未经评估:安全,耐受性,和非胆汁酸类法尼醇X受体激动剂tropifexor的功效在II期进行了评估,双盲,安慰剂对照研究作为原发性胆汁性胆管炎(PBC)伴熊去氧胆酸反应不足的患者的潜在二线治疗。
UNASSIGNED:患者被随机分配(2:1),每天一次口服托福索(30、60、90或150μg)或匹配的安慰剂,共28天。在第56天和第84天进行随访。主要终点是致敏剂的安全性和耐受性以及γ-谷氨酰转移酶(GGT)和其他肝脏生物标志物水平的降低。其他目标包括使用PBC-40生活质量(QoL)和视觉模拟量表评分以及药代动力学的患者报告结果指标。
未经证实:在61名登记的患者中,11、9、12和8收到30-,60-,90-,和150-μg的热带,分别,21例接受安慰剂治疗;在150-μg营养因子组中,3例患者因不良事件(AE)而停止治疗.瘙痒是研究中最常见的AE(52.5%[tropifexor]vs.28.6%[安慰剂]),大多数事件为轻度至中度严重程度。在LDL-中看到的减少,HDL-,和总胆固醇水平在60-,90-,停药后150μg剂量稳定。到第28天,在30-至150-μg剂量下,trophexor导致GGT从基线降低26-72%(60-时p<0.001,90-,和150-μg热带素与安慰剂)。第28天的QoL评分在安慰剂组和热带福克森组之间具有可比性。观察到血浆热带蛋白浓度的剂量依赖性增加,AUC0-8h和Cmax在30至150μg剂量之间增加5至5.55倍。
UNASSIGNED:Tropifexor显示胆汁淤积标志物相对于安慰剂有所改善,可预测的药代动力学,和可接受的安全耐受性曲线,从而支持其潜在的PBC进一步临床开发。
未经证实:胆汁酸熊去氧胆酸(UDCA)是原发性胆汁性胆管炎(PBC)的标准治疗方法,但是大约40%的患者对这种疗法反应不足。Tropifexor是法尼醇X受体的高效非胆汁酸激动剂,目前正在临床开发中用于各种慢性肝病。在目前的研究中,在对UDCA反应不足的患者中,热带被发现是安全的和良好的耐受性,在非常低的(微克)剂量下胆管损伤标志物水平提高。在包括安慰剂在内的所有组中都观察到轻度至中度严重程度的瘙痒,但在最高致偏剂量下更频繁。
未经评估:本研究在ClinicalTrials.gov(NCT02516605)注册。
UNASSIGNED: The safety, tolerability, and efficacy of the non-bile acid farnesoid X receptor agonist tropifexor were evaluated in a phase II, double-blind, placebo-controlled study as potential second-line therapy for patients with primary biliary cholangitis (PBC) with an inadequate ursodeoxycholic acid response.
UNASSIGNED: Patients were randomised (2:1) to receive tropifexor (30, 60, 90, or 150 μg) or matched placebo orally once daily for 28 days, with follow-up on Days 56 and 84. Primary endpoints were safety and tolerability of tropifexor and reduction in levels of γ-glutamyl transferase (GGT) and other liver biomarkers. Other objectives included patient-reported outcome measures using the PBC-40 quality-of-life (QoL) and visual analogue scale scores and tropifexor pharmacokinetics.
UNASSIGNED: Of 61 enrolled patients, 11, 9, 12, and 8 received 30-, 60-, 90-, and 150-μg tropifexor, respectively, and 21 received placebo; 3 patients discontinued treatment because of adverse events (AEs) in the 150-μg tropifexor group. Pruritus was the most frequent AE in the study (52.5% [tropifexor] vs. 28.6% [placebo]), with most events of mild to moderate severity. Decreases seen in LDL-, HDL-, and total-cholesterol levels at 60-, 90-, and 150 μg doses stabilised after treatment discontinuation. By Day 28, tropifexor caused 26-72% reduction in GGT from baseline at 30- to 150-μg doses (p <0.001 at 60-, 90-, and 150-μg tropifexor vs. placebo). Day 28 QoL scores were comparable between the placebo and tropifexor groups. A dose-dependent increase in plasma tropifexor concentration was observed, with 5- to 5.55-fold increases in AUC0-8h and Cmax between 30- and 150-μg doses.
UNASSIGNED: Tropifexor showed improvement in cholestatic markers relative to placebo, predictable pharmacokinetics, and an acceptable safety-tolerability profile, thereby supporting its potential further clinical development for PBC.
UNASSIGNED: The bile acid ursodeoxycholic acid (UDCA) is the standard-of-care therapy for primary biliary cholangitis (PBC), but approximately 40% of patients have an inadequate response to this therapy. Tropifexor is a highly potent non-bile acid agonist of the farnesoid X receptor that is under clinical development for various chronic liver diseases. In the current study, in patients with an inadequate response to UDCA, tropifexor was found to be safe and well tolerated, with improved levels of markers of bile duct injury at very low (microgram) doses. Itch of mild to moderate severity was observed in all groups including placebo but was more frequent at the highest tropifexor dose.
UNASSIGNED: This study is registered at ClinicalTrials.gov (NCT02516605).