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    Clinical Trial Results:
    A placebo-controlled, proof-of-concept study to evaluate the safety and efficacy of Lanifibranor alone and in combination with the sodium-glucose transport protein 2 (SGLT2) inhibitor EmpaGliflozin in patiEnts with Non-alcoholic steatohepatitis (NASH) and type 2 Diabetes mellitus (T2DM)

    Summary
    EudraCT number
    2021-005057-87
    Trial protocol
    FR   BE   NL  
    Global end of trial date
    04 Jun 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Jul 2026
    First version publication date
    16 Jul 2026
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    337HNAS21016
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05232071
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    LEGEND: LEGEND
    Sponsors
    Sponsor organisation name
    Inventiva SA
    Sponsor organisation address
    50 rue de Dijon, DAIX, France, 21121
    Public contact
    Martine ZIMMERMAN (Executive Vice President of Regulatory Affairs and Quality Assurance), Inventiva S.A., Martine.Zimmermann@inventivapharma.com
    Scientific contact
    Thomas CAPOZZA (Senior VP Clinical Development), Inventiva S.A., Thomas.Capozza@inventivapharma.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
    31 Jul 2024
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    08 May 2024
    Global end of trial reached?
    Yes
    Global end of trial date
    04 Jun 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Primary objective To assess the effect of lanifibranor alone compared to placebo and the effect of lanifibranor in combination with empagliflozin compared to placebo on HbA1c after a 24-week treatment duration. Secondary objectives To assess the effect of lanifibranor alone compared to placebo and lanifibranor in combination with empagliflozin compared to placebo after a 24-week treatment duration on: • Liver tests • Markers of glycemic control and insulin resistance • Inflammatory markers • Lipid parameters • Body weight and body composition and To assess the safety and tolerability of lanifibranor alone and in combination with empagliflozin during the 24-week treatment period and the 4-week follow-up period.
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    29 Jun 2022
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 2
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    United States: 35
    Country: Number of subjects enrolled
    United Kingdom: 1
    Worldwide total number of subjects
    39
    EEA total number of subjects
    3
    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)
    29
    From 65 to 84 years
    10
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment of patients started in June 2022 and last patient was recruited in November 2023. A total of 213 patients were screened for the study.

    Pre-assignment
    Screening details
    Patients were invited to participate by their doctor based on their medical records. They had to fulfil all eligibility criteria. 41 patients were randomised. Main reason for non-randomization was screen failure. 2 of 41 patients were not treated and excluded from Full Analysis Set (FAS). Enrollment, disposition, analyses are based on FAS (n=39).

    Period 1
    Period 1 title
    Core Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Investigator, Subject, Monitor, Data analyst
    Blinding implementation details
    Group "lanifibranor 800mg" : blinded Group "placebo" : blinded (lanifibranor 800mg matching placebo) Group "lanifbranor 800mg + empagliflozin 10mg" : open-label

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    LANI800mg
    Arm description
    Lanifibranor (800 mg/day): two film-coated tablets of 400 mg each, once-a-day (QD) with food. For oral use. QD for 24 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    lanifibranor
    Investigational medicinal product code
    IVA337
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    White to off-white, bi-convex tablet of 400mg to be taken orally. Each tablet contained 400 mg of the active ingredient in an immediate release formulation

    Arm title
    LANI800mg+EMPA10mg
    Arm description
    Lanifibranor (800 mg/day): two film-coated tablets of 400 mg each. Empagliflozin : one film-coated tablet of 10 mg (10mg/day) Once-a-day (QD) with food. For oral use. QD for 24 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    lanifibranor+empagliglozin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Lanifibranor : white to off-white, bi-convex film-coated tablet of 400mg to be taken orally. Each tablet contained 400 mg of the active ingredient in an immediate release formulation Empagliflozin: 10 mg pale yellow, round, bi-convex and bevel-edged, film-coated tablets debossed with “S 10” on one side and the Boehringer Ingelheim company symbol on the other side

    Arm title
    Placebo
    Arm description
    Two lanifibranor placebo-matching tablets once-a-day (QD) with food. For oral use. QD for 24 weeks.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    2 lanifibranor matching-placebo tablets for oral use QD for 24 weeks

    Number of subjects in period 1
    LANI800mg LANI800mg+EMPA10mg Placebo
    Started
    12
    13
    14
    Completed
    12
    12
    9
    Not completed
    0
    1
    5
         Adverse event, non-fatal
    -
    1
    -
         Non compliance with Study Drug
    -
    -
    1
         Lost to follow-up
    -
    -
    2
         Withdrawal by subject
    -
    -
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    LANI800mg
    Reporting group description
    Lanifibranor (800 mg/day): two film-coated tablets of 400 mg each, once-a-day (QD) with food. For oral use. QD for 24 weeks.

    Reporting group title
    LANI800mg+EMPA10mg
    Reporting group description
    Lanifibranor (800 mg/day): two film-coated tablets of 400 mg each. Empagliflozin : one film-coated tablet of 10 mg (10mg/day) Once-a-day (QD) with food. For oral use. QD for 24 weeks.

    Reporting group title
    Placebo
    Reporting group description
    Two lanifibranor placebo-matching tablets once-a-day (QD) with food. For oral use. QD for 24 weeks.

    Reporting group values
    LANI800mg LANI800mg+EMPA10mg Placebo Total
    Number of subjects
    12 13 14 39
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0
        Newborns (0-27 days)
    0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0
        Children (2-11 years)
    0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0
        Adults (18-64 years)
    9 10 10 29
        From 65-84 years
    3 3 4 10
        85 years and over
    0 0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    55.1 ( 11.45 ) 54.2 ( 13.48 ) 54.7 ( 13.01 ) -
    Gender categorical
    Units: Subjects
        Female
    6 8 7 21
        Male
    6 5 7 18
    Subject analysis sets

    Subject analysis set title
    Full Analysis Set (FAS)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS included all randomised patients who received at least 1 dose of the assigned study drug, regardless of whether they prematurely discontinued randomised treatment or experienced any other intercurrent event, and who met the targeted patient population of interest consistently with the primary estimand: Adults with non-cirrhotic NASH and T2DM defined by inclusion criteria No. 4 and 5 met, and exclusion criteria No. 2 and 15 not met. ‘Received at least 1 dose of the assigned study drug’ for the combination arm means that at least 1 dose of the 2 treatments empagliflozin and lanifibranor were to be received concomitantly, to be considered in the FAS. Patients were analysed according to their randomised treatment

    Subject analysis set title
    Per Protocol Set (PPS)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The PPS included all patients in the FAS who did not have any major protocol deviations (i.e. considered to have a significant effect on the primary endpoint) and who did not prematurely discontinue from treatment.

    Subject analysis set title
    Safety Analysis Set (SAS)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The SAS included all randomised patients who received at least 1 dose of study drug. Patients in the SAS were analysed and summarised based on the treatment they actually received. ‘Received at least 1 dose of study drug’ for the combination arm meant that at least 1 dose of lanifibranor, i.e. the IMP, was to be received.

    Subject analysis sets values
    Full Analysis Set (FAS) Per Protocol Set (PPS) Safety Analysis Set (SAS)
    Number of subjects
    39
    29
    39
    Age categorical
    Units: Subjects
        In utero
    0
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
    0
        Newborns (0-27 days)
    0
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
    0
        Children (2-11 years)
    0
    0
    0
        Adolescents (12-17 years)
    0
    0
    0
        Adults (18-64 years)
    29
    22
    29
        From 65-84 years
    10
    7
    10
        85 years and over
    0
    0
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    54.6 ( 12.38 )
    55.6 ( 12.26 )
    54.6 ( 12.38 )
    Gender categorical
    Units: Subjects
        Female
    21
    16
    21
        Male
    18
    13
    18

    End points

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    End points reporting groups
    Reporting group title
    LANI800mg
    Reporting group description
    Lanifibranor (800 mg/day): two film-coated tablets of 400 mg each, once-a-day (QD) with food. For oral use. QD for 24 weeks.

    Reporting group title
    LANI800mg+EMPA10mg
    Reporting group description
    Lanifibranor (800 mg/day): two film-coated tablets of 400 mg each. Empagliflozin : one film-coated tablet of 10 mg (10mg/day) Once-a-day (QD) with food. For oral use. QD for 24 weeks.

    Reporting group title
    Placebo
    Reporting group description
    Two lanifibranor placebo-matching tablets once-a-day (QD) with food. For oral use. QD for 24 weeks.

    Subject analysis set title
    Full Analysis Set (FAS)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS included all randomised patients who received at least 1 dose of the assigned study drug, regardless of whether they prematurely discontinued randomised treatment or experienced any other intercurrent event, and who met the targeted patient population of interest consistently with the primary estimand: Adults with non-cirrhotic NASH and T2DM defined by inclusion criteria No. 4 and 5 met, and exclusion criteria No. 2 and 15 not met. ‘Received at least 1 dose of the assigned study drug’ for the combination arm means that at least 1 dose of the 2 treatments empagliflozin and lanifibranor were to be received concomitantly, to be considered in the FAS. Patients were analysed according to their randomised treatment

    Subject analysis set title
    Per Protocol Set (PPS)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The PPS included all patients in the FAS who did not have any major protocol deviations (i.e. considered to have a significant effect on the primary endpoint) and who did not prematurely discontinue from treatment.

    Subject analysis set title
    Safety Analysis Set (SAS)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The SAS included all randomised patients who received at least 1 dose of study drug. Patients in the SAS were analysed and summarised based on the treatment they actually received. ‘Received at least 1 dose of study drug’ for the combination arm meant that at least 1 dose of lanifibranor, i.e. the IMP, was to be received.

    Primary: Absolute change in HbA1c

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    End point title
    Absolute change in HbA1c
    End point description
    Absolute change in HbA1c from baseline (Week 0) to Week 24 (%)
    End point type
    Primary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    11
    13
    13
    Units: %
        least squares mean (confidence interval 95%)
    -1.11 (-1.60 to -0.62)
    -1.54 (-2.02 to -1.06)
    0.16 (-0.32 to 0.63)
    Statistical analysis title
    LANI800 vs PBO
    Statistical analysis description
    To assess the superiority of each active arm versus placebo on absolute change in HbA1c from baseline, a mixed model for repeated measures (MMRM) was used with treatment group, time, treatment×time interaction as fixed effects, baseline HbA1c value and sex as covariates and the patient effect as a random effect. The MMRM was used to handle missingness because outcomes are measured repeatedly over time. No explicit imputation was done for missing data.
    Comparison groups
    LANI800mg v Placebo
    Number of subjects included in analysis
    24
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    -1.27
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.95
         upper limit
    -0.58
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.33
    Statistical analysis title
    LANI800+EMPA10 vs PBO
    Statistical analysis description
    To assess the superiority of each active arm versus placebo on absolute change in HbA1c from baseline, a mixed model for repeated measures (MMRM) was used with treatment group, time, treatment×time interaction as fixed effects, baseline HbA1c value and sex as covariates and the patient effect as a random effect. The MMRM was used to handle missingness because outcomes are measured repeatedly over time. No explicit imputation was done for missing data.
    Comparison groups
    LANI800mg+EMPA10mg v Placebo
    Number of subjects included in analysis
    26
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    -1.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.38
         upper limit
    -1.02
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.33

    Secondary: Change in liver tests (ALT)

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    End point title
    Change in liver tests (ALT)
    End point description
    ALT Absolute Change from Baseline
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    12
    13
    13
    Units: U/L
        least squares mean (confidence interval 95%)
    -26.6 (-38.08 to -15.12)
    -29.63 (-42.13 to -17.13)
    -5.65 (-17.89 to 6.59)
    No statistical analyses for this end point

    Secondary: Change in liver tests (AST)

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    End point title
    Change in liver tests (AST)
    End point description
    AST Absolute Change from Baseline
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    12
    13
    13
    Units: U/L
        least squares mean (confidence interval 95%)
    -13.67 (-20.66 to -6.68)
    -17.81 (-25.5 to -10.12)
    1.3 (-6.11 to 8.71)
    No statistical analyses for this end point

    Secondary: Change in insulin resistance and glycaemic control (HOMA-IR)

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    End point title
    Change in insulin resistance and glycaemic control (HOMA-IR)
    End point description
    HOMA-IR Relative Change from Baseline
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    11
    13
    13
    Units: %
        least squares mean (confidence interval 95%)
    -50.79 (-95.69 to -5.89)
    -45.23 (-89.86 to -0.61)
    35.01 (-10.29 to 80.32)
    No statistical analyses for this end point

    Secondary: Change in insulin resistance and glycaemic control (insulin)

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    End point title
    Change in insulin resistance and glycaemic control (insulin)
    End point description
    Insuline - Relative Change from Baseline
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    11
    13
    13
    Units: %
        least squares mean (confidence interval 95%)
    -33.48 (-68.24 to 1.28)
    -38.16 (-72.16 to -4.16)
    10.17 (-23.63 to 43.96)
    No statistical analyses for this end point

    Secondary: Change in insulin resistance and glycaemic control (adiponectin)

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    End point title
    Change in insulin resistance and glycaemic control (adiponectin)
    End point description
    Adiponectine Fold Change from Baseline
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    11
    13
    13
    Units: fold change
        least squares mean (confidence interval 95%)
    2.87 (2.05 to 3.68)
    3.03 (2.18 to 3.89)
    1.24 (0.39 to 2.09)
    No statistical analyses for this end point

    Secondary: Change in lipid parameters (HDL cholesterol)

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    End point title
    Change in lipid parameters (HDL cholesterol)
    End point description
    HDL cholesterol - Relative Change from Baseline
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    12
    13
    13
    Units: %
        least squares mean (confidence interval 95%)
    16.48 (5.24 to 27.72)
    15.30 (3.04 to 27.56)
    2.55 (-9.76 to 14.86)
    No statistical analyses for this end point

    Secondary: Change in body weight and body composition (Body Weight)

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    End point title
    Change in body weight and body composition (Body Weight)
    End point description
    Body Weight Relative Change from Baseline
    End point type
    Secondary
    End point timeframe
    from Baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    12
    13
    13
    Units: %
        least squares mean (confidence interval 95%)
    3.6 (2.00 to 5.19)
    0.25 (-1.50 to 2.01)
    -1.16 (-2.84 to 0.53)
    No statistical analyses for this end point

    Secondary: Change in body weight and body composition (VAT/SAT ratio)

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    End point title
    Change in body weight and body composition (VAT/SAT ratio)
    End point description
    Ratio VAT / SAT - Results for Relative Change from Baseline VAT : MRI L3 visceral adipose tissue SAT : MRI L3 subcutaneous adipose tissue
    End point type
    Secondary
    End point timeframe
    From baseline to Week 24
    End point values
    LANI800mg LANI800mg+EMPA10mg Placebo
    Number of subjects analysed
    9
    7
    7
    Units: %
        least squares mean (confidence interval 95%)
    -4.6 (-14.44 to 5.25)
    -17.45 (-28.67 to -6.23)
    2.01 (-9.12 to 13.14)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    On or after the first dose of treatment up to 30 days post last dose.
    Adverse event reporting additional description
    TEAEs are events with start date & time on or after the date and time of 1st dose of study treatment and up to 30 days after date & time of last dose of study treatment, and events with start date and time prior to the date & time of first dose of study treatment whose severity worsens on or after the date and time of 1st dose of study treatment.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    LANI800mg
    Reporting group description
    Lanifibranor 2 film-coated tablets for oral use of 400 mg (total dose 800 mg)

    Reporting group title
    LANI800mg+EMPA10mg
    Reporting group description
    Lanifibranor 2 film-coated tablets for oral use of 400 mg (total dose 800 mg) plus empagliflozin 1 tablet of 10 mg, QD for 24 weeks.

    Reporting group title
    Placebo
    Reporting group description
    Lanifibranor matching placebo 2 tablets for oral use QD for 24 weeks

    Serious adverse events
    LANI800mg LANI800mg+EMPA10mg Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Renal and urinary disorders
    Haematuria
    Additional description: One patient experienced haematuria (described as hematuria). Started during the follow-up period, 26 days after final dose of study drug and was assessed as not treatment-related (neither lanifibranor nor empagliflozin) by the investigator
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    LANI800mg LANI800mg+EMPA10mg Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 12 (83.33%)
    9 / 13 (69.23%)
    8 / 14 (57.14%)
    Vascular disorders
    Varicose vein
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    1
    1
    0
    Hot flush
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Influenza like illness
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Oedema peripheral
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Reproductive system and breast disorders
    Vaginal odour
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Oropharyngeal pain
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    Cough
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Epistaxis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Nasal congestion
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Productive cough
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Wheezing
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Psychiatric disorders
    Depressed mood
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Depression
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Insomnia
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Investigations
    Blood glucose decreased
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    Blood creatinine increased
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Injury, poisoning and procedural complications
    Overdose
         subjects affected / exposed
    1 / 12 (8.33%)
    2 / 13 (15.38%)
    0 / 14 (0.00%)
         occurrences all number
    1
    2
    0
    Congenital, familial and genetic disorders
    Phimosis
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Nervous system disorders
    Headache
         subjects affected / exposed
    2 / 12 (16.67%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    2
    1
    0
    Neuropathy peripheral
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 12 (16.67%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    2
    0
    1
    Ear and labyrinth disorders
    Ear pruritus
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    1 / 12 (8.33%)
    2 / 13 (15.38%)
    0 / 14 (0.00%)
         occurrences all number
    1
    2
    0
    Abdominal pain
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    Diarrhoea
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    Toothache
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    1
    2
    0
    Dyspepsia
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Infrequent bowel movements
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Tongue discomfort
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Vomiting
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    2 / 12 (16.67%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    0
    Rash
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    2 / 14 (14.29%)
         occurrences all number
    0
    0
    2
    Hidradenitis
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Rosacea
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Skin lesion
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Renal and urinary disorders
    Pollakiuria
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    1
    Micturition urgency
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    1
    Bone pain
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Myalgia
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Pain in extremity
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Infections and infestations
    COVID-19
         subjects affected / exposed
    1 / 12 (8.33%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    1
    1
    0
    Bronchitis
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Gastroenteritis viral
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Influenza
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Oral herpes
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Paronychia
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Pneumonia
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Tonsillitis
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Tooth abscess
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Tooth infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 12 (0.00%)
    1 / 13 (7.69%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Metabolism and nutrition disorders
    Diabetes mellitus inadequate control
         subjects affected / exposed
    0 / 12 (0.00%)
    2 / 13 (15.38%)
    0 / 14 (0.00%)
         occurrences all number
    0
    2
    0
    Dehydration
         subjects affected / exposed
    0 / 12 (0.00%)
    0 / 13 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    0
    1
    Increased appetite
         subjects affected / exposed
    1 / 12 (8.33%)
    0 / 13 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    04 Mar 2022
    Protocol Version 2.0 dated 25-Jan-2022 (FDA May Proceed Letter): - Clarification regarding prohibited medication: treatment with substrates of CYP 2B6 and CYP2C8, CYP2C8 strong inducers and CYP2C8 strong inhibitors excluded - In US and EU Renal Impairment guidances, the Food and Drug Administration and European Medicines Agency recommend expressing glomerular filtration rate (GFR) in mL/min because renal clearance of a drug is proportional to individual GFR and not to standard body surface area (BSA)-standardised GFR, therefore study parameters were modified: eGFR no-longer BSA normalised - Clarification regarding SARS-CoV-2 infection - Clarification of rational, background and study design - Clarification regarding randomisation process
    23 May 2022
    Protocol Version 3.0 dated 08-Apr-2022: - Clarification regarding stratifying factors in the randomisation process - Addition of a randomisation procedure before baseline visit, allowing the treatment ordering and treatment shipment/delivery to the site - Update of patient individual study duration, due to addition of randomisation procedure - Update of exclusion criteria No. 1 & No. 2 for further clarification - Addition of the possibility to perform phone call visit if medically needed to ensure appropriate patient follow-up in case on-site visit is not possible - Update of the AESI reporting period to be in line with lanifibranor AESI reporting guidelines - To align with lanifibranor AE management guidelines across the clinical development programme, 1) the drug-Induced Liver Injury Monitoring and stopping rules were updated as were 2) the guideline for AEs requiring specific management related to anaemia, heart failure, aminotransferase elevation, bone fracture, peripheral oedema, cholelithiasis, hypoglycaemia, ovulation resumption and weight gain local guidelines/clinical practice - Update of the known potential risks of empagliflozin in line with the empagliflozin labelling - List of clinical laboratory parameters was updated (HIV-1 and HIV-2 antibodies and serum ketones measures) to document the history of HIV infection and to ensure appropriate monitoring for the risk of ketoacidosis due to the use of empagliflozin - Justification for dose updated to clarify the choice of 800 mg dosage for lanifibranor - Update of exclusion criteria N°36 with patient with history of pancreatitis excluded
    07 Feb 2023
    Protocol Version 4.0 dated 12-Jan-2023 : - Additional details regarding exploratory endpoints related to cT1 - Update of the inclusion criteria: o No. 6, No. 19, and No. 38, for clarification o No. 7, to further define Gilberts Syndrome that is regarded as a benign trait o No. 9, to allow patients with ‘Benign ethnic neutropenia’ to be eligible based on the investigator’s clinical judgement o No. 10, to allow recruitment of patients who have mild thrombocytopenia o No. 41 o the list of prohibited medication was updated. o Correction of a typing error in Figure 1: Study design o Addition of one footnote related to screening period to the Schedule of Activities (Clarification in visit time window for screening period) o Addition of one footnote related to patient rescreening to the Schedule of Activities (allow the use of previous LMS result for patient re-screening) o Update of the allowable Medications for Standard Care or Precautions (clarification that patients who have clinically insignificant changes in the listed concomitant medications are eligible) o Addition of a reference added regarding the definition of NASH (Definition of NASH corresponding to the inclusion criterion 5 revised) o Update of the Adverse Event Reporting guidance (to precise the AESI reporting timelines applicable for the study) o Update of the guideline for Adverse Events requiring specific management related to Anemia (to clarify the guidance)
    13 Dec 2023
    Protocol Version 5.0 dated 19-Oct-2023 : - An interim analysis was added to obtain preliminary information on observed effects sizes / variability allowing an early insight on the treatment effect on multiple mechanistic endpoints - Exclusion criterion N°48 was updated to refer to the full list of permitted and prohibited concomitant medications - Addition of the overall study termination to clarify that both investigator and Sponsor can terminate the study at any time, especially at time of interim analysis - The anti-SARS-CoV-2-IgM as serological test in case of aminotransferase elevation was deleted to align with the central lab testing availability
    12 Apr 2024
    Protocol Version 6.0 dated 22-Feb-2024: To mimic the recommendations issued by the Data Monitoring Committee for the Phase 3 study, NATiV3 (IND140010 EudraCT 2020-004986-38), in patients with NASH and liver fibrosis, following changes were implemented: - Update of the exclusion criterion No. 1 - Addition of the exclusion criterion No. 50 related to autoimmunity and addition of corresponding laboratory parameters - Addition of liver tests and INR monitoring - Addition of the possibility to use local laboratories for the above tests - Update of the known potential risks

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    15 Mar 2024
    As planned per protocol, an interim analysis was conducted in March 2024 based on 32 patients randomised and treated, corresponding to half of the planned randomised patients. As per protocol, recruitment was to be paused at this time. Following the interim analysis results, recruitment was to be either re-initiated or stopped. Results of the interim analysis showed that the primary endpoint - i.e. demonstrating the superiority of lanifibranor alone and lanifibranor and empagliflozin versus placebo on the primary endpoint - was met based on the 32 patients analysed then. Since achieving the primary endpoint was one of the pre-defined study stopping criteria defined in the SAP and considering the overall interim study results (including secondary, exploratory, and safety outcomes), the Sponsor decided on the following: - not to re-initiate patient recruitment, - to continue monitoring the follow-up of the 7 patients that were still ongoing in the study at time of interim analysis, - to perform the final analysis based on 39 patients randomised and treated. The results posted are that from the final analysis based on 39 patients.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    No multiplicity adjustments when testing for treatment effect on secondary endpoints. Numerical improvements with active vs placebo on some of these endpoints but the sample size was too small to achieve statistical significance.
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