FIREFLY Trial: Fenofibrate Intervention---Randomized Evaluation in First-Line PBC Therapy

NCT07296458 | Recruiting Phase 3

• 1 other identifier: KY-20252505
• Study Type: interventional
• Target: 132
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn if the drug Fenofibrate works to treat adults with a liver disease called Primary Biliary Cholangitis (PBC) who have not received previous treatment. It will also learn about the safety of Fenofibrate. The main questions it aims to answer are: Is Fenofibrate better at helping the liver return to normal function (measured by a blood test called ALP) than the standard medication, Ursodeoxycholic What kind of medical problems do participants have when taking Fenofibrate compared to those taking UDCA? Researchers will compare Fenofibrate to the active drug UDCA (the current standard treatment) to see which one works better.\*\* Participants will: Be randomly assigned to take either Fenofibrate plus a UDCA placebo, or UDCA plus a Fenofibrate placebo, every day for 12 months. (Neither they nor their doctor will know which group they are in.) Visit the clinic 5 times over the year (at 1, 3, 6, 9, and 12 months) for check-ups, blood tests, and questionnaires. Undergo a special scan (like FibroScan) to measure liver stiffness at some visits. Be encouraged to have a liver biopsy at the start and end of the study to provide detailed information about liver health (this is optional).

Conditions

Primary Biliary Cholangitis (PBC)

Outcome Measures

Primary Outcomes (1)

• Percentage of Participants with Normal ALP level

  at 12 months

Secondary Outcomes (10)

• Percentage of Participants with both ALP and total bilirubin normalisation

  12 months

• Percentage of participants with ALP normalization

  1, 3, 6, and 9 months of treatment

• Absolute and relative changes in ALP compared to baseline

  1, 3, 6, 9, and 12 months of treatment

• Changes in ALT compared to baseline

  1, 3, 6, 9, and 12 months of treatment

• Changes in AST compared to baseline

  1, 3, 6, 9, and 12 months of treatment

Study Arms (2)

Fenofibrate

EXPERIMENTAL

Drug: Fenofibrate

UDCA

ACTIVE COMPARATOR

Drug: UDCA (Ursodeoxycholic acid)

Interventions

Fenofibrate DRUG

Fenofibrate 200mg+placebo

Fenofibrate

UDCA (Ursodeoxycholic acid) DRUG

UDCA13-15mg/kg/day+placebo

UDCA

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Voluntarily join the group and be able to understand and sign the informed consent form;
• Age: 18 years old or above and below 75 years old;
• The diagnosis of primary biliary cholangitis follows the AASLD international diagnostic and treatment guidelines (meeting two of the following three criteria: positive AMA or gp210, sp100; elevated serum ALP; pathological manifestations of non-suppurative cholangitis and interlobular bile duct destruction);
• The patient did not receive UDCA and fenofibrate treatment in the 6 months before enrollment, and ALP was greater than the upper limit of normal (ULN).

You may not qualify if:

• Combined liver diseases caused by other factors: including viral hepatitis, chronic alcoholic hepatitis, steatohepatitis, drug-induced hepatitis, autoimmune hepatitis, primary sclerosing cholangitis, etc;
• Pregnant women, lactating women, or those who plan to give birth during the study period;
• Individuals who are allergic to fenofibrate or ursodeoxycholic acid;
• At the time of diagnosis or in the past, there have been variceal bleeding, hepatic encephalopathy, ascites, spontaneous bacterial peritonitis, hepatocellular carcinoma, and hepatorenal syndrome;
• Individuals with a history of severe diseases or functional failures in the heart, cerebrovascular system, kidneys, respiratory system, as well as mental illnesses (including those caused by alcohol and drug abuse);
• Transaminase greater than 5×ULN, or total bilirubin greater than 3×ULN;
• Creatinine level greater than 1.5×ULN;
• Glomerular filtration rate (GFR) ≤ 45 mL/min/1.73 m2;
• International normalized ratio (INR) ≥ 1.5 (for patients undergoing anticoagulant therapy, an INR value within the therapeutic target range is sufficient);
• Subjects who have received treatment with obeticholic acid and other fibrates (such as gemfibrozil, bezafibrate, pemafibrate, Elafibranor, Seladelpar, Lanifibranor, Saroglitizar, etc.) within the previous 6 weeks prior to screening;
• Screening for individuals who have taken colchicine, methotrexate, azathioprine, or undergone systemic hormone therapy for more than 2 weeks within the previous 2 months;
• Is currently undergoing treatment with immunosuppressants (such as cyclosporine, tacrolimus, and related biologics);
• Plan to receive organ transplantation or have already undergone organ transplantation;
• Clear history of HIV infection or HIV antibody positive during the screening period;
• Screen for individuals with a clear history of malignant tumor or anti-tumor treatment within the previous 2 years;

Sponsors & Collaborators

• Xijing Hospital of Digestive Diseases: lead

Study Sites (1)

Xijing Hospital

Xi'an, Shaanxi, 710032, China

RECRUITING

MeSH Terms

Conditions

Liver Cirrhosis, Biliary

Interventions

Fenofibrate; Ursodeoxycholic Acid

Condition Hierarchy (Ancestors)

Cholestasis, Intrahepatic; Cholestasis; Bile Duct Diseases; Biliary Tract Diseases; Digestive System Diseases; Liver Diseases; Liver Cirrhosis; Fibrosis; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Fibric Acids; Isobutyrates; Butyrates; Acids, Acyclic; Carboxylic Acids; Organic Chemicals; Phenyl Ethers; Ethers; Benzophenones; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Phenols; Ketones; Deoxycholic Acid; Cholic Acids; Bile Acids and Salts; Steroids; Fused-Ring Compounds; Polycyclic Compounds; Cholanes

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: December 22, 2025
• Study Start: December 15, 2025
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): December 31, 2028
• Last Updated: December 29, 2025

Record last verified: 2025-12

Locations

CN (1)