Peripheral Blood Mononuclear Cell (PBMC) Gene Expression in HCV Genotype 1 Patients (PBMC)
Primary Purpose
Chronic Hepatitis C
Status
Completed
Phase
Phase 4
Locations
Taiwan
Study Type
Interventional
Intervention
pegylated interferon alpha 2a and plus ribavirin
Sponsored by
About this trial
This is an interventional diagnostic trial for Chronic Hepatitis C focused on measuring Chronic Hepatitis C, Single nucleotide polymorphisms, Sustained virological response, Peginterferon, Ribavirin
Eligibility Criteria
Inclusion Criteria:
- Male and female patients >18 years of age
- Patients have never been treated with traditional interferon plus ribavirin or peginterferon plus ribavirin
- Serologic evidence of chronic hepatitis C infection by an anti-HCV antibody test
- Detectable serum HCV-RNA
- Liver biopsy findings consistent with the diagnosis of chronic hepatitis C infection with or without compensated cirrhosis (Exception: hemophiliacs in whom biopsy is medically contra-indicated do not require biopsy.)
- Compensated liver disease (Child-Pugh Grade A clinical classification)
- Negative urine or blood pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of study drug
- All fertile males and females receiving ribavirin must be using two forms of effective contraception during treatment and during the 6 months after treatment end
Exclusion Criteria:
- Women with ongoing pregnancy or breast feeding
- Present therapy with any systemic anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) within 6 months prior to the first dose of study drug
- Any investigational drug 6 weeks prior to the first dose of study drug
- Co-infection with active hepatitis A, hepatitis B and/or human immunodeficiency virus (HIV)
- History or other evidence of a medical condition associated with chronic liver disease other than HCV (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures)
- Clinical evidence of hepatocellular carcinoma
- History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease
- Neutrophil count <1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening
- Serum creatinine level >1.5 times the upper limit of normal at screening
- History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt, hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease
- History of a severe seizure disorder or current anticonvulsant use
- History of immunologically mediated disease, chronic pulmonary disease associated with functional limitation, severe cardiac disease, major organ transplantation or other evidence of severe illness, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study
- 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
- Evidence of severe retinopathy (e.g. CMV retinitis, macula degeneration)
- Evidence of drug abuse (including excessive alcohol consumption>40 g/day) within one year of study entry
- Inability or unwillingness to provide informed consent or abide by the requirements of the study
- Male partners of women who are pregnant
- Hgb <11 g/dL in women or <12 g/dL in men at screening
- Any patient with major thalassemia
- 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 4 g/dL (as may be seen with ribavirin therapy) would not be well-tolerated
- Evidence or history of hepatocellular carcinoma
- Local or Systemic malignancy unstable status
Sites / Locations
- Kaohsiung Medical University Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
A
B
Arm Description
15 patients with HCV genotype 1 infection receiving peginterferon plus ribavirin achieve a sustained virological response
15 patients with HCV genotype 1 infection receiving peginterferon plus ribavirin did not achieve a sustained virological response
Outcomes
Primary Outcome Measures
Efficacy - Sustained virological response (SVR), HCV RNA seronegative by PCR throughout 24-week off-treatment period.
Secondary Outcome Measures
Rapid virologic response (RVR), HCV RNA seronegative by PCR at week 4.
Early virological response (EVR), by PCR-negative or at least 2 logs decline from baseline of serum HCV RNA at 12 weeks of treatment.
Safety - adverse event rate and profile
Full Information
NCT ID
NCT00680173
First Posted
May 15, 2008
Last Updated
March 11, 2016
Sponsor
Kaohsiung Medical University Chung-Ho Memorial Hospital
1. Study Identification
Unique Protocol Identification Number
NCT00680173
Brief Title
Peripheral Blood Mononuclear Cell (PBMC) Gene Expression in HCV Genotype 1 Patients
Acronym
PBMC
Official Title
Analysis of Gene Expression of PBMC in the Hepatitis C Virus Genotype 1b-infected Patients During Peg-interferon-α Plus Ribavirin Combination Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
August 2006 (undefined)
Primary Completion Date
March 2016 (Actual)
Study Completion Date
March 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Kaohsiung Medical University Chung-Ho Memorial Hospital
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Our previous collaborative studies has developed a molecular diagnosis tool, which is characterized with a prediction model consisting single nucleotide polymorphisms (SNPs), for assessing the efficacy of interferon combined therapy for chronic hepatitis C (CHC) patients prior to treatment.
Aims of this project:
To analyze and validate the gene expression profiling dependent of treatment response to peg-interferon-α plus ribavirin combination therapy in CHC genotype-1 patients.
To select the candidate genes and establish a monitoring model assessing the efficacy of interferon treatment.
Detailed Description
A combination of pegylated-interferon (PEG-IFN) with ribavirin has been the choice for treating chronic hepatitis C (CHC) patients. In addition to the high cost, the treatment takes 6 to 12 months and often brings significant adverse reactions to some patients. It would therefore be beneficial to include a pre-treatment evaluation and post-treatment monitoring system to maximize the efficacy of CHC therapy. We have established a molecular diagnosis tool for assessing the efficacy of interferon combined therapy for CHC patients prior to treatment. This diagnostic tool is characterized with a prediction model consisting single nucleotide polymorphisms (SNPs) strongly associated with interferon efficacy in treating CHC patients. The prediction model has been validated by hepatitis C samples in Taiwan, and it achieved 80 % accuracy, higher than the current efficacy rates. Supplemented with the viral genotype information would further increase the prediction accuracy to 85%.
In this project, we aim to analyze patients' gene expression profiling during the treatment. The current study will focus on 30 PEG-IFN and ribavirin treated patients with HCV genotype 1 infection. After the responding status of those patients has been confirmed, we will compare gene expression profiling among the different responses before and during treatment. By using this information, we can properly select the candidate genes, and establish a monitoring model with these biomarkers. This monitoring model can thus be applied to assess the efficacy of PEG-IFN plus ribavirin combination treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis C
Keywords
Chronic Hepatitis C, Single nucleotide polymorphisms, Sustained virological response, Peginterferon, Ribavirin
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Actual)
8. Arms, Groups, and Interventions
Arm Title
A
Arm Type
Active Comparator
Arm Description
15 patients with HCV genotype 1 infection receiving peginterferon plus ribavirin achieve a sustained virological response
Arm Title
B
Arm Type
Active Comparator
Arm Description
15 patients with HCV genotype 1 infection receiving peginterferon plus ribavirin did not achieve a sustained virological response
Intervention Type
Drug
Intervention Name(s)
pegylated interferon alpha 2a and plus ribavirin
Other Intervention Name(s)
PEGASYS®
Intervention Description
pegylated interferon alpha 2a 180 mcg/week and Ribavirin 1000-1200 mg/day for 24 weeks, follow up for 24 weeks
Primary Outcome Measure Information:
Title
Efficacy - Sustained virological response (SVR), HCV RNA seronegative by PCR throughout 24-week off-treatment period.
Time Frame
1.5 year
Secondary Outcome Measure Information:
Title
Rapid virologic response (RVR), HCV RNA seronegative by PCR at week 4.
Time Frame
1.5 year
Title
Early virological response (EVR), by PCR-negative or at least 2 logs decline from baseline of serum HCV RNA at 12 weeks of treatment.
Time Frame
1.5 year
Title
Safety - adverse event rate and profile
Time Frame
1.5 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male and female patients >18 years of age
Patients have never been treated with traditional interferon plus ribavirin or peginterferon plus ribavirin
Serologic evidence of chronic hepatitis C infection by an anti-HCV antibody test
Detectable serum HCV-RNA
Liver biopsy findings consistent with the diagnosis of chronic hepatitis C infection with or without compensated cirrhosis (Exception: hemophiliacs in whom biopsy is medically contra-indicated do not require biopsy.)
Compensated liver disease (Child-Pugh Grade A clinical classification)
Negative urine or blood pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of study drug
All fertile males and females receiving ribavirin must be using two forms of effective contraception during treatment and during the 6 months after treatment end
Exclusion Criteria:
Women with ongoing pregnancy or breast feeding
Present therapy with any systemic anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) within 6 months prior to the first dose of study drug
Any investigational drug 6 weeks prior to the first dose of study drug
Co-infection with active hepatitis A, hepatitis B and/or human immunodeficiency virus (HIV)
History or other evidence of a medical condition associated with chronic liver disease other than HCV (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures)
Clinical evidence of hepatocellular carcinoma
History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease
Neutrophil count <1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening
Serum creatinine level >1.5 times the upper limit of normal at screening
History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt, hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease
History of a severe seizure disorder or current anticonvulsant use
History of immunologically mediated disease, chronic pulmonary disease associated with functional limitation, severe cardiac disease, major organ transplantation or other evidence of severe illness, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study
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
Evidence of severe retinopathy (e.g. CMV retinitis, macula degeneration)
Evidence of drug abuse (including excessive alcohol consumption>40 g/day) within one year of study entry
Inability or unwillingness to provide informed consent or abide by the requirements of the study
Male partners of women who are pregnant
Hgb <11 g/dL in women or <12 g/dL in men at screening
Any patient with major thalassemia
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 4 g/dL (as may be seen with ribavirin therapy) would not be well-tolerated
Evidence or history of hepatocellular carcinoma
Local or Systemic malignancy unstable status
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wan-Long Chuang, MD, PhD
Organizational Affiliation
Kaohsiung Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kaohsiung Medical University Hospital
City
Kaohsiung
ZIP/Postal Code
807
Country
Taiwan
12. IPD Sharing Statement
Citations:
PubMed Identifier
16938650
Citation
Dai CY, Chuang WL, Hsieh MY, Lee LP, Hou NJ, Chen SC, Lin ZY, Hsieh MY, Wang LY, Tsai JF, Chang WY, Yu ML. Polymorphism of interferon-gamma gene at position +874 and clinical characteristics of chronic hepatitis C. Transl Res. 2006 Sep;148(3):128-33. doi: 10.1016/j.trsl.2006.04.005.
Results Reference
background
PubMed Identifier
15871664
Citation
Houldsworth A, Metzner M, Rossol S, Shaw S, Kaminski E, Demaine AG, Cramp ME. Polymorphisms in the IL-12B gene and outcome of HCV infection. J Interferon Cytokine Res. 2005 May;25(5):271-6. doi: 10.1089/jir.2005.25.271.
Results Reference
background
PubMed Identifier
15868370
Citation
Naito M, Matsui A, Inao M, Nagoshi S, Nagano M, Ito N, Egashira T, Hashimoto M, Mishiro S, Mochida S, Fujiwara K. SNPs in the promoter region of the osteopontin gene as a marker predicting the efficacy of interferon-based therapies in patients with chronic hepatitis C. J Gastroenterol. 2005 Apr;40(4):381-8. doi: 10.1007/s00535-005-1558-3.
Results Reference
background
PubMed Identifier
15117331
Citation
Suzuki F, Arase Y, Suzuki Y, Tsubota A, Akuta N, Hosaka T, Someya T, Kobayashi M, Saitoh S, Ikeda K, Kobayashi M, Matsuda M, Takagi K, Satoh J, Kumada H. Single nucleotide polymorphism of the MxA gene promoter influences the response to interferon monotherapy in patients with hepatitis C viral infection. J Viral Hepat. 2004 May;11(3):271-6. doi: 10.1111/j.1365-2893.2004.00509.x.
Results Reference
background
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Peripheral Blood Mononuclear Cell (PBMC) Gene Expression in HCV Genotype 1 Patients
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