golexanolone for Primary biliary cholangitis

Inclusion criteria

• {"criterion_text":"- Male and female subjects age ≥ 18 years."}
• {"criterion_text":"- Willing and able to give informed consent."}
• {"criterion_text":"- The subject should be judged by the Investigator to be lucid and oriented to person, place, time, and situation when giving the informed consent."}
• {"criterion_text":"- Diagnosis of PBC based on the presence of ≥2 of the 3 key disease characteristics: a. Anti-mitochondrial antibody or PBC-specific anti-nuclear antibody titre ≥1/40 b. Elevated alkaline phosphatase (ALP) (> upper limit of normal [ULN] for the relevant laboratory) c. Compatible or diagnostic liver biopsy"}
• {"criterion_text":"- Clinically significant fatigue defined for the purposes of this study as a PBC-40 fatigue domain score of ≥29 at screening."}
• {"criterion_text":"- Clinically significant cognitive symptoms, defined for the purposes of this study as a PBC-40 cognitive domain ≥16 at screening."}
• {"criterion_text":"- Stable PBC SoC therapy (if any), which may include UDCA, OCA, bezafibrate and/or fenofibrate, for at least 3 months prior to randomisation."}
• {"criterion_text":"- For all women of childbearing potential (WOCBP) a negative pregnancy test at screening and a negative urine dip-stick pregnancy test at baseline, prior to first dose of IMP will be required."}
• {"criterion_text":"- WOCBP must be willing to use a contraceptive method with a failure rate of < 1% (intrauterine device [IUD], intrauterine hormone-releasing system [IUS], transdermal or local hormonal contraception, bilateral tubal occlusion, vasectomised partner, sexual abstinence), and agree to continue use of this method for the duration of the study and thereafter for 1 month after the last dosing of the IMP. Note that IUS, transdermal (e.g. patches, gels and sprays) or local (e.g. vaginal tablets, gels, creams, rings, suppositories) administration of oestrogen or progesterone are the only hormonal contraceptive methods allowed due to possible interactions with the IMP."}
• {"criterion_text":"- Females of non-childbearing potential must have documented tubal ligation or hysterectomy; or be post-menopausal (defined as 12 months of amenorrhoea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) 25-140 IE/L and oestradiol <200 pmol/L is confirmatory])."}
• {"criterion_text":"- Fertile male subjects must be willing to use condom and assure that their female partner will use contraceptive methods with a failure rate of < 1%1 to prevent pregnancy and drug exposure of a fertile female partner and refrain from donating sperm from the date of dosing until 1 month after dosing of the IMP. Men who are surgically sterile may be included without they/their partner fulfilling the above criteria on birth control."}

Exclusion criteria

• {"criterion_text":"- Child-Pugh class B or C cirrhosis."}
• {"criterion_text":"- Prolonged QTcF (>500 ms), or any clinically significant abnormality in the resting ECG, as judged by the Investigator (at screening)."}
• {"criterion_text":"- Concomitant disease characterised by chronic fatigue and/or cognitive impairment (e.g. Alzheimer's, Parkinson's, etc.) which in the judgement of the Investigator would either limit the potential benefit to the subject and/or confound the interpretation of results."}
• {"criterion_text":"- Clinically significant bowel disease, including obstruction, active inflammatory bowel disease, or malabsorption."}
• {"criterion_text":"- Poorly controlled obstructive sleep apnoea, as defined by >5 episodes/hour more than 70% of occasions, despite use of continuous positive airway pressure (CPAP)."}
• {"criterion_text":"- An uncontrolled thyroid disorder: a. Uncontrolled hyperthyroidism: defined as any history of hyperthyroidism that has either not been treated with either radioactive iodine and/or surgery or that has been treated with radioactive iodine and/or surgery but has required ongoing continuous or intermittent use of thyroid hormone synthesis inhibitors (i.e. methimazole or propylthiouracil) in the 24 weeks before screening. b. Uncontrolled hypothyroidism: defined as initiation of thyroid hormone replacement therapy or dose adjustment of replacement therapy in the 12 weeks before screening. c. Subjects without a diagnosed thyroid disease should be excluded if thyroid-stimulating hormone (TSH)-value is above ULN, or/and if free triiodothyronine (FT3)- or free thyroxine (FT4)-values are outside normal limits."}
• {"criterion_text":"- Subjects with a history of or currently active immune disorders other that PBC (including autoimmune disease) and/or diseases requiring immunosuppressive drugs (including azathioprine, prednisone, prednisolone, budesonide, cyclosporine, tacrolimus, methotrexate, or mycophenolate mofetil)."}
• {"criterion_text":"- Clinical diagnosis of autoimmune hepatitis overlap defined using the Paris overlap criteria"}
• {"criterion_text":"- Criterion deleted but numbering unchanged."}
• {"criterion_text":"- The presence, as judged by the Investigator, of clinically significant concomitant illness which would jeopardise safe participation in the study and /or the interpretation of study findings, such as major psychiatric disorder and major depressive disorder formally diagnosed by a psychiatrist."}
• {"criterion_text":"- Regular use of prescribed or over the counter (OTC) medications known to cause fatigue or cognitive dysfunction. Approval by the Medical Monitor is required if a subject takes any drug known to cause fatigue or alter cognitive functioning. Examples include benzodiazepines, sedating antihistamines (first generation), anticonvulsants, sedating antidepressants (e.g. tricyclic and sedating heterocyclic antidepressants), anticholinergics (benztropine), antiparkinsonian medications (amantadine, selegiline, benztropine), psychostimulants, narcotic medications within 4 weeks prior to baseline. The purpose is to assure that any change observed in cognition can be associated with study drug and not any concomitant medication."}
• {"criterion_text":"- Clinical evidence of hepatic decompensation (e.g. current or prior HE, ascites, or variceal bleeding)."}
• {"criterion_text":"- Use of prohibited medications within 14 days prior to randomisation, as specified in Section 9.4.8.2."}
• {"criterion_text":"- Anticipated change in PBC medication and/or significant medical or surgical intervention within the duration of the study."}
• {"criterion_text":"- Regular (more than 1 week per month) alcohol consumption in excess of 14 units per week."}
• {"criterion_text":"- Administration of another new chemical entity (defined as a compound that has not been approved for marketing) or has participated in any other clinical study that included drug treatment with the last administration within 3 months prior to administration of IMP in this study."}
• {"criterion_text":"- Females who are pregnant, nursing or actively trying to conceive a child."}
• {"criterion_text":"- Expected inability to swallow the required number of IMP capsules at the applicable dose level."}
• {"criterion_text":"- History of severe allergy/hypersensitivity or on-going allergy/hypersensitivity, as judged by the Investigator. Known allergy or hypersensitivity to drugs with a similar chemical structure or class to golexanolone, i.e. GABAA receptor modulating steroid antagonists (GAMSA). Known allergy of or hypersensitivity to any other component of the investigational drug (i.e. glyceryl mono and dicaprylocaprate)."}
• {"criterion_text":"- Investigator considers the subject unlikely to comply with study procedures, restrictions, and requirements."}
• {"criterion_text":"- History of hepatocellular carcinoma."}
• {"criterion_text":"- Bilirubin >1.5 x ULN."}
• {"criterion_text":"- Glomerular filtration rate (GFR) <35 ml/min/1.73m2 estimated using the CKD-EPI equation."}
• {"criterion_text":"- Haemoglobin (HB) <110 g/L, i.e. subjects with moderate/severe anaemia."}
• {"criterion_text":"- S-B12 < 125 pmol/L or P-folate < 7 nmol/L."}
• {"criterion_text":"- Evidence of biliary obstruction."}
• {"criterion_text":"- Any positive result on screening for human immunodeficiency virus (HIV), or hepatitis B (serum hepatitis B surface antigen positive). Subjects positive for HCV antibodies should be tested for PCR HCV RNA and in case of positive result considered as not eligible."}

Primary endpoints

• {"endpoint_text":"- Part A: Frequency, intensity, and seriousness of adverse events (AEs), changes from baseline to Day 5 in laboratory parameters and clinical safety parameters.","definition_or_measurement_approach":"Assessment of frequency, intensity and seriousness of AEs; changes from baseline to Day 5 in laboratory parameters and clinical safety parameters."}
• {"endpoint_text":"- Part B: Frequency, intensity, and seriousness of AEs, changes from baseline to Day 28 in laboratory parameters and clinical safety parameters.","definition_or_measurement_approach":"Assessment of frequency, intensity and seriousness of AEs; changes from baseline to Day 28 in laboratory parameters and clinical safety parameters."}

Secondary endpoints

• {"endpoint_text":"- Part A: PK parameters: after the first dose; after the last dose and accumulation ratio between first and last dose.","definition_or_measurement_approach":"Pharmacokinetic parameters measured after first dose and after last dose; calculation of accumulation ratio between first and last dose."}
• {"endpoint_text":"- Part A: Metabolite profile in human plasma and urine (to be reported separately).","definition_or_measurement_approach":"Characterisation of metabolite profile in human plasma and urine; reported separately."}
• {"endpoint_text":"- Part B : Change from baseline to Day 28 in the following HRQoL measures: − PBC-40 scores for each of the domains (cognition, itch, fatigue, social, emotional, and general symptoms). − EQ-5D-3L tool","definition_or_measurement_approach":"Change from baseline to Day 28 in PBC-40 domain scores and EQ-5D-3L instrument."}
• {"endpoint_text":"- Part B: Change from baseline to Day 28 in daytime sleepiness related symptoms using the Epworth Sleepiness Scale (ESS).","definition_or_measurement_approach":"Change from baseline to Day 28 measured by the Epworth Sleepiness Scale (ESS)."}
• {"endpoint_text":"- Part B: Change from baseline to Day 28 in a battery of cognitive tests, including: − Portosystemic Hepatic Encephalopathy Score (PHES) total score − Rey Auditory Verbal Learning test (RAVLT) − Delis and Kaplan Executive Function System (D-KEFS) Letter and Category fluency subtests","definition_or_measurement_approach":"Change from baseline to Day 28 in cognitive test battery: PHES total score, RAVLT, D-KEFS Letter and Category fluency subtests."}
• {"endpoint_text":"- Part B: Clinical Global Impression of change, PBC version (CGI-C-PBC).","definition_or_measurement_approach":"Investigator-rated Clinical Global Impression of change adapted for PBC (CGI-C-PBC)."}
• {"endpoint_text":"- Part B: Lowest plasma concentration before the next dose (Ctrough) will be assessed pre-dose on Days 1, 7, 14 and 28.","definition_or_measurement_approach":"Measurement of trough plasma concentrations pre-dose on Days 1, 7, 14 and 28 (Ctrough)."}

Hungary

Earliest CTIS Part Ii Submission Date

10-10-2024

Latest Decision Or Authorization Date

20-11-2025

Processing Time Days

406

Number Of Sites

3

Number Of Participants

18

Greece

Earliest CTIS Part Ii Submission Date

10-10-2024

Latest Decision Or Authorization Date

20-11-2025

Processing Time Days

406

Number Of Sites

2

Number Of Participants

20

Spain

Earliest CTIS Part Ii Submission Date

10-10-2024

Latest Decision Or Authorization Date

16-01-2026

Processing Time Days

463

Number Of Sites

9

Number Of Participants

25

Italy

Earliest CTIS Part Ii Submission Date

10-10-2024

Latest Decision Or Authorization Date

20-02-2026

Processing Time Days

498

Number Of Sites

7

Number Of Participants

25

Germany

Earliest CTIS Part Ii Submission Date

10-10-2024

Latest Decision Or Authorization Date

22-04-2026

Processing Time Days

559

Number Of Sites

3

Number Of Participants

28

Primary sponsor

Full Name

Umecrine Cognition AB

Organisation Type

Pharmaceutical company

Country Of Registered Address

Sweden

Contract research organisations

Name

Signant Health Global LLC

Responsibilities

Scientific & Clinical Consulting, COA, IP management, EDC, Data Analytics, Patient engagement, Site enablement

Name

CTC Clinical Trial Consultants AB

Responsibilities

Pharmacokinetic calculations

Name

Accelsiors Kft.

Responsibilities

IVRS – treatment randomisation

Name

GBA Central Lab Services GmbH

Name

Lablytica Life Science AB

Third parties

• {"country":"United States","full_name":"Signant Health Global LLC","duties_or_roles":"Scientific & Clinical Consulting, COA, IP management, EDC, Data Analytics, Patient engagement, Site enablement","organisation_type":"Pharmaceutical company"}
• {"country":"Sweden","full_name":"CTC Clinical Trial Consultants AB","duties_or_roles":"Pharmacokinetic calculations","organisation_type":"Pharmaceutical company"}
• {"country":"Sweden","full_name":"Lablytica Life Science AB","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
• {"country":"Hungary","full_name":"Accelsiors Kft.","duties_or_roles":"IVRS – treatment randomisation","organisation_type":"Pharmaceutical company"}
• {"country":"Germany","full_name":"GBA Central Lab Services GmbH","duties_or_roles":"","organisation_type":"Laboratory/Research/Testing facility"}