To Study the Efficacy and Safety of Renessans in Chronic HCV Patients

November 21, 2011 updated by: MTI Medical Private Limited, Pakistan

An Open Labelled, Active Controlled, Three Arm, Parallel- Group Study of the Safety and Efficacy of Renessans Administered Alone and in Combination With Standard Interferon Therapy in Patients Chronic HCV Hepatitis

Chronic HCV infection is one of the common causes of the chronic liver disease. Approximately 6-10% of the general public is expected to be suffering from this infection. In case that these patients are not treated at an appropriate time, these patients develop the sequelae of the chronic liver disease e.g. cirrhosis of liver, Ascites, and Hepatocellular carinoma. Interferon alpha 2 a or alpha 2b injections and Ribavirin combination is the treatment of choice for people suffering from Chronic HCV infection and this combination need to be administered for 6-12 months. Interferons are biological agents and are to be administered parenterally. Interferons are expensive and are associated with number of minor and major adverse effects. Ribavirin is also associated with significant adverse effects. These compounds cannot be considered as one of the ideal forms of the treatment.

In the past, quite a few natural products have been tested to assess their hepatoprotective activity and possibly anti viral activity as well. These include Vitamin C (Ascorbic acid), Vitamin E, Zinc, Silymarin, Red beet roots, crushed licorice and etc. etc.

Rationale Iodine , Potassium iodide and Ascorbic acid are natural products used in the management of Thyroiditis and chronic cutaneous fungal infections. This combination of iodine compounds along with ascorbic acid is being used for the management of chronic hepatitis B & C in the central Asian states e.g. Kazakhstan etc.

The investigators have conducted a feasibility study in which oral Iodine Compound {RENESSANS} was given to patients suffering HCV related Chronic Active Hepatitis and anti-viral activity and safety has been analyzed. In this study, RENESSANS containing regimen has been well tolerated by all the patients and has shown some antiviral activity.

In this study the investigators will assess whether the administration of RENESSANS {oral } improves the antiviral activity in patients receiving standard interferon therapy.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Unknown

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

  1. Primary

    The primary objective of this study is to assess the efficacy of combination therapy comprising of RENESSANS, INTERFERONS and RIBAVIRIN in the management of treatment naïve HCV related Chronic Active Hepatitis patients.

  2. Secondary

    The secondary objectives of this study are:

    1. Determine the biochemical or virological improvement in patients suffering from HCV related Chronic Active Hepatitis.
    2. Determine the safety and tolerability of Renessans {oral} when administered as a part of antiviral activity outlined in this protocol.

  3. ENDPOINTS

    The primary endpoint will be the number of subjects achieving

    1. Virological response as evident by Rapid Viral Response(RVR), Early Viral Response(EVR) and Sustained Viral Response(SVR).
    2. Biochemical response as evident by normalization of ALT.

    The secondary endpoint will be

    a. Assessment of the safety and tolerability of RENESSANS through: routine physical examination, routine clinical laboratory tests, clinical monitoring and adverse events reporting.

  4. INVESTIGATIONAL PLAN

    Study Design.

    This is an open labeled, active controlled, three arm, parallel-group study of the safety and efficacy of the oral formulation of natural iodine compound (Renessans) administered alone and in combination with standard interferon therapy in patient suffering from chronic HCV hepatitis.

    The enrolled patients will be tested for following base line laboratory tests

    VISIT 1:

    CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes Thyroid Function tests HBsAg, HIV antibody Urinalysis ANA, RA factor and serum ferritin levels USG of abdomen HCV RNA (PCR by amplicor, roche) qualitative analysis, if positive then quantitative analysis (Real time) and genotype as well.

    Pregnancy test in case of females Informed consent shall be obtained and each individual patient's treatment risk shall be covered under a certified health insurance plan.

    Renessans will be administered in eligible patients as follows:

    Study Arm Dosing Schema Group I ORAL RENESSANS 5gm. Thrice Daily{active iodine 300mg} for 6months Group II a ORAL RENESSANS 5gm. Twice Daily +INTERFERON ALPHA 2b 3 Million Units s/c +RIBAVIRIN 15mg/kg Group II b INTERFERON ALPHA 2b 3 Million Units s/c +RIBAVIRIN 15mg/kg Blood samples shall be collected and stored for post - hoc analysis of HCV RNA at day 1, 7 and 15(visit 2,3 & 4).

    Patients will be reviewed for the hepatoprotection, anti viral activity and any adverse event every four weeks with following clinical and lab work.

    VISIT 5 Detailed history and physical examination Following lab. Investigations at week 4. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes Thyroid Function tests Ferritin HCV RNA (PCR) quantitative analysis VISIT 6 Detailed history and physical examination Following lab. Investigations at week 8. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes

    VISIT 7 Detailed history and physical examination Following lab. Investigations at week 12. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes Thyroid Function tests Ferritin HCV RNA (PCR) quantitative analysis

    VISIT 8 Detailed history and physical examination Following lab. Investigations at week 16. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 9 Detailed history and physical examination Following lab. Investigations at week 20. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 10 Detailed history and physical examination Following lab. Investigations at week 24. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 11 Detailed history and physical examination Following lab. Investigations at week 28. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 12 Detailed history and physical examination Following lab. Investigations at week 32. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 13 Detailed history and physical examination Following lab. Investigations at week 36. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 14 Detailed history and physical examination Following lab. Investigations at week 40. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 15 Detailed history and physical examination Following lab. Investigations at week 44. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 16 Detailed history and physical examination Following lab. Investigations at week 48. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 15 Detailed history and physical examination Following lab. Investigations at week 52. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes VISIT 15 Detailed history and physical examination Following lab. Investigations at week 60. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes

    VISIT 16 Detailed history and physical examination Following lab. Investigations at week 72. CBC including platelet count and ESR Liver function tests including albumin and total proteins. Creatinine Serum electrolytes Thyroid Function tests Ferritin HCV RNA (PCR) quantitative analysis

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
90

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 42200
        • Medical Unit 1,Lahore General Hospital,Postgraduate Medical Institute

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 55 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Following groups of the people will be enrolled for the study.

    • Patients suffering from chronic HCV infection as evident with a positive serology for Anti HCV antibody and raised ALT.
    • Both males and females
    • Age group: 18 - 55 years
    • Informed consent

Exclusion Criteria:

  • Following groups of people will be excluded from the study

    • Pregnant females
    • Body mass index more than 25
    • Uncontrolled Diabetes Mellitus, Hypertension, Ischemic heart disease, Renal failure, Respiratory failure, Chronic infections, gall stone disease or renal stone disease.
    • Patients known to have hypersensitivity to Iodine compounds in the past.
    • Psychiatric disorders except mild anxiety disorders.
    • Patients suffering from auto immune diseases e.g. Rheumatoid Arthritis, SLE, or thyroid diseases.
    • Patients suffering from concomitant HBV infection, HIV infection or any other chronic liver disease.
    • Bilirubin more than 2mg/dl, Albumin less than 3.0 gms/dl, INR more than 1.5, Hb. less than 10 gms /dl, absolute neutrophil count less than 1500/cmm and platelet count less than 100,000/cmm
    • Serum sodium less than 130mmol/l.
    • Patients who have received the interferon treatment in the past.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Group II a
TRIPPLE THERAPY
Biological: RENESSANS , INTERFERON ALPHA 2b, Ribavirin
ORAL RENESSANS 5gm. Twice Daily +INTERFERON ALPHA 2b 3 Million Units s/c +RIBAVIRIN 15mg/kg
Other Names:
  • IODINE POLYMER
  • HEBERON
  • VIRON
Active Comparator: Group II b
DUAL THERAPY
Drug: Interferon Alfa-2b AND RIBAVIRIN
INTERFERON ALPHA 2b 3 Million Units s/c +RIBAVIRIN 15mg/kg
Other Names:
  • HEBERON
  • VIRON
Experimental: Group I
ORAL RENESSANS
Biological: RENESSANS
ORAL RENESSANS 5gm. Thrice Daily{active iodine 300mg} for 6months
Other Names:
  • IODINE POLYMER

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Efficacy of Renessans based triple therapy versus dual therapy
Time Frame: 03 years
Efficacy will be assessed by biochemical and virological response. Biochemical response will be assessed in the form of mean decline in ALT from baseline at 3 month and end of treatment. Virological response will be assessed in the form of response guided therapy i-e RVR [negative RNA at week 4],EVR [negative RNA at 12 weeks],ETR [negative RNA at end of treatment] and SVR[negative PCR after 6 month of completion of therapy].
03 years

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Assess the safety and tolerability of Renessans in patients with chronic HCV patients
Time Frame: 3.5 years
Safety will be assessed by Adverse event and Serious adverse events.
3.5 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
MTI Medical Private Limited, Pakistan

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: GHIAS UN NABI, FCPS,MRCP, Professor of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 1, 2010

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 1, 2013

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2013

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 30, 2011

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 1, 2011

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 2, 2011

Study Record Updates

Last Update Posted (Estimate)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 22, 2011

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 21, 2011

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REN1

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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