ELMWOOD trial for PSC - J of Hepatology - Jan.26

The ELMWOOD trial, published in the Journal of Hepatology on January 26, focuses on evaluating the efficacy and safety of **Elafibranor**, a dual peroxisome proliferator-activated receptor-α/δ (PPAR-α/δ) agonist, in treating **primary sclerosing cholangitis (PSC)**. PSC is a rare, chronic liver disease characterized by progressive inflammation and scarring of the bile ducts, often leading to liver damage and complications such as cirrhosis.

### Problem Statement

The trial aimed to address the lack of effective treatments for PSC, as current therapeutic options are limited. Specifically, the study investigated whether Elafibranor could provide biochemical and clinical improvements in patients with PSC, focusing on its impact on **alkaline phosphatase (ALP)** levels (a key marker of liver health) and **enhanced liver fibrosis (ELF) scores**, while also assessing its safety and tolerability compared to placebo.

### Conclusion

The ELMWOOD trial demonstrated that **Elafibranor was well tolerated** in patients with PSC and showed **significant biochemical improvements** over 12 weeks compared to placebo. Key findings include:

• **ALP reductions**: Elafibranor led to substantial decreases in ALP levels, with greater responses observed at the higher dose (120 mg). ALP normalization occurred only in patients receiving Elafibranor.
• **ELF score improvements**: Although changes in ELF scores were observed, the reductions were more modest.
• **Safety profile**: Elafibranor was generally safe, with treatment-emergent adverse events (TEAEs) comparable to placebo, and no serious TEAEs reported in the Elafibranor groups.

Overall, the trial supports the potential of Elafibranor as a promising therapeutic option for PSC, with the higher dose (120 mg) showing a greater magnitude of response. Further studies are needed to confirm long-term efficacy and safety.