Study of PEG-Intron Plus REBETOL in Pediatric Subjects With Chronic Hepatitis C (Study P02538 Part 1)

Assessment of the Safety, Efficacy, Tolerability and Pharmacokinetics of PEG-Intron® Plus REBETOL® in Pediatric Patients With Chronic Hepatitis C

The primary objective is to assess the safety, efficacy and tolerability of the combination of PEG-Intron plus REBETOL in pediatric subjects with chronic hepatitis C. The secondary objective is to measure the multiple-dose pharmacokinetics of PEG-Intron and REBETOL in pediatric subjects with chronic hepatitis C.

Study Overview

• Status: Completed
• Conditions: Hepatitis C, Chronic
• Intervention / Treatment: Biological: peginterferon alfa-2b (PEG2b) (SCH 54031); Drug: ribavirin (SCH 18908)

Detailed Description

This global, multicenter, open-label Phase 3 study will evaluate the safety, efficacy and tolerability of PEG-Intron plus REBETOL in previously untreated pediatric subjects, ages 3 through 17 years, with chronic hepatitis C.

• Study Type: Interventional
• Enrollment (Actual): 107
• Phase: Phase 3

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years to 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Children age 3-17 years old
• Individuals weighing ≤ 90 kg
• Previously untreated children with chronic hepatitis C (HCV RNA qPCR plasma positive)
• Individuals with any HCV (hepatitis C virus) genotype

• Hematology laboratory results of:

  • Hemoglobin (HGB) ≥ 11 g/dL for females or ≥ 12g/dL for males,
  • White Blood Cell Count (WBC) ≥ 3,000/mm^3,
  • Neutrophils ≥ 1,500/mm^3,
  • Platelets ≥ 100,000/mm^3

• Chemistry laboratory results of:

  • Normal Thyroid Stimulating Hormone (TSH), albumin, creatinine, and Bilirubin,
  • Antinuclear antibody (ANA) ≤ 1:160,
  • Fasting Glucose 70-140 mg/dL. Note: If glucose levels are between 116-140 mg/dL or an individual has diabetes, HbA1C must be ≤ 8.5%
• Compensated liver disease
• Historic or pre-treatment liver biopsy slides available
• No significant co-existing psychiatric disease
• Those with diabetes, hypertension, or birth prior to 32 weeks gestational age must have normal eye exams and retinal photographs (these will be done as part of the study before hepatitis C treatment is given)
• Patients and partners of patients willing to use adequate contraception during the course of the study
• Abstain from alcohol and any other illicit drugs

Exclusion Criteria:

• Serum ALT >10 times the upper limit of normal within the 6 months prior to study
• Previous hepatitis C treatment
• Children with liver disease not caused by hepatitis C
• Most recent liver biopsy is normal
• Individuals infected with the hepatitis B virus and/or human immunodeficiency virus (HIV)
• Known blood disorders such as hemoglobinopathy, coagulopathy, or G6PD deficiency
• Known immunodeficiency disorders requiring immunoglobulin therapy
• Body organ transplant
• Any known or suspected cancer within the past 5 years
• Children with chronic pulmonary disease
• Individuals who have a medical condition that would likely require systemic steroids
• Those with a history of central nervous system (CNS) trauma or seizure disorders
• Individuals with pre-existing psychiatric disorders including but not limited to moderate to severe depression
• Current or previous use of lithium or antipsychotic drugs
• Patients with clinically significant electrocardiogram (ECG) abnormalities and/or significant cardiovascular dysfunction (e.g., angina, congestive heart failure, recent myocardial infarction, uncontrolled hypertension, significant arrhythmia, cardiac sequelae from Kawasaki disease, cardiomyopathy, and/or history of congenital heart disease)
• Insulin-dependent diabetes mellitus or poorly controlled non-insulin dependent diabetes mellitus
• Immunologically mediated disease (e.g., inflammatory bowel disease [Crohn's disease, ulcerative colitis], rheumatoid arthritis, idiopathic thrombocytopenic purpura, systemic lupus erythematosus, autoimmune hemolytic anemia, scleroderma, severe psoriasis, or symptomatic thyroid disorder)
• History of substance abuse, including alcohol (e.g., binge drinking, blackouts), intravenous drugs and inhaled drugs
• Subjects who have a history of pregnancy or who are pregnant and/or breast feeding. Subjects who intend to become pregnant during the study period. Subjects with partners who intend to become pregnant during the study period
• Subjects with clinically significant retinal abnormalities such as known retinopathy of prematurity or other retinopathies

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: PEG-Intron alfa 2b (PEG2b) plus REBETOL (RBV); PEG2b 1.5 μg/kg/wk given subcutaneously (once weekly) and RBV 400-1200 mg/day by mouth divided in 2 daily doses (administered twice daily with food, dosed 12 hours apart) for 48 weeks. Subjects treated up to 48 weeks and followed for additional 24 weeks after the end of treatment (total of 72 weeks study participation).	Biological: peginterferon alfa-2b (PEG2b) (SCH 54031); PEG2b 1.5 μg/kg/wk given subcutaneously (once weekly) for 48 weeks.; Other Names: PEG-Intron (SCH 54031); Drug: ribavirin (SCH 18908); 15 mg/kg/day for up to 48 weeks; Other Names: REBETOL (SCH 18908)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With a Sustained Virologic Response (SVR) at 24 Weeks Post-treatment	SVR is defined as undetectable hepatitis C virus ribonucleic acid (HCV-RNA) at 24 weeks post-treatment	Up to 48-week treatment duration. Follow-up of 24 weeks.

Collaborators and Investigators

• Sponsor: Merck Sharp & Dohme LLC

Publications and helpful links

General Publications

• Haber B, Alonso E, Pedreira A, Rodriguez-Baez N, Ciocca M, Lacaille F, Lang T, Gonzalez T, Goodman Z, Yang Z, Jackson B, Noviello S, Albrecht JK. Long-Term Follow-Up of Children Treated With Peginterferon and Ribavirin for Hepatitis C Virus Infection. J Pediatr Gastroenterol Nutr. 2017 Jan;64(1):89-94. doi: 10.1097/MPG.0000000000001239.
• Wirth S, Ribes-Koninckx C, Calzado MA, Bortolotti F, Zancan L, Jara P, Shelton M, Kerkar N, Galoppo M, Pedreira A, Rodriguez-Baez N, Ciocca M, Lachaux A, Lacaille F, Lang T, Kullmer U, Huber WD, Gonzalez T, Pollack H, Alonso E, Broue P, Ramakrishna J, Neigut D, Valle-Segarra AD, Hunter B, Goodman Z, Xu CR, Zheng H, Noviello S, Sniukiene V, Brass C, Albrecht JK. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa-2b plus ribavirin. J Hepatol. 2010 Apr;52(4):501-7. doi: 10.1016/j.jhep.2010.01.016. Epub 2010 Feb 4.

Study record dates

Study Major Dates

• Study Start: February 1, 2005
• Primary Completion (Actual): November 1, 2007
• Study Completion (Actual): November 1, 2007

Study Registration Dates

• First Submitted: February 22, 2005
• First Submitted That Met QC Criteria: February 22, 2005
• First Posted (Estimate): February 23, 2005

Study Record Updates

• Last Update Posted (Actual): April 4, 2017
• Last Update Submitted That Met QC Criteria: March 7, 2017
• Last Verified: March 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; RNA Virus Infections; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Liver Diseases; Flaviviridae Infections; Hepatitis, Viral, Human; Enterovirus Infections; Picornaviridae Infections; Hepatitis, Chronic; Hepatitis; Hepatitis A; Hepatitis C; Hepatitis C, Chronic; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Antiviral Agents; Antimetabolites; Immunologic Factors; Interferon-alpha; Ribavirin; Peginterferon alfa-2b
• Other Study ID Numbers: P02538: Part 1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes

IPD Plan Description

http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf

http://engagezone.msd.com/ds_documentation.php