New drug aims to stop liver scarring in Alpha-1 patients

NCT ID NCT06165341

Disease control Sponsor: Takeda Source: ClinicalTrials.gov ↗

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This study tests a medicine called fazirsiran for people with Alpha-1 antitrypsin deficiency who already have mild liver scarring. The drug works by reducing the buildup of an abnormal protein in the liver that causes damage. About 50 participants will receive either fazirsiran or a placebo for around 2 years, and researchers will check safety and whether the drug slows or reverses liver scarring.

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Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 3

Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.

Participants

About 50 people

The number the study aims to enrol. It can still change while the study runs.

Started

Mar 2024

Expected to finish

Aug 2028

An estimate. End dates often move.

Lead sponsor

A company

The lead sponsor is a pharmaceutical, biotech, or medical-device company.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 to 75 years

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * In the opinion of the investigator, the participant is capable of understanding and fully complying with the protocol requirements and adhering to the protocol schedule. * The participant is able to read, understand, and complete the study questionnaires electronically per the investigator's judgment. * The participant signs and dates a written Informed Consent Form (ICF). Any required privacy authorization should also be signed before the initiation of any study procedures. * The participant, of any sex, is aged 18 to 75 years, inclusive. * The participant must have a diagnosis of the protease inhibitor Z mutation (PiZZ) genotype AATD. A diagnosis of PiZZ from source-verifiable medical records is permitted. Otherwise, participants must undergo PiZZ confirmatory testing (genotyping for PiS and PiZ alleles) at screening. PiMZ or PiSZ genotypes are not permitted. * The participant's liver biopsy core samples collected as per protocol requirements. * The participant has evidence of METAVIR stage F1 liver fibrosis, evaluated by a centrally read baseline liver biopsy during the screening period; or confirmed as meeting all the entry criteria by central reading from a previous biopsy conducted within 1 year before the estimated enrollment date using an adequate liver biopsy and slides as defined in the study laboratory manual. * The participant has a pulmonary status that meets the protocol requirements. * It must be confirmed that the participant does not have hepatocellular carcinoma (HCC). * Any participant who is taking statins, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or beta-1 selective adrenergic receptor inhibitors must have been receiving a stable dose of these medications for at least 8 weeks before randomization. All attempts are to be made for the participant to continue the same dose of the medication for the duration of study participation. * An adult participant must have a body mass index (BMI) between 18 and 39 kilogram per meter square (kg/m\^2), inclusive. * The participant has a 12-lead electrocardiogram at screening that, in the opinion of the investigator, has no abnormalities that could compromise the participant's safety in this study. * The participant is a nonsmoker. * If the participant was being treated with any respiratory medications including inhaled bronchodilators, inhaled anticholinergics, inhaled corticosteroids, or low-dose systemic corticosteroids (prednisone less than or equal to \[\<=10\] milligrams per day \[mg/d\] or its equivalent), the doses of the participant's medications must have remained unchanged for greater than or equal to (\>=) 4 weeks before screening. * The participant must have suitable venous access for blood sampling. * A person of childbearing potential (POCBP) must have a negative serum pregnancy test at screening and a negative urine pregnancy test on Day 1 before dosing. * The participant must use appropriate contraception methods (that is, highly effective methods for female and medically appropriate methods for male study participants) for the entire duration of the study and for 6 months after the last dose of study medication. The participant must not donate sperm for at least 6 months after the last dose of study medication. Exclusion criteria: * The participant has evidence of \>= F2 fibrosis based on liver biopsy during the screening period. * The participant has a history of liver decompensating events. * The participant has a history of varices based on a previous esophagogastroduodenoscopy. * The participant has portal vein thrombosis. * The participant has undergone a prior trans-jugular portosystemic shunt procedure. * The participant has evidence of other forms of chronic liver diseases. * The participant has a history of malignancy within the last 5 years, except for adequately treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer. Participants with curatively treated malignancies who have no evidence of metastatic disease and disease-free interval greater than (\>) 1 year may be enrolled after approval by the medical monitor. * The participant has an abnormal finding of clinical relevance at the screening evaluation and before administration of the first dose of study dosing that, in the opinion of the investigator, could adversely impact participant safety during the study or adversely impact study results. * The participant has any laboratory abnormalities at screening and before the first dose of the study drug that meet protocol parameters. * The participant is expected to have severe and unavoidable high-level exposure to inhaled pulmonary toxins during the study such as may occur with occupational exposure to mineral dusts or metals. * The participant has a recent lower respiratory tract infection, such as pneumonia, within the last 6 months before screening. The participant may be screened earlier based on principal investigator (PI) assessment of clinical recovery and return to baseline pulmonary function in discussion with the medical monitor. * The participant has a history of frequent pulmonary exacerbations (\>=2 moderate or severe exacerbations within 52 weeks before screening). * The participant is experiencing a pulmonary exacerbation at the time of screening (participant may be rescreened after the clinical resolution of an exacerbation). * The participant is receiving long-term, around-the-clock oxygen supplementation or supplemental oxygen with continuous positive airway pressure (CPAP) or bilevel positive airway pressure for acute respiratory failure. The following conditions are allowable for the participant to enter screening: short-term use of oxygen supplementation (example, for the management of acute chronic obstructive pulmonary disease \[COPD\] exacerbation) or CPAP for obstructive sleep apnea. * The participant has human immunodeficiency virus (HIV) infection as shown by the presence of anti-HIV antibody (seropositive). * The participant is seropositive for hepatitis B virus (HBV surface antigen positive and/or HBV core antibody positive without HBV surface antibody at screening) or hepatitis C virus (HCV) (detectable HCV Ribonucleic Acid \[RNA\] at screening). Cured HCV (positive antibody test without detectable HCV RNA for at least 6 months after treatment) is acceptable. * The participant has unstable, poorly controlled, or severe hypertension. Participants may be rescreened once their blood pressure (BP) is successfully controlled. * The participant has a history of torsades de pointes, ventricular rhythm disturbances (example, ventricular tachycardia), heart block (excluding first-degree block, being PR interval prolongation only), congenital long QT syndrome or new ST-segment elevation or depression or a new Q wave on ECG. Participants with a history of atrial arrhythmias should be discussed with the medical monitor. * The participant has symptomatic heart failure (per New York Heart Association guidelines), unstable angina, myocardial infarction, severe cardiovascular disease (ejection fraction less than \[\<\] 20 percent \[%\]), transient ischemic attack, or cerebrovascular accident within 6 months before screening. * The participant has a history of major surgery within 12 weeks of screening (or longer, at the discretion of the investigator). * The participant has a history of more than moderate alcohol consumption within 12 months before the screening visit. * The participant has a history of drug abuse (such as cocaine, phencyclidine) within 1 year before the screening visit or has a positive urine drug screen at screening. * The participant has previously been treated with fazirsiran or any other RNA interference (RNAi) for alpha-1 antitrypsin deficiency-associated liver disease (AATD-LD). * The participant has a history of hypersensitivity or allergies with any associated excipients of fazirsiran. * The participant has received an investigational agent or device within 30 days, or 5 half-lives, whichever is longer, before the dosing of study medication or is currently participating in an investigational study involving a therapeutic intervention. * The participant has donated \>=500 milliliter (mL) of blood within 1 month of the administration of study treatment. * The participant has any concomitant medical or psychiatric condition or social situation that would make it difficult to comply with protocol requirements or put the participant at additional safety risk. The participant has a history of clinically significant hematologic, renal, hepatic, pulmonary, neurologic, psychiatric, gastrointestinal (GI), systemic inflammatory, metabolic, or endocrine disorder or any other condition that, in the opinion of the investigator, rendered the participant a poor candidate for inclusion into the study. * The participant has a history of thromboembolic disease (including deep vein thrombosis or pulmonary embolism), within 6 months before screening, or is taking chronic anticoagulants. * This participant is unable to return for all scheduled study visits. * The participant has known or suspected coronavirus disease 2019 (COVID-19) that, in the opinion of the sponsor and investigator, does not resolve during screening. Positive antibody testing for COVID-19 without other evidence of current or recent active infection does not exclude participation. Enrollment of participants who fail inclusion due to COVID-19 infection may be temporarily delayed at the discretion of the sponsor and investigator. If the participant has a positive polymerase chain reaction (PCR) with no other evidence of infection, a retest may be allowed; however, to enroll in the study the participant must have a negative PCR. * The participant is a study site employee involved in the conduct of this study, an immediate family member (example, spouse, parent, child, sibling), is in a dependent relationship with study site employee who is involved in the conduct of this study or may consent under duress. * The participant takes or is required to take excluded medications. * The participant is pregnant or breastfeeding or intending to become pregnant before participating in this study, during the study, or within 6 months after last dose of the study drug; or the participant is intending to donate ova during such time period.

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Conditions

The condition(s) this trial relates to.

alpha 1-antitrypsin deficiency

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

ALPHA1-antitrypsin deficiency

How to take part

Only the study team decides who joins. These are the ways to reach them.

The study's own enquiry address

This study publishes an address for enquiries. See it below .
The places running it

40 sites in 12 countries. The list below names each one and where it is.
The official record

ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.

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A doctor treating you

A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.

Contacts and locations

Show contact details

Study contacts

Contact

Email: •••••@•••••

Locations

Bon Secours St. Mary's Hospital
RECRUITING

Newport, Virginia, 23602-4414, United States
Boston Medical Center
RECRUITING

Boston, Massachusetts, 02118-2335, United States
CCA Hospital Braga
RECRUITING

Braga, 4710-243, Portugal
Centro Hospitalar de Universitário de Santo António E.P.E
RECRUITING

Porto, 4099-001, Portugal
Charité - Campus Virchow-Klinikum
RECRUITING

Berlin, 13353, Germany
Columbia University Irving Medical Center
RECRUITING

New York, New York, 10032-3722, United States
Fondazione IRCCS Policlinico San Matteo
RECRUITING

Pavia, 27100, Italy
Hannover Medical School
RECRUITING

Hanover, 30625, Germany
Henry Ford Health System
RECRUITING

Novi, Michigan, 48377-3600, United States
Hopital PONTCHAILLOU CHU de Rennes
RECRUITING

Rennes, 35000, France
Hospital Dr. Nélio Mendonça
RECRUITING

Funchal, 9000-168, Portugal
Hospital Universitario Virgen del Rocio - PPDS
RECRUITING

Seville, 41018, Spain
Hôpital Paul Brousse
RECRUITING

Val-de-Marne, 94800, France
Hôpital de La Croix Rousse
RECRUITING

Lyon, 69317, France
ID Clinic Arkadiusz Pisula
WITHDRAWN

Mysłowice, 41-400, Poland
Indiana University School of Medicine-Indianapolis
RECRUITING

Indianapolis, Indiana, 46202-2266, United States
Inspiration Research Limited
RECRUITING

Toronto, Ontario, M5T 3A9, Canada
KABEG - Klinikum Klagenfurt Am Wörthersee
RECRUITING

Klagenfurt, 9020, Austria
Karolinska Universitetssjukhuset Huddinge
RECRUITING

Huddinge, 14186, Sweden
King's College Hospital
RECRUITING

London, SE5 9RS, United Kingdom
LKH-Universitätsklinikum Graz
RECRUITING

Graz, 8036, Austria
Mayo Clinic - PPDS
RECRUITING

Phoenix, Arizona, 85054-4502, United States
Mayo Clinic PPDS
RECRUITING

Rochester, Minnesota, 55905, United States
NYU Langone Medical Center
RECRUITING

New York, New York, 10016-6402, United States
Peak Gastroenterology Associates
RECRUITING

Colorado Springs, Colorado, 80907, United States
Penn State Health Milton S. Hershey Medical Center
RECRUITING

Hershey, Pennsylvania, 17033-2360, United States
Schiff Center for Liver Diseases/University of Miami
RECRUITING

Miami, Florida, 33136, United States

Contact Email: •••••@•••••
St Joseph's Hospital and Medical Center
RECRUITING

Phoenix, Arizona, 85013-4224, United States
Texas Liver Institute American Research Corporation
RECRUITING

San Antonio, Texas, 78215, United States
UCLA Pulmonary and Critical Care
RECRUITING

Los Angeles, California, 90095-3075, United States
UZ Antwerpen
RECRUITING

Antwerp, 2650, Belgium
UZ Leuven
RECRUITING

Leuven, 3000, Belgium
University Hospitals Cleveland Medical Center
RECRUITING

Cleveland, Ohio, 44106-1716, United States
University Of Iowa Hospitals And Clinics
RECRUITING

Iowa City, Iowa, 52242-1009, United States
University of Arizona Thomas D. Boyer Liver Institute
RECRUITING

Tucson, Arizona, 85724-0001, United States
University of California Benioff Children's Hospital
RECRUITING

San Francisco, California, 94143-2203, United States
University of California San Diego
RECRUITING

La Jolla, California, 92037-1337, United States
University of Michigan Hospital - 1500 E Medical Center Dr
RECRUITING

Ann Arbor, Michigan, 48109, United States
Universitätsklinikum Tübingen
RECRUITING

Tübingen, 72076, Germany
Universitätsklinikum der RWTH Aachen
RECRUITING

Aachen, 52074, Germany
Universitätsspital Bern
RECRUITING

Bern, 3010, Switzerland

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