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A Study to Assess the Safety, Tolerability, Pharmacokinetics and Efficacy of EDP-305 in Subjects With Non-Alcoholic Steatohepatitis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03421431
Recruitment Status : Completed
First Posted : February 5, 2018
Results First Posted : September 16, 2021
Last Update Posted : September 16, 2021
Sponsor:
Collaborators:
ICON Clinical Research
Triangle Biostatistics
Information provided by (Responsible Party):
Enanta Pharmaceuticals

Brief Summary:
A randomized, double-blind study to assess the safety, tolerability, PK and efficacy of EDP-305 in subjects with Non-Alcoholic Steatohepatitis

Condition or disease Intervention/treatment Phase
Non-Alcoholic Steatohepatitis Drug: EDP-305 Dose 1 Drug: EDP-305 Dose 2 Drug: Placebo Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 134 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 2 Dose Ranging, Randomized, Double Blind, and Placebo-Controlled Study Evaluating the Safety, Tolerability, Pharmacokinetics and Efficacy of EDP-305 in Subjects With Non-Alcoholic Steatohepatitis (NASH)
Actual Study Start Date : April 25, 2018
Actual Primary Completion Date : June 14, 2019
Actual Study Completion Date : July 10, 2019

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: EDP-305 Dose 1
Subjects will take 2 tablets once a day orally for 12 weeks
Drug: EDP-305 Dose 1
Two tablets daily for 12 weeks

Experimental: EDP-305 Dose 2
Subjects will take 2 tablets once a day orally for 12 weeks
Drug: EDP-305 Dose 2
Two tablets daily for 12 weeks

Placebo Comparator: Placebo
Subjects will take 2 tablets once a day orally for 12 weeks
Drug: Placebo
Two tablets daily for 12 weeks




Primary Outcome Measures :
  1. Mean Change From Baseline (Average) in Alanine Aminotransferase (ALT) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the ALT level. Baseline refers to the average of the screening and the Day 1 values; if either the screening or Day 1 values were missing, the non-missing value was used. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.


Secondary Outcome Measures :
  1. Mean Change From Baseline in Percentage of Fat in the Liver as Assessed by Magnetic Resonance Imaging - Proton Density Fat Fraction (MRI-PDFF) at Week 12 [ Time Frame: Baseline and Week 12 ]
    The liver fat percentage was assessed by MRI-PDFF, which is an established method that enables the quantification of fat content in the liver; the value of liver fat is expressed in percentage and ranges from 0 to 100% with higher values representing higher liver fat level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  2. Mean Change From Baseline in Aspartate Aminotransferase to Platelet Ratio Index (APRI) at Week 12 [ Time Frame: Baseline and Week 12 ]

    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the aspartate aminotransferase (AST) level and platelet count. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. The APRI score (AST to platelet ratio index) is an index comprised of biochemical values and is used to determine the degree of hepatic fibrosis. APRI is calculated from the level of AST measured in a blood test (international units per liter [IU/L]) and platelet count (10^9/L) according to the following formula:

    APRI = ([AST value in IU/L / upper limit of the normal range of AST] / [platelet count in 10^9/L]) × 100.

    In general, APRI scores range from 0 to >2.0, where scores <0.5 indicate no significant fibrosis, scores >1.5 indicate significant fibrosis, and scores >2.0 have been shown to be best correlated with the presence of cirrhosis. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.


  3. Mean Change From Baseline in Triglycerides (TG) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the TG level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  4. Mean Change From Baseline in Total Cholesterol at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the total cholesterol level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  5. Mean Change From Baseline in High-Density Lipoprotein Cholesterol (HDL-C) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the HDL-C level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  6. Mean Change From Baseline in Low-Density Lipoprotein Cholesterol (LDL-C) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the LDL-C level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  7. Mean Change From Baseline in Adiponectin at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the adiponectin level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  8. Mean Change From Baseline in Apolipoproteins A1 (ApoA-1) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the ApoA-1 level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  9. Mean Change From Baseline in Apolipoproteins B (ApoB) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the ApoB level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  10. Mean Change From Baseline in Apolipoproteins C3 (ApoC3) at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the ApoC3 level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  11. Mean Change From Baseline in Fasting Blood Glucose at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the fasting glucose level. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  12. Mean Change From Baseline in Fasting Insulin at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the fasting insulin (in micro International units per milliliter [μIU/mL]). Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  13. Mean Change From Baseline in Homeostasis Model Assessment (HOMA) Index for Nondiabetic Participants at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation; from the results of fasting glucose and insulin, an insulin resistance (IR) was estimated for the nondiabetic participants using the HOMA-IR computer algorithm. A higher HOMA-IR indicates a higher degree of insulin resistance. Participants who were not considered as having type 2 diabetes mellitus (T2DM) were identified as nondiabetic. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  14. Mean Change From Baseline in HOMA Index for Diabetic Participants at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation; from the results of fasting glucose and insulin, an insulin resistance (IR) was estimated for the nondiabetic participants using the HOMA-IR computer algorithm. A higher HOMA-IR indicates a higher degree of insulin resistance. Participants who were considered as having T2DM were identified as diabetic. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  15. Mean Change From Baseline in Glycated Hemoglobin (HbA1c) in Participants With T2DM at Week 12 [ Time Frame: Baseline and Week 12 ]
    Blood samples were collected at specific timepoints for the laboratory evaluation to assess the HbA1c. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  16. Maximum Plasma Concentration (Cmax) of EDP-305 on Day 1 and Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Cmax is the maximum observed plasma concentration, which was measured for EDP-305 on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the Pharmacokinetic (PK) Population.

  17. Time to Reach Maximum Plasma Concentration (Tmax) of EDP-305 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Tmax was measured for EDP-305 on Day 1 and at Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  18. Area Under the Plasma Concentration-Time Curve (AUC) From Time Zero to the Time of the Last Quantifiable Concentration (AUC[Last]) of EDP-305 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    AUC(last) is defined as the area under the plasma concentration-time curve from time zero to time the last quantifiable concentration, computed using the linear up/log down trapezoidal rule. AUC(last) was computed for EDP-305 on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  19. Cmax of EP-022571 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Cmax is the maximum observed plasma concentration, which was measured for EP-022571 (a metabolite of EDP-305) on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  20. Tmax of EP-022571 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Tmax was measured for EP-022571 (a metabolite of EDP-305) on Day 1 and at Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  21. AUC(Last) of EP-022571 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    AUC(last) is defined as the area under the plasma concentration-time curve from time zero to time the last quantifiable concentration, computed using the linear up/log down trapezoidal rule. AUC(last) was computed for EP-022571 (a metabolite of EDP-305) on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  22. Cmax of EP-022572 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Cmax is the maximum observed plasma concentration, which was measured for EP-022572 (a metabolite of EDP-305) on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  23. Tmax of EP-022572 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Tmax was measured for EP-022572 (a metabolite of EDP-305) on Day 1 and at Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  24. AUC(Last) of EP-022572 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    AUC(last) is defined as the area under the plasma concentration-time curve from time zero to time the last quantifiable concentration, computed using the linear up/log down trapezoidal rule. AUC(last) was computed for EP-022572 (a metabolite of EDP-305) on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  25. Cmax of EP-022679 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Cmax is the maximum observed plasma concentration, which was measured for EP-022679 (a metabolite of EDP-305) on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  26. Tmax of EP-022679 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    The Tmax was measured for EP-022679 (a metabolite of EDP-305) on Day 1 and at Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  27. AUC(Last) of EP-022679 on Day 1 and at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and on Day 84 (Week 12) ]
    AUC(last) is defined as the area under the plasma concentration-time curve from time zero to time the last quantifiable concentration, computed using the linear up/log down trapezoidal rule. AUC(last) was computed for EP-022679 (a metabolite of EDP-305) on Day 1 and Week 12 for the samples collected according to the intensive sampling scheme for the participants in the PK Population.

  28. Mean Change From Baseline in Body Weight at Week 12 [ Time Frame: Baseline and Week 12 ]
    Body weight was measured at specific timepoints for the participants. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  29. Mean Change From Baseline in Waist to Hip (WTH) Ratio at Week 12 [ Time Frame: Baseline and Week 12 ]
    The WTH ratio is calculated as the ratio of waist to hip circumference, which was measured at specific timepoints. Baseline refers to the last non-missing value collected prior to the first dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  30. Mean Change From Baseline in Fibroblast Growth Factor 19 (FGF19) by Nominal Timepoint (Intensive Pharmacodynamic [PD] Samples) at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and Day 84 (Week 12) ]
    Blood samples were collected according to the intensive sampling scheme at specific timepoints to assess the PD marker: FGF19. Baseline refers to the last non-missing predose value collected prior to the most recent dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  31. Mean Change From Baseline in FGF19 by Bin Timepoint (Sparse PD Samples) at Week 12 [ Time Frame: Predose and two samples postdose (first sample between 1 to 3 hours postdose and second sample 1 hour later than fist sample) on Day 1 and Day 84 (Week 12) ]
    Blood samples were collected according to the sparse sampling scheme at specific timepoints to assess the PD marker: FGF19. Baseline refers to the last non-missing predose value collected prior to the most recent dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  32. Mean Change From Baseline in 7a-Hydroxy-4-Cholestene-3-One (C4) by Nominal Timepoint (Intensive PD Samples) at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and Day 84 (Week 12) ]
    Blood samples were collected according to the intensive sampling scheme at specific timepoints to assess the PD marker: C4. Baseline refers to the last non-missing predose value collected prior to the most recent dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  33. Mean Change From Baseline in C4 by Bin Timepoint (Sparse PD Samples) at Week 12 [ Time Frame: Predose and two samples postdose (first sample between 1 to 3 hours postdose and second sample 1 hour later than fist sample) on Day 1 and Day 84 (Week 12) ]
    Blood samples were collected according to the sparse sampling scheme at specific timepoints to assess the PD marker: C4. Baseline refers to the last non-missing predose value collected prior to the most recent dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  34. Mean Change From Baseline in Bile Acid (BA) by Nominal Timepoint (Intensive PD Samples) at Week 12 [ Time Frame: Predose and 2, 6, and 8 hours postdose on Day 1 and Day 84 (Week 12) ]
    Blood samples were collected according to the intensive sampling scheme at specific timepoints to assess the PD marker: BA. Baseline refers to the last non-missing predose value collected prior to the most recent dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.

  35. Mean Change From Baseline in BA by Bin Timepoint (Sparse PD Samples) at Week 12 [ Time Frame: Predose and two samples postdose (first sample between 1 to 3 hours postdose and second sample 1 hour later than fist sample) on Day 1 and Day 84 (Week 12) ]
    Blood samples were collected according to the sparse sampling scheme at specific timepoints to assess the PD marker: BA. Baseline refers to the last non-missing predose value collected prior to the most recent dose of study treatment. Mean change was defined as the mean value at Week 12 minus the mean value at baseline.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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

Inclusion Criteria:

  • An informed consent document must be signed and dated by the subject
  • Male and female subjects of any ethnic origin between the ages of 18 and 75 years, inclusive
  • Male or female with presence of NASH by:

    • Histologic evidence on a historical liver biopsy within 24 months of Screening consistent with NASH with fibrosis (no cirrhosis), and elevated ALT at Screening AND Screening MRI PDFF with >8 % steatosis OR
    • Phenotypic diagnosis of NASH based on elevated ALT and diagnosis of T2DM or pre-diabetes AND Screening MRI PDFF with >8 % steatosis
  • Body mass index (BMI) >25 kg/m2; for Asian-Americans, BMI >23 kg/m2
  • Female subjects of childbearing potential must agree to use two effective methods of contraception from the date of Screening until 90 days after the last dose of EDP-305.
  • Subject must be willing and able to adhere to the assessments, visit schedules, prohibitions and restrictions, as described in this protocol

Exclusion Criteria:

  • Laboratory Screening Results:

    • Total bilirubin > ULN (normal range 0.2-1.2 mg/dL)
    • Total white blood cells (WBC) <3,000 cells/mm3
    • Absolute neutrophil count (ANC) <1,500 cells/mm3
    • Platelet count <140,000/mm3
    • Prothrombin time (international normalized ratio, INR) > 1.2
    • Creatine kinase above the upper limit of normal (ULN) except when in relation with intense exercise
    • Serum creatinine >2 mg/dL or creatinine clearance <60 ml/min (based on Cockroft Gault method)
  • Known history of alpha-1-antitrypsin deficiency
  • Use of an experimental treatment for NASH within the past 6 months
  • Use of immunosuppressant (eg, corticosteroids) for more than 2 weeks in duration within 1 year prior to Screening and during the course of the study
  • Use of experimental or unapproved drugs within a year of Screening
  • Any other condition(s) (including cardiovascular diseases) that would compromise the safety of the subject or compromise the quality of the clinical study, as judged by the Principal Investigator (PI)
  • Pregnant or nursing females
  • Recipients of liver or other organ transplantation or anticipated need for orthotropic organ transplantation in one year as determined by a Model for End-Stage Liver Disease (MELD) Score ≥ 15
  • Clinical suspicion of advanced liver disease or cirrhosis
  • Coexisting liver or biliary diseases, such as primary sclerosing cholangitis (PSC), choledocholithiasis, acute or chronic hepatitis, autoimmune hepatitis, alcoholic liver disease, acute infection of bile duct system or gall bladder, history of gastrointestinal bleeding (secondary to portal hypertension), cirrhosis
  • Suspicion of cancer (eg, liver cancer) with the exception of basal cell carcinoma that has been resected
  • Cirrhosis with or without complications, including history or presence of: spontaneous bacterial peritonitis, hepatocellular carcinoma, bilirubin > 2xULN
  • Hepatorenal syndrome (type I or II) or Screening serum creatinine > 2 mg/dL (178 μmol/L)
  • Prior variceal hemorrhage, uncontrolled encephalopathy, Child-Pugh Class A, B, and C, esophageal varices, or refractory ascites within the previous 6 months of Screening (defined as date informed consent signed)
  • Any condition possibly affecting drug absorption (eg, gastrectomy <3 years prior to Screening)
  • Subject has received an investigational agent or vaccine within 30 days, or a biological product within 3 months or 5 elimination half-lives (whichever is longer) prior to the planned intake of study drug. NOTE: Flu vaccine will be allowed upon Medical Monitor's approval
  • Use of a new statin regimen from Screening and throughout study duration. NOTE: Subjects on a stable dose of statins for at least three months prior to Screening are allowed. No dose modification during the study will be allowed.
  • Current use of fibrates. Note: Subjects who discontinued fibrates for at least 3 months before Screening can participate
  • Clinically significant history of drug sensitivity or allergy, as determined by the PI
  • Uncontrolled diabetes mellitus (ie, HbA1c ≥9% or higher) 60 days prior to Day 1
  • Subjects with contraindications to MRI imaging, or not being able to have the MRI performed

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03421431


Locations
Show Show 82 study locations
Sponsors and Collaborators
Enanta Pharmaceuticals
ICON Clinical Research
Triangle Biostatistics
Investigators
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Study Director: Nathalie Adda, MD Enanta Pharmaceuticals Inc.
  Study Documents (Full-Text)

Documents provided by Enanta Pharmaceuticals:
Study Protocol  [PDF] February 21, 2018
Statistical Analysis Plan  [PDF] June 5, 2019

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Responsible Party: Enanta Pharmaceuticals
ClinicalTrials.gov Identifier: NCT03421431    
Other Study ID Numbers: EDP 305-101
First Posted: February 5, 2018    Key Record Dates
Results First Posted: September 16, 2021
Last Update Posted: September 16, 2021
Last Verified: August 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Enanta Pharmaceuticals:
NASH
Non-Alcoholic Steatohepatitis (NASH)
Additional relevant MeSH terms:
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Fatty Liver
Non-alcoholic Fatty Liver Disease
Liver Diseases
Digestive System Diseases