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西尼riviroc 治疗非酒精性脂肪性肝炎成人肝纤维化:AURORA 期 3 研究设计。

Cenicriviroc for the treatment of liver fibrosis in adults with nonalcoholic steatohepatitis: AURORA Phase 3 study design.

机构信息

Institute of Translational & Clinical Research, 4(th) floor, William Leech Building, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.

Division of Gastroenterology and Hepatology, Saint Louis University, 3635 Vista Avenue, St. Louis, MO 63110, USA.

出版信息

Contemp Clin Trials. 2020 Feb;89:105922. doi: 10.1016/j.cct.2019.105922. Epub 2019 Dec 24.

Abstract

INTRODUCTION

Nonalcoholic steatohepatitis (NASH) is a sub-classification of nonalcoholic fatty liver disease (NAFLD) characterized by increased risk of progressive liver fibrosis. Cenicriviroc (CVC) is a novel, orally administered, potent chemokine 2 and 5 receptor antagonist currently in development for the treatment of liver fibrosis in adults with NASH.

METHODS AND ANALYSIS

Efficacy and safety of CVC will be comprehensively evaluated in a global, Phase 3, multicenter, randomized, double-blind, placebo-controlled study (AURORA, NCT03028740) of subjects with NASH and Stage F2 or F3 fibrosis. Approximately 2000 adults (Part 1, 1200 subjects; Part 2, 800 additional subjects) aged 18-75 years with histological evidence of NASH with Stage F2 or F3 fibrosis (NASH Clinical Research Network classification system) will be randomized 2:1 to CVC 150 mg or placebo orally once daily. Primary efficacy endpoints will include the proportion of subjects with ≥1-stage improvement in liver fibrosis and no worsening of steatohepatitis at Month 12 relative to screening (Part 1), and time to first occurrence of any adjudicated event: death; histopathologic progression to cirrhosis; liver transplant; Model of End-Stage Liver Disease score ≥ 15; ascites; hospitalization due to liver decompensation (Part 2). Patient-reported outcomes will assess changes in health outcomes from baseline (Chronic Liver Disease Questionnaire - NAFLD; Work Productivity and Activity Impairment in NASH; 36-Item Short Form Health Survey version 2). Adverse events will be assessed throughout the study. As there are currently no approved treatments indicated for NASH, the AURORA CVC Phase 3 study addresses an unmet medical need.

摘要

简介

非酒精性脂肪性肝炎(NASH)是一种非酒精性脂肪性肝病(NAFLD)的亚类,其特征是进展性肝纤维化的风险增加。Cenicriviroc(CVC)是一种新型的、口服的、有效的趋化因子 2 和 5 受体拮抗剂,目前正在开发用于治疗 NASH 成人的肝纤维化。

方法和分析

CVC 的疗效和安全性将在一项全球、3 期、多中心、随机、双盲、安慰剂对照研究(AURORA,NCT03028740)中进行综合评估,该研究纳入了 NASH 合并 F2 或 F3 期纤维化的受试者。大约 2000 名年龄在 18-75 岁之间的成年人(第 1 部分,1200 名受试者;第 2 部分,800 名额外受试者)具有组织学证据的 NASH 合并 F2 或 F3 期纤维化(NASH 临床研究网络分类系统),将以 2:1 的比例随机分为 CVC 150mg 或安慰剂口服,每天一次。主要疗效终点将包括在第 12 个月与筛查时相比,肝纤维化改善≥1 期且无脂肪性肝炎恶化的受试者比例(第 1 部分),以及首次发生任何裁决事件的时间:死亡;组织学进展为肝硬化;肝移植;终末期肝病模型评分≥15;腹水;因肝失代偿而住院(第 2 部分)。患者报告的结局将评估从基线开始的健康结局变化(慢性肝病问卷-NASH;非酒精性脂肪性肝炎工作效率和活动障碍;36 项简明健康状况调查量表第 2 版)。整个研究期间将评估不良事件。由于目前尚无批准的 NASH 治疗方法,因此 AURORA CVC 3 期研究满足了未满足的医疗需求。

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