A Phase 2 interventional study of IDN-6556 and Placebo in Liver Fibrosis, Hepatic Fibrosis and Liver Cirrhosis, sponsored by Conatus Pharmaceuticals Inc.. Completed at 35 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-12-11.
Sponsored by Conatus Pharmaceuticals Inc. · Phase 2, Interventional, and Treatment
This is a double-blind, multicenter study involving patients with chronic HCV infection who had a liver transplantation; developed HCV-related liver fibrosis and/or incomplete cirrhosis; achieved a sustained virologic response (SVR) following anti-HCV therapy; but still have fibrosis and/or incomplete cirrhosis on liver biopsy to see if treatment with IDN-6556 is better than placebo in reversing or stopping the progression of the damage to the new liver caused by HCV.
There are data to suggest that with eradication of the HCV virus, improvements in liver fibrosis can be seen in the post-transplant population. However, amelioration of inflammatory activity, and deceleration of fibrosis progression is a gradual process over the course of many years. This placebo-controlled study is designed to evaluate the effects of IDN-6556, compared to placebo, on markers of apoptosis and inflammation, and liver histology.
1,668 studies on the registry are indexed under Liver Cirrhosis; 360 are open to participants now.
This study's enrollment of 64 is below the median of 72 across 1,003 interventional studies indexed under Liver Cirrhosis.
Browse Liver Cirrhosis studies →Conatus Pharmaceuticals Inc. is the lead sponsor of 17 studies on the registry; none are open to participants now.
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Exclusion Criteria:
IDN-6556 25 mg BID
Drug: IDN-6556
Placebo BID
Drug: Placebo
Also known as: emricasan, PF-03491390
Placebo control
Number of Participants With At Least a One Stage Reduction From Baseline in Ishak Fibrosis Score
At least a one stage reduction from baseline in Ishak Fibrosis Stage. Score F0 No fibrosis F1 Fibrous expansion of some portal areas, with or without short fibrous septa F2 Fibrous expansion of most portal areas, with or without short fibrous septa F3 Fibrous expansion of most portal areas, with occasional portal to portal bridging F4 Fibrous expansion of portal areas, with marked bridging (portal to portal as well as portal to central) F5 Marked bridging (portal to portal and/or portal to central) with occasional nodules (incomplete cirrhosis) F6 Cirrhosis probable or definite Since the primary analysis used multiple imputation methodology, the numerator and denominator varied across 20 imputations.
Time frame: 24 months
Number of Participants With At Least a One Stage Reduction From Baseline in Ishak Fibrosis Score (Observed Cases Only)
At least a one stage reduction from baseline in Ishak Fibrosis Stage. Score F0 No fibrosis F1 Fibrous expansion of some portal areas, with or without short fibrous septa F2 Fibrous expansion of most portal areas, with or without short fibrous septa F3 Fibrous expansion of most portal areas, with occasional portal to portal bridging F4 Fibrous expansion of portal areas, with marked bridging (portal to portal as well as portal to central) F5 Marked bridging (portal to portal and/or portal to central) with occasional nodules (incomplete cirrhosis) F6 Cirrhosis probable or definite
Time frame: 24 months
Number of Participants With At Least a One Stage Reduction From Baseline in Ishak Fibrosis Score
At least a one stage reduction from baseline in Ishak Fibrosis Stage. Score F0 No fibrosis F1 Fibrous expansion of some portal areas, with or without short fibrous septa F2 Fibrous expansion of most portal areas, with or without short fibrous septa F3 Fibrous expansion of most portal areas, with occasional portal to portal bridging F4 Fibrous expansion of portal areas, with marked bridging (portal to portal as well as portal to central) F5 Marked bridging (portal to portal and/or portal to central) with occasional nodules (incomplete cirrhosis) F6 Cirrhosis probable or definite
Time frame: 12 months
Alanine Aminotransferase (ALT) - Change From Baseline
Liver function laboratory parameter
Time frame: Baseline and 24 months
Aspartate Aminotransferase (AST) Change From Baseline
Liver function laboratory parameter
Time frame: Baseline and 24 months
Caspase 3/7 Change From Baseline
Mechanistic biomarker of liver function
Time frame: Baseline and 24 months
cCK18/M30 Change From Baseline
Mechanistic biomarker of liver function.
Time frame: Baseline and 24 months
flCK18/M65 Change From Baseline
Mechanistic biomarker of liver function
Time frame: Baseline and 24 months
Ishak Modification of Knodell Histological Activity Index - Interface Hepatitis
The Ishak modification of Knodell histological activity index was determined by liver biopsy. Interface hepatitis * 0 = None * 1 = Mild (local, few portal areas) * 2 = Mild/moderate (focal, most portal areas) * 3 = Moderate (continuous around \<50% of tracts or septa) * 4 = Severe (continuous around \>50% of tracts or septa)
Time frame: 24 months
Ishak Modification of Knodell Histological Index - Confluent Necrosis
The Ishak modification of Knodell histological activity index will be determined by liver biopsy. The four items and their categorizations scores include: • confluent necrosis * 0 = None * 1 = Focal confluent necrosis * 2 = Zone 3 necrosis in some areas * 3 = Zone 3 necrosis in most areas * 4 = Zone 3 necrosis + occasional portal-central bridging * 5 = Zone 3 necrosis + multiple portal-central bridging * 6 = Panacinar or multiacinar necrosis
Time frame: 24 months
Ishak Modification of Knodell Histological Index - Parenchymal Injury
The Ishak modification of Knodell histological activity index will be determined by liver biopsy. • parenchymal injury (focal lytic necrosis, apoptosis and focal inflammation) * 0 = None * 1 = One focus or less per 10× objective * 2 = Two to four foci per 10× objective * 3 = Five to ten foci per 10× objective * 4 = More than ten foci per 10× objective
Time frame: 24 months
Ishak Modification of Knodell Histological Index - Portal Inflammation
Portal inflammation * 0 = None * 1 = Mild, some or all portal areas * 2 = Moderate, some or all portal areas * 3 = Moderate/marked, all portal areas * 4 = Marked, all portal areas
Time frame: 24 months
Subjects were enrolled from 20 of 35 US sites that obtained IRB approval. First subject randomized Sep 2014, last subject last visit was 15 Feb 2018. A total of 114 subjects were screened, 64 subjects randomized with 41 subjects randomized to emricasan and 23 subjects randomized to placebo. Thirteen subjects discontinued the study.
| Milestone | IDN-6556 | Placebo |
|---|---|---|
| Started | 41 | 23 |
| Completed | 32 | 19 |
| Not completed | 9 | 4 |
| Withdrew: Adverse event | 3 | 3 |
| Withdrew: Lost to follow-up | 2 | 1 |
| Withdrew: Physician decision | 2 | 0 |
| Withdrew: Non compliance | 1 | 0 |
| Withdrew: Withdrawal by subject | 1 | 0 |
At least a one stage reduction from baseline in Ishak Fibrosis Stage. Score F0 No fibrosis F1 Fibrous expansion of some portal areas, with or without short fibrous septa F2 Fibrous expansion of most portal areas, with or without short fibrous septa F3 Fibrous expansion of most portal areas, with occasional portal to portal bridging F4 Fibrous expansion of portal areas, with marked bridging (portal to portal as well as portal to central) F5 Marked bridging (portal to portal and/or portal to central) with occasional nodules (incomplete cirrhosis) F6 Cirrhosis probable or definite Since the primary analysis used multiple imputation methodology, the numerator and denominator varied across 20 imputations.
| participants | IDN-6556 | Placebo |
|---|---|---|
| Number of Participants With At Least a One Stage Reduction From Baseline in Ishak Fibrosis Score | 25 | 14 |
At least a one stage reduction from baseline in Ishak Fibrosis Stage. Score F0 No fibrosis F1 Fibrous expansion of some portal areas, with or without short fibrous septa F2 Fibrous expansion of most portal areas, with or without short fibrous septa F3 Fibrous expansion of most portal areas, with occasional portal to portal bridging F4 Fibrous expansion of portal areas, with marked bridging (portal to portal as well as portal to central) F5 Marked bridging (portal to portal and/or portal to central) with occasional nodules (incomplete cirrhosis) F6 Cirrhosis probable or definite
| Participants | IDN-6556 | Placebo |
|---|---|---|
| Number of Participants With At Least a One Stage Reduction From Baseline in Ishak Fibrosis Score (Observed Cases Only) | 25 | 14 |
At least a one stage reduction from baseline in Ishak Fibrosis Stage. Score F0 No fibrosis F1 Fibrous expansion of some portal areas, with or without short fibrous septa F2 Fibrous expansion of most portal areas, with or without short fibrous septa F3 Fibrous expansion of most portal areas, with occasional portal to portal bridging F4 Fibrous expansion of portal areas, with marked bridging (portal to portal as well as portal to central) F5 Marked bridging (portal to portal and/or portal to central) with occasional nodules (incomplete cirrhosis) F6 Cirrhosis probable or definite
| Participants | IDN-6556 | Placebo |
|---|---|---|
| Number of Participants With At Least a One Stage Reduction From Baseline in Ishak Fibrosis Score | 27 | 17 |
Liver function laboratory parameter
| U/L | IDN-6556 | Placebo |
|---|---|---|
| Alanine Aminotransferase (ALT) - Change From Baseline | -3.7 ± 10 | 43.7 ± 239.5 |
Liver function laboratory parameter
| U/L | IDN-6556 | Placebo |
|---|---|---|
| Aspartate Aminotransferase (AST) Change From Baseline | -4.0 ± 8.5 | 31.4 ± 161.8 |
Mechanistic biomarker of liver function
| Raw RLU | IDN-6556 | Placebo |
|---|---|---|
| Caspase 3/7 Change From Baseline | -296.1 ± 830.3 | 2081.2 ± 10116.4 |
Mechanistic biomarker of liver function.
| U/L | IDN-6556 | Placebo |
|---|---|---|
| cCK18/M30 Change From Baseline | -104.7 ± 193.2 | -66.1 ± 176.9 |
Mechanistic biomarker of liver function
| U/L | IDN-6556 | Placebo |
|---|---|---|
| flCK18/M65 Change From Baseline | -70.2 ± 189.0 | -98.6 ± 311.7 |
The Ishak modification of Knodell histological activity index was determined by liver biopsy. Interface hepatitis * 0 = None * 1 = Mild (local, few portal areas) * 2 = Mild/moderate (focal, most portal areas) * 3 = Moderate (continuous around \<50% of tracts or septa) * 4 = Severe (continuous around \>50% of tracts or septa)
| Participants | IDN-6556 | Placebo |
|---|---|---|
| Interface Hepatitis Score of 0 | 6 | 5 |
| Interface Hepatitis Score of 1 | 14 | 4 |
| Interface Hepatitis Score of 2 | 8 | 6 |
| Interface Hepatitis Score of 3 | 3 | 1 |
| Interface Hepatitis Score of 4 | 1 | 3 |
| Missing Interface Hepatitis Score | 9 | 4 |
The Ishak modification of Knodell histological activity index will be determined by liver biopsy. The four items and their categorizations scores include: • confluent necrosis * 0 = None * 1 = Focal confluent necrosis * 2 = Zone 3 necrosis in some areas * 3 = Zone 3 necrosis in most areas * 4 = Zone 3 necrosis + occasional portal-central bridging * 5 = Zone 3 necrosis + multiple portal-central bridging * 6 = Panacinar or multiacinar necrosis
| Participants | IDN-6556 | Placebo |
|---|---|---|
| Confluent necrosis score of 0 | 32 | 19 |
| Missing confluent necrosis score | 9 | 4 |
The Ishak modification of Knodell histological activity index will be determined by liver biopsy. • parenchymal injury (focal lytic necrosis, apoptosis and focal inflammation) * 0 = None * 1 = One focus or less per 10× objective * 2 = Two to four foci per 10× objective * 3 = Five to ten foci per 10× objective * 4 = More than ten foci per 10× objective
| Participants | IDN-6556 | Placebo |
|---|---|---|
| Parenchymal Injury Score of 0 | 1 | 2 |
| Parenchymal Injury Score of 1 | 22 | 9 |
| Parenchymal Injury Score of 2 | 5 | 7 |
| Parenchymal Injury Score of 3 | 4 | 1 |
| Missing Parenchymal Injury Score | 9 | 4 |
Portal inflammation * 0 = None * 1 = Mild, some or all portal areas * 2 = Moderate, some or all portal areas * 3 = Moderate/marked, all portal areas * 4 = Marked, all portal areas
| Participants | IDN-6556 | Placebo |
|---|---|---|
| Portal Inflammation Score of 1 | 11 | 4 |
| Portal Inflammation Score of 2 | 19 | 8 |
| Portal Inflammation Score of 3 | 2 | 6 |
| Portal Inflammation Score of 4 | 0 | 1 |
| Missing Portal Inflammation Score | 9 | 4 |
Collected over Treatment emergent adverse events were collected from the first day of study drug administration until the subject's last study follow-up visit. All treatment emergent adverse events were collected up to the subsequent follow-up visit of the month 24 month visit.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| IDN-6556 | 0/41 (0%) | 0/41 (0%) | 37/41 (90.2%) |
| Placebo | 1/23 (4.3%) | 1/23 (4.3%) | 20/23 (87%) |
| Event | IDN-6556 | Placebo |
|---|---|---|
| DeathNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/41 | 1/23 |
| Event | IDN-6556 | Placebo |
|---|---|---|
| FatigueGeneral disorders | 8/41 | 6/23 |
| DiarrheaGastrointestinal disorders | 9/41 | 5/23 |
| NauseaGastrointestinal disorders | 7/41 | 5/23 |
| HypertensionVascular disorders | 6/41 | 4/23 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 6/41 | 2/23 |
| Abdominal painGastrointestinal disorders | 4/41 | 2/23 |
Subjects who underwent orthotopic liver transplantation for chronic HCV, developed HCV-related liver fibrosis or cirrhosis, achieved a SVR with anti-viral treatment and had demonstrable fibrosis or cirrhosis on liver histology were enrolled.
| Age, Categorical(Participants) | IDN-6556 | Placebo | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 29 | 17 | 46 |
| >=65 years | 12 | 6 | 18 |
| Sex: Female, Male(Participants) | IDN-6556 | Placebo | Total |
|---|---|---|---|
| Female | 9 | 5 | 14 |
| Male | 32 | 18 | 50 |
| Ethnicity (NIH/OMB)(Participants) | IDN-6556 | Placebo | Total |
|---|---|---|---|
| Hispanic or Latino | 10 | 6 | 16 |
| Not Hispanic or Latino | 31 | 17 | 48 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | IDN-6556 | Placebo | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 7 | 2 | 9 |
| White | 30 | 20 | 50 |
| More than one race | 1 | 0 | 1 |
| Unknown or Not Reported | 3 | 1 | 4 |
| Region of Enrollment(participants) | IDN-6556 | Placebo | Total |
|---|---|---|---|
| United States | 41 | 23 | 64 |
| Baseline Ishak Fibrosis Score(participants) | IDN-6556 | Placebo | Total |
|---|---|---|---|
| Baseline Ishak Fibrosis Score F2 | 9 | 6 | 15 |
| Baseline Ishak Fibrosis Score F3 | 20 | 7 | 27 |
| Baseline Ishak Fibrosis Score F4 | 5 | 5 | 10 |
| Baseline Ishak Fibrosis Score F5 | 2 | 2 | 4 |
| Baseline Ishak Fibrosis Score F6 | 5 | 3 | 8 |
Documents are hosted by the registry — open the source record to download them.
The record gives a start of May 2014, a primary completion of Feb 2018 and a completion of Mar 2018. It does not say whether these dates are actual or estimated.
Results were first posted in Dec 2019, 1 year 9 months after primary completion.
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This study is completed, as verified in Nov 2019. You cannot join it, but the record below documents what was studied.
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Studies of the drug tested here: Emricasan
Conatus Pharmaceuticals Inc.