Scott L. Friedman
A randomized, placebo-controlled trial of cenicriviroc for treatment of nonalcoholic steatohepatitis with fibrosis
Friedman, Scott L.; Ratziu, Vlad; Harrison, Stephen A.; Abdelmalek, Manal F.; Aithal, Guruprasad P.; Caballeria, Juan; Francque, Sven; Farrell, Geoffrey; Kowdley, Kris V.; Craxi, Antonio; Simon, Krzysztof; Fischer, Laurent; Melchor-Khan, Liza; Vest, Jeffrey; Wiens, Brian L.; Vig, Pamela; Seyedkazemi, Star; Goodman, Zachary; Wong, Vincent Wai-Sun; Loomba, Rohit; Tacke, Frank; Sanyal, Arun; Lefebvre, Eric
Authors
Vlad Ratziu
Stephen A. Harrison
Manal F. Abdelmalek
GURUPRASAD AITHAL Guru.Aithal@nottingham.ac.uk
Professor of Hepatology
Juan Caballeria
Sven Francque
Geoffrey Farrell
Kris V. Kowdley
Antonio Craxi
Krzysztof Simon
Laurent Fischer
Liza Melchor-Khan
Jeffrey Vest
Brian L. Wiens
Pamela Vig
Star Seyedkazemi
Zachary Goodman
Vincent Wai-Sun Wong
Rohit Loomba
Frank Tacke
Arun Sanyal
Eric Lefebvre
Abstract
The aim of this study was to evaluate cenicriviroc (CVC), a dual antagonist of C-C chemokine receptor types 2 and 5, for treatment of nonalcoholic steatohepatitis (NASH) with liver fibrosis.
A randomized, double-blind, multinational phase 2b study enrolled subjects with NASH, a nonalcoholic fatty liver disease activity score [NAS] ≥4, and liver fibrosis (stages 1–3, NASH Clinical Research Network) at 81 clinical sites. Subjects (N = 289) were randomly assigned CVC 150 mg or placebo. Primary outcome was ≥2-point improvement in NAS and no worsening of fibrosis at year 1. Key secondary outcomes were: resolution of steatohepatitis and no worsening of fibrosis; improvement in fibrosis by ≥1 stage and no worsening of steatohepatitis. Biomarkers of inflammation and adverse events were assessed.
Full study recruitment was achieved. The primary end point of NAS improvement in the intent-to-treat population and resolution of steatohepatitis was achieved in a similar proportion of subjects on CVC (N = 145) and placebo (N = 144) (16% vs 19%, P = 0.52 and 8% vs 6%, P = 0.49, respectively). However, the fibrosis end point was met in significantly more subjects on CVC than placebo (20% vs 10%; P = 0.02). Treatment benefits were greater in those with higher disease activity and fibrosis stage at baseline. Biomarkers of systemic inflammation were reduced with CVC. Safety and tolerability of CVC were comparable to placebo.
Conclusions: After 1 year of CVC treatment, twice as many subjects achieved improvement in fibrosis and no worsening of steatohepatitis compared with placebo. Given the urgent need to develop antifibrotic therapies in NASH, these findings warrant phase 3 evaluation.
Citation
Friedman, S. L., Ratziu, V., Harrison, S. A., Abdelmalek, M. F., Aithal, G. P., Caballeria, J., …Lefebvre, E. (2018). A randomized, placebo-controlled trial of cenicriviroc for treatment of nonalcoholic steatohepatitis with fibrosis. Hepatology, 67(5), https://doi.org/10.1002/hep.29477
Journal Article Type | Article |
---|---|
Acceptance Date | Aug 13, 2017 |
Online Publication Date | Jan 29, 2018 |
Publication Date | Apr 18, 2018 |
Deposit Date | Aug 21, 2017 |
Publicly Available Date | Jan 29, 2018 |
Journal | Hepatology |
Print ISSN | 0270-9139 |
Electronic ISSN | 1527-3350 |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Volume | 67 |
Issue | 5 |
DOI | https://doi.org/10.1002/hep.29477 |
Keywords | NASH, NAFLD, CVC, nonalcoholic fatty liver, inflammation |
Public URL | https://nottingham-repository.worktribe.com/output/927093 |
Publisher URL | http://onlinelibrary.wiley.com/doi/10.1002/hep.29477/abstract |
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0
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