Status:

WITHDRAWN

A Phase 3 Study Evaluating the Safety and Efficacy of Denifanstat in Patients With MASH and F2/F3 Fibrosis

Lead Sponsor:

Sagimet Biosciences Inc.

Conditions:

MASH

NASH

Eligibility:

All Genders

18-75 years

Phase:

PHASE3

Brief Summary

A randomized, double-blind, placebo-controlled Phase 3 study to determine if denifanstat 50 mg or 25 mg is effective, as compared to placebo, in resolving MASH without the worsening of fibrosis and/or...

Detailed Description

Approximately 1260 patients (including at least 60% of F3 patients) will be enrolled to receive either denifanstat 50 mg (580 patients), placebo (580 patients), or denifanstat 25 mg (100 patients).

Eligibility Criteria

Inclusion

  • Willing and able to participate in the study and provide written informed consent.
  • Adults between 18 and 75 years of age.
  • Body mass index (BMI) ≥23 kg/m\^2 for Asian patients and ≥25 kg/m\^2 for patients of other races.
  • Presence of metabolic risk factor(s), as follows:
  • T2DM.
  • OR
  • 2 out of 4 of the following:
  • BMI ≥30 kg/m\^2.
  • Hypertension, or on active antihypertensive treatment.
  • Elevated fasting serum TGs or on active treatment for hypertriglyceridemia.
  • Reduced fasting serum HDL-c or on active treatment for dyslipidemia.
  • For patients with T2DM:
  • HbA1c ≤9.5%.
  • Metformin, insulin, dipeptidyl peptidase-4 inhibitors (DPP4-Is), sodium-glucose transport protein-2 inhibitors (SGLT2-Is), and alpha-glucosidase inhibitors (α-GIs): stable dose for at least 12 weeks prior to qualifying liver biopsy and screening.
  • Sulfonylureas (SUs) and glinides: stable dose with no history of relevant hypoglycemia for at least 12 weeks prior to qualifying liver biopsy and screening.
  • GLP-1 RA: stable dose for at least 18 weeks prior to start of screening.
  • Noncirrhotic, biopsy-proven MASH with:
  • A fibrosis stage of F2 or F3.
  • NAS ≥4 with at least a score of 1 in each of the following NAS components:
  • Steatosis (scored 0 to 3).
  • Hepatocyte ballooning (scored 0 to 2).
  • Lobular inflammation (scored 0 to 3).
  • A qualifying historical liver biopsy within 6 months before the screening visit. Historical biopsy results will be confirmed by central reading.
  • If there is no available historical liver biopsy within this time period, a liver biopsy must be performed during the screening period. Patients should be deemed likely to have MASH F2/F3 fibrosis prior to proceeding to a liver biopsy, as indicated by the following:
  • FibroScan.
  • Liver stiffness measurement (LSM) ≥8.5 kPa.
  • Controlled attenuation parameter (CAP) ≥280 dB/m.
  • Aspartate aminotransferase (AST) \>20 U/L.
  • Stable ALT and AST levels.

Exclusion

  • Previous intake of an approved MASH medication.
  • Exclusionary laboratory values:
  • ALT and/or AST \>5 × ULN.
  • ALP ≥2 × ULN.
  • Total serum bilirubin concentration \>1.3 mg/dL.
  • Serum albumin concentration \<3.5 g/dL.
  • INR \>1.3 except for patients receiving anticoagulant treatment.
  • Platelet count \<140,000/μL.
  • Fasting TG level ≥500 mg/dL.
  • eGFR \<45 mL/min/1.73 m\^2.
  • History of excessive alcohol intake for a period of more than 3 consecutive months within 1 year prior to screening.
  • Presence of cirrhosis on liver histology according to the assessment of the central reader.
  • Current or historical clinically evident hepatic decompensation.
  • Evidence of another form of active liver disease.
  • Positive serologic evidence of current infectious liver disease.
  • MELD score ≥12.
  • Planned or history of liver transplantation.
  • Prior or planned bariatric surgery.
  • Gain or loss of \>5% of body weight in the 3 months or \>10% of body weight in the 6 months prior to screening, qualifying liver biopsy, and the baseline visit (V1).
  • Any of the following within 6 months prior to the baseline visit (V1):
  • Myocardial infarction.
  • CABG/PTCA.
  • Unstable angina.
  • Transient ischemic attack, stroke, or cerebrovascular disease.
  • Unstable or undiagnosed arrhythmias.
  • Uncontrolled high BP.
  • Malignancy with a complete remission date within 5 years prior to the baseline visit (V1).
  • Any current or history of hepatocellular carcinoma.
  • Diabetes other than T2DM.
  • Uncontrolled hypothyroidism.
  • Any other known serious disease or other disease which in the Investigator's opinion would exclude the patient from participating in the study.
  • Previous intake of an approved MASH medication, unless there is at least a 6-month wash-out period between the last date of intake of the approved MASH medication and date of screening.
  • Use of a nonpermitted concomitant medication within 30 days or 5 half-lives prior to the qualifying liver biopsy and screening.

Key Trial Info

Start Date :

March 1 2025

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 1 2030

Estimated Enrollment :

Patients enrolled

Trial Details

Trial ID

NCT06594523

Start Date

March 1 2025

End Date

December 1 2030

Last Update

May 15 2025

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