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Safety and Efficacy of Grazoprevir and Elbasvir for GT1ang GT6 With and Without HIV

Primary Purpose

Compensated Cirrhosis

Status
Unknown status
Phase
Phase 4
Locations
Thailand
Study Type
Interventional
Intervention
Grazaoprevir/Elbasavir
Grazaoprevir/Elbasavir/RBV
Sponsored by
The HIV Netherlands Australia Thailand Research Collaboration
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Compensated Cirrhosis focused on measuring Safety, Efficacy, grazoprevir, elbasvir, compensated cirrhosis, genotype 1 (GT1), genotype 6 (GT6), hepatitis virus C (HCV), human immunodeficiency virus (HIV)

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women aged 18 years or older
  2. Documented chronic HCV GT1 or GT6 (positive for anti-HCV antibody and HCV RNA at least 6 months prior to screening)
  3. HCV RNA of at least 10,000 IU/ml
  4. Cirrhosis defined by: liver biopsy showing cirrhosis METAVIR F4; or TE showing cirrhosis with a result of >13.0 kPa
  5. Treatment-naïve individuals for chronic HCV infection
  6. Treatment-experienced individuals (Previous treatment failure with PEG-IFN plus RBV) for chronic HCV infection
  7. HIV-infected participants enrolled in this study must meet following criteria:

    7.1 Documented HIV infection 7.2 Naïve to treatment with any antiretroviral therapy (ART) or on HIV ART for at least 8 weeks prior to study entry using a dual nucleoside reverse transcriptase inhibitor (NRTI) backbone of tenofovir or abacavir and either emtricitabine or lamivudine plus raltegravir (or dolutegravir or rilpivirine) 7.3 CD4+ T-cell count >200 cells/mm3 if on ART or >500 cell/mm3 if ART treatment naïve 7.4 Undetectable plasma HIV-RNA at least 8 weeks prior to screening if on ART or <50,000 copies/mL if ART treatment naïve

  8. Agree to use two acceptable methods of birth control from at least 2 weeks prior to Day 1 and continue until at least 6 months after last dose of study drug, or longer if dictated by local regulations (for female subject who is of childbearing potential or male subject with female sexual partner who is of childbearing potential).

Exclusion Criteria:

  1. Evidence of decompensated liver disease (Child-Pugh Class B or C or Child-Pugh score >6, platelets less than 75 × 10³/μL, serum albumin < 3·0 g/dL, presence of or history of ascites, gastric or variceal bleeding, hepatic encephalopathy or other signs or symptoms of advanced liver disease)
  2. Co-infected with hepatitis B virus
  3. Has cirrhosis and liver imaging within 6 months showing evidence of HCC or is under evaluation for HCC
  4. Pregnant or breast-feeding from day 1 or anytime during treatment, and 14 days after the last dose of study medication
  5. Any medical condition requiring or likely to require chronic systemic administration of corticosteroids or other immunosuppressant drugs during the course of the study

Sites / Locations

  • Faculty of Medicine, Chulalongkorn University
  • HIV-NAT, Thai Red Cross AIDS Research Centre

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

HCV mono-infection Treatment naives

HCV mono-infection Treatment experienced

HCV/HIV co-infection Treatment naives

HCV/HIV co-infection Treatment experienced

Arm Description

HCV treatment-naïve patients will be treated with the combination of grazoprevir plus elbasvir for 12 weeks.

HCV treatment-experienced patients, including null responders, partial responders or post-treatment relapsers, will be assigned to treat with the combination plus weight-based RBV for 16 weeks.

HCV/HIV coinfected, treatment-naïve patients will be treated with the combination of grazoprevir plus elbasvir for 12 weeks.

HCV/HIV co-infected treatment-experienced patients, including null responders, partial responders or post-treatment relapsers, will be assigned to treat with the combination plus weight-based RBV for 16 weeks.

Outcomes

Primary Outcome Measures

Rate of SVR12
To evaluate the rate of sustained virological response (SVR) at 12 weeks after the end of treatment (SVR12) in compensated cirrhotic participants with GT1 and GT6 HCV infection with or without HIV infection treated with the combination of grazoprevir and elbasvir

Secondary Outcome Measures

Rate of SVR24
To evaluate the rate of sustained virological response (SVR) at 24 weeks after the end of treatment (SVR24)
Decline of liver stiffness
To evaluate the percentage of participants achieving a significant decline in liver stiffness (LS) values (defined as a ≥30% decrease from baseline) up to 240 weeks (5 years) after treatment
changes in liver stiffness
To compare the longitudinal changes in LS values over time between participants and untreated historical controls

Full Information

First Posted
January 27, 2017
Last Updated
February 11, 2020
Sponsor
The HIV Netherlands Australia Thailand Research Collaboration
Collaborators
Chulalongkorn University, Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03037151
Brief Title
Safety and Efficacy of Grazoprevir and Elbasvir for GT1ang GT6 With and Without HIV
Official Title
Safety and Fibrosis Improvement of Grazoprevir and Elbasvir for HCV GT1 and GT6 With or Without HIV
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Unknown status
Study Start Date
August 1, 2018 (Actual)
Primary Completion Date
December 31, 2020 (Anticipated)
Study Completion Date
December 31, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The HIV Netherlands Australia Thailand Research Collaboration
Collaborators
Chulalongkorn University, Merck Sharp & Dohme LLC

4. Oversight

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

5. Study Description

Brief Summary
This study will evaluate the safety and efficacy of combination treatment with grazoprevir + elbasvir for compensated cirrhotic participants with chronic genotype 1 (GT1) and genotype 6 (GT6) hepatitis C virus (HCV) infection with or without human immunodeficiency virus (HIV) infection.
Detailed Description
Total 100 patients with compensated cirrhosis, chronically infected with HCV GT1 or GT6 with or without HIV infection will be included. Patients with HCV GT1 and GT6 will be enrolled on a 1:1 basis (approximately 50 patients with GT1 and 50 patients with GT6). Treatment-naïve patients will be treated with the combination of grazoprevir plus elbasvir for 12 weeks. Treatment-experienced patients, including null responders, partial responders or post-treatment relapsers, will be assigned to treat with the combination plus weight-based RBV for 16 weeks. The dosages of study drugs are 100 mg of grazoprevir once daily and 50 mg of elbasvir once daily. All patients will follow up to assess SVR (defined by HCV RNA level <12 IU/mL) at week12 and week 24 after treatment (SVR12 and SVR24, respectively). Additionally, participants will be evaluated the longitudinal changes in LS values by TE up to 240 weeks (5 years) after treatment

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Compensated Cirrhosis
Keywords
Safety, Efficacy, grazoprevir, elbasvir, compensated cirrhosis, genotype 1 (GT1), genotype 6 (GT6), hepatitis virus C (HCV), human immunodeficiency virus (HIV)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HCV mono-infection Treatment naives
Arm Type
Experimental
Arm Description
HCV treatment-naïve patients will be treated with the combination of grazoprevir plus elbasvir for 12 weeks.
Arm Title
HCV mono-infection Treatment experienced
Arm Type
Experimental
Arm Description
HCV treatment-experienced patients, including null responders, partial responders or post-treatment relapsers, will be assigned to treat with the combination plus weight-based RBV for 16 weeks.
Arm Title
HCV/HIV co-infection Treatment naives
Arm Type
Experimental
Arm Description
HCV/HIV coinfected, treatment-naïve patients will be treated with the combination of grazoprevir plus elbasvir for 12 weeks.
Arm Title
HCV/HIV co-infection Treatment experienced
Arm Type
Experimental
Arm Description
HCV/HIV co-infected treatment-experienced patients, including null responders, partial responders or post-treatment relapsers, will be assigned to treat with the combination plus weight-based RBV for 16 weeks.
Intervention Type
Drug
Intervention Name(s)
Grazaoprevir/Elbasavir
Intervention Description
treatment naive
Intervention Type
Drug
Intervention Name(s)
Grazaoprevir/Elbasavir/RBV
Intervention Description
treatment experienced
Primary Outcome Measure Information:
Title
Rate of SVR12
Description
To evaluate the rate of sustained virological response (SVR) at 12 weeks after the end of treatment (SVR12) in compensated cirrhotic participants with GT1 and GT6 HCV infection with or without HIV infection treated with the combination of grazoprevir and elbasvir
Time Frame
12 weeks post-treatment
Secondary Outcome Measure Information:
Title
Rate of SVR24
Description
To evaluate the rate of sustained virological response (SVR) at 24 weeks after the end of treatment (SVR24)
Time Frame
24 weeks post-treatment
Title
Decline of liver stiffness
Description
To evaluate the percentage of participants achieving a significant decline in liver stiffness (LS) values (defined as a ≥30% decrease from baseline) up to 240 weeks (5 years) after treatment
Time Frame
5 years post-treatment
Title
changes in liver stiffness
Description
To compare the longitudinal changes in LS values over time between participants and untreated historical controls
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women aged 18 years or older Documented chronic HCV GT1 or GT6 (positive for anti-HCV antibody and HCV RNA at least 6 months prior to screening) HCV RNA of at least 10,000 IU/ml Cirrhosis defined by: liver biopsy showing cirrhosis METAVIR F4; or TE showing cirrhosis with a result of >13.0 kPa Treatment-naïve individuals for chronic HCV infection Treatment-experienced individuals (Previous treatment failure with PEG-IFN plus RBV) for chronic HCV infection HIV-infected participants enrolled in this study must meet following criteria: 7.1 Documented HIV infection 7.2 Naïve to treatment with any antiretroviral therapy (ART) or on HIV ART for at least 8 weeks prior to study entry using a dual nucleoside reverse transcriptase inhibitor (NRTI) backbone of tenofovir or abacavir and either emtricitabine or lamivudine plus raltegravir (or dolutegravir or rilpivirine) 7.3 CD4+ T-cell count >200 cells/mm3 if on ART or >500 cell/mm3 if ART treatment naïve 7.4 Undetectable plasma HIV-RNA at least 8 weeks prior to screening if on ART or <50,000 copies/mL if ART treatment naïve Agree to use two acceptable methods of birth control from at least 2 weeks prior to Day 1 and continue until at least 6 months after last dose of study drug, or longer if dictated by local regulations (for female subject who is of childbearing potential or male subject with female sexual partner who is of childbearing potential). Exclusion Criteria: Evidence of decompensated liver disease (Child-Pugh Class B or C or Child-Pugh score >6, platelets less than 75 × 10³/μL, serum albumin < 3·0 g/dL, presence of or history of ascites, gastric or variceal bleeding, hepatic encephalopathy or other signs or symptoms of advanced liver disease) Co-infected with hepatitis B virus Has cirrhosis and liver imaging within 6 months showing evidence of HCC or is under evaluation for HCC Pregnant or breast-feeding from day 1 or anytime during treatment, and 14 days after the last dose of study medication Any medical condition requiring or likely to require chronic systemic administration of corticosteroids or other immunosuppressant drugs during the course of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anchalee Avihingsanon, MD, PhD
Organizational Affiliation
HIV-NAT, Thai Red Cross - AIDS Research Centre
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Pisit Tangkijvanich, MD
Organizational Affiliation
Chulalongkorn University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Faculty of Medicine, Chulalongkorn University
City
Bangkok
ZIP/Postal Code
10330
Country
Thailand
Facility Name
HIV-NAT, Thai Red Cross AIDS Research Centre
City
Bangkok
ZIP/Postal Code
10330
Country
Thailand

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
only when needed as per the auditing/monitoring processes and requirement
Links:
URL
http://www.hivnat.org
Description
Related Info

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Safety and Efficacy of Grazoprevir and Elbasvir for GT1ang GT6 With and Without HIV

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