MAESTRO-NASH: A Phase 3 Study to Evaluate the Efficacy and Safety of MGL-3196 (Resmetirom) in Patients With NASH and Fibrosis

Sponsor
Madrigal Pharmaceuticals, Inc. (Industry)
Overall Status
Recruiting
CT.gov ID
NCT03900429
Collaborator
(none)
2,000
223
3
59.1
9
0.2

Study Details

Study Description

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 on liver biopsy and prevents progression to cirrhosis and/or advanced liver disease

Condition or Disease Intervention/Treatment Phase
Phase 3

Study Design

Study Type:
Interventional
Anticipated Enrollment :
2000 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official 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
Actual Study Start Date :
Mar 28, 2019
Anticipated Primary Completion Date :
Dec 1, 2021
Anticipated Study Completion Date :
Mar 1, 2024

Arms and Interventions

Arm Intervention/Treatment
Placebo Comparator: Matching Placebo

Placebo Daily

Drug: Placebo
Matching Tablets

Active Comparator: 80 mg MGL-3196

80 mg daily

Drug: MGL-3196
Tablet
Other Names:
  • Resmetirom
  • Active Comparator: 100 mg MGL-3196

    100 mg daily

    Drug: MGL-3196
    Tablet
    Other Names:
  • Resmetirom
  • Outcome Measures

    Primary Outcome Measures

    1. To evaluate the effect of MGL-3196 80 mg or 100 mg compared to placebo to achieve NASH resolution on liver histology in non-cirrhotic NASH patients with stage 2 or 3 fibrosis [Measurements at Baseline and 52 weeks]

      Assessment will be in the first 900 patients, at least 450 F3, and be based on the proportion of MGL-3196 80 mg or 100 mg treated patients relative to placebo achieving NASH resolution (NASH Activity Score (NAS), ballooning =0; lobular inflammation =0,1) with at least a 2 point reduction in NAS and no worsening of fibrosis.

    2. Composite long-term outcome events composed of all-cause mortality, cirrhosis, and other significant liver-related events [Time frame to accrue a prespecified number of adjudicated events; up to 54 months]

      To evaluate the effect of MGL-3196 80 mg or 100 mg compared to placebo on composite long-term outcome measured by the number of patients with the onset of any of the adjudicated events, composed of cirrhosis, all-cause mortality and liver-related clinical outcomes.

    Secondary Outcome Measures

    1. 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 low-density lipoprotein cholesterol (LDL-C) [Measurements at Baseline and 24 weeks]

      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.

    2. To evaluate the effect of MGL-3196 80 mg or 100 mg compared to placebo to achieve improvement in fibrosis on liver histology in non-cirrhotic NASH patients with stage 2 or 3 fibrosis [Measurements at Baseline and 52 weeks]

      Assessment will be in the first 900 patients, at least 450 F3, and be based on the proportion of MGL-3196 80 mg or 100 mg treated patients relative to placebo achieving at least a 1-point improvement in fibrosis (NASH Clinical Research Network system) by liver biopsy with no worsening of NAS.

    Other Outcome Measures

    1. To evaluate the effect of MGL-3196 80 mg or 100 mg compared to placebo to achieve NASH resolution on liver histology in non-cirrhotic NASH patients with Stage 1 fibrosis [Measurements at Baseline and 52 weeks]

      Assessment will be in Stage 1 fibrosis patients and be based on the proportion of MGL-3196 80 mg or 100 mg treated patients relative to placebo achieving NASH resolution (NASH Activity Score (NAS), ballooning =0; lobular inflammation =0,1) with at least a 2 point reduction in NAS and no worsening of fibrosis.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    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

    4. Metabolic risk factors and AST > 20 U/L

    5. Criteria consistent with liver fibrosis as defined as one of the following:

    • Biochemical test for fibrosis OR

    • Fibroscan test OR

    • Historical liver biopsy with diagnosis of NASH with fibrosis Stage 2 or 3

    1. MRI-PDFF with increased fat fraction

    2. Biopsy-proven NASH (Baseline liver biopsy) based on a liver biopsy obtained within 24 weeks before anticipated date of randomization (if the biopsy is deemed acceptable for interpretation by the central reader) with fibrosis stage 1A, 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:

    3. Steatosis (scored 0 to 3)

    4. Ballooning degeneration (scored 0 to 2)

    5. Lobular inflammation (scored 0 to 3)

    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. History of bariatric surgery or intestinal bypass surgery within the 5 years prior to randomization or planned during the conduct of the study.

    4. Recent significant weight gain or loss

    5. HbA1c ≥ 9.0%.

    6. 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.

    7. Presence of cirrhosis on liver biopsy defined as stage 4 fibrosis.

    8. Diagnosis of hepatocellular carcinoma (HCC).

    9. MELD score ≥12, as determined at Screening, unless due to therapeutic anti coagulation.

    10. Hepatic decompensation

    11. Chronic liver diseases other than NASH

    12. Active autoimmune disease

    13. Serum ALT > 250 U/L.

    14. Active, serious medical disease with a likely life expectancy < 2 years.

    15. Participation in an investigational new drug trial in the 60 days or 5 half-lives, whichever is longer.

    16. 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.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 East Valley Family Physicians Chandler Arizona United States 85224
    2 The Institute for Liver Health - Chandler Chandler Arizona United States 85224
    3 The Institute for Liver Health - Glendale Glendale Arizona United States 85306
    4 Desert Clinical Research Mesa Arizona United States 85213
    5 Adobe Gastroenterology Tucson Arizona United States 85712
    6 The Institute for Liver Health - Tucson Tucson Arizona United States 85712
    7 Arkansas Gastroenterology North Little Rock Arkansas United States 72117
    8 Fresno Clinical Research Center Fresno California United States 93720
    9 National Research Institute - Huntington Park Huntington Park California United States 90255
    10 University of California San Diego La Jolla California United States 92037
    11 Cedars-Sinai Medical Center Los Angeles California United States 90048
    12 National Research Institute - Los Angeles Los Angeles California United States 90057
    13 Ruane Clinical Research Los Angeles California United States 90057
    14 National Research Institute - Panorama City Panorama City California United States 91402
    15 Alliance Clinical Research Poway California United States 92064
    16 San Fernando Valley Health Institute Van Nuys California United States 91405
    17 Colorado Springs Family Practice Colorado Springs Colorado United States 80909
    18 South Denver Gastroenterology - Swedish Medical Center Office Englewood Colorado United States 80113
    19 Excel Medical Clinical Trials Boca Raton Florida United States 33434
    20 University of Florida Hepatology Research at CTRB Gainesville Florida United States 32610
    21 Nature Coast Clinical Research Inverness Florida United States 34452
    22 Florida Research Institute Lakewood Ranch Florida United States 34211
    23 Miami Dade Medical Research Institute Miami Florida United States 33176
    24 Bioclinica Research - Orlando Orlando Florida United States 32806
    25 Progressive Medical Research Port Orange Florida United States 32127
    26 Covenant Research Sarasota Florida United States 34240
    27 Bioclinica Research - The Villages The Villages Florida United States 32162
    28 GI Specialists of Georgia Marietta Georgia United States 30060
    29 Clinical Research - Chicago Chicago Illinois United States 60602
    30 Northwestern Medical Faculty Foundation Chicago Illinois United States 60611
    31 The University of Chicago Medicine Chicago Illinois United States 60637
    32 University of Kansas Medical Center Research Institute Fairway Kansas United States 66205
    33 Kansas Medical Clinic - Gastroenterology Topeka Kansas United States 66606
    34 Texas Digestive Disease Consultants - Gastroenterology Associates - Baton Rouge Baton Rouge Louisiana United States 70809
    35 Tandem Clinical Research Marrero Louisiana United States 70072
    36 Ochsner Medical Center New Orleans Louisiana United States 70121
    37 Clinical Trials of America West Monroe Louisiana United States 71291
    38 Walter Reed National Military Medical Center Bethesda Maryland United States 20889
    39 Gastrointestinal Associates and Endoscopy Center - Madison Flowood Mississippi United States 39232
    40 Southern Therapy and Advanced Research Jackson Mississippi United States 39216
    41 Kansas City Research Institute Kansas City Missouri United States 64131
    42 Saint Louis University Saint Louis Missouri United States 63104
    43 Clinical Research US - Henderson Henderson Nevada United States 89052
    44 Mt. Sinai Medical Center New York New York United States 10029
    45 Duke University Medical Center Durham North Carolina United States 27705
    46 Cumberland Research Associates Fayetteville North Carolina United States 28304
    47 Lucas Research Morehead City North Carolina United States 28557
    48 Consultants for Clinical Research Cincinnati Ohio United States 45249
    49 Aventiv Research - Columbus Columbus Ohio United States 43213
    50 Awasty Research Network Marion Ohio United States 43302
    51 Premier Medical Group - Clarksville Clarksville Tennessee United States 37040
    52 Gastro One - Germantown - Centre Oak Way Germantown Tennessee United States 38138
    53 Associates in Gastroenterology Hermitage Tennessee United States 37076
    54 Gastrointestinal Associates - Knoxville Knoxville Tennessee United States 37909
    55 Dallas Research Center Dallas Texas United States 75234
    56 Liver Center of Texas Dallas Texas United States 75234
    57 Texas Digestive Disease Consultants - Dallas Dallas Texas United States 75234
    58 The Liver Institute at Methodist Dallas Medical Center Dallas Texas United States 75234
    59 South Texas Research Institute Edinburg Texas United States 78539
    60 Brooke Army Medical Center Fort Sam Houston Texas United States 78234
    61 Texas Digestive Disease Consultants - Fort Worth Fort Worth Texas United States 76104
    62 Liver Associates of Texas Houston Texas United States 77030
    63 Doctor's Hospital at Renaissance McAllen Texas United States 78504
    64 Plano Research Center Plano Texas United States 75093
    65 Pinnacle Clinical Research - Austin Rollingwood Texas United States 78746
    66 Pinnacle Clinical Research San Antonio Texas United States 78229
    67 San Antonio Research Center San Antonio Texas United States 78229
    68 The Texas Liver Institute San Antonio Texas United States 78229
    69 Texas Digestive Disease Consultants - San Marcos San Marcos Texas United States 78666
    70 Texas Digestive Disease Consultants - Bay Area Gastroenterology Webster Texas United States 77598
    71 Wasatch Peak Family Practice Layton Utah United States 84041
    72 Salt Lake City Research Center Murray Utah United States 84123
    73 University of Virginia Health System Charlottesville Virginia United States 22903
    74 Bon Secours St. Mary's Hospital of Richmond Richmond Virginia United States 23226
    75 Hunter Holmes McGuire Veterans Administration Medical Center Richmond Virginia United States 23249
    76 Virginia Commonwealth University Richmond Virginia United States 23249
    77 Liver Institute Northwest Seattle Washington United States 98105
    78 Royal Prince Alfred Hospital Camperdown New South Wales Australia 2050
    79 Saint Vincent's Hospital Sydney Darlinghurst New South Wales Australia 2010
    80 Nepean Hospital Kingswood New South Wales Australia 2747
    81 John Hunter Hospital New Lambton New South Wales Australia 2305
    82 Westmead Hospital Westmead New South Wales Australia 2145
    83 Royal Brisbane and Women's Hospital Herston Queensland Australia 4029
    84 Mater Misericordiae South Brisbane Queensland Australia 4101
    85 Royal Adelaide Hospital Adelaide South Australia Australia 5000
    86 Monash Medical Centre Clayton Victoria Australia 3168
    87 Austin Health Heidelberg Victoria Australia 3084
    88 The Alfred Hospital Melbourne Victoria Australia 3004
    89 The Royal Melbourne Hospital Parkville Victoria Australia 3050
    90 Sir Charles Gairdner Hospital Nedlands Western Australia Australia 6009
    91 Royal Perth Hospital Perth Western Australia Australia 6000
    92 Klinikum Klagenfurt Am Wörthersee Klagenfurt Carinthia Austria
    93 Ordensklinikum Linz GmbH Barmherzige Schwestern Linz Upper Austria Austria
    94 Krankenanstalt Rudolfstiftung Wien Vienna Austria
    95 Landesklinik St. Veit Salzburg Austria
    96 Medizinische Universität Wien Vienna Austria
    97 Klinikum Wels-Grieskirchen Wels Austria
    98 Universitair Ziekenhuis Antwerpen Edegem Antwerpen Belgium
    99 Hôpital Erasme Bruxelles Brussels Belgium
    100 Universitair Ziekenhuis Leuven Leuven Flemish Brabant Belgium
    101 Ziekenhuis Oost-Limburg' Genk Limburg Belgium
    102 Algemeen Ziekenhuis Maria Middelares Gent Oost-Vlaanderen Belgium
    103 Universitair Ziekenhuis Gent Gent Oost-Vlaanderen Belgium
    104 AZ Delta Campus Wilgenstraat Roeselare West-Vlaanderen Belgium
    105 Cliniques Universitaires Saint-Luc Brussels Belgium
    106 Centre Hospitalier Universitaire Brugmann Laeken Belgium
    107 Universitair Ziekenhuis Leuven Leuven Belgium
    108 University of Calgary Liver Unit Calgary Alberta Canada
    109 University of Alberta Edmonton Alberta Canada
    110 South Shore Medical Arts Bridgewater Nova Scotia Canada
    111 LMC/ Manna Research - Brampton Brampton Ontario Canada
    112 William Osler Health System Brampton Ontario Canada
    113 McMaster University Hamilton Ontario Canada
    114 Toronto General Hospital - Clinical Trials Pharmacy Toronto Ontario Canada
    115 Toronto Liver Center Toronto Ontario Canada
    116 GI Research Institute Vancouver Canada
    117 Nouvel Hôpital Civil Strasbourg Cedex Alsace France
    118 Les Hôpitaux Universitaires de Strasbourg - Hôpital Hautepierre Strasbourg Alsace France
    119 Centre Hospitalier Universitaire Estaing Clermont-Ferrand Auvergne France
    120 Centre Hospitalier Universitaire de Rennes Rennes Cedex 9 Bretagne France
    121 Hôpital Jean-Minjoz Besançon Franche-Comte France
    122 Hôpital Avicenne Bobigny Cedex Ile-de-France France
    123 Centre Hospitalier Universitaire Henri Mondor Créteil Cedex Ile-de-France France
    124 Assistance Publique-Hôpitaux de Paris Hôpital Cochin Paris Cedex 14 Ile-de-France France
    125 Centre Hospitalier Universitaire de Montpellier Montpellier Cedex 5 Languedoc-Roussillon France
    126 Hôpital Dupuytren Limoges Limousin France
    127 Centre Hospitalier Universitaire de Toulouse - Hôpital Rangueil Toulouse Cedex Midi-Pyrenees France
    128 Centre Hospitalier Régional Universitaire de Lille Lille Nord Pas-de-Calais France
    129 Center Hospitalier Universitaire d'Angers Angers Pays De La Loire France
    130 Centre Hospitalier Universitaire de Nice Hôpital l'Archet Nice Cedex 3 Provence Alpes Cote D'Azur France
    131 Hôpital de la Croix Rousse Lyon Cedex 04 Rhone-Alpes France
    132 Centre Hospitalier Universitaire Amiens-Picardie Amiens France
    133 Hôpital Beaujon Clichy France
    134 Hôpital Universitaire Pitié Salpêtrière Paris Cedex 13 France
    135 Centre Hospitalier Universitaire de Nancy - Hôpital de Brabois Vandœuvre-lès-Nancy France
    136 Berlin Clinical Research Center Berlin Germany
    137 Charité Universitätsmedizin Berlin - Campus Mitte Berlin Germany
    138 Charité Universitätsmedizin Berlin Berlin Germany
    139 EPIMED Berlin Germany
    140 Zentrum für Infektiologie Berlin Prenzlauer Berg Berlin Germany
    141 Frankfurt Clinical Research Center Frankfurt am main Germany
    142 Universitätsklinikum Frankfurt Frankfurt am main Germany
    143 Universitätsklinikum des Saarlandes Homburg Germany
    144 EUGASTRO Leipzig Germany
    145 Leipzig Research Center Leipzig Germany
    146 SIBAmed Studienzentrum Leipzig Germany
    147 Universitätsklinikum Würzburg Würzburg Germany
    148 Békés Megyei Központi Kórház Dr. Réthy Pál Tagkórház Békéscsaba Bekes Hungary
    149 Magyarország Egészségügyi Szolgáltató - Gyula Gyula Bekes Hungary
    150 Debreceni Egyetem Kenézy Gyula Egyetemi Kórház Debrecen Hajdu-Bihar Hungary
    151 Magyarország Research Center Debrecen Hajdu-Bihar Hungary
    152 Szabolcs-Szatmár-Bereg Megyei Kórházak és Egyetemi Oktatókórház Nyíregyháza Szabolcs-Szatmar-Bereg Hungary
    153 Dél-pesti Centrumkórház - Országos Hematológiai és Infektológiai Intézet Budapest Hungary
    154 Magyarország Research Center Budapest Hungary
    155 The Chaim Sheba Medical Center Ramat Gan Tel Aviv Israel
    156 Emek Medical Center Afula Israel
    157 Soroka University Medical Center Be'er Sheva Israel
    158 Rambam Health Care Campus - Rambam Medical Center Haifa Israel
    159 The Lady Davis Carmel Medical Center Haifa Israel
    160 Hadassah University Hospital Ein Kerem Jerusalem Israel
    161 Shaare Zedek Medical Center Jerusalem Israel
    162 Western Galilee Hospital-Nahariya Nahariya Israel
    163 Holy Family Hospital Nazareth Israel
    164 Rabin Medical Center Petah Tikva Israel
    165 Tel Aviv Sourasky Medical Center Tel Aviv Israel
    166 Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy
    167 Azienda Ospedaliero - Universitaria Careggi Firenze Italy
    168 Azienda Ospedaliera Universitaria Policlinico Gaetano Martino Messina Italy
    169 Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano Italy
    170 Polo Universitario - L'Azienda Ospedaliera Luigi Sacco Milano Italy
    171 Azienda Ospedaliera Universitaria-Maggiore della Carità di Novara Novara Italy
    172 Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone Palermo Italy
    173 Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT) Palermo Italy
    174 Fondazione Policlinico Universitario Agostino Gemelli Roma Italy
    175 Universita degli Studi di Roma La Sapienza - Umberto I Policlinico di Roma Roma Italy
    176 Ospedale Casa Sollievo della Sofferenza San Giovanni Rotondo Italy
    177 Polska Oddział w Częstochowie Częstochowa Poland
    178 Polska Oddział w Gdansk Gdańsk Poland
    179 Polska Oddział w Gdyni Gdynia Poland
    180 Polska Oddział w Katowicach Katowice Poland
    181 Polska Oddział w Poznaniu Poznań Poland
    182 Polska Oddział w Warszawie Warszawa Poland
    183 Polska Oddział w Wrocław Wrocław Poland
    184 Polska Oddział w Łodz Łódź Poland
    185 Fundación De Investigación De Diego San Juan Puerto Rico
    186 Hospital Universitario Puerta de Hierro - Majadahonda Majadahonda Madrid Spain
    187 Complejo Hospitalario Torrecárdenas Almeria Spain
    188 Hospital de la Santa Creu i de Sant Pau Barcelona Spain
    189 Hospital del Mar - Parc de Salut Mar Barcelona Spain
    190 Hospital Universitari Vall d'Hebrón Barcelona Spain
    191 Hospital General Universitario Gregorio Marañón Madrid Spain
    192 Hospital Universitario Ramón Y Cajal Madrid Spain
    193 Complejo Hospitalario de Pontevedra Pontevedra Spain
    194 Hospital Universitario Marqués de Valdecilla Santander Spain
    195 Hospital Universitario Virgen del Rocio Sevilla Spain
    196 Consorci Hospital General Universitari de València Valencia Spain
    197 Hospital Universitari i Politecnic La Fe de Valencia Valencia Spain
    198 Universitatsspital Bern Bern Switzerland
    199 Fondazione Epatocentro Ticino Lugano Switzerland
    200 Universitatsspital Zurich Zürich Switzerland
    201 Midlands Clinical Research Centre Birmingham England United Kingdom
    202 University Hospitals Birmingham NHS Foundation Trust Birmingham England United Kingdom
    203 Cambridge University Hospitals NHS Foundation Trust Cambridge England United Kingdom
    204 Lancashire Clinical Research Centre Chorley England United Kingdom
    205 North Teesside Clinical Research Centre Hardwick England United Kingdom
    206 Merseyside Clinical Research Centre Liverpool England United Kingdom
    207 Barts Health NHS Trust London England United Kingdom
    208 Chelsea and Westminster Hospital NHS Foundation Trust London England United Kingdom
    209 Imperial College Healthcare NHS Trust London England United Kingdom
    210 Royal Free London NHS Foundation Trust London England United Kingdom
    211 Manchester Clinical Research Centre Manchester England United Kingdom
    212 The Newcastle Upon Tyne Hospitals NHS Foundation Trust Newcastle Upon Tyne England United Kingdom
    213 Norfolk and Norwich University Hospital Norwich England United Kingdom
    214 Nottingham University Hospitals NHS Trust Nottingham England United Kingdom
    215 Thames Valley Dedicated Research Centre Reading England United Kingdom
    216 Belfast Health and Social Care Trust Belfast Northern Ireland United Kingdom
    217 The Hexham Clinic Hexham Northumberland, England United Kingdom
    218 The Wales Clinic Cardiff Wales United Kingdom
    219 Abertawe Bro Morgannwg University Health Board Swansea Wales United Kingdom
    220 Aintree University Hospitals NHS Foundation Trust Liverpool United Kingdom
    221 Saint George's University Hospitals NHS Foundation Trust London United Kingdom
    222 Plymouth Hospitals NHS Trust Plymouth United Kingdom
    223 Portsmouth Hospitals NHS Trust Portsmouth United Kingdom

    Sponsors and Collaborators

    • Madrigal Pharmaceuticals, Inc.

    Investigators

    • Study Director: Rebecca Taub, MD, Madrigal Pharmaceuticals, Inc.

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Madrigal Pharmaceuticals, Inc.
    ClinicalTrials.gov Identifier:
    NCT03900429
    Other Study ID Numbers:
    • MGL-3196-11
    First Posted:
    Apr 3, 2019
    Last Update Posted:
    Jul 7, 2021
    Last Verified:
    Jul 1, 2021
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Jul 7, 2021