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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03900429
Registration number
NCT03900429
Ethics application status
Date submitted
26/03/2019
Date registered
3/04/2019
Date last updated
20/02/2024
Titles & IDs
Public title
A Phase 3 Study to Evaluate the Efficacy and Safety of MGL-3196 (Resmetirom) in Patients With NASH and Fibrosis
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Scientific title
A Phase 3, Multinational, Double-Blind, Randomized, Placebo-Controlled Study of MGL-3196 (Resmetirom) in Patients With Non-Alcoholic Steatohepatitis (NASH) and Fibrosis to Resolve NASH and Reduce Progression to Cirrhosis and/or Hepatic Decompensation
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Secondary ID [1]
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MGL-3196-11
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Universal Trial Number (UTN)
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Trial acronym
MAESTRO-NASH
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
NASH - Nonalcoholic Steatohepatitis
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Condition category
Condition code
Oral and Gastrointestinal
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Metabolic and Endocrine
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Metabolic disorders
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Diet and Nutrition
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - MGL-3196
Treatment: Drugs - Placebo
Treatment: Surgery - Liver Biopsy
Placebo comparator: Matching Placebo - Placebo Daily
Active comparator: 80 mg MGL-3196 - 80 mg daily
Active comparator: 100 mg MGL-3196 - 100 mg daily
Treatment: Drugs: MGL-3196
Tablet
Treatment: Drugs: Placebo
Matching Tablets
Treatment: Surgery: Liver Biopsy
A procedure in which a needle is inserted into the liver to collect a tissue sample
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Week 52 Dual Primary Objectives: To determine the effect of 80 or 100 mg MGL-3196 vs matching placebo on liver biopsy (NASH CRN score) at Week 52 compared with Baseline
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Assessment method [1]
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1. Proportion with resolution of NASH (ballooning 0, inflammation 0,1) associated with at least 2-point reduction in NAFLD Activity Score (NAS) without worsening of fibrosis stage OR
2. Proportion with at least a 1-point improvement in fibrosis stage with no worsening of NAS
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Timepoint [1]
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52 weeks
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Primary outcome [2]
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Month 54 Primary Objective: Time to experiencing an adjudicated Composite Clinical Outcome event (Final Primary Endpoint, at 54 months)
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Assessment method [2]
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The Composite Clinical Outcome is composed of all-cause mortality, liver transplant, and significant hepatic events (including hepatic decompensation events \[ascites, encephalopathy, or gastroesophageal variceal hemorrhage\], histological progression to cirrhosis, and a confirmed increase of MELD score from \<12 to =15).
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Timepoint [2]
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up to 54 months
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Secondary outcome [1]
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Week 52 Key Secondary Objective: To determine the effect of once-daily, oral administration of MGL-3196 80 or 100 mg versus matching placebo on the percent change from Baseline at 24 weeks in directly measured low-density lipoprotein cholesterol (LDL-C)
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Assessment method [1]
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Assess the effect of MGL-3196 80 mg or 100 mg compared to placebo on LDL-C measured by percent change from Baseline at 24 weeks.
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Timepoint [1]
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24 weeks
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Eligibility
Key inclusion criteria
1. Must be willing to participate in the study and provide written informed consent.
2. Male and female adults = 18 years of age.
3. Suspected or confirmed diagnosis of NASH fibrosis suggested by the historical data. Meet one of the following criteria that is consistent with NASH liver fibrosis:
1. Historical biochemical test for fibrosis: PRO-C3 >14 ng/mL or ELF =9
2. FibroScan with transient elastography =8.5 kPa and controlled attenuation parameter =280 dB.m-1
3. Historical liver biopsy obtained <2 years before expected randomization showing Stage 1B, 2 or 3 fibrosis with NASH based on existing pathology review, with no significant change in body weight >5% or medication that might affect NAS or fibrosis stage.
4. MRI-PDFF fat fraction =8% obtained during the screening period
5. Biopsy-proven NASH (baseline liver biopsy) based on a liver biopsy obtained =6 months before anticipated date of randomization (if the biopsy is deemed acceptable for interpretation by the central reader) with fibrosis stage 1A/1C, 1B, 2, or 3 on liver biopsy and NAS of =4 with a score of at least 1 in each of the following NAS components:
1. Steatosis (scored 0 to 3)
2. Ballooning degeneration (scored 0 to 2)
3. Lobular inflammation (scored 0 to 3)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. History of significant alcohol consumption for a period of more than 3 consecutive months within 1 year prior to Screening.
2. Regular use of drugs historically associated with NAFLD
3. Thyroid diseases:
1. Active hyperthyroidism.
2. Untreated clinical hypothyroidism defined by thyroid stimulating hormone (TSH) >7 IU/L with symptoms of hypothyroidism or >10 IU/L without symptoms.
3. Patients who have had a thyroidectomy and are on replacement thyroxine doses >75 µg per day are allowed.
4. History of bariatric surgery or intestinal bypass surgery within the 5 years prior to randomization or planned during the conduct of the study.
5. Recent significant weight gain or loss
6. HbA1c = 9.0%.
7. Glucagon-like peptide 1 [GLP-1] agonist, high dose Vitamin E (> 400 IU/day), or pioglitazone therapy unless stable dose for 24 weeks prior to biopsy.
8. Presence of cirrhosis on liver biopsy defined as stage 4 fibrosis.
9. Diagnosis of hepatocellular carcinoma (HCC).
10. MELD score =12, as determined at Screening, unless due to therapeutic anti coagulation.
11. Hepatic decompensation
12. Chronic liver diseases other than NASH
13. Active autoimmune disease
14. Serum ALT > 250 U/L.
15. Active, serious medical disease with a likely life expectancy < 2 years.
16. Participation in an investigational new drug trial in the 60 days or 5 half-lives, whichever is longer.
17. 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.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
28/03/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/01/2028
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Actual
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Sample size
Target
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Accrual to date
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Final
1759
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Recruitment in Australia
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NSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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Saint Vincent's Hospital Sydney - Darlinghurst
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Nepean Hospital - Kingswood
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John Hunter Hospital - New Lambton
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Westmead Hospital - Westmead
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Royal Brisbane and Women's Hospital - Herston
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Sir Charles Gairdner Hospital - Nedlands
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Royal Perth Hospital - Perth
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2050 - Camperdown
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2010 - Darlinghurst
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2747 - Kingswood
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2305 - New Lambton
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2145 - Westmead
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4029 - Herston
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4101 - South Brisbane
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5000 - Adelaide
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3168 - Clayton
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3084 - Heidelberg
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3004 - Melbourne
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3050 - Parkville
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6009 - Nedlands
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6000 - Perth
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Recruitment outside Australia
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Zürich
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United Kingdom
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England
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United Kingdom
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Northern Ireland
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United Kingdom
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Northumberland, England
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United Kingdom
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Wales
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United Kingdom
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Liverpool
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United Kingdom
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London
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United Kingdom
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Plymouth
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United Kingdom
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Portsmouth
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Madrigal Pharmaceuticals, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
A double-blind placebo controlled randomized Phase 3 study to determine if 80 or 100 mg of MGL-3196 as compared with placebo resolves NASH and/or reduces fibrosis on liver biopsy and prevents progression to cirrhosis and/or advanced liver disease
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Trial website
https://clinicaltrials.gov/study/NCT03900429
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Trial related presentations / publications
Harrison SA, Bashir M, Moussa SE, McCarty K, Pablo Frias J, Taub R, Alkhouri N. Effects of Resmetirom on Noninvasive Endpoints in a 36-Week Phase 2 Active Treatment Extension Study in Patients With NASH. Hepatol Commun. 2021 Jan 4;5(4):573-588. doi: 10.1002/hep4.1657. eCollection 2021 Apr.
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Public notes
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Contacts
Principal investigator
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Rebecca Taub, MD
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Address
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Madrigal Pharmaceuticals, Inc.
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03900429
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