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Assessing the Efficacy and Safety of Rosiglitazone Added to Standard Therapy for Hepatitis C Genotype 1 With Fatty Liver

31 octobre 2007 mis à jour par: Beth Israel Medical Center

Randomized Placebo-Control Pilot Study Evaluating the Efficacy and Safety of Rosiglitazone Combined With Pegylated Interferon Plus Ribavirin Versus Pegylated Interferon Plus Ribavirin Alone in Genotype 1 Hepatitis C With Steatosis

To study the effectiveness and safety of adding Rosiglitazone, an insulin sensitizing agent to people with chronic hepatitis C infection genotype 1 with fatty liver disease, who are being treated with standard therapy. Standard therapy consists of weekly pegylated interferon injections and daily ribavirin pills, whose dosage is weight based. This regimen in genotype 1 patients is effective in only 45% of patients at best. In addition, this therapy must be given for 48 weeks to be effective and has alot of side-effects. One risk factor for a poor response is fatty liver. Rosiglitazone has been shown to be effective in the treatment of patients with fatty liver alone. This study hopes to show that the addition of Rosiglitazone to the standard therapy in genotype 1 patients with fatty liver disease will increase effectiveness of the standard therapy of hepatitis C.

Aperçu de l'étude

Statut

Résilié

Les conditions

Intervention / Traitement

Médicament: Rosiglitazone and Pegasys/Ribavirin

Description détaillée

Eligible thirty subjects will be randomized in a double blinded fashion to either Rosiglitazone 4mg pills twice a day versus placebo for six weeks. Then after this six week period, both groups will be treated for 48 weeks of standard therapy for hepatitis C consisting of Pegasys 180mcq weekly injections with Ribavirin 1,000mg-1,200mg daily depending if the subject weights less than 75 kg will then receive the lower dosage. In addition, the subjects will be continued on Rosiglitazone or placebo for the 48 weeks.

The subjects will be monitored for side-effects by history taking and blood testing at predetermined time periods during the study. If the viral load has not dropped more than two log at week 12 of standard therapy for hepatitis C then therapy will be stopped and the subject is considered a treatment failure. Similarly, if there was a greater than two log drop in the viral load at week 12 but there is still virus present in the blood at week 24 then therapy is stopped and the subject is considered treatment failure. If the virus is undetectable in the blood at week 12 and 24 then therapy is continued for the full 48 weeks. If the virus is detectable at week 48 then the subject is considered a treatment failure.

After this 48 week treatment period and the virus is still undetectable, there is a follow-up period consisting of 24 weeks off therapy. At the end of the 24 weeks, blood will be tested for the virus and if the virus is not present then the subject has a sustained viral response and is a treatment success.

During therapy if the subject becomes significantly anemic Procrit 40,000Units weekly injections will be started. Similarly, if the white blood cell count drops below a certain level then weekly Neupogen 300mcq injections will be started. In addition, if there is mild depressive symptoms treatment will be started but if there is major depressive symptoms, then therapy will be stopped and a referral to a psychiatrist will be made.

Type d'étude

Interventionnel

Inscription (Anticipé)

Phase

Phase 4

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

États-Unis
- New York
  - New York, New York, États-Unis, 10003
    - Beth Israel Medical Center - Philipps Ambulatory Care Center

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

21 ans à 65 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

Men and women at least 21 years of age.
Positive serum hepatitis C RNA for at least 6 months.
Naive to any therapy for hepatitis C infection.
Significant steatosis or fat on the liver biopsy.
Genotype 1 patients.

Exclusion Criteria:

Subjects with decompensated liver disease.
Hemoglobin <12g/dl.
WBC<2,000mm3.
ANC<1,000mm3.
Platelet count<50,000/mm3.
Creatinine>1.5mg/dl.
Albumin<2.5g/dl.
Bilirubin>4mg/dl.
HIV or hepatitis B co-infection.
History of other liver disease besides fatty liver disease.
History of unstable cardiac or cerebrovascular disease.
History of significant psychiatric disorders.
Alcohol or drug abuse within last year.
Pregnant or lactating women or men whose sexual partner is pregnant or lactating.
Taking of insulin or oral hypoglycemic agents within six months of the study.
Uncontrolled thyroid disorder.
History of malignancy within the past 5 years unless cured by surgery.
History of autoimmune disorder or organ transplantations requiring immunosuppression.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Objectif principal: Traitement
Répartition: Randomisé
Modèle interventionnel: Affectation parallèle
Masquage: Double

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
To compare the efficacy of Rosiglitazone in combination with pegylated interferon alfa-2a and ribavirin (weight-based) to that of pegylated interferon alfa-2a and ribavirin alone in terms of sustained viral response.

Mesures de résultats secondaires

Mesure des résultats
To compare the safety and tolerability of Rosiglitazone in combination with pegylated interferon-2a and ribavirin to that of pegylated interferon alfa-2a and ribavirin alone in terms of adverse events.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Beth Israel Medical Center

Les enquêteurs

Chercheur principal: Douglas Meyer, M.D., Beth Israel Medical Center
Directeur d'études: Henry C. Bodenheimer, M.D., Beth Israel Medical Center

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 janvier 2006

Achèvement de l'étude (Réel)

1 octobre 2007

Dates d'inscription aux études

Première soumission

9 janvier 2006

Première soumission répondant aux critères de contrôle qualité

10 janvier 2006

Première publication (Estimation)

11 janvier 2006

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

1 novembre 2007

Dernière mise à jour soumise répondant aux critères de contrôle qualité

31 octobre 2007

Dernière vérification