Phase 2
N=104
Selonsertib in Combination With Prednisolone Versus Prednisolone Alone in Participants With Severe Alcoholic Hepatitis (AH)
Alcoholic Hepatitis (AH)
Bottom Line
View on ClinicalTrials.gov: NCT02854631 ↗Enrolled (actual)
104
Serious AEs
45.1%
Results posted
Feb 2019
Primary outcome: Primary: Percentage of Participants With Treatment-Emergent (TE) Adverse Events (AE), Serious AEs (SAE), AEs Leading to Premature Study Drug Discontinuation, and Grade 3 or 4 Laboratory Abnormalities — 94.0; 94.2; 50.0; 40.4 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Selonsertib (Drug); Prednisolone (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Gilead Sciences
- Primary completion
- Feb 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Treatment-Emergent (TE) Adverse Events (AE), Serious AEs (SAE), AEs Leading to Premature Study Drug Discontinuation, and Grade 3 or 4 Laboratory Abnormalities |
94.0; 94.2; 50.0; 40.4; 18.0; 7.7 | — |
| SECONDARY Percentage of Participants Who Died by Day 28 |
4.3; 4.0 | 1.00 |
| SECONDARY Percentage of Participants Who Died by Week 8 |
20.5; 6.1 | 0.061 |
| SECONDARY Percentage of Participants Who Died by Week 12 |
25.6; 10.2 | 0.060 |
| SECONDARY Percentage of Participants Who Died by Week 24 |
31.7; 18.8 | 0.22 |
| SECONDARY Percentage of Participants With Survival at Day 28 Using Kaplan-Meier |
95.7; 96.1 | — |
| SECONDARY Percentage of Participants With Survival at Week 8 Using Kaplan-Meier |
80.0; 94.0 | — |
| SECONDARY Percentage of Participants With Survival at Week 12 Using Kaplan-Meier |
75.3; 89.9 | — |
| SECONDARY Percentage of Participants With Survival at Week 24 Using Kaplan-Meier |
70.3; 81.7 | — |
| SECONDARY Percentage of Participants Who Received a Liver Transplant |
2.2; 0; 2.8; 0; 3.0; 0 | — |
| SECONDARY Percentage of Participants With Hepatorenal Syndrome (HRS) |
4.2; 2.0 | — |
| SECONDARY Percentage of Participants With Infection |
37.5; 29.4 | — |
| SECONDARY Length of Hospital Stay |
11.0; 11.0; 36.0; 6.0 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: Alanine Aminotransferase (ALT) |
26; 29; 31; 36; 24; 24 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: Aspartate Aminotransferase (AST) |
-2; 4; -17; -11; -34; -39 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: Gamma Glutamyl Transferase (GGT) |
3; -1; 9; 9; -12; 9 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: Alkaline Phosphatase |
11; -3; 23; -5; 10; -4 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: Bilirubin |
-2.1; -4.3; -2.9; -6.3; -4.8; -7.2 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: Albumin |
0.2; 0.2; 0.3; 0.4; 0.3; 0.4 | — |
| SECONDARY Change From Baseline in Liver Biochemistry Tests: International Normalized Ratio (INR) |
-0.1; -0.1; -0.2; -0.2; -0.3; -0.2 | — |
| SECONDARY Percentage of Participants With Lille Response (Score < 0.45) at Day 7 |
77.1; 86.3 | 0.30 |
| SECONDARY Percentage of Participants With a Lille Null Response (Score ≥ 0.56) at Day 7 |
14.6; 7.8 | — |
| SECONDARY Lille Score at Day 7 as a Continuous Variable |
0.254; 0.178 | — |
| SECONDARY Percentage of Participants With Estimated Mortality at Month 2 and Month 6: Combined Scoring Including Lille Score at Day 7 and Baseline Model for End-Stage Liver Disease (MELD) Score |
13.0; 9.7; 19.8; 15.2 | — |
| SECONDARY Change From Baseline in Prognostic Index: Model for End-Stage Liver Disease (MELD) Score |
-2; -3; -3; -5; -4; -5 | — |
| SECONDARY Change From Baseline in Prognostic Index: Child-Pugh-Turcotte (CPT) Score |
0; -1; -1; -1; -1; -1 | — |
| SECONDARY Change From Baseline in Prognostic Index: Maddrey Discriminant Function (DF) Score |
-8; -10; -13; -15; -17; -17 | — |
Summary
The primary objective of this study is to evaluate the safety and tolerability of selonsertib (GS-4997) in combination with prednisolone versus prednisolone alone in participants with severe alcoholic hepatitis (AH).
Eligibility Criteria
Key Inclusion Criteria
- Willing and able to give informed consent prior to any study specific procedures being performed. In individuals with hepatic encephalopathy (HE) which may impair decision-making, consent will be obtained per hospital procedures (eg, by Legally Authorized Representative)
- Clinical diagnosis of severe AH
- Maddrey's Discriminant Function (DF) ≥ 32 at screening
Key Exclusion Criteria
- Pregnant or lactating females;
- Other causes of liver disease including chronic hepatitis B (hepatitis B surface antigen [HBsAg] positive), chronic hepatitis C (HCV RNA positive), acetaminophen hepatotoxicity, biliary obstruction, and autoimmune liver disease;
- Serum aspartate aminotransferase (AST) >400 U/L or alanine aminotransferase (ALT) >300 U/L;
- Model for End Stage Liver Disease (MELD) >30 at screening;
- Maddrey's DF >60 at screening;
- Grade 4 Hepatic Encephalopathy (HE) by West Haven criteria;
- Concomitant or previous history of hepatocellular carcinoma;
- History of liver transplantation;
- HIV Ab positive;
- Clinical suspicion of pneumonia;
- Uncontrolled sepsis;
- Uncontrolled gastrointestinal (GI) bleeding or controlled GI bleeding within 7 days of screening that was associated with shock or required transfusion of more than 3 units of blood;
- Type 1 hepatorenal syndrome (HRS) or renal failure defined as a serum creatinine >221 μmol/L (>2.5 mg/dL) or the requirement for renal replacement therapy;
- Individuals dependent on inotropic (eg, epinephrine or norepinephrine) or ventilatory support (ie, endotracheal intubation or positive-pressure ventilation);
- Portal vein thrombosis;
- Acute pancreatitis;
- Cessation of alcohol consumption for more than 2 months before Baseline/ Day 1
Note: Other protocol defined Inclusion/ Exclusion criteria may apply.
Data sourced from ClinicalTrials.gov (NCT02854631). 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.