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Pharmacokinetic and Pharmacodynamic Study of IDN-6556 in ACLF

Primary Purpose

Acute on Chronic Hepatic Failure, Acute Liver Failure, Liver Cirrhosis

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
IDN-6556
Placebo
Sponsored by
Conatus Pharmaceuticals Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute on Chronic Hepatic Failure focused on measuring Liver Failure, Cirrhosis, Alcoholic Hepatitis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female subjects of minimum adult legal age (according to local laws for signing the informed consent document), able to provide written informed consent, and understand and comply with the requirements of the study
  • Subjects with a clinical, radiological and/or histological diagnosis of cirrhosis
  • Subjects having not required hospital admission within 4 weeks of screening for a complication of cirrhosis
  • Subjects with an acute deterioration of liver function
  • Subjects who meet one of the following criteria:

    1. Subjects with renal failure (defined as creatinine ≥ 2.0 to ≤ 3.4 mg/dL)
    2. Subjects with other single organ failure with i. Renal impairment (defined as an increase in creatinine of > 0.3 mg/dL from either an established prior Baseline level or if applicable, upon admission to hospital if prior level is unavailable; for inclusion, the creatinine level must be raised above normal levels), and/or ii. Hepatic encephalopathy grade I or II
    3. Subjects with two organ failures
  • If a subject received steroids for alcohol-induced acute liver failure, he/she must be unresponsive to steroid therapy. Responsiveness is based on investigator discretion.
  • Willingness to utilize two reliable forms of contraception (for both males and females of childbearing potential) from screening to one month after the last dose of study drug

Exclusion Criteria:

  • Known infection with HIV
  • Subjects with cirrhosis who develop decompensation at any time in the postoperative period following partial hepatectomy
  • Subjects with evidence of uncontrolled infection defined as persistent bacterial culture positivity despite adequate antibiotic therapy
  • Subjects with clinical evidence of disseminated intravascular coagulation
  • Subjects with chronic and/or pre-existing kidney disease defined as eGFR (estimated glomerular filtration rate) of less than 30 mL/min for 3 months or longer
  • Subjects who are hypotensive (defined as mean arterial pressure <70 mmHg) or require the use of inotropic support
  • Subjects with evidence of significant and/or uncontrolled bleeding
  • Subjects requiring mechanical ventilation
  • Subjects with active or history of malignancies other than hepatocellular carcinoma (HCC) within Milan criteria or curatively treated skin cancer (basal cell or squamous cell carcinomas), unless adequately treated or in complete remission for five or more years
  • Subjects previously exposed to IDN-6556
  • History or presence of clinically concerning cardiac arrhythmias, or prolongation of Screening (pre-treatment) QT or QTc interval of > 480 milliseconds (msec)

Sites / Locations

  • University of Alabama at Birmingham
  • Scripps Clinic
  • VA San Diego Healthcare System
  • Sutter Pacific Medical Foundation
  • Georgetown University Hospital
  • University of Kansas Medical Center
  • Univerisity of Louisville Liver Research Center
  • University of Mississippi Medical Center
  • Montefiore Medical Center
  • University of Utah
  • University of Washington Harborview Medical Center
  • Singleton Hospital
  • Basildon and Thurrock University Hospital
  • Blackpool Victoria Hospital
  • Bristol Royal Infirmary
  • Ninewells Hospital
  • Glasgow Royal Infirmary
  • Leicester Royal Infirmary
  • Royal Liverpool University Hospital
  • University College London, Royal Free Hospital
  • Royal London Hospital
  • Central Manchester University Hospitals NHS Trust
  • Freeman Hospital
  • Nottingham University Hospitals NHS Trust
  • Derriford Hospital
  • Queen Alexandra Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

IDN-6556 5 mg

IDN-6556 25 mg

IDN-6556 50 mg

Placebo

Arm Description

Dosed twice daily

Dosed twice daily

Dosed twice daily

Dosed twice daily

Outcomes

Primary Outcome Measures

Area Under the Curve (AUC)
Primary endpoints for AUC_0-8, AUC_0 last, AUC_0-inf on Day 1 and Day 4 for the active treatment arms were analyzed.
Cmax
Primary endpoints forCmax on Day 1 and Day 4 for the active treatment arms were analyzed.
Tmax & t1/2 Parameters
Primary endpoints for tmax & t1/2 on Day 1 and Day 4 for the active treatment arms were analyzed.

Secondary Outcome Measures

Levels of CK18/M30
Caspase-cleaved cytokeratin serum levels (CK18/M30)
Levels of CK18/M65
Caspase full-length cytokeratin serum levels CK18/M65
Levels of Caspase 3/7 RLU
Concentration of Caspase 3/7 Relative Light Units

Full Information

First Posted
September 4, 2013
Last Updated
March 28, 2016
Sponsor
Conatus Pharmaceuticals Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01937130
Brief Title
Pharmacokinetic and Pharmacodynamic Study of IDN-6556 in ACLF
Official Title
A Placebo-Controlled, Multicenter, Double-Blind, Randomized, Pharmacokinetic and Pharmacodynamic Trial of IDN-6556 in Subjects With Acute-on-Chronic Liver Failure
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Terminated
Why Stopped
Data needs met
Study Start Date
September 2013 (undefined)
Primary Completion Date
January 2015 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Conatus Pharmaceuticals Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The study will evaluate the pharmacokinetics, pharmacodynamics, safety and preliminary efficacy of IDN-6556 in subjects with cirrhosis of the liver who are hospitalized for more than 24 hours due to acute deterioration of liver function.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute on Chronic Hepatic Failure, Acute Liver Failure, Liver Cirrhosis, Acute Alcoholic Hepatitis
Keywords
Liver Failure, Cirrhosis, Alcoholic Hepatitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IDN-6556 5 mg
Arm Type
Experimental
Arm Description
Dosed twice daily
Arm Title
IDN-6556 25 mg
Arm Type
Experimental
Arm Description
Dosed twice daily
Arm Title
IDN-6556 50 mg
Arm Type
Experimental
Arm Description
Dosed twice daily
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Dosed twice daily
Intervention Type
Drug
Intervention Name(s)
IDN-6556
Other Intervention Name(s)
emricasan, PF-03491390
Intervention Type
Other
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Area Under the Curve (AUC)
Description
Primary endpoints for AUC_0-8, AUC_0 last, AUC_0-inf on Day 1 and Day 4 for the active treatment arms were analyzed.
Time Frame
28 days
Title
Cmax
Description
Primary endpoints forCmax on Day 1 and Day 4 for the active treatment arms were analyzed.
Time Frame
28 Days
Title
Tmax & t1/2 Parameters
Description
Primary endpoints for tmax & t1/2 on Day 1 and Day 4 for the active treatment arms were analyzed.
Time Frame
28 Days
Secondary Outcome Measure Information:
Title
Levels of CK18/M30
Description
Caspase-cleaved cytokeratin serum levels (CK18/M30)
Time Frame
Baseline, Day 2, Day 4, Day 7, Day 14, Day 21, and Day 28
Title
Levels of CK18/M65
Description
Caspase full-length cytokeratin serum levels CK18/M65
Time Frame
Baseline, Day 2, Day 4, Day 7, Day 14, Day 21, and Day 28
Title
Levels of Caspase 3/7 RLU
Description
Concentration of Caspase 3/7 Relative Light Units
Time Frame
Baseline, Day 2, Day 4, Day 7, Day 14, Day 21, and Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects of minimum adult legal age (according to local laws for signing the informed consent document), able to provide written informed consent, and understand and comply with the requirements of the study Subjects with a clinical, radiological and/or histological diagnosis of cirrhosis Subjects having not required hospital admission within 4 weeks of screening for a complication of cirrhosis Subjects with an acute deterioration of liver function Subjects who meet one of the following criteria: Subjects with renal failure (defined as creatinine ≥ 2.0 to ≤ 3.4 mg/dL) Subjects with other single organ failure with i. Renal impairment (defined as an increase in creatinine of > 0.3 mg/dL from either an established prior Baseline level or if applicable, upon admission to hospital if prior level is unavailable; for inclusion, the creatinine level must be raised above normal levels), and/or ii. Hepatic encephalopathy grade I or II Subjects with two organ failures If a subject received steroids for alcohol-induced acute liver failure, he/she must be unresponsive to steroid therapy. Responsiveness is based on investigator discretion. Willingness to utilize two reliable forms of contraception (for both males and females of childbearing potential) from screening to one month after the last dose of study drug Exclusion Criteria: Known infection with HIV Subjects with cirrhosis who develop decompensation at any time in the postoperative period following partial hepatectomy Subjects with evidence of uncontrolled infection defined as persistent bacterial culture positivity despite adequate antibiotic therapy Subjects with clinical evidence of disseminated intravascular coagulation Subjects with chronic and/or pre-existing kidney disease defined as eGFR (estimated glomerular filtration rate) of less than 30 mL/min for 3 months or longer Subjects who are hypotensive (defined as mean arterial pressure <70 mmHg) or require the use of inotropic support Subjects with evidence of significant and/or uncontrolled bleeding Subjects requiring mechanical ventilation Subjects with active or history of malignancies other than hepatocellular carcinoma (HCC) within Milan criteria or curatively treated skin cancer (basal cell or squamous cell carcinomas), unless adequately treated or in complete remission for five or more years Subjects previously exposed to IDN-6556 History or presence of clinically concerning cardiac arrhythmias, or prolongation of Screening (pre-treatment) QT or QTc interval of > 480 milliseconds (msec)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephen Ryder, Dr.
Organizational Affiliation
Nottingham University Hospital NHS Trust
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Scripps Clinic
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
VA San Diego Healthcare System
City
San Diego
State/Province
California
ZIP/Postal Code
92161
Country
United States
Facility Name
Sutter Pacific Medical Foundation
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Georgetown University Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Univerisity of Louisville Liver Research Center
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
University of Mississippi Medical Center
City
Jackson
State/Province
Mississippi
ZIP/Postal Code
39216
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
University of Washington Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Singleton Hospital
City
Swansea
State/Province
Wales
ZIP/Postal Code
SA2 8QA
Country
United Kingdom
Facility Name
Basildon and Thurrock University Hospital
City
Basildon
ZIP/Postal Code
SS16 5NL
Country
United Kingdom
Facility Name
Blackpool Victoria Hospital
City
Blackpool
ZIP/Postal Code
FY3 8NR
Country
United Kingdom
Facility Name
Bristol Royal Infirmary
City
Bristol
ZIP/Postal Code
BS2 8HW
Country
United Kingdom
Facility Name
Ninewells Hospital
City
Dundee
ZIP/Postal Code
DD1 9SY
Country
United Kingdom
Facility Name
Glasgow Royal Infirmary
City
Glasgow
Country
United Kingdom
Facility Name
Leicester Royal Infirmary
City
Leicester
ZIP/Postal Code
LE1 5WW
Country
United Kingdom
Facility Name
Royal Liverpool University Hospital
City
Liverpool
ZIP/Postal Code
L7 8XP
Country
United Kingdom
Facility Name
University College London, Royal Free Hospital
City
London
ZIP/Postal Code
NW3 2PF
Country
United Kingdom
Facility Name
Royal London Hospital
City
London
Country
United Kingdom
Facility Name
Central Manchester University Hospitals NHS Trust
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom
Facility Name
Freeman Hospital
City
Newcastle upon tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
Facility Name
Nottingham University Hospitals NHS Trust
City
Nottingham
ZIP/Postal Code
NG7 2UH
Country
United Kingdom
Facility Name
Derriford Hospital
City
Plymouth
Country
United Kingdom
Facility Name
Queen Alexandra Hospital
City
Portsmouth
ZIP/Postal Code
PO6 3LY
Country
United Kingdom

12. IPD Sharing Statement

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Pharmacokinetic and Pharmacodynamic Study of IDN-6556 in ACLF

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