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Phase 2 N=104 Randomized Double-blind Treatment

Selonsertib in Combination With Prednisolone Versus Prednisolone Alone in Participants With Severe Alcoholic Hepatitis (AH)

Alcoholic Hepatitis (AH)

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

OutcomeResultp-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.

View full record on ClinicalTrials.gov →

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.

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