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DUR-928

Phase 2

Alcoholic Hepatitis | Small molecule | Infectious Disease |DURECT Corporation|Last Updated: Sep 24, 2024

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment326
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04563026A Phase 2b Study in Subjects With Alcoholic Hepatitis to Evaluate Safety and Efficacy of DUR-928 TreatmentPHASE2 COMPLETED 307Jan 22, 2021Sep 6, 2023Sep 5, 202468 United States, Australia +4
NCT03432260A Research Study to Assess the Safety, Pharmacokinetics and Pharmacodynamics of DUR-928 in Patients With Alcoholic HepatitisPHASE2 COMPLETED 19Apr 18, 2018Sep 9, 2019Sep 24, 20247 United States
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Study Endpoints
Primary Endpoints
Difference in 90-day mortality or liver transplant between IV DUR-928, 30 mg or 90 mg, and placebo.
Day 90
Lille Model for Alcoholic Hepatitis Score
Day 7

The Lille score predicts response of AH subjects to treatment with glucocorticoids, such as prednisolone. This score is based on age, serum albumin, creatinine, PT, and the difference in bilirubin between pre-treatment and Day 7 post-treatment. The Lille score ranges from 0.01 to 1.00. A score \>0.45 predicts a higher risk of death and the recommendation to stop steroid administration. Lille Score = Exp(-R)/(1 + Exp(-R)) Where: R = \[3.19 - (0.101 x Age in years)\] + (1.47 x Albumin in g/dL) + \[0.28215 x (Bilirubin initial - Bilirubin day 7 in mg/dL)\] - (0.206 x Creatinine in mg/dL) - (0.11115 x Bilirubin initial in mg/dL) - (0.0096 x PT in seconds) NOTE: When calculating Lille, use "baseline" values for ALL parameters EXCEPT bilirubin at Day 7. Baseline would be the Day 1 Pre-dose sample result, if available. If not available, then use the Screening sample result.

Model for End Stage Liver Disease (MELD) Score
Baseline (Screening or Day 1 Pre-dose), Day 7 and Day 28

The MELD score at enrollment is a good predictor for AH patient prognosis. Laboratory values for international normalized ratio (INR), serum creatinine (sCr) and bilirubin are used to calculate the MELD score. The MELD score ranges from 6.0 to 40.0 (capped) with a higher score predicting a higher risk of death. A sequentially improving MELD score is associated with a better chance of recovery. MELD score will be calculated using the original formula (pre-2016) which does not include serum sodium level. Original MELD Score = (0.957 x Ln(Serum Creatinine in mg/dL) + 0. 378 x Ln(Serum Bilirubin in mg/dL) + 1.120 x Ln (INR) + 0.643) x 10 Note: (1) If patient received two or more dialysis treatments within the prior 7 days, then the value for serum creatinine will be set to 4.0. (2) If any laboratory value is less than 1.0, the value will be set to 1.0 for the MELD score calculation, in order to avoid negative values resulting from taking the natural log of values less than 1.

Model for End Stage Liver Disease (MELD) Score - Percent Change From Baseline
Baseline (Screening or Day 1 Pre-dose), Day 7 and Day 28

The MELD Score %change from baseline is a %change between 2 time points, baseline and value at a specific time point (Day 7 or Day 28). MELD score is a good predictor of outcome. A declining MELD score suggests disease improvement. Lab values for international normalized ratio (INR), serum creatinine (sCr) and bilirubin are used to calculate the MELD score. MELD score will be calculated using the original formula (pre-2016) which does not include serum sodium level. Original MELD Score = (0.957 x Ln(Serum Creatinine in mg/dL) + 0. 378 x Ln(Serum Bilirubin in mg/dL) + 1.120 x Ln (INR) + 0.643) x 10 Note: (1) If patient received two or more dialysis treatments within the prior 7 days, then the value for serum creatinine will be set to 4.0. (2) If any laboratory value is less than 1.0, the value will be set to 1.0 for the MELD score calculation, in order to avoid negative values resulting from taking the natural log of values less than 1.

Secondary Endpoints
Difference in 90-day mortality between IV DUR-928, 30 mg or 90 mg, and placebo.
Day 90
Difference in 28-day mortality or liver transplant between IV DUR-928, 30 mg or 90 mg, and placebo.
Day 28
Difference in 28-day mortality between IV DUR-928, 30 mg or 90 mg, and placebo.
Day 28
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
DUR-928 (larsucosterol, 30 mg)EXPERIMENTAL -
DUR-928 (larsucosterol, 90 mg)EXPERIMENTAL -
(Placebo) Sterile Water for InjectionPLACEBO_COMPARATOR -
Part A (Moderate AH) DUR-928 30 mgEXPERIMENTALLowest dose of 3 dose escalation arms: 30mg, 90 mg and 150 mg
Part A (Moderate AH) DUR-928 90 mgEXPERIMENTALMiddle dose of 3 dose escalation arms: 30mg, 90 mg and 150 mg
Part A (Moderate AH) DUR-928 150 mgEXPERIMENTALHighest dose of dose escalation arms: 30mg, 90 mg and 150 mg
Part B (Severe AH) DUR-928 30 mgEXPERIMENTALLowest dose of dose escalation arms: 30mg, 90 mg and 150 mg
Part B (Severe AH) DUR-928 90 mgEXPERIMENTALMiddle dose of dose escalation arms: 30mg, 90 mg and 150 mg
Part B (Severe AH) DUR-928 150 mgEXPERIMENTALHighest dose of dose escalation arms: 30mg, 90 mg and 150 mg
Interventions
NameTypeDescription
DUR-928 30 mgDRUGIV infusion
DUR-928 90 mgDRUGIV infusion
Placebo+ Standard of Care (SOC)DRUGIV infusion
DUR-928 150 mgDRUGHighest dose of 3 dose escalation arms.
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites68

Inclusion Criteria: 1. Able to provide written informed consent (either from subject or subject's legally acceptable representative). 2. Onset of jaundice within prior 8 weeks. 3. Average daily consumption of \>40 (females) or \>60 (males) grams of alcohol for 6 months or longer, with \< 8 weeks of...

Countries:United StatesAustraliaAustriaBelgiumFranceUnited Kingdom
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