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Phase 3 N=193 Randomized Double-blind Treatment

RESPONSE: Response to Seladelpar in Subjects With Primary Biliary Cholangitis (PBC) and an Inadequate Control to or an Intolerance to Ursodeoxycholic Acid (UDCA)

Primary Biliary Cholangitis

Enrolled (actual)
193
Serious AEs
6.7%
Results posted
Jul 2024
Primary outcome: Primary: Percentage of Participants With Response Criteria for the Composite Endpoint of ALP <1.67 × Upper Limit of Normal (ULN), ≥15% Reduction in ALP, and Total Bilirubin ≤ 1.0× ULN at Month 12 — 20.0; 61.7 percentage of participants — p=< 0.0001

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Seladelpar 10 mg (Drug); Placebo (Drug); Seladelpar 5 mg (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Gilead Sciences
Primary completion
Aug 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants With Response Criteria for the Composite Endpoint of ALP <1.67 × Upper Limit of Normal (ULN), ≥15% Reduction in ALP, and Total Bilirubin ≤ 1.0× ULN at Month 12
20.0; 61.7 < 0.0001 sig
PRIMARY
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs
84.6; 86.7; 6.2; 7.0
PRIMARY
Percentage of Participants With Shift of ≥ 2 CTCAE Grades From Baseline in Treatment-emergent Laboratory Abnormalities Related to Hematology and Select Liver Biochemistry
12.3; 14.1; 6.2; 7.0
SECONDARY
Percentage of Participants With ALP ≤1.0× ULN at Month 12
0.0; 25.0 < 0.0001 sig
SECONDARY
Change From Baseline in Weekly Averaged Pruritus Numerical Rating Scale (NRS) in Participants With NRS ≥ 4 at Month 6
-1.7; -3.2 0.0047 sig

Summary

The purposes of this study are to evaluate the treatment effect of seladelpar on composite biochemical improvement in cholestasis markers based on ALP and total bilirubin and to evaluate the safety of seladelpar over 12 months of treatment compared to placebo. The study also checked the effect of treatment on the symptoms of PBC, including pruritus.

Eligibility Criteria

Key Inclusion Criteria

  • Must have given written informed consent (signed and dated) and any authorizations required by local law.
  • Male or female with a definitive diagnosis of primary biliary cholangitis (PBC).
  • Ursodeoxycholic acid (UDCA) for the past 12 months (stable dose for >3 months prior to screening) or intolerant to UDCA (last dose of UDCA >3 months prior to screening).
  • Laboratory parameters measured by the Central Laboratory at screening:
  • Alkaline phosphatase (ALP) ≥1.67× ULN (upper limit of normal)
  • Aspartate aminotransferase (AST) ≤3× ULN
  • Alanine aminotransferase (ALT) ≤3× ULN
  • Total bilirubin ≤2× ULN
  • Estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m^2 (calculated by the Modification of Diet in Renal Disease study equation).
  • International normalized ratio (INR) below 1.1× ULN (For individuals on anticoagulation therapy, INR must be maintained in the range required for prophylaxis for their specific disease).
  • Platelet count ≥100 ×10^3/µL.
  • Females of reproductive potential must use at least 1 barrier contraceptive and a second effective birth control method during the study and for at least 90 days after the last dose. Male individuals who are sexually active with female partners of reproductive potential must use barrier contraception, and their female partners must use a second effective birth control method during the study and for at least 90 days after the last dose.

Key Exclusion Criteria

  • Previous exposure to seladelpar (MBX-8025).
  • A medical condition other than PBC that, in the investigator's opinion, would preclude full participation in the study (e.g., cancer) or confound its results (e.g., Paget's disease, any active infection).
  • Advanced PBC as defined by the Rotterdam criteria (albumin below the lower limit of normal and total bilirubin above 1.0 × ULN).
  • Presence of clinically important hepatic decompensation, including the following:
  • History of liver transplantation, current placement on liver transplantation list, or current Model for End-Stage Liver Disease (MELD) score ≥12. For individuals on anticoagulation medication, evaluation of the baseline INR, in concert with their current dose adjustments of their anticoagulant medication, will be taken into account when calculating the MELD score. This will be done in consultation with the medical monitor.
  • Complications of portal hypertension, including known esophageal varices, history of variceal bleeds or related interventions (e.g., transjugular intrahepatic portosystemic shunt placement), ascites, and hepatic encephalopathy.
  • Cirrhosis with complications, including history or presence of spontaneous bacterial peritonitis, hepatocellular carcinoma, or hepatorenal syndrome.
  • Other chronic liver diseases:
  • Current features of autoimmune hepatitis (AIH) as determined by the investigator based on immunoserology, liver biochemistry, or historic confirmed liver histology.
  • PSC determined by the presence of diagnostic cholangiographic findings.
  • History or clinical evidence of alcoholic liver disease.
  • History or clinical evidence of alpha-1-antitrypsin deficiency.
  • History of biopsy confirmed nonalcoholic steatohepatitis (NASH).
  • History or evidence of Gilbert's syndrome with elevated total bilirubin.
  • History or evidence of hemochromatosis.
  • Hepatitis B, defined as the presence of hepatitis B surface antigen.
  • Hepatitis C, defined as the presence of hepatitis C virus ribonucleic acid.
  • History, evidence, or high suspicion of hepatobiliary malignancy based on imaging, screening laboratory values, and/or clinical symptoms.
  • Known history of human immunodeficiency virus (HIV) or positive antibody test at screening
  • Clinically important alcohol consumption, defined as more than 2 drink units per day (equivalent to 20 g) in women and 3 drink units per day (equivalent to 30 g) in men, or inability to quantify alcohol intake reliably.
  • History of malignancy diagnosed or treated, actively or within 2 y
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04620733). 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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