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Rezdiffra® With Concomitant Therapies Commonly Used to Treat Comorbidities in Adults With MASH and F2-F3 Fibrosis

15. října 2026 aktualizováno: Madrigal Pharmaceuticals, Inc.

A Phase 4, Open-label, Multi-group Study of Rezdiffra® in Combination With Concomitant Therapies Commonly Used to Treat Comorbidities in Adults With MASH and Moderate to Advanced (F2-F3) Fibrosis, Administered According to Their Approved Labeling

To determine the safety of Rezdiffra (Resmetirom) when administered alongside common prescriptions for Diabetes Metellus (Farxiga/dapagliflozin & Actos/pioglitazone)

Přehled studie

Postavení

Nábor

Podmínky

Intervence / Léčba

Detailní popis

This Phase 4 study will evaluate the safety and tolerability of REZDIFFRA® (resmetirom) when used in combination with concomitant therapies commonly used to treat diabetes in adults with metabolic dysfunction-associated steatohepatitis (MASH) and noncirrhotic, moderate-to-advanced (F2-F3) fibrosis. The concomitant therapies evaluated in this study will include ACTOS®/pioglitazone and FARXIGA®/dapagliflozin. All study medications will be administered according to their approved labeling.

Participants will be assigned to one of six cohorts based on their existing therapy and the concomitant medication being evaluated. In Group A, participants who are receiving a stable dose of pioglitazone or dapagliflozin will initiate resmetirom. In Group B, participants who are receiving a stable dose of REZDIFFRA will initiate pioglitazone or dapagliflozin. In Group C, participants who are not currently receiving either treatment will initiate resmetirom and either pioglitazone or dapagliflozin in a staggered manner, with a 4- to 6-week run-in period between initiation of the first and second medications.

Approximately 25 participants are planned for each of the six cohorts, for a maximum planned enrollment of approximately 150 participants. Following initiation of combination treatment, participants will be followed for 24 weeks, with a safety follow-up visit approximately 4 weeks after completion of treatment.

Safety and tolerability will be characterized through assessment of treatment-emergent adverse events, physical examinations, vital signs, clinical laboratory parameters, treatment discontinuations, and dose interruptions or reductions. Exploratory assessments will evaluate changes in liver fat by MRI-PDFF, noninvasive measures of hepatic steatosis and fibrosis, and biomarkers related to MASH disease state, insulin resistance, glucose homeostasis, body weight, and liver function.

Typ studie

Intervenční

Zápis (Odhadovaný)

150

Fáze

  • Fáze 4

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní místa

    • Arizona
      • Chandler, Arizona, Spojené státy, 85224
        • Zatím nenabíráme
        • Arizona Liver Health - Chandler
    • Arkansas
      • North Little Rock, Arkansas, Spojené státy, 72117
        • Zatím nenabíráme
        • Arkansas Gastroenterology
    • California
      • Coronado, California, Spojené státy, 92118
        • Zatím nenabíráme
        • Southern California Research Center
      • Rialto, California, Spojené státy, 37411
        • Zatím nenabíráme
        • Inland Empire Liver Foundation
    • Florida
      • Lakewood Rch, Florida, Spojené státy, 34211
        • Zatím nenabíráme
        • Florida Research Institute
      • Miami, Florida, Spojené státy, 33176
        • Nábor
        • Gastro Health PLLC Galloway
      • Miami, Florida, Spojené státy, 33186
        • Zatím nenabíráme
        • Med Research of Florida, LLC
    • Louisiana
      • Lake Charles, Louisiana, Spojené státy, 70605
        • Nábor
        • Elevate Clinical Research
    • North Carolina
      • Morehead City, North Carolina, Spojené státy, 28557
        • Zatím nenabíráme
        • Centricity Research - Morehead City - Multispecialty - PPDS
    • Ohio
      • Cincinnati, Ohio, Spojené státy, 45219
        • Nábor
        • Gastro Health Research
    • Tennessee
      • Chattanooga, Tennessee, Spojené státy, 37411
        • Zatím nenabíráme
        • University Diabetes and Endocrine Consultants
    • Texas
      • Arlington, Texas, Spojené státy, 76012-3216
        • Zatím nenabíráme
        • Texas Clinical Research Institute
      • Corpus Christi, Texas, Spojené státy, 78414
        • Zatím nenabíráme
        • South Texas Endocrinology & Metabolism Center
      • Dallas, Texas, Spojené státy, 75234
        • Zatím nenabíráme
        • The Liver Institute at Methodist Dallas Medical Center
      • McAllen, Texas, Spojené státy, 78504
        • Zatím nenabíráme
        • Elevate Clinical Research - McAllen - PPDS
      • San Antonio, Texas, Spojené státy, 78229
        • Zatím nenabíráme
        • Diabetes and Glandular Disease Clinic, PA

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria

All Subjects:

  1. Willing to participate in the study and provide written informed consent.

  2. Meets all requirements per REZDIFFRA Prescribing Information, in the opinion of the PI.

  3. Male and female adults ≥18 of age at time of screening.

  4. Evidence of hepatic steatosis consistent with MASH demonstrated by an MRI-PDFF fat fraction >5% obtained during second screening period.

  5. Evidence of moderate-to-advanced fibrosis (F2-F3) without cirrhosis.

  6. Stable medical conditions and background medications (non-concomitant medications as defined in this protocol) per PI judgement.

  7. Female subjects of reproductive potential are eligible if they have a negative serum pregnancy test (beta human chorionic gonadotropin), are not breastfeeding, and do not plan to become pregnant during the study and agree to use 1 highly effective birth control method during the study and for at least 30 days after newly introduced medication administration.

    Highly effective birth control methods include hormonal and non-hormonal intrauterine device, combination estrogen-progesterone hormonal contraception (oral, transdermal, or vaginal), tubal ligation, a vasectomized or sterile male partner, or sexual abstinence (defined as refraining from heterosexual intercourse), from Screening throughout the study, and for at least 30 days after newly introduced medication administration. Reliance on abstinence from heterosexual intercourse is acceptable only if it is the subject's habitual practice. NOTE: Female subjects who are not of child-bearing potential (ie, surgically [bilateral oophorectomy, hysterectomy] or naturally sterile [>12 consecutive months without menses]) do not require contraception during the study.

  8. Must be taking a stable dose of ACTOS/pioglitazone for at least 2 months prior to Baseline. (Group A1)

  9. Must be taking a stable dose of FARXIGA/dapagliflozin for at least 2 months prior to Baseline. (Group A2)

  10. Must be taking a stable dose of REZDIFFRA for at least 2 months prior to Baseline. (Groups B1 and B2)

  11. Must not have previously taken RESMETIROM or ACTOS/pioglitazone or FARXIGA/dapagliflozin. (Group C)

  12. For Groups A1, B1, and C1: Meets all requirements per ACTOS/pioglitazone Prescribing Information, in the opinion of the PI.

  13. For Groups B1 and C1: (ie, naïve to ACTOS/pioglitazone): HbA1c at screening ≥7.0% and ≤10.0%.

  14. For Groups A2, B2, and C2: Meets all requirements per FARXIGA/dapagliflozin Prescribing Information, in the opinion of the PI.

  15. For Groups B2 and C2 (ie, naïve to FARXIGA/dapagliflozin): HbA1c at screening ≥7.0% and ≤10.0%.

Exclusion Criteria All subjects

  1. Off label use of the commercially available study medications.

  2. Evidence of cirrhosis demonstrated by clinical, imaging, histologic, or NIT thresholds consistent with cirrhosis.

  3. Other chronic liver diseases (eg, viral hepatitis, autoimmune hepatitis, hemochromatosis).

  4. Documented history of decompensated liver disease.

  5. Use of rosuvastatin or simvastatin at a dose greater than 20 mg/day, or pravastatin or atorvastatin at a dose greater than 40 mg/day, at the time of the first dose of resmetirom. Subjects receiving a statin dose above the applicable limit during the screening period may remain eligible if the dose is reduced to the applicable maximum permitted dose before the first dose of resmetirom.

  6. Any other condition which, in the opinion of the investigator, would impede compliance, hinder completion of the study, compromise the well-being of the subject, or interfere with the study outcomes.

  7. Active or suspected bladder cancer.

  8. Diagnosis of heart failure.

  9. eGFR < 60mL/min/1.73 m2

  10. Developmental/intellectual disability, limited capacity of recognition, any history of clinically important emotional and/or psychiatric illness, inability to follow the study procedures, or any other condition which, in the opinion of the Investigator, would impede compliance, hinder completion of the study, compromise the well-being of the patient, or interfere with the study outcomes.

  11. Individuals who are currently incarcerated or who are anticipated to be incarcerated during the study period.

    Groups B and C:

  12. Unable to secure a prescription for a concomitant medication.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Nerandomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Jiný: Actos (pioglitazone) [Ongoing] | Resmetirom [New]

Experienced Actos/Pioglitazone + Resmetirom Naive (A1)

Resmetirom - weight-based dosing:

  • <100 kg: 80 mg orally once daily.
  • ≥100 kg: 100 mg orally once daily

Label dosing recommendations indicated for patients without congestive heart failure (15 or 30 mg orally once daily; if tolerated, increase by 15 mg increments up to a maximum of 45 mg orally once daily for additional glycemic control

Jiný: Farxiga (dapagliflozin) [Ongoing] | Resmetirom [New]

Experienced Farxiga/Dapagliflozin + Resmetirom Naive (A2)

Resmetirom - weight-based dosing:

  • <100 kg: 80 mg orally once daily.
  • ≥100 kg: 100 mg orally once daily

Label dosing recommendations indicated for glycemic control in type 2 diabetes (5 mg orally once daily; if tolerated, increase to 10 mg orally once daily for additional glycemic control)

Jiný: REZDIFFRA [Ongoing] | Actos (pioglitazone) [New]

Experienced REZDIFFRA + Actos/Pioglitazone Naive (B1)

Label dosing recommendations indicated for patients without congestive heart failure (15 or 30 mg orally once daily; if tolerated, increase by 15 mg increments up to a maximum of 45 mg orally once daily for additional glycemic control

All study medications will be administered according to their labels:

• REZDIFFRA- Label weight-based dosing:

  • <100 kg: 80 mg orally once daily.
  • ≥100 kg: 100 mg orally once daily
Jiný: REZDIFFRA [Ongoing] | Farxiga (dapagliflozin) [New]

Experienced REZDIFFRA + Farxiga/Dapagliflozin Naive (B2)

Label dosing recommendations indicated for glycemic control in type 2 diabetes (5 mg orally once daily; if tolerated, increase to 10 mg orally once daily for additional glycemic control)

All study medications will be administered according to their labels:

• REZDIFFRA- Label weight-based dosing:

  • <100 kg: 80 mg orally once daily.
  • ≥100 kg: 100 mg orally once daily
Jiný: Actos (pioglitazone) [New] | Resmetirom [New]

Naive Actos/Pioglitazone + Resmetirom Naive (C2)

Resmetirom - weight-based dosing:

  • <100 kg: 80 mg orally once daily.
  • ≥100 kg: 100 mg orally once daily

Label dosing recommendations indicated for patients without congestive heart failure (15 or 30 mg orally once daily; if tolerated, increase by 15 mg increments up to a maximum of 45 mg orally once daily for additional glycemic control

Jiný: Farxiga (dapagliflozin) [New] | Resmetirom [New]

Naïve Farxiga/dapagliflozin + Resmetirom Naïve (C2)

Resmetirom - weight-based dosing:

  • <100 kg: 80 mg orally once daily.
  • ≥100 kg: 100 mg orally once daily

Label dosing recommendations indicated for glycemic control in type 2 diabetes (5 mg orally once daily; if tolerated, increase to 10 mg orally once daily for additional glycemic control)

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Number and Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs)
Časové okno: From First Dose of newly introduced medication up to 28 weeks

The total number of TEAEs and the number and percentage of participants with at least 1 TEAE will be summarized by study group. TEAEs will also be summarized by System Organ Class and Preferred Term.

From First Dose of newly introduced medication up to 28 weeks
Number and Percentage of Participants With TEAEs by Maximum Severity
Časové okno: From First Dose of newly introduced medication up to 28 weeks

The number and percentage of participants with TEAEs will be summarized by maximum severity using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0.

From First Dose of newly introduced medication up to 28 weeks
Number and Percentage of Participants With TEAEs by Relationship to Study Medication
Časové okno: From First Dose of newly introduced medication up to 28 weeks

The number and percentage of participants with TEAEs assessed as Related or Not Related to each applicable study medication (REZDIFFRA/resmetirom, ACTOS/pioglitazone, or FARXIGA/dapagliflozin) will be summarized by study group.

From First Dose of newly introduced medication up to 28 weeks

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Ředitel studie: Tom Hare, Madrigal Pharmaceuticals, Inc.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

7. října 2026

Primární dokončení (Odhadovaný)

1. listopadu 2027

Dokončení studie (Odhadovaný)

1. listopadu 2027

Termíny zápisu do studia

První předloženo

25. srpna 2026

První předloženo, které splnilo kritéria kontroly kvality

23. září 2026

První zveřejněno (Aktuální)

29. září 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

16. října 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

15. října 2026

Naposledy ověřeno

1. října 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • MGL-3196-33

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ano

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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