Pharmacokinetics and Pharmacodynamics of Cilofexor in Adults With Normal and Impaired Hepatic Function

Sponsor
Gilead Sciences (Industry)
Overall Status
Completed
CT.gov ID
NCT02808312
Collaborator
(none)
57
5
6
27.1
11.4
0.4

Study Details

Study Description

Brief Summary

The primary objective of this study is to evaluate the single-dose pharmacokinetics of cilofexor in adults with impaired hepatic function relative to matched, healthy controls with normal hepatic function.

Condition or Disease Intervention/Treatment Phase
Phase 1

Study Design

Study Type:
Interventional
Actual Enrollment :
57 participants
Allocation:
Non-Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase 1 Open-Label, Parallel-Group, Adaptive, Single-Dose Study to Evaluate the Pharmacokinetics and Pharmacodynamics of GS-9674 in Subjects With Normal and Impaired Hepatic Function
Actual Study Start Date :
Jul 13, 2016
Actual Primary Completion Date :
Oct 16, 2018
Actual Study Completion Date :
Oct 16, 2018

Arms and Interventions

Arm Intervention/Treatment
Experimental: Cohort 1: Mild Hepatic Impairment

Participants with mild hepatic impairment will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).

Drug: Cilofexor
Tablet(s) administered orally in a fed state on Day 1
Other Names:
  • GS-9674
  • Experimental: Cohort 1: Normal Hepatic Function

    Matched normal hepatic function participants to mild hepatic impairment participants will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).

    Drug: Cilofexor
    Tablet(s) administered orally in a fed state on Day 1
    Other Names:
  • GS-9674
  • Experimental: Cohort 2: Moderate Hepatic Impairment

    Participants with moderate hepatic impairment will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).

    Drug: Cilofexor
    Tablet(s) administered orally in a fed state on Day 1
    Other Names:
  • GS-9674
  • Experimental: Cohort 2: Normal Hepatic Function

    Matched normal hepatic function participants to moderate hepatic impairment participants will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).

    Drug: Cilofexor
    Tablet(s) administered orally in a fed state on Day 1
    Other Names:
  • GS-9674
  • Experimental: Cohort 3: Severe Hepatic Impairment

    Participants with severe hepatic impairment will receive a single oral dose of cilofexor 10 mg (1 x 10 mg tablet).

    Drug: Cilofexor
    Tablet(s) administered orally in a fed state on Day 1
    Other Names:
  • GS-9674
  • Experimental: Cohort 3: Normal Hepatic Function

    Matched normal hepatic function participants to severe hepatic impairment participants will receive a single oral dose of cilofexor 10 mg (1 x 10 mg tablet).

    Drug: Cilofexor
    Tablet(s) administered orally in a fed state on Day 1
    Other Names:
  • GS-9674
  • Outcome Measures

    Primary Outcome Measures

    1. Pharmacokinetic (PK) Parameter: AUClast of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      AUClast is defined as the concentration of drug from time zero to the last observable concentration.

    2. PK Parameter: AUCinf of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      AUCinf is defined as the concentration of drug extrapolated to infinite time.

    3. PK Parameter: Cmax of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      Cmax is defined as the maximum concentration of drug.

    4. PK Parameter: %AUCexp of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      %AUCexp is defined as the percentage of AUC extrapolated between AUClast and AUCinf.

    5. PK Parameter: Clast of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      Clast is defined as the last observable concentration of drug.

    6. PK Parameter: Tmax of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      Tmax is defined as the time (observed time point) of Cmax.

    7. PK Parameter: Tlast of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      Tlast is defined as the time (observed time point) of Clast.

    8. PK Parameter: λz of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      λz is defined as the terminal elimination rate constant, estimated by linear regression of the terminal elimination phase of the log plasma concentration of drug versus time curve of the drug.

    9. PK Parameter: CL/F of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      CL/F is defined as the apparent oral clearance following administration of the drug.

    10. PK Parameter: Vz/F of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      Vz/F is defined as the apparent volume of distribution of the drug.

    11. PK Parameter: t1/2 of Cilofexor [≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1]

      t1/2 is defined as the estimate of the terminal elimination half-life of the drug.

    Secondary Outcome Measures

    1. Percentage of Participants Experiencing Treatment-Emergent Adverse Events [Day 1 up to Day 31]

    2. Percentage of Participants Who Experienced Graded Laboratory Abnormalities [Day 1 up to Day 31]

      A treatment-emergent laboratory abnormality was defined as an increase of at least 1 toxicity grade from predose at any time postdose up to and including the date of last study drug dose plus 30 days. The most severe graded abnormality from all tests was counted for each participant.

    3. Pharmacodynamic (PD) Parameter: Mean Day 1/ Day -1 Ratio of AUC2-12 for α-hydroxy-4-cholesten-3-one (C4) [0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1]

      AUC2-12 is defined as area under the curve calculated by the trapezoidal rule for the time from 2 to 12 hours. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.

    4. PD Parameter: Mean Day 1/ Day -1 Ratio of Cmin for α-hydroxy-4-cholesten-3-one (C4) [0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1]

      Cmin for C4 is defined as the minimum observed concentration of C4. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.

    5. PD Parameter: Mean Day 1/ Day -1 Ratio of AUC2-12 for Fibroblast Growth Factor 19 (FGF19) [0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1]

      AUC2-12 is defined as area under the curve calculated by the trapezoidal rule for the time from 2 to 12 hours. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.

    6. PD Parameter: Mean Day 1/ Day -1 Ratio of Cmax for Fibroblast Growth Factor 19 (FGF19) [0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1]

      Cmax for FGF19 is defined as the maximum observed concentration of FGF19. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Key Inclusion Criteria:
    Cohort 1:
    • Individuals with mildly impaired and normal hepatic function.

    • Individuals with mild hepatic impairment must have a score of 5-6 on the Child-Pugh-Turcotte (CPT) classification at screening without evidence of worsening clinical and/or laboratory signs of hepatic impairment within 2 months prior or within the screening period.

    Cohort 2:
    • Individuals with moderately impaired and normal hepatic function.

    • Individuals with moderate hepatic impairment must have a score of 7-9 on the CPT classification at screening without evidence of worsening clinical and/or laboratory signs of hepatic impairment within 2 months prior or within the screening period.

    Cohort 3:
    • Individuals with severely impaired and normal hepatic function.

    • Individuals with severe hepatic impairment must have a score of 10-15 on the CPT classification at screening without evidence of worsening clinical and/or laboratory signs of hepatic impairment within 2 months prior or within the screening period.

    Note: Other protocol defined Inclusion/Exclusion criteria may apply.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Miami Florida United States 33014
    2 Orlando Florida United States 32809
    3 Knoxville Tennessee United States 37920
    4 San Antonio Texas United States 78215
    5 Auckland New Zealand 1640

    Sponsors and Collaborators

    • Gilead Sciences

    Investigators

    • Study Director: Gilead Study Director, Gilead Sciences

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Gilead Sciences
    ClinicalTrials.gov Identifier:
    NCT02808312
    Other Study ID Numbers:
    • GS-US-402-3885
    First Posted:
    Jun 21, 2016
    Last Update Posted:
    Jan 7, 2021
    Last Verified:
    Dec 1, 2020
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details Participants were enrolled at study sites in the United States (US) and New Zealand. The first participant was screened on 13 July 2016. The last study visit occurred on 16 October 2018.
    Pre-assignment Detail In the control groups (normal hepatic function), each participant was matched for age, gender, race, and body mass index with a participant in the hepatic impairment group. 17 total unique participants with normal hepatic function were enrolled in Cohort 1 (N = 10) and Cohort 2 (N = 7). 5 participants with normal hepatic function from Cohort 1 also served as matched controls in Cohort 2.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 & 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild or moderate hepatic impairment participants received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Period Title: Overall Study
    STARTED 10 10 17 10 10
    COMPLETED 10 10 16 10 10
    NOT COMPLETED 0 0 1 0 0

    Baseline Characteristics

    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 & 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function Total
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild or moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets ) or 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Total of all reporting groups
    Overall Participants 10 10 16 10 10 56
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    54
    (10.1)
    57
    (8.9)
    55
    (7.6)
    54
    (9.5)
    52
    (8.4)
    54.45
    (8.67)
    Sex: Female, Male (Count of Participants)
    Female
    3
    30%
    2
    20%
    5
    31.3%
    3
    30%
    3
    30%
    16
    28.6%
    Male
    7
    70%
    8
    80%
    11
    68.8%
    7
    70%
    7
    70%
    40
    71.4%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    4
    40%
    3
    30%
    7
    43.8%
    6
    60%
    5
    50%
    25
    44.6%
    Not Hispanic or Latino
    6
    60%
    7
    70%
    9
    56.3%
    4
    40%
    5
    50%
    31
    55.4%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Asian
    1
    10%
    0
    0%
    1
    6.3%
    0
    0%
    0
    0%
    2
    3.6%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    1
    10%
    0
    0%
    0
    0%
    1
    10%
    1
    10%
    3
    5.4%
    White
    8
    80%
    10
    100%
    15
    93.8%
    9
    90%
    9
    90%
    51
    91.1%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Region of Enrollment (participants) [Number]
    New Zealand
    2
    20%
    1
    10%
    3
    18.8%
    1
    10%
    1
    10%
    8
    14.3%
    United States
    8
    80%
    9
    90%
    13
    81.3%
    9
    90%
    9
    90%
    48
    85.7%

    Outcome Measures

    1. Primary Outcome
    Title Pharmacokinetic (PK) Parameter: AUClast of Cilofexor
    Description AUClast is defined as the concentration of drug from time zero to the last observable concentration.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    The PK Analysis Sets included all enrolled participants who took at least 1 dose of study drug and had at least 1 nonmissing postdose concentration value reported by the PK laboratory for the corresponding analytes. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [h*ng/mL]
    5381.0
    (2175.34)
    2972.6
    (1230.49)
    8223.7
    (7492.41)
    2756.7
    (851.38)
    6534.3
    (3791.05)
    960.0
    (352.71)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments An analysis of variance (ANOVA) model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (AUClast) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% Confidence Intervals (CIs) were calculated for the ratios of geometric least-squares means (GLSMs) of PK parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.7869
    Confidence Interval (2-Sided) 90%
    1.2885 to 2.4781
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (AUClast) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 2.4868
    Confidence Interval (2-Sided) 90%
    1.6735 to 3.6954
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (AUClast) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 6.3240
    Confidence Interval (2-Sided) 90%
    4.3675 to 9.1569
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Primary Outcome
    Title PK Parameter: AUCinf of Cilofexor
    Description AUCinf is defined as the concentration of drug extrapolated to infinite time.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [h*ng/mL]
    5411.9
    (2181.82)
    3024.3
    (1224.02)
    8288.2
    (7583.42)
    2805.6
    (851.26)
    6719.4
    (4056.73)
    986.2
    (354.93)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (AUCinf) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.7628
    Confidence Interval (2-Sided) 90%
    1.2750 to 2.4374
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (AUCinf) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 2.4559
    Confidence Interval (2-Sided) 90%
    1.6531 to 3.6486
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (AUCinf) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 6.2497
    Confidence Interval (2-Sided) 90%
    4.2965 to 9.0910
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    3. Primary Outcome
    Title PK Parameter: Cmax of Cilofexor
    Description Cmax is defined as the maximum concentration of drug.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [ng/mL]
    994.1
    (533.38)
    603.5
    (275.33)
    909.2
    (477.20)
    495.7
    (199.45)
    426.6
    (136.40)
    182.4
    (86.67)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (Cmax) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.5703
    Confidence Interval (2-Sided) 90%
    1.0723 to 2.2995
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (Cmax) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.7343
    Confidence Interval (2-Sided) 90%
    1.2193 to 2.4667
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments An ANOVA model with hepatic function group as a fixed effect was fitted to the natural logarithmic transformation of PK parameters (Cmax) for each cohort.
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PK parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 2.5369
    Confidence Interval (2-Sided) 90%
    1.7562 to 3.6648
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    4. Primary Outcome
    Title PK Parameter: %AUCexp of Cilofexor
    Description %AUCexp is defined as the percentage of AUC extrapolated between AUClast and AUCinf.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [percentage of AUCexp]
    0.63
    (0.270)
    1.95
    (1.621)
    0.64
    (0.194)
    1.87
    (1.653)
    1.81
    (1.874)
    2.96
    (1.962)
    5. Primary Outcome
    Title PK Parameter: Clast of Cilofexor
    Description Clast is defined as the last observable concentration of drug.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [ng/mL]
    1.97
    (1.005)
    3.84
    (2.162)
    2.76
    (3.377)
    3.73
    (2.378)
    6.03
    (8.044)
    2.18
    (1.387)
    6. Primary Outcome
    Title PK Parameter: Tmax of Cilofexor
    Description Tmax is defined as the time (observed time point) of Cmax.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Median (Inter-Quartile Range) [hours]
    3.75
    3.00
    4.50
    3.75
    5.00
    4.00
    7. Primary Outcome
    Title PK Parameter: Tlast of Cilofexor
    Description Tlast is defined as the time (observed time point) of Clast.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Median (Inter-Quartile Range) [hours]
    64.80
    48.00
    72.00
    48.00
    96.00
    48.00
    8. Primary Outcome
    Title PK Parameter: λz of Cilofexor
    Description λz is defined as the terminal elimination rate constant, estimated by linear regression of the terminal elimination phase of the log plasma concentration of drug versus time curve of the drug.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [1/hour]
    0.070
    (0.0377)
    0.099
    (0.0661)
    0.051
    (0.0152)
    0.100
    (0.0655)
    0.045
    (0.0117)
    0.099
    (0.0659)
    9. Primary Outcome
    Title PK Parameter: CL/F of Cilofexor
    Description CL/F is defined as the apparent oral clearance following administration of the drug.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [mL/h]
    6621.5
    (3219.50)
    11324.4
    (4184.32)
    5264.4
    (2686.26)
    11631.7
    (3666.25)
    1963.1
    (964.19)
    11535.9
    (4627.39)
    10. Primary Outcome
    Title PK Parameter: Vz/F of Cilofexor
    Description Vz/F is defined as the apparent volume of distribution of the drug.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [mL]
    97797.6
    (18500.74)
    148898.5
    (81520.19)
    99541.7
    (31192.41)
    153854.9
    (83844.37)
    41375.1
    (11767.71)
    160423.9
    (92259.03)
    11. Primary Outcome
    Title PK Parameter: t1/2 of Cilofexor
    Description t1/2 is defined as the estimate of the terminal elimination half-life of the drug.
    Time Frame ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PK Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Median (Inter-Quartile Range) [hours]
    11.45
    9.49
    13.53
    8.12
    15.90
    9.31
    12. Secondary Outcome
    Title Percentage of Participants Experiencing Treatment-Emergent Adverse Events
    Description
    Time Frame Day 1 up to Day 31

    Outcome Measure Data

    Analysis Population Description
    The Safety Analysis Set included all participants who took at least 1 dose of study drug.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 and 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild or moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 16 10 10
    Number [percentage of participants]
    10.0
    100%
    20.0
    200%
    12.5
    78.1%
    30.0
    300%
    0
    0%
    13. Secondary Outcome
    Title Percentage of Participants Who Experienced Graded Laboratory Abnormalities
    Description A treatment-emergent laboratory abnormality was defined as an increase of at least 1 toxicity grade from predose at any time postdose up to and including the date of last study drug dose plus 30 days. The most severe graded abnormality from all tests was counted for each participant.
    Time Frame Day 1 up to Day 31

    Outcome Measure Data

    Analysis Population Description
    Participants in the Safety Analysis Set were analyzed.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 and 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild or moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 16 10 10
    Any Laboratory Abnormality
    90.0
    900%
    100.0
    1000%
    50.0
    312.5%
    100.0
    1000%
    60.0
    600%
    Grade 3 or above Laboratory Abnormalities
    20.0
    200%
    20.0
    200%
    0
    0%
    40.0
    400%
    0
    0%
    14. Secondary Outcome
    Title Pharmacodynamic (PD) Parameter: Mean Day 1/ Day -1 Ratio of AUC2-12 for α-hydroxy-4-cholesten-3-one (C4)
    Description AUC2-12 is defined as area under the curve calculated by the trapezoidal rule for the time from 2 to 12 hours. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.
    Time Frame 0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PD Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [ratio]
    0.706
    (0.2273)
    0.817
    (0.2836)
    0.716
    (0.2370)
    0.681
    (0.2614)
    1.063
    (0.2469)
    0.978
    (0.4155)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 0.8722
    Confidence Interval (2-Sided) 90%
    0.6827 to 1.1144
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.0731
    Confidence Interval (2-Sided) 90%
    0.8295 to 1.3883
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.1475
    Confidence Interval (2-Sided) 90%
    0.8783 to 1.4992
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    15. Secondary Outcome
    Title PD Parameter: Mean Day 1/ Day -1 Ratio of Cmin for α-hydroxy-4-cholesten-3-one (C4)
    Description Cmin for C4 is defined as the minimum observed concentration of C4. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.
    Time Frame 0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PD Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [ratio]
    0.599
    (0.3272)
    0.707
    (0.2838)
    0.668
    (0.2384)
    0.583
    (0.1634)
    0.953
    (0.2073)
    0.727
    (0.2674)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 0.8188
    Confidence Interval (2-Sided) 90%
    0.5837 to 1.1486
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.1323
    Confidence Interval (2-Sided) 90%
    0.8772 to 1.4615
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.3563
    Confidence Interval (2-Sided) 90%
    1.0468 to 1.7574
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    16. Secondary Outcome
    Title PD Parameter: Mean Day 1/ Day -1 Ratio of AUC2-12 for Fibroblast Growth Factor 19 (FGF19)
    Description AUC2-12 is defined as area under the curve calculated by the trapezoidal rule for the time from 2 to 12 hours. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.
    Time Frame 0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PD Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [ratio]
    3.031
    (1.0376)
    2.840
    (0.9254)
    3.730
    (1.3768)
    2.848
    (1.0250)
    1.582
    (0.8182)
    2.179
    (1.6972)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.0658
    Confidence Interval (2-Sided) 90%
    0.8275 to 1.3726
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.2942
    Confidence Interval (2-Sided) 90%
    0.9663 to 1.7334
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 0.8225
    Confidence Interval (2-Sided) 90%
    0.5479 to 1.2347
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    17. Secondary Outcome
    Title PD Parameter: Mean Day 1/ Day -1 Ratio of Cmax for Fibroblast Growth Factor 19 (FGF19)
    Description Cmax for FGF19 is defined as the maximum observed concentration of FGF19. For PD assessments on Day -1, participants were administered a single oral dose of placebo-to-match cilofexor tablet on Day -1; the reported Time Frame is with respect to the placebo dosing.
    Time Frame 0.5 hour predose, ≤ 5 minutes predose, and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, and 16 hours postdose on Day -1 and Day 1; 4.5 hours postdose on Day -1; 24, 48, 72, and 96 hours postdose on Day 1

    Outcome Measure Data

    Analysis Population Description
    Participants in the PD Analysis Set were analyzed. A participant with normal hepatic function might serve as a matched control across cohorts evaluating the same cilofexor dose.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 1: Normal Hepatic Function Cohort 2: Moderate Hepatic Impairment Cohort 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    Measure Participants 10 10 10 10 10 10
    Mean (Standard Deviation) [ratio]
    3.778
    (1.4954)
    3.494
    (1.4423)
    4.459
    (1.9899)
    3.145
    (1.4484)
    1.899
    (1.1619)
    2.098
    (1.1579)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Cohort 1: Mild Hepatic Impairment, Cohort 1: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between mild hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.0806
    Confidence Interval (2-Sided) 90%
    0.7910 to 1.4762
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Cohort 2: Moderate Hepatic Impairment, Cohort 2: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between moderate hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 1.3729
    Confidence Interval (2-Sided) 90%
    0.9663 to 1.9506
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Cohort 3: Severe Hepatic Impairment, Cohort 3: Normal Hepatic Function
    Comments
    Type of Statistical Test Other
    Comments Two-sided 90% CIs were calculated for the ratios of GLSMs of PD parameters between severe hepatic impairment group and the control (normal hepatic function) group.
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter GLSM ratio
    Estimated Value 0.9030
    Confidence Interval (2-Sided) 90%
    0.6142 to 1.3275
    Parameter Dispersion Type:
    Value:
    Estimation Comments

    Adverse Events

    Time Frame Day 1 up to Day 31
    Adverse Event Reporting Description The Safety Analysis Set included all participants who took at least 1 dose of study drug.
    Arm/Group Title Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 and 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Arm/Group Description Participants with mild hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with moderate hepatic impairment received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Matched normal hepatic function participants to mild or moderate hepatic impairment participants, received a single oral dose of cilofexor 30 mg (3 x 10 mg tablets) in a fed state, on Day 1. Participants with severe hepatic impairment received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1. Matched normal hepatic function participants to severe hepatic impairment participants, received a single oral dose of cilofexor 10 mg (1 x 10 mg tablet) in a fed state, on Day 1.
    All Cause Mortality
    Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 and 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/10 (0%) 0/10 (0%) 0/16 (0%) 0/10 (0%) 0/10 (0%)
    Serious Adverse Events
    Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 and 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/10 (0%) 1/10 (10%) 0/16 (0%) 1/10 (10%) 0/10 (0%)
    Gastrointestinal disorders
    Gastrointestinal haemorrhage 0/10 (0%) 1/10 (10%) 0/16 (0%) 0/10 (0%) 0/10 (0%)
    Upper gastrointestinal haemorrhage 0/10 (0%) 0/10 (0%) 0/16 (0%) 1/10 (10%) 0/10 (0%)
    Other (Not Including Serious) Adverse Events
    Cohort 1: Mild Hepatic Impairment Cohort 2: Moderate Hepatic Impairment Cohort 1 and 2: Normal Hepatic Function Cohort 3: Severe Hepatic Impairment Cohort 3: Normal Hepatic Function
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 1/10 (10%) 1/10 (10%) 2/16 (12.5%) 2/10 (20%) 0/10 (0%)
    Gastrointestinal disorders
    Dyspepsia 0/10 (0%) 1/10 (10%) 0/16 (0%) 0/10 (0%) 0/10 (0%)
    Injury, poisoning and procedural complications
    Skin abrasion 0/10 (0%) 0/10 (0%) 0/16 (0%) 1/10 (10%) 0/10 (0%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 0/10 (0%) 0/10 (0%) 0/16 (0%) 1/10 (10%) 0/10 (0%)
    Back pain 0/10 (0%) 0/10 (0%) 1/16 (6.3%) 0/10 (0%) 0/10 (0%)
    Nervous system disorders
    Headache 0/10 (0%) 0/10 (0%) 1/16 (6.3%) 0/10 (0%) 0/10 (0%)
    Vascular disorders
    Haematoma 1/10 (10%) 0/10 (0%) 0/16 (0%) 0/10 (0%) 0/10 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    After conclusion of the study and without prior written approval from Gilead, investigators in this study may communicate, orally present, or publish in scientific journals or other media only after the following conditions have been met: The results of the study in their entirety have been publicly disclosed by or with the consent of Gilead in an abstract, manuscript, or presentation form; or The study has been completed at all study sites for at least 2 years

    Results Point of Contact

    Name/Title Gilead Clinical Study Information Center
    Organization Gilead Sciences
    Phone 1-833-445-3230 (GILEAD-0)
    Email GileadClinicalTrials@gilead.com
    Responsible Party:
    Gilead Sciences
    ClinicalTrials.gov Identifier:
    NCT02808312
    Other Study ID Numbers:
    • GS-US-402-3885
    First Posted:
    Jun 21, 2016
    Last Update Posted:
    Jan 7, 2021
    Last Verified:
    Dec 1, 2020