SH229 Tablets Combined With Daclatasvir Dihydrochloride Tablets in Treatment Adult Patients With Chronic Hepatitis C

A Multicenter, Open-Label Study to Evaluate the Efficacy and Safety of SH229 Tablets Combined With Daclatasvir Dihydrochloride Tablets in Treatment Adult Patients With Chronic Hepatitis C

Phase II: Exploring the efficacy and safety of different doses of SH229 tablets combined with fixed-dose Daclatasvi dihydrochloride (DCV) tablets in the treatment of adult patients with chronic hepatitis C for 12 weeks, providing a basis for the design and implementation of phase III clinical trials.

Phase III: Confirmation of the efficacy and safety of SH229 tablets combined with Daclatasvi dihydrochloride (DCV) tablets in the treatment of adult patients with chronic hepatitis C for 12 weeks, providing a sufficient basis for drug registration and clinical use.

Study Overview

• Status: Unknown
• Conditions: Hepatitis C, Chronic
• Intervention / Treatment: Drug: SH229 tablets; Drug: Daclatasvir dihydrochloride

Detailed Description

It is estimated that China has a population of over 10 million infected with HCV and also a highly variable HCV genotype geographic distribution. A simple, universal, non-genotype-specific treatment regimen is preferred for anti-HCV treatment in clinical practice and public health. The combination regimen of SH229 and DCV is expected to completely suppress HCV replication in subjects chronically infected with HCV and achieve a sustained virologic response.

• Study Type: Interventional
• Enrollment (Anticipated): 440
• Phase: Phase 2; Phase 3

Contacts and Locations

Study Locations

• China
  • Jiangsu
    • Jilin, Jiangsu, China, 130021
      • The First Hospital of Jilin University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Willing and able to provide written informed consent.
• Subjects should be able to follow the instructions for the study drug and be able to complete screening, on-treatment, and post treatment assessments.
• Male or female, age above 18 years
• Body mass index ( BMI ) between 18 and 32 kg/m2 at Screening.
• Confirmation of chronic HCV infection, which meets one of the following: (a) positive for anti-HCV antibodies, HCV RNA or HCV genotyping results within ≤ 6 months of screening, or (b) liver biopsy ≤ 12 months of screening.
• HCV RNA above 10^4 IU/mL at Screening by the Central Laboratory.
• HCV genotype 1, 2, 4, 5, 6, or indeterminate assessed at Screening by the Central Laboratory.

• Classification as treatment naïve or treatment experienced (approximately 20% of subjects may be treatment experienced):

  1. Treatment naïve is defined as having never been exposed to approved or experimental HCV-specific direct-acting antiviral agents ( DAA ) or prior treatment of HCV with interferon either with or without RBV.
  2. Treatment experienced is defined as prior treatment failure to a regimen containing IFN-based antiviral (INF-α, β or PEG-IFN ± ribavirin) and met one of the following: (i) Non-Responder: Subject did not achieve undetectable HCV RNA levels while ontreatment,, (ii) Relapse/Breakthrough: Subject achieved undetectable HCV RNA levels duringtreatment but did not achieve SVR, (iii) Terminate the treatment , according to associated-HCV therapy adverse events by subject reported or medical records demonstrated.

• Cirrhosis Determination (approximately 20% of subjects may have cirrhosis)：

  1. Cirrhosis is defined as any one of the following: (i) Fibroscan with a result of >12.5 kPa within ≤ 6 months of screening, (ii) Liver biopsy showing cirrhosis within ≤ 12 months of screening.
  2. Absence of cirrhosis is defined as any one of the following:(i) Fibroscan with a result of ≤ 12.5 kPa within ≤ 6 months of screening, (ii) Liver biopsy showing non-cirrhosis within ≤ 12 months of screening.

Exclusion Criteria:

• Exposure nucleotide analogue including HCV NS3-4A inhibitor, HCV NS5B inhibitor or any HCV NS5A inhibitor before baseline/Day 1.
• Receive IFN-based antiviral therapy within 6 months prior to baseline/day 1.
• Oral or injection of RBV within 3 months prior to baseline/Day 1.
• Systemic use of potent immunomodulators (eg, adrenocortical hormone, thymosin alpha, etc.) for more than 2 weeks prior to baseline/day 1, or expected to be exposed to these agents during the study.
• Use of amiodarone within 2 months before baseline/day 1.
• Positive for Hepatitis B surface antigen (HBsAg) or anti-human immunodeficiency virus antibody (HIV Ab) at screening.
• Evidence of decompensatory liver function, including but not limited to total serum bilirubin (TBIL) above twice of the upper limit of normal (ULN), serum albumin (ALB) below 35 g/L or prothrombin activity (PTA) below 60% confirmed on repeated testing, previous or present history of ascites, upper gastrointestinal bleeding and/or hepatic encephalopathy, or with a liver function reserve of Child-Pugh class B or C.
• Primary liver cancer confirmed or evidenced by serum alfa-fetoprotein (AFP) above 100 ng/ml or liver imaging study showing suspected nodules.
• liver disease of a non-HCV etiology (e.g. alcoholic liver disease, nonalcoholic steatohepatitis, drug-induced hepatitis, autoimmune hepatitis, Wilson disease or hemochromatosis, etc.).
• Subjects has the following laboratory parameters at screening: ALT or AST>10×ULN, WBC < 3×109 /L, ANC< 1.5×109 /L（or < 1.25×109 /L for cirrhotics ), PLT< 50×109 /L, Hb < 100 g/L, INR > 1.5×ULN, CLcr < 50 mL/min（calculated by the Cockcroft-Gault equation ）.
• Uncontrolled diabetes mellitus (HbA1c > 8.0% at screening).
• Uncontrolled hyperthyroidism or diminished.
• Psychiatric or neurologic disorders, including previous or family history of psychiatric disorders (especially depression, depressive state, epilepsy or hysteria).
• Serious cardiovascular disorders, including uncontrolled hypertension (systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥100 mmHg), heart insufficiency of New York Heart Association class III or above, history of myocardial infarction within 6 months before the screening, history of percutaneous transluminal coronary angioplasty within 6 months before the screening, unstable angina pectoris, or QTc interval (Fridericia correction formula QTc = QT×RR^-1/3) at or above 450 mse, second- or third-grade atrioventricular block or any other uncontrolled arrhythmias confirmed on repeated electrocardiography on screening.
• Serious hematologic disorders (e.g. anemia, hemophilia, etc.).
• Serious kidney diseases (e.g. chronic kidney disease, kidney insufficiency, etc.).
• Serious gastrointestinal disorders, (e.g. peptic ulcer, colitis, etc.) or post operative condition that could interfere with the absorption of the study drug.
• Serious respirator disorders, (e.g. active pulmonary tuberculosis, lung infection, chronic obstructive pulmonary disease, pulmonary interstitial disease, etc.).
• Malignancy within the 5 years prior to screening, with the exception of specific cancers that have been cured by surgical resection (basal cell skin cancer, etc).
• Solid organ transplantation.
• Hypersensitive predisposition or a known history of serious allergy, especially to the investigational products and substances.
• Positive urine drug screening at screening, or Clinically-relevant alcohol or drug abuse within 12 months of screening, and compliance and effectiveness evaluated by the investigator.
• Positive screening serum pregnancy test or baseline/day 1 serum or urine pregnancy test, and women are confirmed in pregnancy or lactation.
• Women of childbearing age (menopausal women aged ≤ 50 years old are also considered to have fertility), or partners who are women of childbearing age cannot comply with voluntary effective contraceptive measures during the 6 months from screening to the last dose of test drug.
• Use of any prohibited concomitant medications as described in protocol.
• Participated in clinical studies or previously participated within 3 months prior to baseline/Day 1.
• Conditions which investigator judges that it is not suitable for enrollment.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SH229/DCV 400mg/60mg; HCV GT 1-6 participants were medicated with SH229 tablets 400 mg once daily and DCV tablets 60 mg once daily QD (n=40) for 12weeks	Drug: SH229 tablets; SH229 400 mg was provided in 4 tablets, 100mg each；SH229 600 mg was provided in 6 tablets , 100mg each；SH229 800 mg in was provided in 8tablets , 100mg each。; Other Names: Holybuvir; Drug: Daclatasvir dihydrochloride; Daclatasvir dihydrochloride was provided in a single tablet of 60 mg.; Other Names: DAKLINZA
Experimental: SH229/DCV 600mg/60mg; HCV GT 1-6 participants were medicated with SH229 tablets 600 mg once daily and DCV tablets 60 mg once daily (n=40).	Drug: SH229 tablets; SH229 400 mg was provided in 4 tablets, 100mg each；SH229 600 mg was provided in 6 tablets , 100mg each；SH229 800 mg in was provided in 8tablets , 100mg each。; Other Names: Holybuvir; Drug: Daclatasvir dihydrochloride; Daclatasvir dihydrochloride was provided in a single tablet of 60 mg.; Other Names: DAKLINZA
Experimental: SH229/DCV 800mg/60mg; HCV GT 1-6 participants were medicated with SH229 tablets 800 mg once daily and DCV tablets 60 mg once daily (n=40).	Drug: SH229 tablets; SH229 400 mg was provided in 4 tablets, 100mg each；SH229 600 mg was provided in 6 tablets , 100mg each；SH229 800 mg in was provided in 8tablets , 100mg each。; Other Names: Holybuvir; Drug: Daclatasvir dihydrochloride; Daclatasvir dihydrochloride was provided in a single tablet of 60 mg.; Other Names: DAKLINZA
Experimental: SH229/DCV; HCV GT 1-6 participants were medicated with SH229 tablets 400 mg,600 mg or 800 mg once daily and DCV tablets 60 mg once daily	Drug: SH229 tablets; SH229 400 mg was provided in 4 tablets, 100mg each；SH229 600 mg was provided in 6 tablets , 100mg each；SH229 800 mg in was provided in 8tablets , 100mg each。; Other Names: Holybuvir; Drug: Daclatasvir dihydrochloride; Daclatasvir dihydrochloride was provided in a single tablet of 60 mg.; Other Names: DAKLINZA

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sustained virologic response at 12 weeks after end of treatment (SVR12)	Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)	12 weeks after end of treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sustained virologic response at 4 weeks after end of treatment (SVR4)	Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)	4 weeks after end of treatment
Rapid virologic response at 12 weeks after initiation of treatment (RVR12)	Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)	12 weeks after initiation of treatment
Virologic breakthrough	Percentage of subjects with on-treatment re-detected plasma HCV RNA after HCV RNA below the lower limit of quantitation	2, 4, 8 and 12 weeks after initiation of treatment
Virologic relapse	Percentage of subjects with off-treatment re-detected plasma HCV RNA after end-of-treatment HCV RNA below the lower limit of quantitation	4 and 12 weeks after end of treatment
Rapid virologic response at 4 week after initiation of treatment (RVR4)	Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)	4 week after initiation of treatment
Sustained virologic response at 24 weeks after end of treatment (SVR24)	Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)	24 weeks after end of treatment
Antiviral effects of SH229 tablets combined with Daclatasvi dihydrochloride (DCV) tablets , as measured by HCV RNA levels	To evaluate the kinetics of circulating HCV RNA during treatment and after cessation of treatment	Up to 36 weeks

Collaborators and Investigators

• Sponsor: Nanjing Sanhome Pharmaceutical, Co., Ltd.
• Investigators: Principal Investigator: Junqi Niu, Ph.D, The First Hospital of Jilin University

Publications and helpful links

General Publications

• Hua R, Kong F, Wen X, Xiong Q, Chen J, Meng C, Ma H, Tan Y, Huang Y, Jiang Y, Guan Y, Mao X, Wang J, Xin Y, Gao H, Xu B, Li C, Wu Q, Zhang X, Wang Z, Zhao L, Zhang Y, Li G, Niu J. Efficacy and safety of alfosbuvir plus daclatasvir in Chinese patients with hepatitis C virus genotypes 1, 2, 3, and 6 infection: An open-label, phase 2 study. J Viral Hepat. 2022 Jun;29(6):455-464. doi: 10.1111/jvh.13650. Epub 2022 Apr 8.

Study record dates

Study Major Dates

• Study Start (Actual): March 29, 2019
• Primary Completion (Anticipated): December 1, 2019
• Study Completion (Anticipated): August 1, 2020

Study Registration Dates

• First Submitted: August 11, 2019
• First Submitted That Met QC Criteria: August 25, 2019
• First Posted (Actual): August 28, 2019

Study Record Updates

• Last Update Posted (Actual): August 28, 2019
• Last Update Submitted That Met QC Criteria: August 25, 2019
• Last Verified: August 1, 2019

More Information

Terms related to this study

• Keywords: Hepatitis C virus; SH229
• 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
• Other Study ID Numbers: SHC005-II/III-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: Yes