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Evaluate the Efficacy and Safety of Sofosbuvir/Velpatasvir Fixed-Dose Combination and Ribavirin for 12 Weeks in Participants With Chronic HCV Infection and Child-Pugh-Turcotte Class C Cirrhosis

Primary Purpose

Hepatitis C Virus Infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
SOF/VEL
RBV
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C Virus Infection

Eligibility Criteria

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

Key Inclusion Criteria:

  • A body mass index (BMI) of ≥ 18 kg/m^2
  • Chronic HCV infection (≥ 6 months) as documented by either prior medical history or liver biopsy
  • Quantifiable HCV RNA at screening
  • Individuals may be non-transplanted or with recurrent HCV post-liver transplant.

    • If listed for liver transplant, then the projected date of transplant must be ≥12 weeks after Day1 of treatment
    • If post-liver transplant, then Day1 must be ≥ 6 months from date of transplant
  • CPT score of 10 to 12, inclusive, as determined at screening
  • Liver imaging within 6 months of Day 1 to exclude hepatocellular carcinoma (HCC)
  • If treatment-experienced, the most recent HCV treatment must have been completed at least 8 weeks prior to Screening
  • Females of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test on Day 1 prior to randomization
  • Males and females of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception
  • Females must agree to refrain from egg donation and in vitro fertilization during treatment until at least 30 days after the last dose of SOF/VEL or 6 months after the last dose of RBV, whichever occurs last
  • Lactating females must agree to discontinue nursing before the study drugs are administered
  • Males must agree to refrain from sperm donation from the date of screening until at least 7 months after the last dose of RBV or 30 days after the last dose of SOF/VEL, whichever occurs last
  • Adults must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments

Key Exclusion Criteria:

  • Current or prior history of any of the following:

    • Clinically significant medical or psychiatric illness or individual is currently under evaluation for a potentially clinically significant illness
    • Gastrointestinal disorder or post-operative condition that could interfere with the absorption of the study drug
    • Difficulty with blood collection and/or poor venous access for the purposes of phlebotomy
    • Significant pulmonary disease, significant cardiac disease or porphyria
    • Malignancy within the 5 years prior to screening, with the exception of specific cancers that have been cured by surgical resection (basal cell skin cancer, etc.). Adults under evaluation for possible malignancy are not eligible
    • Significant drug allergy (such as anaphylaxis or hepatotoxicity)
  • Any history of organ transplant other than liver or kidney
  • Chronic liver disease of a non-HCV etiology
  • Inability to exclude HCC by imaging within 6 months of Day 1
  • Alpha-fetoprotein (AFP) > 50 unless negative imaging for hepatic masses within the last 6 months or during screening
  • Active spontaneous bacterial peritonitis at screening
  • Infection requiring systemic antibiotics at the time of screening
  • Evidence of fibrosing cholestatic hepatitis at screening
  • Life threatening serious adverse event (SAE) during screening
  • Active variceal bleeding within 6 months of screening
  • Prior placement of a portosystemic shunt (such as TIPS)
  • ECG with clinically significant abnormalities
  • Laboratory parameters with clinically significant abnormalities
  • Hepatitis B surface antigen positive at screening
  • Infection with human immunodeficiency virus (HIV)
  • Clinically-relevant alcohol or drug abuse within 12 months of screening. A positive drug screen will exclude individuals unless it can be explained by a prescribed medication; the diagnosis and prescription must be approved by the Investigator
  • Prior exposure to any HCV Non-structural Protein 5A (NS5A) inhibitor
  • Current use of corticosteroids at any dose >10 mg of prednisone/day (or equivalent dose of corticosteroid)
  • Use of any prohibited concomitant medications
  • Use of granulocyte macrophage colony-stimulating factor (GM-CSF), epoetin alfa or other hematopoietic stimulating agents within 2 weeks of screening
  • Male with pregnant female partner
  • History of clinically significant hemoglobinopathy (eg, sickle cell disease, thalassemia)
  • Contraindications to RBV therapy
  • Known hypersensitivity to VEL, RBV, SOF, the metabolites, or formulation excipients
  • Participation in a clinical study with an investigational drug or biologic within 3 months prior to Day 1

NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.

Sites / Locations

  • Tampa General Medical Group
  • Northwestern Memorial Hospital; Clinical Research Unit
  • Digestive Disease Associates, PA
  • Southern Therapy and Advanced Research LLC
  • Icahn School of Medicine at Mount Sinai
  • Hospital of the University of Pennsylvania
  • American Research Corporation at Texas Liver Institute
  • Intermountain Liver Disease and Transplant Center
  • Bon Secours St. Mary's Hospital of Richmond, Inc. d/b/a Bon Secours Liver Institute of Virginia
  • University of Washington/ Harborview Medical Center
  • Hopital Henri Mondor
  • Hopital Paul Brousse

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SOF/VEL+ RBV

Arm Description

SOF/VEL FDC plus RBV for 12 weeks

Outcomes

Primary Outcome Measures

Percentage of Participants With Sustained Virologic Response (SVR) 12 Weeks After Discontinuation of Therapy (SVR12)
SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, 15 IU/mL) at 12 weeks after stopping study treatment.
Percentage of Participants Who Permanently Discontinued Study Drug (SOF/VEL or RBV) Due to an Adverse Event

Secondary Outcome Measures

Percentage of Participants With Sustained Virologic Response 4 Weeks After Discontinuation of Therapy (SVR4)
SVR4 was defined as HCV RNA < LLOQ 4 weeks after stopping study treatment.
Percentage of Participants With Sustained Virologic Response 24 Weeks After Discontinuation of Therapy (SVR24)
SVR24 was defined as HCV RNA < LLOQ at 24 weeks after stopping study treatment.
Percentage of Participants With HCV RNA < LLOQ While on Study Treatment
Percentage of Participants With No Change, Improved, and Worsened Child-Pugh-Turcotte (CPT) Class
CPT is a chronic liver disease classification system. Classes include CPT Class A, CPT Class B, and CPT Class C, in order of greater disease severity. Participants with improved CPT class was defined as having Class C at Baseline and Class B or A at Posttreatment Week 24 or Class B at Baseline and Class A at Posttreatment Week 24. Participants with worsened CPT class was defined as having Class A at Baseline and Class B or C at Posttreatment Week 24 or Class B at Baseline and Class C at Posttreatment Week 24. Participants with no change CPT class was defined as having CPT Class same between Baseline and Posttreatment Week 24.
Percentage of Participants With a Decrease, No Change, or Increase in Model for End Stage Liver Disease (MELD) Score
MELD score is a chronic liver disease severity scoring system. Scores can range from 6 to 40, with higher scores indicating greater disease severity. "No change" was assigned for differences (posttreatment visits minus baseline score) of -1, 0 or 1; "Decrease" was assigned for differences that were less than or equal to -2; and "Increase" was assigned for values that were greater than or equal to 2.
Absolute HCV RNA Level Through Week 12
Change From Baseline in HCV RNA
Number of Participants With Virologic Failure
Virologic failure was defined as: On-treatment virologic failure: Breakthrough (confirmed HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment), or Rebound (confirmed > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment), or Non-response (HCV RNA persistently ≥ LLOQ through 8 weeks of treatment) Virologic relapse: Confirmed HCV RNA ≥ LLOQ during the posttreatment period having achieved HCV RNA < LLOQ at last on-treatment visit

Full Information

First Posted
December 13, 2016
Last Updated
February 18, 2020
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT02994056
Brief Title
Evaluate the Efficacy and Safety of Sofosbuvir/Velpatasvir Fixed-Dose Combination and Ribavirin for 12 Weeks in Participants With Chronic HCV Infection and Child-Pugh-Turcotte Class C Cirrhosis
Official Title
A Phase 2, Multicenter, Open-Label Study to Evaluate the Efficacy and Safety of Sofosbuvir/Velpatasvir Fixed-Dose Combination and Ribavirin for 12 Weeks in Subjects With Chronic HCV Infection and Child-Pugh-Turcotte Class C Cirrhosis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
January 23, 2017 (Actual)
Primary Completion Date
September 25, 2018 (Actual)
Study Completion Date
December 12, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objectives of this study are to evaluate the efficacy, safety, and tolerability of the treatment with sofosbuvir velpatasvir (SOF/VEL) fixed-dose combination (FDC) with ribavirin (RBV) for 12 weeks in participants with chronic hepatitis C virus (HCV) infection and Child-Pugh-Turcotte (CPT) Class C cirrhosis.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SOF/VEL+ RBV
Arm Type
Experimental
Arm Description
SOF/VEL FDC plus RBV for 12 weeks
Intervention Type
Drug
Intervention Name(s)
SOF/VEL
Other Intervention Name(s)
Epclusa®, GS-7977/GS-5816
Intervention Description
400/100 mg FDC tablet administered orally once daily
Intervention Type
Drug
Intervention Name(s)
RBV
Intervention Description
Tablets administered orally at 600 mg, if well tolerated then up to a maximum total daily dose of 1000 to 1200 mg (based on weight) divided twice daily.
Primary Outcome Measure Information:
Title
Percentage of Participants With Sustained Virologic Response (SVR) 12 Weeks After Discontinuation of Therapy (SVR12)
Description
SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, 15 IU/mL) at 12 weeks after stopping study treatment.
Time Frame
Posttreatment Week 12
Title
Percentage of Participants Who Permanently Discontinued Study Drug (SOF/VEL or RBV) Due to an Adverse Event
Time Frame
First dose date up to Week 12
Secondary Outcome Measure Information:
Title
Percentage of Participants With Sustained Virologic Response 4 Weeks After Discontinuation of Therapy (SVR4)
Description
SVR4 was defined as HCV RNA < LLOQ 4 weeks after stopping study treatment.
Time Frame
Posttreatment Week 4
Title
Percentage of Participants With Sustained Virologic Response 24 Weeks After Discontinuation of Therapy (SVR24)
Description
SVR24 was defined as HCV RNA < LLOQ at 24 weeks after stopping study treatment.
Time Frame
Posttreatment Week 24
Title
Percentage of Participants With HCV RNA < LLOQ While on Study Treatment
Time Frame
Weeks 2, 4, 8, and 12
Title
Percentage of Participants With No Change, Improved, and Worsened Child-Pugh-Turcotte (CPT) Class
Description
CPT is a chronic liver disease classification system. Classes include CPT Class A, CPT Class B, and CPT Class C, in order of greater disease severity. Participants with improved CPT class was defined as having Class C at Baseline and Class B or A at Posttreatment Week 24 or Class B at Baseline and Class A at Posttreatment Week 24. Participants with worsened CPT class was defined as having Class A at Baseline and Class B or C at Posttreatment Week 24 or Class B at Baseline and Class C at Posttreatment Week 24. Participants with no change CPT class was defined as having CPT Class same between Baseline and Posttreatment Week 24.
Time Frame
Baseline to Posttreatment Week 24
Title
Percentage of Participants With a Decrease, No Change, or Increase in Model for End Stage Liver Disease (MELD) Score
Description
MELD score is a chronic liver disease severity scoring system. Scores can range from 6 to 40, with higher scores indicating greater disease severity. "No change" was assigned for differences (posttreatment visits minus baseline score) of -1, 0 or 1; "Decrease" was assigned for differences that were less than or equal to -2; and "Increase" was assigned for values that were greater than or equal to 2.
Time Frame
Baseline to Posttreatment Week 24
Title
Absolute HCV RNA Level Through Week 12
Time Frame
Baseline; Weeks 2, 4, 8, and 12
Title
Change From Baseline in HCV RNA
Time Frame
Baseline; Weeks 2, 4, 8, and 12
Title
Number of Participants With Virologic Failure
Description
Virologic failure was defined as: On-treatment virologic failure: Breakthrough (confirmed HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while on treatment), or Rebound (confirmed > 1 log10 IU/mL increase in HCV RNA from nadir while on treatment), or Non-response (HCV RNA persistently ≥ LLOQ through 8 weeks of treatment) Virologic relapse: Confirmed HCV RNA ≥ LLOQ during the posttreatment period having achieved HCV RNA < LLOQ at last on-treatment visit
Time Frame
Baseline up to Posttreatment Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: A body mass index (BMI) of ≥ 18 kg/m^2 Chronic HCV infection (≥ 6 months) as documented by either prior medical history or liver biopsy Quantifiable HCV RNA at screening Individuals may be non-transplanted or with recurrent HCV post-liver transplant. If listed for liver transplant, then the projected date of transplant must be ≥12 weeks after Day1 of treatment If post-liver transplant, then Day1 must be ≥ 6 months from date of transplant CPT score of 10 to 12, inclusive, as determined at screening Liver imaging within 6 months of Day 1 to exclude hepatocellular carcinoma (HCC) If treatment-experienced, the most recent HCV treatment must have been completed at least 8 weeks prior to Screening Females of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test on Day 1 prior to randomization Males and females of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception Females must agree to refrain from egg donation and in vitro fertilization during treatment until at least 30 days after the last dose of SOF/VEL or 6 months after the last dose of RBV, whichever occurs last Lactating females must agree to discontinue nursing before the study drugs are administered Males must agree to refrain from sperm donation from the date of screening until at least 7 months after the last dose of RBV or 30 days after the last dose of SOF/VEL, whichever occurs last Adults must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments Key Exclusion Criteria: Current or prior history of any of the following: Clinically significant medical or psychiatric illness or individual is currently under evaluation for a potentially clinically significant illness Gastrointestinal disorder or post-operative condition that could interfere with the absorption of the study drug Difficulty with blood collection and/or poor venous access for the purposes of phlebotomy Significant pulmonary disease, significant cardiac disease or porphyria Malignancy within the 5 years prior to screening, with the exception of specific cancers that have been cured by surgical resection (basal cell skin cancer, etc.). Adults under evaluation for possible malignancy are not eligible Significant drug allergy (such as anaphylaxis or hepatotoxicity) Any history of organ transplant other than liver or kidney Chronic liver disease of a non-HCV etiology Inability to exclude HCC by imaging within 6 months of Day 1 Alpha-fetoprotein (AFP) > 50 unless negative imaging for hepatic masses within the last 6 months or during screening Active spontaneous bacterial peritonitis at screening Infection requiring systemic antibiotics at the time of screening Evidence of fibrosing cholestatic hepatitis at screening Life threatening serious adverse event (SAE) during screening Active variceal bleeding within 6 months of screening Prior placement of a portosystemic shunt (such as TIPS) ECG with clinically significant abnormalities Laboratory parameters with clinically significant abnormalities Hepatitis B surface antigen positive at screening Infection with human immunodeficiency virus (HIV) Clinically-relevant alcohol or drug abuse within 12 months of screening. A positive drug screen will exclude individuals unless it can be explained by a prescribed medication; the diagnosis and prescription must be approved by the Investigator Prior exposure to any HCV Non-structural Protein 5A (NS5A) inhibitor Current use of corticosteroids at any dose >10 mg of prednisone/day (or equivalent dose of corticosteroid) Use of any prohibited concomitant medications Use of granulocyte macrophage colony-stimulating factor (GM-CSF), epoetin alfa or other hematopoietic stimulating agents within 2 weeks of screening Male with pregnant female partner History of clinically significant hemoglobinopathy (eg, sickle cell disease, thalassemia) Contraindications to RBV therapy Known hypersensitivity to VEL, RBV, SOF, the metabolites, or formulation excipients Participation in a clinical study with an investigational drug or biologic within 3 months prior to Day 1 NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilead Study Director
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Tampa General Medical Group
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Northwestern Memorial Hospital; Clinical Research Unit
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Digestive Disease Associates, PA
City
Catonsville
State/Province
Maryland
ZIP/Postal Code
21228
Country
United States
Facility Name
Southern Therapy and Advanced Research LLC
City
Jackson
State/Province
Mississippi
ZIP/Postal Code
39216
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
American Research Corporation at Texas Liver Institute
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Facility Name
Intermountain Liver Disease and Transplant Center
City
Murray
State/Province
Utah
ZIP/Postal Code
84107
Country
United States
Facility Name
Bon Secours St. Mary's Hospital of Richmond, Inc. d/b/a Bon Secours Liver Institute of Virginia
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23226
Country
United States
Facility Name
University of Washington/ Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Hopital Henri Mondor
City
Créteil
ZIP/Postal Code
94010
Country
France
Facility Name
Hopital Paul Brousse
City
Villejuif
ZIP/Postal Code
94800
Country
France

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified external researchers may request IPD for this study after study completion. For more information, please visit our website at https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy.
IPD Sharing Time Frame
18 months after study completion
IPD Sharing Access Criteria
A secured external environment with username, password, and RSA code.
IPD Sharing URL
https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy
Citations:
Citation
Flamm S, Lawitz E, Borg B, Charlton M, Landis C, Reddy R, et al. High Efficacy and Improvement in CPT Class With Sofosbuvir/Velpatasvir Plus Ribavirin for 12 Weeks in Patients With CPT C Decompensated Cirrhosis [Poster THU-138]. EASL: The International Liver Congress; 2019 10-14 April; Vienna, Austria.
Results Reference
result

Learn more about this trial

Evaluate the Efficacy and Safety of Sofosbuvir/Velpatasvir Fixed-Dose Combination and Ribavirin for 12 Weeks in Participants With Chronic HCV Infection and Child-Pugh-Turcotte Class C Cirrhosis

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