassanein T, Iyer R, Ruane P, Shiffman ML, Strasser S, Wong VW, Alkhouri N; for the ATLAS Investigators. Combination Therapies Including Cilofexor and Firsocostat for Bridging Fibrosis and Cirrhosis Attributable to NASH. Hepatology. 2021 Feb;73(2):625-643. doi: 10.1002/hep.31622.

Reference Type DERIVED
PMID: 33169409 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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GS-US-454-4378

Identifier Type: -

Identifier Source: org_study_id