RecruitingPhase 2NCT05639543

FXR Effect on Severe Alcohol-Associated Hepatitis (FRESH) Study

A Phase 2a, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Dose-Escalation, Proof-of-Concept Study Evaluating the Safety, Tolerability, Efficacy and Pharmacokinetics of INT-787 in Subjects With Severe Alcohol Associated Hepatitis


Sponsor

Intercept Pharmaceuticals

Enrollment

80 participants

Start Date

Dec 15, 2022

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this trial is to assess dose related safety, efficacy, and pharmacokinetics (PK) of INT-787 in participants with severe alcohol-associated hepatitis (sAH).


Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria25

  • Males or females aged 18 to 65 years (inclusive)
  • Clinical diagnosis of sAH based on all the following:
  • History of ongoing excess alcohol (>60 g/day \[male\] or >40 g/day \[female\]) use for ≥6 months, with <60 days of abstinence prior to the onset of jaundice
  • Serum total bilirubin >3.0 mg/dL
  • Aspartate aminotransferase (AST) ≥50 U/L
  • AST/Aspartate aminotransferase (ALT) ratio ≥1.5
  • Onset of jaundice within prior 8 weeks
  • Cohort 1 through Cohort 4: Maddrey's Discriminant Factor (mDF) ≥32 and ≤70
  • Cohort 5 and Cohort 6: mDF ≥32
  • Cohort 1 through Cohort 4: MELD score ≥18 to ≤25 (inclusive) and Cohort 5 and Cohort 6: MELD score ≥21 to ≤30
  • Female participants must be postmenopausal, surgically sterile, or, if premenopausal (and not surgically sterile), be prepared to use ≥1 highly effective method of contraception from the initiation of Screening and for 90 days after the last dose of investigational product as follows:
  • Surgical sterilization (bilateral tubal occlusion, etc.)
  • Placement of an intrauterine device (IUD) or intrauterine system (e.g., intrauterine hormone-releasing system \[IUS\])
  • Combined (estrogen and progesterone containing) hormonal contraceptive associated with inhibition of ovulation:
  • Oral
  • Intravaginal
  • Transdermal
  • Progesterone-only hormonal contraception associated with inhibition of ovulation:
  • Oral
  • Injectable
  • Implantable
  • Sexual abstinence: When in line with the preferred and usual lifestyle of the participant, is defined as avoiding all types of activity that could result in conception (pregnancy) from the initiation of Screening and until at least 90 days after the last dose of investigational product
  • Male participants must refrain from sperm donation from the initiation of Screening and until at least 90 days after the last dose of investigational product
  • Must provide written informed consent and agree to comply with the study protocol. In participants with hepatic encephalopathy which may impair decision-making, consent will be obtained per hospital procedures (e.g., by Legally Authorized Representative).
  • Participants must agree to participate in an alcohol use disorder program during the study period, as recommended by the local institution's addiction medicine specialists, including post-hospitalization

Exclusion Criteria26

  • Participants taking products containing obeticholic acid in the 30 days prior to randomization
  • Participants taking >2 doses of systemic corticosteroids within 30 days prior to randomization.
  • Participants who have been inpatient at a referral hospital for >7 days prior to transfer.
  • Pregnancy, planned pregnancy, potential for pregnancy (e.g., unwillingness to use effective birth control during the study), or current or planned breast feeding.
  • Abstinence from alcohol consumption for >2 months before Day 1.
  • AST or ALT >400 U/L.
  • Cohort 1 through Cohort 4: mDF <32 or >70.
  • Cohort 5 and Cohort 6: mDF <32
  • Cohort 1 through Cohort 4: MELD score <18 or >25.
  • Cohort 5 and Cohort 6: MELD <21 or >30
  • Other causes of liver disease including chronic hepatitis B (hepatitis B surface antigen \[HBsAg\] positive), chronic hepatitis C virus (HCV) RNA positive, drug-induced liver injury (DILI), biliary obstruction, and autoimmune liver disease.
  • Current or previous history of hepatocellular carcinoma (HCC)
  • History of liver transplantation or currently listed for liver transplant
  • Untreated infection (e.g., has not initiated appropriate medical treatment for infection)
  • Known positivity for human immunodeficiency virus infection
  • Uncontrolled gastrointestinal (GI) bleeding or controlled GI bleeding that was associated with shock or required transfusion of more than 3 units of blood within 7 days of Screening.
  • Kidney injury defined as a serum creatinine >133 μmol/L (>1.5 mg/dL) or the requirement for renal replacement therapy whether prior to or after study screening.
  • Portal vein thrombosis
  • Acute pancreatitis or acute gallbladder disease (e.g., cholecystitis)
  • Severe, on-going associated disease (e.g., cardiac failure, acute myocardial infarction, severe cardiac arrhythmias, severe pulmonary disease, neurologic disease)
  • Malignancy within the 2 years prior to Screening, with the exception of specific cancers that have been cured by surgical resection (e.g., basal cell skin cancer). Participants under evaluation for possible malignancy are not eligible.
  • Positive urine drug screen (amphetamines, barbiturates, benzodiazepines, cocaine, and opiates) except tetrahydrocannabinol or in the setting of documented prescription medications (e.g., opiates, benzodiazepines, amphetamines, barbiturates), which also include medications prescribed as part of in-patient management. Participants being treated for alcohol withdrawal may be exempt for this reason, verify with Medical Monitor.
  • Participated in a clinical research study and received any active investigational product being evaluated for the treatment of sAH within 3 months before Day 1
  • Participation in a study of another investigational medicine or device within 30 days before Screening
  • Any other condition or clinical laboratory result that, in the opinion of the Investigator, might confound the results, or would impede compliance or hinder completion of the study
  • Participants treated in the Dose Escalation Phase (Cohort 1 through Cohort 4) are not eligible for enrollment into an Extension Cohort (Cohort 5 and Cohort 6), and participants treated in Cohort 5 are not eligible for enrollment into Cohort 6.

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Interventions

DRUGINT-787

Blinded Study Drug

DRUGPlacebo

Placebo


Locations(31)

Stanford Healthcare

Palo Alto, California, United States

Clinical Translational Research Site

Miami, Florida, United States

Tampa General Medical Group

Tampa, Florida, United States

Rush University Medical Center

Chicago, Illinois, United States

Mercy Medical Center

Baltimore, Maryland, United States

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

UMass Memorial Medical Center

Worcester, Massachusetts, United States

Henry Ford Health System

Detroit, Michigan, United States

Mayo Clinic

Rochester, Minnesota, United States

Rutgers-New Jersey Medical School

Newark, New Jersey, United States

Northwell Health Center for Liver Disease and Transplantation

Manhasset, New York, United States

Columbia University Medical Center/New York Presbyterian Hospital

New York, New York, United States

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Medical University of South Carolina

Charleston, South Carolina, United States

Vanderbilt Digestive Disease Center

Nashville, Tennessee, United States

The Liver Institute at Methodist Dallas Medical Center

Dallas, Texas, United States

Parkland Health and Hospital System

Dallas, Texas, United States

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Baylor College of Medicine

Houston, Texas, United States

University of Utah Hospital

Salt Lake City, Utah, United States

VCU Health Clinical Research Services Unit

Richmond, Virginia, United States

CHU Angers

Angers, France, France

Hopital Beaujon

Clichy, France

Hopital Claude Huriez

Lille, France

Hopital Pitie Salpetriere

Paris, France

Hopital Rangueil

Toulouse, France

Cambridge University NHS Foundation Trust

Cambridge, United Kingdom

Royal Free Hospital

London, United Kingdom

Imperial College Healthcare NHS Trust

London, United Kingdom

King's College Hospital

London, United Kingdom

University Hospitals Plymouth NHS Trust

Plymouth, United Kingdom

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NCT05639543