Phase 2
N=27
Phase 2 Study on Effects of Obeticholic Acid (OCA) on Lipoprotein Metabolism in Participants With Primary Biliary Cirrhosis
Primary Biliary Cirrhosis
Bottom Line
View on ClinicalTrials.gov: NCT01865812 ↗Enrolled (actual)
27
Serious AEs
12.8%
Results posted
Oct 2016
Primary outcome: Primary: Absolute Change From Baseline In High-density Lipoprotein (HDL) Cholesterol Concentration — -0.38 mmol/L
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Obeticholic Acid (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Intercept Pharmaceuticals
- Primary completion
- Aug 2014
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Absolute Change From Baseline In High-density Lipoprotein (HDL) Cholesterol Concentration |
-0.38 | — |
| PRIMARY Absolute Change From Baseline In HDL Particle Size |
0.04 | 0.549 |
| PRIMARY Absolute Change From Baseline In HDL Particle Number |
-0.09 | 0.912 |
| SECONDARY Median Change From Baseline In HDL Cholesterol Concentration At Weeks 4, 8, and 12 |
-0.2072; -0.3108; 0.0518 | — |
| SECONDARY Median Change From Baseline In HDL Particle Size At Weeks 4, 8, and 12 |
-0.30; -0.30; 0.00 | — |
| SECONDARY Median Change From Baseline In HDL Particle Number At Weeks 4, 8, and 12 |
0.55; 0.60; 1.60 | — |
| SECONDARY Median Change From Week 8 In HDL Cholesterol Concentration At Week 12 |
0.3108 | — |
| SECONDARY Median Change From Week 8 In HDL Particle Size At Week 12 |
0.30 | — |
| SECONDARY Median Change From Week 8 In HDL Particle Number At Week 12 |
1.40 | — |
| SECONDARY Maximum Plasma Concentration (Cmax) Of OCA And Conjugates |
107; 212; 219; 409 | — |
| SECONDARY Time To Reach Cmax (Tmax) For OCA And Conjugates |
1.00; 5.00; 5.98; 5.00 | — |
| SECONDARY Area Under The Concentration-time Curve From Hour 0 To Last Sampling Time (Hour 6) (AUC0-6) For OCA And Conjugates |
189; 702; 698; 1360 | — |
| SECONDARY Median Change From Baseline In Total Cholesterol |
-0.0518; -0.2849; 0.2331; -0.1813; 0.0777; 0.2849 | — |
| SECONDARY Median Change From Baseline In Total Triglycerides |
-0.0226; 0.0565; 0.1130; -0.1469; -0.0113; -0.0565 | — |
| SECONDARY Median Change From Baseline In Low-density Lipoprotein (LDL) Cholesterol (Direct) |
0.27; 0.31; 0.18; 0.3108; 0.4403; 0.5957 | — |
| SECONDARY Median Change From Baseline In LDL Particle Size |
-0.30; -0.10; 0.00; -0.10; -0.20; -0.10 | — |
| SECONDARY Median Change From Baseline In Total LDL Particles |
108.0; 128.0; 159.0; 148.0; 89.0; 18.0 | — |
| SECONDARY Median Change From Baseline In Very Low-density Lipoprotein (VLDL) Cholesterol |
5.0; -21.0; -7.0; -14.0; -1.0; -11.5 | — |
| SECONDARY Median Change From Baseline In VLDL Particle Size |
42.55; 43.40; 45.10; -4.80; -3.50; -4.90 | — |
| SECONDARY Median Change From Baseline In VLDL Particles |
-5.55; 2.70; -0.90; -4.70; -6.20; -6.80 | — |
| SECONDARY Median Change From Baseline In Apolipoprotein A1 (ApoA1) |
-0.1000; -0.0600; 0.0400; -0.1400; -0.0900; -0.1000 | — |
| SECONDARY Median Change From Baseline In Apolipoprotein B (ApoB) |
0.0950; 0.0700; 0.0500; 0.0400; 0.0400; 0.0600 | — |
| SECONDARY Median Change From Baseline In ApoA1/ApoB Ratio |
-0.0503; -0.2174; -0.1659; -0.2860; -0.1172; -0.291 | — |
| SECONDARY Median Change From Baseline In Apolipoprotein E |
-0.85; -0.65; 0.50; -0.30; -0.30; -0.10 | — |
| SECONDARY Median Change From Baseline In Lipoprotein-a |
0.0000; 0.0000; 0.0000; 0.0000; 0.0000; 0.0000 | — |
| SECONDARY Median Change From Baseline In Lecithin-cholesterol Acyltransferase Activity |
-20.5; -13.5; 15.5; -47.0; 46.0; -19.0 | — |
| SECONDARY Median Change From Baseline In Cholesteryl Ester Transfer Protein |
1.95; 0.30; 4.70; 1.20; -0.60; 0.50 | — |
| SECONDARY Median Change From Baseline In Prebeta-1 HDL Concentration |
1.55; 7.55; -6.90; -10.05; 1.94; -1.35 | — |
| SECONDARY Median Change From Baseline In Macrophage Cholesterol Efflux |
-0.800; -0.705; -1.745; -1.940; -2.450; -0.770 | — |
| SECONDARY Median Change From Baseline In C-reactive Protein |
0.0000; 0.0000; 11.4288; 0.00; 0.00; 0.00 | — |
| SECONDARY Median Change From Baseline In Glycoprotein A |
12.0; -27.0; -13.0; -26.0; 10.0 | — |
| SECONDARY Median Change From Baseline In Fibroblast Growth Factor-19 |
81.8800; 112.5460; 16.8400; 81.390; 29.220; 55.230 | — |
| SECONDARY Participants With Lipoprotein X |
1; 0; 0; 0 | — |
| SECONDARY Median Change From Baseline In Alkaline Phosphatase |
-43.40; -31.50; -31.90; 6.40 | — |
| SECONDARY Median Change From Baseline In Gamma-glutamyl Transferase |
-59.40; -41.60; -40.80; -30.05 | — |
| SECONDARY Median Change From Baseline In Alanine Aminotransferase |
-9.80; -9.80; -11.80; -5.95 | — |
| SECONDARY Median Change From Baseline In Aspartate Aminotransferase |
-5.30; -3.60; -6.00; -4.50 | — |
| SECONDARY Median Change From Baseline In Total And Unconjugated (Direct) Bilirubin |
0.0000; 0.0000; 0.0000; 0.0000 | — |
| SECONDARY Median Change From Baseline In Albumin |
-0.60; -0.20; 1.30; 0.05 | — |
| SECONDARY Median Change From Baseline In Prothrombin Time |
0.000; -0.050; 0.400; 0.200 | — |
| SECONDARY Median Change From Baseline In Prothrombin International Normalized Ratio |
0.0000; 0.0000; 0.0000; 0.0000 | — |
| SECONDARY Median Change From Baseline In Enhanced Liver Fibrosis (ELF) Score |
0.000; 0.150 | — |
| SECONDARY Median Change From Baseline In Hyaluronic Acid |
-5.700; -1.805 | — |
| SECONDARY Median Change From Baseline In Amino-terminal Propeptide Of Type III Procollagen |
0.670; 2.095 | — |
| SECONDARY Median Change From Baseline In Tissue Inhibitor Of Metalloproteinases 1 |
9.600; 2.000 | — |
| SECONDARY Median Change From Baseline In Hepatic Stiffness |
-1.15; -1.70 | — |
| SECONDARY Median Change From Baseline In Total Bile Acids |
-1.56; -1.14; -4.61; -4.91 | — |
| SECONDARY Median Change From Baseline In Total Endogenous Bile Acid |
-0.83; -0.77; -2.19; -2.02 | — |
| SECONDARY Median Change From Baseline In Total UDCA |
-0.34; -0.47; -2.89; -1.68 | — |
| SECONDARY Median Change From Baseline In Total Chenodeoxycholic Acid |
-0.20; -0.35; -1.28; -1.17 | — |
| SECONDARY Median Change From Baseline In Total Lithocholic Acid |
0.00; 0.00; 0.00; 0.00 | — |
| SECONDARY Median Change From Baseline In Total Cholic Acid |
-0.39; -0.48; -0.49; -0.39 | — |
| SECONDARY Median Change From Baseline In Total Deoxycholic Acid |
-0.59; -0.56; -0.51; -0.59 | — |
| SECONDARY Absolute Change From Baseline In HDL Cholesterol Concentration |
0.5 | 0.852 |
| SECONDARY Absolute Change From Baseline In HDL Particle Size |
0.04 | 0.549 |
| SECONDARY Absolute Change From Baseline In HDL Particle Number |
-0.09 | 0.912 |
Summary
The purpose of this study was to determine if OCA had an effect on cholesterol levels in the blood in participants with primary biliary cirrhosis (PBC).
Eligibility Criteria
Key Inclusion Criteria
- Definite or probable PBC diagnosis as demonstrated by the presence of ≥ 2 of the following 3 diagnostic factors:
- History of elevated alkaline phosphatase levels for at least 6 months
- A positive anti-microbial antibody (AMA) titer or, if AMA negative or in low titer (<1:80), PBC-specific antibodies
- Liver biopsy consistent with PBC
- Taking UDCA for at least 12 months (stable dose for ≥ 3 months) prior to Day 0 or unable to tolerate UDCA (no UDCA for ≥ 3 months prior to Day 0).
- Contraception: Female participants must have been postmenopausal, surgically sterile, or if premenopausal, were prepared to use ≥ 1 effective (≤ 1% failure rate) method of contraception during the trial and until at least 30 days after the last dose of Investigational Product.
- Must have provided written informed consent and agreed to comply with the trial protocol.
Key Exclusion Criteria
- Participants with decompensated PBC (as determined by the Investigator).
- Severe pruritus or systemic treatment for pruritus (for example, treatment with bile acid sequestrants or rifampicin) within 2 months of Day 0.
- History or presence of other significant liver diseases including:
- Active or chronic Hepatitis B or C virus infection
- Primary sclerosing cholangitis
- Alcoholic liver disease
- Definite autoimmune liver disease or overlap hepatitis
- Nonalcoholic steatohepatitis
Note: Participants with Gilbert's disease or those with a history of hepatitis B who were currently antigen negative and seroconverted were not considered exclusionary.
- Uncontrolled diabetes or other uncontrolled or unstable medical condition that may have interfered with trial results.
- Administration of any of the following medications as specified below:
- Prohibited 28 days prior to Day 0: bile acid sequestrants including cholestyramine, colesevelam, colestipol or omega-3 fatty acid containing dietary supplements
- Prohibited 3 months prior to Day 0 and throughout trial participation: serum-lipid modifying agents including 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, fenofibrate or other fibrates, nicotinic acid and derivatives, ezetimibe, Vitamin E (other than as standard dietary supplement)
- Prohibited 6 months prior to Day 0 and throughout the trial participation: azathioprine, colchicine, cyclosporine, methotrexate, mycophenolate mofetil, pentoxifylline; budesonide and other systemic corticosteroids; potentially hepatotoxic drugs (including α-methyl-dopa, sodium valproic acid, isoniazide, or nitrofurantoin)
- Prohibited 12 months prior to Day 0 and throughout the trial participation: antibodies or immunotherapy directed against interleukins or other cytokines or chemokines
- Planned change in diet or exercise habits during participation in the trial.
- Presence or history of clinically significant cardiac arrhythmias that may have prohibited the participant from participating in the trial.
- If female: known pregnancy, or had a positive urine pregnancy test (confirmed by a positive serum pregnancy test), or lactating.
- Recent (3 months prior to day 0) participation in another trial involving OCA or participation in another investigational trial (30 days prior to Day 0) and during the trial.
Data sourced from ClinicalTrials.gov (NCT01865812). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.