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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03449446
Registration number
NCT03449446
Ethics application status
Date submitted
23/02/2018
Date registered
28/02/2018
Titles & IDs
Public title
Study to Evaluate the Safety and Efficacy of Selonsertib, Firsocostat, Cilofexor, and Combinations in Participants With Bridging Fibrosis or Compensated Cirrhosis Due to Nonalcoholic Steatohepatitis (NASH)
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Scientific title
A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of Selonsertib, GS-0976, GS-9674, and Combinations in Subjects With Bridging (F3) Fibrosis or Compensated Cirrhosis (F4) Due to Nonalcoholic Steatohepatitis (NASH)
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Secondary ID [1]
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GS-US-454-4378
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Universal Trial Number (UTN)
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Trial acronym
ATLAS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Nonalcoholic Steatohepatitis
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Condition category
Condition code
Oral and Gastrointestinal
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Metabolic and Endocrine
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Metabolic disorders
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Diet and Nutrition
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - SEL
Treatment: Drugs - FIR
Treatment: Drugs - CILO
Treatment: Drugs - Placebo to match FIR
Treatment: Drugs - Placebo to match CILO
Treatment: Drugs - Placebo to match SEL
Experimental: Selonsertib (SEL) - Participants will receive SEL + placebo to match firsocostat 20 mg tablet + placebo to match cilofexor 30 mg tablet orally once daily for 48 weeks.
Experimental: Firsocostat (FIR) - Participants will receive placebo to match SEL 18 mg tablet + FIR + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.
Experimental: Cilofexor (CILO) - Participants will receive placebo to match SEL 18 mg tablet + placebo to match FIR 20 mg tablet + CILO orally once daily for 48 weeks.
Experimental: Selonsertib (SEL) + Firsocostat (FIR) - Participants will receive SEL + FIR + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.
Experimental: Selonsertib (SEL) + Cilofexor (CILO) - Participants will receive SEL + placebo to match FIR 20 mg tablet + CILO orally once daily for 48 weeks.
Experimental: Firsocostat (FIR) + Cilofexor (CILO) - Participants will receive placebo to match SEL 18 mg tablet + FIR + CILO orally once daily for 48 weeks.
Experimental: Placebo - Participants will receive placebo to match SEL 18 mg + placebo to match FIR 20 mg tablet + placebo to match CILO 30 mg tablet orally once daily for 48 weeks.
Treatment: Drugs: SEL
18 mg tablet administered orally once daily without regard to food
Treatment: Drugs: FIR
20 mg tablet administered orally once daily without regard to food
Treatment: Drugs: CILO
30 mg tablet administered orally once daily without regard to food
Treatment: Drugs: Placebo to match FIR
Tablet administered orally once daily without regard to food
Treatment: Drugs: Placebo to match CILO
Tablet administered orally once daily without regard to food
Treatment: Drugs: Placebo to match SEL
Tablet administered orally once daily without regard to food
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs)
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Assessment method [1]
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Timepoint [1]
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First dose date up to 48 weeks plus 30 days
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Primary outcome [2]
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Percentage of Participants Experiencing Treatment-Emergent Laboratory Abnormalities
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Assessment method [2]
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Treatment-emergent laboratory abnormalities were defined as values that increase at least one toxicity grade from baseline. Participants with any laboratory abnormality were reported.
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Timepoint [2]
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First dose date up to 48 weeks plus 30 days
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Primary outcome [3]
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Percentage of Participants Who Achieved a = 1-Stage Improvement in Fibrosis Without Worsening of NASH at Week 48
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Assessment method [3]
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Fibrosis improvement was defined as = 1-stage decrease from baseline in fibrosis according to the NASH clinical research network classification (CRN) classification. Worsening of NASH was defined as = 1-point increase from baseline in hepatocellular ballooning or lobular inflammation. The 95% CI was based on the Clopper-Pearson method.
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Timepoint [3]
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Week 48
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Eligibility
Key inclusion criteria
Key
* Liver biopsy consistent with NASH and F3 or F4 in the opinion of the central reader
* In participants who have never had a liver biopsy, liver stiffness by FibroScan® = 14.0 kPa and Enhanced Liver Fibrosis (ELFâ„¢) Test score = 9.8 at Screening
* Screening laboratory parameters, as determined by the central laboratory:
* Estimated glomerular filtration rate (eGFR) = 60 mL/min, as calculated by the Cockcroft-Gault equation
* Hemoglobin A1c (HbA1c) = 9.5%
* Alanine aminotransferase (ALT) < 5 x Upper Limits of Normal (ULN)
* Platelet count = 125,000/µL
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Minimum age
18
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Maximum age
80
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Prior history of decompensated liver disease including ascites, hepatic encephalopathy, or variceal bleeding
* Child-Pugh (CP) score > 6 at Screening, unless due to an alternative etiology such as Gilbert's syndrome or therapeutic anticoagulation
* Model for End-Stage Liver Disease (MELD) score > 12 at Screening, unless due to an alternate etiology such as therapeutic anticoagulation
* Other causes of liver disease based on medical history and/or centralized review of liver histology, including but not limited to: alcoholic liver disease, hepatitis B, hepatitis C, autoimmune disorders (eg, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis), drug-induced hepatotoxicity, Wilson disease, clinically significant iron overload, or alpha-1-antitrypsin deficiency requiring treatment
* History of liver transplantation
* Current or prior history of hepatocellular carcinoma
Note: Other protocol defined Inclusion/ Exclusion criteria may apply
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
21/03/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
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Actual
19/11/2019
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Sample size
Target
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Accrual to date
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Final
395
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Recruitment in Australia
Recruitment state(s)
QLD,SA,VIC,WA
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Recruitment hospital [1]
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Royal Brisbane & Women's Hospital - Herston
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Royal Adelaide Hospital - Adelaide
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Monash Health, Monash Medical Centre - Clayton
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St Vincent's Hospital Melbourne - Fitzroy
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Melbourne Health, Royal Melbourne Hospital - Parkville
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Sir Charles Gairdner Hospital - Nedlands
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Royal Perth Hospital - Perth
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Royal Prince Alfred Hospital - Camperdown
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St Vincent's Hospital Sydney - Darlinghurst
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Austin Health - Heidelberg
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The Alfred Hospital, Alfred Health - Melbourne
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Westmead Hospital - Westmead
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4029 - Herston
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Recruitment postcode(s) [2]
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5000 - Adelaide
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3168 - Clayton
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Recruitment postcode(s) [4]
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3065 - Fitzroy
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3050 - Parkville
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6009 - Nedlands
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6000 - Perth
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2050 - Camperdown
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2010 - Darlinghurst
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3084 - Heidelberg
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Recruitment postcode(s) [11]
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3004 - Melbourne
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Recruitment postcode(s) [12]
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2145 - Westmead
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Recruitment outside Australia
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Gilead Sciences
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The primary objectives of this study are: * To assess the safety and tolerability of selonsertib (SEL), firsocostat (FIR) and cilofexor (CILO), administered alone or in combination, in participants with bridging fibrosis or compensated cirrhosis due to NASH * To evaluate changes in liver fibrosis, without worsening of NASH
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Trial website
https://clinicaltrials.gov/study/NCT03449446
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Trial related presentations / publications
Loomba R, et al. Safety and efficacy of combination therapies including cilofexor/firsocostat in patients with bridging fibrosis and cirrhosis due to NASH: Results of the Phase 2b ATLAS trial [accepted for oral presentation]. European Association for the Study of the Liver (EASL); 2020; Virtual. Loomba R, Alkhouri N, Strasser S, Wong VWS, Schall RA, McColgan B, et al. Clinical utility and application of non-invasive tests of fibrosis in the selection of patients with advanced fibrosis due to NASH in the Phase 2 ATLAS trial (Poster SAT-315). EASL; 2019; Vienna, Austria. Loomba R, Alkhouri N, Patel K, Zhang J, McColgan BJ, Djedjos S, et al. Validation of Cutoffs for Controlled Attenuation Parameter with MRI-Proton Density Fat Fraction (PDFF) as a Reference Standard in Subjects with Nonalcoholic Steatohepatitis (NASH) Across Multiple Randomized, Controlled Trials (Poster 1727). American Association for the Study of Liver Diseases (AASLD); 2019; Boston, MA, USA. Loomba R, Alkhouri N, Noureddin M, Zhang J, McColgan BJ, Djedjos S, et al. Validation of the Diagnostic Accuracy of Magnetic Resonance Elastography (MRE) for the Detection of Advanced Fibrosis Due to Nash Across Multiple Phase 2 and 3 Clinical Trials (Poster 1728). AASLD; 2019; Boston, MA, USA. Alkhouri N, Strasser SI, Wong VWS, Aguilar R, Chuang J, Huss R, et al. Alcohol use is Underreported in Clinical Trials of NASH: Baseline Alcohol Biomarkers from a Phase 2 Clinical Trial (Poster 1765). AASLD; 2019; Boston, MA, USA. Loomba R, Noureddin M, Kowdley KV, Kohli A, Sheikh A, Neff G, Bhandari BR, Gunn N, Caldwell SH, Goodman Z, Wapinski I, Resnick M, Beck AH, Ding D, Jia C, Chuang JC, Huss RS, Chung C, Subramanian GM, Myers RP, Patel K, Borg BB, Ghalib R, Kabler H, Poulos J, Younes Z, Elkhashab M, Hassanein T, Iyer R, Ruane P, Shiffman ML, Strasser S, Wong VW, Alkhouri N; for the ATLAS Investigators. Combination Therapies Including Cilofexor and Firsocostat for Bridging Fibrosis and Cirrhosis Attributable to NASH. Hepatology. 2021 Feb;73(2):625-643. doi: 10.1002/hep.31622.
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Public notes
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Contacts
Principal investigator
Name
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Gilead Study Director
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Address
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Gilead Sciences
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/46/NCT03449446/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/46/NCT03449446/SAP_001.pdf
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Loomba R, et al. Safety and efficacy of combinatio...
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Journal
Loomba R, Alkhouri N, Strasser S, Wong VWS, Schall...
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Journal
Loomba R, Alkhouri N, Patel K, Zhang J, McColgan B...
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Journal
Loomba R, Alkhouri N, Noureddin M, Zhang J, McColg...
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Journal
Alkhouri N, Strasser SI, Wong VWS, Aguilar R, Chua...
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Results are available at
https://clinicaltrials.gov/study/NCT03449446