P26 Elafibranor improves fatigue versus placebo in patients with primary biliary cholangitis (PBC), with limited correlation with pruritus: analyses from the phase III ELATIVE trial
Bibliographic record
Abstract
Fatigue and pruritus are common symptoms in PBC. In the phase III ELATIVE® trial (NCT04526665), elafibranor significantly improved biomarkers of cholestasis in PBC. Here, we report the impact of elafibranor vs placebo on fatigue, and the association between fatigue and pruritus. Patients with PBC were randomized 2:1 to elafibranor 80 mg (n=108) or placebo (n=53). Fatigue was assessed via the Patient-Reported Outcome Measurement Information System Fatigue Short Form 7a (PFSF 7a) and PBC-40 Fatigue domain. Data are reported for patients with moderate-to-severe fatigue at baseline (PFSF 7a score ≥60; PBC-40 Fatigue domain score ≥29). Changes to Week 52 were summarized as categorical changes, percentage changes, and minimal clinically important differences (MCIDs; PFSF 7a: ≥3; PBC-40 Fatigue domain: ≥5). Spearman’s correlation coefficients were calculated between fatigue (PFSF 7a and PBC-40 Fatigue domain) and pruritus (5-D Itch and PBC-40 Itch domain) patient-reported outcomes (PROs) for scores at baseline and change from baseline to Week 52. Patients with missing data at baseline and/or Week 52 were excluded. For PFSF 7a, 42/95 (44.2%) patients receiving elafibranor and 16/46 (34.8%) receiving placebo had moderate-to-severe fatigue at baseline. By Week 52, 18/42 (42.9%) patients receiving elafibranor vs 5/16 (31.3%) receiving placebo improved to mild/normal fatigue. Mean (95% CI) percentage change in PFSF 7a score was greater with elafibranor (−9.5% [−12.9%, −6.2%]) vs placebo (−4.2% [−9.6%, 1.2%]). Patients with an improvement ≥MCID at Week 52: elafibranor, n=28/42 (66.7%); placebo, n=5/16 (31.3%). For the PBC-40 Fatigue domain, 53/95 (55.8%) patients receiving elafibranor and 26/46 (56.5%) receiving placebo had moderate-to-severe fatigue at baseline. By Week 52, 12/53 (22.6%) patients receiving elafibranor vs 4/26 (15.4%) receiving placebo improved to mild/no fatigue. Mean (95% CI) percentage change in PBC-40 Fatigue domain score was greater with elafibranor (−9.8% [−15.4%, −4.1%]) vs placebo (−5.8% [−12.0%, 0.4%]). Patients with an improvement ≥MCID at Week 52: elafibranor, n=21/53 (39.6%); placebo, n=7/26 (26.9%). At baseline, fatigue and pruritus PRO scores had a weak correlation (r=0.25–0.35), suggesting pruritus was not a main driver of fatigue. Similarly, changes in fatigue and pruritus PROs from baseline to Week 52 did not demonstrate a strong correlation (r=0.26–0.33), and they could improve independently of one another. Elafibranor resulted in clinically meaningful improvements in fatigue, with greater improvements vs placebo. A weak correlation between fatigue and pruritus PROs at baseline, and in improvements over time, suggests that elafibranor can improve these debilitating PBC symptoms independently of each other.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".