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A Clinical Trial of 16 Weeks of Duration to Evaluate Retreatment With Elbasvir/Grazoprevir Plus Sofosbuvir and Ribavirin in Patients With Chronic Hepatitis C Genotypes 1,4 Who Have Failed to Treat With a Regime Based on an Inhibitor of the NS5A (C-RESCUE)

Primary Purpose

HCV

Status
Withdrawn
Phase
Phase 4
Locations
Spain
Study Type
Interventional
Intervention
elbasvir/grazoprevir
Sofosbuvir
Ribavirin
Sponsored by
Fundacion SEIMC-GESIDA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HCV

Eligibility Criteria

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

Inclusion Criteria:

  • Adults with chronic HCV genotype 1, 4 infection with or without HIV infection aged 18 years or above
  • HCV RNA plasma concentration of at least 1000 IU / mL
  • Subjects previously treated with NS5A-based regimens for at least 8 weeks.
  • Patients with HCV relapse after receiving a complete treatment with NS5A-based AAD regimen for at least 8 weeks and becoming undetectable at the end of treatment. Relapse is defined as a confirmed HCV RNA detectable upon completion of therapy of A5 based on NS5A against HCV.
  • Subjects with compensated hepatic cirrhosis (Child A) could be included.
  • For patients with HIV coinfection:

    • Be infected with HIV-1, documented by any rapid HIV test with the corresponding license and confirmed by a Western blot or second antibody test using a method other than the initial rapid HIV and / or I / CIA method or by HIV-1 p24 antigen or viral load of HIV-1 RNA plasma.
    • Be on stable HIV antiretroviral therapy (ART) for at least 4 weeks prior to entry into the study using a dual ITN backbone of tenofovir or abacavir and emtricitabine or lamivudine PLUS raltegravir or dolutegravir or rilpivirine (with CD4 + T cell count> 100 cells / mm 3 and undetectable HIV-1 RNA at baseline. Results from prior analysis will be accepted within 24 weeks prior to study entry).

Exclusion Criteria:

  • Subjects with hepatitis other than C or steatosis.
  • Subjects previously treated less than 8 weeks with regimens based on NS5A.
  • Evidence of previous hepatocellular carcinoma although it has criteria of cure
  • Subjects with past or current decompensated liver disease; Only decompensated patients who have received a liver transplant and have not decompensated after transplantation will be included.
  • Subjects suspected of clinical or genotypic reinfection of HCV.
  • Subject with HCV response regrowth while receiving NS5A-based ADA therapy against HCV. Said regrowth is defined as a confirmation of detectable HCV RNA after achieving undetectable HCV RNA during NS5A-based AADs against HCV.
  • Recent history of drug or alcohol abuse.
  • Important comorbidities.

    • Pregnant, lactating or non-lactating women Contraceptives, if they are women of childbearing age. Women of childbearing age are defined as those women who have not undergone permanent infertility procedures or who have been amenorrheic for less than 12 months.
    • Subjects with a glomerular filtration rate of less than 30 ml / min.

Sites / Locations

  • Hospital Univ. La Paz
  • Hospital Univ. Gregorio Marañon
  • Hospital Infanta Leonor
  • Hospita 12 de octubre
  • Hospital Univ. La Paz

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single arm

Arm Description

16 weeks treatment with elbasvir/grazoprevir plus sofosbuvir and ribavirina

Outcomes

Primary Outcome Measures

The rate of patients achieved SVR12

Secondary Outcome Measures

The proportion of subjects infected with HCV genotype 1a with reference VARs NS5A / NS3 who achieved RVS12.
To analyze the impact of VARs NS5A/NS3 on RVS12
The proportion of subjects infected with HCV genotype 1b with reference VARs NS5A / NS3 who achieved RVS12.
Analyze the impact of VARs NS5A/NS3 on RVS12
The proportion of subjects infected with HCV genotype 4 with reference VARs NS5A /NS3 who achieved RVS12.
Analyze the impact of VARs NS5A/NS3 on RVS12
The proportion of subjects infected with HCV genotypes 1.4 with reference VARs NS5A /NS3 who achieved RVS24.
Analyze the impact of VARs NS5A/NS3 on RVS24
The occurrence of Viral resistance variants (VARs) to NS5A or elbasvir, to NS3 or grazoprevir and to NS5B or SOF in patients who did not reach SVR12 after 16 weeks of re-treatment
the occurrence of resistance in patients who did not reach SVR12 after 16 weeks of re-treatment
The occurrence of resistance variants (VARs) viral to NS5A or elbasvir, to NS3 or grazoprevir, and to NS5B or SOF in HIV patients included
The impact of VARs NS5A/NS3 on RVS12 The proportion of subjects developing HIV-1 virological failure (HIV RNA> 200 Copies / mL), confirmed in 2 consecutive tests with at least 2 weeks between them.
The proportion of subjects developing HIV-1 virological failure (HIV RNA> 200 Copies / mL), confirmed in 2 consecutive tests with at least 2 weeks between them
the impact of treatment with EL / BRA plus SOFT and ribavirin in HIV-1 subjects
The proportion of subjects experiencing adverse events of high laboratory values who report as ECI at any time during the study period.
Adverse events
The proportion of subjects with at least one adverse experience
Adverse events
The proportion of subjects with an adverse experience related to medication
Adverse events
The proportion of subjects with a severe adverse experience
Adverse events
The proportion of subjects with a serious adverse experience related to medication
Adverse events
The proportion of subjects with an adverse experience leading to disruption
Adverse events

Full Information

First Posted
March 16, 2017
Last Updated
June 7, 2018
Sponsor
Fundacion SEIMC-GESIDA
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1. Study Identification

Unique Protocol Identification Number
NCT03105349
Brief Title
A Clinical Trial of 16 Weeks of Duration to Evaluate Retreatment With Elbasvir/Grazoprevir Plus Sofosbuvir and Ribavirin in Patients With Chronic Hepatitis C Genotypes 1,4 Who Have Failed to Treat With a Regime Based on an Inhibitor of the NS5A
Acronym
C-RESCUE
Official Title
A Phase III, Open Label, Multicentric Clinical Trial of a Single Arm of 16 Weeks of Duration to Evaluate Retreatment With Elbasvir/Grazoprevir Plus Sofosbuvir and Ribavirin in Patients With Chronic Hepatitis C Genotype 1,4 Who Have Failed to Treat With a Regime Based on an Inhibitor of the NS5A
Study Type
Interventional

2. Study Status

Record Verification Date
June 2018
Overall Recruitment Status
Withdrawn
Why Stopped
No availability of investigational medication.
Study Start Date
July 1, 2017 (Anticipated)
Primary Completion Date
December 2017 (Anticipated)
Study Completion Date
February 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fundacion SEIMC-GESIDA

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 is a phase 4 clinical trial to treat patients who have failed to treat with regimen based on an inhibitor of the NS5A
Detailed Description
The duration of the treatment will be 16 weeks and then will be a security perid with 2 visits (Week 12 post treatment and week 24 post treatment) The study in an open label study with a single arm .

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HCV

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single arm
Arm Type
Experimental
Arm Description
16 weeks treatment with elbasvir/grazoprevir plus sofosbuvir and ribavirina
Intervention Type
Drug
Intervention Name(s)
elbasvir/grazoprevir
Other Intervention Name(s)
Zepatier
Intervention Description
16 weeks treatment
Intervention Type
Drug
Intervention Name(s)
Sofosbuvir
Intervention Description
16 weeks treatment
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Intervention Description
16 weeks treatment
Primary Outcome Measure Information:
Title
The rate of patients achieved SVR12
Time Frame
Week 12 post treatment
Secondary Outcome Measure Information:
Title
The proportion of subjects infected with HCV genotype 1a with reference VARs NS5A / NS3 who achieved RVS12.
Description
To analyze the impact of VARs NS5A/NS3 on RVS12
Time Frame
Week 12 post treatment
Title
The proportion of subjects infected with HCV genotype 1b with reference VARs NS5A / NS3 who achieved RVS12.
Description
Analyze the impact of VARs NS5A/NS3 on RVS12
Time Frame
Week 12 post treatment
Title
The proportion of subjects infected with HCV genotype 4 with reference VARs NS5A /NS3 who achieved RVS12.
Description
Analyze the impact of VARs NS5A/NS3 on RVS12
Time Frame
Week 12 post treatment
Title
The proportion of subjects infected with HCV genotypes 1.4 with reference VARs NS5A /NS3 who achieved RVS24.
Description
Analyze the impact of VARs NS5A/NS3 on RVS24
Time Frame
Week 24 post treatment
Title
The occurrence of Viral resistance variants (VARs) to NS5A or elbasvir, to NS3 or grazoprevir and to NS5B or SOF in patients who did not reach SVR12 after 16 weeks of re-treatment
Description
the occurrence of resistance in patients who did not reach SVR12 after 16 weeks of re-treatment
Time Frame
Week 16
Title
The occurrence of resistance variants (VARs) viral to NS5A or elbasvir, to NS3 or grazoprevir, and to NS5B or SOF in HIV patients included
Description
The impact of VARs NS5A/NS3 on RVS12 The proportion of subjects developing HIV-1 virological failure (HIV RNA> 200 Copies / mL), confirmed in 2 consecutive tests with at least 2 weeks between them.
Time Frame
Week 12 post treatment
Title
The proportion of subjects developing HIV-1 virological failure (HIV RNA> 200 Copies / mL), confirmed in 2 consecutive tests with at least 2 weeks between them
Description
the impact of treatment with EL / BRA plus SOFT and ribavirin in HIV-1 subjects
Time Frame
Week 4, week 8, week 12 and week 16
Title
The proportion of subjects experiencing adverse events of high laboratory values who report as ECI at any time during the study period.
Description
Adverse events
Time Frame
Week 4, week 8, week 12, week 16, week 12 post-treatment and week 24 post-treatment
Title
The proportion of subjects with at least one adverse experience
Description
Adverse events
Time Frame
Week 4, week 8, week 12, week 16, week 12 post-treatment and week 24 post-treatment
Title
The proportion of subjects with an adverse experience related to medication
Description
Adverse events
Time Frame
Week 4, week 8, week 12, week 16, week 12 post-treatment and week 24 post-treatment
Title
The proportion of subjects with a severe adverse experience
Description
Adverse events
Time Frame
Week 4, week 8, week 12, week 16, week 12 post-treatment and week 24 post-treatment
Title
The proportion of subjects with a serious adverse experience related to medication
Description
Adverse events
Time Frame
Week 4, week 8, week 12, week 16, week 12 post-treatment and week 24 post-treatment
Title
The proportion of subjects with an adverse experience leading to disruption
Description
Adverse events
Time Frame
Week 4, week 8, week 12, week 16, week 12 post-treatment and week 24 post-treatment

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults with chronic HCV genotype 1, 4 infection with or without HIV infection aged 18 years or above HCV RNA plasma concentration of at least 1000 IU / mL Subjects previously treated with NS5A-based regimens for at least 8 weeks. Patients with HCV relapse after receiving a complete treatment with NS5A-based AAD regimen for at least 8 weeks and becoming undetectable at the end of treatment. Relapse is defined as a confirmed HCV RNA detectable upon completion of therapy of A5 based on NS5A against HCV. Subjects with compensated hepatic cirrhosis (Child A) could be included. For patients with HIV coinfection: Be infected with HIV-1, documented by any rapid HIV test with the corresponding license and confirmed by a Western blot or second antibody test using a method other than the initial rapid HIV and / or I / CIA method or by HIV-1 p24 antigen or viral load of HIV-1 RNA plasma. Be on stable HIV antiretroviral therapy (ART) for at least 4 weeks prior to entry into the study using a dual ITN backbone of tenofovir or abacavir and emtricitabine or lamivudine PLUS raltegravir or dolutegravir or rilpivirine (with CD4 + T cell count> 100 cells / mm 3 and undetectable HIV-1 RNA at baseline. Results from prior analysis will be accepted within 24 weeks prior to study entry). Exclusion Criteria: Subjects with hepatitis other than C or steatosis. Subjects previously treated less than 8 weeks with regimens based on NS5A. Evidence of previous hepatocellular carcinoma although it has criteria of cure Subjects with past or current decompensated liver disease; Only decompensated patients who have received a liver transplant and have not decompensated after transplantation will be included. Subjects suspected of clinical or genotypic reinfection of HCV. Subject with HCV response regrowth while receiving NS5A-based ADA therapy against HCV. Said regrowth is defined as a confirmation of detectable HCV RNA after achieving undetectable HCV RNA during NS5A-based AADs against HCV. Recent history of drug or alcohol abuse. Important comorbidities. Pregnant, lactating or non-lactating women Contraceptives, if they are women of childbearing age. Women of childbearing age are defined as those women who have not undergone permanent infertility procedures or who have been amenorrheic for less than 12 months. Subjects with a glomerular filtration rate of less than 30 ml / min.
Facility Information:
Facility Name
Hospital Univ. La Paz
City
Madrid
State/Province
Madri
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Univ. Gregorio Marañon
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Hospital Infanta Leonor
City
Madrid
ZIP/Postal Code
28031
Country
Spain
Facility Name
Hospita 12 de octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Hospital Univ. La Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Clinical Trial of 16 Weeks of Duration to Evaluate Retreatment With Elbasvir/Grazoprevir Plus Sofosbuvir and Ribavirin in Patients With Chronic Hepatitis C Genotypes 1,4 Who Have Failed to Treat With a Regime Based on an Inhibitor of the NS5A

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