Miricorilant to reduce liver fat in people with MASLD

A Phase 1, Open-Label Study Evaluating the Effect of Miricorilant on Hepatic Lipids in Patients With Presumed Metabolic Dysfunction-Associated Steatohepatitis (MASH)

This trial will try a daily 100 mg dose of miricorilant to reduce liver fat in adults with MASLD/MASH who have at least 8% liver fat on MRI.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 8 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Corcept Therapeutics (Industry-sponsored)
• Locations: 1 site (Columbia, Missouri)
• Trial ID: NCT06947304 on ClinicalTrials.gov

What this trial studies

This is an open-label Phase 1 trial enrolling about eight participants to receive a single cohort dose of miricorilant 100 mg daily. Participants undergo a screening period, six weeks of treatment, and a four-week follow-up, for up to 16 weeks of total participation. Liver fat is measured by MRI-PDFF (required within four weeks of baseline) to determine change in hepatic lipids. The trial is conducted at a single site and focuses on short-term safety and signal of effect on liver fat.

Who should consider this trial

Good fit: Adults with MASLD/MASH/NAFLD who have MRI-PDFF ≥ 8% and meet the trial's liver enzyme or qualifying biopsy criteria (including certain NAS and fibrosis scores) are ideal candidates.

Not a fit: People with advanced fibrosis or cirrhosis, other causes of liver disease, or who do not meet the MRI-PDFF or enzyme/biopsy criteria are unlikely to benefit from this small Phase 1 test.

Why it matters

Potential benefit: If successful, the drug could lower liver fat and may lead to improvements in liver inflammation and future treatment options for MASLD/MASH.

How similar studies have performed: Early-phase work on miricorilant and other agents that modulate glucocorticoid signaling has shown preliminary metabolic signals, but clinical proof of meaningful liver-fat reduction remains limited.

Eligibility criteria

Inclusion Criteria:

* AST \> 17 U/L for women and AST \> 20 U/L for men. The AST inclusion criterion does not apply to participants with an eligible historical liver biopsy performed within 12 months of screening showing one of the following:

  1. NAFLD Activity Score (NAS) ≥ 4 (with at least 1 point in each subcomponent of steatosis, inflammation, and ballooning) and NASH Clinical Research Network (CRN) fibrosis score of F0 OR
  2. NAS ≥ 3 (with at least 1 point in each subcomponent of steatosis, inflammation, and ballooning) and NASH CRN fibrosis score of F1 OR
  3. NAS ≥ 2 (with at least 1 point in subcomponent of ballooning or inflammation) and a NASH CRN fibrosis score of F2-3
* MRI-PDFF with ≥ 8% steatosis; this assessment must be performed within 4 weeks of the Baseline Visit.
* Presence of at least 1 of the following metabolic syndrome characteristics that increase the risk of MASH:

  a. Diagnosis of type 2 diabetes managed with diet alone or diet and metformin (metformin dose must be stable for at least 1 month prior to screening) OR b. Presence of 3 or more components of metabolic syndrome: i. Fasting blood glucose ≥ 100 mg/dL (5.6 mmol/L) or treatment for elevated blood glucose with metformin ii. Systolic blood pressure ≥ 130 mm Hg, diastolic blood pressure ≥ 85 mm Hg, or treatment for hypertension iii. Serum TG ≥ 150 mg/dL (1.7 mmol/L) iv. Serum high-density lipoprotein cholesterol (HDL) \< 40 mg/dL (1 mmol/L) in men and \< 50 mg/dL (1.3 mmol/L) in women or drug treatment for low HDL v. Having overweight or obesity (body mass index \[BMI\] ≥ 25 kg/m2 \[BMI
  * 23 kg/m2 in Asians\]), or increased waist circumference ≥ 102 cm (40 in) in men and ≥ 88 cm (35 in) in women (men ≥ 90 cm \[35.4 in\]; women ≥ 80 cm \[31.5 in\] in Asians).

Other inclusion criteria may apply

Exclusion Criteria:

* Participation in another clinical trial for MASH or weight loss (e.g., GLP-1 receptor agonists) within the last 3 months.
* Participation in any other clinical trial within the last 3 months or 5 half-lives of the treatment, whichever is longer.
* Women who are pregnant, planning to become pregnant, or lactating.
* BMI \< 18 kg/m² or \> 45 kg/m².
* Significant alcohol consumption exceeding 20 g/day for women or 30 g/day for men within 1 year prior to screening.
* Positive urine drug screen for amphetamines, cocaine, opiates, or cannabinoids.
* Known or suspected cirrhosis or signs of hepatic decompensation.
* Other chronic liver diseases such as hepatitis B or C, autoimmune hepatitis, primary biliary cholangitis, or Wilson's disease.
* History of myocardial infarction, unstable angina, or stroke within 3 months prior to screening.
* Uncontrolled hypertension (systolic \> 160 mm Hg or diastolic \> 100 mm Hg).
* Current use of medications prohibited due to potential drug-drug interactions with study treatment.
* Contraindications to magnetic resonance imaging (MRI).

Other exclusion criteria may apply

Where this trial is running

Columbia, Missouri

• University of Missouri — Columbia, Missouri, United States (Recruiting)

Study contacts

• Study coordinator: Elizabeth Parks, PhD

Conditions Nonalcoholic Steatohepatitis; Metabolic Dysfunction-Associated Steatohepatitis; Metabolic Dysfunction-Associated Steatotic Liver Disease; Non-alcoholic Fatty Liver Disease; Nonalcoholic Fatty Liver Disease; Metabolic dysfunction-Associated Steatohepatitis; Metabolic dysfunction-Associated Steatosis Liver Disease