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A Multi-part, Double Blind Study to Assess Safety, Tolerability and Efficacy of Tropifexor (LJN452) in PBC Patients

Primary Purpose

Primary Biliary Cholangitis

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Part 1: LJN452
Part 1: Placebo
Part 2: LJN452 Dose level 1
Part 2: Placebo
Part 2: LJN452 Dose level 2
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Biliary Cholangitis focused on measuring Primary Biliary Cirrhosis, PBC, Primary Biliary Cholangitis

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥ 18 years
  • Diagnosis of PBC as demonstrated by the presence of at least 2 of the following 3 diagnostic criteria:

    • History of alkaline phosphatase (ALP) elevated above upper limit of normal (ULN) for at least 6 months
    • Positive antimitochondrial antibodies (AMA) titer or if AMA negative or in low titer (<1:80) PBC specific antibodies (anti-GP210 and/or anti-SP100 and/or antibodies against the major M2 components (PDC-E2, 2-oxo-glutaric acid dehydrogenase complex))
    • Previous liver biopsy findings consistent with PBC
  • At least 1 of the following markers of disease severity:

    • ALP ≥ 1.67 × ULN
    • Total bilirubin > ULN but < 1.5 × ULN
  • In addition, patients must meet the following biochemical criteria at enrollment:

    • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤ 5 × ULN
    • Total bilirubin ≤ 1.5 × ULN
    • INR ≤ ULN
  • Taking UDCA for at least 12 months, or for at least 6 months and has reached maximal response to UDCA with a plateau in alkaline phosphatase, with no changes in dose for ≥ 3 months prior to Day 1.
  • Patients must weigh at least 40 kg to participate in the study, and must have a body mass index (BMI) within the range of 18 - 40 kg/m2. BMI = Body weight (kg) / [Height (m)]2

Exclusion Criteria:

  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception for 30 days before randomization, during dosing and for 30 days following the end of treatment.
  • Presence of other concomitant liver diseases.

    • Cirrhosis with complications, including history or presence of:
    • Variceal bleed
    • Uncontrolled ascites
    • Encephalopathy
    • Spontaneous bacterial peritonitis
  • Significant hepatic impairment as defined by Child-Pugh classification of B or C, history of liver transplantation, current placement on a liver transplant list or current Model for End Stage Liver Disease (MELD) score ≥15.
  • History of conditions that may cause increases in ALP (e.g., Paget's disease).
  • Use of investigational drugs, or immunosuppressive drugs at the time of enrollment, or within 5 half-lives, or 30 days of randomization, whichever is longer; or longer if required by local regulations. Use of high dose oral steroids to treat co-morbid conditions (e.g., airways disease) will be allowed but must be properly documented as such in concomitant medications.
  • Currently taking obeticholic acid or have taken obeticholic acid within 30 days of randomization
  • Previous participation in CLJN452X2201 and received study medication within three months of randomization (or longer if required by local regulations).

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

LJN452

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Fold Change in Serum Gamma-glutamyl Transferase (GGT)
Fold change in serum gamma-glutamyl transferase (GGT) from baseline to Day 28
Blood Pressure
Vital signs - Systolic Blood pressure
Pulse Rate
Vital signs
Body Temperature
Vital signs
ECG - Heart Rate
Electrocardiogram (ECG)
ECG Intervals - PR Interval
Electrocardiogram (ECG)
Haemoglobin
Hematology panel for safety laboratory assessments.

Secondary Outcome Measures

Plasma PK Parameter - AUC 0-8h
Tropifexor levels were determined in plasma using a validated LC-MS/MS method. AUC0-t=The area under the plasma concentration-time curve from time zero to time 't' where t is a defined time point after administration [mass x time / volume]
Plasma PK Parameter - Cmax
Tropifexor levels were determined in plasma using a validated LC-MS/MS method. Cmax=The observed maximum plasma concentration following drug administration [mass /volume]
Plasma PK Parameter - Tmax
Tropifexor levels were determined in plasma using a validated LC-MS/MS method. Tmax = The time to reach the maximum concentration after drug administration [time]
Changes From Baseline in Total PBC-40 Score
Baseline is defined as the latest available predose value. The PBC-40 is a paper-based, patient-derived, disease-specific health-related quality of life (HRQOL) patient reported outcome (PRO) measure which was developed and validated for use in PBC patients (Jacoby et al 2005). It consists of 40 questions arranged in 6 domains with between 3 and 11 questions in each domain. Each question is scored from 1 to 5 in increasing order of severity. All questions within a domain are summed and all domain totals are summed to obtain a total score. The total score range is between a minimum of 40 and a maximum of 200. Higher scores represent a poorer quality of life. The median difference from baseline in total sum score for each treatment group is presented.
Change From Baseline in Itch Subdomain of PBC-40 Score
Baseline is defined as the latest available predose value. The PBC-40 is a paper-based, patient-derived, disease-specific health-related quality of life (HRQOL) patient reported outcome (PRO) measure which was developed and validated for use in PBC patients (Jacoby et al 2005). It consists of 40 questions arranged in 6 domains with between 3 and 11 questions in each domain. Each question is scored from 1 to 5 in increasing order of severity. This dataset focuses on the itch subdomain which consists of 3 questions. These 3 questions within the itch subdomain are summed to obtain a total score for the itch subdomain. The total score range is between a minimum of 3 and a maximum of 15. Higher scores represent a poorer quality of life. The median change from baseline in total itch subdomain score in each treatment group is presented.
Change From Baseline in Global Itch Visual Analogue Scale (VAS)
Baseline is defined as the latest available predose value. The Global Itch Visual Analogue Scale, a 100 mm visual analogue scale (VAS), was used to assess the severity of patients itch (ranging from 0 = none at all to 100 = the worst imaginable itch). The score range is between a minimum of 0 and a maximum of 100. The score (distance in mm from left) on the VAS was recorded by the patient marking with a line and used to test for an effect of tropifexor over placebo. The mean change from baseline in itch VAS score in each treatment group is presented.

Full Information

First Posted
August 4, 2015
Last Updated
December 9, 2020
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02516605
Brief Title
A Multi-part, Double Blind Study to Assess Safety, Tolerability and Efficacy of Tropifexor (LJN452) in PBC Patients
Official Title
A Multi-part, Randomized, Double-blind, Placebo-controlled Study to Assess the Safety, Tolerability and Efficacy of Tropifexor (LJN452) in Patients With Primary Biliary Cholangitis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
September 9, 2015 (Actual)
Primary Completion Date
August 2, 2018 (Actual)
Study Completion Date
August 2, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A multi-part study to assess safety, tolerability and efficacy of tropifexor (LJN452) in patients with primary biliary cholangitis

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Biliary Cholangitis
Keywords
Primary Biliary Cirrhosis, PBC, Primary Biliary Cholangitis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LJN452
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Part 1: LJN452
Other Intervention Name(s)
tropifexor
Intervention Description
LJN452 capsules administered once daily for 28 days
Intervention Type
Drug
Intervention Name(s)
Part 1: Placebo
Intervention Description
Matching placebo capsules administered once daily for 28 days
Intervention Type
Drug
Intervention Name(s)
Part 2: LJN452 Dose level 1
Other Intervention Name(s)
tropifexor
Intervention Description
LJN452 capsules administered once a day for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Part 2: Placebo
Intervention Description
Matching placebo to LJN452 administered once a day for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Part 2: LJN452 Dose level 2
Other Intervention Name(s)
tropifexor
Intervention Description
LJN452
Primary Outcome Measure Information:
Title
Fold Change in Serum Gamma-glutamyl Transferase (GGT)
Description
Fold change in serum gamma-glutamyl transferase (GGT) from baseline to Day 28
Time Frame
Baseline to Day 28
Title
Blood Pressure
Description
Vital signs - Systolic Blood pressure
Time Frame
Screening, Baseline, day 1, day 7, day 14, day 21, day 28, day 56, day 84
Title
Pulse Rate
Description
Vital signs
Time Frame
Screening, Baseline, day 1, day 7, day 14, day 21, day 28, day 56, day 84
Title
Body Temperature
Description
Vital signs
Time Frame
Screening, Baseline, day 1, day 7, day 14, day 21, day 28, day 56, day 84
Title
ECG - Heart Rate
Description
Electrocardiogram (ECG)
Time Frame
Screening, Baseline, day 1, day 28
Title
ECG Intervals - PR Interval
Description
Electrocardiogram (ECG)
Time Frame
Screening, Baseline, day 1, day 28
Title
Haemoglobin
Description
Hematology panel for safety laboratory assessments.
Time Frame
Screening, Baseline, day 1, day 7, day 14, day 21, day 28, day 56, day 84
Secondary Outcome Measure Information:
Title
Plasma PK Parameter - AUC 0-8h
Description
Tropifexor levels were determined in plasma using a validated LC-MS/MS method. AUC0-t=The area under the plasma concentration-time curve from time zero to time 't' where t is a defined time point after administration [mass x time / volume]
Time Frame
Day 1, Day 28
Title
Plasma PK Parameter - Cmax
Description
Tropifexor levels were determined in plasma using a validated LC-MS/MS method. Cmax=The observed maximum plasma concentration following drug administration [mass /volume]
Time Frame
Day 1, Day 28
Title
Plasma PK Parameter - Tmax
Description
Tropifexor levels were determined in plasma using a validated LC-MS/MS method. Tmax = The time to reach the maximum concentration after drug administration [time]
Time Frame
Day 1, Day 28
Title
Changes From Baseline in Total PBC-40 Score
Description
Baseline is defined as the latest available predose value. The PBC-40 is a paper-based, patient-derived, disease-specific health-related quality of life (HRQOL) patient reported outcome (PRO) measure which was developed and validated for use in PBC patients (Jacoby et al 2005). It consists of 40 questions arranged in 6 domains with between 3 and 11 questions in each domain. Each question is scored from 1 to 5 in increasing order of severity. All questions within a domain are summed and all domain totals are summed to obtain a total score. The total score range is between a minimum of 40 and a maximum of 200. Higher scores represent a poorer quality of life. The median difference from baseline in total sum score for each treatment group is presented.
Time Frame
Baseline, Day 28, Day 56, Day 84
Title
Change From Baseline in Itch Subdomain of PBC-40 Score
Description
Baseline is defined as the latest available predose value. The PBC-40 is a paper-based, patient-derived, disease-specific health-related quality of life (HRQOL) patient reported outcome (PRO) measure which was developed and validated for use in PBC patients (Jacoby et al 2005). It consists of 40 questions arranged in 6 domains with between 3 and 11 questions in each domain. Each question is scored from 1 to 5 in increasing order of severity. This dataset focuses on the itch subdomain which consists of 3 questions. These 3 questions within the itch subdomain are summed to obtain a total score for the itch subdomain. The total score range is between a minimum of 3 and a maximum of 15. Higher scores represent a poorer quality of life. The median change from baseline in total itch subdomain score in each treatment group is presented.
Time Frame
Baseline, Day 28, Day 56, Day 84
Title
Change From Baseline in Global Itch Visual Analogue Scale (VAS)
Description
Baseline is defined as the latest available predose value. The Global Itch Visual Analogue Scale, a 100 mm visual analogue scale (VAS), was used to assess the severity of patients itch (ranging from 0 = none at all to 100 = the worst imaginable itch). The score range is between a minimum of 0 and a maximum of 100. The score (distance in mm from left) on the VAS was recorded by the patient marking with a line and used to test for an effect of tropifexor over placebo. The mean change from baseline in itch VAS score in each treatment group is presented.
Time Frame
Day 7, Day 14, Day 21, Day 28, Day 56, and Day 84

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Diagnosis of PBC as demonstrated by the presence of at least 2 of the following 3 diagnostic criteria: History of alkaline phosphatase (ALP) elevated above upper limit of normal (ULN) for at least 6 months Positive antimitochondrial antibodies (AMA) titer or if AMA negative or in low titer (<1:80) PBC specific antibodies (anti-GP210 and/or anti-SP100 and/or antibodies against the major M2 components (PDC-E2, 2-oxo-glutaric acid dehydrogenase complex)) Previous liver biopsy findings consistent with PBC At least 1 of the following markers of disease severity: ALP ≥ 1.67 × ULN Total bilirubin > ULN but < 1.5 × ULN In addition, patients must meet the following biochemical criteria at enrollment: Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤ 5 × ULN Total bilirubin ≤ 1.5 × ULN INR ≤ ULN Taking UDCA for at least 12 months, or for at least 6 months and has reached maximal response to UDCA with a plateau in alkaline phosphatase, with no changes in dose for ≥ 3 months prior to Day 1. Patients must weigh at least 40 kg to participate in the study, and must have a body mass index (BMI) within the range of 18 - 40 kg/m2. BMI = Body weight (kg) / [Height (m)]2 Exclusion Criteria: Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception for 30 days before randomization, during dosing and for 30 days following the end of treatment. Presence of other concomitant liver diseases. Cirrhosis with complications, including history or presence of: Variceal bleed Uncontrolled ascites Encephalopathy Spontaneous bacterial peritonitis Significant hepatic impairment as defined by Child-Pugh classification of B or C, history of liver transplantation, current placement on a liver transplant list or current Model for End Stage Liver Disease (MELD) score ≥15. History of conditions that may cause increases in ALP (e.g., Paget's disease). Use of investigational drugs, or immunosuppressive drugs at the time of enrollment, or within 5 half-lives, or 30 days of randomization, whichever is longer; or longer if required by local regulations. Use of high dose oral steroids to treat co-morbid conditions (e.g., airways disease) will be allowed but must be properly documented as such in concomitant medications. Currently taking obeticholic acid or have taken obeticholic acid within 30 days of randomization Previous participation in CLJN452X2201 and received study medication within three months of randomization (or longer if required by local regulations).
Facility Information:
Facility Name
Novartis Investigative Site
City
Rialto
State/Province
California
ZIP/Postal Code
92377
Country
United States
Facility Name
Novartis Investigative Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Novartis Investigative Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
Facility Name
Novartis Investigative Site
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
Facility Name
Novartis Investigative Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Novartis Investigative Site
City
Manhasset
State/Province
New York
ZIP/Postal Code
11030
Country
United States
Facility Name
Novartis Investigative Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Novartis Investigative Site
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Facility Name
Novartis Investigative Site
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Novartis Investigative Site
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 4N1
Country
Canada
Facility Name
Novartis Investigative Site
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2B7
Country
Canada
Facility Name
Novartis Investigative Site
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Novartis Investigative Site
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Novartis Investigative Site
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Novartis Investigative Site
City
Muenchen
ZIP/Postal Code
81377
Country
Germany
Facility Name
Novartis Investigative Site
City
Wuerzburg
ZIP/Postal Code
97080
Country
Germany
Facility Name
Novartis Investigative Site
City
Lodz
ZIP/Postal Code
91-347
Country
Poland
Facility Name
Novartis Investigative Site
City
Myslowice
ZIP/Postal Code
41-400
Country
Poland
Facility Name
Novartis Investigative Site
City
Warsaw
ZIP/Postal Code
02-097
Country
Poland
Facility Name
Novartis Investigative Site
City
Wroclaw
ZIP/Postal Code
50-449
Country
Poland
Facility Name
Novartis Investigative Site
City
Moscow
ZIP/Postal Code
117198
Country
Russian Federation
Facility Name
Novartis Investigative Site
City
Saint-Petersburg
ZIP/Postal Code
194044
Country
Russian Federation
Facility Name
Novartis Investigative Site
City
Samara
ZIP/Postal Code
443011
Country
Russian Federation
Facility Name
Novartis Investigative Site
City
Birmingham
State/Province
West Midlands
ZIP/Postal Code
B15 2TH
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Cambridge
ZIP/Postal Code
CB2 2QQ
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Hull
ZIP/Postal Code
HU3 2JZ
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
London
ZIP/Postal Code
NW3 2PF
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Newcastle upon Tyne
ZIP/Postal Code
NE1 4LP
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Citations:
PubMed Identifier
36267872
Citation
Schramm C, Wedemeyer H, Mason A, Hirschfield GM, Levy C, Kowdley KV, Milkiewicz P, Janczewska E, Malova ES, Sanni J, Koo P, Chen J, Choudhury S, Klickstein LB, Badman MK, Jones D. Farnesoid X receptor agonist tropifexor attenuates cholestasis in a randomised trial in patients with primary biliary cholangitis. JHEP Rep. 2022 Jul 21;4(11):100544. doi: 10.1016/j.jhepr.2022.100544. eCollection 2022 Nov.
Results Reference
derived
Links:
URL
https://www.novctrd.com/ctrdweb/patientsummary/patientsummaries?patientSummaryId=322
Description
A Plain Language Trial Summary is available on novartisclinicatrials.com

Learn more about this trial

A Multi-part, Double Blind Study to Assess Safety, Tolerability and Efficacy of Tropifexor (LJN452) in PBC Patients

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