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Pilot Trial of Bavituximab Combined With Ribavirin for Initial Treatment of Chronic HepC Virus Genotype 1 Infection

Primary Purpose

Hepatitis C

Status
Completed
Phase
Phase 1
Locations
Georgia
Study Type
Interventional
Intervention
Bavituximab
Pegylated interferon (PEG-IFN)
Sponsored by
Peregrine Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female between the ages of 18 and 65 years
  2. Chronic hepatitis C virus (HCV) genotype 1 infection
  3. HCV RNA level >10,000 IU/mL
  4. Chronic HCV infection, defined as:

    • Previous documentation of positive HCV serology (HCV antibody or RNA) at least 6 months (24 weeks) previously, or
    • Positive HCV serology (HCV antibody or RNA) with a prior remote (more than 6 months previously) risk factor for acquisition of HCV or
    • Historical biopsy consistent with chronic HCV infection
  5. No clinically significant abnormalities in hematology, coagulation, or chemistry variables:

    • Hemoglobin >12 g/dL for women; >13 g/dL for men
    • Total white cell count >3000/mm3 and absolute neutrophil count >1500/mm3
    • Platelets >100,000/mm3
    • Prothrombin time (PT) and/or international normalized ratio (INR) less than or equal to 1.2 times the local upper limit of normal (ULN)
    • Conjugated (direct) bilirubin less than or equal to 1.5 times the ULN
    • Serum creatinine within normal limits
    • Thyroid-stimulating hormone (TSH) and free thyroxine (T4) within normal limits
  6. Female patients: negative urine pregnancy test
  7. Ability to provide informed consent

Exclusion Criteria:

  1. Previous interferon-based antiviral therapy for chronic HCV infection
  2. Previous treatment with known immunogenic drugs
  3. Concomitant human immunodeficiency (HIV) or hepatitis B virus (HBV) infection
  4. Cause of liver disease other than chronic HCV infection, such as autoimmune or alcoholic liver disease
  5. Decompensated clinical liver disease, including a history of encephalopathy, bleeding esophageal or gastric varices, or ascites
  6. Recipient of liver or other solid-organ transplantation
  7. Evidence of clinically significant bleeding, defined as gross hematuria, hemoptysis, or gastrointestinal bleeding
  8. History of bleeding diathesis or coagulopathy (eg, von Willebrand disease or hemophilia)
  9. History of thromboembolic events (eg, deep-vein thrombosis [DVT] or pulmonary embolism). Previous central venous catheter-related thrombosis is acceptable if there is resolution recorded at least 12 months before enrollment.
  10. Requirement for concurrent treatment with oral or parenteral anticoagulants or hormones (estrogen-containing contraceptives, hormone replacement, antiestrogen agents, progestins)
  11. Condition requiring daily therapy with antiplatelet agents (eg, thienopyridines, dipyridamole, cilostazol; cardiovascular prophylaxis with aspirin is allowed) or corticosteroids
  12. Investigational therapy within 28 days before the first planned dose of study drug
  13. Major surgery within 28 days before the first planned dose of study drug
  14. Uncontrolled intercurrent disease (eg, diabetes, hypertension, thyroid disease)
  15. Ongoing angina pectoris or other symptoms of coronary artery disease (CAD); history of stroke, or transient ischemic attack (TIA)
  16. History of suicidal ideation or attempt
  17. Condition requiring treatment (past or current) with coumarin-type agents
  18. Cardiac arrhythmia requiring medical therapy
  19. Serious nonhealing wound (including wound healing by secondary intention, ulcer, or bone fracture)
  20. Cancer, autoimmune disease, or any disease or concurrent therapy known to cause significant alteration in immune function (corticosteroids are allowed before study enrollment and during the study to treat an AE)
  21. Female patients and female partners of male patients: pregnancy, lactation, or inability/unwillingness to practice effective contraception

Sites / Locations

  • LTD Vakhtang Bochorishvili Anticeptic Centre

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Bavituximab 3 mg/kg

Bavituximab 0.3 mg/kg

Pegylated interferon (PEG-IFN)

Arm Description

Bavituximab 3 mg/kg given by intravenous (IV) infusion once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks

Bavituximab 0.3 mg/kg given by IV infusion once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks

Pegylated interferon (PEG-IFN) alpha-2a 180 micrograms given by subcutaneous (SC) injection once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks

Outcomes

Primary Outcome Measures

Reduction in Hepatitis C Virus RNA
The primary endpoint is the proportion of patients who show a greater or equal 2-log(10) IU reduction in HCV RNA level at Study Week 12 (early virological response, EVR).

Secondary Outcome Measures

Full Information

First Posted
January 7, 2011
Last Updated
February 2, 2012
Sponsor
Peregrine Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01273948
Brief Title
Pilot Trial of Bavituximab Combined With Ribavirin for Initial Treatment of Chronic HepC Virus Genotype 1 Infection
Official Title
A Randomized, Active-Control Phase II Pilot Trial of Bavituximab Combined With Ribavirin for Initial Treatment of Chronic Hepatitis C Virus Genotype 1 Infection
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Completed
Study Start Date
January 2011 (undefined)
Primary Completion Date
January 2012 (Actual)
Study Completion Date
February 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Peregrine Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This will be a randomized, open-label, active-control Phase II pilot trial of bavituximab combined with ribavirin for initial treatment of chronic HCV genotype 1 infection. Eligible patients with normal coagulation, hematological, and renal function will undergo a screening/washout period of up to 28 days, followed by randomization to receive weekly bavituximab or PEG-IFN alpha-2a therapy for 12 weeks, both with twice-daily ribavirin. The primary endpoint of this study is the proportion of patients who show a greater than or equal to 2-log10 IU reduction in plasma HCV RNA level after 12 weeks of treatment (early virological response; EVR). Secondary endpoints include the proportion of patients with an undetectable HCV RNA level after 12 weeks of treatment; the proportion of patients who show a reduction in HCV RNA level of greater than or equal to 2 log10 IU after 4 weeks of treatment, viral kinetics for individual patients over time, and comprehensive evaluation of the safety and tolerability of bavituximab infusion.
Detailed Description
Primary Objective: The primary objective of this study is to assess the effect of 12 weeks of initial treatment with bavituximab versus PEG-IFN, each combined with ribavirin, on plasma HCV RNA level in patients with chronic HCV genotype 1 infection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
66 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bavituximab 3 mg/kg
Arm Type
Experimental
Arm Description
Bavituximab 3 mg/kg given by intravenous (IV) infusion once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks
Arm Title
Bavituximab 0.3 mg/kg
Arm Type
Experimental
Arm Description
Bavituximab 0.3 mg/kg given by IV infusion once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks
Arm Title
Pegylated interferon (PEG-IFN)
Arm Type
Active Comparator
Arm Description
Pegylated interferon (PEG-IFN) alpha-2a 180 micrograms given by subcutaneous (SC) injection once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Bavituximab
Other Intervention Name(s)
Bavituxmab
Intervention Description
Bavituximab 3 mg/kg given by intravenous (IV) infusion once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks or Bavituximab 0.3 mg/kg given by IV infusion once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal to 75 kg) divided into twice-daily doses, for 12 weeks or
Intervention Type
Drug
Intervention Name(s)
Pegylated interferon (PEG-IFN)
Other Intervention Name(s)
Pegasys
Intervention Description
Pegylated interferon (PEG-IFN) alpha-2a 180 micrograms given by subcutaneous (SC) injection once weekly, plus oral ribavirin 1000 mg (weight <75 kg) or 1200 mg (weight greater than or equal 75 kg) divided into twice-daily doses, for 12 weeks
Primary Outcome Measure Information:
Title
Reduction in Hepatitis C Virus RNA
Description
The primary endpoint is the proportion of patients who show a greater or equal 2-log(10) IU reduction in HCV RNA level at Study Week 12 (early virological response, EVR).
Time Frame
12 weeks

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: Male or female between the ages of 18 and 65 years Chronic hepatitis C virus (HCV) genotype 1 infection HCV RNA level >10,000 IU/mL Chronic HCV infection, defined as: Previous documentation of positive HCV serology (HCV antibody or RNA) at least 6 months (24 weeks) previously, or Positive HCV serology (HCV antibody or RNA) with a prior remote (more than 6 months previously) risk factor for acquisition of HCV or Historical biopsy consistent with chronic HCV infection No clinically significant abnormalities in hematology, coagulation, or chemistry variables: Hemoglobin >12 g/dL for women; >13 g/dL for men Total white cell count >3000/mm3 and absolute neutrophil count >1500/mm3 Platelets >100,000/mm3 Prothrombin time (PT) and/or international normalized ratio (INR) less than or equal to 1.2 times the local upper limit of normal (ULN) Conjugated (direct) bilirubin less than or equal to 1.5 times the ULN Serum creatinine within normal limits Thyroid-stimulating hormone (TSH) and free thyroxine (T4) within normal limits Female patients: negative urine pregnancy test Ability to provide informed consent Exclusion Criteria: Previous interferon-based antiviral therapy for chronic HCV infection Previous treatment with known immunogenic drugs Concomitant human immunodeficiency (HIV) or hepatitis B virus (HBV) infection Cause of liver disease other than chronic HCV infection, such as autoimmune or alcoholic liver disease Decompensated clinical liver disease, including a history of encephalopathy, bleeding esophageal or gastric varices, or ascites Recipient of liver or other solid-organ transplantation Evidence of clinically significant bleeding, defined as gross hematuria, hemoptysis, or gastrointestinal bleeding History of bleeding diathesis or coagulopathy (eg, von Willebrand disease or hemophilia) History of thromboembolic events (eg, deep-vein thrombosis [DVT] or pulmonary embolism). Previous central venous catheter-related thrombosis is acceptable if there is resolution recorded at least 12 months before enrollment. Requirement for concurrent treatment with oral or parenteral anticoagulants or hormones (estrogen-containing contraceptives, hormone replacement, antiestrogen agents, progestins) Condition requiring daily therapy with antiplatelet agents (eg, thienopyridines, dipyridamole, cilostazol; cardiovascular prophylaxis with aspirin is allowed) or corticosteroids Investigational therapy within 28 days before the first planned dose of study drug Major surgery within 28 days before the first planned dose of study drug Uncontrolled intercurrent disease (eg, diabetes, hypertension, thyroid disease) Ongoing angina pectoris or other symptoms of coronary artery disease (CAD); history of stroke, or transient ischemic attack (TIA) History of suicidal ideation or attempt Condition requiring treatment (past or current) with coumarin-type agents Cardiac arrhythmia requiring medical therapy Serious nonhealing wound (including wound healing by secondary intention, ulcer, or bone fracture) Cancer, autoimmune disease, or any disease or concurrent therapy known to cause significant alteration in immune function (corticosteroids are allowed before study enrollment and during the study to treat an AE) Female patients and female partners of male patients: pregnancy, lactation, or inability/unwillingness to practice effective contraception
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janet Nuttall, MPH
Organizational Affiliation
Peregrine Pharmaceuticals
Official's Role
Study Chair
Facility Information:
Facility Name
LTD Vakhtang Bochorishvili Anticeptic Centre
City
Tbilisi
Country
Georgia

12. IPD Sharing Statement

Learn more about this trial

Pilot Trial of Bavituximab Combined With Ribavirin for Initial Treatment of Chronic HepC Virus Genotype 1 Infection

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