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Alcoholic Hepatitis (AH)Phase 2NCT02854631

Selonsertib in Combination With Prednisolone Versus Prednisolone Alone in Participants With Severe Alcoholic Hepatitis (AH)

A Phase 2 study testing Selonsertib and Prednisolone in people with Alcoholic Hepatitis (AH), run by Gilead Sciences at 44 sites in 7 countries.

Completed

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

Official record
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Trial summary

The primary objective of this study is to evaluate the safety and tolerability of selonsertib (GS-4997) in combination with prednisolone versus prednisolone alone in participants with severe alcoholic hepatitis (AH). Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Alcoholic Hepatitis (AH)
What is being tested?
Selonsertib and Prednisolone
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
104 participants
Where
44 sitesin 7 countries
Study dates
1 Sep 2016to 31 May 2018
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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Willing and able to give informed consent prior to any study specific procedures being performed. In individuals with hepatic encephalopathy (HE) which may impair decision-making, consent will be obtained per hospital procedures (eg, by Legally Authorized Representative)
  • Clinical diagnosis of severe AH
  • Maddrey's Discriminant Function (DF) ≥ 32 at screening

Who cannot join

  • Pregnant or lactating females;
  • Other causes of liver disease including chronic hepatitis B (hepatitis B surface antigen [HBsAg] positive), chronic hepatitis C (HCV RNA positive), acetaminophen hepatotoxicity, biliary obstruction, and autoimmune liver disease;
  • Serum aspartate aminotransferase (AST) >400 U/L or alanine aminotransferase (ALT) >300 U/L;
  • Model for End Stage Liver Disease (MELD) >30 at screening;
  • Maddrey's DF >60 at screening;
  • Grade 4 Hepatic Encephalopathy (HE) by West Haven criteria;
Show all 18Show fewer
  • Concomitant or previous history of hepatocellular carcinoma;
  • History of liver transplantation;
  • HIV Ab positive;
  • Clinical suspicion of pneumonia;
  • Uncontrolled sepsis;
  • Uncontrolled gastrointestinal (GI) bleeding or controlled GI bleeding within 7 days of screening that was associated with shock or required transfusion of more than 3 units of blood;
  • Type 1 hepatorenal syndrome (HRS) or renal failure defined as a serum creatinine >221 μmol/L (>2.5 mg/dL) or the requirement for renal replacement therapy;
  • Individuals dependent on inotropic (eg, epinephrine or norepinephrine) or ventilatory support (ie, endotracheal intubation or positive-pressure ventilation);
  • Portal vein thrombosis;
  • Acute pancreatitis;
  • Cessation of alcohol consumption for more than 2 months before Baseline/ Day 1
  • Note: Other protocol defined Inclusion/ Exclusion criteria may apply.

Trial locations and contacts

44 sites in 7 countries.

44 sites in 7 countries

United States11 sites
  • University of Michigan

    Ann Arbor, Michigan

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts

  • Southern California Research Centers

    Coronado, California

  • Methodist Healthcare Dallas - The Liver Institute

    Dallas, Texas

  • University of Arkansas for Medical Sciences

    Little Rock, Arkansas

  • Cedars Sinai Medical Center

    Los Angeles, California, 90048

  • Oschner Medical Center

    New Orleans, Louisiana

  • Liver Institute of Virginia

    Newport News, Virginia

  • University of Pennsylvania

    Philadelphia, Pennsylvania

  • University of Washington

    Seattle, Washington

  • Cleveland Clinic Florida

    Weston, Florida

Other trials in United States

United Kingdom11 sites
  • Brighton & Sussex University Hospitals NHS Trust

    Brighton

  • Hull and East Yorkshire Hospitals NHS Trust

    Hull

  • Royal Liverpool & Broadgreen University Hospitals NHS Trust

    Liverpool

  • Barts Health NHS Trust

    London

  • Chelsea and Westminster Hospital

    London

  • Imperial College

    London

  • Kings College Hospital NHS Trust

    London

  • Freeman Hospital

    Newcastle

  • Nottingham University Hospitals NHS Trust

    Nottingham

  • Derriford Hospital

    Plymouth

  • Portsmouth Hospitals NHS Trust

    Portsmouth

Other trials in United Kingdom

France10 sites
  • CHU Amiens Picardie

    Amiens

  • CHU Angers

    Angers

  • Hôpital Jean Minjoz

    Besançon

  • C.H.U. de Caen

    Caen

  • CHU henri Mondor

    Créteil

  • CHU de Grenoble- Hopital Michallon

    La Tronche

  • CHRU de Lille

    Lille

  • Hôpital de la Croix Rousse

    Lyon

  • Hopital La Pitie Salpetriere

    Paris

  • Hopital Paul Brousse

    Villejuif

Other trials in France

Belgium5 sites
  • Cliniques Universitaires UCL Saint-Luc

    Brussels

  • CUB Hopital Erasme

    Brussels

  • Ghent University Hospital

    Ghent

  • Universitair Ziekenhuis Leuven

    Leuven

  • Centre Hospitalier Universitaire de Liege

    Liège

Other trials in Belgium

Austria3 sites
  • Medizinische Universitat Graz

    Graz

  • Universitätsklinik für Innere Medizin I

    Innsbruck

  • Medical University Vienna

    Vienna

Other trials in Austria

Canada3 sites
  • University of Calgary

    Calgary, Alberta

  • Toronto General Hospital

    Toronto, Ontario

  • University of Manitoba

    Winnipeg, Manitoba

Other trials in Canada

Switzerland1 site
  • University of Zurich

    Zurich

Other trials in Switzerland

About this study

Official title: A Phase 2, Double-Blind, Randomized Study Evaluating the Safety, Tolerability, and Efficacy of GS-4997 in Combination With Prednisolone Versus Prednisolone Alone in Subjects With Severe Alcoholic Hepatitis (AH)

The primary objective of this study is to evaluate the safety and tolerability of selonsertib (GS-4997) in combination with prednisolone versus prednisolone alone in participants with severe alcoholic hepatitis (AH).

Being tested
Selonsertib, Prednisolone, Placebo
Keywords
Cirrhosis, Prednisone, Jaundice
Medical subject headings
Hepatitis, Alcoholic, Fibrosis, Jaundice

What participants receive

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

  • SelonsertibDrug

    Also called GS-4997

    18 mg tablet administered orally once daily

  • PrednisoloneDrug

    40 mg (4 x 10 mg tablets) administered orally once daily

  • PlaceboDrug

    Selonsertib placebo tablet administered orally once daily

Study groups in NCT02854631
Study groupRoleWhat they receive
Selonsertib + PrednisoloneExperimentalSelonsertib + prednisolone for 28 days
Receives: Drug: Selonsertib; Drug: Prednisolone
PrednisolonePlacebo comparatorSelonsertib placebo + prednisolone for 28 days
Receives: Drug: Prednisolone; Drug: Placebo

What is being measured

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

  1. Percentage of Participants With Treatment-Emergent (TE) Adverse Events (AE), Serious AEs (SAE), AEs Leading to Premature Study Drug Discontinuation, and Grade 3 or 4 Laboratory Abnormalities

    An AE was defined as any untoward medical occurrence that occurred during the course of the trial after study treatment had started. An adverse event was therefore any unfavorable and unintended sign, symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug. An SAE is any untoward medical occurrence that at any dose results in death, are life threatening, requires hospitalization or prolongation of hospitalization or results in disability/incapacity, and congenital anomaly/birth defect. Laboratory toxicity grading was based on Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03.

    Measured: Up to Day 28 plus 30 days

Secondary outcomes (26)
  1. Percentage of Participants Who Died by Day 28

    The percentage of participants who died by Day 28 was calculated.

    Measured: Day 28

  2. Percentage of Participants Who Died by Week 8

    The percentage of participants who died by Week 8 was calculated.

    Measured: Week 8

  3. Percentage of Participants Who Died by Week 12

    The percentage of participants who died by Week 12 was calculated.

    Measured: Week 12

  4. Percentage of Participants Who Died by Week 24

    The percentage of participants who died by Week 24 was calculated.

    Measured: Week 24

  5. Percentage of Participants With Survival at Day 28 Using Kaplan-Meier

    The percentage of participants with survival at Day 28 using Kaplan-Meier was calculated.

    Measured: Day 28

  6. Percentage of Participants With Survival at Week 8 Using Kaplan-Meier

    The percentage of participants with survival at Week 8 using Kaplan-Meier was calculated.

    Measured: Week 8

  7. Percentage of Participants With Survival at Week 12 Using Kaplan-Meier

    The percentage of participants with survival at Week 12 using Kaplan-Meier was calculated.

    Measured: Week 12

  8. Percentage of Participants With Survival at Week 24 Using Kaplan-Meier

    The percentage of participants with survival at Week 24 using Kaplan-Meier was calculated.

    Measured: Week 24

  9. Percentage of Participants Who Received a Liver Transplant

    The percentage of participants who received a liver transplant by week 24 was calculated.

    Measured: Day 28, Week 8, Week 12, and Week 24

  10. Percentage of Participants With Hepatorenal Syndrome (HRS)

    The occurrence of HRS was confirmed based on the following diagnostic criteria from the International Ascites Club (IAC): 1) Cirrhosis with ascites, 2) Diagnosis of acute kidney injury (AKI) according to the ICA-AKI criteria, 3) Absence of shock, 4) No current or recent treatment with nephrotoxic drugs, and 5) Absence of parenchymal renal disease as indicated by proteinuria >500 mg/day, microhematuria (> 50 red blood cells per high power field) and/or abnormal renal ultrasonography.

    Measured: Up to 24 weeks

  11. Percentage of Participants With Infection

    The occurrence of bacterial, fungal, or viral infections was recorded. An infection was considered definite in participants with clinical evidence of infection and a positive culture from a normally sterile source (with the exception of spontaneous bacterial peritonitis).

    Measured: Up to 24 weeks

  12. Length of Hospital Stay

    Length of initial hospital stay from first dose date of study drug was calculated for participants who were released from initial hospitalization separately from those who died during their initial hospitalization.

    Measured: Up to 24 weeks

  13. Change From Baseline in Liver Biochemistry Tests: Alanine Aminotransferase (ALT)

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  14. Change From Baseline in Liver Biochemistry Tests: Aspartate Aminotransferase (AST)

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  15. Change From Baseline in Liver Biochemistry Tests: Gamma Glutamyl Transferase (GGT)

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  16. Change From Baseline in Liver Biochemistry Tests: Alkaline Phosphatase

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  17. Change From Baseline in Liver Biochemistry Tests: Bilirubin

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  18. Change From Baseline in Liver Biochemistry Tests: Albumin

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  19. Change From Baseline in Liver Biochemistry Tests: International Normalized Ratio (INR)

    Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  20. Percentage of Participants With Lille Response (Score < 0.45) at Day 7

    The Lille score is a tool used to predict which participants with severe alcoholic hepatitis (AH) were not responding to corticosteroid therapy. It ranges between 0 and 1, with low scores (< 0.16) indicating complete response or positive response to steroids (continue therapy) and high scores (≥ 0.56) indicating no response or poor response to steroids (stop therapy). The Lille score was calculated using baseline factors: age, albumin, total bilirubin, serum creatinine, prothrombin time; and the change in total bilirubin between baseline (Day 1) and Day 7. Lille response was defined as having a Lille score < 0.45.

    Measured: Day 7

  21. Percentage of Participants With a Lille Null Response (Score ≥ 0.56) at Day 7

    The Lille score is a tool used to predict which participants with severe AH were not responding to corticosteroid therapy. It ranges between 0 and 1, with low scores (< 0.16) indicating complete response or positive response to steroids (continue therapy) and high scores (≥ 0.56) indicating no response or poor response to steroids (stop therapy). The Lille score was calculated using baseline factors: age, albumin, total bilirubin, serum creatinine, prothrombin time; and the change in total bilirubin between baseline (Day 1) and Day 7. Lille null response was defined as having a Lille score ≥ 0.56.

    Measured: Day 7

  22. Lille Score at Day 7 as a Continuous Variable

    The Lille score is a tool used to predict which participants with severe AH were not responding to corticosteroid therapy. It ranges between 0 and 1, with low scores (< 0.16) indicating complete response or positive response to steroids (continue therapy) and high scores (≥ 0.56) indicating no response or poor response to steroids (stop therapy). The Lille score was calculated using baseline factors: age, albumin, total bilirubin, serum creatinine, prothrombin time; and the change in total bilirubin between baseline (Day 1) and Day 7.

    Measured: Day 7

  23. Percentage of Participants With Estimated Mortality at Month 2 and Month 6: Combined Scoring Including Lille Score at Day 7 and Baseline Model for End-Stage Liver Disease (MELD) Score

    The Lille score is a tool used to predict which participants with severe AH were not responding to corticosteroid therapy. It ranges between 0 and 1, with low scores (< 0.16) indicating complete response or positive response to steroids (continue therapy) and high scores (≥ 0.56) indicating no response or poor response to steroids (stop therapy). MELD scores are used to assess prognosis and suitability for liver transplantation. Scores can range from 6 to 40, with higher scores indicating greater disease severity. A scoring system combining the Lille score at Day 7 and the baseline MELD score was used to calculate the percentage of participants expected to die by Month 2 and by Month 6.

    Measured: Baseline and Day 7 Time Points used to calculate Overall Mortality Risk at Months 2 and 6

  24. Change From Baseline in Prognostic Index: Model for End-Stage Liver Disease (MELD) Score

    MELD scores are used to assess prognosis and suitability for liver transplantation. Scores can range from 6 to 40, with higher scores indicating greater disease severity. Change from Baseline was calculated as the value at endpoint minus the value at Baseline.

    Measured: Baseline (Day 1) and up to 24 weeks

  25. Change From Baseline in Prognostic Index: Child-Pugh-Turcotte (CPT) Score

    CPT scores are used to assess the severity of cirrhosis. Scores can range from 5 to 15, with higher scores indicating a greater severity of disease

    Measured: Baseline (Day 1) and up to 24 weeks

  26. Change From Baseline in Prognostic Index: Maddrey Discriminant Function (DF) Score

    Baseline Maddrey DF score is a prognostic tool used to determine the next step of treatment based on the severity of AH. Maddrey DF score of < 32 indicates mild to moderate AH and a lower chance of death in the next few months. Maddrey DF score of ≥ 32 indicates severe AH and a higher chance of death in the next few months. The score has no bounds.

    Measured: Baseline (Day 1) and up to 24 weeks

Timeline

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

  1. First posted3 Aug 2016 (estimated)
  2. Study start1 Sep 2016
  3. Primary completion16 Feb 2018
  4. Study completion31 May 2018

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
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
104 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02854631
Sponsor's protocol ID
GS-US-416-2124
Other IDs
2016-000821-37, 2016
Status last verified
Feb 2019
First submitted
29 Jul 2016
Last updated
6 Feb 2019
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Selonsertib and Prednisolone in people with Alcoholic Hepatitis (AH), run by Gilead Sciences at 44 sites in 7 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 3 inclusion and 18 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 6 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 44 sites in United States, United Kingdom, France, Belgium, Austria and 2 more countries. 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 6 Feb 2019). 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?

Percentage of Participants With Treatment-Emergent (TE) Adverse Events (AE), Serious AEs (SAE), AEs Leading to Premature Study Drug Discontinuation, and Grade 3 or 4 Laboratory Abnormalities (time frame: Up to Day 28 plus 30 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 6 Feb 2019.

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