FOR US RESIDENTS ONLY

Pruritus often occurs with jaundice but can also be the first sign of cholestasis, appearing before jaundice or
other symptoms. Its prevalence varies by condition, but affects up to 80% of patients with PSC and PBC.2

The symptoms of PSC and PBC don't just affect physical
health—they also take a toll on your patients' quality of life.3


96%
Indicated that evening and nighttime were the worst times of the day for itching

50%
Reported that itch led to disruption of day-to-day responsibilities

45%
Reported itch lasting ≥1 month in duration

Learn about our investigational medicine—volixibat—in helping treat itch in PSC and PBC4,5

As a healthcare provider, you’re aware the current treatment options for cholestatic itch are limited, leaving many patients with unmet needs. Our clinical trials seek to explore volixibat, a minimally absorbed, orally administered ileal bile acid transporter (IBAT) inhibitor, as a potential treatment for itch associated with PSC and PBC. IBAT is a protein primarily responsible for recycling bile acids from the intestine to the liver. Participants will be asked to record their itch once per day. The primary endpoint of the trials is the change in pruritus from baseline. Secondary endpoints include safety and tolerability, markers of disease progression, and quality of life (QoL). Long-term assessments will focus on changes in pruritus and QoL, markers of disease progression, and overall safety.

Study designs for our two trials4,5

VISTAS Trial Design

VANTAGE Trial Design

Dose:

  • Volixibat or placebo 
2x/day by mouth

Primary endpoint:

  • Change in pruritus from Baseline through 28 weeks

Secondary endpoints:

  • Safety & tolerability
  • Markers of disease and QoL

Long-term assessments:

  • Change in pruritus and QoL
  • Markers of disease progression
  • Safety

Your patients will have the convenient option of participating in our studies from the comfort of their homes. They will be monitored by the study doctor through a mix of telemedicine and home visits. The study doctor’s role is limited to the clinical study. While in the study, you will continue to see your patients for routine medical care and prescriptions.

Learn more about our clinical trials

SubjectWell Spacer

Volixibat mechanism of action6

Volixibat works by blocking an important bile acid transport protein on the surface of the small intestine. This results in more bile acids being excreted in the feces. This leads to lower levels of bile acids systemically, thereby potentially reducing bile acid–mediated liver damage and its related effects and complications. Additionally, volixibat is designed to be minimally absorbed into the bloodstream.


For illustrative purposes only.

Study eligibility4,5

Review the following criteria to determine if your patient qualifies for the VISTAS Study.

Ages Eligible for Study: 12 Years and older
Sexes Eligible for Study: All
Accepts Healthy Volunteers: No

Inclusion Criteria:

  • Provide freely signed informed consent and assent (as applicable) and be willing to comply with all study visits and requirements through end of study, including the follow-up period.
  • Subjects aged ≥12 years for eligible regions; otherwise ≥18 years.
  • Confirmed diagnosis of large duct or small duct PSC based on American Association for the Study of Liver Disease (AASLD) guidelines.
  • Pruritus associated with PSC as assessed by Adult ItchRO.
  • Ursodeoxycholic acid (UDCA) and anti-pruritic medication use will be allowed if meeting additional criteria.
  • Concomitant Inflammatory Bowel Disease (IBD) is allowed if meeting additional criteria.

Exclusion Criteria:

  • Pruritus associated with an etiology other than PSC.
  • Evidence or clinical suspicion of decompensated cirrhosis, or a history of decompensation events.
  • History of ileostomy or small bowel surgery/resection or other surgeries that may have disrupted the enterohepatic circulation.
  • Evidence, history, or suspicion of other liver disease; PSC patients with AIH are not excluded.
  • Bile duct stent or percutaneous bile duct drain placement, or balloon dilatation procedure of a stricture within 12 weeks of screening.
  • Exceeding pre-defined biochemical values for alanine aminotransferase/ aspartate aminotransferase (ALT/AST), estimated glomerular filtration rate (eGFR), serum creatinine (sCr), platelet count, international normalized ratio (INR) and total bilirubin.
  • History of liver transplantation.

Review the following criteria to determine if your patient qualifies for the VANTAGE Study.

Ages Eligible for Study: 18 Years and older
Sexes Eligible for Study: All
Accepts Healthy Volunteers: No

Inclusion Criteria:

  • Provide signed informed consent at the screening visit as well as comply with all study visits and requirements through the end of the study.
  • Male or female, age ≥18 years at the screening visit.
  • Confirmed diagnosis of PBC in line with the AASLD guidelines.
  • UDCA and anti-pruritic medication use will be allowed if meeting additional criteria.
  • Qualified pruritus associated with PBC as assessed by Adult ItchRO.

Exclusion Criteria:

  • Pruritus associated with an etiology other than PBC.
  • Evidence or clinical suspicion of decompensated cirrhosis or a history of decompensation events.
  • Current symptomatic cholelithiasis or inflammatory gallbladder disease.
  • History of small bowel surgery/resection impacting the terminal ileum that may disrupt the enterohepatic circulation.
  • Evidence, history, or suspicion of other liver diseases; PBC patients with AIH are not excluded.
  • History of liver transplantation.
References

1. Patel SP, Vasavda C, Ho B, Meixiong J, Dong X, Kwatra SG. Cholestatic pruritus: Emerging mechanisms and therapeutics. J Am Acad Dermatol. 2019;81(6):1371-1378. doi:10.1016/j.jaad.2019.04.035. 2. Hegade VS, Kendrick SF, Jones DE. Drug treatment of pruritus in liver diseases. Clin Med (Lond). 2015;15(4):351-357. doi:10.7861/clinmedicine.15-4-351. 3. Kowdley KV, et al. Presented at EASL 2022. 4. ClinicalTrials.gov. NCT04663308.​ Updated February 10, 2025. Accessed February 11, 2025. https://clinicaltrials.gov/ct2/show/NCT04663308. 5. ClinicalTrials.gov. NCT05050136. Updated February 5, 2025. Accessed February 10, 2025. https://clinicaltrials.gov/ct2/show/NCT05050136. 6. National Center for Biotechnology Information. PubChem Compound Summary for CID 24987688, Volixibat. Accessed Feb. 12, 2025. https://pubchem.ncbi.nlm.nih.gov/compound/Volixibat. 7. Gonzales E, et al. Lancet. 2021;398:1581-1592. 8. Colapietro F, Gershwin ME & Lleo A. J Autoimmun. 2023;6:100188. 9. Bowlus CL, et al. Hepat Med. 2016;8:89-95.