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Trial · Interventional

CompletedPhase 2Results postedRegistry data

Study of Semaglutide, and Cilofexor/Firsocostat, Alone and in Combination, in Adults With Cirrhosis Due to Nonalcoholic Steatohepatitis (NASH)

Short name WAYFIND

NCTNCT04971785 (opens ClinicalTrials.gov in a new tab)Other idGS-US-454-6075Other id2021-001445-12Other idjRCT2071210112

Overview

Status
Completed
Phase
Phase 2
Enrollment
457 participants (actual)
Sponsor
Gilead Sciences · Industry
Design
Randomized · Double masking
Countries
7 countries

United States, Australia, Canada, France, Japan, Puerto Rico, Spain

Start
9 Aug 2021
Primary completion
12 Nov 2024
Completion
9 Dec 2024
First posted
21 Jul 2021
Last update posted
26 Nov 2025
Conditions
Nonalcoholic Steatohepatitis

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20212022202320242025
  1. Ph 2

    WAYFIND

    NCT04971785

    9 Aug 2021 to 9 Dec 2024

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

The goal of this clinical study is to understand whether the study drugs, semaglutide (SEMA) with the fixed-dose combination (FDC) of cilofexor/firsocostat (CILO/FIR), cause fibrosis improvement and Nonalcoholic Steatohepatitis (NASH) resolution in participants with cirrhosis due to NASH.

Interventions

  • Semaglutide (SEMA)Drug
  • Cilofexor (CILO)/Firsocostat (FIR)Drug
  • PTM SEMADrug
  • PTM CILO/FIRDrug

Arms4

  • Experimental

    SEMA + CILO/FIR FDC

    Participants will receive semaglutide (SEMA) 3.0 mg/mL, once weekly and cilofexor and firsocostat (CILO/FIR) 30 mg/20 mg fixed-dose combination (FDC) tablet, once daily up to 72 weeks.

  • Experimental

    SEMA + PTM CILO/FIR

    Participants will receive SEMA 3.0 mg/mL, once weekly and Placebo-To-Match (PTM) CILO/FIR FDC tablet, once daily up to 72 weeks.

  • Experimental

    PTM SEMA + CILO/FIR FDC

    Participants will receive PTM SEMA, once weekly and CILO/FIR 30 mg/20 mg FDC tablet, once daily up to 72 weeks.

  • Placebo comparator

    PTM SEMA + PTM CILO/FIR

    Participants will receive PTM SEMA, once weekly and PTM CILO/FIR FDC tablet, once daily up to 72 weeks.

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Percentage of Participants Who Achieved ≥ 1-Stage Improvement in Fibrosis Without Worsening of Nonalcoholic Steatohepatitis (NASH) at Week 72 in Semaglutide (SEMA) + Cilofexor/Firsocostat (CILO/FIR) Fixed Dose Combination (FDC) Versus Placebo Groups

    Time frame · Week 72

    Registry description

    Fibrosis improvement was defined as ≥ 1-stage decrease from baseline in fibrosis according to the NASH clinical research network (CRN) classification. Worsening of NASH was defined as ≥ 1-point increase from baseline in hepatocellular ballooning or lobular inflammation. Clopper-Pearson method was used in outcome measure analysis in each arm. Percentages were rounded-off.

Secondary outcomes(3)
  1. Percentage of Participants Who Achieved ≥1-Stage Improvement in Fibrosis Without Worsening of NASH at Week 72 in SEMA + CILO/FIR FDC Versus SEMA Alone

    Time frame · Week 72

    Registry description

    Fibrosis improvement was defined as ≥ 1-stage decrease from baseline in fibrosis according to the NASH CRN classification. Worsening of NASH was defined as ≥ 1-point increase from baseline in hepatocellular ballooning or lobular inflammation. Clopper-Pearson method was used in outcome measure analysis in each arm. Percentages were rounded-off.

  2. Percentage of Participants With NASH Resolution Without Worsening in Fibrosis at Week 72 in SEMA + CILO/FIR FDC Versus Placebo Groups

    Time frame · Week 72

    Registry description

    NASH resolution is defined as lobular inflammation of 0 or 1 and hepatocellular ballooning of 0. Worsening in fibrosis was defined as a change in fibrosis worsening stage as per NASH CRN criteria. Clopper-Pearson method was used in outcome measure analysis in each arm. Percentages were rounded-off.

  3. Percentage of Participants With NASH Resolution Without Worsening in Fibrosis In Participants Treated With SEMA + CILO/FIR FDC Versus CILO/FIR Alone Groups

    Time frame · Week 72

    Registry description

    NASH resolution is defined as lobular inflammation of 0 or 1 and hepatocellular ballooning of 0. Worsening in fibrosis was defined as a change in fibrosis worsening stage as per NASH CRN criteria. Clopper-Pearson method was used in outcome measure analysis in each arm. Percentages were rounded-off.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeNumber· Week 72

Percentage of Participants Who Achieved ≥ 1-Stage Improvement in Fibrosis Without Worsening of Nonalcoholic Steatohepatitis (NASH) at Week 72 in Semaglutide (SEMA) + Cilofexor/Firsocostat (CILO/FIR) Fixed Dose Combination (FDC) Versus Placebo Groups

GroupValue (percentage of participants)
SEMA + CILO/FIR FDC13.7
PTM SEMA + PTM CILO/FIR8.3
Secondary and other outcome results(3)
Secondary outcomeNumber· Week 72

Percentage of Participants Who Achieved ≥1-Stage Improvement in Fibrosis Without Worsening of NASH at Week 72 in SEMA + CILO/FIR FDC Versus SEMA Alone

GroupValue (percentage of participants)
SEMA + CILO/FIR FDC13.7
SEMA + PTM CILO/FIR15.6
Secondary outcomeNumber· Week 72

Percentage of Participants With NASH Resolution Without Worsening in Fibrosis at Week 72 in SEMA + CILO/FIR FDC Versus Placebo Groups

GroupValue (percentage of participants)
SEMA + CILO/FIR FDC57.3
PTM SEMA + PTM CILO/FIR22.4
Secondary outcomeNumber· Week 72

Percentage of Participants With NASH Resolution Without Worsening in Fibrosis In Participants Treated With SEMA + CILO/FIR FDC Versus CILO/FIR Alone Groups

GroupValue (percentage of participants)
SEMA + CILO/FIR FDC57.3
PTM SEMA + CILO/FIR FDC31.8

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
SEMA + CILO/FIR FDCParticipants received semaglutide (SEMA) 3.0 mg/mL subcutaneous (SC) injection once weekly and cilofexor and firsocostat (CILO/FIR) 30 mg/20 mg fixed-dose combination (FDC) tablet orally, once daily up to 72 weeks.0 / 12517 / 124101 / 124
SEMA + PTM CILO/FIRParticipants received SEMA 3.0 mg/mL SC injection, once weekly and Placebo-To-Match (PTM) CILO/FIR FDC tablet orally, once daily up to 72 weeks.1 / 12413 / 12297 / 122
PTM SEMA + CILO/FIR FDCParticipants received PTM SEMA SC injection, once weekly and CILO/FIR 30 mg/20 mg FDC tablet orally, once daily up to 72 weeks.1 / 12318 / 12385 / 123
PTM SEMA + PTM CILO/FIRParticipants received PTM SEMA SC injection, once weekly and PTM CILO/FIR FDC tablet orally, once daily up to 72 weeks.0 / 8511 / 8460 / 84

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies0

Studies that cite this trial.

No study cites this trial.

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years up to 80 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Key Inclusion Criteria: * Liver biopsy consistent with cirrhosis (F4) due to nonalcoholic steatohepatitis (NASH) in the opinion of the central reader. In individuals who have never had a liver biopsy, a screening liver biopsy may be performed. * Screening laboratory parameters as determined by the study central laboratory: * Estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m\^2, as calculated by the Modification of Diet in Renal Disease (MDRD) equation. * Hemoglobin A1c (HbA1c) ≤ 10% * International normalized ratio (INR) ≤ 1.4, unless due to therapeutic anticoagulation * Platelet count ≥ 125,000/µL * Alanine aminotransferase (ALT) \< 5 x upper limit of normal (ULN) * Serum albumin ≥ 3.5 g/dL * Serum alkaline phosphatase (ALP) ≤ 2 x ULN * Body mass index (BMI) ≥ 23 kg/m\^2 at screening. Key Exclusion Criteria: * Prior history of decompensated liver disease, including ascites, hepatic encephalopathy (HE), or variceal bleeding. * Child-Pugh (CP) score \> 6 at screening, unless due to an alternative etiology such as Gilbert's syndrome or therapeutic anticoagulation. * Model for End-stage Liver Disease (MELD) score \> 12 at screening, unless due to an alternative etiology such as therapeutic anticoagulation. * Other causes of liver disease based on medical history and/or central reader review of liver histology, including but not limited to: alcoholic liver disease, autoimmune disorders (eg, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis), drug-induced hepatotoxicity, Wilson disease, clinically significant iron overload, or alpha-1-antitrypsin deficiency. * Chronic hepatitis B virus (HBV) infection (HBsAg positive), or Chronic hepatitis C virus (HCV) infection (HCV antibody and HCV ribonucleic acid (RNA) positive). Individuals cured of HCV infection less than 2 years prior to the screening visit are not eligible. * History of liver transplantation. * Current or prior history of hepatocellular carcinoma (HCC). * Men who habitually drink greater than 21 units/week of alcohol or women who habitually drink greater than 14 units/week of alcohol (1 unit is equivalent to 12 ounce (oz)/360 mL of beer, a 4 oz/120 mL glass of wine, or 1 oz/30 mL of hard liquor). * For individuals on vitamin E regimen ≥ 800 IU/day, or pioglitazone, dose must be stable, in the opinion of the investigator for at least 180 days prior to the historical or screening liver biopsy. * For individuals on medications for diabetes, dose must be stable, in the opinion of the investigator, for at least 90 days prior to the historical or screening liver biopsy. * History of type 1 diabetes. * Treatment with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in the period from 90 days prior to the screening visit and for individuals with a qualifying historical liver biopsy, for 90 days prior to the date of the historical liver biopsy. * For individuals who have not completed a series of an authorized coronavirus disease 2019 (COVID-19) vaccination regimen prior to screening, a positive result for COVID-19 on severe acute respiratory syndrome (SARS)-coronavirus 2 (CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) test. Note: Other protocol defined Inclusion/Exclusion criteria may apply.

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