RecruitingPhase 3NCT05035030

Long-term Safety and Efficacy of Odevixibat in Patients With Alagille Syndrome

An Open Label Study to Evaluate the Long-term Safety and Efficacy of Odevixibat (A4250) in Patients With Alagille Syndrome (ASSERT-EXT)


Sponsor

Albireo, an Ipsen Company

Enrollment

70 participants

Start Date

Sep 3, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this study is to assess the long-term safety and effectiveness of odevixibat in participants with Alagille syndrome (ALGS). The participants of this study will have ALGS a rare genetic disorder that can affect multiple organ systems of the body including the liver, heart, skeleton, eyes and kidneys. Common symptoms, which often develop during the first three months of life, include blockage of the flow of bile from the liver (cholestasis), yellowing of the skin and mucous membranes (jaundice), poor weight gain and growth and severe itching (pruritis). The drug used for the study is odevixibat and was authorized for the treatment of cholestatic pruritus in infants with ALGS over 12 months of age by the United States Food and Drug Administration on 13 June 2023.


Eligibility

Inclusion Criteria10

  • Cohort 1 :
  • Completion of the 24-week Treatment Period of Study A4250-012
  • Signed informed consent and assent as appropriate. Patients who turn 18 years of age (or legal age per country) during the study will be required to re-consent to remain on the study
  • Caregivers (and age-appropriate patients) must be willing and able to use an electronic diary (eDiary) device as required by the study
  • Sexually active males and females must agree to use a reliable contraceptive method with ≤1% failure rate (such as hormonal contraception, intra-uterine device, or complete abstinence) from signed informed consent through 90 days after last dose of study drug.
  • Cohort 2 :
  • Infant with clinically confirmed ALGS , ≤11 months of age at Study Day 1
  • Body weight ≥2 kg at Study Day 1
  • Gestational age ≥36 weeks. For children born with gestational age between 32 and 36 weeks, a postmenstrual age of ≥36 weeks is required .
  • Signed parent/legal guardian informed consent.

Exclusion Criteria28

  • Cohort 1 :
  • Decompensated liver disease, history or presence of clinically significant ascites, variceal hemorrhage, and/or encephalopathy
  • Patients who were not compliant with study drug treatment or procedures in Study A4250-012
  • Any other conditions or abnormalities which, in the opinion of the investigator, may compromise the safety of the patient, or interfere with the patient participating in or completing the study
  • Known hypersensitivity to any components of odevixibat
  • Cohort 2 :
  • Patient with past medical history or ongoing presence of other types of liver disease including, but not limited to, the following:
  • Biliary atresia of any kind
  • Progressive familial intrahepatic cholestasis (PFIC)
  • Benign recurrent intrahepatic cholestasis
  • Patient with a past medical history or ongoing presence of any other disease or condition known to interfere with the absorption, distribution, metabolism (specifically bile acid metabolism), or excretion of drugs in the intestine, including but not limited to, inflammatory bowel disease
  • Patient with past medical history or ongoing chronic diarrhea requiring intravenous fluid or nutritional intervention for treatment of the diarrhea and/or its sequelae
  • Patient has a confirmed past diagnosis of infection with human immunodeficiency virus or other present and active, clinically significant chronic infection
  • Recent infection requiring hospitalization or treatment with parenteral anti-infective within 4 weeks of Study Day 1 or completion of oral anti-infective treatment within 2 weeks prior to the Screening Visit
  • Cancer diagnosis (except for basal cell carcinoma)
  • Chronic kidney disease with an impaired renal function and a glomerular filtration rate \<70 mL/min/1.73 m2
  • Patient with surgical history of disruption of the enterohepatic circulation (biliary diversion surgery) within 6 months prior to the Screening Visit
  • Patient has had a liver transplant, or a liver transplant is planned within 6 months of Study Day 1
  • Decompensated liver disease, history or presence of clinically significant ascites, variceal hemorrhage, and/or encephalopathy
  • International normalized ratio (INR) \>1.4 (the patient may be treated with Vitamin K, and if INR is ≤1.4 at resampling the patient may be enrolled)
  • Serum alanine aminotransferase (ALT) \>10 × upper limit of normal (ULN) at Screening
  • Serum ALT \>15 × ULN at any time point during the last 6 months unless an alternate etiology was confirmed for the elevation
  • Total bilirubin \>15 × ULN at Screening
  • Patient suffers from uncontrolled, recalcitrant pruritic condition other than ALGS. Examples include, but not limited to, refractory atopic dermatitis or other primary pruritic skin diseases.
  • Patient exposed to alcohol or substance abuse in utero
  • Bile acid or lipid binding resins and medications that slow gastrointestinal motility
  • Patient has had investigational exposure to a drug, biologic agent, or medical device within 30 days prior to the Screening Visit, or 5 half-lives of the study agent, whichever is longer
  • Any other conditions or abnormalities which, in the opinion of the investigator may compromise the safety of the patient, or interfere with the patient participating in or completing the study

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Interventions

DRUGOdevixibat

Odevixibat is a small molecule and selective inhibitor of IBAT.


Locations(35)

Rady Children's Hospital

San Diego, California, United States

UCSF

San Francisco, California, United States

Children's Healthcare of Atlanta

Atlanta, Georgia, United States

Riley Hospital for Children at IU Health

Indianapolis, Indiana, United States

Johns Hopkins Hospital

Baltimore, Maryland, United States

Boston Children's Hospital

Boston, Massachusetts, United States

Children's Mercy Hospital and Clinics

Kansas City, Missouri, United States

Northwell Health System

New Hyde Park, New York, United States

Hassenfeld Children's Hospital at NYU Langone

New York, New York, United States

The Childrens Hospital at Montefiore Albert Einstein School of Medicine

The Bronx, New York, United States

Atrium Health Carolinas Medical

Durham, North Carolina, United States

Cincinnati Children's Hospital

Cincinnati, Ohio, United States

Oregon Health Science University School of Medicine

Portland, Oregon, United States

Monroe Carell Jr. Childrens Hospital at Vanderbilt

Nashville, Tennessee, United States

Childrens Medical Center of Dallas University of Texas Southwestern

Dallas, Texas, United States

Texas Children's Hospital

Houston, Texas, United States

Texas Liver Institute

San Antonio, Texas, United States

The Royal Children's Hospital Melbourne

Parkville, Victoria, Australia

Cliniques Universitaires Saint-Luc Bruxelles

Brussels, Belgium

Hôpital Femme Mère Enfant de Lyon

Bron, France

Antenne pediatrique du CIC-Hopital Jeanne De Flandre

Lille, France

Hopital Necker Enfants Malades

Paris, France

Charité - Universitätsmedizin Berlin

Berlin, Germany

Medizinische Hochschul

Hanover, Germany

Universitatsklinik fur Kinder-und Jugendmedizin Tubingen

Tübingen, Germany

AOU Meyer

Florence, Italy

Azienda Ospedale University

Padova, Italy

Ospedale Pediatrico Bambino Gesu

Rome, Italy

University of Malaya Medical Center

Kuala Lumpur, Malaysia

Universitair Medisch Centrum Groningen

Groningen, Netherlands

Wilhelmina Children's Hospital UMCU Utrecht

Utrecht, Netherlands

Instytut Pomnik-Centrum Zdrowia Dzieck

Warsaw, Poland

Istanbul University Istanbul Medical Faculty Hospital

Istanbul, Turkey (Türkiye)

Birmingham Women's and Children's NHS Foundation Trust

Birmingham, United Kingdom

King's College Hospital NHS Foundation Trust King's College Hospital Paediatric Research

London, United Kingdom

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NCT05035030


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