Fenofibrate Combined With Ursodeoxycholic Acid in Subjects With Primary Biliary Cholangitis

NCT ID: NCT05751967

Last Updated: 2026-01-08

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-22

Study Completion Date

2027-12-01

Brief Summary

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Current treatment guidelines recommend ursodeoxycholic acid (UDCA) as the first-line treatment for new-diagnosed primary biliary cholangitis (PBC) patients. However, up to 40% patients are insensitive to UDCA monotherapy, and evaluation of UDCA response at 12 months may result in long period of ineffective treatment. We aimed to develop a new criterion to reliably identify non-response patients much earlier. Recently, our team designed and validated a new early criterion for distinguishing high-risk PBC patients in a Chinese population for the first time. Our data indicated that PBC patients with ALP ≤ 2.5 × ULN, AST ≤ 2 × ULN, and TBIL ≤ 1 × ULN (Xi'an criterion) after 1 month UDCA treatment were likely to have better prognosis. It can be readily applied in the rapid identification of PBC patients who require additional therapeutic approaches. However, whether it is reasonable to apply it to the response definition of clinical research, and the guidance of PBC management and choice of second-line treatment, further research is needed.

Detailed Description

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This is a multi-center, randomized, placebo-controlled, parallel-group study that will assess the efficacy and safety of fenofibrate in patients with PBC who had an inadequate biochemical response to UDCA, as defined by the Xi'an criteria. Fenofibrate or placebo 200 mg will be daily administered in combination with UDCA 13-15 mg/kg/d for 48 months. Patient safety will be monitored. Primary end-point will be the percentage of patients with a complete normalization of the ALP and TBIL. Secondary endpoints will include the percentage of drug-related adverse events, survival rates without liver transplantation or liver decompensation, time course of non-invasive liver fibrosis measurements (LSM), time course of endoscopic, ultrasound, and biochemical features of portal hypertension, time course of pruritus and of quality of life using validated scales.

Conditions

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Primary Biliary Cholangitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo

1 tablet/ day

Group Type PLACEBO_COMPARATOR

Placebo Combined With Ursodeoxycholic Acid

Intervention Type DRUG

1 tablet/ day

Fenofibrate

200 mg/day

Group Type EXPERIMENTAL

Fenofibrate Combined With Ursodeoxycholic Acid

Intervention Type DRUG

200 mg/day

Interventions

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Placebo Combined With Ursodeoxycholic Acid

1 tablet/ day

Intervention Type DRUG

Fenofibrate Combined With Ursodeoxycholic Acid

200 mg/day

Intervention Type DRUG

Other Intervention Names

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UDCA 13-15mg/kg/d UDCA 13-15mg/kg/d

Eligibility Criteria

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Inclusion Criteria

* Must have provided written informed consent;
* Age 18-75 years;
* BMI 17-28 kg/m2
* Male or female with a diagnosis of PBC, by at least two of the following criteria:

* History of AP above ULN for at least six months;
* Positive AMA titers (\>1/40 on immunofluorescence or M2 positive by enzyme linked immunosorbent assay (ELISA) or positive PBC-specific antinuclear antibodies;
* Documented liver biopsy result consistent with PBC.
* Incomplete response to UDCA defined by Xi'an criteria (ALP \>2.5× ULN, AST\>2×ULN or TBIL\>1×ULN) after UDCA treatment for 4-6 weeks with at least one abnormal test in ALP or TBIL.

Exclusion Criteria

* History or presence of other concomitant liver diseases.
* ALT/AST \> 5×ULN, TBIL \> 3×ULN.
* If female: known pregnancy, or has a positive urine pregnancy test (confirmed by a positive serum pregnancy test), or lactating.
* Allergic to fenofibrate or ursodeoxycholic acid.
* Taking hepatotoxic drugs (e.g., dapsone, erythromycin, fluconazole, ketoconazole, rifampicin) for more than 2 weeks within 6 months, and long-term hormonal users.
* Recurrent variceal bleeding, poorly controlled hepatic encephalopathy or refractory ascites.
* Patients with a history of severe cardiac, cerebrovascular, renal, respiratory disease or functional failure, and psychiatric disorders (including those due to alcohol and drug abuse).
* Creatinine \>1.5×ULN and creatinine clearance \<60 ml/min.
* Currently using statins (such as pravastatin, fluvastatin, and simvastatin), other fibrates (such as gemfibrozil and bezafibrate), and drugs structurally similar to fenofibrate (like ketoprofen).
* Planned to receive an organ transplant or an organ transplant recipient.
* Needing Liver transplantation within 1 year according to the Mayo Rick score.
* Any other condition(s) that would compromise the safety of the subject or compromise the quality of the clinical study, as judged by the Investigator.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Xijing Hospital of Digestive Diseases

OTHER

Sponsor Role lead

Responsible Party

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Han Ying

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ying Han, Doctor

Role: PRINCIPAL_INVESTIGATOR

The First Affiliated Hospital of Air Force Medicial University

Locations

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The second hospital of Lanzhou University

Lanzhou, Gansu, China

Site Status RECRUITING

Sun Yat-sen Memorial Hospital

Guangzhou, Guangdong, China

Site Status NOT_YET_RECRUITING

Nanjing Drum Tower Hospital

Nanjing, Jiangsu, China

Site Status RECRUITING

The First Hospital of China Medical University

Shenyang, Liaoning, China

Site Status RECRUITING

Ying han

Xi'an, Shaanxi, China

Site Status RECRUITING

Sichuan Provincial People's Hospital,

Chengdu, Sichuan, China

Site Status RECRUITING

Tianjin Medical University General Hospital

Tianjin, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yulong Shang

Role: CONTACT

+86 18629661032

Ying Han

Role: CONTACT

+86-29-84771539

Facility Contacts

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Zhang

Role: primary

15193100697

Zhuang

Role: primary

13632322509

Role: primary

15863787910

Wang

Role: primary

13604010738

Ying Han

Role: primary

+86-29-84771539

Li

Role: primary

18981838872

Zhou

Role: primary

15822531649

Other Identifiers

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KY20222274-C-1

Identifier Type: -

Identifier Source: org_study_id

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