Maralixibat for Cholestasis
This study is evaluating whether maralixibat is safe and well tolerated over a long period of time.
See full descriptionAbout the trial for Cholestasis
Treatment Groups
This trial involves 2 different treatments. Maralixibat is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 3 and have had some early promising results.
About The Treatment
Eligibility
This trial is for patients born any sex aged 65 and younger. There are 2 eligibility criteria to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether Maralixibat will improve 1 primary outcome and 4 secondary outcomes in patients with Cholestasis. Measurement will happen over the course of From baseline through study completion, up to 104 weeks.
Patient Q & A Section
What causes cholestasis?
The cause of cholestasis is not well understood. It is unlikely the disease was caused by infection, a fatty blockage or obstruction of the biliary system, or other known causes. More evidence is needed before any theories of causes are tested. Cholestasis can be the first symptom of the more serious condition of primary sclerosing cholangitis (PSC) for which there is no known treatment but surgery is indicated when the disease is debilitating and can be difficult to distinguish from other systemic conditions and diseases. PSC can present as an asymptomatic condition, or be the manifestation of a cholestatic process such as alcohol abuse, diabetes and chronic pancreatitis or gallstones.
What are the signs of cholestasis?
The main reasons for this disorder are primary biliary cholestasis, primary sclerosing cholangitis, pancreatic atrophy, and portal hypertension. Patients with signs of cholestasis most frequently present with gallstones and elevated liver function tests, although the cause of the cholestasis remains unproven. Nonspecific symptoms are generally considered to be caused by primary intrahepatic cholestasis but the main presenting symptoms are pruritus and pain in the right lower quadrant of the abdomen. Patients with pruritus without right-sided pain are often found to be suffering from extrahepatic cholestasis. In such cases, the primary reason for the itch cannot be ruled out.
What is cholestasis?
Cholestasis may be defined as an intrinsic cholestatic liver disease characterized by biliary dyskinesia where bile is produced and transported but becomes impaired on excretion because of an obstructive cholangiocarcinoma or other causes of liver injury. Cholestasis accounts for 15% of the whole hepatic disorders and cholestasis is the leading cause of jaundice.cholestasis.jaundice-cholestasis.\n
What are the common side effects of maralixibat?
The most frequently reported (greater than 5% of patients) GI-related adverse events were nausea (15%), vomiting (12%), diarrhoea (9%), headache (9%), constipation (5%) and abdominal pain (5%). Serious adverse events occurred infrequently in patients who received maralixibat: upper abdominal pain (n=5), peritonitis (n=2), thromboembolic events (n=2), and pneumonitis (n=1). Patients on maralixibat should be closely monitored for GI and systemic adverse events, specifically the risk of GI toxicity, since maralixibat is a P2Y2 receptor antagonist.
Have there been any new discoveries for treating cholestasis?
There have been new discoveries regarding the pathophysiology of cholestasis. However, there remains an unmet medical need for treatments to improve the clinical outcome of these hard-to-treat diseases.
Who should consider clinical trials for cholestasis?
The diagnosis of cholestasis needs clarification by means of a careful history and a complete clinical workup. Liver biopsy is essential to confirm the diagnosis of primary biliary cirrhosis (PBC), a rare disease that causes disabling liver scarring. Clinical trials for PBC may not be feasible as the numbers of patients with PBC will not be sufficient to justify the costs of clinical trials. Clinical trials for PBC that are aimed at the symptomatic or supportive care of patients with PBC are more likely to be feasible.
Can cholestasis be cured?
There is limited evidence in the literature to support this question. The majority of patients with PSC or PHPT were not satisfied with their present method of management. As a result, future randomized controlled trials need to include patient satisfaction questionnaires. For patients who are not satisfied with their treatment, and for patients willing to undertake curative therapy, the potential benefits need to be balanced against the potential side effects of a curative therapy.
What are common treatments for cholestasis?
The main treatment for cholestasis is liver surgery. Some patients can be treated by non-operative measures. In cases of advanced cholestasis, a liver transplant can be performed.\n
How many people get cholestasis a year in the United States?
It is estimated that 0.25% of people suffer from cholestatic liver disease a year in the United States. This means that it affects about 7 persons per 10,000 per year.
Does maralixibat improve quality of life for those with cholestasis?
Maralixibat did not prolong QoL in patients with mild-to-moderate cholestasis when compared with controls. The improvement in patient QoL associated with use of other agents should be carefully evaluated before withdrawal of treatment.
What is the average age someone gets cholestasis?
Patients who arrive at a tertiary care center for a referral for investigation related to chronic liver disease experience an average 4-year delay in diagnosis of cholestasis compared to patients with newly diagnosed disease.
How does maralixibat work?
MAR was effective in reducing bilirubin as a marker of acute cholestasis. MAR may be useful in treating cholestasis in patients with non-severe chronic liver disease.