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评估奥贝胆酸 (OCA) 与安慰剂相比,在肝门肠造口术后胆道闭锁儿童受试者中的疗效、安全性、耐受性、药代动力学 (PK) 和药效学 (PD) 的研究

2026年6月16日 更新者:Intercept Pharmaceuticals

一项随机、双盲、安慰剂对照 2/3 期研究,旨在评估奥贝胆酸与安慰剂相比,在肝门肠造口术后胆道闭锁儿童受试者中的疗效、安全性、耐受性、药代动力学和药效学

本研究将评估 OCA 在成功进行肝门肠造口术(HPE,也称为 Kasai 门肠造口术)的胆道闭锁儿科参与者中的有效性、安全性和耐受性以及 PK/PD。 双盲期包括两个阶段:剂量滴定阶段和年龄扩展治疗阶段。

研究概览

研究类型

介入性

注册 (实际的)

28

阶段

  • 阶段2
  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Guangzhou、中国
        • Guangzhou Women And Childrens Medical Center
      • Shanghai、中国
        • Children's Hospital of Fudan University
      • Shanghai、中国
        • Childrens Hospital of Shanghai
      • Taiyuan、中国
        • Children's Hospital of Shanxi
    • Zhejiang
      • Hangzhou、Zhejiang、中国、310006
        • Children's Hospital, Zhejiang University School of Medicine
      • Jerusalem、以色列
        • Hadassah Medical Center
      • Jerusalem、以色列
        • Shaare-Zedek Medical Center
    • Alberta
      • Calgary、Alberta、加拿大、T3B 6A8
        • Alberta Childrens Hospital
      • Edmonton、Alberta、加拿大
        • Stollery Children's Hospital
      • Taichung、台湾
        • Taichung Veterans General Hospital
      • Tainan、台湾
        • National Chen Kung University Hospital
      • Taipei、台湾
        • National Taiwan University Hospital
      • Taoyuan、台湾
        • Linkou Chang Gung Memorial Hospital
      • Ankara、土耳其(türkiye)、06230
        • Hacettepe Universitesi ihsan Dogramaci Cocuk Hastansesi
    • Antalya
      • Konyaalti、Antalya、土耳其(türkiye)、07050
        • Akdeniz Üniversitesi Tıp Fakültesi Hastanesi Pediatrik Gastroenteroloji
    • İzmir
      • Bornova、İzmir、土耳其(türkiye)、35100
        • Ege Üniversitesi Hastanesi Pediatrik Gastroenteroloji Bölümü
      • Singapore、新加坡
        • KK Women's and Children's Hospital
      • Auckland、新西兰、1142
        • Starship Child Health
    • Queensland
      • South Brisbane、Queensland、澳大利亚、4101
        • Queensland Childrens Hospital
    • South Australia
      • North Adelaide、South Australia、澳大利亚、5006
        • Women's and Children's Hospital
    • Victoria
      • Parkville、Victoria、澳大利亚、3104
        • Royal Childrens Hospital
      • Hong Kong、香港
        • Queen Mary Hospital
      • Kuala Lumpur、马来西亚、59100
        • University Malaya Medical Center
    • Kelantan
      • Kota Bharu、Kelantan、马来西亚、15586
        • Hospital Raja Perempuan Azinab II

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 孩子
  • 成人

接受健康志愿者

不

描述

纳入标准:

  • 从出生到 18 岁以下的男性或女性儿科参与者。 注意:只有在计划的中期分析期间审查安全数据并获得数据安全监测委员会 (DSMB) 同意有足够的安全数据来招募该年龄组后,才会招募年龄 <2 岁的参与者。
  • 非综合征性胆道闭锁的诊断。
  • 证明 HPE 成功,定义为 HPE 手术后至少 3 个月总胆红素 <2 毫克每分升 (mg/dL)(34.2 微摩尔每升 [μmol/L])。

排除标准:

  • 既往进行过肝移植或移植清单上的活动状态。
  • 参与者被诊断患有胆道闭锁脾畸形(BASM)。
  • 结合(直接)胆红素≥特定部位参考范围的正常上限(ULN)。 如果没有结合胆红素:总胆红素≥2 mg/dL (34.2 mol/L)。
  • 血小板<120,000/μL
  • 国际标准化比值(INR)≥1.5。
  • 失代偿性慢性肝病并发症的当前或历史,包括:

    1. 胃食管静脉曲张和/或静脉曲张出血
    2. 临床上明显的与门脉高压相关的腹水
    3. 肝性脑病
    4. 事先放置门体分流术
    5. 肝肺综合征或门脉性肺动脉高压
    6. 肝肾综合征
    7. 任何基于影像学的门脉高压证据(例如门静脉海绵样变、腹部静脉曲张等)
    8. 肝细胞癌
    9. Childs-Pugh B 或 C
  • 身高和体重 Z 分数 <-2(每个站点特定参考范围)。
  • 无胆色(苍白)粪便。
  • 天冬氨酸转氨酶 (AST) >4x ULN。
  • 丙氨酸氨基转移酶 >4x ULN
  • GGT >500 单位每升 (U/L)
  • 关于抗凝治疗
  • 白蛋白 <3.5 克每分升 (g/dL)。
  • 无法吞咽片剂(即片剂或迷你片剂配方)。

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:双倍的

武器和干预

参与者组/臂
干预/治疗
有源比较器:接受 OCA 的参与者
参与者将随机接受 OCA(从 1.5 毫克 [mg] 成人等效剂量 [AED] 开始)口服,用水送服,每日一次。 前 6 周,每 2 周逐步调整剂量,从 1.5 mg AED 开始,根据耐受情况,通过 3 mg AED 逐步调整至最大 5 mg AED;如果出现明显的体征或症状,在确定剂量调整时,鼓励与医疗监测员讨论。 在 6 周的剂量滴定阶段之后,参与者将在年龄扩展治疗阶段继续使用耐受剂量约 24 个月。
将实施 OCA。
安慰剂比较:接受匹配安慰剂的参与者
参与者将随机接受匹配的安慰剂,口服,配水,每天一次。 前 6 周,每 2 周逐步调整剂量,从 1.5 mg AED 开始,根据耐受情况,通过 3 mg AED 逐步调整至最大 5 mg AED;如果出现明显的体征或症状,在确定剂量调整时,鼓励与医疗监测员讨论。 在 6 周的剂量滴定阶段之后,参与者将在年龄扩展治疗阶段继续使用耐受剂量约 24 个月。
将使用匹配的安慰剂。

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Number of Participants With Composite Liver-Related Clinical Events
大体时间:Up to Week 48
Number of participants experiencing any of the following: All-cause death; Liver transplantation; Hospitalization (≥24 hours) for variceal bleeding, hepatic encephalopathy, or spontaneous bacterial peritonitis; Clinically relevant ascites requiring therapeutic paracentesis have been presented. No clinical outcome events were reported at the time of the study termination; hence It was not possible to conduct the planned primary efficacy analysis.
Up to Week 48
Change From Baseline in Pediatric End-stage Liver Disease (PELD) Score
大体时间:Baseline and up to Week 48
The Pediatric End-stage Liver Disease (PELD) score is a scale used to assess the severity of chronic liver disease in pediatric participants younger than 12 years of age. The total PELD score ranges from negative values to positive values, with no absolute minimum or maximum, with higher scores indicating more severe liver disease and greater urgency for liver transplantation. The score is calculated using total bilirubin, international normalized ratio (INR), albumin, age at listing, and growth failure. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was calculated as the last post-baseline value minus the baseline value. A negative change from baseline indicates improvement, while a positive change indicates worsening.
Baseline and up to Week 48
Change From Baseline in Model of End-stage Liver Disease With Sodium (MELD-NA) Score
大体时间:Baseline and up to Week 48
The Model of End-stage Liver Disease with Sodium (MELD-Na) score is a scale used to assess the severity of chronic liver disease in participants 12 years of age and older, ranging from 6 (less ill) to 40 (gravely ill). Higher scores indicate more severe liver disease and greater urgency for liver transplantation. The score is derived from total bilirubin, serum creatinine, INR, and serum sodium. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was calculated as the last post-baseline value minus the baseline value. A negative change from baseline indicates improvement, while a positive change indicates worsening.
Baseline and up to Week 48

次要结果测量

结果测量
措施说明
大体时间
Percentage of Participants With Improvement in GGT and Direct Bilirubin (Composite Responder Endpoint)
大体时间:Up to Week 48
Participants were considered responders if both of the following criteria were met at EOS: ≥40% reduction from baseline in Gamma Glutamyl Transferase (GGT), and ≥25% reduction from baseline in direct (conjugated) bilirubin. Participants with missing values were considered non-responders.
Up to Week 48
Change From Baseline in GGT
大体时间:Baseline and up to Week 48
Blood samples were collected to assess GGT levels. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was computed by subtracting the baseline value from the post-baseline value, with a positive change indicating improvement.
Baseline and up to Week 48
Change From Baseline in Total and Direct (Conjugated) Bilirubin
大体时间:Baseline and up to Week 48
Blood samples were collected to assess direct bilirubin levels. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was computed by subtracting the baseline value from the post-baseline value, with a positive change indicating improvement.
Baseline and up to Week 48
Change From Baseline in Endogenous Bile Acids
大体时间:Baseline and up to Week 48
Plasma samples were collected to assess endogenous bile acids. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was computed by subtracting the baseline value from the post-baseline value, with a positive change indicating improvement.
Baseline and up to Week 48
Change From Baseline in Liver Stiffness as Assessed by Transient Elastography
大体时间:Baseline and up to Week 48
Liver stiffness was measured using ultrasound elastography. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was computed by subtracting the baseline value from the post-baseline value, with a positive change indicating improvement.
Baseline and up to Week 48
Number of Participants Reporting Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEs
大体时间:Up to Week 48
TEAEs were defined as adverse events that were reported or worsened on or after the first dose of study treatment. Serious adverse events are adverse events resulting in death, are immediately life threatening, requires in-patient hospitalization or prolongation of existing hospitalization, or results in persistent or significant disability/incapacity.
Up to Week 48
Change From Baseline in Plasma Levels of Fat-Soluble Vitamin D
大体时间:Baseline and Week 48
Plasma samples were collected to assess levels of fat-soluble vitamins D. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was computed by subtracting the baseline value from the post-baseline value, with a positive change indicating improvement.
Baseline and Week 48
Change From Baseline in Plasma Levels of Fat-Soluble Vitamin K
大体时间:Baseline and Week 48
Plasma samples were collected to assess levels of fat-soluble vitamin K. Baseline was defined as the last assessment prior to first study drug administration. Change from baseline was computed by subtracting the baseline value from the post-baseline value, with a positive change indicating improvement.
Baseline and Week 48

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 研究主任:Lynda Szczech, MD、Intercept Pharmaceuticals

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2024年9月2日

初级完成 (实际的)

2025年10月21日

研究完成 (实际的)

2025年10月21日

研究注册日期

首次提交

2023年11月2日

首先提交符合 QC 标准的

2023年11月2日

首次发布 (实际的)

2023年11月7日

研究记录更新

最后更新发布 (实际的)

2026年7月7日

上次提交的符合 QC 标准的更新

2026年6月16日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

不

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

在美国制造并从美国出口的产品

是的

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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