- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning 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.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
- Fas 3
Kontakter och platser
Studieorter
-
-
-
Cordoba, Spanien
- Hospital Universitario Reina Sofia
-
Seviila, Spanien
- Hospitales Universitarios Virgen del Rocío
-
Sevilla, Spanien
- Hospital Universitario de Valme
-
Sevilla, Spanien
- Hospital Universitario Virgen Macarena
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
---|---|
Experimentell: PegIFN alfa-2a and Ribavirin
HIV-coinfected patients with compensated cirrhosis by hepatitis C virus, genotype 1 or 4.
|
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.
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
---|---|
Sustained viral response (undetectable serum HCV-RNA)
Tidsram: Throughout treatment and 24 weeks after finishing it
|
Throughout treatment and 24 weeks after finishing it
|
Sekundära resultatmått
Resultatmått |
Tidsram |
---|---|
Relationships between the plasma interferon an ribavirin concentrations and efficacy
Tidsram: Throughout treatment and 24 weeks after finishing it.
|
Throughout treatment and 24 weeks after finishing it.
|
safety and tolerability of the studied medications
Tidsram: 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
Tidsram: baseline and after finishing treatment
|
baseline and after finishing treatment
|
Samarbetspartners och utredare
Utredare
- Studierektor: Luis F Lopez-Cortes, MD, PhD, Instituto de Biomedicina de Sevilla. Hospitales Universitarios Virgen del Rocio
- Huvudutredare: Luis F Lopez-Cortes, MD, PhD, Instituto de Biomedicina de Sevilla. Hospitales Universitarios Virgen del Rocio
- Huvudutredare: Antonio Rivero, MD, PhD, Hospital Universitario Reina Sofia. Cordoba
- Huvudutredare: Mª Jose Rios-Villegas, MD, PhD, Hospital Universitario Viren MAcarena. Sevilla
- Huvudutredare: Juan A. Pineda, MD, PhD, Hospital Universitario de Valme. Sevilla
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Matsmältningssystemets sjukdomar
- Patologiska processer
- RNA-virusinfektioner
- Virussjukdomar
- Infektioner
- Blodburna infektioner
- Smittsamma sjukdomar
- Sexuellt överförbara sjukdomar, virala
- Sexuellt överförbara sjukdomar
- Lentivirusinfektioner
- Retroviridae-infektioner
- Immunologiska bristsyndrom
- Immunsystemets sjukdomar
- Leversjukdomar
- Flaviviridae-infektioner
- Hepatit, Viral, Human
- Fibros
- HIV-infektioner
- Hepatit
- Hepatit C
- Levercirros
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Anti-infektionsmedel
- Antivirala medel
- Antimetaboliter
- Antineoplastiska medel
- Immunologiska faktorer
- Interferoner
- Interferon-alfa
- Ribavirin
- Peginterferon alfa-2a
- Interferon alfa-2
Andra studie-ID-nummer
- HEPAVIR_IFN_2009
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