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Safety and Tolerability of Yaq-001 in Patients With Cirrhosis

Primary Purpose

Liver Cirrhosis

Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
4g Yaq-001
4g Placebo
8g Yaq-001
8g Placebo
Sponsored by
Yaqrit Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Liver Cirrhosis focused on measuring Cirrhosis, Liver, Fibrosis, Liver, Hepatic Cirrhosis, Liver Fibrosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Male and female patients
  2. Age ≥ 18 years at screening
  3. Clinical diagnosis of cirrhosis for any cause. Liver biopsy is not required
  4. Cirrhotic patients with diuretic-responsive ascites and Child-Pugh score = 7-11 inclusive
  5. Abstinence from alcohol for at least 4 weeks prior to screening

Exclusion Criteria:

  1. Refusal or inability (lack of capacity) to give informed consent
  2. Prohibited medication within 4 weeks before the start of the study treatment: all oral antibiotics, immunosuppressants, long acting benzodiazepines or barbiturates and antiviral medication
  3. Change in dose of proton pump inhibitor therapy within 4 weeks before the start of the study treatment
  4. Patients with once daily medications in which orocaecal transit time is greater than 10 hours
  5. Patients requiring medication in which the dosing schedule is three times per day or greater
  6. Antiviral therapy for hepatitis C within 3 months prior to screening
  7. Hospital admission for liver-related indication for at least 4 weeks (except paracentesis)
  8. BMI > 35 or BMI < 18
  9. Clostridium Difficile diarrhoea within 4 weeks before the start of the study treatment
  10. Uncontrolled infection (chronic viral hepatitis is not an exclusion criterion)
  11. Human immunodeficiency virus
  12. Presence of a transjugular intrahepatic portosystemic shunt (TIPSS)
  13. Participation in any clinical study of an investigational medicinal product within 30 days of five half-lives of the investigational product, whichever is longer
  14. Presence of clinically relevant cardiovascular, pulmonary, gastro-intestinal, renal, hepatic, metabolic, haematological, neurological, psychiatric, systemic, ocular, gynaecologic or any acute infection disease or signs of acute illness that, in the opinion of the investigator, might compromise the patient's safe participation in the trial and/or results in a WHO performance status of 2 or more.
  15. Presence of the history of cancer within the past 5 years with exception of hepatocellular carcinoma within Milan criteria, adequately treated localised basal cell carcinoma of the skin, in situ cervical carcinoma or solid malignancy surgical excised in total without recurrence for five years.
  16. Women of child bearing potential. Only postmenopausal women or with surgical sterilization will be included.

Sites / Locations

  • Hospital Beaujon, Hepatology and Liver Intensive Care,
  • Policlinico S.Orsola Malpighi, Department of Medical and Surgical Sciences
  • Azienda Ospedaliera di Padova, Hepatic Emergencies Unit
  • University Hospital of Santa Maria
  • Hospital Vall d'Hebron, Liver Unit
  • Hospital Clinic of Barcelona , Liver Unit,
  • Hospital Ramon y Cajal, Department of Gastroenterology and Hepatology
  • Inselspital Universitaet Bern, Department for Visceral Surgery and Medicine,
  • Royal Free Hospital, Institute of Liver and Digestive Disease

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

Cohort 1 (4g Yaq-001)

Cohort 1 (4g Placebo)

Cohort 2 (8g Yaq-001)

Cohort 2 (8g Placebo)

Arm Description

Standard medical treatment + Yaq-001 (4 g/ day)

Standard medical treatment + placebo-control (placebo for 4 g of Yaq-001/ day)

Standard medical treatment + Yaq-001 (8 g/ day)

Standard medical treatment + placebo-control (placebo for 8 g of Yaq-001/ day)

Outcomes

Primary Outcome Measures

Assessment of reported and observed Serious Adverse Events
The percentage of patients experiencing SAEs will be tabulated by arm.
Assessment of treatment-related Serious Adverse Events
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Assessment of withdrawals due to Adverse Events
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Assessment of reported and observed Serious Adverse Events
The percentage of patients experiencing SAEs will be tabulated by arm.
Assessment of treatment-related Serious Adverse Events
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Assessment of withdrawals due to Adverse Events
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Assessment of reported and observed Serious Adverse Events
The percentage of patients experiencing SAEs will be tabulated by arm.
Assessment of treatment-related Serious Adverse Events
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Assessment of withdrawals due to Adverse Events
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Assessment of reported and observed Serious Adverse Events
The percentage of patients experiencing SAEs will be tabulated by arm.
Assessment of treatment-related Serious Adverse Events
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Assessment of withdrawals due to Adverse Events
The percentage of patients who withdraw due to an AE will be tabulated by arm
Assessment of reported and observed Adverse Events
The percentage of patients experiencing SAEs will be tabulated by arm.
Assessment of treatment-related Serious Adverse Events
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Assessment of withdrawals due to Adverse Events
The percentage of patients who withdraw due to an AE will be tabulated by arm.

Secondary Outcome Measures

Assessment of changes in blood endotoxin activity
The changes from baseline in blood endotoxin activity, measured by the EAA, will be used as device-related performance indicator.
Assessment of changes in organ function as per the CHILD-PUGH score
Changes from baseline in kidney, liver, brain, intestinal and immune functions will be assessed by means of the CHILD-PUGH score.
Assessment of changes in organ function as per the MELD score
Changes from baseline in kidney, liver, brain, intestinal and immune functions will be assessed by means of the MELD score.
Assessment of changes in nutritional status
Changes from baseline in nutritional status be assessed by means of the global assessment score (RFH-GA);

Full Information

First Posted
April 5, 2017
Last Updated
August 21, 2020
Sponsor
Yaqrit Ltd
Collaborators
University College, London, University of Brighton, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Azienda Ospedaliera di Padova, Hospital Universitari Vall d'Hebron Research Institute, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Lisbon, Servicio Madrileño de Salud, Madrid, Spain, University of Bern, Assistance Publique - Hôpitaux de Paris, A2F Associates Limited, Alpha Bioresearch S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT03202498
Brief Title
Safety and Tolerability of Yaq-001 in Patients With Cirrhosis
Official Title
Safety and Tolerability of Yaq-001 in Patients With Cirrhosis ("CARBALIVE-SAFETY")
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Terminated
Why Stopped
COVID-19 pandemic prevents patients from making in-hospital visits, which are mandatory to assessment of safety in this study
Study Start Date
February 28, 2019 (Actual)
Primary Completion Date
March 26, 2020 (Actual)
Study Completion Date
March 26, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Yaqrit Ltd
Collaborators
University College, London, University of Brighton, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Azienda Ospedaliera di Padova, Hospital Universitari Vall d'Hebron Research Institute, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Lisbon, Servicio Madrileño de Salud, Madrid, Spain, University of Bern, Assistance Publique - Hôpitaux de Paris, A2F Associates Limited, Alpha Bioresearch S.L.

4. Oversight

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

5. Study Description

Brief Summary
In patients with cirrhosis (scarring of the liver), bacterial fragments leak from the gut into the blood and cause harm. This study looks into a new way to lower the leakage of bacterial fragments into the blood. Yaq-001 is a new type of carbon that in previous laboratory studies has been shown to have the ability to bind these bacterial fragments and so confine them to the gut. The purpose of this clinical trial is to test the product Yaq-001 for the first time in patients with cirrhosis. This trial will assess if the treatment with Yaq-001 is safe, is well tolerated, and if it helps improve the overall health status of the cirrhotic patients. Candidate patients must be at least 18 years old and have a clinical diagnosis of cirrhosis for any cause. Only postmenopausal women or with surgical sterilisation are eligible. Additional inclusion and exclusion criteria of medical nature will be determined with the investigator at the screening visit, by means of standard care routines plus an additional test to assess the bowel transit time. Eligible patients will be randomly grouped to receive standard care treatment plus Yaq-001, or standard treatment plus placebo (non-active treatment). The use of placebo is necessary to better understand how safe and tolerable Yaq-001 really is. The treatment lasts for 12 weeks. During treatment, the patient will be visited by a study doctor 5 times. At all the visits the patients will undergo a routine physical examination, electrocardiogram, collection of blood and urine samples. On three occasions the patients will be asked to provide additional samples of blood, urine and stool for analysis outside the hospital. 56 patients from 9 hospitals in UK, France, Italy, Portugal, Spain and Switzerland will participate in this study.
Detailed Description
First-in-human clinical investigation with Yaq-001. This is a multicentre, randomized, double blinded, placebo controlled trial to intended to evaluate safety and tolerability of oral administration of Yaq-001 therapy in two dosing cohorts. 56 cirrhotic patients with diuretic-responsive ascites will be enrolled. Patients will be randomized to two dosing cohorts. Cohort 1 (1:1 randomization) Standard medical treatment + Yaq-001 (4 g/ day) - n= 14. Standard medical treatment + placebo-control (placebo for 4 g of Yaq-001/ day) - n= 14. Cohort 2 (1:1 randomization) Standard medical treatment + Yaq-001 (8 g/ day) - n= 14. Standard medical treatment + placebo-control (placebo for 8 g of Yaq-001/ day) - n= 14. Study patients will be dosed daily with Yaq-001 (or an equivalent quantity of placebo) for 12 weeks. Assessments of DSMB will take place after 4 and 12 weeks. Investigational centres specialized in the management of patients with liver cirrhosis will participate in the study. For each patient, the study duration will be up to 17 weeks, including the screening (up to 4 weeks), treatment (12 weeks) and 7-day follow up period. The total study duration is estimated to be approximately 6 months from screening of first patient until study completion of the last patient. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 634579.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Liver Cirrhosis
Keywords
Cirrhosis, Liver, Fibrosis, Liver, Hepatic Cirrhosis, Liver Fibrosis

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Sequential Assignment
Model Description
Cohort 1 (1:1 randomization): Standard medical treatment + Yaq-001 (4 g/ day) - n= 14. Standard medical treatment + placebo-control (placebo for 4 g of Yaq-001/ day) - n= 14. Cohort 2 (1:1 randomization): Standard medical treatment + Yaq-001 (8 g/ day) - n= 14. Standard medical treatment + placebo-control (placebo for 8 g of Yaq-001/ day) - n= 14.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Placebo
Allocation
Randomized
Enrollment
31 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 (4g Yaq-001)
Arm Type
Experimental
Arm Description
Standard medical treatment + Yaq-001 (4 g/ day)
Arm Title
Cohort 1 (4g Placebo)
Arm Type
Placebo Comparator
Arm Description
Standard medical treatment + placebo-control (placebo for 4 g of Yaq-001/ day)
Arm Title
Cohort 2 (8g Yaq-001)
Arm Type
Experimental
Arm Description
Standard medical treatment + Yaq-001 (8 g/ day)
Arm Title
Cohort 2 (8g Placebo)
Arm Type
Placebo Comparator
Arm Description
Standard medical treatment + placebo-control (placebo for 8 g of Yaq-001/ day)
Intervention Type
Device
Intervention Name(s)
4g Yaq-001
Intervention Description
Study patients will be dosed daily with 4g of product Yaq-001 for a period of 12 weeks. The product will be provided as beads packed in individual sachets intended each for one oral administration. For each patient, the study duration will be up to 17 weeks, including the screening (up to 4 weeks), treatment (12 weeks) and 7-day follow up period.
Intervention Type
Other
Intervention Name(s)
4g Placebo
Intervention Description
Study patients will be dosed daily with a quantity of placebo equivalent to 4g of product Yaq-001 for a period of 12 weeks. The product will be provided as beads packed in individual sachets intended each for one oral administration. For each patient, the study duration will be up to 17 weeks, including the screening (up to 4 weeks), treatment (12 weeks) and 7-day follow up period.
Intervention Type
Device
Intervention Name(s)
8g Yaq-001
Intervention Description
Study patients will be dosed daily with 8g of product Yaq-001 for a period of 12 weeks. The product will be provided as beads packed in individual sachets intended each for one oral administration. For each patient, the study duration will be up to 17 weeks, including the screening (up to 4 weeks), treatment (12 weeks) and 7-day follow up period.
Intervention Type
Other
Intervention Name(s)
8g Placebo
Intervention Description
Study patients will be dosed daily with a quantity of placebo equivalent to 8g of product Yaq-001 for a period of 12 weeks. The product will be provided as beads packed in individual sachets intended each for one oral administration. For each patient, the study duration will be up to 17 weeks, including the screening (up to 4 weeks), treatment (12 weeks) and 7-day follow up period.
Primary Outcome Measure Information:
Title
Assessment of reported and observed Serious Adverse Events
Description
The percentage of patients experiencing SAEs will be tabulated by arm.
Time Frame
Day 1
Title
Assessment of treatment-related Serious Adverse Events
Description
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Time Frame
Day 1
Title
Assessment of withdrawals due to Adverse Events
Description
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Time Frame
Day 1
Title
Assessment of reported and observed Serious Adverse Events
Description
The percentage of patients experiencing SAEs will be tabulated by arm.
Time Frame
Week 1
Title
Assessment of treatment-related Serious Adverse Events
Description
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Time Frame
Week 1
Title
Assessment of withdrawals due to Adverse Events
Description
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Time Frame
Week 1
Title
Assessment of reported and observed Serious Adverse Events
Description
The percentage of patients experiencing SAEs will be tabulated by arm.
Time Frame
Week 4
Title
Assessment of treatment-related Serious Adverse Events
Description
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Time Frame
Week 4
Title
Assessment of withdrawals due to Adverse Events
Description
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Time Frame
Week 4
Title
Assessment of reported and observed Serious Adverse Events
Description
The percentage of patients experiencing SAEs will be tabulated by arm.
Time Frame
Week 8
Title
Assessment of treatment-related Serious Adverse Events
Description
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Time Frame
Week 8
Title
Assessment of withdrawals due to Adverse Events
Description
The percentage of patients who withdraw due to an AE will be tabulated by arm
Time Frame
Week 8
Title
Assessment of reported and observed Adverse Events
Description
The percentage of patients experiencing SAEs will be tabulated by arm.
Time Frame
Week 12
Title
Assessment of treatment-related Serious Adverse Events
Description
The percentage of patients experiencing device-related SAEs will be tabulated by arm.
Time Frame
Week 12
Title
Assessment of withdrawals due to Adverse Events
Description
The percentage of patients who withdraw due to an AE will be tabulated by arm.
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
Assessment of changes in blood endotoxin activity
Description
The changes from baseline in blood endotoxin activity, measured by the EAA, will be used as device-related performance indicator.
Time Frame
The EAA will be performed at randomization, 1-week, 4-week, 8-week and 12-week visits.
Title
Assessment of changes in organ function as per the CHILD-PUGH score
Description
Changes from baseline in kidney, liver, brain, intestinal and immune functions will be assessed by means of the CHILD-PUGH score.
Time Frame
CHILD-PUGH scores will be calculated at screening, randomization, 1-week, 4-week, 8-week and 12-week visits.
Title
Assessment of changes in organ function as per the MELD score
Description
Changes from baseline in kidney, liver, brain, intestinal and immune functions will be assessed by means of the MELD score.
Time Frame
MELD scores will be calculated at screening, randomization, 1-week, 4-week, 8-week and 12-week visits.
Title
Assessment of changes in nutritional status
Description
Changes from baseline in nutritional status be assessed by means of the global assessment score (RFH-GA);
Time Frame
Global assessment will be performed at randomization, 1-week, 4-week, 8-week and 12-week visits.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients Age ≥ 18 years at screening Clinical diagnosis of cirrhosis for any cause. Liver biopsy is not required Cirrhotic patients with diuretic-responsive ascites and Child-Pugh score = 7-11 inclusive Abstinence from alcohol for at least 4 weeks prior to screening Exclusion Criteria: Refusal or inability (lack of capacity) to give informed consent Prohibited medication within 4 weeks before the start of the study treatment: all oral antibiotics, immunosuppressants, long acting benzodiazepines or barbiturates and antiviral medication Change in dose of proton pump inhibitor therapy within 4 weeks before the start of the study treatment Patients with once daily medications in which orocaecal transit time is greater than 10 hours Patients requiring medication in which the dosing schedule is three times per day or greater Antiviral therapy for hepatitis C within 3 months prior to screening Hospital admission for liver-related indication for at least 4 weeks (except paracentesis) BMI > 35 or BMI < 18 Clostridium Difficile diarrhoea within 4 weeks before the start of the study treatment Uncontrolled infection (chronic viral hepatitis is not an exclusion criterion) Human immunodeficiency virus Presence of a transjugular intrahepatic portosystemic shunt (TIPSS) Participation in any clinical study of an investigational medicinal product within 30 days of five half-lives of the investigational product, whichever is longer Presence of clinically relevant cardiovascular, pulmonary, gastro-intestinal, renal, hepatic, metabolic, haematological, neurological, psychiatric, systemic, ocular, gynaecologic or any acute infection disease or signs of acute illness that, in the opinion of the investigator, might compromise the patient's safe participation in the trial and/or results in a WHO performance status of 2 or more. Presence of the history of cancer within the past 5 years with exception of hepatocellular carcinoma within Milan criteria, adequately treated localised basal cell carcinoma of the skin, in situ cervical carcinoma or solid malignancy surgical excised in total without recurrence for five years. Women of child bearing potential. Only postmenopausal women or with surgical sterilization will be included.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rajiv Jalan
Organizational Affiliation
Head, Liver Failure Group ILDH, Division of Medicine UCL Medical School Royal Free Campus Rowland Hill Street London NW32PF
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Jane Macnaughtan
Organizational Affiliation
Consultant, Liver Failure Group, ILDH, Division of Medicine UCL Medical School Royal Free Campus Rowland Hill Street London NW32PF
Official's Role
Study Director
Facility Information:
Facility Name
Hospital Beaujon, Hepatology and Liver Intensive Care,
City
Clichy
ZIP/Postal Code
82110
Country
France
Facility Name
Policlinico S.Orsola Malpighi, Department of Medical and Surgical Sciences
City
Bologna
ZIP/Postal Code
40138
Country
Italy
Facility Name
Azienda Ospedaliera di Padova, Hepatic Emergencies Unit
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
University Hospital of Santa Maria
City
Lisbon
ZIP/Postal Code
1649-035
Country
Portugal
Facility Name
Hospital Vall d'Hebron, Liver Unit
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Clinic of Barcelona , Liver Unit,
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital Ramon y Cajal, Department of Gastroenterology and Hepatology
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Facility Name
Inselspital Universitaet Bern, Department for Visceral Surgery and Medicine,
City
Bern
ZIP/Postal Code
3010
Country
Switzerland
Facility Name
Royal Free Hospital, Institute of Liver and Digestive Disease
City
London
ZIP/Postal Code
NW3 2PF
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety and Tolerability of Yaq-001 in Patients With Cirrhosis

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