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.
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
Show all 11Show fewer
- 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
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).
- Conditions
- Alcoholic Hepatitis
- 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 group | Role | What they receive |
|---|---|---|
| Part A (Moderate AH) DUR-928 30 mg | Experimental | Lowest 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 mg | Experimental | Middle 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 mg | Experimental | Highest dose of dose escalation arms: 30mg, 90 mg and 150 mg Receives: Drug: DUR-928 150 mg |
| Part B (Severe AH) DUR-928 30 mg | Experimental | Lowest dose of dose escalation arms: 30mg, 90 mg and 150 mg Receives: Drug: DUR-928 30 mg |
| Part B (Severe AH) DUR-928 90 mg | Experimental | Middle dose of dose escalation arms: 30mg, 90 mg and 150 mg Receives: Drug: DUR-928 90 mg |
| Part B (Severe AH) DUR-928 150 mg | Experimental | Highest 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.
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
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
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)
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
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
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
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.
- First posted14 Feb 2018
- Study start18 Apr 2018
- Primary completion9 Sep 2019
- Study completion9 Sep 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Alcoholic HepatitisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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)
Sponsor and investigators
- Lead sponsor
- Durect
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- CTI Clinical Trial and Consulting Services
- Responsible party
- Sponsor
- Investigators
- Robert Gordon, MD, Study director, CTI Clinical Trial and Consulting Services
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
- Results posted
- Yes, on ClinicalTrials.gov
- 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
Study at a glance
From the registry record, last updated by the sponsor on 24 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Open- Label, Dose Escalation Study to Assess the Safety, Pharmacokinetics and Pharmacodynamic Signals of DUR-928 in Patients With Alcoholic Hepatitis
- ClinicalTrials.gov ID
- NCT03432260
- Acronym / sponsor ID
- AH / C928-010
- Conditions
- Alcoholic Hepatitis
- Keywords
- Alcoholic Hepatitis, acute alcoholic liver disease, progressive inflammatory liver injury, IV infusion
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 19 participants (actual)
- Lead sponsor
- DurectIndustry (pharma, biotech, devices)
- Collaborators
- CTI Clinical Trial and Consulting Services
- Study start
- 18 Apr 2018 (actual)
- Primary completion
- 9 Sep 2019 (actual)
- Study completion
- 9 Sep 2019 (actual)
- First posted
- 14 Feb 2018 (actual)
- Results
- Posted 14 Dec 2022
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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).
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 6
- Model description
- Staggered parallel design.
| Arm | Type | Receives |
|---|---|---|
| Part A (Moderate AH) DUR-928 30 mg | Experimental | Drug: DUR-928 30 mgLowest dose of 3 dose escalation arms: 30mg, 90 mg and 150 mg |
| Part A (Moderate AH) DUR-928 90 mg | Experimental | Drug: DUR-928 90 mgMiddle dose of 3 dose escalation arms: 30mg, 90 mg and 150 mg |
| Part A (Moderate AH) DUR-928 150 mg | Experimental | Drug: DUR-928 150 mgHighest dose of dose escalation arms: 30mg, 90 mg and 150 mg |
| Part B (Severe AH) DUR-928 30 mg | Experimental | Drug: DUR-928 30 mgLowest dose of dose escalation arms: 30mg, 90 mg and 150 mg |
| Part B (Severe AH) DUR-928 90 mg | Experimental | Drug: DUR-928 90 mgMiddle dose of dose escalation arms: 30mg, 90 mg and 150 mg |
| Part B (Severe AH) DUR-928 150 mg | Experimental | Drug: DUR-928 150 mgHighest dose of dose escalation arms: 30mg, 90 mg and 150 mg |
Who may qualify
- Ages
- 21 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- 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:
- No evidence of active infection as determined by the investigator.
- Women of child-bearing potential must utilize appropriate birth control throughout the study duration.
Key exclusion criteria (11 listed)
- Other or concomitant cause(s) of liver disease as a result of:
- Co-infection with human immunodeficiency virus (HIV) or Hepatitis B
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| DUR-928 30 mgLowest dose of 3 dose escalation arms. | Drug | Part A (Moderate AH) DUR-928 30 mg, Part B (Severe AH) DUR-928 30 mg |
| DUR-928 90 mgMiddle dose of 3 dose escalation arms. | Drug | Part A (Moderate AH) DUR-928 90 mg, Part B (Severe AH) DUR-928 90 mg |
| DUR-928 150 mgHighest dose of 3 dose escalation arms. | Drug | Part A (Moderate AH) DUR-928 150 mg, Part B (Severe AH) DUR-928 150 mg |
Primary outcome
Lille Model for Alcoholic Hepatitis Score
Time frame: Day 7
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.
Model for End Stage Liver Disease (MELD) Score
Time frame: Baseline (Screening or Day 1 Pre-dose), Day 7 and Day 28
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.
Model for End Stage Liver Disease (MELD) Score - Percent Change From Baseline
Time frame: Baseline (Screening or Day 1 Pre-dose), Day 7 and Day 28
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.
4 secondary outcomes
Serum Cytokeratin 18 (M30)
Time frame: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28
Serum Cytokeratin 18 (M65)
Time frame: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28
International Normalized Ratio (INR) - Percent Change From Baseline
Time frame: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28
Bilirubin - Percent Change From Baseline
Time frame: Baseline (Screening or Day 1 Pre-dose), Day 7, Day 28
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Sep 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37011138Hassanein 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.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Robert Gordon, MD study director
CTI Clinical Trial and Consulting Services
7 sites in 1 country: see every site and its status.
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.