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Alagille SyndromePhase 2ICONICNCT02160782

Safety and Efficacy Study of LUM001 (Maralixibat) With a Drug Withdrawal Period in Participants With Alagille Syndrome (ALGS)

A Phase 2 study testing LUM001 (Maralixibat) in people with Alagille Syndrome, run by Mirum Pharmaceuticals, Inc. at 9 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a long-term, open-label study with a double-blind, placebo-controlled, randomized drug withdrawal period in children with Alagille Syndrome (ALGS) designed to evaluate the safety and efficacy of LUM001 (Also known as maralixibat or MRX). Read more about this study

Who is it for?
Ages 12 months to 18 years
Conditions the study is for
Alagille Syndrome
What is being tested?
LUM001 (Maralixibat)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
31 participants
Where
9 sitesin 6 countries
Study dates
28 Oct 2014to 28 May 2020
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 months to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Male or female between the ages of 12 months and 18 years inclusive.
  • Diagnosis of ALGS.
  • Evidence of cholestasis (one or more of the following):
  • Total serum bile acid > 3x ULN for age.
  • Conjugated bilirubin > 1 mg/dL.
  • Fat soluble vitamin deficiency otherwise unexplainable.
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  • GGT > 3x ULN for age.
  • Intractable pruritus explainable only by liver disease.
  • Females of childbearing potential must have a negative serum pregnancy test during Screening.
  • Males and females of child-bearing potential who are sexually active, or are not currently sexually active during the study, but become sexually active during the period of the study and 30 days following the last dose of study drug, must agree and use acceptable contraception during the trial.
  • Participant is expected to have a consistent caregiver(s) for the duration of the study.
  • Informed consent and assent (per IRB/IEC) as appropriate.
  • Access to phone for scheduled calls from study site.
  • Caregivers (and age-appropriate participants) must be willing and able to use an eDiary device during the study.
  • Caregivers (and age-appropriate participants) must digitally accept the licensing agreement in the eDiary software.
  • Caregivers (and age-appropriate participants) must complete at least 10 eDiary reports (morning or evening) during each of two consecutive weeks of the screening period (maximum possible reports = 14 per week).
  • Average daily score >2 on the Itch Reported Outcome (ItchRO™) questionnaire (maximum possible daily score of 4) for two consecutive weeks in the screening period, prior to dosing. A daily score is the higher of the scores for the morning and evening ItchRO. The average daily score is the sum of all daily scores divided by the number of days the ItchRO was completed.
  • Inclusion Criteria for participants to be eligible for the 52-week optional follow-up treatment period:
  • Completed the protocol through the Week 48 visit with no safety concerns. Participants who were discontinued due to safety reasons can be rechallenged if blood tests are back to relatively normal values for this patient population and participant does not meet any of the protocol's stopping rules. The decision will be made by the investigator in consultation with the sponsor medical monitor.
  • Participants who have undergone a surgical disruption of the enterohepatic circulation will not be eligible to enter into the follow up treatment period.
  • Participants who were discontinued for other reasons will be considered for the 52-week optional follow-up treatment period on an individual basis. The decision will be made by the investigator in consultation with the sponsor medical monitor.
  • Inclusion Criteria for participants with LUM001dosing interruption <7 days, or >=7 days:
  • The Participant has either: completed the protocol through the Week 48 visit with no major safety concerns OR discontinued due to safety reasons judged unrelated to the study drug, and laboratory results have returned to levels acceptable for this patient population or individual and participant does not meet any of the protocol's stopping rules at the time of entry into the follow-up period. The decision will be made by the investigator in consultation with the sponsor medical monitor. [Participants who were discontinued for other reasons will be considered on an individual basis.]
  • Females of childbearing potential must have a negative urine or serum pregnancy test (beta- human chorionic gonadotropin [β-hCG]) at the time of entry into the long-term optional follow-up treatment period.
  • Males and females of child-bearing potential who are sexually active, or are not currently sexually active during the study, but become sexually active during the period of the study and 30 days following the last dose of study drug, must agree and use acceptable contraception during the trial.
  • Informed consent and assent (per IRB/EC) as appropriate.
  • Access to phone for scheduled calls from study site.
  • Caregivers (and age-appropriate participants) must be willing and able to use an eDiary device during the study.

Who cannot join

  • Chronic diarrhea requiring ongoing intravenous fluid or nutritional intervention.
  • Surgical interruption of the enterohepatic circulation.
  • Previous liver transplant
  • Decompensated cirrhosis (ALT >15 x ULN, INR >1.5 [unresponsive to vitamin K therapy], albumin <3.0 g/dL, history or presence of clinically significant ascites, variceal hemorrhage, and/or encephalopathy).
  • History or presence of other concomitant liver disease.
  • History or presence of any other disease or condition known to interfere with the absorption, distribution, metabolism or excretion of drugs, including bile salt metabolism in the intestine (eg, inflammatory bowel disease).
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  • History or presence of gallstones or kidney stones.
  • Known diagnosis of human immunodeficiency virus (HIV) infection.
  • Cancers, except for in situ carcinoma, or cancers treated at least 5 years prior to Screening with no evidence of recurrence.
  • Recent medical history or current status that suggests that the participant may be unable to complete the study.
  • Any female who is pregnant or lactating or who is planning to become pregnant during the study period.
  • Known history of alcohol or substance abuse.
  • Administration of bile acid or lipid binding resins within 28 days prior to screening and throughout the trial.
  • Known hypersensitivity to LUM001 or any of its components.
  • Receipt of investigational drug, biologic, or medical device within 28 days prior to screening, or 5 half-lives of the study agent, whichever is longer.
  • History of non-adherence to medical regimens, unreliability, mental instability or incompetence that could compromise the validity of informed consent or lead to nonadherence with the study protocol based upon investigator judgment.
  • Any other conditions or abnormalities which, in the opinion of the investigator or sponsor medical monitor, may compromise the safety of the participant, or interfere with the participant participating in or completing the study.
  • Participants weighing over 50 kg at screening.
  • Exclusion Criteria for participants with LUM001 dosing interruption >=7 days:
  • All exclusion criteria mentioned above apply upon entry into the long-term optional follow-up period, with the exception of participants weighing over 50 kg at screening.

Trial locations and contacts

9 sites in 6 countries.

9 sites in 6 countries

France3 sites
  • Hopital Femme Mere Enfant De Lyon

    Bron, 69677

  • Hopital Necker-Enfants Malades

    Paris, 75015

  • Hopital Kremlin Bicetre

    Paris, 94275

Other trials in France

Australia2 sites
  • The Royal Children's Hospital Melbourne

    Parkville, Victoria, 3052

  • Children's Hospital Westmead

    Westmead, New South Wales, 2145

Other trials in Australia

Belgium1 site
  • Cliniques Universitaires Saint-Luc

    Brussels

Other trials in Belgium

Poland1 site
  • The Children's Memorial Health Institute

    Warsaw, 04-730

Other trials in Poland

Spain1 site
  • Hospital Universitario La Paz- Hospital Materno Infantil

    Madrid, 261

Other trials in Spain

United Kingdom1 site
  • Paediatric Liver Center, Kings College Hospital

    London, SE5 9RS

Other trials in United Kingdom

About this study

Official title: Long-Term, Open-Label Study With a Double-Blind, Placebo-Controlled, Randomized Drug Withdrawal Period of LUM001 (Maralixibat), an Apical Sodium-Dependent Bile Acid Transporter Inhibitor (ASBTi), in Patients With Alagille Syndrome

This is a long-term, open-label study with a double-blind, placebo-controlled, randomized drug withdrawal period in children with Alagille Syndrome (ALGS) designed to evaluate the safety and efficacy of LUM001 (Also known as maralixibat or MRX).

Read the detailed description

The study is divided into 6 parts: a 6-week open-label, dose escalation period, a 12-week open-label stable dosing period, a 4-week randomized, double-blind, placebo-controlled drug withdrawal period, a 26-week long-term stable dosing period, and an a 52-week optional follow-up treatment period, and a long-term optional follow-up treatment period for eligible participants who choose to stay on treatment with LUM001.

Being tested
LUM001 (Maralixibat), Placebo
Medical subject headings
Alagille Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • LUM001 (Maralixibat)Drug

    LUM001, also known as Maralixibat (MRX) will be administered orally Once Daily (OD). To be administered Twice Daily (BID) for patients who are eligible.

  • PlaceboDrug

    Placebo will be administered orally once daily during randomized withdrawal period

Study groups in NCT02160782
Study groupRoleWhat they receive
LUM001 (Maralixibat)ExperimentalLUM001, also known as Maralixibat (MRX) will be administered orally once a day (QD) up to 400 microgram per kilogram per day (mcg/kg/day) up to Week 52, followed by an increase in dose orally twice a day (BID) during long-term follow-up based on efficacy (serum bile acid [sBA] level and ItchRO[Obs] score) and safety assessment. Note: 400 mcg/kg maralixibat chloride is equivalent to 380 mcg/kg free maralixibat.
Receives: Drug: LUM001 (Maralixibat)
PlaceboPlacebo comparatorPlacebo will be administered orally once a day during randomized withdrawal period (Week 19 to Week 22)
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Week 18 to Week 22 in Fasting sBA Levels in Participants Who Had a Reduction in sBA ≥50% From Baseline to Week 12 or Week 18

    The primary efficacy endpoint of this study was the mean change from Week 18 to Week 22 (the RWD period) of fasting sBA levels in participants who had a reduction in sBA ≥50% from baseline to Week 12 or Week 18 (Modified Intent-to-Treat [MITT] Population). Five participants in the MRX group and 10 participants in the placebo group met the prespecified sBA reduction criteria.

    Measured: Week 18 to Week 22

Secondary outcomes (13)
  1. Change From Baseline to Week 18 in Fasting sBA Levels

    This secondary efficacy endpoint is the mean change from baseline to Week 18 in fasting sBA levels

    Measured: Baseline to Week 18

  2. Change From Baseline to Week 18 in Pruritus as Measured by ItchRO (Obs)

    This secondary efficacy endpoint is the change from baseline to Week 18 in pruritus as measured by ItchRO(Obs) weekly average morning score. ItchRO scores range from 0 to 4; the higher score indicates increasing itch severity (0 = none; 4 = very severe).

    Measured: Baseline to Week 18

  3. Change From Baseline to Week 18 in Pruritus as Measured by ItchRO (Pt)

    This secondary efficacy endpoint is the change from baseline to Week 18 in pruritus as measured by ItchRO(Pt) weekly average morning score

    Measured: Baseline to Week 18

  4. Change From Week 18 to Week 22 in Pruritus as Measured by ItchRO(Obs)

    This secondary efficacy endpoint is the change from Week 18 to Week 22 in pruritus as measured by ItchRO(Obs) weekly average morning score. ItchRO scores range from 0 to 4; the higher score indicates increasing itch severity (0 = none; 4 = very severe).

    Measured: Week 18 to Week 22

  5. Change From Week 18 to Week 22 in Pruritus as Measured by ItchRO(Pt)

    This secondary efficacy endpoint is the change from Week 18 to Week 22 in pruritus as measured by ItchRO(Pt) weekly average morning score. ItchRO scores range from 0 to 4; the higher score indicates increasing itch severity (0 = none; 4 = very severe).

    Measured: Week 18 to Week 22

  6. Change From Baseline to Week 18 in Alkaline Phosphatase

    This secondary efficacy endpoint is the mean change from baseline to Week 18 in ALP

    Measured: Baseline to Week 18

  7. Change From Week 18 to Week 22 in Alkaline Phosphatase

    This secondary efficacy endpoint is the mean change from Week 18 to Week 22 in ALP

    Measured: Week 18 to Week 22

  8. Change From Baseline to Week 18 in Alanine Aminotransferase

    This secondary efficacy endpoint is the mean change from baseline to Week 18 in ALT

    Measured: Baseline to Week 18

  9. Change From Week 18 to Week 22 in Alanine Aminotransferase

    This secondary efficacy endpoint is the mean change from Week 18 to Week 22 in alanine aminotransferase (ALT)

    Measured: Week 18 to Week 22

  10. Change From Baseline to Week 18 in Total Bilirubin

    This secondary efficacy endpoint is the mean change from baseline to Week 18 in total bilirubin

    Measured: Baseline to Week 18

  11. Change From Week 18 to Week 22 in Total Bilirubin

    This secondary efficacy endpoint is the mean change from Week 18 to Week 22 in total bilirubin

    Measured: Week 18 to Week 22

  12. Change From Baseline to Week 18 in Direct Bilirubin

    This secondary efficacy endpoint is the mean change from baseline to Week 18 in direct bilirubin

    Measured: Baseline to Week 18

  13. Change From Week 18 to Week 22 in Direct Bilirubin

    This secondary efficacy endpoint is the mean change from Week 18 to Week 22 in direct bilirubin

    Measured: Week 18 to Week 22

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2014 (estimated)
  2. Study start28 Oct 2014
  3. Primary completion28 May 2020
  4. Study completion28 May 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Open-label single arm study with a randomized placebo-controlled parallel group period
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02160782
Sponsor's protocol ID
LUM001-304
Other IDs
2013-005373-43
Acronym
ICONIC
Status last verified
Jun 2021
First submitted
9 Jun 2014
Last updated
14 Jul 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No
Expanded access
Available

Publications

  • Hoskins BJ, Mogul DB, Chen C, Karnsakul W. Maralixibat Improves Xanthomas and Hypercholesterolemia in Children with Alagille Syndrome: A Post Hoc Integrated Analysis From Two Clinical Trials. J Pediatr. 2026 Jul;294:115108. doi: 10.1016/j.jpeds.2026.115108. Epub 2026 Apr 17.

    PubMed 42002216
  • Kamath BM, Goldstein A, Howard R, Garner W, Vig P, Marden JR, Billmyer E, Anderson A, Kirson N, Jacquemin E, Gonzales E. Maralixibat Treatment Response in Alagille Syndrome is Associated with Improved Health-Related Quality of Life. J Pediatr. 2023 Jan;252:68-75.e5. doi: 10.1016/j.jpeds.2022.09.001. Epub 2022 Sep 10.

    PubMed 36096175
  • Gonzales E, Hardikar W, Stormon M, Baker A, Hierro L, Gliwicz D, Lacaille F, Lachaux A, Sturm E, Setchell KDR, Kennedy C, Dorenbaum A, Steinmetz J, Desai NK, Wardle AJ, Garner W, Vig P, Jaecklin T, Sokal EM, Jacquemin E. Efficacy and safety of maralixibat treatment in patients with Alagille syndrome and cholestatic pruritus (ICONIC): a randomised phase 2 study. Lancet. 2021 Oct 30;398(10311):1581-1592. doi: 10.1016/S0140-6736(21)01256-3. Epub 2021 Oct 28.

    PubMed 34755627

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing LUM001 (Maralixibat) in people with Alagille Syndrome, run by Mirum Pharmaceuticals, Inc. at 9 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 28 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in France, Australia, Belgium, Poland, Spain and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Jul 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Week 18 to Week 22 in Fasting sBA Levels in Participants Who Had a Reduction in sBA ≥50% From Baseline to Week 12 or Week 18 (time frame: Week 18 to Week 22). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02160782, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jul 2021.

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