Thymosin Alpha-1 in Combination With Peg-Interferon Alfa- 2a and Ribavirin for the Therapy of Chronic Hepatitis C Nonresponsive to the Combination of IFN and Ribavirin.
Primary Purpose
Chronic Hepatitis C
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Thymosin alpha 1
Ribavirin
PEGinterferon alfa2a
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Hepatitis C
Eligibility Criteria
Inclusion Criteria:
- Signed written informed consent
- Age 18
- Presence of HCV RNA measured by quantitative PCR
- Non responder to previous approved doses of therapy with PEGinterferon alpha plus ribavirin. Patients must have been treated for at least 12 weeks with documented HCV RNA quantitative not showing major of 2 log10 HCV RNA reduction or patients treated for at least 24 weeks with documented HCV RNA qualitative not showing a virological response (viral RNA clearance)
- Liver biopsy consistent with a diagnosis of chronic hepatitis C or histological cirrhosis. Biopsy will not be required if the patient can produce a biopsy performed within the year preceding the randomization day and was performed at least 6 months after the end of the latter course of therapy
- Wash-out period of at least 6 months from previous therapy with PEGinterferon alpha plus ribavirin
- Negative pregnancy test prior (no more than 24 hours) to first study medication dose
Exclusion Criteria:
- Use of systemic corticosteroids within 6 months of entry
- More than one previous course of therapy with PEGinterferon alpha plus ribavirin
- Any other liver disease
- Decompensated liver disease based on a history of hepatic encephalopathy, bleeding oesophageal varices, or ascites
- Decompensate or advanced liver cirrhosis (ChildPugh B or C)
- HIV infection diagnosed by HIV seropositivity and confirmed by Western blot
- Insulin-dependent Diabetes Mellitus
- Severe haemoglobinopathy
- Positive liver and kidney microsomal auto antibodies
- Positive anti thyroid antibodies
- Pregnancy as documented by a urine pregnancy test
- Alcohol or intravenous drug abuse within the previous 1 year
- Patients who are in poor medical or psychiatric conditions, or who have any non-malignant systemic disease that, in the opinion of the Investigator, would make it unlikely that the patient could complete the study protocol
- Any indication that the patient would not comply with the conditions of the study protocol
- Previous treatment with thymosin alpha 1
- Patients with known hypersensitivity to any PEGinterferon and or ribavirin
- Patients with a history of severe depression that required either hospitalization or electroshock therapy or depression associated with suicide attempt
- Simultaneous participation in another investigational drug study or participation in any clinical trial involving investigational drugs within 3 months before study entry
- Presence of serious pulmonary or cardiovascular disorders
Sites / Locations
- Hôpital Necker
- Universitätsklinikum Tübingen
- University Hospital of Ioannina
- Ospedale Casa Sollievo della Sofferenza
- Policlinico S.Orsola-Malpighi
- Ospedale Cardarelli
- Università Cattolica del Sacro Cuore
- Dipartimento Medico Chirurgico delle Malattie dell'Apparato Digerente e della Nutrizione, Azienda Ospedaliera S Giovanni Battista
- Hospital del Mar
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Thymosin alpha 1
Placebo
Arm Description
Patients affected by chronic hepatitis C not responding to a course with approved doses of PEGinterferon alpha plus ribavirin therapy (i.e. at least 1.0 mcg/kg PEGinterferon alpha2b, 180 mcg PEGinterferon alfa2a, 800 mg ribavirin).
Patients affected by chronic hepatitis C not responding to a course with approved doses of PEGinterferon alpha plus ribavirin therapy (i.e. at least 1.0 mcg/kg PEGinterferon alpha2b, 180 mcg PEGinterferon alfa2a, 800 mg ribavirin).
Outcomes
Primary Outcome Measures
Sustained Virological Response (SVR)
The proportion of patients who were HCV RNA negative at the end of observation period.
Secondary Outcome Measures
Sustained Biochemical Response (SBR)
The proportion of patients with normal serum ALT at the end of observation period.
End of Treatment Biochemical Response (EBR)
The proportion of patients with normal serum ALT at the end of treatment period.
End of Treatment Virological Response [EVR]
The proportion of patients who were HCV RNA negative at the end of treatment period.
Safety
Safety and tolerability were evaluated by AEs recording, laboratory (hematology and chemistry), ECG, and vital signs evaluations. All laboratory tests were centralized.
Full Information
NCT ID
NCT01178996
First Posted
August 9, 2010
Last Updated
August 9, 2010
Sponsor
sigma-tau i.f.r. S.p.A.
Collaborators
SciClone Pharmaceuticals
1. Study Identification
Unique Protocol Identification Number
NCT01178996
Brief Title
Thymosin Alpha-1 in Combination With Peg-Interferon Alfa- 2a and Ribavirin for the Therapy of Chronic Hepatitis C Nonresponsive to the Combination of IFN and Ribavirin.
Official Title
A Phase III, Multicentre, Double Blinded Study In Patients With Chronic Hepatitis C Who Are Non-Responders To Prior Peginterferon Alpha + Ribavirin Therapy Comparing Treatment With Thymosin Alpha 1 + Peginterferon Alpha-2a Plus Ribavirin With Peginterferon Alpha-2a + Ribavirin + Placebo
Study Type
Interventional
2. Study Status
Record Verification Date
August 2010
Overall Recruitment Status
Completed
Study Start Date
December 2004 (undefined)
Primary Completion Date
May 2008 (Actual)
Study Completion Date
July 2009 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
sigma-tau i.f.r. S.p.A.
Collaborators
SciClone Pharmaceuticals
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of the study was to determine safety and efficacy of 48 weeks treatment with Thymosin alpha 1 (Talpha1) in combination with pegylated interferon (PEGIFN) alpha2a and ribavirin (RBV) in adult patients with chronic hepatitis C (CHC) already treated with, and not responding to previous courses of PEGIFN alpha plus RBV combination therapy, in comparison with a concurrent group treated with PEG IFN alpha2a in combination with RBV and placebo.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis C
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
552 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Thymosin alpha 1
Arm Type
Experimental
Arm Description
Patients affected by chronic hepatitis C not responding to a course with approved doses of PEGinterferon alpha plus ribavirin therapy (i.e. at least 1.0 mcg/kg PEGinterferon alpha2b, 180 mcg PEGinterferon alfa2a, 800 mg ribavirin).
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients affected by chronic hepatitis C not responding to a course with approved doses of PEGinterferon alpha plus ribavirin therapy (i.e. at least 1.0 mcg/kg PEGinterferon alpha2b, 180 mcg PEGinterferon alfa2a, 800 mg ribavirin).
Intervention Type
Biological
Intervention Name(s)
Thymosin alpha 1
Other Intervention Name(s)
Zadaxin
Intervention Description
Thymosin alpha 1 (Zadaxin) 1.6 mg/day, two times weekly in the morning, by subcutaneous injection for 48 weeks.
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Other Intervention Name(s)
Copegus
Intervention Description
Ribavirin 1000 mg (<75 kg) or 1200 mg (>75 kg) daily with food divided in two doses orally for 48 weeks
Intervention Type
Biological
Intervention Name(s)
PEGinterferon alfa2a
Other Intervention Name(s)
Pegasys
Intervention Description
180 mcg, once weekly in the evening, by subcutaneous injection for 48 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Sustained Virological Response (SVR)
Description
The proportion of patients who were HCV RNA negative at the end of observation period.
Time Frame
Week 72
Secondary Outcome Measure Information:
Title
Sustained Biochemical Response (SBR)
Description
The proportion of patients with normal serum ALT at the end of observation period.
Time Frame
Week 72
Title
End of Treatment Biochemical Response (EBR)
Description
The proportion of patients with normal serum ALT at the end of treatment period.
Time Frame
Week 48
Title
End of Treatment Virological Response [EVR]
Description
The proportion of patients who were HCV RNA negative at the end of treatment period.
Time Frame
Week 48
Title
Safety
Description
Safety and tolerability were evaluated by AEs recording, laboratory (hematology and chemistry), ECG, and vital signs evaluations. All laboratory tests were centralized.
Time Frame
During the treatment period (up to 48 weeks) and the follow-up period (up to 24 weeks)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed written informed consent
Age 18
Presence of HCV RNA measured by quantitative PCR
Non responder to previous approved doses of therapy with PEGinterferon alpha plus ribavirin. Patients must have been treated for at least 12 weeks with documented HCV RNA quantitative not showing major of 2 log10 HCV RNA reduction or patients treated for at least 24 weeks with documented HCV RNA qualitative not showing a virological response (viral RNA clearance)
Liver biopsy consistent with a diagnosis of chronic hepatitis C or histological cirrhosis. Biopsy will not be required if the patient can produce a biopsy performed within the year preceding the randomization day and was performed at least 6 months after the end of the latter course of therapy
Wash-out period of at least 6 months from previous therapy with PEGinterferon alpha plus ribavirin
Negative pregnancy test prior (no more than 24 hours) to first study medication dose
Exclusion Criteria:
Use of systemic corticosteroids within 6 months of entry
More than one previous course of therapy with PEGinterferon alpha plus ribavirin
Any other liver disease
Decompensated liver disease based on a history of hepatic encephalopathy, bleeding oesophageal varices, or ascites
Decompensate or advanced liver cirrhosis (ChildPugh B or C)
HIV infection diagnosed by HIV seropositivity and confirmed by Western blot
Insulin-dependent Diabetes Mellitus
Severe haemoglobinopathy
Positive liver and kidney microsomal auto antibodies
Positive anti thyroid antibodies
Pregnancy as documented by a urine pregnancy test
Alcohol or intravenous drug abuse within the previous 1 year
Patients who are in poor medical or psychiatric conditions, or who have any non-malignant systemic disease that, in the opinion of the Investigator, would make it unlikely that the patient could complete the study protocol
Any indication that the patient would not comply with the conditions of the study protocol
Previous treatment with thymosin alpha 1
Patients with known hypersensitivity to any PEGinterferon and or ribavirin
Patients with a history of severe depression that required either hospitalization or electroshock therapy or depression associated with suicide attempt
Simultaneous participation in another investigational drug study or participation in any clinical trial involving investigational drugs within 3 months before study entry
Presence of serious pulmonary or cardiovascular disorders
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mario Rizzetto, MD
Organizational Affiliation
Dipartimento Medico Chirurgico delle Malattie dell'Apparato Digerente e della Nutrizione, Azienda Ospedaliera S Giovanni Battista, Corso Bramante 88, Turin, Italy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital Necker
City
Paris
ZIP/Postal Code
75743
Country
France
Facility Name
Universitätsklinikum Tübingen
City
Tübingen
ZIP/Postal Code
D-72076
Country
Germany
Facility Name
University Hospital of Ioannina
City
Ioannina
ZIP/Postal Code
45 500
Country
Greece
Facility Name
Ospedale Casa Sollievo della Sofferenza
City
San Giovanni Rotondo
State/Province
Foggia
ZIP/Postal Code
71013
Country
Italy
Facility Name
Policlinico S.Orsola-Malpighi
City
Bologna
ZIP/Postal Code
40138
Country
Italy
Facility Name
Ospedale Cardarelli
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Facility Name
Università Cattolica del Sacro Cuore
City
Rome
ZIP/Postal Code
00100
Country
Italy
Facility Name
Dipartimento Medico Chirurgico delle Malattie dell'Apparato Digerente e della Nutrizione, Azienda Ospedaliera S Giovanni Battista
City
Turin
ZIP/Postal Code
10126
Country
Italy
Facility Name
Hospital del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
12. IPD Sharing Statement
Citations:
PubMed Identifier
22233415
Citation
Ciancio A, Andreone P, Kaiser S, Mangia A, Milella M, Sola R, Pol S, Tsianos E, De Rosa A, Camerini R, McBeath R, Rizzetto M. Thymosin alpha-1 with peginterferon alfa-2a/ribavirin for chronic hepatitis C not responsive to IFN/ribavirin: an adjuvant role? J Viral Hepat. 2012 Jan;19 Suppl 1:52-9. doi: 10.1111/j.1365-2893.2011.01524.x.
Results Reference
derived
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Thymosin Alpha-1 in Combination With Peg-Interferon Alfa- 2a and Ribavirin for the Therapy of Chronic Hepatitis C Nonresponsive to the Combination of IFN and Ribavirin.
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