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Effect of Infliximab on the Efficacy of Peg-Intron/Ribavirin in Patients With Hepatitis C (Study P04257AM4)(COMPLETED) (Pegade)

Primary Purpose

Hepatitis C, Chronic

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Induction dose of (a) infliximab followed by combination of (b) pegylated interferon alfa-2b and (c) ribavirin
Combination of (a) pegylated interferon alfa-2b and (b) ribavirin
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C, Chronic focused on measuring pegylated interferon alfa-2b, ribavirin, infliximab, chronic hepatitis C

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Subjects must demonstrate their willingness to participate in the study and comply with its procedures by signing a written informed consent. Subjects must be 18 to 65 years of age. HCV genotype 1 (including mixtures of subtypes of genotype 1). Naïve to interferon (any formulation) and ribavirin. Serum TNF-alpha >300 pg/mL(single measure at Pre-Screen Visit). HCV ribonucleic acid (RNA) positive. Any alanine aminotransferase (ALT) level. Fasting glucose should be 3.8-6.2 mmol/L. Results between 6.3-7.8 mmol/L require a HbA1c <=8.5%. All diabetic subjects must have an HbA1c <=8.5%, whether on medication or diet controlled. Liver biopsy within 24 months of enrolment demonstrating Stage 0-3 fibrosis (Metavir System). Compensated liver disease with the following minimum hematological, biochemical, and serological criteria at the screen visit (WNL = within normal limits): Hemoglobin values of equal or more than 12 g/dL for females and 13 g/dL for males. White blood cell (WBC) count equal to or more than 3,000/mm**3 Neutrophil count equal to or more than 1,500/mm**3 Platelet count equal to or more than 80,000/mm**3 Total bilirubin WNL Indirect bilirubin WNL (unless non-hepatitis related factors such as Gilbert's disease explain an indirect bilirubin rise). In such cases indirect bilirubin should be less than or equal to 50 µmol/L Albumin WNL Serum creatinine WNL Women of childbearing potential (includes women who are less than 1 year postmenopausal and women who become sexually active) must be willing to use an acceptable method of birth control, deemed acceptable by the investigator, (e.g., hormonal contraceptive, medically prescribed intrauterine device (IUD), condom in combination with spermicidal) or be surgically sterilized (e.g., hysterectomy or tubal ligation). Subjects must understand and be able to adhere to the dosing and visit schedules, and agree to record, study medication compliance, concomitant medications, and adverse events accurately and consistently in a daily diary. Exclusion Criteria: Women who are pregnant or nursing. Subjects who have not observed the designated washout periods for any of the prohibited medications. Subjects who have used any investigational product within 30 days prior to enrollment. Acute HCV infection defined as infection for <6 months. Male partners to/or Heterosexually active women of childbearing potential not practicing a highly effective form of contraception. Positive screening for tuberculosis (TB) or Tuberculin Skin Test > 5mm. History or presence of cirrhosis (Stage 4 on Metavir System) and/or complication such as ascites, bleeding varices or hepatic encephalopathy Active hepatitis B virus (HBV) infection (hepatitis B surface antigen [HBsAg] positive). Any known pre-existing psychiatric condition that could interfere with the subject's participation in and completion of the study such as: Pre-existing psychiatric condition, including but not limited to moderate to severe depression, or a history of severe psychiatric disorders, such as psychosis, suicidal ideation and/or suicidal attempt Severe depression includes the following: Hospitalization for depression, Electro convulsive therapy for depression, or Depression that resulted in a prolonged absence from work and/or significant disruption of daily functions. Subjects with uncontrolled hypertension and/or diabetes. Alcohol consumption >50 g/day. Nonprescription injection drug use in past 6 months. HIV antibody positive. Previous Infliximab or other anti-TNF treatment, previous interferon; Pegylated interferon alfa-2b and ribavirin of any form. Clinically significant impairment in cardiac or renal function, central nervous system, pulmonary, immunological, vascular and gastrointestinal disease. Current malignancy (other than resected cutaneous basal, squamous cell carcinoma and/or in situ cervical cancer). Use of illicit drugs which, in the investigator's opinion, may interfere with compliance with the study procedures. Any other condition which, in the opinion of a physician, would make the subject unsuitable for enrollment or could interfere with the subject participating in and completing the study. Have shown a previous immediate hypersensitivity response, including anaphylaxis, to an immunoglobulin product (plasma-derived or recombinant, e.g., monoclonal antibody). Have a known allergy to murine proteins or other chimeric proteins. Have or have had any of the following infections within 6 months of screening: herpes zoster [shingles], cytomegalovirus, Pneumocystis carinii, aspergillosis, histoplasmosis, or mycobacteria other than TB. Have a transplanted organ (with the exception of a corneal transplant performed > 3 months prior to screening). Have a concomitant diagnosis or any history of congestive heart failure (CHF). History of noncompliance to medical regimens, or other condition/circumstance that could interfere with the patient's adherence to protocol requirements (e.g., psychiatric disease, lack of motivation, travel, etc). Any cause of liver disease other than chronic hepatitis C, including but not limited to: Hemochromatosis Alpha-1 antitrypsin deficiency Wilson's disease Autoimmune hepatitis Alcoholic liver disease Non-alcoholic steatohepatitis (NASH) Drug-related liver disease Subject with a positive TST might be enrolled if the diagnosis of tuberculosis is ruled out. To rule out TB, the following criteria must be met: The medical history is negative for symptoms of TB The physical examination must reveal no observations that could be related to TB The patient has a documented adequate course of treatment for either LTBI or TB at least 6 months prior to screening

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Arm A

    Arm B

    Arm Description

    Remicade induction dose at Day -7 prior to initiation of PEGETRON treatment for up to 48 weeks

    PEGETRON treatment for up to 48 weeks

    Outcomes

    Primary Outcome Measures

    Proportion of subjects who have achieved sustained virological response (SVR) in the infliximab (induction dose) plus PEGETRON and the PEGETRON groups at 24 weeks post treatment end

    Secondary Outcome Measures

    Early virological response (EVR)
    Safety parameters

    Full Information

    First Posted
    October 10, 2005
    Last Updated
    August 24, 2020
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00237484
    Brief Title
    Effect of Infliximab on the Efficacy of Peg-Intron/Ribavirin in Patients With Hepatitis C (Study P04257AM4)(COMPLETED)
    Acronym
    Pegade
    Official Title
    Effect of Infliximab in Hepatitis-C Genotype 1 Naïve Patients With High TNF-alpha on the Efficacy of Pegylated Interferon Alfa-2b/Ribavirin Therapy
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2020
    Overall Recruitment Status
    Completed
    Study Start Date
    July 18, 2005 (Actual)
    Primary Completion Date
    June 30, 2011 (Actual)
    Study Completion Date
    June 30, 2011 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This is a Phase IIIB, randomized, prospective, multicenter, single-country, open-label, controlled pilot trial designed to evaluate the effect of infliximab induction therapy on sustained virologic response (SVR) to treatment with pegylated interferon alfa-2b plus ribavirin in a group of 96 therapy-naïve subjects with genotype 1 hepatitis C virus (HCV) infection and high serum tumor necrosis factor (TNF)-alpha values.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hepatitis C, Chronic
    Keywords
    pegylated interferon alfa-2b, ribavirin, infliximab, chronic hepatitis C

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    89 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Arm A
    Arm Type
    Experimental
    Arm Description
    Remicade induction dose at Day -7 prior to initiation of PEGETRON treatment for up to 48 weeks
    Arm Title
    Arm B
    Arm Type
    Active Comparator
    Arm Description
    PEGETRON treatment for up to 48 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Induction dose of (a) infliximab followed by combination of (b) pegylated interferon alfa-2b and (c) ribavirin
    Other Intervention Name(s)
    (a) SCH 215596, Remicade, PEGETRON combination therapy, (b) SCH 54031, PEG-Intron, PegIntron, (c) SCH 18908, REBETOL
    Intervention Description
    Powder for intravenous infusion (100 mg strength), intravenous, single dose of 5 mg/kg, at Day -7, prior to initiation of the following combination therapy: powder for injection in vials or Redipen (80, 100, 120, and 150 microgram strengths), subcutaneous, dose of 1.5 micrograms/kg, weekly for up to 48 weeks 200 mg capsules, oral, dose of 800-1400 mg (weight based dosing as per PEGETRON Product Monograph), daily for up to 48 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Combination of (a) pegylated interferon alfa-2b and (b) ribavirin
    Other Intervention Name(s)
    PEGETRON combination therapy, (a) SCH 54031, PEG-Intron; PegIntron, (b) SCH 18908, REBETOL
    Intervention Description
    Powder for injection in vials or Redipen (80, 100, 120, and 150 microgram strengths), subcutaneous, dose of 1.5 micrograms/kg, weekly for up to 48 weeks 200 mg capsules, oral, dose of 800-1400 mg (weight based dosing as per PEGETRON Product Monograph), daily for up to 48 weeks
    Primary Outcome Measure Information:
    Title
    Proportion of subjects who have achieved sustained virological response (SVR) in the infliximab (induction dose) plus PEGETRON and the PEGETRON groups at 24 weeks post treatment end
    Time Frame
    24 weeks after completion of up to 48 weeks of PEGETRON therapy
    Secondary Outcome Measure Information:
    Title
    Early virological response (EVR)
    Time Frame
    Week 12 of PEGETRON treatment period
    Title
    Safety parameters
    Time Frame
    During 48-week PEGETRON treatment period and 24-week follow up

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Subjects must demonstrate their willingness to participate in the study and comply with its procedures by signing a written informed consent. Subjects must be 18 to 65 years of age. HCV genotype 1 (including mixtures of subtypes of genotype 1). Naïve to interferon (any formulation) and ribavirin. Serum TNF-alpha >300 pg/mL(single measure at Pre-Screen Visit). HCV ribonucleic acid (RNA) positive. Any alanine aminotransferase (ALT) level. Fasting glucose should be 3.8-6.2 mmol/L. Results between 6.3-7.8 mmol/L require a HbA1c <=8.5%. All diabetic subjects must have an HbA1c <=8.5%, whether on medication or diet controlled. Liver biopsy within 24 months of enrolment demonstrating Stage 0-3 fibrosis (Metavir System). Compensated liver disease with the following minimum hematological, biochemical, and serological criteria at the screen visit (WNL = within normal limits): Hemoglobin values of equal or more than 12 g/dL for females and 13 g/dL for males. White blood cell (WBC) count equal to or more than 3,000/mm**3 Neutrophil count equal to or more than 1,500/mm**3 Platelet count equal to or more than 80,000/mm**3 Total bilirubin WNL Indirect bilirubin WNL (unless non-hepatitis related factors such as Gilbert's disease explain an indirect bilirubin rise). In such cases indirect bilirubin should be less than or equal to 50 µmol/L Albumin WNL Serum creatinine WNL Women of childbearing potential (includes women who are less than 1 year postmenopausal and women who become sexually active) must be willing to use an acceptable method of birth control, deemed acceptable by the investigator, (e.g., hormonal contraceptive, medically prescribed intrauterine device (IUD), condom in combination with spermicidal) or be surgically sterilized (e.g., hysterectomy or tubal ligation). Subjects must understand and be able to adhere to the dosing and visit schedules, and agree to record, study medication compliance, concomitant medications, and adverse events accurately and consistently in a daily diary. Exclusion Criteria: Women who are pregnant or nursing. Subjects who have not observed the designated washout periods for any of the prohibited medications. Subjects who have used any investigational product within 30 days prior to enrollment. Acute HCV infection defined as infection for <6 months. Male partners to/or Heterosexually active women of childbearing potential not practicing a highly effective form of contraception. Positive screening for tuberculosis (TB) or Tuberculin Skin Test > 5mm. History or presence of cirrhosis (Stage 4 on Metavir System) and/or complication such as ascites, bleeding varices or hepatic encephalopathy Active hepatitis B virus (HBV) infection (hepatitis B surface antigen [HBsAg] positive). Any known pre-existing psychiatric condition that could interfere with the subject's participation in and completion of the study such as: Pre-existing psychiatric condition, including but not limited to moderate to severe depression, or a history of severe psychiatric disorders, such as psychosis, suicidal ideation and/or suicidal attempt Severe depression includes the following: Hospitalization for depression, Electro convulsive therapy for depression, or Depression that resulted in a prolonged absence from work and/or significant disruption of daily functions. Subjects with uncontrolled hypertension and/or diabetes. Alcohol consumption >50 g/day. Nonprescription injection drug use in past 6 months. HIV antibody positive. Previous Infliximab or other anti-TNF treatment, previous interferon; Pegylated interferon alfa-2b and ribavirin of any form. Clinically significant impairment in cardiac or renal function, central nervous system, pulmonary, immunological, vascular and gastrointestinal disease. Current malignancy (other than resected cutaneous basal, squamous cell carcinoma and/or in situ cervical cancer). Use of illicit drugs which, in the investigator's opinion, may interfere with compliance with the study procedures. Any other condition which, in the opinion of a physician, would make the subject unsuitable for enrollment or could interfere with the subject participating in and completing the study. Have shown a previous immediate hypersensitivity response, including anaphylaxis, to an immunoglobulin product (plasma-derived or recombinant, e.g., monoclonal antibody). Have a known allergy to murine proteins or other chimeric proteins. Have or have had any of the following infections within 6 months of screening: herpes zoster [shingles], cytomegalovirus, Pneumocystis carinii, aspergillosis, histoplasmosis, or mycobacteria other than TB. Have a transplanted organ (with the exception of a corneal transplant performed > 3 months prior to screening). Have a concomitant diagnosis or any history of congestive heart failure (CHF). History of noncompliance to medical regimens, or other condition/circumstance that could interfere with the patient's adherence to protocol requirements (e.g., psychiatric disease, lack of motivation, travel, etc). Any cause of liver disease other than chronic hepatitis C, including but not limited to: Hemochromatosis Alpha-1 antitrypsin deficiency Wilson's disease Autoimmune hepatitis Alcoholic liver disease Non-alcoholic steatohepatitis (NASH) Drug-related liver disease Subject with a positive TST might be enrolled if the diagnosis of tuberculosis is ruled out. To rule out TB, the following criteria must be met: The medical history is negative for symptoms of TB The physical examination must reveal no observations that could be related to TB The patient has a documented adequate course of treatment for either LTBI or TB at least 6 months prior to screening

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php

    Learn more about this trial

    Effect of Infliximab on the Efficacy of Peg-Intron/Ribavirin in Patients With Hepatitis C (Study P04257AM4)(COMPLETED)

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