A Phase 2 interventional study of BMS-986036 and Placebo in Hepatic Cirrhosis, Liver Fibrosis and Nonalcoholic Fatty Liver Disease (NAFLD), sponsored by Bristol-Myers Squibb. Completed at 91 sites in 2 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2022-10-13.
Sponsored by Bristol-Myers Squibb · Phase 2, Interventional, and Treatment
This is a study of experimental medication BMS-986036 given to adults with Nonalcoholic Steatohepatitis (NASH; the buildup of fat and inflammation in the liver that is not caused by alcohol) and liver cirrhosis (liver damage characterized by normal liver tissue being replaced by scar tissue).
Exclusion Criteria:
Other protocol-defined inclusion/exclusion criteria apply
Drug: BMS-986036
Drug: BMS-986036
Drug: BMS-986036
Other: Placebo
Specified dose on specified days.
Also known as: Pegbelfermin
Specified dose on specified days.
The Percentage of Participants Who Achieve a ≥ 1-Stage Improvement in Fibrosis Without Worsening of Nonalcoholic Steatohepatitis (NASH) at Week 48
An improvement in fibrosis is defined as a decrease of fibrosis by ≥1-stage in the NASH Clinical Research Network (CRN) Fibrosis Score at week 48 in liver biopsy. Worsening of NASH is defined as an increase of the nonalcoholic fatty liver disease activity score (NAS) by ≥ 1-stage. Worsening of NASH is defined as an increase of the nonalcoholic fatty liver disease (NAFLD) Activity Score (NAS) by ≥1 point. Worsening of fibrosis is defined as an increase of fibrosis by ≥1 point as determined by the NASH CRN Fibrosis Score.
Time frame: From first dose to 48 weeks after first dose
The Percentage of Participants Who Achieve a ≥ 1-Stage Improvement in Ishak Fibrosis Score at Week 48
An improvement in Ishak fibrosis is defined as a decrease of fibrosis by ≥ 1-stage in the Ishak fibrosis score at week 48 in liver biopsy. ISHAKs uses a 0-6 scale: 1: centrilobular pericellular fibrosis, 2: centrilobular and periportal fibrosis, 3: bridging fibrosis (few bridges), 4: bridging fibrosis (many bridges), 5: early or incomplete cirrhosis, 6: established or advanced cirrhosis.
Time frame: From first dose to 48 weeks after first dose
The Percentage of Participants With Improvement in Fibrosis Without Worsening of Nonalcoholic Steatohepatitis (NASH) or NASH Improvement at Week 48
The percentage of participants who achieved a ≥1-stage improvement in fibrosis without worsening of NASH or NASH improvement with no worsening of fibrosis at week 48 in liver biopsy. Improvement in fibrosis is defined by the NASH Clinical Research Network (CRN) Fibrosis Score. Improvement in NASH is defined by a ≥2-stage decrease in the nonalcoholic fatty liver disease activity score (NAS). NASH CRN Fibrosis is staged on a 0-4 scale: 0 (none); 1 (perisinusoidal or periportal fibrosis); 2 (perisinusoidal and portal/periportal fibrosis); 3 (bridging fibrosis); 4 (cirrhosis).
Time frame: From first dose to 48 weeks after first dose
The Percentage of Participants Who Achieved >=1 Point Improvement in Fibrosis at Week 48
An improvement in fibrosis is defined as a decrease of ≥ 1-stage in the non-alcoholic steatohepatitis clinical research network (NASH CRN) Fibrosis Score at week 48 in liver biopsy. NASH CRN Fibrosis is staged on a 0-4 scale: 0 (none); 1 (perisinusoidal or periportal fibrosis); 2 (perisinusoidal and portal/periportal fibrosis); 3 (bridging fibrosis); 4 (cirrhosis).
Time frame: From first dose to 48 weeks after first dose
The Percentage of Participants With Any Improvement in Collagen Proportionate Area (CPA) at Week 48
An improvement in CPA is defined as any decrease in CPA at week 48 in liver biopsy.
Time frame: From first dose to 48 weeks after first dose
The Percentage of Participants With Nonalcoholic Steatohepatitis (NASH) Resolution at Week 48
NASH resolution defined by the nonalcoholic fatty liver disease activity score (NAS) component of ballooning = 0 and inflammation = 0-1 at week 48 in liver biopsy. Ballooning = 0 (none) inflammation = 0 (none) - 1 (Grade \<2).
Time frame: From first dose to 48 weeks after first dose
The Percentage of Participants With Nonalcoholic Steatohepatitis (NASH) Improvement at Week 48
The percentage of participants with NASH improvement at week 48 in liver biopsy. NASH improvement is defined as a reduction of nonalcoholic fatty liver disease activity score (NAS) by ≥ 2 points with contribution from \> 1 NAS component. The NASH CRN system assesses liver biopsies for degree of steatosis (0-3), lobular inflammation (0-3), hepatocellular ballooning (0-2), and fibrosis (0-4). The 3 categories are added together in an unweighted fashion to determine the NAS, which ranges from 0 to 8.
Time frame: From first dose to 48 weeks after first dose
| Milestone | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| Started | 39 | 38 | 39 | 39 |
| Completed | 39 | 37 | 39 | 39 |
| Not completed | 0 | 1 | 0 | 0 |
| Withdrew: Withdrawal by subject | 0 | 1 | 0 | 0 |
| Milestone | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| Started | 39 | 37 | 39 | 39 |
| Completed | 35 | 31 | 34 | 34 |
| Not completed | 4 | 6 | 5 | 5 |
| Withdrew: Withdrawal by subject | 3 | 3 | 3 | 2 |
| Withdrew: Other reasons | 0 | 2 | 1 | 1 |
| Withdrew: Adverse event | 0 | 1 | 1 | 0 |
| Withdrew: Lost to follow-up | 1 | 0 | 0 | 2 |
An improvement in fibrosis is defined as a decrease of fibrosis by ≥1-stage in the NASH Clinical Research Network (CRN) Fibrosis Score at week 48 in liver biopsy. Worsening of NASH is defined as an increase of the nonalcoholic fatty liver disease activity score (NAS) by ≥ 1-stage. Worsening of NASH is defined as an increase of the nonalcoholic fatty liver disease (NAFLD) Activity Score (NAS) by ≥1 point. Worsening of fibrosis is defined as an increase of fibrosis by ≥1 point as determined by the NASH CRN Fibrosis Score.
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants Who Achieve a ≥ 1-Stage Improvement in Fibrosis Without Worsening of Nonalcoholic Steatohepatitis (NASH) at Week 48 | 28.2 | 24.3 | 28.2 | 30.8 |
An improvement in Ishak fibrosis is defined as a decrease of fibrosis by ≥ 1-stage in the Ishak fibrosis score at week 48 in liver biopsy. ISHAKs uses a 0-6 scale: 1: centrilobular pericellular fibrosis, 2: centrilobular and periportal fibrosis, 3: bridging fibrosis (few bridges), 4: bridging fibrosis (many bridges), 5: early or incomplete cirrhosis, 6: established or advanced cirrhosis.
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants Who Achieve a ≥ 1-Stage Improvement in Ishak Fibrosis Score at Week 48 | 38.5 | 32.4 | 33.3 | 35.9 |
The percentage of participants who achieved a ≥1-stage improvement in fibrosis without worsening of NASH or NASH improvement with no worsening of fibrosis at week 48 in liver biopsy. Improvement in fibrosis is defined by the NASH Clinical Research Network (CRN) Fibrosis Score. Improvement in NASH is defined by a ≥2-stage decrease in the nonalcoholic fatty liver disease activity score (NAS). NASH CRN Fibrosis is staged on a 0-4 scale: 0 (none); 1 (perisinusoidal or periportal fibrosis); 2 (perisinusoidal and portal/periportal fibrosis); 3 (bridging fibrosis); 4 (cirrhosis).
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants With Improvement in Fibrosis Without Worsening of Nonalcoholic Steatohepatitis (NASH) or NASH Improvement at Week 48 | 33.3 | 40.5 | 35.9 | 30.8 |
An improvement in fibrosis is defined as a decrease of ≥ 1-stage in the non-alcoholic steatohepatitis clinical research network (NASH CRN) Fibrosis Score at week 48 in liver biopsy. NASH CRN Fibrosis is staged on a 0-4 scale: 0 (none); 1 (perisinusoidal or periportal fibrosis); 2 (perisinusoidal and portal/periportal fibrosis); 3 (bridging fibrosis); 4 (cirrhosis).
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants Who Achieved >=1 Point Improvement in Fibrosis at Week 48 | 35.9 | 29.7 | 28.2 | 33.3 |
An improvement in CPA is defined as any decrease in CPA at week 48 in liver biopsy.
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants With Any Improvement in Collagen Proportionate Area (CPA) at Week 48 | 61.8 | 54.2 | 41.9 | 53.1 |
NASH resolution defined by the nonalcoholic fatty liver disease activity score (NAS) component of ballooning = 0 and inflammation = 0-1 at week 48 in liver biopsy. Ballooning = 0 (none) inflammation = 0 (none) - 1 (Grade \<2).
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants With Nonalcoholic Steatohepatitis (NASH) Resolution at Week 48 | 2.6 | 5.4 | 2.6 | 0.0 |
The percentage of participants with NASH improvement at week 48 in liver biopsy. NASH improvement is defined as a reduction of nonalcoholic fatty liver disease activity score (NAS) by ≥ 2 points with contribution from \> 1 NAS component. The NASH CRN system assesses liver biopsies for degree of steatosis (0-3), lobular inflammation (0-3), hepatocellular ballooning (0-2), and fibrosis (0-4). The 3 categories are added together in an unweighted fashion to determine the NAS, which ranges from 0 to 8.
| Percentage of Participants | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| The Percentage of Participants With Nonalcoholic Steatohepatitis (NASH) Improvement at Week 48 | 15.4 | 24.3 | 12.8 | 2.6 |
Collected over Participants were assessed for All-Cause Mortality from their randomization until the study was completed (up to approximately 39 months). SAEs and Other AEs were assessed from first dose to 30 days following last dose (up to approximately 52 weeks).. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| BMS-986036 10 mg | 1/39 (2.6%) | 7/39 (17.9%) | 27/39 (69.2%) |
| BMS-986036 20 mg | 0/38 (0%) | 7/37 (18.9%) | 36/37 (97.3%) |
| BMS-986036 40 mg | 0/39 (0%) | 8/39 (20.5%) | 29/39 (74.4%) |
| Placebo | 1/39 (2.6%) | 3/39 (7.7%) | 33/39 (84.6%) |
| Event | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| Clostridium difficile infectionInfections and infestations | 0/39 | 0/37 | 2/39 | 0/39 |
| Acute coronary syndromeCardiac disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Coronary artery diseaseCardiac disorders | 1/39 | 1/37 | 0/39 | 0/39 |
| HypophosphataemiaMetabolism and nutrition disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Cerebral haemorrhageNervous system disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Spondylitic myelopathyNervous system disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| UreterolithiasisRenal and urinary disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Acute respiratory failureRespiratory, thoracic and mediastinal disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Diaphragmatic paralysisRespiratory, thoracic and mediastinal disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Drug eruptionSkin and subcutaneous tissue disorders | 0/39 | 1/37 | 0/39 | 0/39 |
| Event | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo |
|---|---|---|---|---|
| DiarrhoeaGastrointestinal disorders | 2/39 | 16/37 | 11/39 | 6/39 |
| NauseaGastrointestinal disorders | 1/39 | 11/37 | 7/39 | 5/39 |
| Injection site bruisingGeneral disorders | 2/39 | 7/37 | 3/39 | 4/39 |
| Abdominal painGastrointestinal disorders | 0/39 | 6/37 | 2/39 | 3/39 |
| Frequent bowel movementsGastrointestinal disorders | 3/39 | 6/37 | 5/39 | 0/39 |
| FatigueGeneral disorders | 1/39 | 6/37 | 1/39 | 1/39 |
| Increased appetiteMetabolism and nutrition disorders | 0/39 | 6/37 | 1/39 | 0/39 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 1/39 | 1/37 | 6/39 | 5/39 |
| SinusitisInfections and infestations | 1/39 | 5/37 | 1/39 | 4/39 |
| Injection site erythemaGeneral disorders | 1/39 | 1/37 | 5/39 | 2/39 |
| Age, Categorical(Participants) | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo | Total |
|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 27 | 30 | 30 | 25 | 112 |
| >=65 years | 12 | 8 | 9 | 14 | 43 |
| Sex: Female, Male(Participants) | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo | Total |
|---|---|---|---|---|---|
| Female | 28 | 26 | 21 | 24 | 99 |
| Male | 11 | 12 | 18 | 15 | 56 |
| Ethnicity (NIH/OMB)(Participants) | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo | Total |
|---|---|---|---|---|---|
| Hispanic or Latino | 13 | 6 | 7 | 11 | 37 |
| Not Hispanic or Latino | 25 | 30 | 31 | 28 | 114 |
| Unknown or Not Reported | 1 | 2 | 1 | 0 | 4 |
| Race (NIH/OMB)(Participants) | BMS-986036 10 mg | BMS-986036 20 mg | BMS-986036 40 mg | Placebo | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 | 0 |
| Asian | 4 | 7 | 4 | 3 | 18 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 1 | 1 | 2 |
| Black or African American | 1 | 0 | 0 | 0 | 1 |
| White | 30 | 31 | 34 | 33 | 128 |
| More than one race | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 4 | 0 | 0 | 2 | 6 |
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