Trial of Obeticholic Acid in Patients With Moderately Severe Alcoholic Hepatitis (AH)
Condition: Alcoholic Hepatitis
MeSH terms: Hepatitis A; Hepatitis; Hepatitis, Alcoholic
Intervention: Placebo; 10 mg Obeticholic Acid (OCA)
Intervention description: 1 tablet of placebo, taken orally daily with water, approximately 30 minutes prior to breakfast for 6 weeks.; 10 mg Obeticholic Acid (OCA) Study medication will be administered orally, once daily, approximately 30 minutes prior to breakfast for 6 weeks.
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 19.0
Sex: All
Minimum age: 21 Years
Healthy volunteers: No

Summary:

      The main purpose of this study is to test the effectiveness of Obeticholic Acid when used in
      patients with moderately severe alcoholic hepatitis. The researchers suspect that individuals
      with alcoholic hepatitis have certain abnormalities in how their body handles bile acids (a
      product made by the liver on a daily basis) produced by the liver. Obeticholic acid has been
      shown to affect bile acid abnormalities and thus it is possible that obeticholic acid may
      improve liver condition in individuals with alcoholic hepatitis.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Individuals ≥ 21 years with a diagnosis of acute AH. The diagnosis of acute alcoholic
             hepatitis will be based on clinical features and testing including hepatomegaly,
             jaundice, fever, leukocytosis, compatible liver biochemistries in the context of heavy
             alcohol consumption. A liver biopsy is not mandatory, but will be required to confirm
             the diagnosis if a firm diagnosis of AH cannot be made on clinical and laboratory
             criteria

          -  Moderate severity defined as MELD score > 11 and < 20

          -  Heavy alcohol consumption (defined as > 40 grams per day on average in women and > 60
             grams per day on average in men for a minimum of 6 months and within the 6 weeks prior
             to study enrollment)

          -  Written informed consent

          -  Negative urine pregnancy test where appropriate

          -  Women of child bearing potential should be willing to practice contraception
             throughout the treatment period

        Exclusion Criteria:

          -  Significant active infection (e.g., sepsis, or spontaneous bacterial peritonitis;
             SBP). Subjects can be reconsidered after the infection is under control.

          -  Serum creatinine > 2.5 mg/dL

          -  Must not be receiving systemic steroids > 1 week at the time of Screening or any
             experimental medicines for AH

          -  Presence of any other disease or condition that is interfering with the absorption,
             distribution, metabolism, or excretion of drugs including bile salt metabolism in the
             intestine. Patients who have undergone gastric bypass procedures will be excluded
             (gastric lap band is acceptable).

          -  Participation in another investigational drug, biologic, or medical device trial
             within 30 days prior to screening