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Safety Study of INX-08189, Pharmacokinetic and Pharmacodynamic With Ribavirin and Food Effect Study, in Chronically-infected Genotype 1 Hepatitis C Virus, Treatment-naïve Subjects (INH-189-006)

Primary Purpose

Hepatitis C

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
200 mg INX-08189 Fasted
Placebo QD Fasted
100 mg INX-08189 QD
Placebo QD
100 mg INX-08189 with low-fat meal
Placebo with low-fat meal
100 mg INX-08189 BID Fasted
Placebo BID Fasted
ribavirin
Sponsored by
Bristol-Myers Squibb
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C focused on measuring Inhibitex, Chronic Hepatitis, Hepatitis C Virus

Eligibility Criteria

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

Inclusion Criteria:

Screening visit (Visit 1), subject criteria:

  • Males and females, 18 to 65 years of age inclusive with a body mass index (BMI) of at least 18 kg/m2 but not exceeding 36 kg/m2;
  • Diagnosed with chronic HCV by at least 1 previous polymerase chain reaction (PCR) result prior to Visit 1 (screening), with a positive HCV viral load of least 100,000 IU/ml at Visit 1 (screening) as measured by quantitative PCR;
  • HCV genotype 1 per laboratory testing report;
  • HCV treatment-naïve where "treatment-naïve" is defined as no prior treatment with interferon alpha, pegylated interferon alpha, ribavirin, or any HCV direct acting anti-viral drugs;
  • Liver biopsy consistent with chronic HCV infection but with a classification of non-cirrhotic as judged by a pathologist (defined as Knodell ≤ 3, Metavir ≤ 2, Ishak ≤ 4, or Batts & Ludwig ≤ 2) within the last 2 years and before Visit 2 (biopsy can be done within the screening period);
  • Negative urine drug screen for drugs of abuse (see Appendix B; note: methadone is not allowed);
  • Females will have a negative serum beta human chorionic gonadotropin (βHCG) pregnancy test at screening and a negative urine dipstick pregnancy test upon entry to the clinical unit on Study Day -1;
  • Agreement by both female subjects of childbearing potential and male subjects (who have not been surgically sterilized) to practice an acceptable method of birth control, which includes at least 1 barrier during the study and at least 6 months after cessation of treatment. Surgical sterilization of either the female or the male must have occurred at least 6 month prior to first dose and females must be post-menopausal for 2 years to be considered non-child-bearing potential.
  • Willing and able to complete all study visits and procedures, and able to effectively communicate with the Investigator and other testing center personnel;
  • Signed informed consent form (ICF) executed prior to protocol screening assessments

Exclusion Criteria:

screening visit (Visit1), subject criteria:

  • Advanced liver disease, cirrhosis, or signs of decompensated liver disease such as variceal bleeding, ascites, hepatic encephalopathy, active jaundice defined by a total bilirubin > 2, or other evidence of decompensated liver disease;
  • Co-infection with hepatitis B virus (HBV)or human immunodeficiency virus (HIV) (positive test for hepatitis B surface antigen [HBsAg] or anti-HIV antibody [Ab]);
  • Acute cardiac ischemia, unstable heart disease or clinically symptomatic cardiac abnormalities apparent on electrocardiogram (ECG) and physical exam, or a QTcF interval at Visit 1 of ≥ 450 ms by Fridericia's correction, or a personal or family history of Torsades de pointes;
  • Use of the following medications concurrently or within the 30 days prior Screening (Visit 1) associated with QT prolongation: macrolides, antiarrhythmic agents, azoles, fluoroquinolones, and tricyclic anti-depressants (note: methadone use is not allowed);
  • Use of immunosuppressive or immune-modulating agents (including corticosteroids and immunosuppressive agents) or presence of an immunologically-mediated autoimmune disease (other than asthma) or history of solid organ or bone marrow transplantation (note: inhaled steroids for asthma and topical steroid for minor skin conditions allowed and washout period for PO/IM/IV corticosteroid use is 8 weeks; washout periods for other immunosuppressives determined by Medical Monitor);
  • Use of strong Cytochrome P (CYP)3A4-inhibiting protease inhibitors (specifically atazanavir, indinavir, nelfinavir, saquinavir, and ritonavir), strong CYP3A4 inhibitors (specifically clarithromycin, itraconazole, ketoconazole, nefazodone, telithromycin), or strong CYP3A4 inducers (specifically rifampin, efavirenz, etravirine, phenobarbital, phenytoin, and carbamazepine);
  • Absolute neutrophil count of < 1,800 cells/mm3, or platelet count < 130,000 cells/mm3, or hemoglobin < 12 g/dl for women and < 13 g/dl for men, or a history of anemia, sickle cell anemia, or thalassemia; (note: if baseline value within 5% of minimum qualifying value, 1 re-test allowed for the purpose of qualifying for study);
  • A history of abnormal thyroid function that is not adequately controlled (defined as thyroid stimulating hormone [TSH] levels < 0.8 x lower limit of normal [LLN] or > 1.2 x the upper limit of normal [ULN]);
  • Serum creatinine concentration ≥ 1.5 times the upper limit of normal, or albumin ≤ 3 g/dl;
  • Any history of suicide attempt, receipt of professional counseling for suicidal ideation or any current suicidal ideation, or other serious psychiatric disorders (ie, bipolar disorder, severe depression, psychosis) requiring or having required hospitalization or medication
  • Any malignancy within the last 5 years other than treated cervical carcinoma in situ or treated basal cell carcinoma with no more than 20% risk of recurrence within 2 years;
  • Alcohol abuse within the past 2 years or an alcohol use pattern that will interfere with the study conduct;
  • Drug abuse within the last 6 months.
  • Current lactation or breastfeeding;
  • Major surgery within 30 days prior Visit 1;
  • Participation in another clinical trial of an investigational drug or device within 6 months prior to visit 1 unless that prior participation involved exposure only to placebo by clear and available documentation;
  • Donation of blood or plasma within 30 days prior to Visit 1.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm Type

Experimental

Placebo Comparator

Experimental

Active Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

200 mg INX-08189 Fasted

Placebo QD Fasted

100 mg INX-08189 with Ribavirin

Placebo QD dosed with ribavirin

100 mg INX-08189 with a low-fat meal

Placebo with low-fat meal

100 mg INX-08189 Fasted

Placebo BID Fasted

Arm Description

Cohort 1: 200 mg INX-08189 QD fasted for seven days

Cohort 1: Placebo QD fasted for seven days

Cohort 2: 100 mg INX-08189 100 mg dosed with ribavirin x7 days (ribavirin will be dosed in a weight-based fashion as labeled BID, the AM dose will be taken 4 hours after INX-08189 so it may be taken with food)

Cohort 2: Placebo QD dosed with ribavirin x7 days (ribavirin will be dosed in a weight-based fashion as labeled BID)

Cohort 3: 100 mg INX-08189 with a low-fat meal QD x7 days

Cohort 3: Placebo administered with a low-fat meal QD for 7 days

Cohort 4: 100 mg INX-08189 BID fasted x7 days

Cohort 4: Placebo BID fasted x7 days

Outcomes

Primary Outcome Measures

Change from baseline in HCV RNA 24 hours following the final dose of Study Drug (INX-08189/placebo)

Secondary Outcome Measures

Change in HCV RNA over time during the 7 days of dosing and during the follow-up period and the maximum change from baseline in HCV RNA.

Full Information

First Posted
September 27, 2011
Last Updated
June 23, 2016
Sponsor
Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT01445795
Brief Title
Safety Study of INX-08189, Pharmacokinetic and Pharmacodynamic With Ribavirin and Food Effect Study, in Chronically-infected Genotype 1 Hepatitis C Virus, Treatment-naïve Subjects
Acronym
INH-189-006
Official Title
A Multi-center, Placebo-controlled, Multiple Dose, Study of the Safety and Pharmacokinetics and Pharmacodynamics of INX-08189 Dosed Either QD, BID or Adjunctively With Ribavirin, and a Study of the Food Effect, in Chronically-infected Genotype 1 HCV, Treatment-naïve Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
June 2016
Overall Recruitment Status
Completed
Study Start Date
September 2011 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
May 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bristol-Myers Squibb

4. Oversight

5. Study Description

Brief Summary
This study is to determine the safety and Pharmacokinetics (PK) and Pharmacodynamics (PD) of INH-08189 dosed once a day (QD), two times a day (BID) or adjunctively with Ribavirin and a study of the food effect in Chronically-infected Genotype 1 Hepatitis C Virus (HCV), Treatment-naïve subjects.
Detailed Description
Primary Objectives: To evaluate in chronically-infected, non-cirrhotic, genotype 1 treatment naïve-subjects dosed with Study Drug for 7 consecutive days Safety - The safety of each of the 4 dosing cohorts of INX-08189 (200 mg daily (QD), 100 mg twice a day (BID), 100 mg QD with low-fat meal, and 100 mg QD with adjunctive ribavirin). Pharmacokinetic - To characterize the pharmacokinetic (PK) profile of oral doses of INX-08189 (200 mg QD, 100 mg BID, 100 mg QD with low-fat meal, and 100 mg QD with adjunctive ribavirin) and the PK profile of the metabolite (INX-08032). Pharmacodynamic - To evaluate the relationship between the kinetics of the reduction from baseline in serum HCV RNA and PK parameters of INX-08189 and the metabolite INX-08032 Efficacy - To measure the kinetics of viral load reduction in plasma HCV RNA by each of the 4 dosing cohorts of INX-08189 (200 mg QD, 100 mg BID, 100 mg QD with low-fat meal, and 100 mg QD with adjunctive ribavirin).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C
Keywords
Inhibitex, Chronic Hepatitis, Hepatitis C Virus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Factorial Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
200 mg INX-08189 Fasted
Arm Type
Experimental
Arm Description
Cohort 1: 200 mg INX-08189 QD fasted for seven days
Arm Title
Placebo QD Fasted
Arm Type
Placebo Comparator
Arm Description
Cohort 1: Placebo QD fasted for seven days
Arm Title
100 mg INX-08189 with Ribavirin
Arm Type
Experimental
Arm Description
Cohort 2: 100 mg INX-08189 100 mg dosed with ribavirin x7 days (ribavirin will be dosed in a weight-based fashion as labeled BID, the AM dose will be taken 4 hours after INX-08189 so it may be taken with food)
Arm Title
Placebo QD dosed with ribavirin
Arm Type
Active Comparator
Arm Description
Cohort 2: Placebo QD dosed with ribavirin x7 days (ribavirin will be dosed in a weight-based fashion as labeled BID)
Arm Title
100 mg INX-08189 with a low-fat meal
Arm Type
Experimental
Arm Description
Cohort 3: 100 mg INX-08189 with a low-fat meal QD x7 days
Arm Title
Placebo with low-fat meal
Arm Type
Placebo Comparator
Arm Description
Cohort 3: Placebo administered with a low-fat meal QD for 7 days
Arm Title
100 mg INX-08189 Fasted
Arm Type
Experimental
Arm Description
Cohort 4: 100 mg INX-08189 BID fasted x7 days
Arm Title
Placebo BID Fasted
Arm Type
Placebo Comparator
Arm Description
Cohort 4: Placebo BID fasted x7 days
Intervention Type
Drug
Intervention Name(s)
200 mg INX-08189 Fasted
Intervention Description
200 mg capsule INX-08189 fasted x7 days
Intervention Type
Drug
Intervention Name(s)
Placebo QD Fasted
Intervention Description
Placebo capsule QD fasted x7 days
Intervention Type
Drug
Intervention Name(s)
100 mg INX-08189 QD
Intervention Description
100 mg INX-08189 capsule QD x 7 days
Intervention Type
Drug
Intervention Name(s)
Placebo QD
Intervention Description
Placebo capsule Placebo QD dosed with ribavirin x7 days (ribavirin will be dosed in a weight-based fashion as labeled BID)
Intervention Type
Drug
Intervention Name(s)
100 mg INX-08189 with low-fat meal
Intervention Description
INX-08189 100 mg capsule, with low-fat meal QD for seven days
Intervention Type
Drug
Intervention Name(s)
Placebo with low-fat meal
Intervention Description
Placebo capsule administered with a low-fat meal QD for seven days
Intervention Type
Drug
Intervention Name(s)
100 mg INX-08189 BID Fasted
Intervention Description
100 mg INX-08189 BID fasted x7 days
Intervention Type
Drug
Intervention Name(s)
Placebo BID Fasted
Intervention Description
Placebo BID fasted x7 days
Intervention Type
Drug
Intervention Name(s)
ribavirin
Primary Outcome Measure Information:
Title
Change from baseline in HCV RNA 24 hours following the final dose of Study Drug (INX-08189/placebo)
Time Frame
24 hours following the final dose of Study Drug
Secondary Outcome Measure Information:
Title
Change in HCV RNA over time during the 7 days of dosing and during the follow-up period and the maximum change from baseline in HCV RNA.
Time Frame
HCV RNA will be measured at the following time points: Once each at Screening (Visit1), Study Day 10 (Visit 12), and Study Day 14 (Visit 13). Samples will be taken for HCV analysis pre-dose, and at 12, 24 and 48 hours after the first dose of Study Drug

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: Screening visit (Visit 1), subject criteria: Males and females, 18 to 65 years of age inclusive with a body mass index (BMI) of at least 18 kg/m2 but not exceeding 36 kg/m2; Diagnosed with chronic HCV by at least 1 previous polymerase chain reaction (PCR) result prior to Visit 1 (screening), with a positive HCV viral load of least 100,000 IU/ml at Visit 1 (screening) as measured by quantitative PCR; HCV genotype 1 per laboratory testing report; HCV treatment-naïve where "treatment-naïve" is defined as no prior treatment with interferon alpha, pegylated interferon alpha, ribavirin, or any HCV direct acting anti-viral drugs; Liver biopsy consistent with chronic HCV infection but with a classification of non-cirrhotic as judged by a pathologist (defined as Knodell ≤ 3, Metavir ≤ 2, Ishak ≤ 4, or Batts & Ludwig ≤ 2) within the last 2 years and before Visit 2 (biopsy can be done within the screening period); Negative urine drug screen for drugs of abuse (see Appendix B; note: methadone is not allowed); Females will have a negative serum beta human chorionic gonadotropin (βHCG) pregnancy test at screening and a negative urine dipstick pregnancy test upon entry to the clinical unit on Study Day -1; Agreement by both female subjects of childbearing potential and male subjects (who have not been surgically sterilized) to practice an acceptable method of birth control, which includes at least 1 barrier during the study and at least 6 months after cessation of treatment. Surgical sterilization of either the female or the male must have occurred at least 6 month prior to first dose and females must be post-menopausal for 2 years to be considered non-child-bearing potential. Willing and able to complete all study visits and procedures, and able to effectively communicate with the Investigator and other testing center personnel; Signed informed consent form (ICF) executed prior to protocol screening assessments Exclusion Criteria: screening visit (Visit1), subject criteria: Advanced liver disease, cirrhosis, or signs of decompensated liver disease such as variceal bleeding, ascites, hepatic encephalopathy, active jaundice defined by a total bilirubin > 2, or other evidence of decompensated liver disease; Co-infection with hepatitis B virus (HBV)or human immunodeficiency virus (HIV) (positive test for hepatitis B surface antigen [HBsAg] or anti-HIV antibody [Ab]); Acute cardiac ischemia, unstable heart disease or clinically symptomatic cardiac abnormalities apparent on electrocardiogram (ECG) and physical exam, or a QTcF interval at Visit 1 of ≥ 450 ms by Fridericia's correction, or a personal or family history of Torsades de pointes; Use of the following medications concurrently or within the 30 days prior Screening (Visit 1) associated with QT prolongation: macrolides, antiarrhythmic agents, azoles, fluoroquinolones, and tricyclic anti-depressants (note: methadone use is not allowed); Use of immunosuppressive or immune-modulating agents (including corticosteroids and immunosuppressive agents) or presence of an immunologically-mediated autoimmune disease (other than asthma) or history of solid organ or bone marrow transplantation (note: inhaled steroids for asthma and topical steroid for minor skin conditions allowed and washout period for PO/IM/IV corticosteroid use is 8 weeks; washout periods for other immunosuppressives determined by Medical Monitor); Use of strong Cytochrome P (CYP)3A4-inhibiting protease inhibitors (specifically atazanavir, indinavir, nelfinavir, saquinavir, and ritonavir), strong CYP3A4 inhibitors (specifically clarithromycin, itraconazole, ketoconazole, nefazodone, telithromycin), or strong CYP3A4 inducers (specifically rifampin, efavirenz, etravirine, phenobarbital, phenytoin, and carbamazepine); Absolute neutrophil count of < 1,800 cells/mm3, or platelet count < 130,000 cells/mm3, or hemoglobin < 12 g/dl for women and < 13 g/dl for men, or a history of anemia, sickle cell anemia, or thalassemia; (note: if baseline value within 5% of minimum qualifying value, 1 re-test allowed for the purpose of qualifying for study); A history of abnormal thyroid function that is not adequately controlled (defined as thyroid stimulating hormone [TSH] levels < 0.8 x lower limit of normal [LLN] or > 1.2 x the upper limit of normal [ULN]); Serum creatinine concentration ≥ 1.5 times the upper limit of normal, or albumin ≤ 3 g/dl; Any history of suicide attempt, receipt of professional counseling for suicidal ideation or any current suicidal ideation, or other serious psychiatric disorders (ie, bipolar disorder, severe depression, psychosis) requiring or having required hospitalization or medication Any malignancy within the last 5 years other than treated cervical carcinoma in situ or treated basal cell carcinoma with no more than 20% risk of recurrence within 2 years; Alcohol abuse within the past 2 years or an alcohol use pattern that will interfere with the study conduct; Drug abuse within the last 6 months. Current lactation or breastfeeding; Major surgery within 30 days prior Visit 1; Participation in another clinical trial of an investigational drug or device within 6 months prior to visit 1 unless that prior participation involved exposure only to placebo by clear and available documentation; Donation of blood or plasma within 30 days prior to Visit 1.
Facility Information:
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
City
San Juan
ZIP/Postal Code
00927
Country
Puerto Rico

12. IPD Sharing Statement

Learn more about this trial

Safety Study of INX-08189, Pharmacokinetic and Pharmacodynamic With Ribavirin and Food Effect Study, in Chronically-infected Genotype 1 Hepatitis C Virus, Treatment-naïve Subjects

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