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High Dose Versus Standard Dose of Ribavirin in Patients With Chronic Hepatitis C, Genotype 3 (DARGEN-3)

12. mars 2012 oppdatert av: Dr. Conrado Fernandez

Effect of High Dose vs. Standard Dose of Ribavirin in Patients With Chronic Hepatitis C, Genotype 3, High Viral Load Without Rapid Virological Response

The rate of sustained virological response (SVR) in patients with chronic hepatitis C, genotype 3, high viral load and without rapid virological response (RNA-HCV negative at week 4) is low. Standard of care of these patients include treatment with weekly peginterferon plus 800 mg/day of ribavirin (RBV). Extended treatment to 48 weeks does not provide more clinical benefit than the standard duration. The main hypothesis is that higher dose of ribavirin may be better in terms of SVR than the standard dose.

Studieoversikt

Detaljert beskrivelse

Aims:

  1. Efficacy 1.1) Rate of RNA-HCV negative at week 4 and 24 in each arm. 1.2) Rate of SVR in each arm.
  2. Safety 2.1) Rate of adverse effects in each arm.

Design: Randomized controlled trial.

Patients will be randomly allocated into three arms:

Arm A : Peginterferon α-2a (180 μg/week)SC. plus Ribavirin (800 mg/day) p.o. over 24 weeks.

Arm B: Peginterferon α-2a (180 μg/week) plus Ribavirin (1600 mg/day) with support of Epoetin β (450 IU/kg/week) SC over 4 weeks:

B1.- If RNA-HCV undetectable at week 4, standard of care will be continued (Peginterferon α-2a, 180 μg/wee plus Ribavirin (800 mg/day) over 20 additional weeks).

B2.- If RNA-HCV were detectable at week 4, treatment will be continued with peginterferon α-2a (180 μg/week) plus RBV(1,600 mg/day) plus Epoetin β (450 UI/kg/week) over 20 additional weeks.

Sample size: 111 patients. To increase the SVR from 50% to 75%. Beta: 0.1; alfa: 0.05; Loss: 15%.

Randomization will be 1:2, 37 patients in Group A and 74 patients in group B.

Studietype

Intervensjonell

Registrering (Faktiske)

101

Fase

  • Fase 4

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

      • Barcelona, Spania, 08003
        • Hospital del Mar
      • Barcelona, Spania, 08036
        • Hospital Clinic i Provincial de Barcelona
      • Córdoba, Spania, 14004
        • Hospital Universitario Reina Sofia
      • Granada, Spania
        • Hospital San Cecilio
      • Granada, Spania, 18004
        • Hospital Universitario Virgen de Las Nieves
      • León, Spania, 24071
        • Hospital de Leon
      • Madrid, Spania, 28034
        • Hospital Ramón Y Cajal
      • Madrid, Spania, 28007
        • Hospital Gregorio Marañón
      • Madrid, Spania, 28006
        • Hospital La Princesa
      • Madrid, Spania, 28021
        • Hospital 12 de Octubre
      • Málaga, Spania, 29010
        • Hospital Clinico Universitario Virgen de la Victoria
      • Oviedo, Spania, 33006
        • Hospital Central de Asturias
      • Salamanca, Spania, 37007
        • Hospital Clínico Universitario de Salamanca
      • Santander, Spania, 39008
        • Hospital Marqués de Valdecilla
      • Sevilla, Spania, 41014
        • Hospital De Valme
      • Valencia, Spania, 46010
        • Hospital Clinico Universitario de Valencia
      • Valladolid, Spania, 47005
        • Hospital Clinico Universitario de Valladolid
      • Vitoria, Spania, 01004
        • Hospital Santiago Apostol
      • Zaragoza, Spania, 50009
        • Hospital Miguel Servet
      • Zaragoza, Spania, 50009
        • Hospital Clínico de Zaragoza
    • Barcelona
      • Badalona, Barcelona, Spania, 08916
        • Hospital Germans Trias i Pujol
      • L´Hospitalet de Llobregat, Barcelona, Spania, 08907
        • Hospital De Bellvitge
      • Sabadell, Barcelona, Spania, 08208
        • Hospital Parc Tauli
    • Guipuzcoa
      • San Sebastian, Guipuzcoa, Spania, 20014
        • Hospital de Donostia
    • Madrid
      • Alcorcón, Madrid, Spania, 28922
        • Hospital Fundación Alcorcón
      • Getafe, Madrid, Spania, 28901
        • Hospital de Getafe
      • Majadahonda, Madrid, Spania, 28222
        • Hospital Puerta de Hierro
    • Málaga
      • Marbella, Málaga, Spania, 29603
        • Hospital Costa del Sol

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 70 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • HCV Genotype 3
  • RNA-HCV > > 600.000 IU/ml.
  • Compromise to use contraceptive measures on treatment until 6 months after the end of treatment.

Exclusion Criteria:

  • Pregnant or breastfeeding females.
  • Concurrent treatment with antineoplastic or immunomodulatory agents, including corticosteroids or radiation therapy over the last 6 months before starting the trial
  • Treatment with investigational drugs < 6 weeks before starting the trial
  • Chronic liver disease other than hepatitis C.
  • Evidence of hepatocellular carcinoma.
  • Evidence of carcinoma hepatocellular
  • Decompensated liver disease
  • Baseline Neutrophil count < 1500/cc; or Platelet count < 90,000/cc
  • Baseline Hemoglobin <12 g/dL in females o <13 g/dL in males.
  • Increased risk of anemia(Eg, thalassemia, spherocytosis..).
  • Ischemic heart disease or cerebrovascular disease.
  • Serum creatinine >1.5 times upper limit of normality.
  • History of severe psychiatric conditions (Major antidepressives or neuroleptic drugs required for major depression or psychosis), suicide attempts or psychiatric disability .
  • History of convulsive disorders.
  • Immunological conditions.
  • Chronic Obstructive Lung Disease with limited functionality
  • Severe heart disease or congestive cardiac insufficiency cardiopathy grave.
  • Advanced atherosclerosis
  • Solid organ or bone marrow transplant.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: A
Patients in this arm will receive standard of care (Peginterferon alfa 2A 180 mcg/weeks SC plus ribavirin 800 mg/day for 24 weeks).
Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 800 mg/day po (Control Group) Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day po plus Epoetin β (450 IU/kg/week) SC over 4 weeks (Arm B1) Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day po plus Epo beta 450 UI over four weeks (Arm B1) If RNA-HCV positive at week 4, Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day plus Epo beta 450 UI to keep Hb>12 g/dL if required over 20 additional weeks (Arm B2)
Andre navn:
  • Pegasys
RBV 1600 mg/day 24 weeks
Andre navn:
  • peginterferon alfa 2 a
  • Epoetin beta
ribavirin 800 mg/day for 24 weeks
Andre navn:
  • Pegasys
RBV 1600 mg/day 4 weeks and then ribavirin 800 mg/day 20 weeks
Andre navn:
  • Pegasys
Eksperimentell: B1
After a period of 4 weeks with peginterferon alfa 2 a 180 mcg/week plus RBV 1600 mg/day (Induction phase), these patients will be allocated according to negativity or positivity of RNA-HCV at week 4. If RNA-HCV negative, treatment with peginterferon alfa 2 a 180 mcg/week plus RBV 800 mg/day (SOC) will be continued over 20 additional weeks (Arm B1). Epo β (450 IU/kg/week) will be administered as required to maintain hemoglobin > 12g/dL.
Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 800 mg/day po (Control Group) Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day po plus Epoetin β (450 IU/kg/week) SC over 4 weeks (Arm B1) Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day po plus Epo beta 450 UI over four weeks (Arm B1) If RNA-HCV positive at week 4, Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day plus Epo beta 450 UI to keep Hb>12 g/dL if required over 20 additional weeks (Arm B2)
Andre navn:
  • Pegasys
RBV 1600 mg/day 24 weeks
Andre navn:
  • peginterferon alfa 2 a
  • Epoetin beta
ribavirin 800 mg/day for 24 weeks
Andre navn:
  • Pegasys
RBV 1600 mg/day 4 weeks and then ribavirin 800 mg/day 20 weeks
Andre navn:
  • Pegasys
Ribavirin 1,600 mg/day plus peginterferon alfa 2A 180 mcg/week plus Epo beta 450 IU/Kg/day to maintain Hb>12g/dl over 4 or 24 weeks
Andre navn:
  • Pegasys
Peginterferon alfa 2 a 180 mcg/week for 4 weeks and then peginterferon alfa 2A for 20 weeks
Andre navn:
  • Pegasys
Eksperimentell: B2
If RNA-HCV at week 4 remains positive after the induction phase, then peginterferon alfa 2 a 180 mcg/week plus RBV 1600 mg/day will be continued for 20 additional weeks (Arm B2). Epo β (450 IU/kg/week) will be administered as required to maintain hemoglobin > 12g/dL.
Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 800 mg/day po (Control Group) Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day po plus Epoetin β (450 IU/kg/week) SC over 4 weeks (Arm B1) Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day po plus Epo beta 450 UI over four weeks (Arm B1) If RNA-HCV positive at week 4, Peginterferon alfa 2 A 180 mcg/week SC plus Ribavirin 1,600 mg/day plus Epo beta 450 UI to keep Hb>12 g/dL if required over 20 additional weeks (Arm B2)
Andre navn:
  • Pegasys
RBV 1600 mg/day 24 weeks
Andre navn:
  • peginterferon alfa 2 a
  • Epoetin beta
ribavirin 800 mg/day for 24 weeks
Andre navn:
  • Pegasys
RBV 1600 mg/day 4 weeks and then ribavirin 800 mg/day 20 weeks
Andre navn:
  • Pegasys
Ribavirin 1,600 mg/day plus peginterferon alfa 2A 180 mcg/week plus Epo beta 450 IU/Kg/day to maintain Hb>12g/dl over 4 or 24 weeks
Andre navn:
  • Pegasys

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Rate of patients with RNA-HCV negative in each arm at week 24 after the end of treatment.
Tidsramme: 1 year
1 year

Sekundære resultatmål

Resultatmål
Tidsramme
Rate of patients with undetectable RNA-HCV in each arm at week 4 and 24 of treatment. Rate of adverse effects in each arm.
Tidsramme: 1 year
1 year

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studieleder: Conrado M Fernandez-Rodriguez, Hospital Universitario Fundacion Alcorcon; University Rey Juan Carlos.

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. november 2008

Primær fullføring (Faktiske)

1. september 2011

Studiet fullført (Faktiske)

1. desember 2011

Datoer for studieregistrering

Først innsendt

27. januar 2009

Først innsendt som oppfylte QC-kriteriene

27. januar 2009

Først lagt ut (Anslag)

28. januar 2009

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

13. mars 2012

Siste oppdatering sendt inn som oppfylte QC-kriteriene

12. mars 2012

Sist bekreftet

1. mars 2012

Mer informasjon

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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