A Study to Assess How Well and Safely Elafibranor Works in Adult Participants With Primary Sclerosing Cholangitis

• Elafibranor (Drug), also known as IPN60190: Round and orange film coated tablet of 120 mg
• Placebo (Other): Round and orange film coated tablet of placebo

Primary outcomes

• Event-Free Survival [From baseline until the end of treatment (estimated up to 5 years)]: Event-free survival is defined as the time from randomisation to either adjudicated disease progression or death, whichever occurs first.

Secondary outcomes

• Percentage of participants with ALP level within the pre-defined level [From baseline to Week 48]: Difference between elafibranor and placebo in the percentage of participants with alkaline phosphatase (ALP) within the pre-defined level at Week 48.
• Change from baseline in severity of a patient-reported cholestatic symptom: Pruritus [From baseline to Week 24]: Symptom will be assessed using a patient-reported outcome scale
• Change from baseline in severity of a patient-reported cholestatic symptom: Fatigue [From baseline to Week 48]: Symptom will be assessed using a patient-reported outcome scale
• Percentage of participants experiencing treatment-emergent adverse events (TEAEs), Serious Adverse Events (SAEs), and Adverse Events of Special Interests (AESIs) [From baseline until the end of treatment (estimated up to 5 years)]: An Adverse event (AE) is any untoward medical occurrence, temporally associated with the use of study intervention, whether or not related to the study intervention. AESIs are AEs that may not be serious but are of special importance to a particular drug or class of drugs
• Percentage of participants developing clinically significant changes in physical examination findings [From baseline until the end of treatment (estimated up to 5 years)]: The clinical significance will be graded by the investigator
• Percentage of participants developing clinically significant changes in vital signs [From baseline until the end of treatment (estimated up to 5 years)]: The clinical significance will be graded by the investigator
• Percentage of participants developing clinically significant changes in Electrocardiogram (ECG) readings. [From baseline until the end of treatment (estimated up to 5 years)]: The clinical significance will be graded by the investigator
• Percentage of participants with clinically significant changes in laboratory parameters (blood chemistry, hematology, coagulation and urinalysis) [From baseline until the end of treatment (estimated up to 5 years)]: The clinical significance will be graded by the investigator
• Percentage of participants developing cholangiocarcinoma (CCA), hepatocellular carcinoma (HCC), or colorectal cancer (CRC) [From baseline until the end of treatment (estimated up to 5 years)]

Sex: All, ages: 18 Years to 75 Years

Inclusion Criteria:

* Adults participants aged 18 years or older
* Confirmed diagnosis of primary sclerosing cholangitis based on standard clinical, biochemical, and imaging criteria
* Compensated liver disease at screening
* Stable background therapy, where applicable prior to study entry
* Women of childbearing potential have to apply during the entire duration of the study a highly effective method of birth control
* Ability to provide written informed consent and comply with study procedures.

Exclusion Criteria:

\- History or presence of other concomitant chronic liver disease

\- History of hepatic decompensation, including: i) History of liver transplantation, current MELD 3.0 score ≥12 due to hepatic impairment.

ii) Evidence of complications of cirrhosis

* Participants with cirrhosis who are also classified as Child-Pugh B or C based on the Child Pugh score.
* History of biliary intervention within 60 days prior to the screening period, and/or presence of percutaneous drain or bile duct stent at SV.
* History of bacterial cholangitis, and/or participant on antibiotics for prophylaxis of recurrent cholangitis within 60 days prior to the SV.
* History or any current suspicion of cholangiocarcinoma or hepatocellular carcinoma
* Known malignancy or history of malignancy within the last 5 years, with the exception of local, successfully treated basal cell carcinoma or in-situ carcinoma of the uterine cervix.
* Medical conditions that may cause non-hepatic increases in ALP (e.g. Paget's disease).
* Administration of the following medications are prohibited as specified below:

  i) 3 months prior to baseline: norucholic acid, fibrates, seladelpar and glitazones.

ii) 3 months prior to baseline: cyclosporine, mycophenolate, pentoxifylline, and chronic systemic corticosteroids (except as part of management of IBD at an ongoing stable dose); potentially hepatotoxic drugs (including α-methyl-dopa, sodium valproic acid, isoniazid, or nitrofurantoin).

* Participants who are currently participating in, plan to participate in, or have participated in an investigational drug or medical device study containing active substance within 30 days or five half-lives, whichever is longer, prior to the SV. - Participants with previous exposure to elafibranor.
* Electrocardiogram (ECG) with QT interval corrected by Fridericia's formula (QTcF) >450 msec in males or QTcF >470 msec in females for participants without bundle branch block.
* Significant renal disease,
* For female participants: known pregnancy, or has a positive serum pregnancy test, or lactating.
* Regular alcohol intake in excess of the recommended limit of 2 standard drinks per day for men or 1 standard drink per day for women
* History of alcohol abuse, or other substance abuse within 1 year prior to SV.
* Sensitivity to any of the study interventions, or components thereof, or drug or other allergy that contraindicates participation in the study.
* Mental instability or incompetence
* Participant has or is known to have tested positive for human immunodeficiency virus (HIV) type 1 or 2 at SV.
* Medical conditions that may diminish life expectancy to <2 years.

131 more sites not listed.

• Ipsen Medical Director, Study director, Ipsen