Study of Elafibranor in Patients With Primary Biliary Cholangitis (PBC)

Inclusion Criteria

• Males or females age of 18 to 75 years (inclusive)

• Definite or probable Primary biliary cholangitis (PBC) diagnosis

• Alkaline phosphatase (ALP) ≥ 1.67x upper limit of normal (ULN)

• Total bilirubin (TB) ≤ 2x ULN

• Ursodeoxycholic acid (UDCA) for at least 12 months (stable dose ≥ 3 months) prior toscreening, or unable to tolerate UDCA treatment (no UDCA for ≥ 3 months) prior toscreening (per country standard-of-care dosing)

• Must have PBC Worst Itch Numeric rating scale (NRS) collected prior to randomization

• Females participating in this study must be of non-child bearing potential or mustbe using highly efficient contraception for the full duration of the study and for 1month after the last drug intake

Exclusion Criteria:

• History or presence of other concomitant liver disease

• Clinically significant hepatic decompensation, including patients with complicationsof cirrhosis/portal hypertension

• Medical conditions that may cause non-hepatic increases in ALP (e.g., Paget'sdisease) or which may diminish life expectancy to < 2 years, including known cancers

• Patient has a positive test for HIV Type 1 or 2 at screening, or patient is known tohave tested positive for HIV

• Evidence of any other unstable or untreated clinically significant disease

• History of alcohol abuse

• For female patients: known pregnancy or lactating

• Use of fibrates and glitazones within 2 months prior to screening

• Use of Obeticholic acid (OCA), azathioprine, cyclosporine, methotrexate,mycophenolate, pentoxifylline, budesonide and other systemic corticosteroids (parenteral and oral chronic administration only); potentially hepatotoxic drugs

• (including α-methyl-dopa, sodium valproic acid isoniazid, or nitrofurantoin) within 3 months prior to screening

• Use of antibodies or immunotherapy directed against interleukins (ILs) or othercytokines or chemokines within 12 months prior to screening

• For patients with previous exposure to OCA, OCA should be discontinued 3 monthsprior to screening

• Patients who are currently participating in, plan to participate in, or haveparticipated in an investigational drug study or medical device study containingactive substance within 30 days or five half-lives, whichever is longer, prior toscreening; for patients with previous exposure to seladelpar, seladelpar should bediscontinued 3 months prior to screening

• Alanine aminotransferase (ALT) and/or Aspartate aminotransferase (AST) values > 5 xULN

• For patients with AT or TB>ULN at SV1, variability of AT or TB > 40% (see section 3.5.1)

• Albumin<3.0 g/dl

• Severely advanced patients according to Rotterdam criteria (TB > ULN and albumin <LLN)

• INR > 1.3 due to altered hepatic function

• CPK > 2 x ULN

• Screening serum creatinine > 1.5 mg/dl

• Significant renal disease, including nephritic syndrome, chronic kidney disease (defined as patients with markers of kidney failure damage or eGFR < 60 mL/min/1.73m^2) calculated by Modification of diet in renal disease (MDRD)

• Platelet count < 150 x 10^3/μL

• AFP > 20 ng/mL with 4-phase liver CT or MRI imaging suggesting presence of livercancer

• Known hypersensitivity to the investigational product or to any of the formulationexcipients of the elafibranor or placebo tablet Mental instability or incompetence,such that the validity of informed consent or ability to be compliant with the studyis uncertain