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Scale-up of Treatment of Hepatitis C Infection Among People Who Inject Drugs (DARLO-C)

Primary Purpose

Hepatitis C

Status
Terminated
Phase
Phase 4
Locations
Australia
Study Type
Interventional
Intervention
Grazoprevir/elbasvir
Sponsored by
Kirby Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C

Eligibility Criteria

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

Inclusion Criteria:

  • Participants have voluntarily signed the informed consent form.
  • Be ≥18 years of age on day of signing informed consent form.
  • Have chronic HCV genotype 1 or 4 infection (defined as detectable HCV RNA).
  • Recent injecting drug use (previous 6 months) or receiving opioid substitution therapy.
  • HIV-1 infected subjects enrolled in the study must meet the following criteria:

    • Have HIV infection documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry (Baseline) and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 p24 antigen, or plasma HIV-1 RNA viral load
    • b) Be on HIV Antiretroviral Therapy (ART) for at least 4 weeks prior to study entry using an ART regimen that is allowable with the intended DAA regimen as determined by the current PI and the Liverpool drug interaction website (http://www.hiv-druginteractions.org/) or current prescribing guidelines for elbasvir/grazoprevir OR be naive to treatment with any antiretroviral therapy (ART) with a baseline CD4 count of >200 and have no plans to initiate ART treatment while participating in this study and through to at least Follow-up Week 4.
  • Negative pregnancy test at screening and baseline (females of childbearing potential only).
  • All fertile males and females must be using effective contraception during treatment and during 14 days after treatment end.

Exclusion Criteria:

  • Is taking or plans to take any prohibited medications as per DAA Product Information or herbal supplements, including but not limited to St. John's Wort (Hypericum perforatum) within 2 weeks of Baseline.
  • Is currently using or intends to use barbiturates.
  • Is a female and is pregnant or breast-feeding, or expecting to conceive or donate eggs from Baseline and continue throughout treatment, and after the last dose of study medication (as per the regimen requirements), or longer if dictated by local regulations.
  • Has any condition or pre-study laboratory abnormality, ECG abnormality or history of any illness, which, in the opinion of the investigator, might confound the results of the study or pose additional risk in administering the study drugs to the subject.
  • Had a life-threatening SAE during the screening period.
  • Has exclusionary laboratory values as listed below:

    • Haemoglobin < 9.5 g/dL for both males and females
    • Platelets < 50 x 10^3 /µL
    • Serum albumin < 3.0 g/dL
  • Patients with Child Pugh-B or C decompensated cirrhosis
  • Previous HCV treatment-experience.
  • Ongoing severe psychiatric disease as judged by the treating physician.
  • Frequent injecting drug use that is judged by the treating physician to compromise treatment safety.
  • Inability or unwillingness to provide informed consent or abide by the requirements of the study.
  • Is Hepatitis B surface antigen (HBsAg) positive

NOTE: Sanger sequencing will be performed on a pre-treatment sample on all participants.

Sites / Locations

  • Kirketon Road Centre
  • St Vincent's Hospital
  • The Langton Centre
  • Nepean Hospital
  • Drug and Alcohol Clinical Services (Hunter)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Grazoprevir/elbasvir

Arm Description

Grazoprevir/elbasvir (100mg/50mg) daily taken orally for 12 weeks.

Outcomes

Primary Outcome Measures

Undetectable HCV RNA at 12 Weeks Post End of Treatment (SVR12)
Number with undetectable HCV RNA at 12 weeks post end of treatment (SVR12) following 12 weeks of daily grazoprevir/elbasvir (100mg/50mg)

Secondary Outcome Measures

Number of Participants With Treatment Completion
Number who completed HCV treatment as prescribed (12 weeks of grazoprevir/elbasvir (100mg/50mg) daily)
End of Treatment Response (Negative HCV RNA at the End of Treatment)
Number with undetectable HCV RNA at end of treatment following 12 weeks of daily Grazoprevir/Elbasvir (100mg/50mg)

Full Information

First Posted
October 19, 2016
Last Updated
February 21, 2020
Sponsor
Kirby Institute
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1. Study Identification

Unique Protocol Identification Number
NCT02940691
Brief Title
Scale-up of Treatment of Hepatitis C Infection Among People Who Inject Drugs
Acronym
DARLO-C
Official Title
A Phase IV, Open-label, Single Arm, Multicentre Trial of Grazoprevir/Elbasvir for Genotype 1 or 4 in People With Chronic Hepatitis C Virus Infection and Recent Injecting Drug Use or Receiving Opioid Substitution Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Terminated
Why Stopped
Poor recruitment due to new treatments becoming available.
Study Start Date
May 1, 2017 (Actual)
Primary Completion Date
November 1, 2018 (Actual)
Study Completion Date
November 1, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kirby Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is a phase IV, open-label, single arm, multicentre study whose aim is to assess whether interferon-free and ribavirin-free Direct Acting Antiviral (DAA) Hepatitis C Virus (HCV) therapy with grazoprevir/elbasvir, will be feasible for the treatment of People who inject drugs (PWID) with recent injecting drug use or people receiving opioid substitution therapy and chronic HCV genotype 1 or 4 infection.
Detailed Description
A prospective, observational cohort design will be used to enrol patients attending tertiary, drug and alcohol and primary health care services in Sydney, Australia. The study consists of a treatment phase (12 weeks) and a follow-up phase (up to 3 years) where participants will be followed every 3 months for the first year and every 6 months in years 2-3 to evaluate treatment response and reinfection. The effectiveness of the treatment will be assessed by looking at the proportion of patients with undetectable HCV RNA at 12 weeks post end of treatment (SVR12) following therapy with grazoprevir/elbasvir and evaluate demographic and clinical predictors of non-response.

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 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Grazoprevir/elbasvir
Arm Type
Experimental
Arm Description
Grazoprevir/elbasvir (100mg/50mg) daily taken orally for 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Grazoprevir/elbasvir
Other Intervention Name(s)
Zepatier
Intervention Description
Grazoprevir/elbasvir (100mg/50mg) once daily for 12 weeks.
Primary Outcome Measure Information:
Title
Undetectable HCV RNA at 12 Weeks Post End of Treatment (SVR12)
Description
Number with undetectable HCV RNA at 12 weeks post end of treatment (SVR12) following 12 weeks of daily grazoprevir/elbasvir (100mg/50mg)
Time Frame
12 weeks post treatment
Secondary Outcome Measure Information:
Title
Number of Participants With Treatment Completion
Description
Number who completed HCV treatment as prescribed (12 weeks of grazoprevir/elbasvir (100mg/50mg) daily)
Time Frame
12 weeks from treatment administration
Title
End of Treatment Response (Negative HCV RNA at the End of Treatment)
Description
Number with undetectable HCV RNA at end of treatment following 12 weeks of daily Grazoprevir/Elbasvir (100mg/50mg)
Time Frame
12 weeks from treatment administration
Other Pre-specified Outcome Measures:
Title
Sensitivity and Specificity of the Finger-stick Xpert® HCV Viral Load Assay for HCV RNA Detection
Description
To determine the sensitivity and specificity of the Xpert® HCV Viral Load assay for HCV RNA detection in samples collected by finger-stick capillary whole-blood.
Time Frame
12 week post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants have voluntarily signed the informed consent form. Be ≥18 years of age on day of signing informed consent form. Have chronic HCV genotype 1 or 4 infection (defined as detectable HCV RNA). Recent injecting drug use (previous 6 months) or receiving opioid substitution therapy. HIV-1 infected subjects enrolled in the study must meet the following criteria: Have HIV infection documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry (Baseline) and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 p24 antigen, or plasma HIV-1 RNA viral load b) Be on HIV Antiretroviral Therapy (ART) for at least 4 weeks prior to study entry using an ART regimen that is allowable with the intended DAA regimen as determined by the current PI and the Liverpool drug interaction website (http://www.hiv-druginteractions.org/) or current prescribing guidelines for elbasvir/grazoprevir OR be naive to treatment with any antiretroviral therapy (ART) with a baseline CD4 count of >200 and have no plans to initiate ART treatment while participating in this study and through to at least Follow-up Week 4. Negative pregnancy test at screening and baseline (females of childbearing potential only). All fertile males and females must be using effective contraception during treatment and during 14 days after treatment end. Exclusion Criteria: Is taking or plans to take any prohibited medications as per DAA Product Information or herbal supplements, including but not limited to St. John's Wort (Hypericum perforatum) within 2 weeks of Baseline. Is currently using or intends to use barbiturates. Is a female and is pregnant or breast-feeding, or expecting to conceive or donate eggs from Baseline and continue throughout treatment, and after the last dose of study medication (as per the regimen requirements), or longer if dictated by local regulations. Has any condition or pre-study laboratory abnormality, ECG abnormality or history of any illness, which, in the opinion of the investigator, might confound the results of the study or pose additional risk in administering the study drugs to the subject. Had a life-threatening SAE during the screening period. Has exclusionary laboratory values as listed below: Haemoglobin < 9.5 g/dL for both males and females Platelets < 50 x 10^3 /µL Serum albumin < 3.0 g/dL Patients with Child Pugh-B or C decompensated cirrhosis Previous HCV treatment-experience. Ongoing severe psychiatric disease as judged by the treating physician. Frequent injecting drug use that is judged by the treating physician to compromise treatment safety. Inability or unwillingness to provide informed consent or abide by the requirements of the study. Is Hepatitis B surface antigen (HBsAg) positive NOTE: Sanger sequencing will be performed on a pre-treatment sample on all participants.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Greg Dore, MBBS
Organizational Affiliation
Kirby Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kirketon Road Centre
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Facility Name
St Vincent's Hospital
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Facility Name
The Langton Centre
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Facility Name
Nepean Hospital
City
Kingswood
State/Province
New South Wales
ZIP/Postal Code
2751
Country
Australia
Facility Name
Drug and Alcohol Clinical Services (Hunter)
City
Newcastle
State/Province
New South Wales
ZIP/Postal Code
2300
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32270056
Citation
Grebely J, Read P, Cunningham EB, Weltman M, Matthews GV, Dunlop A, Montebello M, Martinello M, Gilliver R, Marks P, Applegate TL, Dore GJ; DARLO-C Study Group. Elbasvir and grazoprevir for hepatitis C virus genotype 1 infection in people with recent injecting drug use (DARLO-C): An open-label, single-arm, phase 4, multicentre trial. Health Sci Rep. 2020 Mar 15;3(2):e151. doi: 10.1002/hsr2.151. eCollection 2020 Jun.
Results Reference
derived

Learn more about this trial

Scale-up of Treatment of Hepatitis C Infection Among People Who Inject Drugs

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