Yet an­oth­er NASH de­feat for Gilead as 3-drug cock­tail fiz­zles. Now one an­a­lyst says it's time for a change-up

There are an es­ti­mat­ed 50 com­pa­nies fo­cused on de­vel­op­ing drugs for NASH, a com­mon liv­er dis­ease that has long flum­moxed re­searchers, trig­ger­ing a laun­dry list of set­backs for the field. Gilead is one of the high-pro­file ca­su­al­ties.

Af­ter two sting­ing de­feats in key late-stage NASH stud­ies (STEL­LAR-4, STEL­LAR-3) test­ing its drug selon­sert­ib — Gilead was bank­ing on a com­bi­na­tion ap­proach to take a bite out of the lu­cra­tive mar­ket that is so far un­tapped. But that ef­fort has al­so fiz­zled, the US drug­mak­er con­ced­ed on Mon­day.

The tri­al, dubbed AT­LAS, test­ed eval­u­at­ed the safe­ty and ef­fi­ca­cy of monother­a­py and dual com­bi­na­tion reg­i­mens of three ex­per­i­men­tal drugs, cilofex­or (FXR ag­o­nist), fir­so­co­stat (ACC in­hibitor) and selon­sert­ib (ASK1 in­hibitor) in 392 pa­tients with ad­vanced fi­bro­sis caused by NASH. The selon­sert­ib monother­a­py arm was dropped out of the tri­al fol­low­ing the STEL­LAR fail­ures.

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