A Study to Evaluate the Efficacy and Safety of Maralixibat in Subjects With Progressive Familial Intrahepatic Cholestasis (MARCH-PFIC)

NCT ID: NCT03905330

Last Updated: 2023-12-11

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

93 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-09

Study Completion Date

2022-09-01

Brief Summary

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The purpose of this study is to determine whether the investigational treatment (maralixibat) is safe and effective in pediatric participants with Progressive Familial Intrahepatic Cholestasis (PFIC).

Detailed Description

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This study was conducted at multiple sites in North America, Europe, Asia and South America.

Conditions

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Progressive Familial Intrahepatic Cholestasis (PFIC)

Keywords

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Cholestasis Maralixibat Mutation PFIC PFIC2 Bile Duct Diseases Liver Diseases Biliary Tract Diseases Digestive System Diseases Pediatric

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Maralixibat

Participants will receive Maralixibat oral solution (up to 600 microgram per kilogram \[mcg/kg\]) orally twice daily for 26 weeks.

Group Type EXPERIMENTAL

Maralixibat

Intervention Type DRUG

Maralixibat oral solution (up to 600 mcg/kg) orally twice daily for 26 weeks.

Placebo

Participants will receive placebo matched to maralixibat oral solution twice daily for 26 weeks.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo matching to maralixibat orally twice daily for 26 weeks.

Interventions

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Maralixibat

Maralixibat oral solution (up to 600 mcg/kg) orally twice daily for 26 weeks.

Intervention Type DRUG

Placebo

Placebo matching to maralixibat orally twice daily for 26 weeks.

Intervention Type OTHER

Other Intervention Names

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Formerly LUM001 and SHP625

Eligibility Criteria

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Inclusion Criteria

1. Informed consent and assent (as applicable) per Institutional Review Board/Ethics Committee (IRB/EC)
2. Male or female subjects with a body weight ≥5 kg, who are ≥12 months and \<18 years of age at time of baseline
3. Cholestasis as manifested by total sBA ≥3× ULN (applies to primary cohort only)
4. An average AM ItchRO(Obs) score ≥1.5 during 4 consecutive weeks of the screening period, leading to the baseline visit (Visit 1)
5. Completion of at least 21 valid\* morning ItchRO(Obs) entries during 4 consecutive weeks of the screening period, leading to the baseline visit (Visit 1) (\*valid = completed and not answered as "I don't know"; maximum allowed invalid reports = 7, no more than 2 invalid reports during the last 7 days before randomization)
6. Diagnosis of PFIC based on the following:

* Chronic cholestasis as manifested by persistent (\>6 months) pruritus in addition to biochemical abnormalities and/or pathological evidence of progressive liver disease and
* Primary Cohort: Subjects with genetic testing results consistent with biallelic disease-causing variation in ABCB11 (PFIC2), based on standard of care genotyping
* Supplemental Cohort: i. Subjects with genetic testing results consistent with biallelic disease-causing variation in ATP8B1 (PFIC1), ABCB4 (PFIC3), or TJP2 (PFIC4), based on standard of care genotyping. ii. Subjects with PFIC phenotype without a known mutation or with another known mutation not described above or with intermittent cholestasis as manifested by fluctuating sBA levels. iii. Subjects with PFIC after internal or external biliary diversion surgery or for whom internal or external biliary diversion surgery was reversed.
7. Male and females of non-childbearing potential. Males and non-pregnant, non-lactating females of childbearing potential who are sexually active must agree to use acceptable methods of contraception during the study and 30 days following the last dose of the study medication. Females of childbearing potential must have a negative pregnancy test
8. Access to email or phone for scheduled remote visits
9. Ability to read and understand the questionnaires (both caregivers and subjects above the age of assent)
10. Access to consistent caregiver(s) during the study
11. Subject and caregiver willingness to comply with all study visits and requirements.

2. Recurrent intrahepatic cholestasis, indicated by a history of sBA levels \<3x ULN or intermittent pruritus (applies to primary cohort only)
3. Current or recent history (\<1 year) of atopic dermatitis or other non-cholestatic diseases associated with pruritus.
4. History of surgical disruption of the enterohepatic circulation (applies to primary cohort only)
5. Chronic diarrhea requiring intravenous fluid or nutritional intervention for the diarrhea and/or its sequelae at screening or during the 6 months prior to screening
6. Previous or need for imminent liver transplant
7. Decompensated cirrhosis (international normalized ratio \[INR\] \>1.5, albumin \<30 g/L, history or presence of clinically significant ascites, variceal hemorrhage, and/or encephalopathy)
8. ALT or total serum bilirubin (TSB) \>15× ULN at screening
9. Presence of other liver disease
10. Presence of any other disease or condition known to interfere with the absorption, distribution, metabolism or excretion of drugs, including bile salt metabolism in the intestine (e.g., inflammatory bowel disease), per Investigator discretion
11. Possibly malignant liver mass on imaging, including screening ultrasound
12. Known diagnosis of human immunodeficiency virus (HIV) infection
13. Any prior cancer diagnosis (except for in situ carcinoma) within 5 years of the screening visit (Visit 0)
14. Any known history of alcohol or substance abuse
15. Administration of bile acids or lipid binding resins, or phenylbutyrates during the screening period
16. Criterion has been deleted as of Amendment 3
17. Administration of any investigational drug, biologic, or medical device during the screening period
18. Previous use of an ileal bile acid transporter inhibitor (IBATi)
19. History of non-adherence to medical regimens, unreliability, medical condition, mental instability or cognitive impairment that, in the opinion of the Investigator or Sponsor medical monitor, could compromise the validity of informed consent, compromise the safety of the subject, or lead to nonadherence with the study protocol or inability to conduct the study procedures
20. Known hypersensitivity to maralixibat or any of its excipients.
Minimum Eligible Age

1 Year

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mirum Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Children's Hospital Los Angeles CHLA

Los Angeles, California, United States

Site Status

Medstar Georgetown University Hospital

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

Site Status

Advent Health

Orlando, Florida, United States

Site Status

The Children's Hospital at Montefiore Yeshiva University - Montefiore Medical Center

New York, New York, United States

Site Status

Cincinnati Children's Hospital

Cincinnati, Ohio, United States

Site Status

Cleveland Clinic - Pediatric Institute

Cleveland, Ohio, United States

Site Status

UPMC Children's Hospital of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

University of Texas - UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

University of Texas, Health Science Center San Antonio

San Antonio, Texas, United States

Site Status

Seattle Children's Hospital

Seattle, Washington, United States

Site Status

Hospital Italiano de Buenos Aires

Buenos Aires, , Argentina

Site Status

Medizinische Universität Wien, Universitätsklinik für Kinder- und Jugendheilkunde

Vienna, , Austria

Site Status

Universite Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint-Luc

Brussels, , Belgium

Site Status

Sociedade Beneficente de Senhoras Hospital Sírio-Libanês

São Paulo, , Brazil

Site Status

University of Alberta - Women and Children's Health Research Institute

Edmonton, , Canada

Site Status

Fundacion Cardioinfantil - Departamento de Investigaciones

Bogotá, , Colombia

Site Status

Hospices Civils de Lyon - Hopital Femme Mere Enfant Service de Gastroenterologie, Hepatologie et Nutrition

Lyon, , France

Site Status

CHU de Marseille, Hôpital de la Timone

Marseille, , France

Site Status

CHU de Toulouse - Hôpital des Enfants

Toulouse, , France

Site Status

Medizinische Hochschule Hannover

Hanover, , Germany

Site Status

Semmelweis Egyetem - Altalanos Orvostudomanyi Kar (SE AOK)

Budapest, , Hungary

Site Status

Hospital Papa Giovanni XXIII / Unità di Pediatria

Bergamo, , Italy

Site Status

Ospedale Pediatrico Bambino Gesu

Roma, , Italy

Site Status

Hotel Dieu de France

Beirut, , Lebanon

Site Status

Consultario de Joshue David Covarrubias Esquer

Zapopan, , Mexico

Site Status

Instytut Pomnik Centrum Zdrowia Dziecka

Warsaw, , Poland

Site Status

KK Women's and Children's Hospital

Singapore, , Singapore

Site Status

Koc University Hospital

Istanbul, , Turkey (Türkiye)

Site Status

Birmingham Children's Hospital

Birmingham, , United Kingdom

Site Status

King's College Hospital NHS

London, , United Kingdom

Site Status

Countries

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United States Argentina Austria Belgium Brazil Canada Colombia France Germany Hungary Italy Lebanon Mexico Poland Singapore Turkey (Türkiye) United Kingdom

References

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Miethke AG, Moukarzel A, Porta G, Covarrubias Esquer J, Czubkowski P, Ordonez F, Mosca A, Aqul AA, Squires RH, Sokal E, D'Agostino D, Baumann U, D'Antiga L, Kasi N, Laborde N, Arikan C, Lin CH, Gilmour S, Mittal N, Chiou FK, Horslen SP, Huber WD, Jaecklin T, Nunes T, Lascau A, Longpre L, Mogul DB, Garner W, Vig P, Hupertz VF, Gonzalez-Peralta RP, Ekong U, Hartley J, Laverdure N, Ovchinsky N, Thompson RJ. Maralixibat in progressive familial intrahepatic cholestasis (MARCH-PFIC): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Gastroenterol Hepatol. 2024 Jul;9(7):620-631. doi: 10.1016/S2468-1253(24)00080-3. Epub 2024 May 6.

Reference Type DERIVED
PMID: 38723644 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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Other Identifiers

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2019-001211-22

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

MRX-502

Identifier Type: -

Identifier Source: org_study_id