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Sofosbuvir and Ribavirin in Patients With Chronic HCV With Cirrhosis and Portal Hypertension With or Without Liver Decompensation

5. august 2016 opdateret af: Gilead Sciences

A Phase 2, Multicenter, Open-Label, Randomized Study to Investigate the Safety and Efficacy of GS-7977 and Ribavirin Administered for 48 Weeks in Patients Infected With Chronic HCV With Cirrhosis and Portal Hypertension With or Without Liver Decompensation

This study will evaluate the antiviral efficacy of combination therapy with sofosbuvir (SOF) plus ribavirin (RBV) for 48 weeks in adults with compensated and decompensated chronic hepatitis C virus (HCV) infection. Approximately 50 adults will be randomized (1:1) to receive study drug for 48 weeks or take part in an untreated observational arm for the first 24 weeks followed by study drug for another 48 weeks.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

50

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Australien
    • New South Wales
      • Newtown, New South Wales, Australien
  • Forenede Stater
    • Colorado
      • Aurora, Colorado, Forenede Stater
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater
    • Minnesota
      • Rochester, Minnesota, Forenede Stater
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forenede Stater
  • Frankrig
    • Clichy
      • Leclerc, Clichy, Frankrig
  • New Zealand
    • Auckland
      • Grafton, Auckland, New Zealand
  • Spanien
      • Barcelona, Spanien
    • Madrid
      • Majadahonda, Madrid, Spanien

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Chronic infection with Hepatitis C with HCV RNA > 1000 IU/mL
  • Individuals with cirrhosis with Child-Pugh score < 10
  • Esophageal or gastric varices on endoscopy within 6 months prior to or at screening
  • Hepatic Venous Pressure Gradient (HVPG) > 6 mmHg
  • Body mass index (BMI) ≥ 18 kg/m^2
  • Naïve to all nucleotides/nucleoside treatments for chronic HCV infection

Exclusion Criteria:

  • Have any serious or active medical or psychiatric illness which, in the opinion of the investigator, would interfere with subject treatment, assessment, or compliance
  • HIV or chronic hepatitis B virus (HBV) infection (HBsAg positive)
  • Alpha-fetoprotein (AFP) > 50 unless negative imaging for hepatic masses within the last 6 months or during screening
  • Refractory ascites as defined by requiring paracentesis > twice within 1 month prior to screening
  • Active variceal bleeding within 6 months of screening
  • Expected survival of < 1 year
  • History of hepatorenal, or hepatopulmonary syndrome.
  • Evidence of renal impairment (CrCl < 50 mL/min)
  • History of major organ transplantation, including liver transplant.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: SOF+RBV
Participants will receive SOF+RBV for 48 weeks.
Medicin: RBV
RBV-tabletter indgivet oralt i en opdelt daglig dosis i henhold til indlægssedlens vægtbaserede doseringsanbefalinger (< 75 kg = 1000 mg og ≥ 75 kg = 1200 mg)
Medicin: SOF
SOF 400 mg tablet indgivet oralt én gang dagligt
Andre navne:
  • Sovaldi®
  • GS-7977
Eksperimentel: Observation, then SOF+RBV
Participants will undergo 24 weeks of observation and then receive SOF+RBV for 48 additional weeks.
Medicin: RBV
RBV-tabletter indgivet oralt i en opdelt daglig dosis i henhold til indlægssedlens vægtbaserede doseringsanbefalinger (< 75 kg = 1000 mg og ≥ 75 kg = 1200 mg)
Medicin: SOF
SOF 400 mg tablet indgivet oralt én gang dagligt
Andre navne:
  • Sovaldi®
  • GS-7977

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Percentage of Participants With Sustained Virologic Response (SVR) 12 Weeks After Discontinuation of Therapy (SVR12)
Tidsramme: Posttreatment Week 12 (SOF+RBV) and up to 24 weeks (Observation)
SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, 25 IU/mL) at 12 weeks after stopping study treatment. For the Observation/SOF+RBV group, SVR12 during the observational period was defined as HCV RNA < LLOQ for 12 consecutive weeks, any time during the observational period.
Posttreatment Week 12 (SOF+RBV) and up to 24 weeks (Observation)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Percentage of Participants With SVR at 4, 24, and 48 Weeks After Discontinuation of Therapy (SVR4, SVR24, and SVR48)
Tidsramme: Posttreatment Weeks 4, 24, and 48
SVR4, SVR24, and SVR48 were defined as HCV RNA < LLOQ at 4, 24, and 48 weeks after stopping study treatment, respectively.
Posttreatment Weeks 4, 24, and 48
Percentage of Participants Experiencing On-Treatment Virologic Failure
Tidsramme: Up to 48 weeks

On-treatment virologic failure was defined as:

  • Breakthrough (confirmed HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment), or
  • Rebound (confirmed > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment), or
  • Non-response (HCV RNA persistently ≥ LLOQ through 8 weeks of treatment)
Up to 48 weeks
Percentage of Participants Experiencing Viral Relapse
Tidsramme: Up to Posttreatment Week 24
Viral relapse was defined as HCV RNA ≥ LLOQ during the post-treatment period having achieved HCV RNA < LLOQ at end of treatment, confirmed with 2 consecutive values or last available post-treatment measurement.
Up to Posttreatment Week 24
Change From Baseline in Hepatic Venous Pressure Gradient (HVPG) at End of Treatment
Tidsramme: Baseline; Week 24 (Observation) and Week 48 (SOF+RBV)
HVPG closely reflects the degree of portal hypertension in patients with cirrhosis. The end of treatment for the Observation group was defined as the end of the observation period. The treatment period for Group 2 was defined as the end of the observation period to the end of the treatment. Baseline values were the last available values on or prior to first dose date of any study drug.
Baseline; Week 24 (Observation) and Week 48 (SOF+RBV)
Change From Baseline in Child-Pugh-Turcotte (CPT) Score
Tidsramme: Baseline; Week 24 (Observation) and Posttreatment Week 4 (SOF+RBV)

CPT scores, widely used to grade the severity of cirrhosis and to determine the need for liver transplantation, are calculated based on a combination of laboratory values and clinical features. CPT scores can range from 5 to 15, with higher scores indicating a greater severity of disease. Data are presented as improvement, no change, or worsening in CPT scores at Week 24 (Observation) and Posttreatment Week 4 (SOF+RBV groups).

Improvement in CPT score was defined as having a decrease in CPT score from baseline, no change in CPT score was defined as having no change in CPT score from baseline, and worsening in CPT score was defined as having an increase in CPT score from baseline.

Baseline values were the last available values on or prior to first dose date of any study drug.
Baseline; Week 24 (Observation) and Posttreatment Week 4 (SOF+RBV)
Change From Baseline in Model for End Stage Liver Disease (MELD) Scores
Tidsramme: Baseline; Week 24 (Observation) and Posttreatment Week 4 (SOF+RBV)

MELD scores, used to assess prognosis and suitability for transplant, are calculated based on laboratory values only and can range from 6 to 40, with higher scores indicating greater disease severity. Data are presented as improvement, no change, or worsening in MELD scores at Week 24 (Observation) and Posttreatment Week 4 (SOF+RBV groups).

Improvement in MELD score was defined as having a baseline MELD score of 11-15 or 16-20 that changed to 0-10, or a baseline MELD score of 16-20 that changed to 11-15; no change in MELD score was defined as having no change in score group (0-10, 11-15, or 16-20) from baseline; and worsening in MELD score was defined as having a baseline MELD score of 0-10 that changed to 11-15 or 16-20, or a baseline MELD score of 11-15 that changed to 16-20.

Baseline values were the last available values on or prior to first dose date of any study drug.
Baseline; Week 24 (Observation) and Posttreatment Week 4 (SOF+RBV)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Gilead Sciences

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. juli 2012

Primær færdiggørelse (Faktiske)

1. januar 2015

Studieafslutning (Faktiske)

1. oktober 2015

Datoer for studieregistrering

Først indsendt

12. september 2012

Først indsendt, der opfyldte QC-kriterier

13. september 2012

Først opslået (Skøn)

18. september 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

16. september 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. august 2016

Sidst verificeret

1. august 2016

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • GS-US-334-0125
  • 2012-002457-29 (EudraCT nummer)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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