Kombinace zibotentan a dapagliflozin, hodnoceno u jaterní cirhózy (studie ZEAL) (ZEAL)
Dvoudílná multicentrická, randomizovaná, dvojitě zaslepená, placebem kontrolovaná, paralelní skupinová studie s rozsahem dávek k posouzení účinnosti, bezpečnosti a snášenlivosti kombinace zibotentanu a dapagliflozinu a dapagliflozinu v monoterapii versus placebo u účastníků s cirhózou S funkcemi portálové hypertenze
This is a two part Phase IIa/b multicentre, randomised, double-blind, placebo-controlled, parallel group dose-ranging study to assess the efficacy, safety, and tolerability of the combination of zibotentan and dapagliflozin, and dapagliflozin monotherapy versus placebo in participants with cirrhosis with features of portal hypertension.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
- Lék: Part A: Placebo (matching zibotentan capsule & matching dapagliflozin tablet)
- Lék: Part A: zibotentan (dose B) + dapagliflozin
- Lék: Part B: Placebo (matching zibotentan capsule & matching dapagliflozin tablet)
- Lék: Part B: placebo (matching zibotentan capsule) + dapagliflozin
- Lék: Part B: zibotentan (dose A) + dapagliflozin
- Lék: Part B: zibotentan (dose B) + dapagliflozin
- Lék: Part B: zibotentan (dose C) + dapagliflozin
Detailní popis
Part A will assess the efficacy, safety, and tolerability of the combination of B mg zibotentan and 10 mg dapagliflozin versus placebo in participants with Child-Pugh A cirrhosis with features of portal hypertension and with no history of decompensation events.
If the safety profile is determined to be acceptable at the conclusion of Part A, Part B will investigate efficacy, safety, and tolerability of A mg, B mg, or C mg zibotentan combined with 10 mg dapagliflozin and of 10 mg dapagliflozin monotherapy versus placebo in participants with cirrhosis with features of portal hypertension. Part B will include a broader range of Child- Pugh A and Child-Pugh B cirrhosis participants, including those with more severe disease, a history of decompensation events, or current ascites.
The study will be conducted in approximately 30 to 45 study centres in North America, Asia, and Europe.
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Fáze
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
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Heidelberg, Austrálie, 3084
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Edegem, Belgie, 2650
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Aarhus N, Dánsko, 8200
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Esbjerg, Dánsko, 6700
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Hvidovre, Dánsko, 2650
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Køge, Dánsko, 4600
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Angers, Francie, 49933
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Clichy, Francie, 92110
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Paris, Francie, 75651
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Toulouse, Francie, 31059
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Amsterdam, Holandsko, 1081 HV
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Dresden, Německo, 01307
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Landshut, Německo, 84034
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Mainz, Německo, 55131
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Münster, Německo, 48149
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Wiesbaden, Německo, 65189
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Vienna, Rakousko, 1090
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Cluj-Napoca, Rumunsko, 400162
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Birmingham, Spojené království, B9 5SS
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Cambridge, Spojené království, CB2 0XY
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London, Spojené království, SE5 9RS
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Alabama
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Birmingham, Alabama, Spojené státy, 35233
- Research Site
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California
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Pasadena, California, Spojené státy, 91105
- Research Site
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San Francisco, California, Spojené státy, 94115
- Research Site
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West Hollywood, California, Spojené státy, 90048
- Research Site
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Minnesota
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Rochester, Minnesota, Spojené státy, 55905
- Research Site
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New York
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The Bronx, New York, Spojené státy, 10467
- Research Site
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South Carolina
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Charleston, South Carolina, Spojené státy, 29425
- Research Site
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Texas
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Dallas, Texas, Spojené státy, 75246
- Research Site
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Virginia
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Charlottesville, Virginia, Spojené státy, 22903
- Research Site
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Richmond, Virginia, Spojené státy, 23249
- Research Site
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Wisconsin
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Milwaukee, Wisconsin, Spojené státy, 53226
- Research Site
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Taipei, Tchaj-wan, 10002
- Research Site
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Taipei, Tchaj-wan, 112
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Prague, Česko, 128 00
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Prague, Česko, 169 02
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Beijing, Čína, 100057
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Chengdu, Čína, 610000
- Research Site
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Guangzhou, Čína, 510515
- Research Site
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Hangzhou, Čína, 310015
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Barcelona, Španělsko, 08035
- Research Site
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Barcelona, Španělsko, 08036
- Research Site
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Barcelona, Španělsko, 08041
- Research Site
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Madrid, Španělsko, 28034
- Research Site
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Madrid, Španělsko, 28007
- Research Site
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Majadahonda, Španělsko, 28222
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Santander, Španělsko, 39008
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Bern, Švýcarsko, 3010
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Lucerne, Švýcarsko, 6000
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Lugano, Švýcarsko, 6900
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Study principal inclusion criteria For both Part A and Part B
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No current or prior (within 1 month of enrolment) medical treatment with an SGLT2 inhibitor or ERAs.
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On no or a stable dose of beta blockers, with no major dose changes within 1 month prior to the first dose of study intervention.
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Provision of signed and dated, written ICF prior to any mandatory study-specific procedures, sampling, and analyses.
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Female participants of non-childbearing potential confirmed at screening by fulfilling one of the following criteria:
- Post-menopausal: defined as amenorrhoea for at least 12 months or more following cessation of all exogenous hormonal treatments; and also, FSH levels in the post-menopausal range by central laboratory.
- Documentation of irreversible surgical sterilisation by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation.
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Female participants must have a negative pregnancy test at screening and must not be lactating
Part A participants who have the following:
- Clinical and/or histological diagnosis of cirrhosis with either (i) features of portal hypertension or (ii) liver stiffness ≥ 21 kPa.
- MELD score < 15.
- Child-Pugh score ≤ 6.
- No clinically evident ascites.
- No evidence of worsening of hepatic function (eg, no clinically significant change in signs, symptoms, or laboratory parameters of hepatic disease status) within the last month prior to dosing, as determined by the investigator or usual practitioner.
- HVPG recording of good enough quality as judged by a central reader.
Part B participants who have the following:
- Clinical and/or histological diagnosis of cirrhosis and either history of decompensation or compensated cirrhosis with signs of clinically significant portal hypertension.
- HVPG recording of good enough quality and HVPG > 10 mmHg, as judged by a central reader.
- MELD score < 15.
- Child-Pugh score < 10.
- No ascites or ascites up to grade 2 without change in diuretic treatment within the last month prior to first dose and no paracentesis within the last month or planned paracentesis in the next 4 months at screening.
- No evidence of worsening of hepatic function (eg, no clinically significant change in signs, symptoms, or laboratory parameters of hepatic disease status) within the last month prior to dosing, as determined by the investigator or usual practitioner.
Study principal exclusion criteria:
- Any evidence of a clinically significant disease which in the investigator's opinion makes it undesirable for the participant to participate in the study.
- Liver cirrhosis caused by chronic cholestatic liver disease
- ALT or AST ≥ 150 U/L and/or total bilirubin ≥ 3 × ULN
- Acute liver injury caused by drug toxicity or by an infection.
- Any history of hepatocellular carcinoma.
- Liver transplant or expected liver transplantation within 6 months of screening.
- History of TIPS or a planned TIPS within 6 months from enrolment into the study.
- Active treatment for HCV within the last 1 year or HBV antiviral therapy for less than 1 year.
- Participants with T1DM.
Medical Conditions (Part A only)
- INR > 1.5.
- Serum/plasma levels of albumin ≤ 35 g/L.
- Platelet count < 75 × 109/L.
- History of ascites
- History of hepatic hydrothorax
- History of portopulmonary syndrome
- History of hepatic encephalopathy
- History of variceal haemorrhage
- History of acute kidney injury
- History of heart failure, including high output heart failure (eg, due to hyperthyroidism or Paget's disease)
Medical Conditions (Part B only)
- INR > 1.7.
- Serum/plasma levels of albumin ≤ 28 g/L.
- Platelet count < 50 × /109L.
- Acute kidney injury within 3 months of screening.
- History of encephalopathy of West Haven grade 2 or higher within 6 months prior to screening.
- History of variceal haemorrhage within 6 months prior to screening.
- NYHA functional heart failure class III or IV or with unstable heart failure requiring hospitalisation for optimisation of heart failure treatment and who are not yet stable on heart failure therapy within 6 months prior to screening.
- Heart failure due to cardiomyopathies that would primarily require specific other treatment: eg, cardiomyopathy due to pericardial disease, amyloidosis or other infiltrative diseases, cardiomyopathy related to congenital heart disease, primary hypertrophic cardiomyopathy, cardiomyopathy related to toxic or infective conditions (ie, chemotherapy, infective myocarditis, septic cardiomyopathy).
- High output heart failure (eg, due to hyperthyroidism or Paget's disease).
- Heart failure due to primary cardiac valvular disease/dysfunction, severe functional mitral or tricuspid valve insufficiency, or planned cardiac valve repair/replacement.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Promítání
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Trojnásobný
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
|
Experimentální: Part A: Treatment Group 1
Participants will receive once daily dose of placebo matching zibotentan capsule + placebo matching dapagliflozin tablet for 6 weeks. |
placebo capsule (matching zibotentan capsule) placebo tablet (matching dapagliflozin tablet) |
|
Experimentální: Part A: Treatment Group 2
Participants will receive once daily dose of zibotentan capsule + dapagliflozin tablet for 6 weeks. |
zibotentan capsule dapagliflozin tablet |
|
Experimentální: Part B: Treatment Group 1
Participants will receive once daily dose of placebo matching zibotentan capsule + placebo matching dapagliflozin tablet for 16 weeks. |
placebo capsule (matching zibotentan capsule) placebo tablet (matching dapagliflozin tablet) |
|
Experimentální: Part B: Treatment Group 2
Participants will receive once daily dose of placebo matching zibotentan capsule + dapagliflozin tablet for 16 weeks. |
placebo capsule (matching zibotentan capsule) dapagliflozin tablet |
|
Experimentální: Part B: Treatment Group 3
Participants will receive once daily dose of zibotentan capsule + dapagliflozin tablet for 16 weeks. |
zibotentan capsule dapagliflozin tablet |
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Experimentální: Part B: Treatment Group 4
Participants will receive once daily dose of zibotentan capsule + dapagliflozin tablet for 16 weeks. |
zibotentan capsule dapagliflozin tablet |
|
Experimentální: Part B: Treatment Group 5
Participants will receive once daily dose of zibotentan capsule + dapagliflozin tablet for 16 weeks. |
zibotentan capsule dapagliflozin tablet |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Absolute Change in HVPG From Baseline to Week 6, Part A
Časové okno: From Baseline to Week 6
|
Absolute change in Hepatic venous pressure gradient from baseline to week 6. |
From Baseline to Week 6
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Absolute Change in HVPG From Baseline to Week 6, Part B
Časové okno: From Baseline to Week 6
|
Absolute change in Hepatic venous pressure gradient from baseline to week 6. |
From Baseline to Week 6
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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HVPG Percentage Change From Baseline to Week 6, Part A
Časové okno: From Baseline to Week 6
|
Hepatic venous pressure gradient percentage change from baseline to week 6, Part A. |
From Baseline to Week 6
|
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HVPG Percentage Change From Baseline to Week 6, Part B
Časové okno: From baseline to week 6
|
Hepatic venous pressure gradient percentage change from baseline to week 6, Part B. |
From baseline to week 6
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Number of Participants With HVPG Response at Week 6, Part A
Časové okno: From baseline to week 6
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A HVPG responder is defined as a subject having <10 mmHg at week 6 if baseline HVPG >=10 or a reduction of >=1.5 mmHg from baseline to week 6. n: Number of subjects in analysis. N: Number of subjects per treatment group. |
From baseline to week 6
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Number of Participants With HVPG Response at Week 6, Part B
Časové okno: From baseline to Week 6
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A HVPG responder in Part B is defined as a subject having at least 20% decrease or a reduction to or below 12 mmHg if baseline HVPG > 12 mmHG from baseline to Week 6. |
From baseline to Week 6
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Change in Body Weight (kg) Over Time Course of Study, Part A
Časové okno: From baseline to Week 6
|
The analysis is performed using MMRM. The model includes the continuous covariate of the Baseline measurements as the fixed effect covariate and fixed categorical effects of treatment group, visit, and treatmentby-visit interaction. |
From baseline to Week 6
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Change in Body Weight (kg) Over Time Course of Study, Part B
Časové okno: From baseline to Week 6 and Week 16
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The analysis is performed using MMRM. The model includes the continuous covariate of the Baseline measurements as the fixed effect covariate and fixed categorical effects of treatment group, visit, and treatmentby-visit interaction. |
From baseline to Week 6 and Week 16
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Change in Total Dosage of Loop-diuretic Equivalents Use From Baseline to Week 6, Part A
Časové okno: From baseline to Week 6
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Change in total dosage of loop-diuretic equivalents use from baseline to Week 6, Part A. A loop-diuretic equivalent is based on 40 mg furosemide = 1 mg bumetanide = 20 mg torsemide = 50 mg ethacrynic acid. |
From baseline to Week 6
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Change in Total Dosage of Loop-diuretic Equivalents Use From Baseline to Week 6 and Week 16, Part B
Časové okno: From Baseline to Week 6 and Week 16
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Change in total dosage of loop-diuretic equivalents use from baseline to Week 6, Part B. A loop-diuretic equivalent is based on 40 mg furosemide = 1 mg bumetanide = 20 mg torsemide = 50 mg ethacrynic acid. |
From Baseline to Week 6 and Week 16
|
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Change in Total Body Water From Baseline to Week 6, Part A
Časové okno: From Baseline to Week 6
|
Change in total body water from baseline to Week 6, Part A. The analysis is performed using MMRM. |
From Baseline to Week 6
|
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Change in Total Body Water From Baseline to Week 6 and Week 16, Part B
Časové okno: From Baseline to Week 6 and Week 16
|
Change in total body water from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. |
From Baseline to Week 6 and Week 16
|
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Change in Extracellular Water From Baseline to Week 6, Part A
Časové okno: From baseline to Week 6
|
Change in extracellular water from baseline to Week 6, Part A. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass. |
From baseline to Week 6
|
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Change in Extracellular Water From Baseline to Week 6 and Week 16, Part B
Časové okno: From Baseline to Week 6 and to Week 16
|
Change in extracellular water from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass. |
From Baseline to Week 6 and to Week 16
|
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Change in Intracellular Water From Baseline to Week 6, Part A
Časové okno: From Baseline to Week 6
|
Change in intracellular water from Baseline to Week 6, Part A. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass. |
From Baseline to Week 6
|
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Change in Intracellular Water From Baseline to Week 6 and Week 16, Part B
Časové okno: From Baseline to Week 6 and Week 16
|
Change in intracellular water from Baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass. |
From Baseline to Week 6 and Week 16
|
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Change in Total Body Fat Mass From Baseline to Week 6, Part A
Časové okno: From baseline to Week 6
|
Change in total body fat mass from Baseline to Week 6, Part A. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass. |
From baseline to Week 6
|
|
Change in Total Body Fat Mass From Baseline to Week 6 and Week 16, Part B
Časové okno: From Baseline to Week 6 and Week 16
|
Change in total body fat mass from Baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. Bioimpedance spectroscopy (BIS) was performed at the study centre to monitor body water volumes and body fat mass. |
From Baseline to Week 6 and Week 16
|
|
Change in Systolic Blood Pressure From Baseline to Week 6, Part A
Časové okno: From Baseline to Week 6
|
Change in systolic blood pressure from baseline to Week 6, Part A. The analysis is performed using MMRM. |
From Baseline to Week 6
|
|
Change in Systolic Blood Pressure From Baseline to Week 6 and Week 16, Part B
Časové okno: From baseline to Week 6 and Week 16
|
Change in systolic blood pressure from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. |
From baseline to Week 6 and Week 16
|
|
Change in Diastolic Blood Pressure From Baseline to Week 6, Part A
Časové okno: From Baseline to Week 6
|
Change in diastolic blood pressure from baseline to Week 6, Part A. The analysis is performed using MMRM. |
From Baseline to Week 6
|
|
Change in Diastolic Blood Pressure From Baseline to Week 6 and Week 16, Part B
Časové okno: From baseline to Week 6 and Week 16
|
Change in diastolic blood pressure from baseline to Week 6 and Week 16, Part B. The analysis is performed using MMRM. |
From baseline to Week 6 and Week 16
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- D4326C00003
- 2021-006577-30 (Číslo EudraCT)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
Časový rámec sdílení IPD
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Kritéria přístupu pro sdílení IPD
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure
Typ podpůrných informací pro sdílení IPD
- PROTOKOL STUDY
- MÍZA
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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