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

15 oktober 2026 bijgewerkt door: 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)

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Geschat)

150

Fase

  • Fase 4

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Ander: 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

Ander: 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)

Ander: 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
Ander: 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
Ander: 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

Ander: 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)

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Number and Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Studie directeur: Tom Hare, Madrigal Pharmaceuticals, Inc.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

7 oktober 2026

Primaire voltooiing (Geschat)

1 november 2027

Studie voltooiing (Geschat)

1 november 2027

Studieregistratiedata

Eerst ingediend

25 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

23 september 2026

Eerst geplaatst (Werkelijk)

29 september 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

16 oktober 2026

Laatste update ingediend die voldeed aan QC-criteria

15 oktober 2026

Laatst geverifieerd

1 oktober 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • MGL-3196-33

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .