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

1 januari 2013 uppdaterad 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.

Studieöversikt

Status

Okänd

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Förväntat)

300

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Jilin
      • Changchun, Jilin, Kina, 130061
        • Rekrytering
        • First Hospital Jilin University
        • Kontakt:
        • Kontakt:
        • Huvudutredare:
          • Yu Pan, PhD/MD

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Barn
  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / Behandling
Interferon och ribavirin
Alla patienter följde standardbehandlingsprotokollet.

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.

Andra namn:
  • Other Names:IFN+Ribavirin
  • Generiskt: Rekombinant humant interferon alfa-2b, ribavirin
  • Märke: Kaiyinyisheng, Weilake
  • FDA-godkännandenummer: S20030032, H10940157

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Absolute Blood HCV RNA Copies at designed time points
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
HCV genotyp
Tidsram: Baslinje
HCV NS5A klonas in i T-vektor och sekvenseras för evolutionär analys.
Baslinje
Narkotikamissbrukshistoria
Tidsram: Baslinje
Patienterna kommer att tillfrågas om deras droganvändningshistorik.
Baslinje
IL-28B polymorfism
Tidsram: Baslinje
IL28-genpolymorfism, rs8099917, rs12979860, etc
Baslinje
Alanine Aminotransferase (ALT) and Aspartate transaminase (AST)
Tidsram: Baseline,4wk,12wk,24wk,48wk
ALT AST are assayed to detect the hepatic function.
Baseline,4wk,12wk,24wk,48wk
Fibrosis stage
Tidsram: Baseline,4wk,12wk,24wk,48wk
Fibrosis is analyzed with Fibroscan.
Baseline,4wk,12wk,24wk,48wk
Regular blood test
Tidsram: 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
Tidsram: Baseline,4wk,12wk,24wk,48wk
Electrocardiography is taken to avoid severe side effects.
Baseline,4wk,12wk,24wk,48wk
Alcohol ,smoking condition
Tidsram: Baseline,4wk,12wk,24wk,48wk
Patients are asked whether they take alcohol or smoke cigarettes during the therapy period.
Baseline,4wk,12wk,24wk,48wk

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Samarbetspartners

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 juli 2012

Primärt slutförande (Förväntat)

1 februari 2014

Avslutad studie (Förväntat)

1 mars 2014

Studieregistreringsdatum

Först inskickad

8 september 2012

Först inskickad som uppfyllde QC-kriterierna

1 januari 2013

Första postat (Uppskatta)

4 januari 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

4 januari 2013

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

1 januari 2013

Senast verifierad

1 januari 2013

Mer information

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