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    Clinical Trial Results:
    A randomized, double-blind, dose-ranging, placebo-controlled, Phase 2a evaluation of the safety, tolerability, and pharmacokinetics of PLN-74809 in participants with primary sclerosing cholangitis (PSC) and suspected liver fibrosis (INTEGRIS-PSC)

    Summary
    EudraCT number
    2020-001428-33
    Trial protocol
    GB   AT   DE   BE   FR   NL  
    Global end of trial date
    18 Mar 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    06 Apr 2025
    First version publication date
    06 Apr 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    PLN-74809-PSC-203
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04480840
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Pliant Therapeutics Inc.
    Sponsor organisation address
    331 Oyster Point Blvd, South San Francisco, United States, CA 94080
    Public contact
    Monica Sandberg, Pliant Therapeutics Inc., +1 650481 6770, Msandberg@pliantrx.com
    Scientific contact
    Eric Lefebvre, Pliant Therapeutics Inc., +1 650481 6770, ELefebvre@pliantrx.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    21 Nov 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Mar 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the safety and tolerability of PLN-74809 following daily administration for up to 12 weeks in participants with PSC in part 1 and part 2 and part 3 for at least 24 weeks and up to 48 weeks.
    Protection of trial subjects
    This study was conducted in accordance with International Conference on Harmonization (ICH) Good Clinical Practice, and the principles of the Declaration of Helsinki, in addition to following the laws and regulations of the country or countries in which a study is conducted. All study subjects were required to read and sign an Informed Consent Form.
    Background therapy
    Participants who were receiving the following medications were allowed: treatment with UDCA, therapy is at a dose of < 25 mg/kg/day, has been stable for at least 3 months before screening concomitant medications for the treatment of IBD, therapy was stable from screening and expected to remain stable for the duration of the study.
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Aug 2020
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 44
    Country: Number of subjects enrolled
    United States: 43
    Country: Number of subjects enrolled
    Australia: 8
    Country: Number of subjects enrolled
    Netherlands: 3
    Country: Number of subjects enrolled
    United Kingdom: 10
    Country: Number of subjects enrolled
    Austria: 7
    Country: Number of subjects enrolled
    Belgium: 2
    Country: Number of subjects enrolled
    France: 1
    Country: Number of subjects enrolled
    Germany: 3
    Worldwide total number of subjects
    121
    EEA total number of subjects
    16
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    110
    From 65 to 84 years
    11
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were screened at 52 centers in 9 countries. This study was divided into 3 parts, each study part included an up to 42-day Screening period, followed by a treatment period of either 12 weeks (Parts 1 and 2) or at least 24 weeks and up to 48 weeks (Part 3), and finally a 4-week post-treatment follow-up period.

    Pre-assignment
    Screening details
    201 participants underwent Screening: 102 participants failed screening and 28 participants were rescreened, of whom 18 were randomized. In total, 112 screen failures including both participants who were counted twice due to re-screening and those who were an initial screening failure but successfully

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Part 1: Bexotegrast 40 mg
    Arm description
    Part 1: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 40 mg) and finally 4-week post-treatment follow-up period. Participants took either Bexotegrast 40mg or a matching placebo
    Arm type
    Experimental

    Investigational medicinal product name
    PLN-74809
    Investigational medicinal product code
    Other name
    Bexotegrast
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug (Bexotegrast 40 mg) will be taken once daily at approximately 24-hour intervals. Participants will take the study drug on an empty stomach (no food for 2 hours before or 2 hours after dosing) and will drink approximately 240 mL (~1 cup) of water after swallowing the study drug

    Arm title
    Part 2: Bexotegrast 80 mg
    Arm description
    Part 2: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 80 mg) and finally 4-week post-treatment follow-up period Participants took either Bexotegrast 80mg or a matching placebo
    Arm type
    Experimental

    Investigational medicinal product name
    PLN-74809
    Investigational medicinal product code
    Other name
    Bexotegrast
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug (Bexotegrast 80 mg) will be taken once daily at approximately 24-hour intervals. Participants will take the study drug on an empty stomach (no food for 2 hours before or 2 hours after dosing) and will drink approximately 240 mL (~1 cup) of water after swallowing the study drug

    Arm title
    Part 2: Bexotegrast 160 mg
    Arm description
    Part 2: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 160 mg) and finally 4-week post-treatment follow-up period Participants took either Bexotegrast 160mg or a matching placebo
    Arm type
    Experimental

    Investigational medicinal product name
    PLN-74809
    Investigational medicinal product code
    Other name
    Bexotegrast
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug (Bexotegrast 160 mg) will be taken once daily at approximately 24-hour intervals. Participants will take the study drug on an empty stomach (no food for 2 hours before or 2 hours after dosing) and will drink approximately 240 mL (~1 cup) of water after swallowing the study drug

    Arm title
    Part 3: Bexotegrast 320 mg
    Arm description
    Part 3: 42-day Screening period, followed by a treatment period for at least 24 weeks and up to 48 weeks (Bexotegrast 320 mg) and finally 4-week post-treatment follow-up period. ongoing safety and liver assessments continued until the last participant reached 24 weeks of the study; therefore, safety and laboratory assessments could extend to up to 48 weeks. 4 participants in Part 3 previously completed participation in either Part 1 or Part 2 with a minimum of 6 months between completion of the earlier part and participation in Part 3
    Arm type
    Experimental

    Investigational medicinal product name
    PLN-74809
    Investigational medicinal product code
    Other name
    Bexotegrast
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug (Bexotegrast 320 mg) will be taken once daily at approximately 24-hour intervals. Participants will take the study drug on an empty stomach (no food for 2 hours before or 2 hours after dosing) and will drink approximately 240 mL (~1 cup) of water after swallowing the study drug

    Arm title
    Placebo
    Arm description
    Matching placebo tablets
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Study drug (placebo) will be taken once daily at approximately 24-hour intervals. Participants will take the study drug on an empty stomach (no food for 2 hours before or 2 hours after dosing) and will drink approximately 240 mL (~1 cup) of water after swallowing the study drug

    Number of subjects in period 1
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Started
    24
    20
    20
    27
    30
    Completed
    22
    19
    19
    23
    28
    Not completed
    2
    1
    1
    4
    2
         Consent withdrawn by subject
    -
    -
    -
    2
    -
         Adverse event, non-fatal
    1
    1
    1
    1
    2
         Other
    -
    -
    -
    1
    -
         Protocol deviation
    1
    -
    -
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Part 1: Bexotegrast 40 mg
    Reporting group description
    Part 1: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 40 mg) and finally 4-week post-treatment follow-up period. Participants took either Bexotegrast 40mg or a matching placebo

    Reporting group title
    Part 2: Bexotegrast 80 mg
    Reporting group description
    Part 2: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 80 mg) and finally 4-week post-treatment follow-up period Participants took either Bexotegrast 80mg or a matching placebo

    Reporting group title
    Part 2: Bexotegrast 160 mg
    Reporting group description
    Part 2: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 160 mg) and finally 4-week post-treatment follow-up period Participants took either Bexotegrast 160mg or a matching placebo

    Reporting group title
    Part 3: Bexotegrast 320 mg
    Reporting group description
    Part 3: 42-day Screening period, followed by a treatment period for at least 24 weeks and up to 48 weeks (Bexotegrast 320 mg) and finally 4-week post-treatment follow-up period. ongoing safety and liver assessments continued until the last participant reached 24 weeks of the study; therefore, safety and laboratory assessments could extend to up to 48 weeks. 4 participants in Part 3 previously completed participation in either Part 1 or Part 2 with a minimum of 6 months between completion of the earlier part and participation in Part 3

    Reporting group title
    Placebo
    Reporting group description
    Matching placebo tablets

    Reporting group values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo Total
    Number of subjects
    24 20 20 27 30 121
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    46.9 ( 15.06 ) 40.5 ( 15.32 ) 45.1 ( 12.65 ) 47.1 ( 14.47 ) 45.2 ( 11.65 ) -
    Gender categorical
    Units: Subjects
        Female
    7 4 6 14 6 37
        Male
    17 16 14 13 24 84
    Fertility Status
    Units: Subjects
        Childbearing Potential
    1 3 3 1 3 11
        Post-Menopausal
    3 1 3 11 2 20
        Surgically Sterile
    3 0 0 1 1 5
        Missing
    0 0 0 1 0 1
        Not Female
    17 16 14 13 24 84
    Participant taking UDCA
    Units: Subjects
        Yes
    14 15 13 18 19 79
        No
    10 5 7 9 11 42
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    1 1 2 0 3 7
        Not Hispanic or Latino
    23 18 18 25 26 110
        Not Reported/ Unknown
    0 1 0 2 1 4
    Race
    Units: Subjects
        White
    20 16 18 26 25 105
        Black or African American
    2 2 1 0 2 7
        Asian
    2 1 1 1 1 6
        American Indian or Alaska Native
    0 0 0 0 0 0
        Nativ Hawaiian or Other Pacific Islander
    0 0 0 0 0 0
        Not Reported/Unknown
    0 0 0 0 2 2
        Other
    0 1 0 0 0 1
    Duration of UDCA Use
    Units: Years
        arithmetic mean (standard deviation)
    8.27 ( 4.551 ) 7.75 ( 10.837 ) 4.60 ( 4.034 ) 7.64 ( 6.325 ) 5.17 ( 6.241 ) -
    Height at Screening
    Units: cm
        arithmetic mean (standard deviation)
    175.37 ( 9.509 ) 175.95 ( 9.155 ) 173.69 ( 9.876 ) 173.17 ( 9.655 ) 176.71 ( 9.127 ) -
    Weight at Screening
    Units: kg
        arithmetic mean (standard deviation)
    86.64 ( 15.718 ) 81.77 ( 14.098 ) 80.59 ( 16.774 ) 74.09 ( 13.375 ) 82.94 ( 15.217 ) -
    BMI at Screening
    Units: kg/m2
        arithmetic mean (standard deviation)
    28.21 ( 5.167 ) 26.45 ( 4.506 ) 26.82 ( 5.950 ) 24.60 ( 3.069 ) 26.44 ( 3.562 ) -
    Duration Since Diagnosis
    Units: Years
        arithmetic mean (standard deviation)
    11.1 ( 8.15 ) 8.3 ( 7.97 ) 7.8 ( 6.78 ) 9.4 ( 11.20 ) 9.0 ( 7.34 ) -
    Subject analysis sets

    Subject analysis set title
    Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety population is defined as all randomized participants who receive at least 1 dose of study drug.

    Subject analysis set title
    PD Analysis Set
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    The PD analysis population is defined as all participants in the safety population who have an evaluable baseline and at least 1 evaluable postbaseline PD measurement.

    Subject analysis set title
    PK Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The PK concentration population is defined as all participants in the safety population who have any valid PLN-74809 concentration data not including BLQ values.

    Subject analysis sets values
    Safety Population PD Analysis Set PK Analysis Set
    Number of subjects
    121
    121
    121
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
        From 65-84 years
        85 years and over
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    44.9 ( 13.91 )
    44.9 ( 13.91 )
    44.9 ( 13.91 )
    Gender categorical
    Units: Subjects
        Female
    37
    37
    37
        Male
    84
    84
    84
    Fertility Status
    Units: Subjects
        Childbearing Potential
    11
    11
    11
        Post-Menopausal
    20
    20
    20
        Surgically Sterile
    5
    5
    5
        Missing
    1
    1
    1
        Not Female
    84
    84
    84
    Participant taking UDCA
    Units: Subjects
        Yes
    79
    79
    79
        No
    42
    42
    42
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    7
    79
    79
        Not Hispanic or Latino
    110
    110
    110
        Not Reported/ Unknown
    4
    4
    4
    Race
    Units: Subjects
        White
    105
    105
    105
        Black or African American
    7
    7
    7
        Asian
    6
    6
    6
        American Indian or Alaska Native
    0
    0
    0
        Nativ Hawaiian or Other Pacific Islander
    0
    0
    0
        Not Reported/Unknown
    2
    2
    2
        Other
    1
    1
    1
    Duration of UDCA Use
    Units: Years
        arithmetic mean (standard deviation)
    6.70 ( 6.886 )
    6.70 ( 6.886 )
    6.7 ( 6.886 )
    Height at Screening
    Units: cm
        arithmetic mean (standard deviation)
    175.05 ( 9.434 )
    175.05 ( 9.434 )
    175.05 ( 9.434 )
    Weight at Screening
    Units: kg
        arithmetic mean (standard deviation)
    81.36 ( 15.484 )
    81.36 ( 15.484 )
    81.36 ( 15.484 )
    BMI at Screening
    Units: kg/m2
        arithmetic mean (standard deviation)
    26.52 ( 4.566 )
    26.52 ( 4.566 )
    26.52 ( 4.566 )
    Duration Since Diagnosis
    Units: Years
        arithmetic mean (standard deviation)
    9.0 ( 8.42 )
    9.0 ( 8.42 )
    9.0 ( 8.42 )

    End points

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    End points reporting groups
    Reporting group title
    Part 1: Bexotegrast 40 mg
    Reporting group description
    Part 1: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 40 mg) and finally 4-week post-treatment follow-up period. Participants took either Bexotegrast 40mg or a matching placebo

    Reporting group title
    Part 2: Bexotegrast 80 mg
    Reporting group description
    Part 2: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 80 mg) and finally 4-week post-treatment follow-up period Participants took either Bexotegrast 80mg or a matching placebo

    Reporting group title
    Part 2: Bexotegrast 160 mg
    Reporting group description
    Part 2: 42-day Screening period, followed by a treatment period of 12 weeks (Bexotegrast 160 mg) and finally 4-week post-treatment follow-up period Participants took either Bexotegrast 160mg or a matching placebo

    Reporting group title
    Part 3: Bexotegrast 320 mg
    Reporting group description
    Part 3: 42-day Screening period, followed by a treatment period for at least 24 weeks and up to 48 weeks (Bexotegrast 320 mg) and finally 4-week post-treatment follow-up period. ongoing safety and liver assessments continued until the last participant reached 24 weeks of the study; therefore, safety and laboratory assessments could extend to up to 48 weeks. 4 participants in Part 3 previously completed participation in either Part 1 or Part 2 with a minimum of 6 months between completion of the earlier part and participation in Part 3

    Reporting group title
    Placebo
    Reporting group description
    Matching placebo tablets

    Subject analysis set title
    Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety population is defined as all randomized participants who receive at least 1 dose of study drug.

    Subject analysis set title
    PD Analysis Set
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    The PD analysis population is defined as all participants in the safety population who have an evaluable baseline and at least 1 evaluable postbaseline PD measurement.

    Subject analysis set title
    PK Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The PK concentration population is defined as all participants in the safety population who have any valid PLN-74809 concentration data not including BLQ values.

    Primary: Number of Participants with Treatment-Emergent Adverse Events

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    End point title
    Number of Participants with Treatment-Emergent Adverse Events [1]
    End point description
    The primary endpoint is the nature and proportion of treatment-emergent adverse events (TEAEs) between PLN-74809 and placebo groups (descriptive)
    End point type
    Primary
    End point timeframe
    Up to 40 Weeks
    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: There is no statistical analysis planned for the number of TEAEs
    End point values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo Safety Population
    Number of subjects analysed
    24
    20
    20
    27
    30
    121
    Units: Subjects
    10
    16
    15
    23
    21
    64
    No statistical analyses for this end point

    Primary: Number of Participants with Serious Treatment-Emergent Adverse Events

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    End point title
    Number of Participants with Serious Treatment-Emergent Adverse Events [2]
    End point description
    End point type
    Primary
    End point timeframe
    Up to 40 Weeks
    Notes
    [2] - 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: There is no statistical analysis planned for the number of TEAEs
    End point values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo Safety Population
    Number of subjects analysed
    24
    20
    20
    27
    30
    121
    Units: Subjects
    1
    1
    0
    1
    1
    4
    No statistical analyses for this end point

    Secondary: Plasma Concentration at Week 12, 2 Hour Post Dose

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    End point title
    Plasma Concentration at Week 12, 2 Hour Post Dose
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 12 weeks
    End point values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    21
    18
    19
    24
    22
    Units: ng/mL
        arithmetic mean (standard deviation)
    638.71 ( 378.193 )
    843.06 ( 474.312 )
    2035.95 ( 1020.567 )
    3667.50 ( 1598.067 )
    0 ( 0 )
    No statistical analyses for this end point

    Other pre-specified: Plasma Concentration at Week 24, 2 Hour Post Dose

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    End point title
    Plasma Concentration at Week 24, 2 Hour Post Dose [3]
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 24 weeks
    Notes
    [3] - 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: Only Part 3 and Placebo continued to Week 24
    End point values
    Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    22
    9
    Units: ng/mL
        arithmetic mean (standard deviation)
    3583.64 ( 1642.404 )
    0 ( 0 )
    No statistical analyses for this end point

    Other pre-specified: Percent Change from Baseline PRO-C3 Liver Fibrosis Biomarker at Week 12

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    End point title
    Percent Change from Baseline PRO-C3 Liver Fibrosis Biomarker at Week 12
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 12 weeks
    End point values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    21
    17
    18
    25
    28
    Units: ng/mL
        arithmetic mean (standard deviation)
    -3.78 ( 20.471 )
    7.12 ( 20.328 )
    5.20 ( 30.899 )
    2.70 ( 36.130 )
    22.35 ( 53.183 )
    No statistical analyses for this end point

    Other pre-specified: Percent Change from Baseline PRO-C3 Liver Fibrosis Biomarker at Week 24

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    End point title
    Percent Change from Baseline PRO-C3 Liver Fibrosis Biomarker at Week 24 [4]
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 24 weeks
    Notes
    [4] - 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: Only Part 3 and Placebo continued to Week 24
    End point values
    Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    23
    9
    Units: ng/mL
        arithmetic mean (standard deviation)
    -12.74 ( 26.539 )
    -1.38 ( 36.859 )
    No statistical analyses for this end point

    Other pre-specified: Change from Baseline Enhanced Liver Fibrosis (ELF) Total Score at Week 12

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    End point title
    Change from Baseline Enhanced Liver Fibrosis (ELF) Total Score at Week 12
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 12 weeks
    End point values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    21
    19
    19
    26
    28
    Units: unitless
        arithmetic mean (standard deviation)
    0.16 ( 0.58 )
    0.19 ( 0.51 )
    0.09 ( 0.55 )
    0.19 ( 0.59 )
    0.42 ( 0.745 )
    No statistical analyses for this end point

    Other pre-specified: Change from Baseline Enhanced Liver Fibrosis (ELF) Total Score at Week 24

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    End point title
    Change from Baseline Enhanced Liver Fibrosis (ELF) Total Score at Week 24 [5]
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 24 weeks
    Notes
    [5] - 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: Only Part 3 and Placebo continued to Week 24
    End point values
    Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    24
    9
    Units: unitless
        arithmetic mean (standard deviation)
    0.19 ( 7.64 )
    0.14 ( 0.58 )
    No statistical analyses for this end point

    Other pre-specified: Change from Baseline Serum Alkaline Phosphatase (ALP) at Week 12

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    End point title
    Change from Baseline Serum Alkaline Phosphatase (ALP) at Week 12
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 12 weeks
    End point values
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    22
    19
    19
    25
    28
    Units: U/L
        arithmetic mean (standard deviation)
    7.5 ( 83.20 )
    4.8 ( 33.56 )
    -7.5 ( 34.63 )
    1.7 ( 44.81 )
    40.2 ( 130.94 )
    No statistical analyses for this end point

    Other pre-specified: Change from Baseline Alkaline Phosphatase (ALP) at Week 24

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    End point title
    Change from Baseline Alkaline Phosphatase (ALP) at Week 24 [6]
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Up to 24 weeks
    Notes
    [6] - 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: Only Part 3 and Placebo continued to Week 24
    End point values
    Part 3: Bexotegrast 320 mg Placebo
    Number of subjects analysed
    24
    9
    Units: U/L
        arithmetic mean (standard deviation)
    -26.1 ( 66.55 )
    34.4 ( 56.57 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 40 weeks
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.0
    Reporting groups
    Reporting group title
    Part 1: Bexotegrast 40 mg
    Reporting group description
    The Safety analysis population includes all randomized participants who receive at least one dose of study drug.

    Reporting group title
    Part 2: Bexotegrast 80 mg
    Reporting group description
    -

    Reporting group title
    Part 2: Bexotegrast 160 mg
    Reporting group description
    -

    Reporting group title
    Part 3: Bexotegrast 320 mg
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Serious adverse events
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 24 (4.17%)
    1 / 20 (5.00%)
    0 / 20 (0.00%)
    1 / 27 (3.70%)
    1 / 30 (3.33%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 24 (4.17%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    0 / 24 (0.00%)
    1 / 20 (5.00%)
    0 / 20 (0.00%)
    1 / 27 (3.70%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 24 (4.17%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Enterobacter bacteraemia
         subjects affected / exposed
    0 / 24 (0.00%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    1 / 27 (3.70%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Part 1: Bexotegrast 40 mg Part 2: Bexotegrast 80 mg Part 2: Bexotegrast 160 mg Part 3: Bexotegrast 320 mg Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 24 (41.67%)
    16 / 20 (80.00%)
    15 / 20 (75.00%)
    23 / 27 (85.19%)
    21 / 30 (70.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 24 (0.00%)
    0 / 20 (0.00%)
    2 / 20 (10.00%)
    0 / 27 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    2
    0
    0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 24 (0.00%)
    0 / 20 (0.00%)
    2 / 20 (10.00%)
    0 / 27 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    2
    0
    1
    Headache
         subjects affected / exposed
    1 / 24 (4.17%)
    2 / 20 (10.00%)
    3 / 20 (15.00%)
    3 / 27 (11.11%)
    4 / 30 (13.33%)
         occurrences all number
    1
    2
    3
    3
    5
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    3 / 24 (12.50%)
    2 / 20 (10.00%)
    4 / 20 (20.00%)
    3 / 27 (11.11%)
    5 / 30 (16.67%)
         occurrences all number
    3
    2
    5
    3
    6
    Pyrexia
         subjects affected / exposed
    1 / 24 (4.17%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    1
    0
    0
    0
    4
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    1 / 24 (4.17%)
    2 / 20 (10.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    2
    0
    0
    1
    Abdominal pain upper
         subjects affected / exposed
    2 / 24 (8.33%)
    2 / 20 (10.00%)
    0 / 20 (0.00%)
    2 / 27 (7.41%)
    1 / 30 (3.33%)
         occurrences all number
    2
    2
    0
    2
    1
    Colitis ulcerative
         subjects affected / exposed
    0 / 24 (0.00%)
    1 / 20 (5.00%)
    0 / 20 (0.00%)
    3 / 27 (11.11%)
    0 / 30 (0.00%)
         occurrences all number
    0
    1
    0
    3
    0
    Constipation
         subjects affected / exposed
    1 / 24 (4.17%)
    2 / 20 (10.00%)
    1 / 20 (5.00%)
    0 / 27 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    2
    1
    0
    1
    Diarrhoea
         subjects affected / exposed
    2 / 24 (8.33%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    4 / 27 (14.81%)
    0 / 30 (0.00%)
         occurrences all number
    2
    0
    0
    4
    0
    Dyspepsia
         subjects affected / exposed
    0 / 24 (0.00%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    0
    0
    0
    0
    3
    Frequent bowel movements
         subjects affected / exposed
    0 / 24 (0.00%)
    3 / 20 (15.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    0
    3
    0
    0
    4
    Nausea
         subjects affected / exposed
    1 / 24 (4.17%)
    2 / 20 (10.00%)
    3 / 20 (15.00%)
    1 / 27 (3.70%)
    0 / 30 (0.00%)
         occurrences all number
    1
    2
    3
    1
    0
    Vomiting
         subjects affected / exposed
    1 / 24 (4.17%)
    2 / 20 (10.00%)
    0 / 20 (0.00%)
    2 / 27 (7.41%)
    0 / 30 (0.00%)
         occurrences all number
    1
    2
    0
    2
    0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    0 / 24 (0.00%)
    1 / 20 (5.00%)
    1 / 20 (5.00%)
    1 / 27 (3.70%)
    4 / 30 (13.33%)
         occurrences all number
    0
    2
    1
    3
    6
    Ocular Icterus
         subjects affected / exposed
    0 / 24 (0.00%)
    0 / 20 (0.00%)
    0 / 20 (0.00%)
    0 / 27 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    0
    0
    0
    0
    3
    Infections and infestations
    COVID-19
         subjects affected / exposed
    2 / 24 (8.33%)
    1 / 20 (5.00%)
    0 / 20 (0.00%)
    5 / 27 (18.52%)
    4 / 30 (13.33%)
         occurrences all number
    2
    1
    0
    5
    4
    Nasopharyngitis
         subjects affected / exposed
    0 / 24 (0.00%)
    2 / 20 (10.00%)
    0 / 20 (0.00%)
    5 / 27 (18.52%)
    1 / 30 (3.33%)
         occurrences all number
    0
    3
    0
    6
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    27 Apr 2020
    Protocol amendment 1 Version 1.0 US (Sequential dosing): Removed Part 2
    06 May 2020
    Protocol amendment 1 Version 1.1 (Parallel dosing): Removed Part 2
    14 Dec 2020
    Protocol amendment 2 Version 1.0 (Sequential dosing): Corrected IND number. Investigational Plan: clarifications. Revised Inclusion Criteria: 2. Revised serum ALP concentration. Clarified and specified the criteria by which Investigators can determine suspected hepatic fibrosis. Revised platelet count. Revised exclusion criteria: Clarified worsening of liver disease. Description of Treatments: Added: Description and rationale for study doses and placebo (40, 80, and 160 mg) and study design for Part 2 Clarification that Part 2 will be randomly assigned (3:1) in parallel treatment cohorts. Selection and Timing of Dose for Each Participant: added language to provide guidance in the even a participant misses a dose of study drug. Allowed Medications: Revised prednisone doses. Disallowed Medications: Added: New contraception language for male and female participants of childbearing potential. Study Procedures: Retesting of a screening laboratory test(s) and/or ultrasound-based transient elastography (FibroScan®) may be permitted once. Liver Imaging (optional): Clarification. Electrocardiograms: Added language regarding triplicate ECG. Definition of SAEs: Added clarification as to which events would not be defined as SAEs. Early Discontinuation of Study or Individual Participants clarification. Retention for the study data for 25 years if per local requirements. Schedule of Assessments, appendix 1: Added or revised assessments to align with revised study procedures
    06 Jan 2021
    Protocol amendment 2 Version 1.1 (Parallel dosing): Corrected IND number. Investigational Plan: clarifications. Revised Inclusion Criteria: 2. Revised serum ALP concentration. Clarified and specified the criteria by which Investigators can determine suspected hepatic fibrosis. Revised platelet count. Revised exclusion criteria: Clarified worsening of liver disease. Description of Treatments: Added: Description and rationale for study doses and placebo (40, 80, and 160 mg) and study design for Part 2 Clarification that Part 2 will be randomly assigned (3:1) in parallel treatment cohorts. Selection and Timing of Dose for Each Participant: added language to provide guidance in the even a participant misses a dose of study drug. Allowed Medications: Revised prednisone doses. Disallowed Medications: Added: New contraception language for male and female participants of childbearing potential. Study Procedures: Retesting of a screening laboratory test(s) and/or ultrasound-based transient elastography (FibroScan®) may be permitted once. Liver Imaging (optional): Clarification. Electrocardiograms: Added language regarding triplicate ECG. Definition of SAEs: Added clarification as to which events would not be defined as SAEs. Early Discontinuation of Study or Individual Participants clarification. Retention for the study data for 25 years if per local requirements. Schedule of Assessments, appendix 1: Added or revised assessments to align with revised study procedures
    10 Jan 2022
    Protocol amendment 3 Version 1.0 (Sequential dosing): Added background information on bexotegrast Updated to include new information for ongoing and completed studies. Investigational Plan: Added: Description and rationale for 320 mg QD dose for Part 3 following DSMB to evaluate the current 80 and 160 mg dose from Part 2. Data are reviewed by the DSMB; removed option for review by Competent Authorities (if applicable). Revised Inclusion Criterion 7. Revised Exclusion Criterion 18. Revised Exclusion Criterion 21. New formulation (phosphate salt formulation of bexotegrast) to be used in Part 3 (supplied as 80-mg immediate-release tablets). Revised storage conditions. Blinding: Added clarification that contacting the Sponsor’s Study Director before unblinding. Added additional data from medication-medication interaction studies between bexotegrast and fluconazole and digoxin. Revised definition of postmenopausal state. Removed option for use of liver MRI within 3 months of Screening as an alternative to baseline MRI. Clarified that targeted physical examination will be performed based on prior findings in the general exam. List of Laboratory tests: Added prothrombin time (coagulation) and CA-19-9 (screening test). Clarified that pharmacogenomics sampling is optional. Causal Relationship of an Adverse Event: Corrected to Yes (related). Definition of SAEs: Clarified timing of pregnancy reporting. Added language to provide direction as to how AEs and serious adverse events are to be reported. Revision of process for reporting SAEs from utilizing EDC to pharmacovigilance vendor (CTI) Interim Analysis: Updated Section to include description of additional interim analyses. Appendix 2 Schedule of Assessments: Part 3: Added assessments and visits for Part 3.
    11 Jan 2022
    Protocol amendment 3 Version 1.1 (Parallel dosing): Added background information on bexotegrast Updated to include new information for ongoing and completed studies. Investigational Plan: Added: Description and rationale for 320 mg QD dose for Part 3 following DSMB to evaluate the current 80 and 160 mg dose from Part 2. Data are reviewed by the DSMB; removed option for review by Competent Authorities (if applicable). Revised Inclusion Criterion 7. Revised Exclusion Criterion 18. Revised Exclusion Criterion 21. New formulation (phosphate salt formulation of bexotegrast) to be used in Part 3 (supplied as 80-mg immediate-release tablets). Revised storage conditions. Blinding: Added clarification that contacting the Sponsor’s Study Director before unblinding. Added additional data from medication-medication interaction studies between bexotegrast and fluconazole and digoxin. Revised definition of postmenopausal state. Removed option for use of liver MRI within 3 months of Screening as an alternative to baseline MRI. Clarified that targeted physical examination will be performed based on prior findings in the general exam. List of Laboratory tests: Added prothrombin time (coagulation) and CA-19-9 (screening test). Clarified that pharmacogenomics sampling is optional. Causal Relationship of an Adverse Event: Corrected to Yes (related). Definition of SAEs: Clarified timing of pregnancy reporting. Added language to provide direction as to how AEs and serious adverse events are to be reported. Revision of process for reporting SAEs from utilizing EDC to pharmacovigilance vendor (CTI) Interim Analysis: Updated Section to include description of additional interim analyses. Appendix 2 Schedule of Assessments: Part 3: Added assessments and visits for Part 3.
    01 Nov 2022
    Protocol amendment 4 Version 1.1 (Parallel dosing): Changed Sponsor Study Director from Greg Cosgrove to Richard Pencek. Revised Inclusion Criterion 9. Revised Inclusion Criterion 10. Revised Inclusion Criterion 3. Revised Exclusion Criterion 11. Revised Exclusion Criterion 28. Revised last bullet to “Treatment with a disallowed medication, other investigational drug within 5 half-lives or 30 days before Screening, whichever time is longer, or the use of an investigational device within 30 days before Screening is prohibited.” Revised first sentence to “Prior use of an investigational drug within 5 half-lives or 30 days before Screening, whichever time is longer, or the use of an investigational device within 30 days before Screening is prohibited.” Moved examples of contraceptive methods with a failure rate of <1% per year under new subheading “Highly Effective Methods of Birth Control.” Revised the time between Visits 1 and 2 to be ≥2 weeks. Clarified that a plasma PK sample is not required at the EoS visit. Clarified that a plasma PK sample is not required at the EoS visit. Changes implemented for non-US sites: - Added Exclusion Criterion 29 to exclude participants who participated in an earlier part of the current study (ie, Part 1 or 2) within 6 months of dosing for a subsequent part (ie, Part 2 or 3); - Revised Exclusion Criterion 7.
    07 Nov 2022
    Protocol amendment 4 Version 1.0 (Sequential dosing): Changed Sponsor Study Director from Greg Cosgrove to Richard Pencek. Revised Inclusion Criterion 9. Revised Inclusion Criterion 10. Revised Inclusion Criterion 3. Revised Exclusion Criterion 11. Revised Exclusion Criterion 28. Revised last bullet to “Treatment with a disallowed medication, other investigational drug within 5 half-lives or 30 days before Screening, whichever time is longer, or the use of an investigational device within 30 days before Screening is prohibited.” Revised first sentence to “Prior use of an investigational drug within 5 half-lives or 30 days before Screening, whichever time is longer, or the use of an investigational device within 30 days before Screening is prohibited.” Moved examples of contraceptive methods with a failure rate of <1% per year under new subheading “Highly Effective Methods of Birth Control.” Revised the time between Visits 1 and 2 to be ≥2 weeks. Clarified that a plasma PK sample is not required at the EoS visit. Clarified that a plasma PK sample is not required at the EoS visit. Changes implemented for non-US sites: - Added Exclusion Criterion 29 to exclude participants who participated in an earlier part of the current study (ie, Part 1 or 2) within 6 months of dosing for a subsequent part (ie, Part 2 or 3); - Revised Exclusion Criterion 7.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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