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NCT Number: NCT07221188

A Clinical Study to Investigate the Safety and Tolerability of Efimosfermin Alfa Injection in Participants With Known or Suspected F2- or F3-stage MASH

This study will evaluate the safety and tolerability of Efimosfermin Alfa for participants with known or suspected MASH with fibrosis consistent with stage F2 or F3.

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Key information

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

GSK Investigational Site, Pokfulam, Hong Kong

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Able and willing to understand and sign a written informed consent form (ICF) that must be obtained prior to the initiation of study procedures
  • Age >=18 through <=75 years at enrolment
  • History or presence of 2 or more of the 5 components of metabolic syndrome per American Heart Association definition
  • History or presence of known or suspected MASH with evidence of fibrosis

Exclusion criteria

  • ALT or AST >=5 × upper limit of normal (ULN)
  • Total bilirubin (BILI) >=1.3 milligram per deciliter (mg/dL). Individuals with documented Gilbert's syndrome may be enrolled if they experienced an isolated increase in total BILI of >=1.3 mg/dL and direct BILI is <=20% of total BILI; otherwise, the individual will be excluded.
  • Serum albumin <=3.5 grams per deciliter (g/dL)
  • International normalized ratio (INR) >=1.3 not due to therapeutic anticoagulation. Individuals receiving chronic anticoagulant treatment with higher INR values may be enrolled at the discretion of the Investigator and Study Medical Monitor.
  • Alkaline phosphatase (ALP) >=2 × ULN
  • Platelet (PLT) count <140 000 per (/) cubic millimeter (mm^3); individuals with a PLT count between 110,000/mm^3 and 140,000/mm^3 may be enrolled after discussion with the Study Medical Monitor
  • Serum creatinine >=1.5 mg/dL or creatinine clearance <=60 milliliter (mL)/minute (min)/1.73 square meter by Chronic Kidney Disease Epidemiology Collaboration equation.
  • Alpha-fetoprotein >=20 nanogram per milliliter (ng/mL)
  • HbA1c >=9.0%
  • Model for End-Stage Liver Disease (MELD) 3.0 score >=12 unless the score is elevated in the absence of liver dysfunction (eg, Gilbert's syndrome)
  • Phosphatidylethanol (PEth) >=80 nanogram per milliliter (ng/mL) at Screening
  • Known co-infection with any of the following: a. Human immunodeficiency virus; b. Hepatitis B virus; c. Hepatitis C virus (HCV); d. Hepatitis D virus; or e. Hepatitis E virus.
  • Chronic liver disease from any other cause including, but not limited to, alcoholic liver disease; evidence of portal hypertension; viral hepatitis, or any history or evidence of cirrhosis; or decompensated liver disease such as clinical ascites, bleeding gastroesophageal varices, hepatorenal syndrome, or hepatic encephalopathy prior to Screening or Day 1.
  • Current or history of excessive alcohol intake for >=3 months within the 12-month period prior to Screening

Treatment and study plan

Efimosfermin alfa

Drug

Efimosfermin Alfa will be administered

Placebo

Drug

Placebo will be administered

Primary outcomes

  1. Number of participants with treatment-emergent adverse events (TEAEs) and TEAEs by severity

    Time frame: At Week 52

  2. Number of participants with TEAEs leading to discontinuation and TEAEs leading to discontinuation by severity

    Time frame: At Week 52

  3. Number of participants with Grade 3 and Grade 4 laboratory abnormalities

    Time frame: At Week 52

Secondary outcomes

  1. Absolute Change from Baseline in enhanced liver fibrosis (ELF) score

    Time frame: Baseline (Day 1) and up to Week 52

    The ELF score will be calculated using a published algorithm combining the values of a set of extracellular matrix markers. The ELF score is used as a prognostic marker for disease progression: ELF score less than (<) 9.8: Low risk of progression, ELF score 9.8 to <11.3: Moderate risk of progression and ELF score greater than or equal to (>=) 11.3: High risk of progression.

  2. Percent Change from Baseline in ELF score

    Time frame: Baseline (Day 1) and up to Week 52

    The ELF score will be calculated using a published algorithm combining the values of a set of extracellular matrix markers. The ELF score is used as a prognostic marker for disease progression: ELF score <9.8: Low risk of progression, ELF score 9.8 to <11.3: Moderate risk of progression and ELF score >=11.3: High risk of progression.

  3. Number of participants achieving an improvement in ELF score greater than equal to 0.5

    Time frame: At Week 52

    The ELF score will be calculated using a published algorithm combining the values of a set of extracellular matrix markers. The ELF score is used as a prognostic marker for disease progression: ELF score <9.8: Low risk of progression, ELF score 9.8 to <11.3: Moderate risk of progression and ELF score >=11.3: High risk of progression.

  4. Absolute Change from Baseline in vibration-controlled transient elastography (VCTE)- liver stiffness measurement (LSM) scores

    Time frame: Baseline (Day 1) and up to Week 52

  5. Percent Change from Baseline in VCTE- LSM scores

    Time frame: Baseline (Day 1) and up to Week 52

  6. Number of participants achieving a change from Baseline in VCTE-LSM >=30 percentage (%)

    Time frame: Baseline (Day 1) and up to Week 52

  7. Absolute Change from Baseline in magnetic resonance elastography (MRE) scores in the subset of participants

    Time frame: Baseline (Day 1) and up to Week 52

    MRE is a non-invasive imaging technique that combine magnetic resonance imaging (MRI) scanning with low-frequency mechanical vibrations to measure the stiffness of liver. MRE scores <2.5 is normal, 2.5 - 3.0 Normal or inflammation, 3.0 - 3.5 Stage 1-2 fibrosis, 3.5 - 4.0 Stage 2-3 fibrosis, 4.0 - 5.0 Stage 3-4 fibrosis and > 5.0 Stage 4 fibrosis.

  8. Percent Change from Baseline in the subset of participants with magnetic resonance elastography (MRE) scores

    Time frame: Baseline (Day 1) and up to Week 52

    MRE is a non-invasive imaging technique that combine MRI scanning with low-frequency mechanical vibrations to measure the stiffness of liver. MRE scores <2.5 is normal, 2.5 - 3.0 Normal or inflammation, 3.0 - 3.5 Stage 1-2 fibrosis, 3.5 - 4.0 Stage 2-3 fibrosis, 4.0 - 5.0 Stage 3-4 fibrosis and > 5.0 Stage 4 fibrosis.

  9. Absolute Change from Baseline in hepatic fat fraction (HFF) by magnetic resonance imaging (MRI)- derived proton density fat fraction (PDFF)

    Time frame: Baseline (Day 1) and up to Week 52

    HFF is the percentage of fat in the liver measured by MRI proton density fat fraction technique, which ranges from 0-75%. Greater than 5% is considered extra fat in the liver.

  10. Percent Change from Baseline in HFF by MRI-PDFF

    Time frame: Baseline (Day 1) and up to Week 52

    HFF is the percentage of fat in the liver measured by MRI proton density fat fraction technique, which ranges from 0-75%. Greater than 5% is considered extra fat in the liver.

  11. Absolute Change from Baseline in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (International units per liter)

    Time frame: Baseline (Day 1) and up to Week 52

  12. Absolute Change from Baseline in ALT and AST ratio (ALT/AST)

    Time frame: Baseline (Day 1) and up to Week 52

  13. Percent Change from Baseline in ALT and AST (International units per liter)

    Time frame: Baseline (Day 1) and up to Week 52

  14. Percent Change from Baseline in ALT and AST ratio (ALT/AST)

    Time frame: Baseline (Day 1) and up to Week 52

  15. Number of participants achieving ALT and HFF normalization

    Time frame: At Week 52

  16. Number of participants achieving HFF less than equal to (<=) 5%

    Time frame: At Week 52

    HFF is the percentage of fat in the liver measured by MRI proton density fat fraction technique, which ranges from 0-75%. Less than or equal to 5% is considered normal (no significant fatty infiltration (steatosis) in the liver.

  17. Change from Baseline in glycated hemoglobin (HbA1c) for participants with type 2 diabetes mellitus (T2DM)

    Time frame: Baseline (Day 1) and up to Week 52

  18. Change from Baseline in body weight for all participants(kilograms)

    Time frame: Baseline (Day 1) and up to Week 52

  19. Change from Baseline in fasting total cholesterol, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)- cholesterol, and fasting triglycerides (Millimoles per liter)

    Time frame: Baseline (Day 1) and up to Week 52

  20. Number of Participants with antidrug and anti-fibroblast growth factor 21 (FGF21) antibodies (ADA) at Week 52

    Time frame: At Week 52

  21. Serum drug Concentration of efimosfermin alfa

    Time frame: Up to Week 52

Study contacts

Contact information is provided by the study sponsor or research team.

EU GSK Clinical Trials Call Center

CONTACT

[email protected]

+44 (0) 20 89904466

US GSK Clinical Trials Call Center

CONTACT

[email protected]

877-379-3718

Sponsors and collaborators

Lead sponsor

GlaxoSmithKline

Industry

Registry information

Official study title

A Phase 3, Randomized, Double-Blind, Placebo-Controlled, 3-Arm Study to Investigate the Safety and Tolerability of Efimosfermin Alfa in Participants With Known or Suspected F2- or F3-Stage Metabolic Dysfunction-Associated Steatohepatitis (MASH) (ZENITH-2)

Acronym: ZENITH-2

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Oct 27, 2025
Registry last updated
Jul 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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