A Study to Test How Well BI 770371 is Tolerated by People With Cirrhosis Caused by a Liver Disease Called MASH

Inclusion criteria

• ≥18 to ≤75 years old

• Male or female participants

• Women of childbearing potential (WOCBP) must be ready and able to use highly effective methods of birth control per International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) M3 (R2) that result in a low failure rate of less than 1% per year when used consistently and correctly. A list of contraception methods meeting these criteria and instructions on the duration of use is provided in the participant information

• Men able to father a child must be willing to use male contraception (condom or sexual abstinence) consistently and correctly until end of study. A list of contraception methods meeting these criteria and instructions on the duration of use is provided in the participant information

• Signed and dated written informed consent in accordance with ICH-Good Clinical Practice (GCP) and local legislation prior to admission to the trial

• Patients meeting criteria for Child-Pugh category A

• Adequate organ function or liver laboratory tests defined as all of the following:

• Total bilirubin ≤1.5 mg/dL. If the total bilirubin is > upper limit of normal (ULN) and a ≤1.5 mg/dL, the direct bilirubin must be <50% of total bilirubin

• For patients with Gilbert's syndrome: total bilirubin ≤3x ULN or direct bilirubin ≤1.5x ULN

• Aspartate transaminase (AST) and alanine transaminase (ALT) ≤5x ULN

• Alkaline Phosphatase <1.5x ULN

• International Normalized Ratio (INR) ≤1.4

• Model for End-Stage Liver Disease (MELD) score <12

• Platelet count ≥110 000/mL

• Albumin >3.4 g/dl

Exclusion criteria

• Major surgery (major according to the investigator's assessment) performed within 24-weeks prior to randomization, major surgery planned within 6 months after screening (e.g. hip replacement), or bariatric surgery within 2 years prior to randomization

• Any documented active or suspected malignancy or history of malignancy within 5-years prior to screening, except appropriately treated basal cell carcinoma of the skin or in situ carcinoma of uterine cervix. Specifically, any patients with suspected, confirmed, or history of hepatocellular carcinoma will be excluded

• Suspected or confirmed portal vein thrombosis within 6 months of enrollment

• History of liver transplantation

• Current listing for liver transplantation

• Present or past evidence of hepatic decompensation, in the opinion of the investigator, including but not limited to variceal hemorrhage, ascites, and/or hepatic encephalopathy

• Patients with clinically significant portal hypertension defined by any one of the following:

• FibroScan ≥25 Kilo Pascal (kPA) if the platelets are ≥150,000/μL

• FibroScan ≥20 kPA if platelets are <150,000/μL

• Evidence of esophageal or gastric varices (≥grade1) on the most recent endoscopy

• Enhanced liver fibrosis (ELF) ≥11.3

• Hepatic venous pressure gradient (HVPG) ≥10 mm Hg

• further exclusion criteria apply