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

15 de octubre de 2026 actualizado por: 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)

Descripción general del estudio

Estado

Reclutamiento

Condiciones

Intervención / Tratamiento

Descripción detallada

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.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

150

Fase

  • Fase 4

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Ubicaciones de estudio

    • Arizona
      • Chandler, Arizona, Estados Unidos, 85224
        • Aún no reclutando
        • Arizona Liver Health - Chandler
    • Arkansas
      • North Little Rock, Arkansas, Estados Unidos, 72117
        • Aún no reclutando
        • Arkansas Gastroenterology
    • California
      • Coronado, California, Estados Unidos, 92118
        • Aún no reclutando
        • Southern California Research Center
      • Rialto, California, Estados Unidos, 37411
        • Aún no reclutando
        • Inland Empire Liver Foundation
    • Florida
      • Lakewood Rch, Florida, Estados Unidos, 34211
        • Aún no reclutando
        • Florida Research Institute
      • Miami, Florida, Estados Unidos, 33176
        • Reclutamiento
        • Gastro Health PLLC Galloway
      • Miami, Florida, Estados Unidos, 33186
        • Aún no reclutando
        • Med Research of Florida, LLC
    • Louisiana
      • Lake Charles, Louisiana, Estados Unidos, 70605
        • Reclutamiento
        • Elevate Clinical Research
    • North Carolina
      • Morehead City, North Carolina, Estados Unidos, 28557
        • Aún no reclutando
        • Centricity Research - Morehead City - Multispecialty - PPDS
    • Ohio
      • Cincinnati, Ohio, Estados Unidos, 45219
        • Reclutamiento
        • Gastro Health Research
    • Tennessee
      • Chattanooga, Tennessee, Estados Unidos, 37411
        • Aún no reclutando
        • University Diabetes and Endocrine Consultants
    • Texas
      • Arlington, Texas, Estados Unidos, 76012-3216
        • Aún no reclutando
        • Texas Clinical Research Institute
      • Corpus Christi, Texas, Estados Unidos, 78414
        • Aún no reclutando
        • South Texas Endocrinology & Metabolism Center
      • Dallas, Texas, Estados Unidos, 75234
        • Aún no reclutando
        • The Liver Institute at Methodist Dallas Medical Center
      • McAllen, Texas, Estados Unidos, 78504
        • Aún no reclutando
        • Elevate Clinical Research - McAllen - PPDS
      • San Antonio, Texas, Estados Unidos, 78229
        • Aún no reclutando
        • Diabetes and Glandular Disease Clinic, PA

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

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.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: No aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Otro: 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

Otro: 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)

Otro: 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
Otro: 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
Otro: 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

Otro: 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)

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Number and Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs)
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Investigadores

  • Director de estudio: Tom Hare, Madrigal Pharmaceuticals, Inc.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

7 de octubre de 2026

Finalización primaria (Estimado)

1 de noviembre de 2027

Finalización del estudio (Estimado)

1 de noviembre de 2027

Fechas de registro del estudio

Enviado por primera vez

25 de agosto de 2026

Primero enviado que cumplió con los criterios de control de calidad

23 de septiembre de 2026

Publicado por primera vez (Actual)

29 de septiembre de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

16 de octubre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

15 de octubre de 2026

Última verificación

1 de octubre de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • MGL-3196-33

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

Sí

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .