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Phase 2 Study of MGL-3196 in Patients With Non-Alcoholic Steatohepatitis (NASH)

Primary Purpose

Non-alcoholic Steatohepatitis

Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MGL-3196
Placebo
Sponsored by
Madrigal Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-alcoholic Steatohepatitis

Eligibility Criteria

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

Inclusion Criteria. Patients who meet all of the following criteria will be eligible to participate in the study:

  • Must be willing to participate in the study and provide written informed consent;
  • Male and female adults ≥18 years of age with a BMI <45 kg/m^2;
  • Female patients of child bearing potential with negative serum pregnancy (beta human chorionic gonadotropin) tests who are not breastfeeding, do not plan to become pregnant during the study, and agree to use effective birth control (ie, condoms, diaphragm, non hormonal intrauterine device [IUD], or sexual abstinence [only if this is in line with the patient's current lifestyle]) throughout the study and for at least 1 month after study completion; hormonal contraception (estrogens stable ≥3 months) and hormonal IUDs are permitted if used with a secondary birth control measure (eg, condoms); OR female patients of non-child bearing potential (ie, surgically [bilateral oophorectomy, hysterectomy, or tubal ligation] or naturally sterile [>12 consecutive months without menses]); Male patients who have sexual intercourse with a female partner of child bearing potential from the first dose of study drug until 1 month after study completion must be either surgically sterile (confirmed by documented azoospermia >90 days after the procedure) OR agree to use a condom with spermicide. All male patients must agree not to donate sperm from the first dose of study drug until 1 month after study completion;
  • Must have confirmation of ≥10% liver fat content on PDFF-MRI;
  • Biopsy-proven NASH. Must have had prior liver biopsy within 180 days of randomization with fibrosis stage 1 to 3 and a NAS of ≥4 with at least a score of 1 in each of the following NAS components:

    • Steatosis (scored 0 to 3),
    • Ballooning degeneration (scored 0 to 2), and
    • Lobular inflammation (scored 0 to 3);
  • Must have documented historical (3 weeks to 6 months prior to the study entry) ALT and AST levels consistent with the screening ALT and AST values.

Exclusion Criteria. Patients who meet any of the following criteria will be excluded from participation in the study:

Note: Unless otherwise specified, repeat testing may be performed in consultation with the Medical Monitor.

  • History of significant alcohol consumption for a period of more than 3 consecutive months within 1 year prior to screening;
  • Weight gain or loss >5% in the 6 months prior to randomization or >10% in the 12 months prior to screening;
  • Hyperthyroidism;
  • Patients on thyroid replacement therapy;
  • Prior or planned (during the study period) bariatric surgery (eg, gastroplasty, roux-en-Y gastric bypass);
  • Type 1 diabetes;
  • Uncontrolled Type 2 diabetes defined as Hemoglobin A1c ≥ 9.5% at screening (patients with HbA1c ≥ 9.5% may be rescreened);
  • Use of obeticholic acid, ursodeoxycholic acid (Ursodiol® and Urso®), high dose vitamin E (>400 IU/day) unless on stable dose of vitamin E >400 IU/day for at least 6 months at the time of liver biopsy, or pioglitazone within 90 days prior to enrollment or since screening biopsy, whichever is longer;
  • Presence of cirrhosis on liver biopsy (stage 4 fibrosis);
  • Platelet count < 140,000/mm^3;
  • Clinical evidence of hepatic decompensation;
  • Evidence of other forms of chronic liver disease;
  • Active, serious medical disease with likely life expectancy <2 years;
  • Participation in an investigational new drug trial in the 30 days prior to randomization; or
  • Any other condition which, in the opinion of the Investigator, would impede compliance, hinder completion of the study, compromise the well-being of the patient, or interfere with the study outcomes.

Sites / Locations

  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site
  • Madrigal Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

MGL-3196

Placebo

Arm Description

Study Drug

Matching Placebo

Outcomes

Primary Outcome Measures

Change from baseline in hepatic fat fraction assessed by MRI-PDFF

Secondary Outcome Measures

Two-point reduction in Non-alcoholic fatty liver disease NASH CRN (NAFLD) activity score (NAS)
Resolution of Non-alcoholic steatohepatitis (NASH) (ballooning = 0; inflammation = 0 to 1) as determined by the NASH CRN NAS score
Improvement in fibrosis by at least 1 stage with no worsening of steatohepatitis
Change from baseline in hepatic fat fraction
Safety and tolerability of MGL-3196 based on Adverse Events and Changes in Laboratory Values
Effect on high-sensitivity C-reactive protein (hsCRP)
Effect on serum alanine aminotransferase (ALT)
Effect on aspartate aminotransferase (AST)
Effect on lipid parameters
Determine the effect on lipid parameters including low-density lipoprotein cholesterol (LDL-C), non- LDL-C, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol, triglycerides, apolipoprotein B (ApoB), and lipoprotein(a) (Lp[a]) particles.
Effect on NASH and fibrosis biomarkers
Determine the effect on NASH and fibrosis biomarkers including cytokeratin-18 (CK-18), fibrosis-4 (FIB-4), and enhanced liver function (ELF) test.

Full Information

First Posted
September 19, 2016
Last Updated
December 15, 2017
Sponsor
Madrigal Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02912260
Brief Title
Phase 2 Study of MGL-3196 in Patients With Non-Alcoholic Steatohepatitis (NASH)
Official Title
A Phase 2, Multi-Center, Double-Blind, Randomized, Placebo-controlled Study of MGL-3196 in Patients With Non-alcoholic Steatohepatitis
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Unknown status
Study Start Date
September 2016 (undefined)
Primary Completion Date
October 2017 (Actual)
Study Completion Date
April 2018 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to determine the effect of once-daily oral MGL-3196 on the percent change in hepatic fat fraction from baseline in patients with biopsy-proven Non-alcoholic Steatohepatitis (NASH).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-alcoholic Steatohepatitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
125 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MGL-3196
Arm Type
Experimental
Arm Description
Study Drug
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching Placebo
Intervention Type
Drug
Intervention Name(s)
MGL-3196
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Change from baseline in hepatic fat fraction assessed by MRI-PDFF
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Two-point reduction in Non-alcoholic fatty liver disease NASH CRN (NAFLD) activity score (NAS)
Time Frame
36 weeks
Title
Resolution of Non-alcoholic steatohepatitis (NASH) (ballooning = 0; inflammation = 0 to 1) as determined by the NASH CRN NAS score
Time Frame
36 weeks
Title
Improvement in fibrosis by at least 1 stage with no worsening of steatohepatitis
Time Frame
36 weeks
Title
Change from baseline in hepatic fat fraction
Time Frame
36 weeks
Title
Safety and tolerability of MGL-3196 based on Adverse Events and Changes in Laboratory Values
Time Frame
12 and 36 weeks
Title
Effect on high-sensitivity C-reactive protein (hsCRP)
Time Frame
12 and 36 weeks
Title
Effect on serum alanine aminotransferase (ALT)
Time Frame
12 and 36 weeks
Title
Effect on aspartate aminotransferase (AST)
Time Frame
12 and 36 weeks
Title
Effect on lipid parameters
Description
Determine the effect on lipid parameters including low-density lipoprotein cholesterol (LDL-C), non- LDL-C, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol, triglycerides, apolipoprotein B (ApoB), and lipoprotein(a) (Lp[a]) particles.
Time Frame
12 and 36 weeks
Title
Effect on NASH and fibrosis biomarkers
Description
Determine the effect on NASH and fibrosis biomarkers including cytokeratin-18 (CK-18), fibrosis-4 (FIB-4), and enhanced liver function (ELF) test.
Time Frame
12 and 36 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria. Patients who meet all of the following criteria will be eligible to participate in the study: Must be willing to participate in the study and provide written informed consent; Male and female adults ≥18 years of age with a BMI <45 kg/m^2; Female patients of child bearing potential with negative serum pregnancy (beta human chorionic gonadotropin) tests who are not breastfeeding, do not plan to become pregnant during the study, and agree to use effective birth control (ie, condoms, diaphragm, non hormonal intrauterine device [IUD], or sexual abstinence [only if this is in line with the patient's current lifestyle]) throughout the study and for at least 1 month after study completion; hormonal contraception (estrogens stable ≥3 months) and hormonal IUDs are permitted if used with a secondary birth control measure (eg, condoms); OR female patients of non-child bearing potential (ie, surgically [bilateral oophorectomy, hysterectomy, or tubal ligation] or naturally sterile [>12 consecutive months without menses]); Male patients who have sexual intercourse with a female partner of child bearing potential from the first dose of study drug until 1 month after study completion must be either surgically sterile (confirmed by documented azoospermia >90 days after the procedure) OR agree to use a condom with spermicide. All male patients must agree not to donate sperm from the first dose of study drug until 1 month after study completion; Must have confirmation of ≥10% liver fat content on PDFF-MRI; Biopsy-proven NASH. Must have had prior liver biopsy within 180 days of randomization with fibrosis stage 1 to 3 and a NAS of ≥4 with at least a score of 1 in each of the following NAS components: Steatosis (scored 0 to 3), Ballooning degeneration (scored 0 to 2), and Lobular inflammation (scored 0 to 3); Must have documented historical (3 weeks to 6 months prior to the study entry) ALT and AST levels consistent with the screening ALT and AST values. Exclusion Criteria. Patients who meet any of the following criteria will be excluded from participation in the study: Note: Unless otherwise specified, repeat testing may be performed in consultation with the Medical Monitor. History of significant alcohol consumption for a period of more than 3 consecutive months within 1 year prior to screening; Weight gain or loss >5% in the 6 months prior to randomization or >10% in the 12 months prior to screening; Hyperthyroidism; Patients on thyroid replacement therapy; Prior or planned (during the study period) bariatric surgery (eg, gastroplasty, roux-en-Y gastric bypass); Type 1 diabetes; Uncontrolled Type 2 diabetes defined as Hemoglobin A1c ≥ 9.5% at screening (patients with HbA1c ≥ 9.5% may be rescreened); Use of obeticholic acid, ursodeoxycholic acid (Ursodiol® and Urso®), high dose vitamin E (>400 IU/day) unless on stable dose of vitamin E >400 IU/day for at least 6 months at the time of liver biopsy, or pioglitazone within 90 days prior to enrollment or since screening biopsy, whichever is longer; Presence of cirrhosis on liver biopsy (stage 4 fibrosis); Platelet count < 140,000/mm^3; Clinical evidence of hepatic decompensation; Evidence of other forms of chronic liver disease; Active, serious medical disease with likely life expectancy <2 years; Participation in an investigational new drug trial in the 30 days prior to randomization; or Any other condition which, in the opinion of the Investigator, would impede compliance, hinder completion of the study, compromise the well-being of the patient, or interfere with the study outcomes.
Facility Information:
Facility Name
Madrigal Research Site
City
Dothan
State/Province
Alabama
Country
United States
Facility Name
Madrigal Research Site
City
Tucson
State/Province
Arizona
Country
United States
Facility Name
Madrigal Research Site
City
Coronado
State/Province
California
Country
United States
Facility Name
Madrigal Research Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90057
Country
United States
Facility Name
Madrigal Research Site
City
Rialto
State/Province
California
Country
United States
Facility Name
Madrigal Research Site
City
San Diego
State/Province
California
Country
United States
Facility Name
Madrigal Research Site
City
Ventura
State/Province
California
Country
United States
Facility Name
Madrigal Research Site
City
Englewood
State/Province
Colorado
Country
United States
Facility Name
Madrigal Research Site
City
Boca Raton
State/Province
Florida
Country
United States
Facility Name
Madrigal Research Site
City
Lakewood Ranch
State/Province
Florida
Country
United States
Facility Name
Madrigal Research Site
City
Lauderdale Lakes
State/Province
Florida
Country
United States
Facility Name
Madrigal Research Site
City
Miami
State/Province
Florida
Country
United States
Facility Name
Madrigal Research Site
City
New Port Richey
State/Province
Florida
Country
United States
Facility Name
Madrigal Research Site
City
Kansas City
State/Province
Kansas
Country
United States
Facility Name
Madrigal Research Site
City
Monroe
State/Province
Louisiana
Country
United States
Facility Name
Madrigal Research Site
City
Baltimore
State/Province
Maryland
Country
United States
Facility Name
Madrigal Research Site
City
Jackson
State/Province
Mississippi
ZIP/Postal Code
39202
Country
United States
Facility Name
Madrigal Research Site
City
Saint Louis
State/Province
Missouri
Country
United States
Facility Name
Madrigal Research Site
City
Albuquerque
State/Province
New Mexico
Country
United States
Facility Name
Madrigal Research Site
City
New York
State/Province
New York
Country
United States
Facility Name
Madrigal Research Site
City
Durham
State/Province
North Carolina
Country
United States
Facility Name
Madrigal Research Site
City
Rapid City
State/Province
South Dakota
Country
United States
Facility Name
Madrigal Research Site
City
Live Oak
State/Province
Texas
ZIP/Postal Code
78233
Country
United States
Facility Name
Madrigal Research Site
City
San Antonio
State/Province
Texas
Country
United States
Facility Name
Madrigal Research Site
City
Charlottesville
State/Province
Virginia
Country
United States
Facility Name
Madrigal Research Site
City
Seattle
State/Province
Washington
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34329774
Citation
Younossi ZM, Stepanova M, Taub RA, Barbone JM, Harrison SA. Hepatic Fat Reduction Due to Resmetirom in Patients With Nonalcoholic Steatohepatitis Is Associated With Improvement of Quality of Life. Clin Gastroenterol Hepatol. 2022 Jun;20(6):1354-1361.e7. doi: 10.1016/j.cgh.2021.07.039. Epub 2021 Jul 27.
Results Reference
derived
PubMed Identifier
33860116
Citation
Harrison SA, Bashir M, Moussa SE, McCarty K, Pablo Frias J, Taub R, Alkhouri N. Effects of Resmetirom on Noninvasive Endpoints in a 36-Week Phase 2 Active Treatment Extension Study in Patients With NASH. Hepatol Commun. 2021 Jan 4;5(4):573-588. doi: 10.1002/hep4.1657. eCollection 2021 Apr.
Results Reference
derived
PubMed Identifier
31727409
Citation
Harrison SA, Bashir MR, Guy CD, Zhou R, Moylan CA, Frias JP, Alkhouri N, Bansal MB, Baum S, Neuschwander-Tetri BA, Taub R, Moussa SE. Resmetirom (MGL-3196) for the treatment of non-alcoholic steatohepatitis: a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial. Lancet. 2019 Nov 30;394(10213):2012-2024. doi: 10.1016/S0140-6736(19)32517-6. Epub 2019 Nov 11.
Results Reference
derived

Learn more about this trial

Phase 2 Study of MGL-3196 in Patients With Non-Alcoholic Steatohepatitis (NASH)

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