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Study of Quadruple Therapy With Eltrombopag for Chronic Hepatitis C (SQUELCH-C)

Primary Purpose

Thrombocytopenia, Hepatitis C

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Eltrombopag
Sponsored by
University of Texas Southwestern Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Thrombocytopenia focused on measuring Thrombocytopenia, Hepatitis, Platelets, Eltrombopag, Liver Disease, Antiviral Treatment

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female patients at least 18 years of age.
  • Require a platelet count below 75 x 10^9 /L at time of screening.
  • The patients must meet the eligibility criteria for all drugs involved.
  • Only genotype 1 (a, b, indeterminate, or mixed).
  • Confirmed history of chronic hepatitis C.
  • Cirrhotic patients will be included.
  • Liver imaging within 1 year to exclude hepatocellular carcinoma (HCC) is required in patients with cirrhosis.
  • Patients without evidence of cirrhosis but meeting platelet criteria will also be admitted to study.
  • Subjects must be able to provide informed consent, comply with drug administration instructions, and be able to complete each study visit.
  • Ability to cover costs of ribavirin, interferon, and boceprevir will also be required.
  • Female subjects are eligible if: Non-pregnant, non-childbearing potential, or of childbearing potential and willing to perform complete abstinence or correctly use a form of birth control during intercourse [barrier method, intrauterine device, hormonal therapy, or surgical sterilization in females or male partner]. They must also be willing to have pregnancy tests performed every 4- weeks until 6 months after completion of ribavirin.
  • Male study participants must agree to use a condom and their female partner must partake in one of the contraceptive methods discussed above until 6 months after completion of ribavirin therapy.

Exclusion Criteria:

  • A history of chronic infection (i.e., HIV or HBV) or a previous organ transplantation.
  • A history of a platelet disorder.
  • A poorly controlled underlying medical illness (i.e., diabetes, hypertension, coronary artery disease, congestive heart failure, etc.).
  • Any contraindication to any study drugs as mentioned in their respective prescribing information.
  • Patients with decompensated cirrhosis defined as current evidence for ascites, encephalopathy, infection or variceal bleeding. All patients should be considered Child-Pugh Class A.
  • Patients with aminotransferase levels ≥ 500 IU/L will be excluded on presumption of another active liver disease.
  • Patients must not be pregnant or nursing.
  • The study physician maintains the right to exclude a patient for a medical condition not listed above or based off laboratory values indicating chronic disease discovered at screening.
  • Patients with eye disease may be excluded from this study if the ophthalmologist does not recommend treatment.
  • Subjects with known hypersensitivity reactions (such as Stevens-Johnson syndrome, toxic, epidermal necrolysis, and erythema multiforme to ribavirin) to study drugs or any component of the products.
  • Subjects with autoimmune hepatitis, hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia), creatinine clearance less than 50 mL/min.
  • Co-administration of drugs that are highly dependent on CYP3A4/5 for clearance and CYP3A4/5 inducers (See Table 2 in boceprevir prescribing information).

Sites / Locations

  • UT Southwestern Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Thrombocytopenic (Low Platelet) Patients

Arm Description

All study patients will undergo intervention in this study. The intervention will be a lead-in with eltrombopag and antiviral triple therapy (interferon, ribavirin and boceprevir).

Outcomes

Primary Outcome Measures

Percentage of Study Patients Completing Antiviral Therapy, as Per Boceprevir Prescribing Guidelines.
The length of therapy will depend on several factors: Study patient's liver disease status. Study patient's antiviral response. Study patient's tolerance to treatment. One patient completed therapy and experienced a sustained viral response. A minimum full course of treatment will be 30 weeks, with a maximum of 56 weeks of treatment.

Secondary Outcome Measures

Full Information

First Posted
March 23, 2013
Last Updated
October 30, 2019
Sponsor
University of Texas Southwestern Medical Center
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT01821625
Brief Title
Study of Quadruple Therapy With Eltrombopag for Chronic Hepatitis C
Acronym
SQUELCH-C
Official Title
Study of Quadruple Therapy With Eltrombopag for Chronic Hepatitis C
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Terminated
Why Stopped
Interferon use for hepatitis C plummeted, eliminating the need for study drug.
Study Start Date
April 2013 (Actual)
Primary Completion Date
April 2015 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Texas Southwestern Medical Center
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will provide chronic hepatitis C patients with low platelets (less than 75x10^9/L) the opportunity to undergo treatment and possible cure of their virus. The main hepatitis C drugs will be administered as standard of care, with the addition of the study drug eltrombopag. The investigators hypothesize that providing eltrombopag to chronic hepatitis C patients with low platelets (less than 75x10^9/L) will permit the initiation and completion of antiviral triple therapy with boceprevir, ribavirin, and pegylated-interferon.
Detailed Description
SQUELCH-C is an investigator-initiated, single arm, non-blinded pilot study on the use of eltrombopag in combination with ribavirin, pegylated-interferon, and boceprevir, for patients who would not otherwise be treatment candidates because of low platelet counts (less than 75x10^9/L). Administration of the drugs ribavirin and boceprevir will be standard of care, with one exception for interferon. The total drug treatment period for the study patient will range from 32 - 56 weeks, depending on liver disease stage and viral response. Follow-up will take place at 12 and 24 weeks post treatment to evaluate for sustained viral response. Total study participation may require 1.5 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thrombocytopenia, Hepatitis C
Keywords
Thrombocytopenia, Hepatitis, Platelets, Eltrombopag, Liver Disease, Antiviral Treatment

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Thrombocytopenic (Low Platelet) Patients
Arm Type
Experimental
Arm Description
All study patients will undergo intervention in this study. The intervention will be a lead-in with eltrombopag and antiviral triple therapy (interferon, ribavirin and boceprevir).
Intervention Type
Drug
Intervention Name(s)
Eltrombopag
Other Intervention Name(s)
Promacta
Intervention Description
Study patients will be provided eltrombopag to raise platelet levels before anti-hepatitis C drugs are initiated, and will continue eltrombopag throughout the study.
Primary Outcome Measure Information:
Title
Percentage of Study Patients Completing Antiviral Therapy, as Per Boceprevir Prescribing Guidelines.
Description
The length of therapy will depend on several factors: Study patient's liver disease status. Study patient's antiviral response. Study patient's tolerance to treatment. One patient completed therapy and experienced a sustained viral response. A minimum full course of treatment will be 30 weeks, with a maximum of 56 weeks of treatment.
Time Frame
Up to 56 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients at least 18 years of age. Require a platelet count below 75 x 10^9 /L at time of screening. The patients must meet the eligibility criteria for all drugs involved. Only genotype 1 (a, b, indeterminate, or mixed). Confirmed history of chronic hepatitis C. Cirrhotic patients will be included. Liver imaging within 1 year to exclude hepatocellular carcinoma (HCC) is required in patients with cirrhosis. Patients without evidence of cirrhosis but meeting platelet criteria will also be admitted to study. Subjects must be able to provide informed consent, comply with drug administration instructions, and be able to complete each study visit. Ability to cover costs of ribavirin, interferon, and boceprevir will also be required. Female subjects are eligible if: Non-pregnant, non-childbearing potential, or of childbearing potential and willing to perform complete abstinence or correctly use a form of birth control during intercourse [barrier method, intrauterine device, hormonal therapy, or surgical sterilization in females or male partner]. They must also be willing to have pregnancy tests performed every 4- weeks until 6 months after completion of ribavirin. Male study participants must agree to use a condom and their female partner must partake in one of the contraceptive methods discussed above until 6 months after completion of ribavirin therapy. Exclusion Criteria: A history of chronic infection (i.e., HIV or HBV) or a previous organ transplantation. A history of a platelet disorder. A poorly controlled underlying medical illness (i.e., diabetes, hypertension, coronary artery disease, congestive heart failure, etc.). Any contraindication to any study drugs as mentioned in their respective prescribing information. Patients with decompensated cirrhosis defined as current evidence for ascites, encephalopathy, infection or variceal bleeding. All patients should be considered Child-Pugh Class A. Patients with aminotransferase levels ≥ 500 IU/L will be excluded on presumption of another active liver disease. Patients must not be pregnant or nursing. The study physician maintains the right to exclude a patient for a medical condition not listed above or based off laboratory values indicating chronic disease discovered at screening. Patients with eye disease may be excluded from this study if the ophthalmologist does not recommend treatment. Subjects with known hypersensitivity reactions (such as Stevens-Johnson syndrome, toxic, epidermal necrolysis, and erythema multiforme to ribavirin) to study drugs or any component of the products. Subjects with autoimmune hepatitis, hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia), creatinine clearance less than 50 mL/min. Co-administration of drugs that are highly dependent on CYP3A4/5 for clearance and CYP3A4/5 inducers (See Table 2 in boceprevir prescribing information).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William M Lee, M.D.
Organizational Affiliation
UT Southwestern Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390-8887
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study of Quadruple Therapy With Eltrombopag for Chronic Hepatitis C

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