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Retreatment With High Doses of pegIFN Alfa-2a and Ribavirin of Previous Nonresponders HIV-coinfected Patients With Cirrhosis Due to HCV 1-4

28. desember 2011 oppdatert av: Antonio Rivero, Sociedad Andaluza de Enfermedades Infecciosas

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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

25

Fase

  • Fase 2
  • Fase 3

Kontakter og plasseringer

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

Studiesteder

  • Spania
      • Cordoba, Spania
        • Hospital Universitario Reina Sofia
      • Seviila, Spania
        • Hospitales Universitarios Virgen del Rocío
      • Sevilla, Spania
        • Hospital Universitario de Valme
      • Sevilla, Spania
        • Hospital Universitario Virgen Macarena

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 og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

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: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: PegIFN alfa-2a and Ribavirin
HIV-coinfected patients with compensated cirrhosis by hepatitis C virus, genotype 1 or 4.
Legemiddel: Pegylated interferon alfa-2a and Ribavirin

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.

Andre navn:
  • Pegasys
  • Copegus

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Sustained viral response (undetectable serum HCV-RNA)
Tidsramme: Throughout treatment and 24 weeks after finishing it
Throughout treatment and 24 weeks after finishing it

Sekundære resultatmål

Resultatmål
Tidsramme
Relationships between the plasma interferon an ribavirin concentrations and efficacy
Tidsramme: Throughout treatment and 24 weeks after finishing it.
Throughout treatment and 24 weeks after finishing it.
safety and tolerability of the studied medications
Tidsramme: Throughout treatment and 24 weeks after finishing it
Throughout treatment and 24 weeks after finishing it
The evolution of liver fibrosis will be evaluated comparing the basal and end of treatment results of transient elastometry
Tidsramme: baseline and after finishing treatment
baseline and after finishing treatment

Samarbeidspartnere og etterforskere

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

Sponsor

Sociedad Andaluza de Enfermedades Infecciosas

Etterforskere

  • Studieleder: Luis F Lopez-Cortes, MD, PhD, Instituto de Biomedicina de Sevilla. Hospitales Universitarios Virgen del Rocio
  • Hovedetterforsker: Luis F Lopez-Cortes, MD, PhD, Instituto de Biomedicina de Sevilla. Hospitales Universitarios Virgen del Rocio
  • Hovedetterforsker: Antonio Rivero, MD, PhD, Hospital Universitario Reina Sofia. Cordoba
  • Hovedetterforsker: Mª Jose Rios-Villegas, MD, PhD, Hospital Universitario Viren MAcarena. Sevilla
  • Hovedetterforsker: Juan A. Pineda, MD, PhD, Hospital Universitario de Valme. Sevilla

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. oktober 2009

Primær fullføring (Faktiske)

1. desember 2011

Studiet fullført (Faktiske)

1. desember 2011

Datoer for studieregistrering

Først innsendt

29. oktober 2009

Først innsendt som oppfylte QC-kriteriene

29. oktober 2009

Først lagt ut (Anslag)

1. november 2009

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

30. desember 2011

Siste oppdatering sendt inn som oppfylte QC-kriteriene

28. desember 2011

Sist bekreftet

1. desember 2011

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • HEPAVIR_IFN_2009

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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