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Safety Pilot Study of Farnesoid X Receptor (FXR) Agonist in Non-alcoholic Fatty Liver Disease (NAFLD) Patients

Primary Purpose

Non Alcoholic Fatty Liver Disease

Status
Completed
Phase
Phase 2
Locations
Austria
Study Type
Interventional
Intervention
Px-104
Sponsored by
Phenex Pharmaceuticals AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Alcoholic Fatty Liver Disease

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • NAFLD patients
  • Weight > 65 kg
  • BMI > 25 and < 40
  • Negative blood or urine pregnancy test (for females of childbearing potential) collected at screening followed by another negative serum pregnancy test collected within 24 hours prior to the first dose of study drug.
  • Contraception: Female patients must be postmenopausal, surgically sterile, or if premenopausal, must be prepared to use at least two effective (≤1% failure rate) method of contraception during the course of the study and for 14 days after the end of dosing. Male patients with female partners of child bearing potential must be prepared to use at least two effective methods of contraception with all sexual partners unless they have had a prior vasectomy
  • Must be willing and able to give written informed consent and agree to comply with the study protocol.
  • Sinus rhythm in 12-lead ECG

Exclusion Criteria:

  • Evidence of excessive alcohol, drug or substance abuse (excluding marijuana use) within 1 year of first dose.
  • History or other evidence of a medical condition associated with chronic liver disease other than.
  • History or other evidence of decompensated liver disease (Child-Pugh Grade B or higher), coagulopathy, hyperbilirubinemia, hepatic encephalopathy, hypoalbuminemia, ascites, hepatic encephalopathy, and bleeding from esophageal varices are conditions consistent with decompensated liver disease.
  • Concomitant intake of fibrates or statins (at least 4-6 weeks before start; considering half life of medication).
  • Any clinically relevant findings in ECG (identified via 24h-Holter ECG or 12-Lead ECG) at screening
  • History of any structural cardiac disease.
  • In addition, patients with documented or presumed unstable coronary artery disease, stable or unstable cardiovascular disease or cerebrovascular disease.
  • One or more of the following conditions: (1) poorly controlled hypertension, OR (2) screening or baseline blood pressure ≥ 160 mmHg for systolic OR (3) screening or baseline blood pressure ≥ 100 mmHg for diastolic blood pressure.
  • Type I or II diabetes with HbA1C > 6.5% at screening and/or fasting plasma glucose > 7mmol/L (> 126 mg/dl).
  • History or other evidence of a clinically relevant ophthalmologic disorder due to diabetes mellitus or hypertension or history or other evidence of severe retinopathy (e.g., cytomegalovirus, macular degeneration).
  • Known sensibility to any ingredients contained in the investigational medicinal product (IMP)
  • All conditions that do not allow magentic resonance (MR) assessments
  • History of having received any investigational drug ≤ 3 months and/or 6 x half-life prior to the first dose of study drug or the expectation that such drugs will be used during the study. Patients enrolled in this study cannot be enrolled in another study for either research, diagnostic or treatment purposes.
  • Woman with childbearing potential unless using adequate contraception (see inclusion criteria); females who are pregnant or breast feeding.
  • History of severe allergic
  • Evidence of an active or suspected cancer, or a history of malignancy within the last 2 years, with the exception of patients with basal cell carcinoma that has been excised and cured.
  • History of any systemic anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) 6 months prior to the first dose of study drug or the expectation that such treatment will be needed at any time during the study.
  • History of bleeding disorders or anticoagulant use
  • History or other evidence of chronic pulmonary disease associated with functional limitation.
  • History of uncontrolled severe seizure disorder.
  • Poorly controlled thyroid dysfunction.
  • History of major organ transplantation with an existing functional graft.
  • Any signs of acute infection or inflammation
  • History or other evidence of severe illness, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study.
  • Any herbal supplements containing silymarin, tocopherol, vitamin C, riboflavins, proflavins, curcumin. (at least 4-6 months before the study)
  • Positive test at screening for anti-Hepatits A virus (HAV) Immunoglobulin M (IgM), Hebatitis B surface antigen (HBsAg), Anti-Hepatits B core Antigen Immunglobulin M antibody (anti-HBc IgM Ab), or anti-HIV Ab.
  • Subjects who have undergone surgery within the last 3 months.
  • Subjects who have had a prior gastrointestinal surgery.
  • Subjects who will be unavailable for the duration of the trial, who are unlikely to be compliant with the protocol, or who are felt to b unsuitable by the investigator for any other reason
  • Imprisonment

Sites / Locations

  • Division of Gastroenterology and Hepatology, Department of Internal Medicine III

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Px-104

Arm Description

Px-104 capsules, 5 mg

Outcomes

Primary Outcome Measures

Safety
Analysis of clinical chemistry, hematology, and assessment of clinical signs and adverse events over 28 days. Change day 28 vs. day 1

Secondary Outcome Measures

Change of hepatocellular lipid content
Measurement of hepatic fat (%) by Magnetic resonance spectroscopy (MRS), change day 28 vs. day 1
Changes in oral glucose tolerance test (oGTT)
Measurement of plasma glucose level (mg/dL)
Change from baseline in fibroblast growth factor 19 (FGF-19)
Measurement by ELISA (pg/mL)
Change from baseline in plasma bile acid concentration
Assessment by LC-MS/MS (µmol/L)
Pharmacokinetics of Px-104 and conjugates
Measurement by LC-MS/MS (ng/mL). AUC, Cmax and other pk parameters

Full Information

First Posted
November 19, 2013
Last Updated
September 28, 2016
Sponsor
Phenex Pharmaceuticals AG
Collaborators
Medical University of Vienna
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1. Study Identification

Unique Protocol Identification Number
NCT01999101
Brief Title
Safety Pilot Study of Farnesoid X Receptor (FXR) Agonist in Non-alcoholic Fatty Liver Disease (NAFLD) Patients
Official Title
A Safety Pilot Study of Px-104 in Non-alcoholic Fatty Liver Disease (NAFLD) Patients
Study Type
Interventional

2. Study Status

Record Verification Date
November 2014
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
January 2015 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Phenex Pharmaceuticals AG
Collaborators
Medical University of Vienna

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary aim of the study is to evaluate the safety and tolerability of Px-104 in NAFLD patients and to assess the influence of Px-104 on hepatic fat.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Alcoholic Fatty Liver Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Px-104
Arm Type
Experimental
Arm Description
Px-104 capsules, 5 mg
Intervention Type
Drug
Intervention Name(s)
Px-104
Intervention Description
28 days treatment
Primary Outcome Measure Information:
Title
Safety
Description
Analysis of clinical chemistry, hematology, and assessment of clinical signs and adverse events over 28 days. Change day 28 vs. day 1
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Change of hepatocellular lipid content
Description
Measurement of hepatic fat (%) by Magnetic resonance spectroscopy (MRS), change day 28 vs. day 1
Time Frame
day 1 and day 28
Title
Changes in oral glucose tolerance test (oGTT)
Description
Measurement of plasma glucose level (mg/dL)
Time Frame
baseline and day 27
Title
Change from baseline in fibroblast growth factor 19 (FGF-19)
Description
Measurement by ELISA (pg/mL)
Time Frame
days 1, 7, 14, 21 and 28
Title
Change from baseline in plasma bile acid concentration
Description
Assessment by LC-MS/MS (µmol/L)
Time Frame
days 1, 7, 14, 21, and 28.
Title
Pharmacokinetics of Px-104 and conjugates
Description
Measurement by LC-MS/MS (ng/mL). AUC, Cmax and other pk parameters
Time Frame
day 1 and day 28
Other Pre-specified Outcome Measures:
Title
Changes in the Saccharose-Lactulose-Mannitol + Sucralose (SLM+S) Test to evaluate the intestinal permeability
Description
Measurement of urinary concentrations of Saccharose, Lactulose, Mannitol and Sucralose by HPLC
Time Frame
baseline and day 27
Title
Assessment of liver steatosis by CAP-Fibroscan
Description
Measurement of hepatic fat (%) by CAP-Fibroscan
Time Frame
baseline and day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: NAFLD patients Weight > 65 kg BMI > 25 and < 40 Negative blood or urine pregnancy test (for females of childbearing potential) collected at screening followed by another negative serum pregnancy test collected within 24 hours prior to the first dose of study drug. Contraception: Female patients must be postmenopausal, surgically sterile, or if premenopausal, must be prepared to use at least two effective (≤1% failure rate) method of contraception during the course of the study and for 14 days after the end of dosing. Male patients with female partners of child bearing potential must be prepared to use at least two effective methods of contraception with all sexual partners unless they have had a prior vasectomy Must be willing and able to give written informed consent and agree to comply with the study protocol. Sinus rhythm in 12-lead ECG Exclusion Criteria: Evidence of excessive alcohol, drug or substance abuse (excluding marijuana use) within 1 year of first dose. History or other evidence of a medical condition associated with chronic liver disease other than. History or other evidence of decompensated liver disease (Child-Pugh Grade B or higher), coagulopathy, hyperbilirubinemia, hepatic encephalopathy, hypoalbuminemia, ascites, hepatic encephalopathy, and bleeding from esophageal varices are conditions consistent with decompensated liver disease. Concomitant intake of fibrates or statins (at least 4-6 weeks before start; considering half life of medication). Any clinically relevant findings in ECG (identified via 24h-Holter ECG or 12-Lead ECG) at screening History of any structural cardiac disease. In addition, patients with documented or presumed unstable coronary artery disease, stable or unstable cardiovascular disease or cerebrovascular disease. One or more of the following conditions: (1) poorly controlled hypertension, OR (2) screening or baseline blood pressure ≥ 160 mmHg for systolic OR (3) screening or baseline blood pressure ≥ 100 mmHg for diastolic blood pressure. Type I or II diabetes with HbA1C > 6.5% at screening and/or fasting plasma glucose > 7mmol/L (> 126 mg/dl). History or other evidence of a clinically relevant ophthalmologic disorder due to diabetes mellitus or hypertension or history or other evidence of severe retinopathy (e.g., cytomegalovirus, macular degeneration). Known sensibility to any ingredients contained in the investigational medicinal product (IMP) All conditions that do not allow magentic resonance (MR) assessments History of having received any investigational drug ≤ 3 months and/or 6 x half-life prior to the first dose of study drug or the expectation that such drugs will be used during the study. Patients enrolled in this study cannot be enrolled in another study for either research, diagnostic or treatment purposes. Woman with childbearing potential unless using adequate contraception (see inclusion criteria); females who are pregnant or breast feeding. History of severe allergic Evidence of an active or suspected cancer, or a history of malignancy within the last 2 years, with the exception of patients with basal cell carcinoma that has been excised and cured. History of any systemic anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) 6 months prior to the first dose of study drug or the expectation that such treatment will be needed at any time during the study. History of bleeding disorders or anticoagulant use History or other evidence of chronic pulmonary disease associated with functional limitation. History of uncontrolled severe seizure disorder. Poorly controlled thyroid dysfunction. History of major organ transplantation with an existing functional graft. Any signs of acute infection or inflammation History or other evidence of severe illness, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study. Any herbal supplements containing silymarin, tocopherol, vitamin C, riboflavins, proflavins, curcumin. (at least 4-6 months before the study) Positive test at screening for anti-Hepatits A virus (HAV) Immunoglobulin M (IgM), Hebatitis B surface antigen (HBsAg), Anti-Hepatits B core Antigen Immunglobulin M antibody (anti-HBc IgM Ab), or anti-HIV Ab. Subjects who have undergone surgery within the last 3 months. Subjects who have had a prior gastrointestinal surgery. Subjects who will be unavailable for the duration of the trial, who are unlikely to be compliant with the protocol, or who are felt to b unsuitable by the investigator for any other reason Imprisonment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Trauner, Professor Dr med
Organizational Affiliation
Medical University Vienna
Official's Role
Principal Investigator
Facility Information:
Facility Name
Division of Gastroenterology and Hepatology, Department of Internal Medicine III
City
Vienna
ZIP/Postal Code
1090
Country
Austria

12. IPD Sharing Statement

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Safety Pilot Study of Farnesoid X Receptor (FXR) Agonist in Non-alcoholic Fatty Liver Disease (NAFLD) Patients

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