Efficacy and Safety Study of Cenicriviroc for the Treatment of Nonalcoholic Steatohepatitis (NASH) in Adult Participants With Liver Fibrosis (CENTAUR)

• ClinicalTrials.gov Identifier: NCT02217475
• Recruitment Status: Completed
• First Posted: August 15, 2014
• Results First Posted: May 10, 2019
• Last Update Posted: May 10, 2019
• Sponsor: Tobira Therapeutics, Inc.
• Information provided by (Responsible Party): Tobira Therapeutics, Inc.

Study Description

Brief Summary:

The purpose of this study is to determine whether cenicriviroc is effective and safe in the treatment of nonalcoholic steatohepatitis (NASH) in adult participants with liver fibrosis.

Condition or disease	Intervention/treatment	Phase
Nonalcoholic Steatohepatitis	Drug: Cenicriviroc; Drug: Placebo	Phase 2

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 289 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Masking: Triple (Participant, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: CENTAUR: Efficacy and Safety Study of Cenicriviroc for the Treatment of Nonalcoholic Steatohepatitis (NASH) in Adult Subjects With Liver Fibrosis
• Actual Study Start Date: September 18, 2014
• Actual Primary Completion Date: June 30, 2016
• Actual Study Completion Date: June 22, 2017

Arms and Interventions

Arm	Intervention/treatment
Experimental: Cenicriviroc (CVC) 150mg/CVC 150 mg; CVC 150 mg tablet in Years 1 and 2.	Drug: Cenicriviroc; CVC 150 mg, administered orally once daily and taken every morning with food.; Other Name: TBR-652
Experimental: Placebo/CVC 150 mg; Placebo-matching CVC tablet in Year 1 then CVC 150 mg tablet in Year 2.	Drug: Cenicriviroc; CVC 150 mg, administered orally once daily and taken every morning with food.; Other Name: TBR-652; Drug: Placebo; Placebo administered orally once daily and taken every morning with food.
Placebo Comparator: Placebo/Placebo; Placebo-matching cenicriviroc (CVC) tablet in Years 1 and 2.	Drug: Placebo; Placebo administered orally once daily and taken every morning with food.

Outcome Measures

Primary Outcome Measures :

1. Number of Participant With Hepatic Histological Improvement in NAS by ≥ 2 Points With at Least 1-Point Reduction in Either Lobular Inflammation or Hepatocellular Ballooning and no Concurrent Worsening of Fibrosis at Year 1 [ Time Frame: Year 1 ]
   Hepatic histological improvement in Nonalcoholic Fatty Liver Disease Activity Score (NAS) at Year 1 was defined as a decrease (improvement) in NAS by ≥ 2 with at least a 1-point reduction in either lobular inflammation or hepatocellular ballooning and with no concurrent worsening of fibrosis stage. The NAS was derived as the unweighted sum of steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocellular ballooning (0 to 2) scores. The NAS ranges from 0-8 with the higher score indicating more aggressive disease. Evaluation of fibrosis stage was based on the nonalcoholic steatohepatitis clinical research network (NASH CRN) fibrosis staging system, which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis. Worsening of fibrosis stage was defined as progression of NASH CRN fibrosis stage.

Secondary Outcome Measures :

1. Number of Participants With Complete Resolution of Steatohepatitis With no Concurrent Worsening of Fibrosis Stage and Improvement in Fibrosis by at Least 1 Stage (NASH CRN System) and no Worsening of Steatohepatitis at Year 1 [ Time Frame: Year 1 ]
   Complete resolution of steatohepatitis was defined as histopathologic interpretation of no fatty liver disease, or simple or isolated steatosis with no steatohepatitis. As per NASH CRN system, no worsening of steatohepatitis was defined as no worsening of lobular inflammation or hepatocellular ballooning grade. The evaluation of fibrosis stage associated with NASH was based on the NASH CRN fibrosis staging system which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis.
2. Number of Participants With Complete Resolution of Steatohepatitis With no Concurrent Worsening of Fibrosis Stage and Improvement in Fibrosis by at Least 1 Stage (NASH CRN System) and no Worsening of Steatohepatitis at Year 2 [ Time Frame: Year 2 ]
   Complete resolution of steatohepatitis was defined as histopathologic interpretation of no fatty liver disease, or simple or isolated steatosis with no steatohepatitis. As per NASH CRN system, no worsening of steatohepatitis was defined as no worsening of lobular inflammation or hepatocellular ballooning grade. The evaluation of fibrosis stage associated with NASH was based on the NASH CRN fibrosis staging system which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis.
3. Number of Participants With Complete Resolution of Steatohepatitis With no Concurrent Worsening of Fibrosis Stage at Year 1 [ Time Frame: Year 1 ]
   Complete resolution of steatohepatitis was defined as histopathologic interpretation of no fatty liver disease, or simple or isolated steatosis with no steatohepatitis. As per NASH CRN system, no worsening of steatohepatitis was defined as no worsening of lobular inflammation or hepatocellular ballooning grade. The evaluation of fibrosis stage associated with NASH was based on the NASH CRN fibrosis staging system which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis.
4. Number of Participants With Complete Resolution of Steatohepatitis With no Concurrent Worsening of Fibrosis Stage at Year 2 [ Time Frame: Year 2 ]
   Complete resolution of steatohepatitis was defined as histopathologic interpretation of no fatty liver disease, or simple or isolated steatosis with no steatohepatitis. As per NASH CRN system, no worsening of steatohepatitis was defined as no worsening of lobular inflammation or hepatocellular ballooning grade. The evaluation of fibrosis stage associated with NASH was based on the NASH CRN fibrosis staging system which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis.
5. Number of Participants With Improvement in Fibrosis by at Least 1 Stage (NASH CRN System) and no Worsening of Steatohepatitis at Year 1 [ Time Frame: Year 1 ]
   The evaluation of fibrosis stage associated with NASH was based on the NASH CRN Fibrosis Staging System which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis. As per NASH CRN system, no worsening of steatohepatitis was defined as no worsening of lobular inflammation or hepatocellular ballooning grade.
6. Number of Participants With Improvement in Fibrosis by at Least 1 Stage (NASH CRN System) and no Worsening of Steatohepatitis at Year 2 [ Time Frame: Year 2 ]
   The evaluation of fibrosis stage associated with NASH was based on the NASH CRN Fibrosis Staging System which was scaled from 0 to 4 stages where, 0=None to 4=Cirrhosis. As per NASH CRN system, no worsening of steatohepatitis was defined as no worsening of lobular inflammation or hepatocellular ballooning grade.
7. Number of Participants With Deaths, Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), TEAEs Leading Study Drug to Discontinuation [ Time Frame: Years 1 and 2 ]
   A TEAE was defined as any adverse event that started or worsened on or after the start of the study medication and up to 30 days after the discontinuation of the study medication. An SAE was defined as any untoward medical occurrence that, at any dose, results in death, was life threatening, requires hospitalization or results in prolongation of existing hospitalization, results in disability/incapacity, or was a congenital anomaly/birth defect.
8. Number of Participants With Clinically Significant Changes in Vital Signs [ Time Frame: Years 1 and 2 ]
   Vital signs included blood pressure, temperature, heart rate, and respiration rate. Vital signs were reviewed by the Investigator for clinically significant changes.
9. Number of Participants With Clinical Laboratory Abnormalities [ Time Frame: Years 1 and 2 ]
   Grade 3-4 abnormal clinical laboratory values that occurred in ≥2% participants were reported. Criteria used for various parameters was:Fasting glucose Grade3:>250 - 500 mg/dL and Grade4: >500 mg/dL; Alanine aminotransferase(ALT)Grade3:>5.0 - 20.0 ×Upper Limit of Normal(ULN)and Grade4:>20.0 ×ULN; Aspartate aminotransferase(AST)Grade3: >5.0 - 20.0 ×ULN and Grade4: >20.0 ×ULN; Activated partial thromboplastin(APT)/Partial thromboplastin time(PTT)Grade3: >2.5×ULN; Triglycerides Grade3 >500 - 1000 mg/dL and Grade4: >1000 mg/dL; Gamma-glutamyl transferase(GGT)Grade3: >5.0 - 20.0 ×ULN and Grade4: >20.0 ×ULN; Creatine kinase Grade 3: >5.0 - 10.0 ×ULN and Grade4: >10.0 ×ULN; Uric acid Grade3:(ULN - 10 mg/dL; ULN - 0.59 mmol/L) and Grade4: >10 mg/dL; Amylase Grade3: >2.0 - 5.0 ×ULN and Grade4: >5.0 ×ULN; Lipase Grade3: >2.0 - 5.0 xULN and Grade4: >5.0 xULN; Phosphorus Grade3: <2.0 - 1.0 mg/dL and Grade4: <1.0 mg/dL and Absolute neutrophil Grade3: <1.0 - 0.5 × 109/L and Grade4: <0.5 × 109/L.
10. Number of Participants With Clinically Abnormal in Electrocardiogram (ECG) Findings [ Time Frame: Years 1 and 2 ]
    A 12-lead ECG was performed. ECG results were reviewed by the Investigator for clinically notable abnormalities.
11. Number of Participants With Hepatic Histological Improvement in NAS at Year 2 [ Time Frame: Year 2 ]
    Hepatic histological improvement in NAS at Year 2 was defined as a decrease (improvement) in NAS by ≥ 2 with at least a 1-point reduction in either lobular inflammation or hepatocellular ballooning and with no concurrent worsening of fibrosis stage. The NAS was derived as the unweighted sum of steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocellular ballooning (0 to 2) scores. The NAS ranges from 0-8 with the higher score indicating more aggressive disease.
12. Change From Baseline in the 3 Categorical Features of NAS (Steatosis, Lobular Inflammation, Hepatocellular Ballooning) at Year 1 [ Time Frame: Year 1 ]
    NAS was calculated using the following 3 categorical features: steatosis which was scaled from 0-3 (steatosis score is defined as 0= <5%, 1= 5 - 33%, 2= >33 - 66%, and 3= >66%), lobular inflammation which was scaled from 0-3 (lobular inflammation score defined as 0= no foci, 1= < 2 foci/200x, 2= 2-4 foci/200x, and 3= > 4 foci/200x), and hepatocellular ballooning which was scaled from 0-2 (hepatocellular ballooning score is defined as 0=none, 1=few balloon cells, 2=many cells/prominent ballooning). A negative change from Baseline indicates improvement.
13. Change From Baseline in the 3 Categorical Features of NAS (Steatosis, Lobular Inflammation, Hepatocellular Ballooning) at Year 2 [ Time Frame: Year 2 ]
    NAS was calculated using the following 3 categorical features: steatosis which was scaled from 0-3 (steatosis score is defined as 0= <5%, 1= 5 - 33%, 2= >33 - 66%, and 3= >66%), lobular inflammation which was scaled from 0-3 (lobular inflammation score defined as 0= no foci, 1= < 2 foci/200x, 2= 2-4 foci/200x, and 3= > 4 foci/200x), and hepatocellular ballooning which was scaled from 0-2 (hepatocellular ballooning score is defined as 0=none, 1=few balloon cells, 2=many cells/prominent ballooning). A negative change from Baseline indicates improvement.
14. Number of Participants With Hepatic Histological Improvement With a Minimum 2-Point Improvement in NAS With at Least a 1-Point Improvement in More Than 1 Categorical Features of NAS and no Concurrent Worsening of Fibrosis Stage at Year 1 [ Time Frame: Year 1 ]
    Hepatic histological improvement in NAS was defined as a decrease (improvement) in NAS by ≥ 2 with at least a 1-point reduction in either steatosis, lobular inflammation or hepatocellular ballooning and with no concurrent worsening of fibrosis stage. The NAS was derived as the unweighted sum of steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocellular ballooning (0 to 2) scores. The NAS ranges from 0-8 with the higher score indicating more aggressive disease. Worsening was defined as progression of NASH CRN fibrosis stage.
15. Number of Participants With Hepatic Histological Improvement With a Minimum 2-Point Improvement in NAS With at Least a 1-point Improvement in More Than 1 Categorical Features of NAS and no Concurrent Worsening of Fibrosis Stage at Year 2 [ Time Frame: Year 2 ]
    Hepatic histological improvement in NAS was defined as a decrease (improvement) in NAS by ≥ 2 with at least a 1-point reduction in either steatosis, lobular inflammation or hepatocellular ballooning and with no concurrent worsening of fibrosis stage. The NAS was derived as the unweighted sum of steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocellular ballooning (0 to 2) scores. The NAS ranges from 0-8 with the higher score indicating more aggressive disease. Worsening was defined as progression of NASH CRN fibrosis stage.
16. Number of Participants With Resolution of NASH Using a Modified Definition Based on Categorical Features of NAS and no Concurrent Worsening of Fibrosis Stage at Year 1 [ Time Frame: Year 1 ]
    Resolution of NASH was defined as having no hepatocellular ballooning (grade 0) and minimal to no lobular inflammation (grade 1 or 0) with no concurrent worsening of fibrosis stage (worsening defined as progression of NASH CRN fibrosis stage).
17. Number of Participants With Resolution of NASH Using a Modified Definition Based on Categorical Features of NAS and no Concurrent Worsening of Fibrosis Stage at Year 2 [ Time Frame: Year 2 ]
    Resolution of NASH was defined as having no hepatocellular ballooning (grade 0) and minimal to no lobular inflammation (grade 1 or 0) with no concurrent worsening of fibrosis stage (worsening defined as progression of NASH CRN fibrosis stage).
18. Change From Baseline in Morphometric Quantitative Collagen on Liver Biopsy at Year 1 [ Time Frame: Year 1 ]
    The morphometric quantitative collagen on liver biopsy was determined as percent collagen area (PCA) using Sirius red stain on liver biopsy at Year 1. A negative change from Baseline indicates improvement.
19. Change From Baseline in Morphometric Quantitative Collagen on Liver Biopsy at Year 2 [ Time Frame: Year 2 ]
    The morphometric quantitative collagen on liver biopsy was determined as percent collagen area (PCA) using Sirius red stain on liver biopsy at Year 2. A negative change from Baseline indicates improvement.
20. Change From Baseline in Hepatic Tissue Fibrogenic Protein Alpha-Smooth Muscle Actin (α-SMA) at Year 1 [ Time Frame: Baseline (Day 1) to Year 1 ]
    The hepatic tissue fibrogenic protein α-SMA level was determined as percent α-SMA + area using α-SMA stain on liver biopsy at Year 1. A positive change from Baseline indicates worsening.
21. Change From Baseline in Hepatic Tissue Fibrogenic Protein Alpha-Smooth Muscle Actin (α-SMA) at Year 2 [ Time Frame: Baseline (Day 1) to Year 2 ]
    The hepatic tissue fibrogenic protein α-SMA level was determined as percent α-SMA + area using α-SMA stain on liver biopsy at Year 2. A positive change from Baseline indicates worsening.
22. Change From Baseline in Morphometric Quantitative Fat Content on Liver Biopsy at Year 1 [ Time Frame: Year 1 ]
    The morphometric quantitative fat content was done to find out the amount of fat accumulated in the liver. A liver biopsy was performed to determine percent fat area, at Year 1. A negative change from Baseline indicates improvement.
23. Change From Baseline in Morphometric Quantitative Fat Content on Liver Biopsy at Year 2 [ Time Frame: Year 2 ]
    The morphometric quantitative fat content was done to find out the amount of fat accumulated in the liver. A liver biopsy was performed to determine percent fat area, at Year 2. A negative change from Baseline indicates improvement.
24. Change From Baseline in Histologic Fibrosis Stage (NASH CRN System and Ishak Scale Score) at Year 1 [ Time Frame: Baseline (Day 1) to Year 1 ]
    The participant's histologic fibrosis stage was determined using the NASH CRN system and Ishak scale score assessment at Year 1. The evaluation of fibrosis stage associated with NASH was based on the NASH CRN Fibrosis Staging System which was scaled from 0 to 4 where, 0=None to 4=Cirrhosis. The histologic fibrosis stage based on the Ishak assessment was divided into 1 to 6 stages. Fibrosis was staged with the Ishak scale (ranging from 0=No fibrosis to 6=Cirrhosis). A positive change from Baseline indicates worsening.
25. Change From Baseline in Histologic Fibrosis Stage (NASH CRN System and Ishak Scale Score) at Year 2 [ Time Frame: Baseline (Day 1) to Year 2 ]
    The participant's histologic fibrosis stage was determined using the NASH CRN system and Ishak scale score assessment at Year 1. The evaluation of fibrosis stage associated with NASH was based on the NASH CRN Fibrosis Staging System which was scaled from 0 to 4 where, 0=None to 4=Cirrhosis. The histologic fibrosis stage based on the Ishak assessment was divided into 1 to 6 stages. Fibrosis was staged with the Ishak scale (ranging from 0=No fibrosis to 6=Cirrhosis). A negative change from Baseline indicates improvement.
26. Change From Baseline in Portal Inflammation Grade on Liver Biopsy at Year 1 [ Time Frame: Baseline (Day 1) to Year 1 ]
    Portal inflammation on liver biopsy was graded from 0 to 4 where 0= None, 1= Mild, 2= Moderate, and 3= Marked. A positive change from Baseline indicates worsening.
27. Change From Baseline in Portal Inflammation Grade on Liver Biopsy at Year 2 [ Time Frame: Baseline (Day 1) to Year 2 ]
    Portal inflammation on liver biopsy was graded from 0 to 4 where 0= None, 1= Mild, 2= Moderate, and 3= Marked. A positive change from Baseline indicates worsening.
28. Change From Baseline in Non-invasive Marker of Hepatic Fibrosis: Aspartate Aminotransferase to Platelet Count Ratio Index (APRI) at Months 3, 6 and 12 [ Time Frame: Baseline (Month 0) to Months 3, 6 and 12 ]
    APRI is the ratio of aspartate aminotransferase (AST) to platelet count. It is calculated using formula, APRI = (AST level [/ULN] / platelet counts [10^9/L]) * 100. An APRI index of <=0.50 indicated the absence of significant fibrosis and an index of > 1.50 indicated the presence of significant fibrosis. A negative change from Baseline indicates decreased fibrosis.
29. Change From Baseline in Non-invasive Marker of Hepatic Fibrosis: Aspartate Aminotransferase to Platelet Count Ratio Index (APRI) at Months 15, 18 and 24 [ Time Frame: Baseline (Month 0) to Months 15, 18 and 24 ]
    APRI is the ratio of aspartate aminotransferase (AST) to platelet count. It is calculated using formula, APRI = (AST level [/ULN] / platelet counts [10^9/L]) * 100. An APRI index of <=0.50 indicated the absence of significant fibrosis and an index of > 1.50 indicated the presence of significant fibrosis. A negative change from Baseline indicates decreased fibrosis.
30. Change From Baseline in Non-invasive Marker of Hepatic Fibrosis: Fibrosis-4 (FIB-4) at Months 3, 6 and 12 [ Time Frame: Baseline (Month 0) to Months 3, 6 and 12 ]
    Fibrosis-4 is the ratio of age in years and aminotransferase to platelet count. It is a non-invasive hepatic fibrosis index score combining standard biochemical values, platelets, alanine aminotransferase (ALT), AST and age that is calculated using formula: FIB-4 = (Age [years] x AST [U/L]) / (platelets [10^9/L] x (square root of ALT [U/L])). A FIB-4 index of < 1.45 indicated no or moderate fibrosis and an index of > 3.25 indicated extensive fibrosis/cirrhosis. A positive change from Baseline indicates increased fibrosis.
31. Change From Baseline in Non-invasive Marker of Hepatic Fibrosis: Fibrosis-4 (FIB-4) at Months 15, 18 and 24 [ Time Frame: Baseline (Month 0) to Months 15, 18 and 24 ]
    Fibrosis-4 is the ratio of age in years and aminotransferase to platelet count. It is a non-invasive hepatic fibrosis index score combining standard biochemical values, platelets, alanine aminotransferase (ALT), AST and age that is calculated using formula: FIB-4 = (Age [years] x AST [U/L]) / (platelets [10^9/L] x (square root of ALT [U/L])). A FIB-4 index of < 1.45 indicated no or moderate fibrosis and an index of > 3.25 indicated extensive fibrosis/cirrhosis. A positive change from Baseline indicates increased fibrosis.
32. Change From Baseline in Non-invasive Marker of Hepatic Fibrosis: Hyaluronic Acid at Months 6 and 12 [ Time Frame: Baseline (Month 0) to Months 6 and 12 ]
    Hyaluronic acid is a non-invasive hepatic fibrosis marker. A negative change from Baseline indicates decreased fibrosis.
33. Change From Baseline in Non-invasive Marker of Hepatic Fibrosis: Hyaluronic Acid at Months 18 and 24 [ Time Frame: Baseline (Month 0) to Months 18 and 24 ]
    Hyaluronic acid is a non-invasive hepatic fibrosis marker. A positive change from Baseline indicates increased fibrosis.
34. Change From Baseline in Non-invasive Markers of Hepatic Fibrosis: Nonalcoholic Fatty Liver Disease (NAFLD) Fibrosis Score (NFS) at Months 3, 6 and 12 [ Time Frame: Baseline (Month 0) to Months 3, 6 and 12 ]
    NFS is calculated using formula: NFS = -1.675 + 0.037 * age (years) + 0.094 * Body mass index (BMI) (kg/m^2) + 1.13 * Impaired fasting glucose (IFG)/diabetes (yes = 1, no = 0) + 0.99 * Aspartate aminotransferase (AST)/ Alanine aminotransferase (ALT) ratio - 0.013 × platelet (*10^9/L) - 0.66 * albumin (g/dL). A negative change from Baseline indicates decreased fibrosis.
35. Change From Baseline in Non-invasive Markers of Hepatic Fibrosis: NAFLD Fibrosis Score (NFS) at Months 15, 18 and 24 [ Time Frame: Baseline (Month 0) to Months 15, 18 and 24 ]
    NFS is calculated using formula: NFS = -1.675 + 0.037 * age (years) + 0.094 * Body mass index (BMI) (kg/m^2) + 1.13 * Impaired fasting glucose (IFG)/diabetes (yes = 1, no = 0) + 0.99 * Aspartate aminotransferase (AST)/ Alanine aminotransferase (ALT) ratio - 0.013 × platelet (*10^9/L) - 0.66 * albumin (g/dL). A negative change from Baseline indicates decreased fibrosis.
36. Change From Baseline in Non-invasive Markers of Hepatic Fibrosis: Enhanced Liver Fibrosis Test (ELF) Score at Months 6 and 12 [ Time Frame: Baseline (Month 0) to Months 6 and 12 ]
    The markers of fibrosis assessed in this test comprised hyaluronic acid (CHA), tissue inhibitor of metalloproteinase (CTIMP1) and procollagen III N-terminal peptide (CP3NP); these are components of the extracellular matrix and basement sinusoidal membrane of the liver and are elevated during activation of the stellate cell. The ELF tests were performed on Centaur device and the composite score was calculated as follows: ELF score = 2.278 + 0.851 ln(CHA) + 0.751 ln (CP3NP) + 0.394 ln(CTIMP1). ELF score < 7.7: no to mild fibrosis; ≥ 7.7 - < 9.8: Moderate fibrosis; ≥ 9.8 - < 11.3: Severe fibrosis; ≥ 11.3: Cirrhosis. A negative change from Baseline indicates decreased fibrosis.
37. Change From Baseline in Non-invasive Markers of Hepatic Fibrosis: Enhanced Liver Fibrosis Test (ELF) Score at Months 18 and 24 [ Time Frame: Baseline (Month 0) to Months 18 and 24 ]
    The markers of fibrosis assessed in this test comprised hyaluronic acid (CHA), tissue inhibitor of metalloproteinase (CTIMP1) and procollagen III N-terminal peptide (CP3NP); these are components of the extracellular matrix and basement sinusoidal membrane of the liver and are elevated during activation of the stellate cell. The ELF tests were performed on Centaur device and the composite score was calculated as follows: ELF score = 2.278 + 0.851 ln(CHA) + 0.751 ln (CP3NP) + 0.394 ln(CTIMP1). ELF score < 7.7: no to mild fibrosis; ≥ 7.7 - < 9.8: Moderate fibrosis; ≥ 9.8 - < 11.3: Severe fibrosis; ≥ 11.3: Cirrhosis. A negative change from Baseline indicates decreased fibrosis.
38. Change From Baseline in Biomarkers of Hepatocyte Apoptosis: Caspase Cleaved (CK-18 [M-30]) Levels and Total M-65 (CK-18 [M-65]) Levels at Months 3, 6 and 12 [ Time Frame: Baseline (Month 0) to Months 3, 6 and 12 ]
    Caspase-cleaved cytokeratin levels (CK18M30) and total M-65 (CK-18 [M-65]) were measured as biomarkers of hepatocyte apoptosis. A negative change from Baseline indicates decreased hepatocyte apoptosis.
39. Change From Baseline in Biomarkers of Hepatocyte Apoptosis: Caspase Cleaved (CK-18 [M-30]) Levels and Total M-65 (CK-18 [M-65]) Levels at Months 15, 18 and 24 [ Time Frame: Baseline (Month 0) to Months 15, 18 and 24 ]
    Caspase-cleaved cytokeratin levels (CK18M30) and total M-65 (CK-18 [M-65]) were measured as biomarkers of hepatocyte apoptosis. A negative change from Baseline indicates decreased hepatocyte apoptosis.
40. Change From Baseline in Weight at Months 3, 6 and 12 [ Time Frame: Baseline (Day 1) to Months 3, 6 and 12 ]
    A negative change from Baseline represents decreased weight.
41. Change From Baseline in Weight at Months 15, 18 and 24 [ Time Frame: Baseline (Day 1) to Months 15, 18 and 24 ]
    A negative change from Baseline represents decreased weight.
42. Change From Baseline in Body Mass Index (BMI) at Months 3, 6 and 12 [ Time Frame: Baseline (Day 1) to Months 3, 6 and 12 ]
    The body mass index is a value derived from the mass (weight in kgs) and height (in centimeters) of an individual and is calculated as the body mass divided by the square of the body height. A negative change from Baseline represents decreased BMI.
43. Change From Baseline in Body Mass Index (BMI) at Months 15, 18 and 24 [ Time Frame: Baseline (Day 1) to Months 15, 18 and 24 ]
    The body mass index is a value derived from the mass (weight in kgs) and height (in centimeters) of an individual and is calculated as the body mass divided by the square of the body height. A negative change from Baseline represents decreased BMI.
44. Change From Baseline in Waist Circumference at Months 3, 6 and 12 [ Time Frame: Baseline (Day 1) to Months 3, 6 and 12 ]
    A negative change from Baseline represents decreased in waist circumference.
45. Change From Baseline in Waist Circumference at Months 15, 18 and 24 [ Time Frame: Baseline (Day 1) to Months 15, 18 and 24 ]
    A negative change from Baseline represents decreased in waist circumference.
46. Change From Baseline in Hip Circumference at Months 3, 6 and 12 [ Time Frame: Baseline (Day 1) to Months 3, 6 and 12 ]
    A negative change from Baseline represents decreased hip circumference.
47. Change From Baseline in Hip Circumference at Months 15, 18 and 24 [ Time Frame: Baseline (Day 1) to Months 15, 18 and 24 ]
    A negative change from Baseline represents decreased hip circumference.
48. Change From Baseline in Forearm Circumference at Months 3, 6 and 12 [ Time Frame: Baseline (Day 1) to Months 3, 6 and 12 ]
    A negative change from Baseline represents decreased forearm circumference.
49. Change From Baseline in Forearm Circumference at Months 15, 18 and 24 [ Time Frame: Baseline (Day 1) to Months 15, 18 and 24 ]
    A negative change from Baseline represents decreased forearm circumference.
50. Change From Baseline in Tricep Skinfold Thickness at Months 3, 6 and 12 [ Time Frame: Baseline (Day 1) to Months 3, 6 and 12 ]
    A negative change from Baseline represents decreased Tricep Skinfold Thickness.
51. Change From Baseline in Tricep Skinfold Thickness at Months 15, 18 and 24 [ Time Frame: Baseline (Day 1) to Months 15, 18 and 24 ]
    A negative change from Baseline represents decreased Tricep Skinfold Thickness.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 75 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Adult participants aged between 18-75
• Histological evidence of NASH, based on biopsy, with a Nonalcoholic fatty liver disease Activity Score (NAS) of >= 4 with at least 1 in each component of NAS
• Histological evidence of liver fibrosis defined as NASH Clinical Research Network (CRN) System Stage 1 to 3

• Meeting any of the 3 major criteria (a, b, c):

  1. Documented evidence of type 2 diabetes mellitus

  2. High body mass index (> 25 kg/m^2) with at least one of the following criteria of metabolic syndrome, as defined by the National Cholesterol Education Program:

     • Central obesity: waist circumference ≥ 102 cm or 40 inches (male), ≥ 88 cm or 35 inches (female)
     • Dyslipidemia: Triglycerides ≥ 1.7 mmol/L (150 mg/dL)
     • Dyslipidemia: High-density lipoprotein (HDL)-cholesterol < 40 mg/dL (male), < 50 mg/dL (female)
     • Blood pressure ≥ 130/85 mmHg (or currently being treated for hypertension)
     • Fasting plasma glucose ≥ 6.1 mmol/L (110 mg/dL)
  3. Bridging fibrosis (NASH CRN Stage 3) and/or definite NASH (NAS ≥ 5)
• Agree to have one liver biopsy at Screening, one at Year 1, and one at the end of study treatment (Year 2)
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5 × upper limit of normal (ULN)

Exclusion Criteria:

• Hepatitis B surface Antigen (HBsAg) positive

• Hepatitis C antibody (HCVAb) positive with the following 2 exceptions:

  1. Participants previously treated for viral hepatitis C with at least a 1-year period since documented sustained virologic response at Week 12 (post-treatment) may be eligible if all other eligibility criteria are met
  2. Participants with presence of hepatitis C antibody but negative hepatitis C virus ribonucleic acid RNA without treatment (i.e., spontaneous clearance) may be eligible if all other eligibility criteria are met
• Prior or planned liver transplantation
• Other known causes of chronic liver disease, including alcoholic liver disease
• History of cirrhosis and/or hepatic decompensation including ascites, hepatic encephalopathy or variceal bleeding
• Alcohol consumption greater than 21 units/week for males or 14 units/week for females (one unit of alcohol is ½ pint of beer [285 mL], 1 glass of spirits [25 mL] or 1 glass of wine [125 mL])
• Human immunodeficiency virus (HIV)-1 or HIV-2 infection
• Weight reduction through bariatric surgery in the past 5 years or planned during the conduct of the study (including gastric banding)
• Females who are pregnant or breastfeeding
• Any other clinically significant disorders or prior therapy that, in the opinion of the investigator, would make the participant unsuitable for the study or unable to comply with the dosing and protocol requirements.

Contacts and Locations

Locations

United States, Alabama

Dothan, Alabama, United States, 36305

United States, Arizona

Phoenix, Arizona, United States, 85054

Tucson, Arizona, United States, 85712

United States, California

Rialto, California, United States, 92377

San Diego, California, United States, 92120

San Diego, California, United States, 92161

San Francisco, California, United States, 94115

United States, Colorado

Littleton, Colorado, United States, 80120

United States, Florida

Miami, Florida, United States, 33136

Tampa, Florida, United States, 33606

United States, Illinois

Chicago, Illinois, United States, 60612

United States, Kentucky

Louisville, Kentucky, United States, 40202

United States, Louisiana

New Orleans, Louisiana, United States, 70112

United States, Maryland

Baltimore, Maryland, United States, 21202

Baltimore, Maryland, United States, 21287

Chevy Chase, Maryland, United States, 20815

Lutherville, Maryland, United States, 21093

United States, Massachusetts

Boston, Massachusetts, United States, 02114

Worcester, Massachusetts, United States, 01655

United States, Michigan

Ann Arbor, Michigan, United States, 48109

United States, Minnesota

Saint Paul, Minnesota, United States, 55114

United States, Mississippi

Flowood, Mississippi, United States, 39232

Jackson, Mississippi, United States

Tupelo, Mississippi, United States, 38801

United States, New York

Buffalo, New York, United States, 14201

New York, New York, United States, 10029

United States, North Carolina

Durham, North Carolina, United States, 27710

Raleigh, North Carolina, United States, 27612

Winston-Salem, North Carolina, United States, 27103

United States, Ohio

Cincinnati, Ohio, United States, 45249

United States, Tennessee

Chattanooga, Tennessee, United States, 37421

Germantown, Tennessee, United States, 38138

United States, Texas

Houston, Texas, United States, 77030

Houston, Texas, United States, 78234

Live Oak, Texas, United States, 78233

San Antonio, Texas, United States, 78215

San Antonio, Texas, United States, 78233

United States, Utah

Salt Lake City, Utah, United States, 84132

United States, Virginia

Richmond, Virginia, United States, 23298

United States, Washington

Seattle, Washington, United States, 98104

Australia, Australian Capital Territory

Garran, Australian Capital Territory, Australia, 2605

Australia, Queensland

Herston, Queensland, Australia, 4029

Australia, South Australia

Adelaide, South Australia, Australia, 5000

Bedford Park, South Australia, Australia, 5042

Australia, Victoria

Clayton, Victoria, Australia, 3168

Heidelberg, Victoria, Australia, 3084

Melbourne, Victoria, Australia, 3004

Australia, Western Australia

Perth, Western Australia, Australia, 6000

Belgium

Brussels, Belgium, 1070

Brussels, Belgium, 1200

Edegem, Belgium, 2650

Leuven, Belgium, 3000

France

Angers, France, 49100

Lyon cedex 04, France, 69317

Montpellier Cedex 5, France, 34295

Paris, France, 75012

Paris, France, 75651

Pessac Cedex, France, 33604

Toulouse, France, 31059

Vandoeuvre-les Nancy, France, 54500

Villejuif, France, 94800

Germany

Heidelberg, BW, Germany, 69120

Marburg, HE, Germany, 35043

Hamburg, HH, Germany, 20246

Hannover, Niedersachsen, Germany, 30625

Aachen, NRW, Germany, 52074

Koeln, NRW, Germany, 50937

Leipzig, Sachsen, Germany, 04103

Leipzig, SN, Germany, 04103

Heidelberg, VIC, Germany, 3084

Berlin, Germany, 13353

Lubeck, Germany, 23538

Hong Kong

Shatin, New Territories, Hong Kong

Italy

Bologna, BO, Italy, 40138

Milan, MI, Italy, 20122

Rozzano, MI, Italy, 20089

Palermo, PA, Italy, 90127

Poland

Chorzow, Poland, 41-500

Lodz, Poland, 91-347

Myslowice, Poland, 41-500

Rzeszow, Poland, 35-055

Wroclaw, Poland, 50-349

Spain

Alicante, Spain, 03010

Barcelona, Spain, 08026

Barcelona, Spain, 08035

Barcelona, Spain, 08036

Madrid, Spain, 28007

United Kingdom

Portsmouth, Hampshire, United Kingdom, PO6 3LY

London, United Kingdom, E1 1BB

London, United Kingdom, NW3 2QR

Newcastle, United Kingdom, NE7 7ND

Nottingham, United Kingdom, NG7 2UH

Sponsors and Collaborators

Tobira Therapeutics, Inc.

Investigators

• Study Director: Eric Lefebvre, MD; Allergan

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Qian T, Fujiwara N, Koneru B, Ono A, Kubota N, Jajoriya AK, Tung MG, Crouchet E, Song WM, Marquez CA, Panda G, Hoshida A, Raman I, Li QZ, Lewis C, Yopp A, Rich NE, Singal AG, Nakagawa S, Goossens N, Higashi T, Koh AP, Bian CB, Hoshida H, Tabrizian P, Gunasekaran G, Florman S, Schwarz ME, Hiotis SP, Nakahara T, Aikata H, Murakami E, Beppu T, Baba H, Rew Warren, Bhatia S, Kobayashi M, Kumada H, Fobar AJ, Parikh ND, Marrero JA, Rwema SH, Nair V, Patel M, Kim-Schulze S, Corey K, O'Leary JG, Klintmalm GB, Thomas DL, Dibas M, Rodriguez G, Zhang B, Friedman SL, Baumert TF, Fuchs BC, Chayama K, Zhu S, Chung RT, Hoshida Y. Molecular Signature Predictive of Long-Term Liver Fibrosis Progression to Inform Antifibrotic Drug Development. Gastroenterology. 2022 Apr;162(4):1210-1225. doi: 10.1053/j.gastro.2021.12.250. Epub 2021 Dec 22. Erratum In: Gastroenterology. 2022 Aug;163(2):536.

Nielsen MJ, Leeming DJ, Goodman Z, Friedman S, Frederiksen P, Rasmussen DGK, Vig P, Seyedkazemi S, Fischer L, Torstenson R, Karsdal MA, Lefebvre E, Sanyal AJ, Ratziu V. Comparison of ADAPT, FIB-4 and APRI as non-invasive predictors of liver fibrosis and NASH within the CENTAUR screening population. J Hepatol. 2021 Dec;75(6):1292-1300. doi: 10.1016/j.jhep.2021.08.016. Epub 2021 Aug 27.

Parthasarathy G, Malhi H. Macrophage Heterogeneity in NASH: More Than Just Nomenclature. Hepatology. 2021 Jul;74(1):515-518. doi: 10.1002/hep.31790. Epub 2021 May 22. No abstract available.

Ratziu V, Sanyal A, Harrison SA, Wong VW, Francque S, Goodman Z, Aithal GP, Kowdley KV, Seyedkazemi S, Fischer L, Loomba R, Abdelmalek MF, Tacke F. Cenicriviroc Treatment for Adults With Nonalcoholic Steatohepatitis and Fibrosis: Final Analysis of the Phase 2b CENTAUR Study. Hepatology. 2020 Sep;72(3):892-905. doi: 10.1002/hep.31108. Epub 2020 Jul 21.

Lefebvre E, Moyle G, Reshef R, Richman LP, Thompson M, Hong F, Chou HL, Hashiguchi T, Plato C, Poulin D, Richards T, Yoneyama H, Jenkins H, Wolfgang G, Friedman SL. Antifibrotic Effects of the Dual CCR2/CCR5 Antagonist Cenicriviroc in Animal Models of Liver and Kidney Fibrosis. PLoS One. 2016 Jun 27;11(6):e0158156. doi: 10.1371/journal.pone.0158156. eCollection 2016.

Friedman S, Sanyal A, Goodman Z, Lefebvre E, Gottwald M, Fischer L, Ratziu V. Efficacy and safety study of cenicriviroc for the treatment of non-alcoholic steatohepatitis in adult subjects with liver fibrosis: CENTAUR Phase 2b study design. Contemp Clin Trials. 2016 Mar;47:356-65. doi: 10.1016/j.cct.2016.02.012. Epub 2016 Mar 2.

• Responsible Party: Tobira Therapeutics, Inc.
• ClinicalTrials.gov Identifier: NCT02217475
• Other Study ID Numbers: 652-2-203; 2016-004754-15 ( EudraCT Number )
• First Posted: August 15, 2014
• Results First Posted: May 10, 2019
• Last Update Posted: May 10, 2019
• Last Verified: March 2019

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Fatty Liver; Non-alcoholic Fatty Liver Disease; Liver Cirrhosis; Fibrosis; Pathologic Processes; Liver Diseases; Digestive System Diseases; Cenicriviroc; CCR5 Receptor Antagonists; Molecular Mechanisms of Pharmacological Action; Anti-HIV Agents; Anti-Retroviral Agents; Antiviral Agents; Anti-Infective Agents