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The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
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    The EU Clinical Trials Register currently displays   43845   clinical trials with a EudraCT protocol, of which   7282   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
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    EudraCT Number:2021-001810-13
    Sponsor's Protocol Code Number:GSN000350
    National Competent Authority:Greece - EOF
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-11-12
    Trial results
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    A. Protocol Information
    A.1Member State ConcernedGreece - EOF
    A.2EudraCT number2021-001810-13
    A.3Full title of the trial
    TRANSFORM: A 52-week, Randomized, Placebo-controlled, Double-blind, Adaptive Phase 2b/3 Trial of Setanaxib with a 52-week Extension Phase in Patients with Primary Biliary Cholangitis (PBC) and Elevated Liver Stiffness
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Trial of Setanaxib in Patients With Primary Biliary Cholangitis (PBC) and Liver Stiffness (TRANSFORM)
    A.3.2Name or abbreviated title of the trial where available
    A.4.1Sponsor's protocol code numberGSN000350
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT05014672
    A.5.4Other Identifiers
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorCalliditas Therapeutics Suisse SA
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportCalliditas Therapeutics AB
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPRA Health Sciences
    B.5.2Functional name of contact pointNelly Ekaterinaki
    B.5.3 Address:
    B.5.3.1Street Address4130 Park Lake Avenue, Suite 400
    B.5.3.2Town/ cityRaleigh, North Carolina
    B.5.3.3Post code27612
    B.5.3.4CountryUnited States
    B.5.4Telephone number+44 7775028032
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/20/2387
    D.3 Description of the IMP
    D.3.1Product nameSETANAXIB
    D.3.2Product code GKT137831
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNSetanaxib
    D.3.9.1CAS number 1218942-37-0
    D.3.9.2Current sponsor codeGKT137831
    D.3.9.3Other descriptive nameGYPP-06 (GKT137831 free base), C10071301-D
    D.3.9.4EV Substance CodeSUB195304
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number400
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D. cell therapy medicinal product No
    D. therapy medical product No
    D. Engineered Product No
    D. ATIMP (i.e. one involving a medical device) No
    D. on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Primary Biliary Cholangitis (PBC) and Elevated Liver Stiffness
    E.1.1.1Medical condition in easily understood language
    Liver disease caused by autoimmune attack on the small to medium bile ducts
    E.1.1.2Therapeutic area Diseases [C] - Digestive System Diseases [C06]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10080429
    E.1.2Term Primary biliary cholangitis
    E.1.2System Organ Class 10019805 - Hepatobiliary disorders
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the effect of setanaxib on biochemical response at Week 52 in patients with PBC and with elevated liver stiffness and intolerance or inadequate response to ursodeoxycholic acid (UDCA)
    E.2.2Secondary objectives of the trial
    - To evaluate the effect of setanaxib on fatigue at Week 52
    - To evaluate the effect of setanaxib on liver stiffness at Week 52
    - To evaluate the effect of setanaxib on pruritus at Week 52
    - To evaluate the safety and tolerability of setanaxib over a 52-week Treatment Period
    - To further evaluate the safety and tolerability of setanaxib in patients with PBC and with elevated liver stiffness and intolerance or inadequate response to UDCA (Extension phase)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Male or female patient aged ≥18 years, inclusive at the time of informed consent.
    2. Willing and able to give written informed consent and to comply with the requirements of the study.
    3. Definite or probable PBC diagnosis as demonstrated by the presence of ≥2 of the following 3 diagnostic factors:
    a. Documented history of elevated ALP levels ≥1.67×ULN of the local reference range.
    b. Documented history of positive AMA titer or positive PBC specific antibodies (anti-GP210 or anti-SP100 or antibodies against the major M2 components [PDC-E2, 2-oxo-glutaric acid dehydrogenase complex]).
    c. Historical liver biopsy consistent with PBC.
    4. Serum ALP ≥1.67×ULN at Screening.
    One repeat blood sampling (with analysis by the central laboratory) can be performed at the discretion of the Investigator at Screening Visit 2 for patients who do not meet this inclusion criterion at Screening Visit 1. If this inclusion criterion is then met at Screening Visit 2, the patient may be eligible for the study.
    5. Liver stiffness measured by transient elastography (FibroScan®) of ≥8.0 kPa and an interquartile range over median ratio (IQR/med) of ≤30% at Screening, are taken with the results expressed in kilopascals [kPa]).
    6. UDCA prescriptional dose use for the past 6 months (at a stable dose for >3 months prior to Screening) OR intolerant to UDCA (last dose of UDCA >3 months prior to Screening). Intolerance to UDCA is defined as patients unable to tolerate the full-labelled dose of UDCA in PBC (13-15 mg/kg) due to frequently reported gastrointestinal symptoms such as diarrhea and abdominal pain.
    7. For patients receiving OCA, fenofibrate, or bezafibrate treatment for at least 6 months and stable dose for >3 months prior to Screening.
    8. For patients intolerant to OCA, OCA must have been discontinued >3 months prior to Screening.
    9. For patients previously treated with bezafibrate or fenofibrate, and these agents were discontinued prior to Screening, they must have been discontinued >3 months prior to Screening.
    10. Female patients of childbearing potential must use a highly effective method of contraception to prevent pregnancy for ≥4 weeks before Randomization and must agree to continue strict contraception up to 90 days after the last dose of IMP.
    a. For the purposes of this study, women of childbearing potential are defined as “Fertile, following menarche and until becoming postmenopausal unless permanently sterile. Permanent sterilization methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy.”
    b. Postmenopausal state is defined as no menses for 12 months without an alternative medical cause. In female patients who are not using hormonal contraception or hormonal replacement therapy but with suspected menopause and less than 12 months of amenorrhea, a high follicle stimulating hormone (FSH) level in the postmenopausal range will be required at Screening to confirm a postmenopausal state. Confirmation with more than one FSH measurement is required.
    c. Highly effective contraception is defined as methods that can achieve a failure rate of less than 1% per year when used consistently and correctly. These methods are:
    (1) Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, or transdermal)
    (2) Progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable)
    (3) Intrauterine device
    (4) Intrauterine hormone-releasing system
    (5) Bilateral tubal occlusion
    (6) Vasectomized partner
    (7) Sexual abstinence (refraining from heterosexual intercourse during the entire period of risk associated with the study treatments). The reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical study and the preferred and usual lifestyle of the patient.
    Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception).
    Female condom and male condom should not be used together.
    11. Female patients of childbearing potential must have a negative serum pregnancy test at Screening and a negative urine pregnancy test at Baseline/Randomization before dosing.
    12. Male patients with female partners of childbearing potential must be willing to use a condom and require their partner to use a highly effective contraceptive method (as defined in the list in item 10c). This requirement begins at the time of informed consent and ends 90 days after receiving the last dose of IMP.
    13. Male patients must be willing not to donate sperm, and female study patients must be willing not to donate eggs, from Baseline until 90 days after the last dose of IMP.
    E.4Principal exclusion criteria
    1. A positive pregnancy test or breastfeeding for female patients.
    2. Any historical or current hepatic decompensation event defined as variceal/portal hypertension bleed and/or hepatic encephalopathy, spontaneous bacterial peritonitis, ascites requiring treatment, or liver transplantation list inclusion.
    3. History of liver transplantation, current placement on a liver transplant list or current MELD score of ≥12 unless the patient is on anticoagulant therapy, or a Child Pugh Score of ≥6.
    4. Cirrhosis with complications, including history or presence of hepatocellular carcinoma.
    5. Total bilirubin >2×ULN. In case of total bilirubin elevation >ULN the Screening serum albumin must be within the reference range.
    One repeat blood sampling (with analysis by the central laboratory) can be performed at the discretion of the Investigator at Screening Visit 2 for patients who meet this exclusion criterion at Screening Visit 1. If this exclusion criterion is not met at Screening Visit 2, the patient may be eligible for the study.
    6. Plasma ALT >3×ULN and/or AST >3×ULN.
    7. INR >1.2 unless patient is on anticoagulant therapy.
    8. Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2, as calculated by the central laboratory using the chronic kidney disease epidemiology collaboration (CKDEPI) equation.
    9. Thyroid stimulating hormone >ULN at Screening.
    10. Competing etiology for liver disease (eg, hepatitis C [unless effectively cured of hepatitis C, with a sustained virologic response for at least 6 months prior to Screening], active hepatitis B [HBsAg positive], nonalcoholic steatohepatitis [NASH], alcoholic liver disease, autoimmune hepatitis, autoimmune hepatitis PBC overlap syndrome, primary sclerosing cholangitis, Gilbert’s Syndrome).
    11. Medical conditions that could cause nonhepatic increases in ALP (eg, Paget's disease).
    12. Known history of HIV infection. If the anti-HIV antibody test is positive, HIV RNA negativity has to be confirmed by the central laboratory.
    13. Surgery (eg, stomach bypass) or medical condition that might significantly affect absorption of medicines (as judged by the Investigator).
    14. Positive urine drug screen (if not due to prescriptional use of a concomitant medication, as confirmed by the Investigator) at Screening. Patients on stable methadone or buprenorphine maintenance treatment for at least 6 months prior to Screening Visit 1 may be included in the study. Medicinal cannabis and cannabidiol products are not allowed.
    15. Patients receiving prohibited medications within 3 months of Screening Visit 1 as specified in Section 6.6 and 6.7.
    16. Treatment with any investigational agent within 12 weeks of Screening Visit 1 or 5 half-lives of the IMP (if known) (whichever is longer) or current enrollment in an interventional clinical study.
    17. Evidence of any of the following cardiac conduction abnormalities: A QTc Fridericia interval >450 milliseconds for males or >470 milliseconds for females, as calculated by the central reader. Patients with a second or third degree atrioventricular block are to be excluded.
    18. For patients in the US, in patients treated with or for planned treatment with a pacemaker, implanted cardioverter defibrillator, or other implanted electronic device, FibroScan® assessments will be prohibited.
    19. History of a malignancy within 5 years of Screening with the following exceptions:
    a. Adequately treated carcinoma in situ of the cervix
    b. Adequately treated basal or squamous cell cancer or other localized nonmelanoma skin cancer.
    20. The occurrence of any acute infection requiring systemic antibiotic therapy within the 2 weeks prior to Screening Visit 1.
    21. A history of bone marrow disorder including aplastic anemia, or any current marked anemia defined as hemoglobin <10.0 g/dL.
    22. Prior treatment with setanaxib or participation in a previous setanaxib clinical study.
    23. Unstable cardiovascular disease as defined by any of the following:
    a. Unstable angina within 6 months prior to Screening
    b. Myocardial infarction, coronary artery bypass graft surgery, or coronary angioplasty within 6 months prior to Screening
    c. Cerebrovascular accident within 6 months prior to Screening
    d. New York Heart Association Class III or IV heart failure
    24. Presence of any laboratory abnormality or condition that, in the opinion of the Investigator, could interfere with or compromise a patient’s treatment, assessment, or compliance with the protocol and/or study procedures.
    25. Any other condition which, in the opinion of the Investigator, constitutes a risk or contraindication for the participation of the patient in the study, or that could interfere with the study objectives, conduct, or evaluation.
    26. Hypersensitivity or intolerance to setanaxib or to any of its excipients or placebo compounds.
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of patients achieving a biochemical response at Week 52, defined as:
    - Alkaline phosphatase (ALP) reduction to <1.67×upper limit of normal (ULN) and
    - ALP reduction of ≥15% from Baseline and
    - Total bilirubin ≤1×ULN
    E.5.1.1Timepoint(s) of evaluation of this end point
    E.5.2Secondary end point(s)
    - Change in fatigue at Week 52 compared to Baseline, as assessed by the Patient Reported Outcomes Measurement Information System (PROMIS) short form-Fatigue 7b Daily
    - Change in liver stiffness at Week 52 compared to Screening, as assessed by transient elastography (FibroScan®)
    - Change in fatigue at Week 52 compared to Baseline, as assessed by the PBC-40 questionnaire (PBC 40) fatigue domain, the Patient’s Global Impression of Severity (PGIS) and the Patient’s Global Impression of Change (PGIC) fatigue
    - Change in pruritus at Week 52 compared to Baseline, as assessed by the Worst Itch Numerical Rating Scale (WI-NRS), the PBC-40 itch domain, and the PGIS and the PGIC pruritus
    - Changes in markers of cholestasis as assessed by proportion of
    patients at Week 52 with:
    - ALP reduction to <1.67×ULN and total bilirubin ≤1×ULN and a ≥30%
    or ≥40% or ≥70% ALP reduction from Baseline, respectively
    - ALP reduction to <1.5×ULN and total bilirubin ≤1× ULN and with a ≥
    40% ALP reduction from Baseline
    - ALP <1× ULN and total bilirubin ≤1 × ULN
    - Total bilirubin <0.6×ULN
    - Adverse events (AEs). Monitoring for AEs at all visits.
    - AEs of special interest (AESIs):
    Drug induced liver injury (DILI)
    - Laboratory tests:
    Thyroid function
    - Vital signs
    - 12-lead electrocardiograms (ECGs): clinically significant abnormalities
    E.5.2.1Timepoint(s) of evaluation of this end point
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E. trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA76
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    New Zealand
    United States
    United Kingdom
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of the study is defined as the date of the last visit or last procedure of the last patient in the study.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months11
    E.8.9.1In the Member State concerned days7
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months11
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 254
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 64
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state13
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 156
    F.4.2.2In the whole clinical trial 318
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-12-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-11-18
    P. End of Trial
    P.End of Trial StatusCompleted
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