Try our beta test site
IMPORTANT: Listing of a study on this site does not reflect endorsement by the National Institutes of Health. Talk with a trusted healthcare professional before volunteering for a study. Read more...

Phase 3 Study of Obeticholic Acid in Patients With Primary Biliary Cirrhosis (POISE)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Intercept Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT01473524
First received: November 14, 2011
Last updated: December 20, 2016
Last verified: December 2016
  Purpose
The investigational drug, Obeticholic Acid (OCA) is a modified bile acid and FXR agonist. FXR is a key regulator of bile acid synthesis and transport. Bile acids are used by the body to help with digestion. It is hypothesized that regular treatment with OCA will improve liver function in persons with Primary Biliary Cirrhosis (PBC).

Condition Intervention Phase
Primary Biliary Cirrhosis
Drug: Obeticholic Acid (OCA)
Drug: Placebo
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 3, Double Blind, Placebo Controlled Trial and Long Term Safety Extension of Obeticholic Acid in Patients With Primary Biliary Cirrhosis

Resource links provided by NLM:


Further study details as provided by Intercept Pharmaceuticals:

Primary Outcome Measures:
  • Composite Endpoint Alkaline Phosphatase and Total Bilirubin, 10 mg OCA vs. Placebo [ Time Frame: 12 months ]
    Proportion of subjects at Month 12 with ALP < 1.67x ULN and total bilirubin ≤ ULN and ALP decrease of ≥ 15% from baseline.


Secondary Outcome Measures:
  • Composite Endpoint Alkaline Phosphatase and Total Bilirubin, 10 mg vs. Placebo [ Time Frame: 6 months ]
    Proportion of subjects at Month 6 with ALP < 1.67x ULN and total bilirubin ≤ ULN and ALP decrease of ≥ 15% from baseline.

  • Composite Endpoint Alkaline Phosphatase and Total Bilirubin, 5-10 mg vs. Placebo [ Time Frame: 12 Months ]
    Proportion of subjects at Month 12 with ALP < 1.67x ULN and total bilirubin ≤ ULN and ALP decrease of ≥ 15% from baseline.

  • Composite Endpoint Alkaline Phosphatase and Total Bilirubin, 5-10 mg vs. Placebo [ Time Frame: 6 Months ]
    Proportion of subjects at Month 6 with ALP < 1.67x ULN and total bilirubin ≤ ULN and ALP decrease of ≥ 15% from baseline.

  • Alkaline Phosphatase Absolute Change From Baseline to Month 12 [ Time Frame: 12 months ]
    Alkaline Phosphatase Absolute Change from Baseline to Month 12

  • Total Bilirubin Absolute Change From Baseline to Month 12 [ Time Frame: 12 months ]
    Total Bilirubin Absolute Change from Baseline to Month 12

  • Direct Bilirubin Absolute Change From Baseline to Month 12 [ Time Frame: 12 months ]
    Direct Bilirubin Absolute Change from Baseline to Month 12

  • Alanine Aminotransferase (ALT) Absolute Change From Baseline to Month 12 [ Time Frame: 12 months ]
    Alanine Aminotransferase (ALT) Absolute Change from Baseline to Month 12

  • Aspartate Aminotransferase (AST) Absolute Change From Baseline to Month 12 [ Time Frame: 12 months ]
    Aspartate Aminotransferase (AST) Absolute Change from Baseline to Month 12

  • Gamma-glutamyltransferase (GGT) Absolute Change From Baseline to Month 12 [ Time Frame: 12 months ]
    Gamma-glutamyltransferase (GGT) Absolute Change from Baseline to Month 12


Enrollment: 217
Study Start Date: January 2012
Estimated Study Completion Date: June 2018
Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: OCA 5-10 mg

OCA 5 mg for 6 months and then titrating up to 10 mg based on tolerability and response for remainder of double-blind period.

After completion of the 1-year double-blind period subjects will be offered the opportunity to enter an open label long term safety extension for up to 5 years beginning at 5 mg OCA. Doses up to 25 mg daily will be evaluated.

Drug: Obeticholic Acid (OCA)
Other Names:
  • 6α-ethyl chenodeoxycholic acid (6-ECDCA)
  • INT-747
Experimental: OCA 10 mg
OCA 10 mg for double-blind period. After completion of the 1-year double-blind period subjects will be offered the opportunity to enter an open label long term safety extension for up to 5 years beginning at 5 mg OCA. Doses up to 25 mg daily will be evaluated.
Drug: Obeticholic Acid (OCA)
Other Names:
  • 6α-ethyl chenodeoxycholic acid (6-ECDCA)
  • INT-747
Placebo Comparator: Placebo
One tablet daily for double-blind period. After completion of the 1-year double-blind period subjects will be offered the opportunity to enter an open label long term safety extension for up to 5 years beginning at 5 mg OCA. Doses up to 25 mg daily will be evaluated.
Drug: Placebo

  Eligibility

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Definite or probable PBC diagnosis (consistent with American Association for the Study of Liver Disease [AASLD] and European Association for Study of the Liver [EASL] Practice Guidelines; [Lindor 2009; EASL 2009]), as demonstrated by the presence of ≥ 2 of the following 3 diagnostic factors:

    • History of elevated Alkaline Phosphatase levels for at least 6 months
    • Positive antimitochondrial antibodies (AMA) titer or if AMA negative or in low titer (<1:80) PBC specific antibodies (anti-GP210 and/or anti-SP100 and/or antibodies against the major M2 components (PDC-E2, 2-oxo-glutaric acid dehydrogenase complex)
    • Liver biopsy consistent with PBC
  2. At least 1 of the following qualifying biochemistry values:

    • ALP ≥ 1.67x upper limit of normal (ULN)
    • Total bilirubin > ULN but < 2x ULN
  3. Age ≥ 18 years
  4. Taking ursodeoxycholic acid (UDCA) for at least 12 months (stable dose for ≥ 3 months) prior to Day 0, or unable to tolerate UDCA (no UDCA for ≥ 3 months) prior to Day 0.
  5. Contraception: Female patients must be postmenopausal, surgically sterile, or if premenopausal, be prepared to use ≥ 1 effective (≤ 1% failure rate) method of contraception during the trial and for 30 days after the end of treatment (EOT) visit. Effective methods of contraception are considered to be:

    • Hormonal (e.g., contraceptive pill, patch, intramuscular implant or injection); or
    • Double barrier method, i.e., (a) condom (male or female) or (b) diaphragm, with spermicide; or
    • Intrauterine device (IUD); or
    • Vasectomy (partner)
  6. Must provide written informed consent and agree to comply with the trial protocol.

Exclusion Criteria:

  1. History or presence of other concomitant liver diseases including:

    • Hepatitis C virus (HCV) infection; patients with active hepatitis B (HBV) infection will be excluded, however, patients who have seroconverted (Hbs Ag and Hbe Ag negative) may be included after consultation with the medical monitor.
    • Primary sclerosing cholangitis (PSC)
    • Alcoholic liver disease
    • Definite autoimmune liver disease or overlap hepatitis
    • Nonalcoholic steatohepatitis (NASH)
    • Gilbert's Syndrome (due to interpretability of bilirubin levels)
  2. Presence of clinical complications of PBC or clinically significant hepatic decompensation, including:

    • History of liver transplantation, current placement on a liver transplant list or current Model for End Stage Liver Disease (MELD) score ≥ 15
    • Portal hypertension with complications, including: known gastric or large esophageal varices, poorly controlled or diuretic resistant ascites, history of variceal bleeds or related therapeutic or prophylactic interventions (e.g., beta blockers, insertion of variceal bands or transjugular intrahepatic portosystemic shunt [TIPS]), or hepatic encephalopathy
    • Cirrhosis with complications, including history or presence of: spontaneous bacterial peritonitis, hepatocellular carcinoma, bilirubin > 2x ULN
    • Hepatorenal syndrome (type I or II) or Screening serum creatinine > 2 mg/dL (178 μmol/L)
  3. Patients with severe pruritus or those requiring systemic treatment for pruritus (e.g., with bile acid sequestrants [BAS] or rifampicin) within 2 months of Day 0 will be excluded
  4. Administration of the following medications is prohibited as specified below:

    • Prohibited 6 months prior to Day 0 and throughout the trial (i.e., to last dose to last dose and/or EOT): azathioprine, colchicine, cyclosporine, methotrexate, mycophenolate mofetil, pentoxifylline; fenofibrate or other fibrates; budesonide and other systemic corticosteroids; potentially hepatotoxic drugs (including α-methyl-dopa, sodium valproic acid, isoniazide, or nitrofurantoin)
    • Prohibited 12 months prior to Day 0 and throughout the trial (i.e., to last dose to last dose and/or EOT): antibodies or immunotherapy directed against interleukins or other cytokines or chemokines
  5. Patients who have previously participated in a clinical trial of OCA will not be allowed to participate
  6. History or presence of clinically concerning cardiac arrhythmias likely to affect survival during the trial, or prolongation of Screening (pretreatment) QT or QTc interval of > 500 milliseconds (msec)
  7. If female: known pregnancy, or has a positive urine pregnancy test (confirmed by a positive serum pregnancy test), or lactating
  8. Known history of human immunodeficiency virus (HIV) infection
  9. Presence of any other disease or condition that is interfering with the absorption, distribution, metabolism, or excretion of drugs including bile salt metabolism in the intestine. Patients with inflammatory bowel disease or who have undergone gastric bypass procedures will be excluded (gastric lap band is acceptable).
  10. Medical conditions that may cause nonhepatic increases in ALP (e.g., Paget's disease) or which may diminish life expectancy to < 2 years, including known cancers (except carcinomas in situ or other stable, relatively benign conditions such as chronic lymphatic leukemia)
  11. Other clinically significant medical conditions that are not well controlled or for which medication needs are anticipated to change during the trial
  12. Anticipated changes to current concomitant medications during the course of the trial
  13. History of alcohol abuse, defined as consumption of more than 210 mL of alcohol per week (i.e., the equivalent of 14 4-ounce (125 mL) glasses of wine or 14 12 ounce cans/bottles of beer), or other substance abuse within 1 year prior to Day 0
  14. Participation in another investigational drug, biologic, or medical device trial within 30 days prior to Screening
  15. History of noncompliance with medical regimens, or patients who are considered to be potentially unreliable
  16. Blood or plasma donation within 30 days prior to Day 0
  17. Mental instability or incompetence, such that the validity of informed consent or compliance with the trial is uncertain
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01473524

  Show 59 Study Locations
Sponsors and Collaborators
Intercept Pharmaceuticals
Investigators
Study Chair: David Shapiro, MD Intercept Pharmaceuticals
  More Information

Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Intercept Pharmaceuticals
ClinicalTrials.gov Identifier: NCT01473524     History of Changes
Other Study ID Numbers: 747-301
Study First Received: November 14, 2011
Results First Received: December 20, 2016
Last Updated: December 20, 2016

Keywords provided by Intercept Pharmaceuticals:
Primary Biliary Cholangitis
Primary Biliary Cirrhosis
PBC
Cirrhosis
Liver

Additional relevant MeSH terms:
Fibrosis
Liver Cirrhosis
Liver Cirrhosis, Biliary
Pathologic Processes
Liver Diseases
Digestive System Diseases
Cholestasis, Intrahepatic
Cholestasis
Bile Duct Diseases
Biliary Tract Diseases
Chenodeoxycholic Acid
Cathartics
Gastrointestinal Agents

ClinicalTrials.gov processed this record on May 22, 2017