Safety and efficacy of HK-660S in patients with primary sclerosing cholangitis: A randomized double-blind phase 2a trial.

IF 14 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Molecular Hepatology Pub Date : 2025-01-01 Epub Date: 2024-09-24 DOI:10.3350/cmh.2024.0629
Woo Hyun Paik, Joo Kyung Park, Moon Jae Chung, Gunn Huh, Ce Hwan Park, Sang Hyub Lee, Heon Se Jeong, Hee Jin Kim, Do Hyun Park
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引用次数: 0

Abstract

Background/aims: A clinical unmet need persists for medications capable of modulating the progression of primary sclerosing cholangitis (PSC). This study aimed to assess the clinical feasibility of HK-660S (beta-lapachone) in PSC.

Methods: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2 trial, participants were assigned in a 2:1 ratio to receive either 100 mg of HK-660S or a placebo twice daily for 12 weeks. The primary outcomes were the reduction in serum alkaline phosphatase (ALP) levels and the percentage of participants showing improvements in PSC severity, as determined by magnetic resonance cholangiopancreatography with the Anali score. Secondary endpoints included changes in liver stiffness and adverse events.

Results: The analysis included 21 patients, 15 receiving HK-660S, and six receiving a placebo. Improvements in the Anali score were observed in 13.3% of the HK-660S group, with no improvements in the placebo group. HK-660S treatment resulted in a 15.2% reduction in mean ALP levels, compared to a 6.6% reduction in the placebo group. A stratified ad-hoc analysis based on baseline ALP levels showed a statistically significant response in the HK-660S group among those with ALP levels greater than twice the upper limit of normal, with a 50% responder rate (p=0.05). Additionally, 26.7% of the HK-660S group showed improvements in the enhanced liver fibrosis score, with no improvements in the placebo group. HK-660S was generally well tolerated.

Conclusion: HK-660S is well tolerated among patients with PSC and may improve bile duct strictures, decrease serum ALP levels, and reduce liver fibrosis (cris.nih.go.kr, Number KCT0006590).

HK-660S对原发性硬化性胆管炎患者的安全性和疗效:随机双盲 2a 期试验。
背景/目的:临床上一直需要能够调节原发性硬化性胆管炎(PSC)病情发展的药物。本研究旨在评估HK-660S(β-拉帕醌)治疗原发性硬化性胆管炎的临床可行性:在这项多中心、随机、双盲、安慰剂对照、平行组2期试验中,参与者按2:1的比例被分配接受100毫克HK-660S或安慰剂,每天两次,为期12周。主要结果是血清碱性磷酸酶(ALP)水平的降低,以及通过磁共振胆胰管造影(MRCP)和Anali评分确定的PSC严重程度有所改善的参与者比例。次要终点包括肝硬变和不良事件的变化:分析包括21名患者,其中15人接受HK-660S治疗,6人接受安慰剂治疗。13.3%的 HK-660S 组患者的 Anali 评分有所改善,而安慰剂组患者的 Anali 评分没有改善。HK-660S 治疗使平均 ALP 水平降低了 15.2%,而安慰剂组仅降低了 6.6%。根据基线 ALP 水平进行的分层特设分析表明,在 ALP 水平超过正常值上限两倍的患者中,HK-660S 组的应答具有显著的统计学意义,应答率为 50%(p = 0.05)。此外,26.7%的HK-660S组患者的肝纤维化增强评分有所改善,而安慰剂组则没有改善。HK-660S的耐受性总体良好:结论:HK-660S在PSC患者中耐受性良好,可改善胆管狭窄、降低血清ALP水平并减轻肝纤维化。(cris.nih.go.kr,编号KCT0006590)。
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来源期刊
Clinical and Molecular Hepatology
Clinical and Molecular Hepatology Medicine-Hepatology
CiteScore
15.60
自引率
9.00%
发文量
89
审稿时长
10 weeks
期刊介绍: Clinical and Molecular Hepatology is an internationally recognized, peer-reviewed, open-access journal published quarterly in English. Its mission is to disseminate cutting-edge knowledge, trends, and insights into hepatobiliary diseases, fostering an inclusive academic platform for robust debate and discussion among clinical practitioners, translational researchers, and basic scientists. With a multidisciplinary approach, the journal strives to enhance public health, particularly in the resource-limited Asia-Pacific region, which faces significant challenges such as high prevalence of B viral infection and hepatocellular carcinoma. Furthermore, Clinical and Molecular Hepatology prioritizes epidemiological studies of hepatobiliary diseases across diverse regions including East Asia, North Asia, Southeast Asia, Central Asia, South Asia, Southwest Asia, Pacific, Africa, Central Europe, Eastern Europe, Central America, and South America. The journal publishes a wide range of content, including original research papers, meta-analyses, letters to the editor, case reports, reviews, guidelines, editorials, and liver images and pathology, encompassing all facets of hepatology.
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