Title

A Study to Evaluate the Safety, Tolerability & Efficacy of MSDC-0602K in Patients With NASH
A Phase 2, Randomized, Double-Blind, Placebo-Controlled, 12-Month, Multiple-Dose Study to Evaluate the Safety, Tolerability and Efficacy of Three Dose Levels of MSDC-0602K in Patients With NASH (EMMINENCE™)
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    392
This is a randomized, double-blinded study of three doses of MSDC-0602K or placebo given orally once daily to subjects with biopsy proven NASH with fibrosis and no cirrhosis.
This is a randomized, double-blinded study of three doses of MSDC-0602K or placebo given orally once daily to subjects with biopsy proven NASH with fibrosis and no cirrhosis. Visits to the clinic will be at baseline, 1, 2, 3, 6, 9, and 12 months, with one 2- week follow-up visit.

Safety will be assessed by monitoring of vital signs, 12 lead electrocardiogram (ECG), physical examinations, safety labs, and adverse events (AEs).
Study Started
Sep 14
2016
Primary Completion
Jun 30
2019
Study Completion
Jun 30
2019
Results Posted
Aug 21
2020
Last Update
Sep 16
2020

Drug Placebo

Placebo capsules

Drug MSDC-0602K

MSDC-0602K capsules

MSDC-0602K Dose 1 capsules Active Comparator

MSDC-0602K Dose 1 capsule taken once daily for 360 days

MSDC-0602K Dose 2 capsules Active Comparator

MSDC-0602K Dose 2 capsules taken once daily for 360 days

MSDC-0602K Dose 3 capsules Active Comparator

MSDC-0602K Dose 3 capsules taken once daily for 360 days

Placebo capsules Placebo Comparator

Matching Placebo capsule taken once daily for 360 days

Criteria

Selected Inclusion Criteria:

Adult subjects 18 years of age or greater
Histological evidence of NASH, based on biopsy, with a NAS (NASH CRN scoring) ≥ 4 with a score of at least 1 in each component of NAS.
Histological evidence of liver fibrosis defined as NASH CRN System fibrosis score F1 to F3.
Subjects with type 2 diabetes mellitus (DM) must be under stable and reasonable control.
Male and female subjects who are taking Vitamin E should be on a stable dose of Vitamin E (if ≥ 400 IU) for a period of at least 3 months prior to randomization.
Females should be either postmenopausal (at least 12 months since last menses) or surgically sterilized (bilateral tubal ligation or hysterectomy). Males with female partners of child-bearing potential must agree to use adequate contraceptive methods (including a condom, plus one other form of contraception) if engaging in sexual intercourse.
Willing and able to sign an informed consent document indicating understanding the purpose of and procedures required for the study and willingness to participate in the study.

Selected Exclusion Criteria:

Known history of HIV.
Prior liver transplantation.
Other well-documented causes of active chronic liver disease.
History of cirrhosis and/or hepatic decompensation including ascites, hepatic encephalopathy or variceal bleeding.
History of alcohol abuse or drug abuse within 6 months of Screening.
Type 1 diabetes mellitus.
Current or history of recent (≤ 6 months) use of ursodeoxycholic acid.
Use of concomitant medications with a known significant metabolism by CYP2C8 or CPY2C9.
History of diabetic ketoacidosis or hyperosmolar non-ketotic coma within 6 months prior to randomization.
History of heart failure (including CHF) or previous cardiovascular event (myocardial infarct, by-pass surgery, or PTCA) within the past 6 months prior to randomization.
Blood pressure greater than 160/100 mmHg.
Participation in an investigational study or received an investigational drug within 30 days or 5 half-lives (whichever is longer) prior to study drug administration.
Malignancy, including leukemia and lymphoma (excluding basal cell and squamous skin cell cancers and localized prostrate cancer) treated within the last 2 years.

Summary

Placebo

MSDC-0602K 62.5 mg

MSDC-0602K 125 mg

MSDC-0602K 250 mg

All Events

Event Type Organ System Event Term Placebo MSDC-0602K 62.5 mg MSDC-0602K 125 mg MSDC-0602K 250 mg

Number of Participants With Hepatic Histological Improvement in NAS

A decrease of at least 2 points in NAS at 12 months. At least a 1 point reduction in either ballooning or inflammation from baseline to 12 months. no increase in CRN fibrosis score (i.e., an increase of 1 stage or more) from baseline to 12 months.

Placebo

22.0
Participants

MSDC-0602K 62.5 mg

25.0
Participants

MSDC-0602K 125 mg

27.0
Participants

MSDC-0602K 250 mg

34.0
Participants

Number of Subjects With Resolution of NASH With no Worsening of Fibrosis at 12 Months.

CRN ballooning score of 0 at 12-months CRN inflammation score of 0 or 1 at 12-months No increase in CRN fibrosis score from baseline to 12-months

Placebo

15.0
Participants

MSDC-0602K 62.5 mg

17.0
Participants

MSDC-0602K 125 mg

23.0
Participants

MSDC-0602K 250 mg

27.0
Participants

Number of Subjects With Improvement of Fibrosis (CRN Staging Score) by at Least 1 Stage With no Worsening of NASH at 12 Months.

Decrease in fibrosis CRN staging score of >= 1 full stage from baseline to 12 months No increase in ballooning CRN score from baseline to 12 months No increase in inflammation CRN score from baseline to 12-months

Placebo

16.0
Participants

MSDC-0602K 62.5 mg

20.0
Participants

MSDC-0602K 125 mg

23.0
Participants

MSDC-0602K 250 mg

25.0
Participants

Mean Change From Baseline in NAFLD Activity Score (NAS)

NAS is the sum of the scores of steatosis, inflammation, and ballooning. It has a range of 0 to 8 with higher scores indicating worse disease severity.

Placebo

-0.6
Scores on a scale (Mean)
Standard Deviation: 1.80

MSDC-0602K 62.5 mg

-1.0
Scores on a scale (Mean)
Standard Deviation: 1.66

MSDC-0602K 125 mg

-1.1
Scores on a scale (Mean)
Standard Deviation: 1.74

MSDC-0602K 250 mg

-1.2
Scores on a scale (Mean)
Standard Deviation: 1.83

Mean Change From Baseline in CRN Steatosis Score

Steatosis is assessed on a scale of 0 to 3 with higher scores indicating more severe steatosis.

Placebo

-0.4
Scores on a scale (Mean)
Standard Deviation: 0.80

MSDC-0602K 62.5 mg

-0.6
Scores on a scale (Mean)
Standard Deviation: 0.88

MSDC-0602K 125 mg

-0.5
Scores on a scale (Mean)
Standard Deviation: 0.93

MSDC-0602K 250 mg

-0.7
Scores on a scale (Mean)
Standard Deviation: 0.94

Mean Change From Baseline in CRN Inflammation Score

Inflammation is assessed on a scale of 0 to 3 with higher scores indicating more severe inflammation.

MSDC-0602K 62.5 mg

-0.1
Scores on a scale (Mean)
Standard Deviation: 0.71

MSDC-0602K 125 mg

-0.2
Scores on a scale (Mean)
Standard Deviation: 0.56

MSDC-0602K 250 mg

-0.1
Scores on a scale (Mean)
Standard Deviation: 0.66

Placebo

-0.1
Scores on a scale (Mean)
Standard Deviation: 0.70

Mean Change From Baseline in CRN Ballooning Score

Hepatocellular ballooning is assessed on a scale of 0 to 2 with higher scores indicating more severe hepatocellular ballooning.

Placebo

-0.2
Scores on a scale (Mean)
Standard Deviation: 0.98

MSDC-0602K 62.5 mg

-0.4
Scores on a scale (Mean)
Standard Deviation: 0.94

MSDC-0602K 125 mg

-0.4
Scores on a scale (Mean)
Standard Deviation: 0.94

MSDC-0602K 250 mg

-0.4
Scores on a scale (Mean)
Standard Deviation: 0.91

Mean Change From Baseline in CRN Fibrosis Staging Score

Fibrosis is assessed on a scale of 0 to 4 with higher scores indicating more severe fibrosis.

Placebo

MSDC-0602K 62.5 mg

0.1
Scores on a scale (Mean)
Standard Deviation: 1.07

MSDC-0602K 125 mg

-0.1
Scores on a scale (Mean)
Standard Deviation: 1.16

MSDC-0602K 250 mg

-0.1
Scores on a scale (Mean)
Standard Deviation: 1.27

Total

392
Participants

Age, Continuous

56.1
years (Mean)
Standard Deviation: 10.64

Age, Customized

Ethnicity (NIH/OMB)

Race/Ethnicity, Customized

Sex: Female, Male

Overall Study

Placebo

MSDC-0602K 62.5 mg

MSDC-0602K 125 mg

MSDC-0602K 250 mg