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Liver & Hepatic

Alagille Syndrome (ALGS) Clinical Trials and Treatments

Also called Alagille-Watson syndrome, ALGS, hepatic ductular hypoplasia, Alagilles Syndrome

Alagille syndrome (ALGS) is an autosomal dominant multi-system disorder caused by mutations in the JAG1 or NOTCH2 genes, which regulate the Notch signaling pathway critical for normal organ development and tissue maintenance throughout life. The hallmark hepatic feature is intrahepatic bile duct hypoplasia, characterized by a decreased number of interlobular bile ducts with progressive obliteration of remaining ducts leading to cholestasis and progressive liver disease.

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About Alagille Syndrome

Alagille syndrome (ALGS) is an autosomal dominant multi-system disorder caused by mutations in the JAG1 or NOTCH2 genes, which regulate the Notch signaling pathway critical for normal organ development and tissue maintenance throughout life. The hallmark hepatic feature is intrahepatic bile duct hypoplasia, characterized by a decreased number of interlobular bile ducts with progressive obliteration of remaining ducts leading to cholestasis and progressive liver disease.

Cardiac involvement occurs in approximately 90% of patients, most commonly manifesting as pulmonary stenosis or other right-sided heart lesions. The characteristic facial features include a broad forehead, pointed chin, hypertelorism (widely-spaced eyes), and straight nose that become more apparent with age. Skeletal abnormalities including butterfly vertebrae and scoliosis are common and may cause functional limitations. Ocular abnormalities such as posterior embryotoxon and retinal pigmentary changes, along with hearing loss, occur in variable proportions.

Notably, disease severity varies dramatically among affected individuals: some patients maintain relatively normal liver function into adulthood with minimal symptoms, while others develop progressive cirrhosis with portal hypertension, esophageal varices, and liver failure requiring transplantation by late childhood. This remarkable variability in phenotype is even observed within families carrying the same mutation.

Common Symptoms of Alagille Syndrome

Recognizing the signs of Alagille Syndrome early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Cholestasis and jaundice in infancy
  • Bile duct hypoplasia and progressive liver disease
  • Cardiac defects including pulmonary stenosis
  • Characteristic facial features
  • Skeletal abnormalities and butterfly vertebrae
  • Hearing loss and eye abnormalities

Who Alagille Syndrome Affects

Alagille syndrome typically manifests in infancy with cholestasis presenting as jaundice and pale stools, though age of onset and severity vary considerably.

The condition affects males and females equally. Since it follows autosomal dominant inheritance, approximately 50% of children born to an affected parent inherit the condition. Both familial cases and de novo mutations occur. Expression is highly variable with incomplete penetrance, meaning some carriers of mutations have minimal or no clinical manifestations while others develop severe multisystem disease.

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Help Paying for Alagille Syndrome Treatment

Charity funds and drugmaker programs for Alagille Syndrome, checked at the source. Pick your insurance to see what fits.

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  • From a charity · Alagille Syndrome Alliance
    ALGSAssistance Program fund
    Open

    Pays for: Rent or mortgage, utilities, insurance premiums, counseling, and medical, adaptive or mobility equipment, up to $1,000 per year.

    The foundation says: “Apply now (reviewed case by case as funding allows)”
  • From a charity · HealthWell Foundation
    Alagille Syndrome Vitamins and Supplements fund
    Open

    Pays for: Copays, premiums or other treatment costs.

Status as each foundation showed it on September 28, 2026.

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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Genetic Testing

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted Alagille Syndrome Resources

Reputable organizations and medical references for learning more about Alagille Syndrome, including disease registries, foundation resources, and clinical guidelines.

Active Clinical Trials for Alagille Syndrome

Use this Alagille Syndrome clinical trial finder to see the 10 studies recruiting patients in the United States and worldwide, with eligibility criteria in plain English. These studies play a critical role in advancing care for liver & hepatic conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

TrialsSite mapPipeline timeline

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

10 active trials worldwide
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RECRUITINGRecently updatedNCT06850038

A Study Observing the Long-term, Effectiveness and Safety of Odevixibat (Bylvay) in Patients With Alagille Syndrome (ALGS) Who Are Receiving Ongoing Treatment

Sponsor: Ipsen

This study will collect information from patients with Alagille syndrome (ALGS) as they use odevixibat (Bylvay) in their daily lives.

Odevixibat is a medicine that helps patients with ALGS, a rare disease that harms their liver and causes itching.

Ages not specified10 locations
Started Apr 2025Updated yesterdayEst. Nov 2030 (~4y 1m)
RECRUITINGRecently updatedNCT07585097

A Study to Observe the Long-term Safety of Odevixibat in Patients With Alagille Syndrome (ALGS) Who Are Receiving Ongoing Treatment

Sponsor: Ipsen

This study will collect information from patients with ALGS who are using odevixibat in their daily lives. Odevixibat is a medication that helps patients with ALGS, a rare disease that affects the liver and causes itching.

Ages 6 Months+14 locations
Started Jul 2026Updated yesterdayEst. Sep 2031 (~4y 12m)
RECRUITINGRecently updatedNCT07335523

Determine the Prevalence of Exocrine Pancreatic Insufficiency (EPI) in Pediatric and Adult Participants With Alagille Syndrome After Liver Transplantation

Intervention: Fecal Fat

Sponsor: Digestive Care, Inc.

The goal of this clinical trial is to determine the prevalence of exocrine pancreatic insufficiency (EPI) in a population of pediatric and adult participants with Alagille Syndrome (ALGS) post liver transplant. During the study, participants will:

* Consume a high fat diet

Ages 7 Years – 50 Years8 locations
Started Aug 2026Updated 1 week agoEst. Aug 2027 (~11 months)
RECRUITINGPHASE4Updated a few months agoNCT07290257

Long-Term Low-Intervention SafEty and Clinical Outcomes Clinical Study of LivmArli® in Patients With Alagille Syndrome or Progressive Familial Intrahepatic Cholestasis in the European Union (LEAP-EU)

Intervention: Livmarli Oral Product

Sponsor: Mirum Pharmaceuticals, Inc.

In patients with Alagille syndrome (ALGS), the key objectives are to evaluate the tolerability, long-term safety (including possible liver toxicity) and long-term efficacy of Livmarli treatment.

Ages 2 Months+15 locations
Started Sep 2025Updated 3 months agoEst. Sep 2030 (~3y 11m)
RECRUITINGUpdated a few months agoNCT06506734

Dental Dyschromia and Quality of Life in Early Prolonged Hyperbilirubinemia

Intervention: Questionnaires

Sponsor: University Hospital, Toulouse

The main objective of this study is to assess the prevalence of dental discoloration (dental dyschromia) in children who experienced high levels of bilirubin in their blood (hyperbilirubinemia) during their early years. The study will also examine risk factors associated with thi...

Ages 12 Years – 18 Years9 locations
Started Apr 2026Updated 4 months agoEst. Oct 2027 (~1 year)
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Active trial locations19 cities in the US
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Trial Pipeline

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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
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Related Liver & Hepatic Conditions

Other rare diseases in the liver & hepatic category. Patients with Alagille Syndrome may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Companies Developing Alagille Syndrome Treatments

3 pharmaceutical companies have Alagille Syndrome in their rare disease portfolio

Frequently Asked Questions About Alagille Syndrome