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Patterns of Early Hepatitis C Virus Decline Predict the Outcome of Interferon Therapy (sIFN-pred2) (sIFN-pred2)

1. januar 2013 oppdatert av: Junqi Niu

Study of Parameters of Early Hepatitis C Virus Dynamics for Predicting the Outcome of Standard Interferon Therapy With Chinese Cohort (Second Phase)

The purpose of this study is to validate the first round HCV early dynamics discovery within a larger population.

Studieoversikt

Detaljert beskrivelse

Hepatitis C virus (HCV) infection rate in China is about 3%, which means about 30 million patients. Combination therapy of ribavirin and interferons (IFN) is the standard clinical treatment of HCV chronical infections. However, overall rate of sustained virological response (SVR) still do not exceed 60% even with ribavirin and peg-IFN. Due to several virus- and patient-related factors, treatment is even less successful in certain populations, especially in HCV genotype 1 infection. Thus the standard therapy duration is optimized according to the virus genotype in the clinical practice. Nowadays, two direct antiviral agents (DAAs) have been approved by Food and Drug Administration (FDA) of USA this year, which increases the SVR rate. However, high price, side effects and long duration render people to hesitate about the addition of the third drug in the traditional prescription.

Predicting the outcome of traditional therapy is the cornerstone of the personalized therapy for HCV infected patients. In order to obtain an accurate prediction, different methods have been tried. Several indicators have been suggested to predict the final treatment outcomes. Rapid Virus Response (RVR), which indicates the non-detectable virus at the forth week since therapy starts, has been used to predict the final treatment outcome.Other indicators, including virus genotype, host genotype of IL-28B, human race and interferon stimulated genes (ISG) expression have also been shown to relate to and be able to predict the treatment outcomes to some extent. Here the investigators propose that the HCV virus dynamics analysis will give a more precise prediction for the therapy outcome.

The general idea is that blood HCV titration data is obtained continuously in the early treatment period (first 2 weeks) of the patients who have strictly followed the therapy method. These titration data will be used to draw virus dynamics curve and calculate the corresponding parameters individually. The parameter(s) that can distinguish patients who reach the therapy evaluation standard from those who failed to reach the evaluation standard will be selected out, and such parameter(s) may be used to predict the therapy outcome of a new patient in the early stage of his/her treatment.

Studietype

Observasjonsmessig

Registrering (Forventet)

300

Kontakter og plasseringer

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

Studiesteder

    • Jilin
      • Changchun, Jilin, Kina, 130061
        • Rekruttering
        • First Hospital Jilin University
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Yu Pan, PhD/MD

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

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Patients are from the northeast of China. Most of the patients have been infected by the hepatitis c virus due to the drug abuse. Many of them share the same syringe for drug intravenous injection. However, HIV infection has been rarely detected.

Beskrivelse

Inclusion Criteria:

  • Serologic evidence of chronic hepatitis C infection by an anti-HCV antibody test
  • Serum HCV-RNA > 3 log IU/ml
  • Has been infected by HCV for more than 6 months
  • ALT,AST have been elevated continuously, inflammation and necrosis have been observed according to the histology diagnosis (G>=2),modest liver fibrosis (S>=2)For those patients whose ALT are normal,treatment accord to the liver biopsy. If obvious fibrosis has been detected (S2,S3),treatment should be done.For those S0,S1 stage patients, treatment could be delayed, but ALT/AST should be assayed every 3-6 months.
  • Compensated liver disease
  • Patients have never been treated with traditional interferon plus ribavirin or peginterferon plus ribavirin

Exclusion Criteria:

-

History:

  • Has history of decompensated liver diseases
  • Has been treated with other anti-virus drugs,or anti-tumor drugs,immuno-suppression drugs
  • Has a history of autoimmune hepatitis
  • History of a severe seizure disorder or current anticonvulsant use
  • History or other evidence of a medical condition associated with chronic liver disease other than HCV which would make the patient, in the opinion of the investigator, unsuitable for the study (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures)
  • Patients with documented or presumed coronary artery disease or cerebrovascular disease should not be enrolled if, in the judgment of the investigator, an acute decrease in hemoglobin by up to 4g/dL (as may be seen with ribavirin therapy) would not be well-tolerated
  • History of thyroid disease poorly controlled on prescribed medications, elevated thyroid stimulating hormone (TSH) concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease

Current condition:

  • Pregnant women or women during the lactation period
  • Co-infected with hepatitis b virus or human immunodeficiency virus
  • Liver cancer or alpha-fetoprotein > 100ng/ml
  • Blood neutrophils count < 1500/mm3, or platelets count < 90000/mm3
  • Female hemoglobin <11.5g/dL, male hemoglobin <12.5g/dL
  • Blood creatinine > 1.5 ULN
  • Have severe mental diseases,especially depression
  • Severe pulmonary dysfunction
  • Severe cardiovascular disease
  • Uncontrolled diabetes
  • Uncontrolled thalassemia
  • Evidence of alcohol abuse (alcohol consumption>40 g/day)
  • Unwillingness to provide informed consent or abide by the requirements of the study
  • Local or System malignancy unstable status

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Interferon og ribavirin
Alle pasientene fulgte standard behandlingsprotokoll.

Interferon:dosage,5 million units/person;frequency,every other day (qod);duration,48 weeks;Subcutaneous injection.

Ribavirin: dosage,15mg/kg/day;frequency,three times a day (t.i.d);duration,48 weeks;take orally.

Andre navn:
  • Other Names:IFN+Ribavirin
  • Generisk: Rekombinant humant interferon alfa-2b, ribavirin
  • Merke: Kaiyinyisheng, Weilake
  • FDA-godkjenningsnummer: S20030032, H10940157

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Absolute Blood HCV RNA Copies at designed time points
Tidsramme: 0hr,24hr,1wk,2wk,4wk,6wk,12wk,24wk,48wk,72wk
Blood HCV RNA copies were assayed with Roche - COBAS® AmpliPrep/COBAS® TaqMan® HCV Test.
0hr,24hr,1wk,2wk,4wk,6wk,12wk,24wk,48wk,72wk

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
HCV genotype
Tidsramme: Grunnlinje
HCV NS5A klones inn i T-vektor og sekvenseres for evolusjonsanalyse.
Grunnlinje
Narkotikamisbrukshistorie
Tidsramme: Grunnlinje
Pasienter vil bli spurt om deres medisinbrukshistorie.
Grunnlinje
IL-28B polymorfisme
Tidsramme: Grunnlinje
IL28 genpolymorfisme, rs8099917, rs12979860, etc
Grunnlinje
Alanine Aminotransferase (ALT) and Aspartate transaminase (AST)
Tidsramme: Baseline,4wk,12wk,24wk,48wk
ALT AST are assayed to detect the hepatic function.
Baseline,4wk,12wk,24wk,48wk
Fibrosis stage
Tidsramme: Baseline,4wk,12wk,24wk,48wk
Fibrosis is analyzed with Fibroscan.
Baseline,4wk,12wk,24wk,48wk
Regular blood test
Tidsramme: Baseline,4wk,12wk,24wk,48wk
The distribution and absolute count of the different types of blood cells are assayed.
Baseline,4wk,12wk,24wk,48wk
Electrocardiography
Tidsramme: Baseline,4wk,12wk,24wk,48wk
Electrocardiography is taken to avoid severe side effects.
Baseline,4wk,12wk,24wk,48wk
Alcohol ,smoking condition
Tidsramme: Baseline,4wk,12wk,24wk,48wk
Patients are asked whether they take alcohol or smoke cigarettes during the therapy period.
Baseline,4wk,12wk,24wk,48wk

Samarbeidspartnere og etterforskere

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

Sponsor

Samarbeidspartnere

Etterforskere

  • Studiestol: Bing Sun, Doctor, Chinese Academy of Sciences
  • Studieleder: Chen Yang, Doctor, Chinese Academy of Sciences

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.

Generelle publikasjoner

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. juli 2012

Primær fullføring (Forventet)

1. februar 2014

Studiet fullført (Forventet)

1. mars 2014

Datoer for studieregistrering

Først innsendt

8. september 2012

Først innsendt som oppfylte QC-kriteriene

1. januar 2013

Først lagt ut (Anslag)

4. januar 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

4. januar 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. januar 2013

Sist bekreftet

1. januar 2013

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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