- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT01006031
Retreatment With High Doses of pegIFN Alfa-2a and Ribavirin of Previous Nonresponders HIV-coinfected Patients With Cirrhosis Due to HCV 1-4
Efficacy of High Doses of Both Pegylated Interferon Alfa-2a and Ribavirin for Retreatment of HIV-coinfected Patients With Liver Cirrhosis Due to HCV Genotype 1 or 4 Nonresponders to Previous Standard Therapy.
Objective: To evaluate the efficacy and safety of high doses of both peginterferon-alfa 2a (360 ug per week) plus ribavirin (800 mg b.i.d.) in HIV-infected patients with compensated liver cirrhosis by HCV genotype 1 or 4 without previous virological response(*) to a standard dose treatment of both drugs.
(*) Non previous virological response: no decrease of plasma RNA-HCV at least 2 log10 after 12 weeks in treatment or breakthrough viremia while on treatment.
Additionally, this study will evaluated the influence of simultaneous peginterferon-alfa 2a and ribavirin plasma concentrations on early viral response (EVR) and sustained viral response (SVR) in these patients.
Method: Pilot clinical trial, phase II-III, open labeled multicenter in which patients from several hospitals of the Servicio Andaluz de Salud will be enrolled.
The usual clinical and analytical follow up will be performed but additional blood samples will be obtained for determination of interferon and ribavirin plasma levels. The primary end point will be a sustained virologic response (defined as an undetectable serum HCV-RNA after 24 weeks after the cessation of treatment). Likewise, rapid virological response (at 4 weeks of treatment), early virological response (at 12 weeks), and end of treatment response rates will be evaluated as well as their relationships with the plasma interferon an ribavirin concentrations determined by ELISA and HPLC, respectively. The safety and tolerability of the studied medications will be evaluated by means of clinical adverse events, physical examination and laboratory results. The evolution of liver fibrosis will be evaluated comparing the basal and end of treatment results of transient elastometry.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- Phase 2
- Phase 3
Contacts et emplacements
Lieux d'étude
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-
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Cordoba, Espagne
- Hospital Universitario Reina Sofia
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Seviila, Espagne
- Hospitales Universitarios Virgen del Rocío
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Sevilla, Espagne
- Hospital Universitario de Valme
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Sevilla, Espagne
- Hospital Universitario Virgen Macarena
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Age older than 18 years
- HIV-infected patients with compensated liver cirrhosis by HCV genotype 1 or 4 without previous virological response(*) to a standard dose treatment of both drugs.
- Women of child-bearing age: negative pregnancy test
- Ability to understand and sign a written consent form
Exclusion Criteria:
- HCV genotypes different to 1 or 4
- Acute or chronic hepatitis B infection (positivity for hepatitis B surface antigen or plasma DNA) or other concomitant causes of liver disease
- Pregnancy or breast feeding.
- Decompensated liver disease at baseline.
- Neutropenia <1000/uL, anemia <100 g/L or thrombocytopenia <20.000/uL.
- Creatinine clearance < 50 mL/min.
- Concomitant treatment with immunomodulators or zidovudine, didanosine or stavudine.
- Organ or bone marrow transplantation
- Current alcoholism or iv drug abuse. Methadone is allowed.
- Current neoplasm and/or anti-tumor chemotherapy or immunomodulators
- Psychosis or uncontrolled clinical depression
- Auto-immune disease, including auto-immune hepatitis
- History of significant cardiovascular disease (NYHA III-IV) including but not limited to uncontrolled hypertension, angina pectoris, myocardial infarction, coronary artery surgery and congestive heart failure.
- Thyroid dysfunction.
- Clinically significant retinal abnormalities
- Inability to understand and sign a written consent form
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: PegIFN alfa-2a and Ribavirin
HIV-coinfected patients with compensated cirrhosis by hepatitis C virus, genotype 1 or 4.
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Pegylated interferon alfa-2a (360 ug per week) plus oral Ribavirin (800 mg b.i.d.) for 48 or 72 weeks. The treatment will be discontinued for patients who did not achieve a reduction with respect to baseline of at least 0.5 log10 IU/ml in plasma RNA-HCV levels at week 4 or 2 log10 UI/ml at week 12 and will be considered as viral failures. Duration: 48 weeks for patients reaching an undetectable plasma RNA_HCV at week12 and 72 weeks for those without a negative viremia at week 12 but a reduction of at least 2 log10 IU/ml in RNA-HCV levels.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
---|---|
Sustained viral response (undetectable serum HCV-RNA)
Délai: Throughout treatment and 24 weeks after finishing it
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Throughout treatment and 24 weeks after finishing it
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Mesures de résultats secondaires
Mesure des résultats |
Délai |
---|---|
Relationships between the plasma interferon an ribavirin concentrations and efficacy
Délai: Throughout treatment and 24 weeks after finishing it.
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Throughout treatment and 24 weeks after finishing it.
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safety and tolerability of the studied medications
Délai: Throughout treatment and 24 weeks after finishing it
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Throughout treatment and 24 weeks after finishing it
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The evolution of liver fibrosis will be evaluated comparing the basal and end of treatment results of transient elastometry
Délai: baseline and after finishing treatment
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baseline and after finishing treatment
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Collaborateurs et enquêteurs
Les enquêteurs
- Directeur d'études: Luis F Lopez-Cortes, MD, PhD, Instituto de Biomedicina de Sevilla. Hospitales Universitarios Virgen del Rocio
- Chercheur principal: Luis F Lopez-Cortes, MD, PhD, Instituto de Biomedicina de Sevilla. Hospitales Universitarios Virgen del Rocio
- Chercheur principal: Antonio Rivero, MD, PhD, Hospital Universitario Reina Sofia. Cordoba
- Chercheur principal: Mª Jose Rios-Villegas, MD, PhD, Hospital Universitario Viren MAcarena. Sevilla
- Chercheur principal: Juan A. Pineda, MD, PhD, Hospital Universitario de Valme. Sevilla
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Maladies du système digestif
- Processus pathologiques
- Infections par virus à ARN
- Maladies virales
- Infections
- Infections transmissibles par le sang
- Maladies transmissibles
- Maladies sexuellement transmissibles, virales
- Maladies sexuellement transmissibles
- Infections à lentivirus
- Infections à rétroviridae
- Syndromes d'immunodéficience
- Maladies du système immunitaire
- Maladies du foie
- Infections à Flaviviridae
- Hépatite, virale, humaine
- Fibrose
- Infections à VIH
- Hépatite
- Hépatite C
- La cirrhose du foie
- Effets physiologiques des médicaments
- Mécanismes moléculaires de l'action pharmacologique
- Agents anti-infectieux
- Agents antiviraux
- Antimétabolites
- Agents antinéoplasiques
- Facteurs immunologiques
- Interférons
- Interféron-alpha
- Ribavirine
- Peginterféron alfa-2a
- Interféron alpha-2
Autres numéros d'identification d'étude
- HEPAVIR_IFN_2009
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