Study to Evaluate the Safety and Efficacy of Selonsertib, Firsocostat, Cilofexor, and Combinations in Participants With Bridging Fibrosis or Compensated Cirrhosis Due to Nonalcoholic Steatohepatitis (NASH) (ATLAS)
Nonalcoholic Steatohepatitis
About this trial
This is an interventional treatment trial for Nonalcoholic Steatohepatitis
Eligibility Criteria
Key Inclusion Criteria:
- Liver biopsy consistent with NASH and F3 or F4 in the opinion of the central reader
- In participants who have never had a liver biopsy, liver stiffness by FibroScan® ≥ 14.0 kPa and Enhanced Liver Fibrosis (ELF™) Test score ≥ 9.8 at Screening
Screening laboratory parameters, as determined by the central laboratory:
- Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min, as calculated by the Cockcroft-Gault equation
- Hemoglobin A1c (HbA1c) ≤ 9.5%
- Alanine aminotransferase (ALT) < 5 x Upper Limits of Normal (ULN)
- Platelet count ≥ 125,000/μL
Key Exclusion Criteria:
- Prior history of decompensated liver disease including ascites, hepatic encephalopathy, or variceal bleeding
- Child-Pugh (CP) score > 6 at Screening, unless due to an alternative etiology such as Gilbert's syndrome or therapeutic anticoagulation
- Model for End-Stage Liver Disease (MELD) score > 12 at Screening, unless due to an alternate etiology such as therapeutic anticoagulation
- Other causes of liver disease based on medical history and/or centralized review of liver histology, including but not limited to: alcoholic liver disease, hepatitis B, hepatitis C, autoimmune disorders (eg, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis), drug-induced hepatotoxicity, Wilson disease, clinically significant iron overload, or alpha-1-antitrypsin deficiency requiring treatment
- History of liver transplantation
- Current or prior history of hepatocellular carcinoma
Note: Other protocol defined Inclusion/ Exclusion criteria may apply
Sites / Locations
- The Institute for Liver Health
- Mayo Clinic Arizona, Mayo Clinic Hospital
- Liver Wellness Center
- Arkansas Gastroenterology
- eStudySite
- Southern California Liver Center
- Fresno Clinical Research Center
- UCSD NAFLD Clinical Research Center
- Ruane Clinical Research Group Inc.
- Cedars-Sinai Medical Center
- California Liver Research Institute
- Huntington Medical Research Institutes Liver Center
- Inland Empire Liver Foundation
- University of California, Davis Medical Center (study visits)
- Medical Associates Research Group
- South Denver Gastroenterology, PC
- Integrity Clinical Research
- UF Hepatology Research at CTRB
- Schiff Center for Liver Diseases/University of Miami
- IMIC Inc
- Genoma Research Group
- Florida Research Institute
- Digestive Healthcare of Georgia
- Piedmont Hospital
- Gastrointestinal Diseases Research
- Gastrointestinal Specialists of Georgia
- Northwestern University; Feinberg School of Medicine
- Indianapolis Gastroenterology Research Foundation
- Iowa Digestive Disease Center, P.C.
- University of Kansas Medical Center
- Delta Research Partners, LLC
- Tulane University
- Louisiana Research Center, LLC
- Mercy Medical Center
- Digestive Disease Associates, PA
- Beth Israel Deaconess Medical Center
- Henry Ford Health Systems
- Mayo Clinic
- Southern Therapy and Advanced Research (STAR) LLC
- Saint Luke's Hospital of Kansas City
- Saint Louis University
- Jubilee Clinical Research, Inc.
- Rutgers New Jersey Medical School- Doctors Office Center
- Montefiore Medical Center
- Sandra Atlas Bass Center for Liver Diseases and Transplantation
- Icahn School of Medicine at Mount Sinai Beth Israel
- Concorde Medical Group, PLLC
- NYU Langone Health
- Weill Cornell Medical College
- Icahn School of Medicine at Mount Sinai
- Carolinas Healthcare System Center for Liver Disease and Transplant
- Duke University Medical Center, Duke South Clinics
- Cumberland Research Associates, LLC
- Consultants for Clinical Research wed
- Hospital of the University of Pennsylvania- Perelman Center for Advanced Medicine
- Thomas Jefferson University
- UPMC - Center for Liver Diseases at the Thomas E. Starlz Institute
- VA Pittsburgh Healthcare System
- University Gastroenterology
- Medical University of South Carolina (Liver Biopsy)
- GHS Gastroenterology and Liver Center
- Gastro One
- Quality Medical Research, PLLC
- Texas Clinical Research Institute, LLC
- Pinnacle Clinical Research, PLLC
- Austin Center for Clinical Research
- The Liver Institute at Methodist Dallas Medical Center
- University of Texas Southwestern Medical Center Internal Medicine Digestive and Liver Diseases Clinical Trials
- Baylor College of Medicine - Advanced Liver Therapies
- Houston Methodist Hospital
- Pinnacle Clinical Research
- American Research Corporation at Texas Liver Institute
- Intermountain Liver Disease and Transplant Center
- University of Utah Hospital
- University of Virginia Medical Center
- California Pacific Medical Center - Sutter Pacific Medical Foundation San Francisco Center for Liver Disease Dept. of Transplant
- Digestive and Liver Disease Specialists
- Bon Secours Richmond Community Hospital, Inc. d/b/a Bon Secours Liver Institute of Richmond
- McGuire DVAMC
- Virginia Mason Medical Center
- Swedish Organ Transplant and Liver Center
- Royal Brisbane & Women's Hospital
- Royal Adelaide Hospital
- Monash Health, Monash Medical Centre
- St Vincent's Hospital Melbourne
- Melbourne Health, Royal Melbourne Hospital
- Sir Charles Gairdner Hospital
- Royal Perth Hospital
- Royal Prince Alfred Hospital
- St Vincent's Hospital Sydney
- Austin Health
- The Alfred Hospital, Alfred Health
- Westmead Hospital
- William Osler Health System-Brampton Civic Hospital
- University of Calgary Liver Unit (Heritage Medical Research Clinic)
- Chronic Viral Illness Service McGill University Health Centre (MUHC)/ Royal Victoria Hospital
- Toronto General Hospital
- Toronto Liver Centre
- Prince of Wales Hospital
- Auckland City Hospital
- Fundacion de Investigacion de Diego
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Selonsertib (SEL)
Firsocostat (FIR)
Cilofexor (CILO)
Selonsertib (SEL) + Firsocostat (FIR)
Selonsertib (SEL) + Cilofexor (CILO)
Firsocostat (FIR) + Cilofexor (CILO)
Placebo
Participants will receive SEL + placebo to match firsocostat 20 mg tablet + placebo to match cilofexor 30 mg tablet orally once daily for 48 weeks.
Participants will receive placebo to match SEL 18 mg tablet + FIR + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.
Participants will receive placebo to match SEL 18 mg tablet + placebo to match FIR 20 mg tablet + CILO orally once daily for 48 weeks.
Participants will receive SEL + FIR + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.
Participants will receive SEL + placebo to match FIR 20 mg tablet + CILO orally once daily for 48 weeks.
Participants will receive placebo to match SEL 18 mg tablet + FIR + CILO orally once daily for 48 weeks.
Participants will receive placebo to match SEL 18 mg + placebo to match FIR 20 mg tablet + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.