Study to Learn About the Safety of Fazirsiran and if it Can Help People With Alpha-1 Antitrypsin Liver Disease With Mild Liver Scarring (Fibrosis)

NCT ID: NCT06165341

Last Updated: 2025-11-28

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-01

Study Completion Date

2028-08-26

Brief Summary

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The liver produces a protein called alpha-1 antitrypsin (AAT). AAT is normally released into the bloodstream. In some people, the liver makes an abnormal version of the AAT protein, called Z-AAT. Making an abnormal version of the AAT protein can result in liver disease as Z-AAT builds up in liver cells, which leads to liver problems such as liver scarring (fibrosis), continuing liver damage (cirrhosis), and eventually end stage liver disease. Fazirsiran is a medicine that reduces the creation of the Z-AAT protein and thus the build-up of this abnormal protein in the liver. People with this type of liver disease who already have mild liver scarring will take part in the study. They will be treated with fazirsiran or a placebo for about 2 years. This study will check the long-term safety of fazirsiran, whether participants tolerate the treatment and if there are any effects on liver scarring. A liver biopsy, a way of collecting a small tissue sample from the liver, will be taken twice during the study.

Detailed Description

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Conditions

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Alpha1-Antitrypsin Deficiency

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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Fazirsiran 200 mg

Participants will receive fazirsiran 200 milligrams (mg), injection, subcutaneously on Day 1, at Week 4 and then every 12 weeks (Q12W) for up to Week 100.

Group Type EXPERIMENTAL

Fazirsiran Injection

Intervention Type DRUG

Fazirsiran will be injected subcutaneously.

Placebo

Participants will receive fazirsiran matching placebo injection, subcutaneously on Day 1, at Week 4 and Q12W for up to Week 100.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Fazirsiran matching placebo.

Interventions

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Fazirsiran Injection

Fazirsiran will be injected subcutaneously.

Intervention Type DRUG

Placebo

Fazirsiran matching placebo.

Intervention Type DRUG

Other Intervention Names

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TAK-999 ARO-AAT ADS-001

Eligibility Criteria

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Inclusion Criteria

* In the opinion of the investigator, the participant is capable of understanding and fully complying with the protocol requirements and adhering to the protocol schedule.
* The participant is able to read, understand, and complete the study questionnaires electronically per the investigator's judgment.
* The participant signs and dates a written Informed Consent Form (ICF). Any required privacy authorization should also be signed before the initiation of any study procedures.
* The participant, of any sex, is aged 18 to 75 years, inclusive.
* The participant must have a diagnosis of the protease inhibitor Z mutation (PiZZ) genotype AATD. A diagnosis of PiZZ from source-verifiable medical records is permitted. Otherwise, participants must undergo PiZZ confirmatory testing (genotyping for PiS and PiZ alleles) at screening. PiMZ or PiSZ genotypes are not permitted.
* The participant's liver biopsy core samples collected as per protocol requirements.
* The participant has evidence of METAVIR stage F1 liver fibrosis, evaluated by a centrally read baseline liver biopsy during the screening period; or confirmed as meeting all the entry criteria by central reading from a previous biopsy conducted within 1 year before the estimated enrollment date using an adequate liver biopsy and slides as defined in the study laboratory manual.
* The participant has a pulmonary status that meets the protocol requirements.
* It must be confirmed that the participant does not have hepatocellular carcinoma (HCC).
* Any participant who is taking statins, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or beta-1 selective adrenergic receptor inhibitors must have been receiving a stable dose of these medications for at least 8 weeks before randomization. All attempts are to be made for the participant to continue the same dose of the medication for the duration of study participation.
* An adult participant must have a body mass index (BMI) between 18 and 39 kilogram per meter square (kg/m\^2), inclusive.
* The participant has a 12-lead electrocardiogram at screening that, in the opinion of the investigator, has no abnormalities that could compromise the participant's safety in this study.
* The participant is a nonsmoker.
* If the participant was being treated with any respiratory medications including inhaled bronchodilators, inhaled anticholinergics, inhaled corticosteroids, or low-dose systemic corticosteroids (prednisone less than or equal to \[\<=10\] milligrams per day \[mg/d\] or its equivalent), the doses of the participant's medications must have remained unchanged for greater than or equal to (\>=) 4 weeks before screening.
* The participant must have suitable venous access for blood sampling.
* A person of childbearing potential (POCBP) must have a negative serum pregnancy test at screening and a negative urine pregnancy test on Day 1 before dosing.
* The participant must use appropriate contraception methods (that is, highly effective methods for female and medically appropriate methods for male study participants) for the entire duration of the study and for 6 months after the last dose of study medication. The participant must not donate sperm for at least 6 months after the last dose of study medication.

Exclusion Criteria

* The participant has evidence of \>= F2 fibrosis based on liver biopsy during the screening period.
* The participant has a history of liver decompensating events.
* The participant has a history of varices based on a previous esophagogastroduodenoscopy.
* The participant has portal vein thrombosis.
* The participant has undergone a prior trans-jugular portosystemic shunt procedure.
* The participant has evidence of other forms of chronic liver diseases.
* The participant has a history of malignancy within the last 5 years, except for adequately treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer. Participants with curatively treated malignancies who have no evidence of metastatic disease and disease-free interval greater than (\>) 1 year may be enrolled after approval by the medical monitor.
* The participant has an abnormal finding of clinical relevance at the screening evaluation and before administration of the first dose of study dosing that, in the opinion of the investigator, could adversely impact participant safety during the study or adversely impact study results.
* The participant has any laboratory abnormalities at screening and before the first dose of the study drug that meet protocol parameters.
* The participant is expected to have severe and unavoidable high-level exposure to inhaled pulmonary toxins during the study such as may occur with occupational exposure to mineral dusts or metals.
* The participant has a recent lower respiratory tract infection, such as pneumonia, within the last 6 months before screening. The participant may be screened earlier based on principal investigator (PI) assessment of clinical recovery and return to baseline pulmonary function in discussion with the medical monitor.
* The participant has a history of frequent pulmonary exacerbations (\>=2 moderate or severe exacerbations within 52 weeks before screening).
* The participant is experiencing a pulmonary exacerbation at the time of screening (participant may be rescreened after the clinical resolution of an exacerbation).
* The participant is receiving long-term, around-the-clock oxygen supplementation or supplemental oxygen with continuous positive airway pressure (CPAP) or bilevel positive airway pressure for acute respiratory failure. The following conditions are allowable for the participant to enter screening: short-term use of oxygen supplementation (example, for the management of acute chronic obstructive pulmonary disease \[COPD\] exacerbation) or CPAP for obstructive sleep apnea.
* The participant has human immunodeficiency virus (HIV) infection as shown by the presence of anti-HIV antibody (seropositive).
* The participant is seropositive for hepatitis B virus (HBV surface antigen positive and/or HBV core antibody positive without HBV surface antibody at screening) or hepatitis C virus (HCV) (detectable HCV Ribonucleic Acid \[RNA\] at screening). Cured HCV (positive antibody test without detectable HCV RNA for at least 6 months after treatment) is acceptable.
* The participant has unstable, poorly controlled, or severe hypertension. Participants may be rescreened once their blood pressure (BP) is successfully controlled.
* The participant has a history of torsades de pointes, ventricular rhythm disturbances (example, ventricular tachycardia), heart block (excluding first-degree block, being PR interval prolongation only), congenital long QT syndrome or new ST-segment elevation or depression or a new Q wave on ECG. Participants with a history of atrial arrhythmias should be discussed with the medical monitor.
* The participant has symptomatic heart failure (per New York Heart Association guidelines), unstable angina, myocardial infarction, severe cardiovascular disease (ejection fraction less than \[\<\] 20 percent \[%\]), transient ischemic attack, or cerebrovascular accident within 6 months before screening.
* The participant has a history of major surgery within 12 weeks of screening (or longer, at the discretion of the investigator).
* The participant has a history of more than moderate alcohol consumption within 12 months before the screening visit.
* The participant has a history of drug abuse (such as cocaine, phencyclidine) within 1 year before the screening visit or has a positive urine drug screen at screening.
* The participant has previously been treated with fazirsiran or any other RNA interference (RNAi) for alpha-1 antitrypsin deficiency-associated liver disease (AATD-LD).
* The participant has a history of hypersensitivity or allergies with any associated excipients of fazirsiran.
* The participant has received an investigational agent or device within 30 days, or 5 half-lives, whichever is longer, before the dosing of study medication or is currently participating in an investigational study involving a therapeutic intervention.
* The participant has donated \>=500 milliliter (mL) of blood within 1 month of the administration of study treatment.
* The participant has any concomitant medical or psychiatric condition or social situation that would make it difficult to comply with protocol requirements or put the participant at additional safety risk. The participant has a history of clinically significant hematologic, renal, hepatic, pulmonary, neurologic, psychiatric, gastrointestinal (GI), systemic inflammatory, metabolic, or endocrine disorder or any other condition that, in the opinion of the investigator, rendered the participant a poor candidate for inclusion into the study.
* The participant has a history of thromboembolic disease (including deep vein thrombosis or pulmonary embolism), within 6 months before screening, or is taking chronic anticoagulants.
* This participant is unable to return for all scheduled study visits.
* The participant has known or suspected coronavirus disease 2019 (COVID-19) that, in the opinion of the sponsor and investigator, does not resolve during screening. Positive antibody testing for COVID-19 without other evidence of current or recent active infection does not exclude participation. Enrollment of participants who fail inclusion due to COVID-19 infection may be temporarily delayed at the discretion of the sponsor and investigator. If the participant has a positive polymerase chain reaction (PCR) with no other evidence of infection, a retest may be allowed; however, to enroll in the study the participant must have a negative PCR.
* The participant is a study site employee involved in the conduct of this study, an immediate family member (example, spouse, parent, child, sibling), is in a dependent relationship with study site employee who is involved in the conduct of this study or may consent under duress.
* The participant takes or is required to take excluded medications.
* The participant is pregnant or breastfeeding or intending to become pregnant before participating in this study, during the study, or within 6 months after last dose of the study drug; or the participant is intending to donate ova during such time period.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Takeda

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Study Director

Role: STUDY_DIRECTOR

Takeda

Locations

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St Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Site Status RECRUITING

Mayo Clinic - PPDS

Phoenix, Arizona, United States

Site Status RECRUITING

University of Arizona Thomas D. Boyer Liver Institute

Tucson, Arizona, United States

Site Status RECRUITING

University of California San Diego

La Jolla, California, United States

Site Status RECRUITING

UCLA Pulmonary and Critical Care

Los Angeles, California, United States

Site Status RECRUITING

University of California Benioff Children's Hospital

San Francisco, California, United States

Site Status RECRUITING

Peak Gastroenterology Associates

Colorado Springs, Colorado, United States

Site Status RECRUITING

Schiff Center for Liver Diseases/University of Miami

Miami, Florida, United States

Site Status RECRUITING

Indiana University School of Medicine-Indianapolis

Indianapolis, Indiana, United States

Site Status RECRUITING

University Of Iowa Hospitals And Clinics

Iowa City, Iowa, United States

Site Status RECRUITING

Boston Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

University of Michigan Hospital - 1500 E Medical Center Dr

Ann Arbor, Michigan, United States

Site Status RECRUITING

Henry Ford Health System

Novi, Michigan, United States

Site Status RECRUITING

Mayo Clinic PPDS

Rochester, Minnesota, United States

Site Status RECRUITING

NYU Langone Medical Center

New York, New York, United States

Site Status RECRUITING

Columbia University Irving Medical Center

New York, New York, United States

Site Status RECRUITING

University Hospitals Cleveland Medical Center

Cleveland, Ohio, United States

Site Status RECRUITING

Penn State Health Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status RECRUITING

Texas Liver Institute American Research Corporation

San Antonio, Texas, United States

Site Status RECRUITING

Bon Secours St. Mary's Hospital

Newport, Virginia, United States

Site Status RECRUITING

LKH-Universitätsklinikum Graz

Graz, , Austria

Site Status RECRUITING

KABEG - Klinikum Klagenfurt Am Wörthersee

Klagenfurt, , Austria

Site Status RECRUITING

UZ Antwerpen

Antwerp, , Belgium

Site Status RECRUITING

UZ Leuven

Leuven, , Belgium

Site Status RECRUITING

Inspiration Research Limited

Toronto, Ontario, Canada

Site Status RECRUITING

Hôpital de La Croix Rousse

Lyon, , France

Site Status RECRUITING

Hopital PONTCHAILLOU CHU de Rennes

Rennes, , France

Site Status RECRUITING

Hôpital Paul Brousse

Val-de-Marne, , France

Site Status RECRUITING

Universitätsklinikum der RWTH Aachen

Aachen, , Germany

Site Status RECRUITING

Charité - Campus Virchow-Klinikum

Berlin, , Germany

Site Status RECRUITING

Hannover Medical School

Hanover, , Germany

Site Status RECRUITING

Universitätsklinikum Tübingen

Tübingen, , Germany

Site Status RECRUITING

Fondazione IRCCS Policlinico San Matteo

Pavia, , Italy

Site Status RECRUITING

ID Clinic Arkadiusz Pisula

Mysłowice, , Poland

Site Status RECRUITING

CCA Hospital Braga

Braga, , Portugal

Site Status RECRUITING

Hospital Dr. Nélio Mendonça

Funchal, , Portugal

Site Status RECRUITING

Centro Hospitalar de Universitário de Santo António E.P.E

Porto, , Portugal

Site Status RECRUITING

Hospital Universitario Virgen del Rocio - PPDS

Seville, , Spain

Site Status RECRUITING

Karolinska Universitetssjukhuset Huddinge

Huddinge, , Sweden

Site Status RECRUITING

Universitätsspital Bern

Bern, , Switzerland

Site Status RECRUITING

King's College Hospital

London, , United Kingdom

Site Status RECRUITING

Countries

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United States Austria Belgium Canada France Germany Italy Poland Portugal Spain Sweden Switzerland United Kingdom

Central Contacts

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Takeda Contact

Role: CONTACT

+1-877-825-3327

Facility Contacts

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Site Contact

Role: primary

602-274-7195

Site Contact

Role: primary

480-301-6990

Site Contact

Role: primary

520-626-3005

Site Contact

Role: primary

858-534-2555

Site Contact

Role: primary

310-825-8061

Site Contact

Role: primary

415-476-5892

Site Contact

Role: primary

719-636-1201

Site Contact

Role: primary

305-243-5185

Site Contact

Role: primary

317-278-4607

Site Contact

Role: primary

319-356-2577

Site Contact

Role: primary

617-638-6525

Site Contact

Role: primary

734-232-3741

Site Contact

Role: primary

248-344-6688

Site Contact

Role: primary

507-284-0141

Site Contact

Role: primary

212-263-3643

Site Contact

Role: primary

216-983-0879

Site Contact

Role: primary

717-531-7532

Site Contact

Role: primary

210-253-3426

Site Contact

Role: primary

804-977-8920

Site Contact

Role: primary

+4331638580287

Site Contact

Role: primary

+3238213323

Site Contact

Role: primary

+328888888888

Site Contact

Role: primary

(416) 944-9602

Site contact

Role: primary

+33145596790

Site Contact

Role: primary

+33299284297

Site Contact

Role: primary

+33145593336

Role: primary

+492418035324

Site Contact

Role: primary

+4939450553022

Site Contact

Role: primary

+495115322730

Site Contact

Role: primary

+4970712977661

Site Contact

Role: primary

+390382503777

Site Contact

Role: primary

+48 32 616 13 94

Site Contact

Role: primary

(351) 291-7056 x00

Site Contact

Role: primary

+351918000000

Site Contact

Role: primary

+34955012065

Site Contact

Role: primary

+46858580000

Site Contact

Role: primary

+41442663568

Site Contact

Role: primary

+442032993506

Related Links

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Other Identifiers

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2023-504198-19-00

Identifier Type: CTIS

Identifier Source: secondary_id

TAK-999-3002

Identifier Type: -

Identifier Source: org_study_id

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