Allergan picked up its lead NASH program, cenicriviroc, in its 2016 acquisition of Tobira Therapeutics. The drug had just failed a phase 2b trial in NASH, missing its primary endpoint of reducing a measure of fatty liver disease activity—called the NAS score—by two points. However, it delivered on one of two key secondary endpoints: improving fibrosis by at least one stage without the worsening of NASH. With regulators’ support, Tobira decided this should be the endpoint of cenicriviroc’s phase 3 program. And after inking a deal that could be worth $1.69 billion, Allergan is carrying the trial forward.
Also called CVC, cenicriviroc is a once-daily pill that blocks two chemokine receptors, CCR2 and CCR5, which are involved in inflammatory and fibrogenic pathways. The phase 3 AURORA study aims to enroll about 2,000 patients with NASH. The first part of the study is pitting CVC against placebo in NASH patients with stage 2 or stage 3 fibrosis, according to ClinicalTrials.gov. The second part of the trial will zero in on patients with more severe disease—that is, those with stage 3 fibrosis. Allergan has also teamed up with Novartis to test CVC in tandem with the latter’s FXR agonist tropifexor in a phase 2b study.