Sofosbuvir/Velpatasvir Fixed-Dose Combination in Adults With Chronic HCV Infection and Child-Pugh Class B Cirrhosis (ASTRAL-4)
A Phase 3, Multicenter, Open-Label Study to Investigate the Efficacy and Safety of Sofosbuvir/GS-5816 Fixed-Dose Combination in Subjects With Chronic HCV Infection and Child-Pugh Class B Cirrhosis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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San Juan, Puerto Rico, 00927
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Arizona
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Phoenix, Arizona, United States
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California
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La Jolla, California, United States
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Los Angeles, California, United States
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Los Angeles, California, United States, 90048
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Pasadena, California, United States
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San Francisco, California, United States
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Colorado
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Aurora, Colorado, United States
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District of Columbia
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Washington, District of Columbia, United States
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Florida
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Gainesville, Florida, United States
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Jacksonville, Florida, United States, 32256
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Miami, Florida, United States
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Tampa, Florida, United States
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Georgia
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Marietta, Georgia, United States
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Illinois
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Chicago, Illinois, United States
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Indiana
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Indianapolis, Indiana, United States, 46202
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Indianapolis, Indiana, United States, 46237
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Kansas
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Kansas City, Kansas, United States
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Louisiana
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Monroe, Louisiana, United States, 71280
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New Orleans, Louisiana, United States
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Maryland
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Baltimore, Maryland, United States
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Massachusetts
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Boston, Massachusetts, United States
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Michigan
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Ann Arbor, Michigan, United States
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Detroit, Michigan, United States
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Minnesota
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Rochester, Minnesota, United States
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Mississippi
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Jackson, Mississippi, United States
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Missouri
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Saint Louis, Missouri, United States
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New Mexico
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Santa Fe, New Mexico, United States, 87505
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New York
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New York, New York, United States, 10016
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New York, New York, United States, 10032
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New York, New York, United States, 10029
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North Carolina
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Chapel Hill, North Carolina, United States
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Charlotte, North Carolina, United States, 28204
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Durham, North Carolina, United States
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Ohio
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Cleveland, Ohio, United States
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Cleveland, Ohio, United States, 44195
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
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Philadelphia, Pennsylvania, United States, 19107
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Pittsburgh, Pennsylvania, United States
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Rhode Island
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Providence, Rhode Island, United States, 02905
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Tennessee
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Germantown, Tennessee, United States, 38138
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Nashville, Tennessee, United States, 37211
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Texas
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Arlington, Texas, United States, 76012
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Dallas, Texas, United States
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San Antonio, Texas, United States
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Utah
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Murray, Utah, United States
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Virginia
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Fairfax, Virginia, United States
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Norfolk, Virginia, United States, 23502
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Richmond, Virginia, United States
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Washington
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Seattle, Washington, United States
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Willing and able to provide written informed consent
- HCV RNA > 10^4 IU/mL at screening
- Chronic HCV infection (≥ 6 months)
- Confirmed CPT class B (7-9) at screening
Exclusion Criteria:
- Current or prior history of solid organ transplantation, significant pulmonary disease, significant cardiac disease, or porphyria
- Inability to exclude hepatocellular carcinoma (HCC) by imaging within 6 months of baseline/Day 1
- Infection with hepatitis B virus (HBV) or human immunodeficiency virus (HIV)
- Screening ECG with clinically significant abnormalities
- Prior exposure to SOF or any other nucleotide analogue HCV nonstructural protein 5B (NS5B) inhibitor or any HCV NS5A inhibitor
- Laboratory results outside of acceptable ranges at screening
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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EXPERIMENTAL: SOF/VEL 12 weeks
Participants will receive SOF/VEL FDC for 12 weeks.
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400/100 mg tablets administered orally once daily
Other Names:
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EXPERIMENTAL: SOF/VEL+RBV 12 weeks
Participants will receive SOF/VEL FDC plus RBV for 12 weeks.
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400/100 mg tablets administered orally once daily
Other Names:
Ribavirin (RBV) tablets administered orally in a divided daily dose according to package insert weight-based dosing recommendations (< 75 kg = 1000 mg and ≥ 75 kg = 1200 mg)
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EXPERIMENTAL: SOF/VEL 24 weeks
Participants will receive SOF/VEL FDC for 24 weeks.
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400/100 mg tablets administered orally once daily
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percentage of Participants With Sustained Virologic Response (SVR) 12 Weeks After Discontinuation of Therapy (SVR12)
Time Frame: Posttreatment Week 12
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SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ) 12 weeks following the last dose of study drug.
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Posttreatment Week 12
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Percentage of Participants Who Permanently Discontinued Any Study Drug Due to an Adverse Event
Time Frame: Up to 24 weeks plus 30 days
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Up to 24 weeks plus 30 days
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percentage of Participants With Sustained Virologic Response 4 and 24 Weeks After Discontinuation of Therapy (SVR4 and SVR24)
Time Frame: Posttreatment Weeks 4 and 24
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SVR4 and SVR24 were defined as HCV RNA < LLOQ at 4 and 24 weeks following the last dose of study drug, respectively.
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Posttreatment Weeks 4 and 24
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Percentage of Participants With HCV RNA < LLOQ at Weeks 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24
Time Frame: Weeks 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24
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Weeks 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24
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Change From Baseline in HCV RNA at Weeks 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24
Time Frame: Baseline; Weeks 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24
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Baseline; Weeks 1, 2, 4, 6, 8, 10, 12, 16, 20, and 24
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Percentage of Participants With Virologic Failure
Time Frame: Up to Posttreatment Week 24
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Virologic failure was defined as
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Up to Posttreatment Week 24
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Percentage of Participants With a Decrease, No Change, or Increase Between Baseline and Posttreatment Week 24 in MELD Score
Time Frame: Baseline to Posttreatment Week 24
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Model for End-Stage Liver Disease (MELD) scores are used to assess prognosis and suitability for liver transplantation.
Scores can range from 6 to 40; higher scores/increased scores indicate greater severity of disease.
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Baseline to Posttreatment Week 24
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Percentage of Participants With a Decrease, No Change, or Increase Between Baseline and Posttreatment Week 24 in Child-Pugh-Turcotte (CPT) Score
Time Frame: Baseline to Posttreatment Week 24
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CPT scores grade the severity of cirrhosis and are used to determine the need for liver transplantation.
Scores can range from 5 to 15; higher scores/increased scores indicate greater severity of disease.
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Baseline to Posttreatment Week 24
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Anu M Osinusi, MD, MPH, Gilead Sciences
Publications and helpful links
General Publications
- Charlton MR, O'Leary JG, Bzowej NH, Muir AJ, Korenblat KM, Fenkel JM, et al. Sofosbuvir/Velapatasvir Fixed Dose Combination for the Treatment of HCV in Patients with Decompensated Liver Disease: The Phase 3 ASTRAL-4 Study. Hepatology 2015; 62 (6): 1387A-1388A.
- Curry MP, O'Leary JG, Bzowej N, Muir AJ, Korenblat KM, Fenkel JM, Reddy KR, Lawitz E, Flamm SL, Schiano T, Teperman L, Fontana R, Schiff E, Fried M, Doehle B, An D, McNally J, Osinusi A, Brainard DM, McHutchison JG, Brown RS Jr, Charlton M; ASTRAL-4 Investigators. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. N Engl J Med. 2015 Dec 31;373(27):2618-28. doi: 10.1056/NEJMoa1512614. Epub 2015 Nov 16.
- Asselah T, Charlton M, Feld J, Foster GR, McNally J, Brainard DM, et al. The ASTRAL Studies: Evaluation of SOF/GS-5816 Single-Tablet Regimen for the Treatment of Genotype 1-6 HCV Infection [Poster P1332]. J Hepatol 2015; 62:S855-S6.
- Younossi ZM, Stepanova M, Charlton M, Curry MP, O'Leary JG, Brown RS, Hunt S. Patient-reported outcomes with sofosbuvir and velpatasvir with or without ribavirin for hepatitis C virus-related decompensated cirrhosis: an exploratory analysis from the randomised, open-label ASTRAL-4 phase 3 trial. Lancet Gastroenterol Hepatol. 2016 Oct;1(2):122-132. doi: 10.1016/S2468-1253(16)30009-7. Epub 2016 Aug 3.
- Younossi ZM, Stepanova M, Feld J, Zeuzem S, Sulkowski M, Foster GR, Mangia A, Charlton M, O'Leary JG, Curry MP, Nader F, Henry L, Hunt S. Sofosbuvir and Velpatasvir Combination Improves Patient-reported Outcomes for Patients With HCV Infection, Without or With Compensated or Decompensated Cirrhosis. Clin Gastroenterol Hepatol. 2017 Mar;15(3):421-430.e6. doi: 10.1016/j.cgh.2016.10.037. Epub 2016 Nov 12.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- RNA Virus Infections
- Virus Diseases
- Blood-Borne Infections
- Disease Attributes
- Liver Diseases
- Flaviviridae Infections
- Hepatitis, Viral, Human
- Fibrosis
- Infections
- Communicable Diseases
- Hepatitis
- Hepatitis C
- Anti-Infective Agents
- Antiviral Agents
- Sofosbuvir
- Sofosbuvir-velpatasvir drug combination
- Velpatasvir
Other Study ID Numbers
Other Study ID Numbers
- GS-US-342-1137
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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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