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NASH - Nonalcoholic SteatohepatitisPhase 2HarmonyNCT04767529

A Study of Efruxifermin in Non-Cirrhotic Subjects With Histologically Confirmed Nonalcoholic Steatohepatitis (NASH)

A Phase 2 study testing Efruxifermin in people with NASH - Nonalcoholic Steatohepatitis, run by Akero Therapeutics, Inc at 55 sites in 2 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

This is a multi-center evaluation of efruxifermin (EFX) in a randomized, double-blind, placebo-controlled study in non-cirrhotic subjects with biopsy-proven F2 - F3 NASH. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
NASH - Nonalcoholic Steatohepatitis
What is being tested?
Efruxifermin
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
128 participants
Where
55 sitesin 2 countries
Study dates
16 Feb 2021to 2 May 2024
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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males and non-pregnant, non-lactating females between 18 - 75 years of age inclusive, based on the date of the screening visit.
  • Previous history or presence of 2 out of 4 components of metabolic syndrome (obesity, dyslipidemia, elevated blood pressure, elevated fasting glucose) or type 2 diabetes.
  • FibroScan measurement > 8.5 kPa [kilopascal].
  • Biopsy-proven NASH. Must have had a liver biopsy obtained ≤ 180 days prior to randomization with fibrosis stage 2 to 3 and a non-alcoholic fatty liver disease (NAFLD) activity score (NAS) of ≥ 4 with at least a score of 1 in each of the following NAS components:
  • Steatosis (scored 0 to 3),
  • Ballooning degeneration (scored 0 to 2), and
  • Lobular inflammation (scored 0 to 3).

Who cannot join

  • Weight loss > 5% in the 3 months prior to screening until randomization or from the time of the diagnostic liver biopsy until randomization, whichever is longer.
  • Presence of cirrhosis on liver biopsy (stage 4 fibrosis).
  • Type 1 or uncontrolled Type 2 diabetes.
  • Other inclusion and exclusion criteria may apply.

Trial locations and contacts

55 sites in 2 countries.

55 sites in 2 countries

United States54 sites
  • Akero Clinical Study Site

    Arlington, Texas, 76012

  • Akero Clinical Study Site

    Austin, Texas, 78757

  • Akero Clinical Study Site

    Baton Rouge, Louisiana, 70809

  • Akero Clinical Study Site

    Cedar Park, Texas, 75246

  • Akero Clinical Study Site

    Chandler, Arizona, 85224

  • Akero Clinical Study Site

    Charlotte, North Carolina, 28204

  • Akero Clinical Study Site

    Charlottesville, Virginia, 22908

  • Akero Clinical Study Site

    Chula Vista, California, 91910

  • Akero Clinical Study Site

    Cincinnati, Ohio, 45219

  • Akero Clinical Study Site

    Dallas, Texas, 75234

  • Akero Clinical Study Site

    Dallas, Texas, 75246

  • Akero Clinical Study Site

    Durham, North Carolina, 27712

  • Akero Clinical Study Site

    Edinburg, Texas, 78539

  • Akero Clinical Study Site

    Flowood, Mississippi, 39232

  • Akero Clinical Study Site

    Fort Myers, Florida, 33912

  • Akero Clinical Study Site

    Fort Worth, Texas, 76104

  • Akero Clinical Study Site

    Fresno, California, 93720

  • Akero Clinical Study Site

    Garland, Texas, 75044

  • Akero Clinical Study Site

    Glendale, Arizona, 85304

  • Akero Clinical Study Site

    Greenville, South Carolina, 29605

  • Akero Clinical Study Site

    Hermitage, Tennessee, 37076

  • Akero Clinical Study Site

    Houston, Texas, 77058

  • Akero Clinical Study Site

    Inverness, Florida, 34452

  • Akero Clinical Study Site

    Jackson, Mississippi, 39216

  • Akero Clinical Study Site

    La Jolla, California, 92037

  • Akero Clinical Study Site

    Lakewood Rch, Florida, 34211

  • Akero Clinical Study Site

    Las Vegas, Nevada, 89106

  • Akero Clinical Study Site

    Los Angeles, California, 90036

  • Akero Clinical Study Site

    Los Angeles, California, 90048

  • Akero Clinical Study Site

    Los Angeles, California, 90057

  • Akero Clinical Study Site

    Marietta, Georgia, 30060

  • Akero Clinical Study Site

    Marrero, Louisiana, 70072

  • Akero Clinical Study Site

    Miami, Florida, 33134

  • Akero Clinical Study Site

    Miami, Florida, 33147

  • Akero Clinical Study Site

    Miami Lakes, Florida, 33016

  • Akero Clinical Study Site

    Morehead City, North Carolina, 28557

  • Akero Clinical Study Site

    Nashville, Tennessee, 37211

  • Akero Clinical Study Site

    North Little Rock, Arkansas, 72117

  • Akero Clinical Study Site

    Ocala, Florida, 34471

  • Akero Clinical Study Site

    Orange, California, 92866

  • Akero Clinical Study Site

    Panorama City, California, 91402

  • Akero Clinical Study Site

    Rialto, California, 92866

  • Akero Clinical Study Site

    Richmond, Virginia, 23249

  • Akero Clinical Study Site

    Richmond, Virginia, 23298

  • Akero Clinical Study Site

    San Antonio, Texas, 78209

  • Akero Clinical Study Site

    San Antonio, Texas, 78215

  • Akero Clinical Study Site

    San Antonio, Texas, 78229

  • Akero Clinical Study Site

    San Marcos, Texas, 78666

  • Akero Clinical Study Site

    Santa Ana, California, 92704

  • Akero Clinical Study Site

    Sarasota, Florida, 94240

  • Akero Clinical Study Site

    Topeka, Kansas, 66606

  • Akero Clinical Study Site

    Tucson, Arizona, 85712

  • Akero Clinical Study Site

    Webster, Texas, 77598

  • Akero Clinical Study Site

    Ypsilanti, Michigan, 48197

Other trials in United States

Puerto Rico1 site
  • Akero Clinical Study Site

    San Juan, 927

Other trials in Puerto Rico

About this study

Official title: A Phase 2b, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of Efruxifermin in Non-Cirrhotic Subjects With Nonalcoholic Steatohepatitis (NASH)

This is a multi-center evaluation of efruxifermin (EFX) in a randomized, double-blind, placebo-controlled study in non-cirrhotic subjects with biopsy-proven F2 - F3 NASH.

Being tested
Efruxifermin, Placebo
Medical subject headings
Non-alcoholic Fatty Liver Disease

What participants receive

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

  • EfruxiferminDrug

    Also called EFX

    subcutaneous injection

  • PlaceboDrug

    subcutaneous injection

Study groups in NCT04767529
Study groupRoleWhat they receive
placeboPlacebo comparatordouble-blind, once-weekly subcutaneous injection
Receives: Drug: Placebo
Efruxifermin 28 mgExperimentaldouble-blind, once-weekly subcutaneous injection
Receives: Drug: Efruxifermin
Efruxifermin 50 mgPlacebo comparatordouble-blind, once-weekly subcutaneous injection
Receives: Drug: Efruxifermin

What is being measured

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

  1. Effect of Efruxifermin (EFX) vs Placebo on Fibrosis Regression in Participants With Metabolic Dysfunction-associated Steatohepatitis (MASH)-Associated Stage 2 or 3 Fibrosis (F2 or F3)

    Proportions of subjects in EFX vs placebo groups with improvement in liver fibrosis, defined as ≥ 1 stage NASH Clinical Research Network [CRN] fibrosis score (score ranges from 0 to 4, increasing with fibrosis severity), and no worsening of steatohepatitis (no increase in NASH Activity Score [NAS], which ranges from 0 to 8 and is the sum of scores of steatosis, lobular inflammation, and hepatocyte ballooning), at Week 24

    Measured: 24 Weeks

Secondary outcomes (15)
  1. Proportion of Subjects Who Achieve Improvement in Liver Fibrosis ≥ 1 Stage and no Worsening of Steatohepatitis at Week 96

    Proportions of subjects in EFX vs baseline groups who achieve improvement in liver fibrosis (decrease of ≥ 1 stage in NASH CRN fibrosis score) and no worsening of steatohepatitis (no increase in NAS for ballooning, inflammation, or steatosis) at Week 96

    Measured: 96 Weeks

  2. Proportion of Subjects Who Achieve Resolution of Steatohepatitis and no Worsening of Liver Fibrosis at Week 24 and Week 96

    Proportions of subjects in EFX vs placebo groups who achieve resolution of steatohepatitis (defined as a NAS of 0-1 for inflammation, 0 for ballooning, and any value for steatosis) and no worsening of liver fibrosis (determined by the NASH CRN criteria)

    Measured: 24 and 96 weeks

  3. Proportion of Subjects Who Achieve Improvement in Liver Fibrosis ≥ 1 Stage at Week 24 and Week 96

    Proportion of subjects in EFX vs placebo groups who achieve improvement in liver fibrosis (decrease ≥ 1 stage in NASH CRN fibrosis score)

    Measured: 24 and 96 Weeks

  4. Change From Baseline in Hepatic Fat Fraction in EFX vs Placebo Groups

    Change from baseline in hepatic fat fraction, measured by magnetic resonance imaging proton-density fat fraction (MRI-PDFF):

    Week 24 and Week 96 MRI-PDFF Analysis Set

    Measured: 24 and 96 Weeks

  5. Change From Baseline in Lipoproteins at Week 24 and Week 96

    Change from baseline of lipoproteins (triglycerides, Non-HDL-C, HDL-C and LDL-C) in EFX vs placebo groups

    Measured: 24 and 96 weeks

  6. Change From Baseline of Hemoglobin A1c (Glycated Hemoglobin, HbA1c) at Week 24 and Week 96

    Change from baseline in hemoglobin A1c (glycated hemoglobin, HbA1c) in EFX vs placebo groups

    Measured: 24 Weeks, 96 Weeks

  7. Change From Baseline in C-peptide at Week 24 and Week 96

    Change from baseline in C-peptide in EFX vs placebo groups

    Measured: 24 Weeks, 96 Weeks

  8. Change From Baseline in Adiponectin at Week 24 and Week 96

    Change from baseline in adiponectin in EFX vs placebo groups

    Measured: 24 Weeks, 96 Weeks

  9. Change From Baseline in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) at Week 24 and Week 96

    Change from baseline in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) in EFX vs placebo groups

    The Homeostatic Model Assessment of Insulin Resistance, HOMA-IR, is a calculated index that estimates insulin resistance based on fasting glucose and insulin levels. Higher values indicate greater insulin resistance.

    < 1.0: Normal insulin sensitivity 1.0-1.9: Mild insulin resistance 2.0-2.9: Moderate insulin resistance > 2.9: Severe insulin resistance

    Measured: 24 Weeks, 96 Weeks

  10. Change From Baseline in Enhanced Liver Fibrosis (ELF) Score at Week 24 and Week 96

    Change from Baseline in Enhanced Liver Fibrosis (ELF) Score in EFX vs placebo groups

    The Enhanced Liver Fibrosis (ELF) score is a non-invasive blood test that assesses the risk of liver fibrosis and its progression.

    Lower risk (<9.8): Suggests a lower risk of advanced liver fibrosis. Mid risk (9.8-11.2): Indicates a moderate risk of disease progression. Higher risk (≥11.3): Suggests a higher risk of developing cirrhosis or liver-related events

    Measured: 24 and 96 Weeks

  11. Change From Baseline in N-terminal Type III Collagen Propeptide (Pro-C3) at Week 24 and Week 96

    Change from Baseline in N-terminal Type III Collagen Propeptide (Pro-C3) in EFX vs placebo groups

    Measured: 24 and 96 Weeks

  12. Change From Baseline in Collagen III Neo-Peptide (C3M) at Week 24 and Week 96

    Change from Baseline in Collagen III Neo-Peptide (C3M) in EFX vs placebo groups

    Measured: 24 and 96 Weeks

  13. Change From Baseline in NIS4 Score at Week 24 and Week 96

    Change from Baseline in NIS4 score in EFX vs placebo groups

    NIS4 scores range from 0 to 1 and are calculated by combining the results of four individual biomarker assays [miR34a-5p, α2-macroglobulin (A2M), YKL-40 and HbA1c] each of which contributes to the test's ability to detect liver inflammation and/or fibrosis.

    >0.63: Higher risk of NASH or advanced fibrosis 0.37-0.63: Moderate risk, and additional testing may be considered <0.36: Lower risk of of NASH or advanced fibrosis

    Measured: 24 and 96 Weeks

  14. Change in Body Weight at Week 24 and Week 96

    Change from baseline in body weight (kg) in EFX vs placebo groups

    Measured: 24 and 96 weeks

  15. Change From Baseline in Liver Stiffness (kPa) at Week 24 and Week 96

    Change from Baseline in Liver Stiffness Evaluated by FibroScan in EFX vs placebo groups at Week 24 and Week 96:

    Full Analysis Set

    Measured: 24 and 96 weeks

Timeline

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

  1. First posted23 Feb 2021
  2. Study start16 Feb 2021
  3. Primary completion2 May 2024
  4. Study completion2 May 2024

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
128 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04767529
Sponsor's protocol ID
AK-US-001-0102
Acronym
Harmony
Status last verified
Jun 2025
First submitted
16 Feb 2021
Last updated
18 Jun 2025
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Harrison SA, Frias JP, Neff G, Abrams GA, Lucas KJ, Sanchez W, Gogia S, Sheikh MY, Behling C, Bedossa P, Shao L, Chan D, Fong E, de Temple B, Shringarpure R, Tillman EJ, Rolph T, Cheng A, Yale K; HARMONY Study Group. Safety and efficacy of once-weekly efruxifermin versus placebo in non-alcoholic steatohepatitis (HARMONY): a multicentre, randomised, double-blind, placebo-controlled, phase 2b trial. Lancet Gastroenterol Hepatol. 2023 Dec;8(12):1080-1093. doi: 10.1016/S2468-1253(23)00272-8. Epub 2023 Oct 3.

    PubMed 37802088
  • Noureddin M, Frias JP, Neff GW, Lucas KJ, Behling C, Bedossa P, Dubourg J, Chan D, Burch M, Fong E, de Temple B, Minerva M, Barrett K, Shringarpure R, Tillman EJ, Rolph T, Cheng A, Yale K. Safety and efficacy of once-weekly efruxifermin versus placebo in metabolic dysfunction-associated steatohepatitis (HARMONY): 96-week results from a multicentre, randomised, double-blind, placebo-controlled, phase 2b trial. Lancet. 2025 Aug 16;406(10504):719-730. doi: 10.1016/S0140-6736(25)01073-6.

    PubMed 40818852

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Efruxifermin in people with NASH - Nonalcoholic Steatohepatitis, run by Akero Therapeutics, Inc at 55 sites in 2 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 7 inclusion and 4 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 18 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 55 sites in United States, Puerto Rico. 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 8 May 2025). 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?

Effect of Efruxifermin (EFX) vs Placebo on Fibrosis Regression in Participants With Metabolic Dysfunction-associated Steatohepatitis (MASH)-Associated Stage 2 or 3 Fibrosis (F2 or F3) (time frame: 24 Weeks). 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 NCT04767529, which also lists 2 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 18 Jun 2025.

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