Clinical Trial Results:
A Phase 2b Randomized, Double Blind, Placebo-Controlled, Multicenter Study Evaluating Safety and Efficacy of EDP-305 in Subjects with Liver-Biopsy Proven Non-Alcoholic Steatohepatitis (NASH) (ARGON-2)
Summary
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EudraCT number |
2019-003876-38 |
Trial protocol |
DE GB |
Global end of trial date |
30 Nov 2021
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Results information
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Results version number |
v1(current) |
This version publication date |
05 Jan 2023
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First version publication date |
05 Jan 2023
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
EDP305-102
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT04378010 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Enanta Pharmaceuticals, Inc.
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Sponsor organisation address |
500 Arsenal St., Watertown, MA 02472, United States,
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Public contact |
Alaa Ahmad, Enanta Pharmaceuticals, Inc., 1 617-607-0800, aahmad@enanta.com
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Scientific contact |
Alaa Ahmad, Enanta Pharmaceuticals, Inc., 1 617-607-0800, aahmad@enanta.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
12 Jul 2022
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
04 Oct 2021
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Global end of trial reached? |
Yes
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Global end of trial date |
30 Nov 2021
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
To evaluate the effect of EDP-305 compared to placebo on liver histology in non-cirrhotic NASH subjects with stage 2 or 3 fibrosis.
NOTE:
The pre-planned first interim analysis of a subjects through Week 12 provided meaningful information on dose selection and characterization for the compound. Enanta made a business decision to prioritize combination approaches for further development of the EDP-305. Therefore, this study on monotherapy was discontinued.
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Protection of trial subjects |
Independent Ethics Committee or Institutional Review Board:
Written approval of the protocol, the final informed consent document, relevant supporting material and subject recruitment information was obtained from the independent ethics committee (IEC)/institutional review board (IRB) prior to study initiation.
Ethical Conduct of the Study:
This study was conducted in accordance with current applicable regulations, International Conference on Harmonisation (ICH) guidelines, and local legal requirements. It complies with the ethical principles described in the 18th World Medical Assembly (Helsinki 1964) and amendments of the 29th (Tokyo 1975), 35th (Venice 1983), the 41st (Hong Kong 1989) and the 48th (South Africa 1996) World Medical Assemblies, Declaration of Helsinki
Subject Information and Consent:
Informed consent was obtained from each subject before the subject was admitted to the study. The Investigator did not undertake any investigation specifically required for the clinical study until valid consent had been obtained. The terms of the consent and the date and time of day when it was obtained were documented in the case report form (CRF). The consent form, with the date and time of day when it was signed, was retained by the Investigator as part of the study records. A copy of the signed informed consent form (ICF) was given to the subject.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
27 Jan 2020
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
United Kingdom: 3
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Country: Number of subjects enrolled |
United States: 92
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Country: Number of subjects enrolled |
Argentina: 1
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Country: Number of subjects enrolled |
Canada: 1
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Worldwide total number of subjects |
97
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EEA total number of subjects |
0
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
76
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From 65 to 84 years |
21
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85 years and over |
0
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Recruitment
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Recruitment details |
Male and female subjects with liver biopsy proven NASH between the ages of 18 and 75 years, inclusive, and with a NAS of 4 or greater with a score of at least 1 in each component of the NAS (steatosis scored 0-3, lobular inflammation scored 0-3, ballooning scored 0-2) and fibrosis stage 2 or 3 using the NASH (CRN) Histologic scoring system. | ||||||||||||
Pre-assignment
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Screening details |
Screening assessments were to be conducted within 70 days prior to the first dose of study drug (i.e., Study Days -70 to -1). They were to be performed sequentially as follows: a) medical history and other noninvasive assessments, b) laboratory assessments, c) MRI-PDFF and MRE and, lastly, d) liver biopsy. | ||||||||||||
Period 1
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Period 1 title |
Overall Treatment Period (overall period)
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Is this the baseline period? |
Yes | ||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||
Roles blinded |
Subject, Investigator | ||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Placebo | ||||||||||||
Arm description |
Placebo orally for 72 weeks. Matching placebo, which was identical in appearance to the test product except that it contained no active ingredient. | ||||||||||||
Arm type |
Placebo | ||||||||||||
Investigational medicinal product name |
Placebo EDP-305
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Investigational medicinal product code |
EDP-305
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Once a day orally for 72 weeks.
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Arm title
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EDP-305 1.5 mg | ||||||||||||
Arm description |
EDP-305 1.5 mg orally for 72 weeks (one 0.5 mg tablet and one 1.0 mg tablet). | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
EDP-305 1.5 mg
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Investigational medicinal product code |
EDP-305
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Oral EDP-305 tablets, 1.5 mg administered once daily.
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Arm title
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EDP-305 2 mg | ||||||||||||
Arm description |
EDP-305 2.0 mg orally for 72 weeks (two 1.0 mg tablets). | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
EDP-305 2 mg
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Investigational medicinal product code |
EDP-305
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Oral EDP-305 tablets, 2.0 mg administered once daily.
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Baseline characteristics reporting groups
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Reporting group title |
Overall Treatment Period
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Reporting group description |
- | |||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Placebo
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Reporting group description |
Placebo orally for 72 weeks. Matching placebo, which was identical in appearance to the test product except that it contained no active ingredient. | ||
Reporting group title |
EDP-305 1.5 mg
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Reporting group description |
EDP-305 1.5 mg orally for 72 weeks (one 0.5 mg tablet and one 1.0 mg tablet). | ||
Reporting group title |
EDP-305 2 mg
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Reporting group description |
EDP-305 2.0 mg orally for 72 weeks (two 1.0 mg tablets). |
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End point title |
Proportion of subjects with ≥1 stage improvement in fibrosis without worsening of steatohepatitis and/or resolution of steatohepatitis and no worsening of liver fibrosis [1] | ||||||||||||
End point description |
Proportion of subjects with ≥1 stage improvement in fibrosis without worsening of steatohepatitis and/or resolution of steatohepatitis and no worsening of liver fibrosis as determined by liver biopsy at Week 72.
NOTE:
99999: Due to study termination, the biopsy at Week 72 was not performed in any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Primary
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End point timeframe |
Screening to Week 72.
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report and no statistical analysis was performed. |
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No statistical analyses for this end point |
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End point title |
Proportion of subjects with improvement of fibrosis by at least 1 stage and/or resolution of NASH without worsening of either | ||||||||||||
End point description |
Proportion of subjects with improvement of fibrosis by at least 1 stage and/or resolution of NASH without worsening of either as determined by liver biopsy at Week 72.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With no Worsening of Fibrosis Combined With no Worsening of NASH as Determined by Liver | ||||||||||||
End point description |
Proportion of Subjects With no Worsening of Fibrosis Combined With no Worsening of NASH as Determined by Liver.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Resolution of Fibrosis | ||||||||||||
End point description |
Proportion of Subjects With Resolution of Fibrosis as Determined by Liver Biopsy at 72 Week.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Improvement in Each Histologic Feature of NASH by at Least 1 Point | ||||||||||||
End point description |
Proportion of Subjects With Improvement in Each Histologic Feature of NASH by at Least 1 Point as determined by liver biopsy at Week 72.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Improvement of Fibrosis by ≥ 2 Stages | ||||||||||||
End point description |
Proportion of Subjects With Improvement of Fibrosis by ≥ 2 Stages by Liver Biopsy at Week 72.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Improvement in NAS by at Least 2 Points With no Worsening of Fibrosis | ||||||||||||
End point description |
Proportion of Subjects With Improvement in NAS by at Least 2 Points With no Worsening of Fibrosis as determined by liver biopsy at Week 72.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Improvement of Fibrosis and Resolution of NASH | ||||||||||||
End point description |
Proportion of Subjects With Improvement of Fibrosis and Resolution of NASH as a Composite Endpoint as defined by liver biopsy at Week 72.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Resolution of NASH and no Worsening of Liver Fibrosis | ||||||||||||
End point description |
Proportion of Subjects With Resolution of NASH and no Worsening of Liver Fibrosis.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Proportion of Subjects With Histological Progression to Cirrhosis as determined by Liver Biopsy | ||||||||||||
End point description |
Proportion of Subjects With Histological Progression to Cirrhosis as determined by Liver Biopsy at Week 72.
NOTE:
Due to study termination, the biopsy at Week 72 was not performed for any subject. Hence, there were no results to report. However, the system does not allow to keep the values blank. So, we have used "99999".
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End point type |
Secondary
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End point timeframe |
Screening to Week 72.
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No statistical analyses for this end point |
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End point title |
Frequency of TEAEs Leading to Discontinuation | ||||||||||||
End point description |
Frequency of TEAEs Leading to discontinuation.
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End point type |
Secondary
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End point timeframe |
From time of informed consent through Week 72 and 4-week follow-up period.
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No statistical analyses for this end point |
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End point title |
Percentage Change of Fat in the Liver From Baseline Versus Placebo | ||||||||||||||||
End point description |
Percentage Change of Fat in the Liver From Baseline Versus Placebo.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in Liver Stiffness From Baseline Versus Placebo | ||||||||||||||||
End point description |
Change in Liver Stiffness From Baseline Versus Placebo.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in 5D-itch Scale From Baseline | ||||||||||||||||
End point description |
Change in 5D-itch Scale From Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in Triglycerides From Baseline | ||||||||||||||||
End point description |
Change in Triglycerides From Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in Adiponectin From Baseline | ||||||||||||||||
End point description |
Change in Adiponectin From Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline through Week 12.
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No statistical analyses for this end point |
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End point title |
Plasma Concentration of EDP-305 [2] | ||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
Baseline through Week 12.
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Notes [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: The Placebo arm did not take part in the determination of plasma concentration. So, we have excluded it. |
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No statistical analyses for this end point |
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End point title |
Change in VAS (Visual Analog Score) From Baseline | ||||||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in Total Cholesterol From Baseline | ||||||||||||||||
End point description |
Change in Total Cholesterol From Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in HDL From Baseline | ||||||||||||||||
End point description |
Change in HDL From Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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End point title |
Change in LDL From Baseline | ||||||||||||||||
End point description |
Change in LDL From Baseline.
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End point type |
Secondary
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End point timeframe |
Baseline to Week 12.
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Day 1 to Week 72.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
24.1
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Reporting groups
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Reporting group title |
Placebo
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Reporting group description |
Once a day tablet orally for 72 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
EDP-305 1.5 mg
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Reporting group description |
Once a day orally for 72 weeks. EDP-305 1.5 mg: Tablet. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
EDP-305 2 mg
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Reporting group description |
Once a day orally for 72 weeks. EDP-305 2 mg: Tablet. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||||||
Date |
Amendment |
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28 May 2020 |
• Inclusion criterion 11 was updated to make clear that the intention was that antihypertensive subjects would be on a stable antihypertensive regimen during the study.
• The following exclusion criteria were revised to the text as given in the CSR to capture the target subject population: exclusion criteria 5, 9, 12, 13, 14, 17, 19, 20, 25, 26. Text in other parts of the CSP were updated as appropriate to reflect changes in the exclusion criteria.
• Additional information on concomitant medications was added as follows:
Generic substitutions of all stable medications for underlying diseases were allowed during the study. Changing a medication within the same therapeutic class was also permitted during the study.
Any subject who initiated a high dose or increased to a higher dose of Vitamin E (≥800 IU/day) during the course of the study had to undergo ET procedures (including liver biopsy and imaging if beyond Week 36).
• Changes were made to update the NCI CTCAE version and provide clarification around documenting and reporting of AEs.
• At home pregnancy tests were added at Weeks 52, 60, and 68 for females of childbearing potential. Due to the 8-week timeframe between clinic visits at Weeks 48, 56, and 72, these at home pregnancy tests were added to confirm subjects did not become pregnant during the extended time between visits. To determine the results of the pregnancy tests, additional phone contacts were added
• The number of laboratory tests conducted to assess lipids and cardiovascular risk were reduced. These were no longer deemed necessary based on data readouts from previous studies. |
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21 Mar 2021 |
The screening time was extended from 8 to 10 weeks because additional time was needed to allow more flexibility for completion of all screening procedures in a sequential manner
• The inclusion criteria for MRI-PDFF ≥8% and AST >30 IU/L were added to further refine the subject population eligible for study entry and thus increase the probability of resulting in eligible liver biopsy criteria
• To avoid unnecessary burden on potential subjects, the inclusion criteria were modified to specify that screening assessments should be performed in a sequential manner and the liver biopsy should only be performed once the subject satisfied all other eligibility criteria
• To avoid confusion noted by the sites with regard to the duration of a month (i.e., 28, 30, or 31 days), durations were changed from months to corresponding weeks throughout the CSP
• Wording on Screening and use of concomitant medications was clarified with regard to rescreening options for subjects who required a medically necessary dose modification with an existing medication
• The schedule of assessments was modified so that for subjects who discontinued between Weeks 10 and 12, the MRI/MRE that would have been conducted at Week 12 was to be conducted at the EOT visit
• The wording of ECG requirements was revised to clarify ECG repeat requirements because the original language was proving to be confusing to sites. Normal ranges for ECG assessments were provided.
• Due to the COVID 19 pandemic, provisions were added to clarify options for rescreening subjects who were affected by COVID 19
• Wording regarding the reporting of AEs was revised to simplify the recording requirements for AEs and all AEs collected would be entered into the eCRF
• Clarified that DLQI was only to be completed at each in-clinic visit as opposed to all visits
• The wording was revised to emphasize the need for reviewing eligibility criteria and detailing the definition of women childbearing potential. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? Yes | |||||||
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Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||||||
No limitations reported for the study. |