Studie for å evaluere sikkerhet og effekt av Larsucosterol hos deltakere med alkoholassosiert hepatitt (AH)
RE-AHFIRM (Randomisert studie av larsucosterol i alkoholassosiert hepatitt for å bekrefte sikkerhet og effekt av behandling)
The primary purpose of this study is to evaluate the safety and efficacy of larsucosterol, as determined by transplant-free survival through Day 90 in participants with severe alcohol-associated hepatitis (AH) with pre-treatment Maddrey Discriminant Function (MDF) score greater than or equal to (>=) 32 and Model for End-stage Liver Disease (MELD) scores 21-30, inclusive.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Fase 3
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Alycia Olsen
- Telefonnummer: 201-846-8376
- E-post: Alycia.Olsen@bauschhealth.com
Studer Kontakt Backup
- Navn: Varsha Bhatt, PhD
- Telefonnummer: 707-230-1712
- E-post: varsha.bhatt@bauschhealth.com
Studiesteder
-
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Alabama
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Birmingham, Alabama, Forente stater, 35233
- Rekruttering
- University of Alabama at Birmingham (UAB) Hospital
-
Mobile, Alabama, Forente stater, 36608-3271
- Har ikke rekruttert ennå
- University of South Alabama
-
-
Arizona
-
Phoenix, Arizona, Forente stater, 85054
- Rekruttering
- Mayo Clinic - Phoenix
-
Phoenix, Arizona, Forente stater, 85006
- Rekruttering
- Banner - University Medical Center, Phoenix, Arizona
-
-
California
-
Coronado, California, Forente stater, 92118
- Tilbaketrukket
- Southern California GI & Liver Centers - Coronado
-
Fresno, California, Forente stater, 93730
- Har ikke rekruttert ennå
- Fresno Clinical Research Center (FCRC)
-
La Jolla, California, Forente stater, 92037
- Har ikke rekruttert ennå
- Scripps
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La Jolla, California, Forente stater, 92093
- Har ikke rekruttert ennå
- UC San Diego School of Medicine
-
Los Angeles, California, Forente stater, 90048
- Rekruttering
- Cedars Sinai Medical Center
-
Los Angeles, California, Forente stater, 90095
- Har ikke rekruttert ennå
- UCLA Health - Ronald Reagan Medical Center
-
Palo Alto, California, Forente stater, 94109
- Rekruttering
- Sutter Health
-
Redwood City, California, Forente stater, 94063
- Har ikke rekruttert ennå
- Stanford Medicine - Clinical and Translational Research Unit - Redwood City
-
Sacramento, California, Forente stater, 95816
- Rekruttering
- University of California at Davis Medical Center
-
-
Connecticut
-
New Haven, Connecticut, Forente stater, 06510
- Har ikke rekruttert ennå
- Yale School of Medicine
-
-
District of Columbia
-
Washington D.C., District of Columbia, Forente stater, 20007
- Har ikke rekruttert ennå
- Georgetown University Medical Center
-
-
Florida
-
Gainesville, Florida, Forente stater, 32608
- Har ikke rekruttert ennå
- University of Florida (UF)
-
Jacksonville, Florida, Forente stater, 32202
- Rekruttering
- Mayo Clinic
-
Miami, Florida, Forente stater, 33136
- Har ikke rekruttert ennå
- University of Miami
-
Miami, Florida, Forente stater, 33165
- Har ikke rekruttert ennå
- Reliant Medical Research
-
Orlando, Florida, Forente stater, 32804
- Har ikke rekruttert ennå
- AdventHealth Transplant Institute
-
Tampa, Florida, Forente stater, 33606
- Rekruttering
- Tampa General Hospital
-
Tampa, Florida, Forente stater, 33613
- Har ikke rekruttert ennå
- AdventHealth Medical Campus
-
-
Georgia
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Atlanta, Georgia, Forente stater, 30322
- Har ikke rekruttert ennå
- Emory University Hospital
-
Atlanta, Georgia, Forente stater, 30309
- Rekruttering
- Piedmont Atlanta Hospital - Piedmont Transplant Institute
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Augusta, Georgia, Forente stater, 30912
- Har ikke rekruttert ennå
- Augusta University
-
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Illinois
-
Chicago, Illinois, Forente stater, 60612
- Rekruttering
- Rush University Medical Center
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Chicago, Illinois, Forente stater, 60601
- Har ikke rekruttert ennå
- Northwestern University - Feinberg School of Medicine
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Maywood, Illinois, Forente stater, 60153
- Har ikke rekruttert ennå
- Loyola University Medical Center (LUMC)
-
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Indiana
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Indianapolis, Indiana, Forente stater, 46202
- Har ikke rekruttert ennå
- Indiana Institute for Medical Research (Indiana VA)
-
-
Iowa
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Iowa City, Iowa, Forente stater, 52242
- Rekruttering
- University of Iowa Hospitals & Clinics
-
-
Kentucky
-
Lexington, Kentucky, Forente stater, 40507
- Har ikke rekruttert ennå
- University of Kentucky -Chandler Medical Center
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Louisville, Kentucky, Forente stater, 40206
- Har ikke rekruttert ennå
- Robley Rex VA Medical Center
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-
Louisiana
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New Orleans, Louisiana, Forente stater, 70112
- Rekruttering
- Tulane University Health Sciences Center - Tulane Avenue
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-
Maine
-
Portland, Maine, Forente stater, 04102-3134
- Har ikke rekruttert ennå
- Maine Medical Center - Bramhall Campus
-
-
Maryland
-
Baltimore, Maryland, Forente stater, 21287
- Har ikke rekruttert ennå
- Johns Hopkins Hospital
-
Baltimore, Maryland, Forente stater, 21202
- Rekruttering
- Mercy Medical Center - The Institute for Digestive Health and Liver Disease
-
-
Massachusetts
-
Boston, Massachusetts, Forente stater, 02114
- Rekruttering
- Massachusetts General Hospital
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Boston, Massachusetts, Forente stater, 02118
- Rekruttering
- Boston University School of Medicine
-
Boston, Massachusetts, Forente stater, 02215
- Har ikke rekruttert ennå
- Beth Israel Deaconess Medical Center
-
Boston, Massachusetts, Forente stater, 02111
- Har ikke rekruttert ennå
- Tufts Medical Center
-
Worcester, Massachusetts, Forente stater, 01655
- Rekruttering
- UMass Chan Medical School
-
-
Michigan
-
Ann Arbor, Michigan, Forente stater, 48109
- Rekruttering
- University of Michigan
-
Detroit, Michigan, Forente stater, 48202
- Rekruttering
- Henry Ford Hospital System
-
-
Minnesota
-
Minneapolis, Minnesota, Forente stater, 55414-2924
- Har ikke rekruttert ennå
- University of Minnesota Medical Center
-
-
Missouri
-
Kansas City, Missouri, Forente stater, 64111
- Har ikke rekruttert ennå
- Saint Luke's Hospital of Kansas City
-
-
Nevada
-
Las Vegas, Nevada, Forente stater, 89154-9900
- Har ikke rekruttert ennå
- University of Nevada Las Vegas
-
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New Jersey
-
Camden, New Jersey, Forente stater, 08103
- Har ikke rekruttert ennå
- Virtua Medical Group (VMG) - Virtua Center for Liver Disease - Toms River
-
Newark, New Jersey, Forente stater, 07103-2425
- Rekruttering
- Rutgers University New Jersey Medical School
-
-
New Mexico
-
Albuquerque, New Mexico, Forente stater, 87106-4713
- Rekruttering
- University of New Mexico (UNM) Hospital
-
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New York
-
Manhasset, New York, Forente stater, 11030
- Rekruttering
- Northwell Health Physician Partners Sandra Atlas Bass Center for Liver Diseases
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New York, New York, Forente stater, 10016
- Rekruttering
- NYU Langone Health
-
New York, New York, Forente stater, 10065
- Har ikke rekruttert ennå
- NewYork-Presbyterian/Weill Cornell Medical Center
-
New York, New York, Forente stater, 10007
- Har ikke rekruttert ennå
- Columbia University Medical Center (CUMC) - Presbyterian Hospital and Vanderbilt Clinic
-
Rochester, New York, Forente stater, 14642
- Har ikke rekruttert ennå
- University of Rochester Medical Center
-
The Bronx, New York, Forente stater, 10467
- Rekruttering
- Montefiore Medical Center
-
Valhalla, New York, Forente stater, 10595
- Har ikke rekruttert ennå
- Westchester Medical Center
-
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North Carolina
-
Chapel Hill, North Carolina, Forente stater, 27514
- Har ikke rekruttert ennå
- University of North Carolina (UNC Hospitals)
-
Charlotte, North Carolina, Forente stater, 28204
- Rekruttering
- Levine Cancer Institute / Atrium Health
-
Durham, North Carolina, Forente stater, 27710
- Har ikke rekruttert ennå
- Duke University Hospital
-
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Ohio
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Cleveland, Ohio, Forente stater, 44106
- Har ikke rekruttert ennå
- University Hospitals Cleveland Medical Center
-
Cleveland, Ohio, Forente stater, 44114
- Har ikke rekruttert ennå
- Cleveland Clinic
-
Columbus, Ohio, Forente stater, 43210
- Rekruttering
- The Ohio State University Wexner Medical Center (OSUWMC)
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Oregon
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Portland, Oregon, Forente stater, 97239
- Har ikke rekruttert ennå
- Oregon Health & Science University
-
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Pennsylvania
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Hershey, Pennsylvania, Forente stater, 17033
- Rekruttering
- Penn State Health, Milton S. Hershey Medical Center
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Philadelphia, Pennsylvania, Forente stater, 19140
- Har ikke rekruttert ennå
- Temple University Hospital
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Philadelphia, Pennsylvania, Forente stater, 19104
- Rekruttering
- University of Pennsylvania Hospital
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Philadelphia, Pennsylvania, Forente stater, 19107
- Har ikke rekruttert ennå
- Thomas Jefferson University Hospital
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Philadelphia, Pennsylvania, Forente stater, 19104-4551
- Rekruttering
- VA Medical Center - Philadelphia
-
Philadelphia, Pennsylvania, Forente stater, 19141
- Har ikke rekruttert ennå
- Einstein Medical Center Philadelphia
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Pittsburgh, Pennsylvania, Forente stater, 15213-3232
- Har ikke rekruttert ennå
- University of Pittsburgh
-
-
South Carolina
-
Charleston, South Carolina, Forente stater, 29425
- Rekruttering
- Medical University of South Carolina
-
Charleston, South Carolina, Forente stater, 29401
- Har ikke rekruttert ennå
- Ralph H. Johnson Department of Veterans Affairs Medical Center
-
-
Tennessee
-
Chattanooga, Tennessee, Forente stater, 37402
- Har ikke rekruttert ennå
- Galen Medical Group - Galen Hepatology
-
Nashville, Tennessee, Forente stater, 37232
- Har ikke rekruttert ennå
- Vanderbilt University Medical Center
-
-
Texas
-
Dallas, Texas, Forente stater, 75203
- Rekruttering
- The Liver Institute at Methodist Dallas Medical Center
-
Dallas, Texas, Forente stater, 75246
- Har ikke rekruttert ennå
- Baylor Scott White Research Institute - Dallas
-
Denton, Texas, Forente stater, 75149-7418
- Har ikke rekruttert ennå
- North Texas Gastroenterology
-
Fort Worth, Texas, Forente stater, 76104
- Har ikke rekruttert ennå
- Baylor Scott & White All Saints Medical Center - Fort Worth
-
Houston, Texas, Forente stater, 77074
- Rekruttering
- Clinical Trial Network - Houston
-
Houston, Texas, Forente stater, 77030
- Rekruttering
- Baylor College of Medicine (BCM) - Baylor Clinic
-
San Antonio, Texas, Forente stater, 78229
- Rekruttering
- Methodist Healthcare - Methodist Hospital Specialty and Transplant
-
Temple, Texas, Forente stater, 76508
- Har ikke rekruttert ennå
- Baylor Scott White Research Institute - Temple
-
-
Utah
-
Murray, Utah, Forente stater, 84107
- Rekruttering
- Intermountain Transplant Clinic
-
Salt Lake City, Utah, Forente stater, 84132
- Har ikke rekruttert ennå
- University of Utah Health - University of Utah
-
-
Virginia
-
Charlottesville, Virginia, Forente stater, 22908
- Rekruttering
- University of Virginia Health
-
Richmond, Virginia, Forente stater, 23226
- Rekruttering
- Bon Secours Liver Institute of Richmond
-
Richmond, Virginia, Forente stater, 23249
- Rekruttering
- Richmond VA Medical Center
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Washington
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Seattle, Washington, Forente stater, 98104
- Har ikke rekruttert ennå
- Swedish Medical Center
-
Seattle, Washington, Forente stater, 98101
- Har ikke rekruttert ennå
- Virginia Mason Medical Center (VMMC) - Seattle
-
Seattle, Washington, Forente stater, 98104
- Har ikke rekruttert ennå
- UW Medicine-Harborview Medical Center
-
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West Virginia
-
Huntington, West Virginia, Forente stater, 25701
- Har ikke rekruttert ennå
- Marshall Health
-
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Wisconsin
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Madison, Wisconsin, Forente stater, 53703
- Har ikke rekruttert ennå
- University of Wisconsin-Madison
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria-
A participant will be eligible for inclusion in this study if he/she meets all the following criteria:
-
Able to provide written informed consent (either from participant or participant's legally acceptable representative).
-
Onset of jaundice within 8 weeks before hospital admission.
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Average daily consumption of greater than (>) 40 (females) or >60 (males) grams alcohol for 6 months or longer, with less than (<) 8 weeks of abstinence before the onset of jaundice. Judgment regarding daily and long-term alcohol use and onset of jaundice will be made and documented by the site Investigator.
-
The determination of AH will be based on typical serum chemistry (as determined by local laboratory):
- Serum total bilirubin >3.0 milligrams per deciliter (mg/dL) (required at randomization)
- ALT <400 international unit per Liter (IU/L) (required at randomization)
- 50 <AST <400 IU/L
- AST <400 IU/L (required at randomization)
- AST >50 IU/L (at any time since current hospital admission or leading to this current hospitalization)
- AST/ALT >1.5 (at any time since current hospital admission or leading to this current hospitalization)
-
Maddrey discriminant function (MDF) >=32, assuming a control prothrombin time of 12 seconds.
NOTE: If a local laboratory's control time differs from 12 seconds, then the local laboratory's control time should be used. If control time is not stated or is stated as a range, the control time should be calculated by the formula prothrombin time/INR.
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Original Model for End-stage Liver Disease (MELD; not MELD-Na) score: 21-30 (inclusive).
-
Male or female participants 18 years of age or older.
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Women of child-bearing potential (defined as females who are not surgically sterile or who are not over the age of 52 and amenorrheic for at least 12 months) must utilize appropriate birth control throughout the 90-day portion of the study. Acceptable methods that may be used are abstinence, birth control pills ("The Pill") or patch, diaphragm, IUD (coil), vaginal ring, condom, surgical sterilization or progestin implant or injection, or sexual activity limited to a sterile (e.g., vasectomized) male partner.
-
Male participants must agree to use a medically acceptable method of contraception/birth control and refrain from sperm donation throughout the 90-day portion of the study.
-
Participants must agree to participate in an alcohol abstinence support program recommended by the local institution's addiction specialists.
-
Participants must be dosed within 9 calendar days (216 hours) of hospital admission inclusive of time spent in other hospital(s)
Exclusion Criteria-
A participant will be excluded from the study if he or she meets any of the following criteria:
-
Participants using systemic corticosteroids for current AH before enrollment or having a history of using systemic corticosteroids for more than 8 days in the last 30 days prior to screening.
NOTE: Inhaled, topical, or local corticosteroid injections are permitted NOTE: A participant who has a confirmed diagnosis of hypoadrenalism and is taking a physiological replacement dose of hydrocortisone (or equivalent) is permitted to take part in the trial
-
Participants experiencing or considered at high risk for alcohol withdrawal seizures or delirium tremens.
-
Active infection (such as spontaneous bacterial peritonitis [SBP], urinary tract infection [UTI], cellulitis, pneumonia, bacteremia, acute viral hepatitis, uncontrolled HIV, and active SARS CoV2 infection).
- Participants who are febrile with leukocytosis are also excluded until active infection has been excluded to the satisfaction of the PI in consultation with the medical monitor.
- Participants with bacterial infections may be enrolled provided they remain in the enrollment window and the infection is adequately treated. For example, participants with bacterial peritonitis may be considered for enrollment once the infection has been treated and follow up paracentesis confirms the absence of SBP.
- Participants with systemic fungal infection of any kind cannot be considered for this trial.
-
Serum creatinine >2.5 mg/dL.
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Participants undergoing continuous veno-venous hemodialysis (CVVH).
-
Gastrointestinal bleeding not controlled by local therapy (i.e., band ligation or injection sclerotherapy). Participant who are at high risk of rebleeding or likely in need of TIPS insertion should be excluded.
-
TIPS insertion or variceal embolization within the last 4 weeks.
-
Known portal vein occlusion.
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A history of pre-admission refractory ascites defined as more than 4 paracenteses in the previous 8 weeks despite diuretic therapy.
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Liver biopsy (if carried out) with findings not compatible with AH. NOTE: A post-dose liver biopsy that is not compatible with AH will not be considered a protocol deviation.
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Stage >=3 hepatic encephalopathy by West Haven criteria.
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Participants with medical conditions that are expected to pose a high risk of short-term (less than or equal to [<=] 90 days) mortality unrelated to alcohol-associated hepatitis, or that may confound assessment of 90-day survival in the Investigator's judgement. Examples include, but are not limited to:
- Severe concomitant cardiopulmonary disease (e.g., New York Heart Association [NYHA] Class III or IV heart failure)
- Clinically significant cardiac arrhythmia (e.g., sustained ventricular tachycardia, unmanaged atrial fibrillation, QTc >=500 msec, or high-grade AV block)
- Ventilator-dependent respiratory failure, or Global Initiative for Chronic Obstructive Lung Disease [GOLD] Stage III or IV chronic obstructive pulmonary disease [COPD])
- End-stage renal disease requiring chronic, ongoing dialysis
- Severe uncontrolled endocrine or metabolic disorders
- Severe psychiatric illness likely to interfere with study participation
- Hypotension/shock as defined by the North American Consortium for the study of End-stage Liver Disease (NACSELD) criteria (i.e., Mean Arterial Pressure [MAP] <60 millimeter of mercury (mmHg), despite adequate fluid resuscitation and cardiac output)
-
Other concomitant cause(s) of liver disease as a result of:
- Autoimmune liver disease
- Ischemic hepatitis
- Wilson disease or alpha 1 antitrypsin deficiency
- Vascular liver disease (e.g., Budd-Chiari)
- Drug induced liver disease
- Surface antigen positive hepatitis B (HBsAg+). NOTE: Participants with isolated core antibody (anti-HBc) or who are on stable antiviral medication with known viral suppression are not excluded, but appropriate HBV prophylaxis should be considered if steroid dosing >4 weeks is anticipated.
- Acute hepatitis A (if test performed per SOC)
- Acute HCV or chronic hepatitis C with a history of decompensated cirrhosis. NOTE: participants with stable chronic HCV or successfully treated HCV are not excluded
- Acute hepatitis E (if test performed per SOC)
- Acute cytomegalovirus (CMV) viral hepatitis (if test performed per SOC)
-
Any known active malignancy or any malignancy diagnosed within the last five years other than curable skin cancer (basal cell or squamous cell carcinomas).
-
Existing or intended pregnancy or breast feeding.
-
Participation in another interventional clinical trial within 30 days of Screening.
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History of organ transplantation other than corneal transplant.
-
Underlying disease that, in the opinion of the site Investigator, might be complicated or exacerbated by proposed treatments or might confound assessment of study drug.
-
Participant listed for liver transplant (LT) prior to study drug administration.
-
Concern of participant's willingness and ability to be compliant with the schedule of protocol assessments, per the Investigator's judgement.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Dobbelt
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
|
Eksperimentell: Larsucosterol 30 mg
Participants will receive Larsucosterol 30 milligrams (mg) intravenous infusion on Day 1. |
Larsucosterol intravenous infusion.
Andre navn:
|
|
Placebo komparator: Placebo
Participants will receive intravenous infusion of placebo matched to Larsucosterol on Day 1. |
Matching-placebo (sterile water for injection) intravenous infusion. |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Transplantasjonsfri overlevelse opp til dag 90
Tidsramme: Opptil dag 90
|
Opptil dag 90
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Overlevelse etter 90 dager
Tidsramme: Dag 90
|
Dag 90
|
|
Tid til død opp til dag 90
Tidsramme: Opp til dag 90
|
Opp til dag 90
|
|
Antall deltakere med dager i live og utenfor sykehus opp til dag 90
Tidsramme: Opp til dag 90
|
Opp til dag 90
|
|
Tid til første innleggelse av alle årsaker etter utskrivelse opp til dag 90
Tidsramme: Opp til dag 90
|
Opp til dag 90
|
|
Antall deltakere med intensivavdeling (ICU) bruk opp til dag 90
Tidsramme: Opp til dag 90
|
Opp til dag 90
|
|
Endring fra baseline i Model for End-Stage Liver Disease (MELD)-skår
Tidsramme: Dag 7 til Dag 180
|
Dag 7 til Dag 180
|
|
Endring fra baseline i bilirubinnivå
Tidsramme: Opp til dag 180
|
Opp til dag 180
|
|
Transplantasjonsfri overlevelse opp til dag 180
Tidsramme: Frem til dag 180
|
Frem til dag 180
|
|
Total overlevelse etter 180 dager
Tidsramme: Dag 180
|
Dag 180
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Etterforskere
Etterforskere
- Studieleder: Varsha Bhatt, PhD, Bausch Health Americas, Inc.
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
Andre studie-ID-numre
- LCAH3141
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
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