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Cilofexor

Phase 2

Primary Sclerosing Cholangitis | Small molecule | Gastrointestinal |Gilead Sciences, Inc.|Last Updated: Jun 7, 2021

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment52

FDA Designations

No designations recorded

Clinical trial landscape

Cilofexor · 3 trials · 3 indications

Phase 2 1Phase 1 2
NCT02943460Study to Evaluate the Safety, Tolerability, and Efficacy of Cilofexor in Adults With Primary Sclerosing Cholangitis Without CirrhosisPrimary Sclerosing Cholangitis
COMPLETED52 Analytics
PHASE2COMPLETED
Study to Evaluate the Safety, Tolerability, and Efficacy of Cilofexor in Adults With Primary Sclerosing Cholangitis Without Cirrhosis
Primary Sclerosing CholangitisUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants Experiencing Treatment-Emergent Adverse Events During the Blinded Phase
First dose date up to last dose date plus 30 days (Up to 17 weeks)

Treatment-emergent adverse events occurring during the Blinded Phase were defined as 1 or both of the following: 1) Any adverse events (AEs) with an onset date on or after the study drug start date and no later than 30 days after permanent discontinuation of study drug in the Blinded Phase (and before the first dosing date in the Open Label Extension (OLE) Phase), or 2) Any AEs leading to premature discontinuation of study drug in the Blinded Phase.

Percentage of Participants Experiencing Treatment-Emergent Serious Adverse Events During the Blinded Phase
First dose date up to last dose date plus 30 days (Up to 17 weeks)

A serious adverse event was defined as an event that, at any dose, resulted in any of the following: death, life-threatening, in-patient hospitalization or prolongation of existing hospitalization, persistent or significant disability/incapacity, a congenital anomaly/birth defect, or a medically important event or reaction.

Percentage of Participants Experiencing Treatment-Emergent Laboratory Abnormalities During the Blinded Phase
First dose date up to last dose date plus 30 days (Up to 17 weeks)

Treatment-emergent laboratory abnormalities occurring during the Blinded Phase were defined as values that increase at least 1 toxicity grade from baseline at any postbaseline time point, up to and including the date of last dose of study drug in the Blinded Phase plus 30 days (and prior to or on the first dose date of the OLE phase). The Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03 was used for assigning toxicity grades (0 to 4, with higher grades indicating more severity).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Single-Dose Pharmacokinetic (PK) Parameter: AUClast of Cilofexor
Day 1: -0.5, 0 (pre-dose), 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 post-dose

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

Single-Dose PK Parameter: AUCinf of Cilofexor
Day 1: -0.5, 0 (pre-dose), 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 post-dose

AUCinf is defined as the concentration of drug extrapolated to infinite time (area under the plasma concentration versus time curve extrapolated to infinite time).

Single-Dose PK Parameter: Cmax of Cilofexor
Day 1: -0.5, 0 (pre-dose), 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 post-dose

Cmax is defined as the maximum observed concentration of drug in plasma.

Multiple-Dose PK Parameter: AUCtau of Cilofexor
Day 20: -0.5, 0 (pre-dose), 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 post-dose

AUCtau is the concentration of drug over time (area under the plasma concentration versus time curve over the dosing interval).

Multiple-Dose PK Parameter: Cmax of Cilofexor
Day 20: -0.5, 0 (pre-dose), 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 post-dose

Cmax is defined as the maximum observed concentration of drug in plasma.

Multiple-Dose PK Parameter: Ctau of Cilofexor
Day 20: -0.5, 0 (pre-dose), 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 post-dose

Ctau is defined as the observed drug concentration at the end of the dosing interval.

Percentage of Participants With at Least One Adverse Event (AE)
First dose date up to last dose date (Maximum: 20 days) plus 30 days

An AE is any untoward medical occurrence in a clinical study participant administered a medicinal product, which does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.

Percentage of Participants With Clinically Significant 12-Lead Electrocardiogram (ECG) Abnormalities
First dose date up to last dose date (Maximum: 20 days) plus 30 days

Investigator determined the ECG findings were clinically significant.

Percentage of Participants With Clinical Laboratory Abnormalities
First dose date up to last dose date (Maximum: 20 days) plus 30 days

Treatment-emergent laboratory (Hematology, Chemistry, and Urinalysis) abnormalities were defined as values that increase at least one toxicity grade from baseline. Laboratory Abnormalities are graded by the investigator as Grade 1, 2, 3, or 4 according to the modified Gilead Sciences, Inc (GSI) Grading Scale. The most severe graded abnormality from all tests was counted for each participant. Data is only reported for those Grades reported in 1 or more participants.

Secondary Endpoints

Percentage of Participants Experiencing Treatment-Emergent Adverse Events
Day 1 up to Day 31
Percentage of Participants Who Experienced Graded Laboratory Abnormalities
Day 1 up to Day 31
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
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Cilofexor 100 mg (Blinded Study Phase)EXPERIMENTALCilofexor 100 mg + placebo to match cilofexor 30 mg for up to 12.6 weeks
Cilofexor 30 mg (Blinded Study Phase)EXPERIMENTALCilofexor 30 mg + placebo to match cilofexor 100 mg for up to 12.7 weeks
Placebo (Blinded Study Phase)PLACEBO_COMPARATORPlacebo to match cilofexor 30 mg + placebo to match cilofexor 100 mg for up to 12.3 weeks
Cilofexor (Open Label Extension Phase)EXPERIMENTALFollowing the Blinded Study Phase, eligible participants received cilofexor for an additional up to 97.4 weeks.
Cohort 1: Mild Hepatic ImpairmentEXPERIMENTALParticipants with mild hepatic impairment will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).
Cohort 1: Normal Hepatic FunctionEXPERIMENTALMatched normal hepatic function participants to mild hepatic impairment participants will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).
Cohort 2: Moderate Hepatic ImpairmentEXPERIMENTALParticipants with moderate hepatic impairment will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).
Cohort 2: Normal Hepatic FunctionEXPERIMENTALMatched normal hepatic function participants to moderate hepatic impairment participants will receive a single oral dose of cilofexor 30 mg (3 x 10 mg tablets).
Cohort 3: Severe Hepatic ImpairmentEXPERIMENTALParticipants with severe hepatic impairment will receive a single oral dose of cilofexor 10 mg (1 x 10 mg tablet).
Cohort 3: Normal Hepatic FunctionEXPERIMENTALMatched normal hepatic function participants to severe hepatic impairment participants will receive a single oral dose of cilofexor 10 mg (1 x 10 mg tablet).
Cohort 1: Cilofexor 10 mgEXPERIMENTALParticipants in fasted state will receive cilofexor 10 mg or placebo once on Day 1 followed by a 5-day washout period then receive cilofexor 10 mg or placebo once daily from Day 7 to Day 20.
Cohort 2: Cilofexor 30 mgEXPERIMENTALParticipants in fasted state will receive cilofexor 30 mg or placebo once on Day 1 followed by a 5-day washout period then receive cilofexor 30 mg or placebo once daily from Day 7 to Day 20.
Cohort 3: Cilofexor 100 mgEXPERIMENTALParticipants in fasted state will receive cilofexor 100 mg or placebo once on Day 1 followed by a 5-day washout period then receive cilofexor 100 mg or placebo once daily from Day 7 to Day 20.
Cohort 4: Cilofexor 300 mgEXPERIMENTALParticipants in fasted state will receive cilofexor 300 mg or placebo once on Day 1 followed by a 5-day washout period then receive cilofexor 300 mg or placebo once daily from Day 7 to Day 20.
Cohort 5: Cilofexor 100 mgEXPERIMENTALParticipants in fed state will receive cilofexor 100 mg or placebo once with food on Day 1 followed by a 5-day washout period then receive cilofexor 100 mg or placebo tablet, orally, once daily with food from Day 7 to Day 20.
Cohort 6: Cilofexor 50 mgEXPERIMENTALParticipants in fed state will receive cilofexor 50 mg or placebo twice with food on Day 1 followed by a 5-day washout period then receive cilofexor 50 mg or placebo twice daily from Day 7 to Day 20.
Cohort 7: Cilofexor 15 mgEXPERIMENTALParticipants in fed state will receive cilofexor 15 mg or placebo twice with food on Day 1 followed by a 5-day washout period then receive cilofexor 15 mg or placebo twice daily from Day 7 to Day 20.
Cohort 8: Cilofexor 10 mgEXPERIMENTALParticipants in fed state will receive cilofexor 10 mg or placebo once with food on Day 1 followed by a 5-day washout period then receive cilofexor 10 mg or placebo once daily from Day 7 to Day 20.
Cohort 9: CilofexorEXPERIMENTALParticipants will receive cilofexor up to 300 mg or placebo once daily in the evening on empty stomach.
Cohort 10: CilofexorEXPERIMENTALParticipants will receive cilofexor up to 300 mg or placebo once daily in the evening on empty stomach.

Interventions

NameTypeDescription
CilofexorDRUGTablet(s) administered orally once daily with food
Placebo to match cilofexorDRUGTablet(s) administered orally once daily with food
PlaceboDRUGTablets administered orally
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Eligibility Criteria

Age Range18 Years to 70 Years
SexALL
Healthy VolunteersNo
Study Sites23

Key Inclusion Criteria: * Diagnosis of PSC based on cholangiogram (magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), or percutaneous transhepatic cholangiogram (PTC)) within the previous 12 months * Serum alkaline phosphatase (ALP) \> 1.67 x ...

Countries:United StatesAustriaCanadaUnited KingdomNew Zealand
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Frequently asked questions about Cilofexor

What is Cilofexor used for?

Cilofexor is an investigational small molecule being developed for Nonalcoholic Steatohepatitis (NASH) and Primary Sclerosing Cholangitis (PSC). It is currently in clinical development and has not been approved by the FDA.

Who makes Cilofexor?

Cilofexor is being developed by Gilead Sciences, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol GILD.

What phase is Cilofexor in?

Cilofexor is in Phase 1 clinical development. It has completed two Phase 1 trials and one Phase 2 trial, but it remains investigational and is not yet approved for any indication.

What clinical trials is Cilofexor in?

Cilofexor has completed two Phase 1 trials: NCT02654002, a healthy volunteer study in the United States, and NCT02808312, a hepatic impairment study in the United States and New Zealand. A Phase 2 trial, NCT02943460, evaluated Cilofexor in adults with Primary Sclerosing Cholangitis without cirrhosis.

How does Cilofexor work?

Cilofexor is a small molecule that targets the farnesoid X receptor (FXR), a nuclear receptor involved in bile acid metabolism and inflammatory pathways. By modulating FXR activity, it aims to address the underlying mechanisms of NASH and PSC.