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NASH - Nonalcoholic SteatohepatitisPhase 2NCT03976401

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

A Phase 2 study testing EFX in people with NASH - Nonalcoholic Steatohepatitis, run by Akero Therapeutics, Inc at 27 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 administered for 16 weeks in subjects with biopsy proven F1 - F4 NASH. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
NASH - Nonalcoholic Steatohepatitis
What is being tested?
EFX
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
110 participants
Where
27 sitesin 2 countries
Study dates
28 May 2019to 10 Jan 2022
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 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males and non-pregnant, non-lactating females between 18 - 80 years of age inclusive, based on the date of the screening visit.
  • Main Study only: Body mass index (BMI) > 25 kg/m^2 (unless the patient has biopsy-proven NASH documented within the last 2 years).
  • Main Study only: Must have confirmation of ≥ 10% liver fat content on magnetic resonance imaging- proton density fat fraction (MRI-PDFF) at screening.
  • Main Study only: Biopsy-proven NASH. Must have had a liver biopsy within 180 days of randomization with fibrosis stage 1 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
Show all 9Show fewer
  • Lobular inflammation (scored 0 to 3)
  • Cohort C only: FibroScan® measurement > 13.1 kPa.
  • Cohort C only: Cirrhosis due to NASH. Liver biopsy consistent with F4 fibrosis according to the NAS system, confirmed by the central or local reader.

Who cannot join

  • Weight gain or loss > 5% in the 3 months prior to randomization or > 10% in the 6 months prior to screening.
  • Type 1 and insulin-dependent Type 2 diabetes.
  • Poorly controlled hypertension (blood pressure > 160/100).

Trial locations and contacts

27 sites in 2 countries.

27 sites in 2 countries

United States26 sites
  • Akero Clinical Study Site

    Baton Rouge, Louisiana, 70809

  • Akero Clinical Study Site

    Berlin, New Jersey, 08009

  • Akero Clinical Study Site

    Boca Raton, Florida, 33434

  • Akero Clinical Study Site

    Cedar Park, Texas, 78613

  • Akero Clinical Study Site

    Chattanooga, Tennessee, 37421

  • Akero Clinical Study Site

    Dallas, Texas, 75246

  • Akero Clinical Study Site

    Edinburg, Texas, 78539

  • Akero Clinical Study Site

    Fort Worth, Texas, 76104

  • Akero Clinical Study Site

    Huntington Park, California, 90255

  • Akero Clinical Study Site

    Kansas City, Missouri, 64131

  • Akero Clinical Study Site

    Lakewood Rch, Florida, 34211

  • Akero Clinical Study Site

    Little Rock, Arkansas, 72117

  • Akero Clinical Study Site

    Los Angeles, California, 90036

  • Akero Clinical Study Site

    Los Angeles, California, 90057

  • Akero Clinical Study Site

    Marrero, Louisiana, 70072

  • Akero Clinical Study Site

    Miami, Florida, 33156

  • Akero Clinical Study Site

    New Port Richey, Florida, 34653

  • Akero Clinical Study Site

    Ocoee, Florida, 34761

  • Akero Clinical Study Site

    Panorama City, California, 91402

  • Akero Clinical Study Site

    Port Orange, Florida, 32127

  • Akero Clinical Study Site

    Poway, California, 92064

  • Akero Clinical Study Site

    San Antonio, Texas, 78215

  • Akero Clinical Study Site

    San Antonio, Texas, 78229

  • Akero Clinical Study Site

    Sarasota, Florida, 34240

  • Akero Clinical Study Site

    Tucson, Arizona, 85711

  • Akero Clinical Study Site

    Webster, Texas, 77598

Other trials in United States

Puerto Rico1 site
  • Akero Clinical Study Site

    San Juan, 00927

Other trials in Puerto Rico

About this study

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

This is a multi-center evaluation of efruxifermin (EFX) in a randomized, double-blind, placebo-controlled study administered for 16 weeks in subjects with biopsy proven F1 - F4 NASH.

Being tested
EFX, 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.

  • EFXDrug

    Administered by subcutaneous injection

  • PlaceboDrug

    Administered by subcutaneous injection

Study groups in NCT03976401
Study groupRoleWhat they receive
EFX Dose 1ExperimentalMain Study
Receives: Drug: EFX
EFX Dose 2ExperimentalMain Study
Receives: Drug: EFX
EFX Dose 3ExperimentalMain Study
Receives: Drug: EFX
PlaceboPlacebo comparatorMain Study
Receives: Drug: Placebo
EFX Dose (Cohort C)ExperimentalNot described
Receives: Drug: EFX
Placebo (Cohort C)Placebo comparatorNot described
Receives: Drug: Placebo

What is being measured

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

  1. Main: Absolute Change From Baseline in Hepatic Fat Fraction Assessed by MRI-PDFF at Week 12.

    Main study. ANCOVA multiple imputation with treatment group and F1 fibrosis score (F1 vs F2-3) as factors and baseline hepatic fat fraction measured by MRI-PDFF as a covariate.

    Measured: 12 weeks

Secondary outcomes (9)
  1. Main: Absolute Change From Baseline in Hepatic Fat Fraction Assessed by MRI-PDFF at Week 22-24.

    Main study. Included subjects with ≥30% relative fat reduction on MRI-PDFF at Week 12 that were required to return between Weeks 22 - 24. ANCOVA model with treatment group and F1 fibrosis score (F1 vs F2-3) as factors and baseline hepatic fat fraction as a covariate were performed.

    Measured: 22-24 weeks

  2. Main: Percent Change From Baseline in Hepatic Fat Fraction Measured by MRI-PDFF at Week 12.

    Main study. ANCOVA multiple imputation with treatment group and F1 fibrosis score (F1 vs F2-3) as factors and baseline hepatic fat fraction measured by MRI-PDFF as a covariate.

    Measured: 12 weeks

  3. Main: Percent Change From Baseline in Hepatic Fat Fraction Measured by MRI-PDFF at Week 22-24.

    Main study. ANCOVA multiple imputation with treatment group and F1 fibrosis score (F1 vs F2-3) as factors and baseline hepatic fat fraction measured by MRI-PDFF as a covariate.

    Measured: 22-24 weeks

  4. Main: Responder: Subjects Who Achieved a Clinically Meaningful Relative Reduction of at Least 30% in Liver Fat Content as Measured by MRI-PDFF at Week 12.

    Main Study. The analyses included the treatment group and F1 fibrosis score (F1 vs F2-3) as factors and baseline hepatic fat fraction measured by MRI-PDFF as a covariate.

    Measured: 12 weeks

  5. Main: Responder Based on NAFLD Activity Score System (NAS): Subjects Who Had a Decrease of ≥2 Points in NAS With at Least a 1-point Reduction in Either Lobular Inflammation or Hepatocellular Ballooning and With no Concurrent Worsening of Fibrosis Stage.

    Main study: Responders were defined for subjects with ≥ 30% relative fat reduction on MRI-PDFF at Week 12 and required to return between Weeks 22 - 24. Fisher's exact test was used for the analysis using the Full Analysis Set with missing values imputed as non-responders and repeated on Liver Biopsy Evaluable Analysis Set without imputation.

    Measured: 22-24 weeks

  6. Main: Change From Baseline in ALT at Week 12, 16, and 20.

    ANCOVA model with treatment group, baseline hepatic fat fraction (<15% vs ≥15%), and F1 fibrosis score (F1 vs F2-3) as factors and baseline value as a covariate.

    Measured: 12, 16, and 20 weeks

  7. Cohort C: Change From Baseline in Liver Stiffness as Evaluated by FibroScan at Week 16

    Cohort C: ANCOVA model with treatment group as a factor and baseline liver stiffness as evaluated by FibroScan® as a covariate using the Full Analysis Set. Missing values at Week 16 were imputed using the last-observed-carried-forward (LOCF) method.

    Measured: 16 weeks

  8. Cohort C: Change From Baseline in Non-invasive Biomarkers Including Pro-C3 at Week 12, 16, and 20.

    Cohort C. ANCOVA model with treatment group as a factor and baseline liver stiffness as evaluated by FibroScan® as a covariate using the Full Analysis Set. Missing values were imputed using the last-observed-carried-forward (LOCF) method.

    Measured: 12, 16, and 20 weeks

  9. Cohort C: Change From Baseline in Non-invasive Biomarkers Including Liver Fibrosis by ELF Test Score at Week 12 and 16.

    Cohort C. The enhanced liver fibrosis (ELF) score describes the severity of liver fibrosis where a score of <7.7 indicates no or mild fibrosis, a score of ≥7.7 to <9.8 indicates moderate fibrosis, and a score of ≥9.8 indicates severe fibrosis. A change from baseline with a negative value indicates a decrease in severity of liver fibrosis.

    An ANCOVA model with treatment group as a factor and baseline liver stiffness as evaluated by FibroScan® as a covariate using the Full Analysis Set was used. Missing values were imputed using the last-observed-carried-forward (LOCF) method.

    Measured: 12 and 16 weeks

Timeline

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

  1. First posted6 Jun 2019
  2. Study start28 May 2019
  3. Primary completion10 Feb 2021
  4. Study completion10 Jan 2022

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
110 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03976401
Sponsor's protocol ID
AK-US-001-0101
Status last verified
Aug 2022
First submitted
3 Jun 2019
Last updated
4 Aug 2022
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Alkhouri N, Beyer C, Shumbayawonda E, Andersson A, Yale K, Rolph T, Chung RT, Vuppalanchi R, Cusi K, Loomba R, Pansini M, Dennis A. Decreases in cT1 and liver fat content reflect treatment-induced histological improvements in MASH. J Hepatol. 2025 Mar;82(3):438-445. doi: 10.1016/j.jhep.2024.08.031. Epub 2024 Sep 25.

    PubMed 39326675
  • Harrison SA, Ruane PJ, Freilich B, Neff G, Patil R, Behling C, Hu C, Shringarpure R, de Temple B, Fong E, Tillman EJ, Rolph T, Cheng A, Yale K. A randomized, double-blind, placebo-controlled phase IIa trial of efruxifermin for patients with compensated NASH cirrhosis. JHEP Rep. 2022 Aug 23;5(1):100563. doi: 10.1016/j.jhepr.2022.100563. eCollection 2023 Jan.

    PubMed 36644237
  • Harrison SA, Ruane PJ, Freilich BL, Neff G, Patil R, Behling CA, Hu C, Fong E, de Temple B, Tillman EJ, Rolph TP, Cheng A, Yale K. Efruxifermin in non-alcoholic steatohepatitis: a randomized, double-blind, placebo-controlled, phase 2a trial. Nat Med. 2021 Jul;27(7):1262-1271. doi: 10.1038/s41591-021-01425-3. Epub 2021 Jul 8.

    PubMed 34239138

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing EFX in people with NASH - Nonalcoholic Steatohepatitis, run by Akero Therapeutics, Inc at 27 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 9 inclusion and 3 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 4 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 27 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 4 Aug 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?

Main: Absolute Change From Baseline in Hepatic Fat Fraction Assessed by MRI-PDFF at Week 12. (time frame: 12 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 NCT03976401, which also lists 3 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 4 Aug 2022.

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