Safety and Efficacy Study in Hepatitis C Patients With PHN121 (ENCHAMP)

Safety and Efficacy Study in Non-Responder Hepatitis C Genotype 1 Patients With PHN121

To evaluate the safety, tolerability and efficacy of escalating dose of PHN121 when administered orally in non-responder hepatitis C genotype 1 patients

Study Overview

• Status: Terminated
• Conditions: Hepatitis C Virus Infection
• Intervention / Treatment: Drug: PHN121

Detailed Description

This is a Phase I/II, open-label, multicenter (2 centers), dose-escalation, multidose study in non-responder hepatitis C genotype 1 patients. Three escalating dose levels will be evaluated. Each cohort of 6 subjects will enroll sequentially. Each cohort will be administered PHN121 orally daily for 12 weeks. Subjects will be requested to return on Week 2, Week 4, Week 6, and Week 9 for evaluation and medication. Subjects will also be asked to return for follow-up evaluation for adverse events on Week 12 and Week 16.

Three doses are planned and include: 2.91, 4.85, and 7.77 g/day. Subjects will be assigned to a dose level in the order of study entry. Initially, 6 subjects will be enrolled at each dose level; up to 8 subjects may be assigned to each dose level, depending upon dose-limiting toxicities (DLTs) seen.

Six subjects will be started on treatment with dose level 1. After the sixth subject completes 84 days of treatment, if no dose-limiting toxicity occurs, then the next group of 6 subjects will be treated at the next higher dose regimen. If 1 of the 6 initial subjects experiences a DLT, the cohort of subjects will be expanded to 8 subjects. If fewer than two DLTs occur in 8 subjects, then the next higher dose group will be initiated. If 2 of the 6 initial subjects or 3 or more (of a cohort of up to 8) subjects experience DLTs, no further dose escalations will occur; the study will be discontinued and the MTD will have been exceeded.

No subject may participate in more than 1 cohort.

• Study Type: Interventional
• Enrollment (Actual): 12
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• Taiwan
  • Kaohsiung, Taiwan
    • Kaohsiung Medical University Chung-Ho Memorial Hospital
  • Taipei, Taiwan
    • PhytoHealth

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Nonsmoking adult subjects age 20 years or above, male or female
• Non-Responder HCV patient who failed to achieve sustained viral response (SVR), either do not respond or relapse, to prior 24-week interferon based therapy
• Any antiviral agent discontinued at least 4 weeks before the screening visit.
• Presence of anti-HCV in serum
• Serum and PCR positive for HCV-RNA*1 (Genotype 1)
• Elevated ALT (> 1.3 x upper limit of normal) during last 6 months and (1.3 x to 10 x upper limit of normal) during the screening phase
• No evidence showing liver cirrhosis or hepatocellular carcinoma*2

• Hematological, biochemical and serologic criteria at the screening phase is within normal limits (WNL):

  • Hemoglobin values of > 12gm/dl for females and > 13gm/dl for males
  • WBC > 3,000/mm3
  • Neutrophil > 1,500/mm3
  • Platelets count > 90,000/mm3
  • Normal PT (INR< 1.2)
  • Total bilirubin < 2 mg/dl
  • Albumin, WNL
  • Serum creatinine, WNL
• Written informed consent

Exclusion Criteria:

• Has evidence of significant renal, cardiovascular, hematopoetic, neurological, pulmonary or gastrointestinal pathology, or any other medical reason or disease that might interfere with the study objectives, as determined by the investigator
• Has participated in other investigational trials within 28 days prior to study enrollment
• Has taken botanical medications*3 within 28 days prior to study enrollment
• Has an surgery within 28 days prior to study enrollment

• Has been diagnosed with any other cause for the liver disease other than chronic hepatitis C including the following conditions:

  • Co-infection with HBV
  • Hemochromatosis
  • Alpha-1 antitrypsin deficiency
  • Wilson's disease
  • Autoimmune hepatitis
  • Alcoholic liver disease
  • Drug-related liver disease
  • Other liver disease that was considered by the principal investigator
• Has been test positive for HIV
• Has been diagnosed with poor-controlled Diabetes Mellitus (HbA1C > 9.0%)
• Active alcohol abuse of daily intake > 30 g for male and > 20 g for female within the previous 1 year
• Active substance abuse, such as inhaled or injection drugs within the previous 1 year *4
• Female subjects of child bearing potential who are pregnant, nursing, do not agree to practice effective birth control during the time period from 14 days before administration of study drug to 28 days after administration of study drug

Study Plan

How is the study designed?

Design Details

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

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lifestyle counseling	Drug: PHN121; a size 0 hard gel capsule containing 323.6 mg active ingredient, a complex mixture prepared from 5 commonly practiced botanical traditional Chinese medicines

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Safety: Safety assessments will include ALT, aspartate aminotransferase (AST), other clinical laboratory tests, HCV RNA quantitation, vital signs, physical examinations, concomitant medications, and adverse events (AEs).	12-week treatment; 4-week safety followup

Secondary Outcome Measures

Outcome Measure	Time Frame
Efficacy: Efficacy will be assessed by evaluating the plasma concentrations of ALT and viral load through calculating the percent change from Baseline on a per-subject and by-cohort basis, normalizing to the baseline measurement.	12-week treatment; 4-week safety followup

Collaborators and Investigators

• Sponsor: PhytoHealth Corporation
• Investigators: Principal Investigator: Wan-Long Chuang, M.D., Ph.D., Kaohsiung Municipal United Hospital; Principal Investigator: Ming-Lung Yu, M.D., Ph.D., Kaohsiung Municipal United Hospital; Principal Investigator: Chia-Yen Dai, M.D., M.S., Kaohsiung Municipal United Hospital

Publications and helpful links

General Publications

• Dai CY, Chuang WL, Huang JF, Hsieh MY, Yu ML. Rapid virological response in hepatitis C virus genotype 1 and early ribavirin exposure. Hepatology. 2008 Aug;48(2):692-3; author reply 693-4. doi: 10.1002/hep.22409. No abstract available.
• Huang JF, Dai CY, Lin YY, Yu ML, Liu SF, Lin IL, Hsieh MY, Lee LP, Lin ZY, Chen SC, Hsieh MY, Chang WY, Chuang WL. Performance characteristics of a real-time RT-PCR assay for quantification of hepatitis C virus RNA in patients with genotype 1 and 2 infections. Clin Chem Lab Med. 2008;46(4):475-80. doi: 10.1515/CCLM.2008.082.

Study record dates

Study Major Dates

• Study Start: September 1, 2009
• Primary Completion (Anticipated): November 1, 2013
• Study Completion (Anticipated): December 1, 2013

Study Registration Dates

• First Submitted: January 17, 2010
• First Submitted That Met QC Criteria: January 19, 2010
• First Posted (Estimate): January 20, 2010

Study Record Updates

• Last Update Posted (Estimate): November 26, 2013
• Last Update Submitted That Met QC Criteria: November 24, 2013
• Last Verified: January 1, 2010

More Information

Terms related to this study

• Keywords: HCV
• 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; Hepatitis A; Hepatitis C
• Other Study ID Numbers: PH-CP015