A Study to Assess the Safety, Tolerability, Pharmacokinetics and Efficacy of EDP-305 in Subjects With Primary Biliary Cholangitis

Enanta Pharmaceuticals

Status and phase: Completed; Phase 2

Conditions: Primary Biliary Cholangitis

Treatments: Drug: EDP-305 2.5 mg; Drug: Placebo; Drug: EDP-305 1 mg

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT03394924

EDP 305-201

Details and patient eligibility

About

A randomized, double-blind study to assess the safety, tolerability, PK and efficacy of EDP-305 in subjects with primary biliary cholangitis

Enrollment: 68 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• An informed consent document 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 a diagnosis of PBC by at least two of the following criteria:

  • History of ALP above ULN for at least six months
  • Positive Anti-Mitochondrial Antibodies (AMA) titers (>1/40 on immunofluorescence or M2 positive by enzyme linked immunosorbent assay (ELISA) or positive PBC-specific antinuclear antibodies)

• For subjects with no documented liver biopsy performed within 2 years, subjects must undergo a transient elastography (Fibroscan) showing liver stiffness < 14.0 kPA

• Must be on a stable dose of UDCA12-20 mg/kg/day for at least 6 months prior to Screening or intolerant of UDCA in the opinion of the Investigator (no UDCA for at least 12 weeks prior to Screening)

• Alkaline Phosphatase (ALP) ≥ 1.67 × ULN and/or total bilirubin >ULN but < 2×ULN (<2.4 mg/dL)

• Subjects must have Screening laboratory values for Hepatitis B surface antigen (HBsAg), anti-HCV antibodies and HCV RNA negative and Human Immunodeficiency Virus (HIV) 1 and 2 antibodies (Ab) as seronegative. Note: subjects previously infected by chronic hepatitis C and treated with direct acting antivirals (DAAs) with sustained virologic response (SVR) for at least 3 years will be allowed.

• 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.

• All male participants who have not had a vasectomy must use effective contraception from Day -1 to 90 days after their last dose of study drug.

• Male subjects must agree to refrain from sperm donation from the date of Screening until 90 days after their last dose of study drug

• Screening body mass index (BMI) of ≥18 kg/m2

• Subject must be willing and able to adhere to the assessments, visit schedule, prohibitions and restrictions, as described in this protocol

Exclusion criteria

• Laboratory Screening Results:

  • AST >5 x ULN
  • ALT >5 x ULN
  • Patients with Gilbert's syndrome will not be allowed due to interpretability of bilirubin levels
  • Total white blood cells (WBC) <3000 cells/mm3
  • Absolute neutrophil count (ANC) <1500 cells/mm3
  • Platelet count <140,000/mm3
  • Prothrombin time (international normalized ratio, INR) >1.2
  • Serum creatinine >2 mg/dL or creatinine clearance <60 mL/min (based on Cockroft-Gault Method)

• Suspected to have relevant nonalcoholic fatty liver disease (NAFLD) as based on the judgment of the Investigator at Screening

• Use of immunosuppressants known to have an effect on the liver of patients with PBC (eg, colchicine, methotrexate, azathioprine, or systemic steroids) in the three months preceding screening

• Current use of fibrates, including fenofibrates. Note: Subjects who discontinued fibrates for at least 3 months before Screening can participate

• Use of an experimental treatment for PBC within the past 6 months

• Co-existing liver or biliary diseases, such as primary sclerosing cholangitis, choledocholithiasis, acute or chronic hepatitis, autoimmune hepatitis, alcoholic liver disease, nonalcoholic steatohepatitis (NASH), acute infection of bile duct system or gall bladder, history of gastrointestinal bleeding (secondary to portal hypertension), cirrhosis, cholangiocarcinoma diagnosed or suspected liver cancers

• Cirrhosis with or without complications, including history or presence of: spontaneous bacterial peritonitis, hepatocellular carcinoma

• 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)

• Medical conditions that may cause nonhepatic increases in ALP (e.g., Paget's disease)

• Use of a new statin regimen from Screening and throughout study duration. NOTE: Subjects on a stable dose of statins for at least 3 months prior to Screening are allowed. No dose modification during the study will be allowed.

• Use of immunosuppressants (eg, systemic corticosteroids) for more than 2 consecutive weeks in duration within 1 year prior to Screening.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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68 participants in 3 patient groups, including a placebo group

EDP-305 1 mg

Experimental group

Description:

Subjects will take 2 tablets once a day orally for 12 weeks

Treatment:

Drug: EDP-305 1 mg

EDP-305 2.5 mg

Experimental group

Description:

Subjects will take 2 tablets once a day orally for 12 weeks

Treatment:

Drug: EDP-305 2.5 mg

Placebo

Placebo Comparator group

Description:

Subjects will take two tablets once a day orally for 12 weeks

Treatment:

Drug: Placebo