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A Phase 2b Study in Subjects With Alcoholic Hepatitis to Evaluate Safety and Efficacy of DUR-928 Treatment (AHFIRM)

Primary Purpose

Alcoholic Hepatitis

Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
DUR-928 30 mg
DUR-928 90 mg
Placebo+ Standard of Care (SOC)
Sponsored by
Durect
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcoholic Hepatitis focused on measuring Alcoholic Hepatitis, acute alcoholic liver disease, progressive inflammatory liver injury

Eligibility Criteria

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

Inclusion Criteria:

  1. Able to provide written informed consent (either from subject or subject's legally acceptable representative).
  2. Onset of jaundice within prior 8 weeks.
  3. Average daily consumption of >40 (females) or >60 (males) grams of alcohol for 6 months or longer, with < 8 weeks of abstinence before the onset of jaundice.
  4. The determination of AH may be based on typical serum chemistry (as determined by local laboratory) or liver biopsy at any time during the current episode of AH:

    • Serum total bilirubin > 3.0 mg/dL
    • 50 < AST < 400 IU/L
    • ALT < 400 IU/L
    • AST/ALT > 1.5
  5. Maddrey discriminant function (MDF) ≥ 32 assuming a control prothrombin time of 12 seconds.
  6. Model for End-stage Liver Disease (MELD) score: 21-30.
  7. Liver biopsy is not required, but may be used to confirm the diagnosis of AH at the Investigator's discretion. Biopsy, if used as a diagnostic criterion, must have occurred during the current episode.
  8. Male or female subjects 18 years of age or older.
  9. Subjects must agree to use effective methods to prevent pregnancy while participating in the study.
  10. Subjects must agree to participate in an alcohol abstinence support program recommended by the local institution's addiction specialists.

Exclusion Criteria:

  1. Subjects taking systemic corticosteroids for a duration exceeding 8 days in the 30 days prior to screening.
  2. Subjects experiencing or considered at high risk for alcohol withdrawal seizures or delirium tremens.
  3. Active infection (such as spontaneous bacterial peritonitis [SBP], urinary tract infection [UTI], bacteremia, acute viral hepatitis, uncontrolled HIV, and active SARS CoV2 infection).
  4. Serum creatinine >2.5 mg/dL.
  5. Subjects undergoing continuous veno-venous hemodialysis (CVVH).
  6. Uncontrolled gastrointestinal bleeding.
  7. A history of pre-admission refractory ascites defined as more than 4 paracenteses in the previous 8 weeks despite diuretic therapy.
  8. Liver biopsy (if carried out) with findings not compatible with AH.
  9. Stage ≥3 hepatic encephalopathy by West Haven criteria.
  10. Any severe concomitant cardiovascular, renal, endocrine, pulmonary, psychiatric disorder, or multi-organ failure.
  11. Other concomitant cause(s) of liver disease.
  12. Any active malignancy or any malignancy diagnosed within the last five years other than curable skin cancer (basal cell or squamous cell carcinomas).
  13. Positive Urine Drug Screen (amphetamines, barbiturates, benzodiazepines, cocaine and opiates) except THC and prescription medications.
  14. Existing or intended pregnancy or breast feeding.
  15. Participation in another interventional clinical trial within 30 days of Screening.
  16. History of organ transplantation, other than a corneal transplant.
  17. Underlying diseases that, in the opinion of the site investigator, might be complicated or exacerbated by proposed treatments or might confound assessment of study drug.

Sites / Locations

  • University of Alabama at Birmingham (UAB) Hospital
  • Mayo Clinic Hospital
  • Southern California Research Center
  • Keck Hospital of University of Southern California (USC)
  • Cedars-Sinai Medical Center
  • University of California Davis (UC Davis) Medical Center
  • University of California San Francisco (UCSF) Medical Center
  • Stanford University Medical Center
  • Yale University School of Medicine
  • MedStar Health - MedStar Georgetown University Hospital
  • Piedmont Atlanta Hospital
  • Northwestern Memorial Hospital
  • Rush University Medical Center
  • University of Chicago Medical Center
  • Loyola University Medical Center
  • Richard Roudebush VA Hospital
  • University of Louisville
  • Tulane Medical Center
  • University of Maryland Medical Center
  • Johns Hopkins Hospital
  • Tufts Medical Center
  • Massachusetts General Hospital
  • Henry Ford Hospital
  • University of Minnesota Medical School
  • Saint Luke's Health System - Saint Luke's Hospital of Kansas City
  • Washington University School of Medicine
  • University of Nebraska Medical Center (UNMC)
  • Rutgers-New Jersey Medical School
  • University of New Mexico (UNM) Hospital
  • Northwell Health - North Shore University Hospital
  • Mount Sinai Hospital
  • New York-Presbyterian - Weill Cornell Medical Center
  • Atrium Health
  • Cleveland Clinic
  • Medical University of South Carolina (MUSC) Health - University Medical Center
  • Methodist Dallas Medical Center
  • Parkland Memorial Hospital
  • Baylor Scott and White Health
  • University of Texas Southwestern (Clements University Hospital)
  • University of Texas Southwestern Medical Center
  • Doctors Hospital at Renaissance (DHR)
  • Baylor College of Medicine Medical Center
  • Houston Methodist Hospital
  • Utah Health - The University of Utah Hospital
  • University of Virginia (UVA) Health - University Hospital
  • Bon Secours Liver Institute of Richmond
  • Virginia Commonwealth University Medical Center
  • Harborview Medical Center - University of Washington
  • Royal Prince Alfred Hospital
  • Nepean Hospital
  • Mater Health - Mater Hospital Brisbane
  • Royal Adelaide Hospital
  • Flinders Medical Centre
  • Eastern Health - Box Hill Hospital
  • Sir Charles Gairdner Hospital
  • Royal Perth Hospital
  • Landeskrankenhaus (LKH) - Universitätsklinikum Graz
  • Université libre de Bruxelles (ULB) - Hôpital Erasme
  • Universitair Ziekenhuis Antwerpen (UZA)
  • Centre Hospitalier Régional Universitaire (CHRU) Besançon - Hôpital Jean Minjoz
  • Centre Hospitalier Universitaire (CHU) de Lille - Hôpital Jeanne de Flandre
  • Hospices Civils de Lyon - Hôpital de la Croix-Rousse
  • Hôpital St Joseph
  • Barts Health NHS Trust - The Royal London Hospital
  • King's College Hospital NHS Foundation Trust
  • Imperial College Healthcare NHS Trust - St. Mary's Hospital
  • University Hospitals Plymouth NHS Trust - Derriford Hospital
  • Royal Free London NHS Foundation Trust Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

DUR-928 (larsucosterol, 30 mg)

DUR-928 (larsucosterol, 90 mg)

(Placebo) Sterile Water for Injection

Arm Description

Outcomes

Primary Outcome Measures

Difference in 90-day mortality or liver transplant between IV DUR-928, 30 mg or 90 mg, and placebo.

Secondary Outcome Measures

Difference in 90-day mortality between IV DUR-928, 30 mg or 90 mg, and placebo.
Difference in 28-day mortality or liver transplant between IV DUR-928, 30 mg or 90 mg, and placebo.
Difference in 28-day mortality between IV DUR-928, 30 mg or 90 mg, and placebo.

Full Information

First Posted
September 18, 2020
Last Updated
June 15, 2023
Sponsor
Durect
Collaborators
CTI Clinical Trial and Consulting Services
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1. Study Identification

Unique Protocol Identification Number
NCT04563026
Brief Title
A Phase 2b Study in Subjects With Alcoholic Hepatitis to Evaluate Safety and Efficacy of DUR-928 Treatment
Acronym
AHFIRM
Official Title
A Randomized, Double-blind, Placebo-controlled, Phase 2b Study to Evaluate Safety and Efficacy of DUR-928 in Subjects With Alcoholic Hepatitis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 22, 2021 (Actual)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
September 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Durect
Collaborators
CTI Clinical Trial and Consulting Services

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
This is a randomized, double-blind, placebo-controlled, phase 2b clinical Trial evaluating Safety and Efficacy of DUR-928 (an experimental medication) in Patients with Alcoholic Hepatitis (AH).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcoholic Hepatitis
Keywords
Alcoholic Hepatitis, acute alcoholic liver disease, progressive inflammatory liver injury

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This is a Phase 2b randomized, double-blind, placebo-controlled, multi-arm, multi-center, parallel design trial.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
301 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DUR-928 (larsucosterol, 30 mg)
Arm Type
Experimental
Arm Title
DUR-928 (larsucosterol, 90 mg)
Arm Type
Experimental
Arm Title
(Placebo) Sterile Water for Injection
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
DUR-928 30 mg
Intervention Description
IV infusion
Intervention Type
Drug
Intervention Name(s)
DUR-928 90 mg
Intervention Description
IV infusion
Intervention Type
Drug
Intervention Name(s)
Placebo+ Standard of Care (SOC)
Intervention Description
IV infusion
Primary Outcome Measure Information:
Title
Difference in 90-day mortality or liver transplant between IV DUR-928, 30 mg or 90 mg, and placebo.
Time Frame
Day 90
Secondary Outcome Measure Information:
Title
Difference in 90-day mortality between IV DUR-928, 30 mg or 90 mg, and placebo.
Time Frame
Day 90
Title
Difference in 28-day mortality or liver transplant between IV DUR-928, 30 mg or 90 mg, and placebo.
Time Frame
Day 28
Title
Difference in 28-day mortality between IV DUR-928, 30 mg or 90 mg, and placebo.
Time Frame
Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able to provide written informed consent (either from subject or subject's legally acceptable representative). Onset of jaundice within prior 8 weeks. Average daily consumption of >40 (females) or >60 (males) grams of alcohol for 6 months or longer, with < 8 weeks of abstinence before the onset of jaundice. The determination of AH may be based on typical serum chemistry (as determined by local laboratory) or liver biopsy at any time during the current episode of AH: Serum total bilirubin > 3.0 mg/dL 50 < AST < 400 IU/L ALT < 400 IU/L AST/ALT > 1.5 Maddrey discriminant function (MDF) ≥ 32 assuming a control prothrombin time of 12 seconds. Model for End-stage Liver Disease (MELD) score: 21-30. Liver biopsy is not required, but may be used to confirm the diagnosis of AH at the Investigator's discretion. Biopsy, if used as a diagnostic criterion, must have occurred during the current episode. Male or female subjects 18 years of age or older. Subjects must agree to use effective methods to prevent pregnancy while participating in the study. Subjects must agree to participate in an alcohol abstinence support program recommended by the local institution's addiction specialists. Exclusion Criteria: Subjects taking systemic corticosteroids for a duration exceeding 8 days in the 30 days prior to screening. Subjects experiencing or considered at high risk for alcohol withdrawal seizures or delirium tremens. Active infection (such as spontaneous bacterial peritonitis [SBP], urinary tract infection [UTI], bacteremia, acute viral hepatitis, uncontrolled HIV, and active SARS CoV2 infection). Serum creatinine >2.5 mg/dL. Subjects undergoing continuous veno-venous hemodialysis (CVVH). Uncontrolled gastrointestinal bleeding. A history of pre-admission refractory ascites defined as more than 4 paracenteses in the previous 8 weeks despite diuretic therapy. Liver biopsy (if carried out) with findings not compatible with AH. Stage ≥3 hepatic encephalopathy by West Haven criteria. Any severe concomitant cardiovascular, renal, endocrine, pulmonary, psychiatric disorder, or multi-organ failure. Other concomitant cause(s) of liver disease. Any active malignancy or any malignancy diagnosed within the last five years other than curable skin cancer (basal cell or squamous cell carcinomas). Positive Urine Drug Screen (amphetamines, barbiturates, benzodiazepines, cocaine and opiates) except THC and prescription medications. Existing or intended pregnancy or breast feeding. Participation in another interventional clinical trial within 30 days of Screening. History of organ transplantation, other than a corneal transplant. Underlying diseases that, in the opinion of the site investigator, might be complicated or exacerbated by proposed treatments or might confound assessment of study drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Gordon, MD, FACS
Organizational Affiliation
CTI Clinical Trial and Consulting Services
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama at Birmingham (UAB) Hospital
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
Mayo Clinic Hospital
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
Southern California Research Center
City
Coronado
State/Province
California
ZIP/Postal Code
92118
Country
United States
Facility Name
Keck Hospital of University of Southern California (USC)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
University of California Davis (UC Davis) Medical Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
University of California San Francisco (UCSF) Medical Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Stanford University Medical Center
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
MedStar Health - MedStar Georgetown University Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Piedmont Atlanta Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
Northwestern Memorial Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Chicago Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Loyola University Medical Center
City
Maywood
State/Province
Illinois
ZIP/Postal Code
60153
Country
United States
Facility Name
Richard Roudebush VA Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Louisville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Tulane Medical Center
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Henry Ford Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
University of Minnesota Medical School
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Saint Luke's Health System - Saint Luke's Hospital of Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Nebraska Medical Center (UNMC)
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States
Facility Name
Rutgers-New Jersey Medical School
City
Newark
State/Province
New Jersey
ZIP/Postal Code
07103
Country
United States
Facility Name
University of New Mexico (UNM) Hospital
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87106
Country
United States
Facility Name
Northwell Health - North Shore University Hospital
City
Manhasset
State/Province
New York
ZIP/Postal Code
11030
Country
United States
Facility Name
Mount Sinai Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
New York-Presbyterian - Weill Cornell Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Atrium Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Medical University of South Carolina (MUSC) Health - University Medical Center
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Methodist Dallas Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75203
Country
United States
Facility Name
Parkland Memorial Hospital
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
Baylor Scott and White Health
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
University of Texas Southwestern (Clements University Hospital)
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Doctors Hospital at Renaissance (DHR)
City
Edinburg
State/Province
Texas
ZIP/Postal Code
78539
Country
United States
Facility Name
Baylor College of Medicine Medical Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Utah Health - The University of Utah Hospital
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
University of Virginia (UVA) Health - University Hospital
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
Bon Secours Liver Institute of Richmond
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23226
Country
United States
Facility Name
Virginia Commonwealth University Medical Center
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
Harborview Medical Center - University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Royal Prince Alfred Hospital
City
Camperdown
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Facility Name
Nepean Hospital
City
Kingswood
State/Province
New South Wales
ZIP/Postal Code
2217
Country
Australia
Facility Name
Mater Health - Mater Hospital Brisbane
City
South Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Royal Adelaide Hospital
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
Flinders Medical Centre
City
Bedford Park
State/Province
South Australia
ZIP/Postal Code
5042
Country
Australia
Facility Name
Eastern Health - Box Hill Hospital
City
Box Hill
State/Province
Victoria
ZIP/Postal Code
3128
Country
Australia
Facility Name
Sir Charles Gairdner Hospital
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Facility Name
Royal Perth Hospital
City
Perth
State/Province
Western Australia
ZIP/Postal Code
6000
Country
Australia
Facility Name
Landeskrankenhaus (LKH) - Universitätsklinikum Graz
City
Graz
ZIP/Postal Code
8036
Country
Austria
Facility Name
Université libre de Bruxelles (ULB) - Hôpital Erasme
City
Brussels
ZIP/Postal Code
1070
Country
Belgium
Facility Name
Universitair Ziekenhuis Antwerpen (UZA)
City
Edegem
ZIP/Postal Code
2650
Country
Belgium
Facility Name
Centre Hospitalier Régional Universitaire (CHRU) Besançon - Hôpital Jean Minjoz
City
Besançon
ZIP/Postal Code
25000
Country
France
Facility Name
Centre Hospitalier Universitaire (CHU) de Lille - Hôpital Jeanne de Flandre
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Hospices Civils de Lyon - Hôpital de la Croix-Rousse
City
Lyon
ZIP/Postal Code
69004
Country
France
Facility Name
Hôpital St Joseph
City
Marseille
ZIP/Postal Code
13008
Country
France
Facility Name
Barts Health NHS Trust - The Royal London Hospital
City
London
State/Province
England
ZIP/Postal Code
E1 1FR
Country
United Kingdom
Facility Name
King's College Hospital NHS Foundation Trust
City
London
State/Province
England
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
Imperial College Healthcare NHS Trust - St. Mary's Hospital
City
London
State/Province
England
ZIP/Postal Code
W2 1NY
Country
United Kingdom
Facility Name
University Hospitals Plymouth NHS Trust - Derriford Hospital
City
Plymouth
State/Province
England
ZIP/Postal Code
PL6 8DH
Country
United Kingdom
Facility Name
Royal Free London NHS Foundation Trust Hospital
City
London
ZIP/Postal Code
NW3 2QG
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 2b Study in Subjects With Alcoholic Hepatitis to Evaluate Safety and Efficacy of DUR-928 Treatment

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