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Alcoholic HepatitisPhase 2AHNCT03432260

A Research Study to Assess the Safety, Pharmacokinetics and Pharmacodynamics of DUR-928 in Patients With Alcoholic Hepatitis

A Phase 2 study testing DUR-928 30 mg, DUR-928 90 mg and DUR-928 150 mg in people with Alcoholic Hepatitis, run by Durect at 7 sites in United States.

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 research trial testing DUR-928 (an experimental medication). The purpose of this trial is to assess the dose related safety, Pharmacokinetics, and Pharmacodynamics of DUR 928 in patients with moderate and severe alcoholic hepatitis (AH). Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Alcoholic Hepatitis
What is being tested?
DUR-928 30 mg, DUR-928 90 mg and DUR-928 150 mg
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
7 sitesUnited States
Study dates
18 Apr 2018to 9 Sep 2019
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 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Able to provide written informed consent (either from patient or patient's legally acceptable representative)
  • Male or female patients 21 years of age or older with BMI ≥ 20 to ≤ 40 kg/m2
  • Patients with alcoholic hepatitis defined as:
  • History of heavy alcohol abuse: > 40 g/day in females or > 60 g/day in males for a minimum period of 6 months, AND
  • Consumed alcohol within 12 weeks of entry into the study, AND
  • Serum bilirubin > 3 mg/dL AND AST > ALT, but less than 300 U/L AND
Show all 10Show fewer
  • MELD score between 11-30, inclusive
  • No evidence of active infection as determined by the investigator.
  • Women of child-bearing potential must utilize appropriate birth control throughout the study duration.
  • Male patients must agree to use a medically acceptable method of contraception/birth control throughout the study duration

Who cannot join

  • Other or concomitant cause(s) of liver disease as a result of:
  • Autoimmune liver disease
  • Wilson disease
  • Vascular liver disease
  • Drug induced liver disease
  • Co-infection with human immunodeficiency virus (HIV) or Hepatitis B
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  • Any active malignancies other than curatively treated skin cancer (basal cell or squamous cell carcinomas)
  • If female, known pregnancy, or has a positive serum pregnancy test, or lactating/breastfeeding
  • Serum creatinine > 2.5 mg/dL
  • Patients who have had organ transplantation (such as liver, kidney, lung, heart, bone marrow, or stem cell etc.), other than cornea transplant
  • Stage 3 or greater encephalopathy by West Haven criteria

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

United States7 sites
  • DURECT Study Site 0004

    Atlanta, Georgia, 30309

  • DURECT Study Site 0002

    Chicago, Illinois, 60611

  • DURECT Study Site 008

    Indianapolis, Indiana, 46202

  • DURECT Study Site 0005

    Louisville, Kentucky, 40202

  • DURECT Study Site 007

    Miami, Florida, 33136

  • DURECT Study Site 006

    San Antonio, Texas, 78215

  • DURECT Study Site 0001

    San Diego, California, 92118

Other trials in United States

About this study

Official title: An Open- Label, Dose Escalation Study to Assess the Safety, Pharmacokinetics and Pharmacodynamic Signals of DUR-928 in Patients With Alcoholic Hepatitis

This is a research trial testing DUR-928 (an experimental medication). The purpose of this trial is to assess the dose related safety, Pharmacokinetics, and Pharmacodynamics of DUR 928 in patients with moderate and severe alcoholic hepatitis (AH).

Being tested
DUR-928 30 mg, DUR-928 90 mg, DUR-928 150 mg
Keywords
Alcoholic Hepatitis, acute alcoholic liver disease, progressive inflammatory liver injury, IV infusion
Medical subject headings
Hepatitis, Alcoholic

What participants receive

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

  • DUR-928 30 mgDrug

    Lowest dose of 3 dose escalation arms.

  • DUR-928 90 mgDrug

    Middle dose of 3 dose escalation arms.

  • DUR-928 150 mgDrug

    Highest dose of 3 dose escalation arms.

Study groups in NCT03432260
Study groupRoleWhat they receive
Part A (Moderate AH) DUR-928 30 mgExperimentalLowest dose of 3 dose escalation arms: 30mg, 90 mg and 150 mg
Receives: Drug: DUR-928 30 mg
Part A (Moderate AH) DUR-928 90 mgExperimentalMiddle dose of 3 dose escalation arms: 30mg, 90 mg and 150 mg
Receives: Drug: DUR-928 90 mg
Part A (Moderate AH) DUR-928 150 mgExperimentalHighest dose of dose escalation arms: 30mg, 90 mg and 150 mg
Receives: Drug: DUR-928 150 mg
Part B (Severe AH) DUR-928 30 mgExperimentalLowest dose of dose escalation arms: 30mg, 90 mg and 150 mg
Receives: Drug: DUR-928 30 mg
Part B (Severe AH) DUR-928 90 mgExperimentalMiddle dose of dose escalation arms: 30mg, 90 mg and 150 mg
Receives: Drug: DUR-928 90 mg
Part B (Severe AH) DUR-928 150 mgExperimentalHighest dose of dose escalation arms: 30mg, 90 mg and 150 mg
Receives: Drug: DUR-928 150 mg

What is being measured

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

  1. Lille Model for Alcoholic Hepatitis Score

    The Lille score predicts response of AH subjects to treatment with glucocorticoids, such as prednisolone. This score is based on age, serum albumin, creatinine, PT, and the difference in bilirubin between pre-treatment and Day 7 post-treatment. The Lille score ranges from 0.01 to 1.00. A score >0.45 predicts a higher risk of death and the recommendation to stop steroid administration.

    Lille Score = Exp(-R)/(1 + Exp(-R))

    Where:

    R = [3.19 - (0.101 x Age in years)] + (1.47 x Albumin in g/dL) + [0.28215 x (Bilirubin initial - Bilirubin day 7 in mg/dL)] - (0.206 x Creatinine in mg/dL) - (0.11115 x Bilirubin initial in mg/dL) - (0.0096 x PT in seconds) NOTE: When calculating Lille, use "baseline" values for ALL parameters EXCEPT bilirubin at Day 7. Baseline would be the Day 1 Pre-dose sample result, if available. If not available, then use the Screening sample result.

    Measured: Day 7

  2. Model for End Stage Liver Disease (MELD) Score

    The MELD score at enrollment is a good predictor for AH patient prognosis. Laboratory values for international normalized ratio (INR), serum creatinine (sCr) and bilirubin are used to calculate the MELD score. The MELD score ranges from 6.0 to 40.0 (capped) with a higher score predicting a higher risk of death. A sequentially improving MELD score is associated with a better chance of recovery.

    MELD score will be calculated using the original formula (pre-2016) which does not include serum sodium level.

    Original MELD Score = (0.957 x Ln(Serum Creatinine in mg/dL) + 0. 378 x Ln(Serum Bilirubin in mg/dL) + 1.120 x Ln (INR) + 0.643) x 10 Note: (1) If patient received two or more dialysis treatments within the prior 7 days, then the value for serum creatinine will be set to 4.0. (2) If any laboratory value is less than 1.0, the value will be set to 1.0 for the MELD score calculation, in order to avoid negative values resulting from taking the natural log of values less than 1.

    Measured: Baseline (Screening or Day 1 Pre-dose), Day 7 and Day 28

  3. Model for End Stage Liver Disease (MELD) Score - Percent Change From Baseline

    The MELD Score %change from baseline is a %change between 2 time points, baseline and value at a specific time point (Day 7 or Day 28). MELD score is a good predictor of outcome. A declining MELD score suggests disease improvement. Lab values for international normalized ratio (INR), serum creatinine (sCr) and bilirubin are used to calculate the MELD score. MELD score will be calculated using the original formula (pre-2016) which does not include serum sodium level. Original MELD Score = (0.957 x Ln(Serum Creatinine in mg/dL) + 0. 378 x Ln(Serum Bilirubin in mg/dL) + 1.120 x Ln (INR) + 0.643) x 10 Note: (1) If patient received two or more dialysis treatments within the prior 7 days, then the value for serum creatinine will be set to 4.0. (2) If any laboratory value is less than 1.0, the value will be set to 1.0 for the MELD score calculation, in order to avoid negative values resulting from taking the natural log of values less than 1.

    Measured: Baseline (Screening or Day 1 Pre-dose), Day 7 and Day 28

Secondary outcomes (4)
  1. Serum Cytokeratin 18 (M30)

    Analysis Population Description: Baseline was defined as the last non-missing value prior to study drug administration, at Screening or Day 1 Pre-dose.

    Measured: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28

  2. Serum Cytokeratin 18 (M65)

    Analysis Population Description: Baseline was defined as the last non-missing value prior to study drug administration, at Screening or Day 1 Pre-dose.

    Measured: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28

  3. International Normalized Ratio (INR) - Percent Change From Baseline

    ITT population. INR (international normalized ratio) is a standardized number based on the prothrombin time and calculated by the clinical lab. INR measures the time it takes for blood to clot in vitro and measures, among other things, liver synthetic function.

    Measured: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28

  4. Bilirubin - Percent Change From Baseline

    ITT population

    Measured: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28

Timeline

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

  1. First posted14 Feb 2018
  2. Study start18 Apr 2018
  3. Primary completion9 Sep 2019
  4. Study completion9 Sep 2019

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
Non-randomised
Intervention model
Parallel groups
Model description
Staggered parallel design.
Masking
None (open label)
Enrolment
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03432260
Sponsor's protocol ID
C928-010
Acronym
AH
Status last verified
Nov 2022
First submitted
1 Feb 2018
Last updated
24 Sep 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Hassanein T, McClain CJ, Vatsalya V, Stein LL, Flamm SL, Martin P, Cave MC, Mitchell M Jr, Barton B, Nagy L, Szabo G, McCullough A, Dasarathy S, Shah J, Blevins C, Scott D, Krebs W, Brown JE, Lin W. Safety, Pharmacokinetics, and Efficacy Signals of Larsucosterol (DUR-928) in Alcohol-Associated Hepatitis. Am J Gastroenterol. 2024 Jan 1;119(1):107-115. doi: 10.14309/ajg.0000000000002275. Epub 2023 Apr 3.

    PubMed 37011138

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing DUR-928 30 mg, DUR-928 90 mg and DUR-928 150 mg in people with Alcoholic Hepatitis, run by Durect at 7 sites in United States.

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 10 inclusion and 11 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 24 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in United States. 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. 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 Dec 2022). 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?

Lille Model for Alcoholic Hepatitis Score (time frame: Day 7). The study lists 3 primary outcomes in all. 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 NCT03432260, which also lists 1 linked publication.

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 24 Sep 2024; AzTrials last refreshed its copy on 7 Nov 2026.

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