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Efficacy and Safety of Elbasvir/Grazoprevir in Brazilian Participants With Chronic Hepatitis C Virus (HCV) Genotype 1 Infection With Advanced Fibrosis (F3 and F4)

Primary Purpose

Hepatitis C

Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
MK-5172A
Sponsored by
Merck Sharp & Dohme LLC
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:

  • Adult (≥ 18 years of age) male and female participants with chronic HCV GT1 infection who reside in Brazil
  • HCV RNA (≥ 10,000 IU/mL in peripheral blood) at the time of screening
  • Has documented chronic HCV GT1 (1a; 1b) infection (with no evidence of non-typeable or mixed genotype) infection.

    • positive for anti HCV antibody, HCV RNA, or HCV GT1 at least 6 months before screening, or
    • positive for anti-HCV antibody or HCV RNA at the time of screening with a liver biopsy consistent with chronic HCV infection (or a liver biopsy performed before enrollment with evidence of chronic hepatitis C (CHC) disease, such as the presence of fibrosis)
  • Is otherwise healthy as determined by the medical history, physical examination, and clinical laboratory measurements at the time of screening
  • Has a history of advanced fibrosis (F3 or F4) as follows:

    • F4: FibroSure®/APRI + FibroTest®
    • Liver biopsy result of METAVIR stage 3 or 4 fibrosis (or its grading system equivalency to advanced fibrosis)
    • FibroScan® result > 9.5 kPa (F3 or F4)
  • Has liver imaging within 6 months of Day 1 (start of treatment) with no evidence of hepatocellular carcinoma (HCC)
  • Is TN or TE
  • Is a male, is a female who is not of reproductive potential, or is a female of reproductive potential who agrees to avoid becoming pregnant from Day 1 (start of treatment) through 14 days after the last dose of study drug (or longer if dictated by local regulations)
  • For HIV-infected participants, has HIV-1 infection documented prior to screening, and is either not currently on antiretroviral therapy (ART) and has no plans to initiate ART or has well-controlled HIV on ART as per study criteria

Exclusion Criteria:

  • Has prior treatment with direct acting antiviral (DAA) therapy with the exception of boceprevir, telaprevir, and simeprevir
  • Has evidence of decompensated liver disease as manifested by the presence of or history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy, or other signs or symptoms of active advanced liver disease
  • Is classified as Child-Pugh B or C or has a Child-Pugh-Turcotte score > 6
  • Is hepatitis B surface antigen (HBsAg) positive at screening
  • Is under evaluation for HCC or other active or suspected malignancy
  • Is currently participating or has participated in a study with an investigational compound within 1 year of signing informed consent and is not willing to refrain from participating in another such study during the course of this study
  • Has clinically-relevant drug or alcohol abuse within 12 months of screening
  • Is a female and is pregnant or breastfeeding, or expecting to conceive or donate eggs from Day 1 (start of treatment) through 14 days after the last dose of study drug or longer if dictated by local regulations; or is a male participant who is expecting to donate sperm from Day 1 (start of treatment) through 14 days after the last dose of study drug or longer if dictated by local regulations
  • Has any clinically-significant illness (other than HCV) or any other major medical disorder that may interfere with treatment, assessment or compliance with the protocol or any medical/surgical conditions that may result in a need for hospitalization during the period of the study; or is currently under evaluation for a potentially clinically-significant illness (other than HCV)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    HCV GT1a TN

    HCV GT1a TE

    HCV GT1b TN

    HCV GT1b TE

    Arm Description

    Participants with HCV GT1a infection who are TN will take MK-5172A for 12 weeks.

    Participants with HCV GT1a infection who are TE will take MK-5172A for 12 weeks.

    Participants with HCV GT1b infection who are TN will take MK-5172A for 12 weeks.

    Participants with HCV GT1b infection who are TE will take MK-5172A for 12 weeks.

    Outcomes

    Primary Outcome Measures

    Percentage of participants achieving sustained virologic response (SVR) 12 weeks after the end of all study therapy (SVR12)
    SVR12 will be declared when a participant has HCV ribonucleic acid (RNA) < lower limit of quantification (LLOQ) 12 weeks after the end of all study therapy. Levels of HCV RNA will be determined with the Roche COBAS® AmpliPrep/COBAS® TaqMan® HCV Test, v2.0, which has a LLoQ of 15 IU/mL.
    Percentage of participants experiencing an adverse event (AE)
    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.
    Percentage of participants withdrawing from study therapy due to an AE
    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.

    Secondary Outcome Measures

    Percentage of participants achieving SVR 24 weeks after the end of all study therapy (SVR24)
    SVR24 will be declared when a participant has HCV RNA < LLOQ 24 weeks after the end of all study therapy. Levels of HCV RNA will be determined with the Roche COBAS® AmpliPrep/COBAS® TaqMan® HCV Test, v2.0, which has a LLoQ of 15 IU/mL.
    Emergence of viral resistance-associated variants (RAVs)
    The RAVs resistant to EBR or GZR, including the association of baseline RAVs with treatment outcomes (SVR12 and SVR24) and the emergence of RAVs in participants who fail to achieve SVR will be determined.

    Full Information

    First Posted
    May 4, 2017
    Last Updated
    November 7, 2017
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03143998
    Brief Title
    Efficacy and Safety of Elbasvir/Grazoprevir in Brazilian Participants With Chronic Hepatitis C Virus (HCV) Genotype 1 Infection With Advanced Fibrosis (F3 and F4)
    Official Title
    A Multi-Site, Open-Label, Trial of the Efficacy and Safety of Fixed-dose Elbasvir/Grazoprevir (EBR/GZR) in Brazilian Patients With Chronic Hepatitis C Virus (HCV) Genotype 1 Infection With Advanced Fibrosis (F3 and F4)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2017
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Business reasons
    Study Start Date
    February 12, 2018 (Anticipated)
    Primary Completion Date
    January 12, 2019 (Anticipated)
    Study Completion Date
    January 12, 2019 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    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
    This is a non-randomized, open-label study of a fixed dose combination (FDC) of elbasvir (50 mg) and grazoprevir (100 mg) (EBR/GZR or MK-5172A) in participants with chronic hepatitis C virus (HCV) genotype 1 (GT1) infection with advanced fibrosis with and without human immunodeficiency virus (HIV) co-infection. All participants will be either HCV treatment naïve (TN) or treatment experienced (TE).

    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
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    HCV GT1a TN
    Arm Type
    Experimental
    Arm Description
    Participants with HCV GT1a infection who are TN will take MK-5172A for 12 weeks.
    Arm Title
    HCV GT1a TE
    Arm Type
    Experimental
    Arm Description
    Participants with HCV GT1a infection who are TE will take MK-5172A for 12 weeks.
    Arm Title
    HCV GT1b TN
    Arm Type
    Experimental
    Arm Description
    Participants with HCV GT1b infection who are TN will take MK-5172A for 12 weeks.
    Arm Title
    HCV GT1b TE
    Arm Type
    Experimental
    Arm Description
    Participants with HCV GT1b infection who are TE will take MK-5172A for 12 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    MK-5172A
    Other Intervention Name(s)
    ZEPATIER®
    Intervention Description
    A single FDC tablet containing grazoprevir 100 mg + elbasvir 50 mg taken once daily by mouth.
    Primary Outcome Measure Information:
    Title
    Percentage of participants achieving sustained virologic response (SVR) 12 weeks after the end of all study therapy (SVR12)
    Description
    SVR12 will be declared when a participant has HCV ribonucleic acid (RNA) < lower limit of quantification (LLOQ) 12 weeks after the end of all study therapy. Levels of HCV RNA will be determined with the Roche COBAS® AmpliPrep/COBAS® TaqMan® HCV Test, v2.0, which has a LLoQ of 15 IU/mL.
    Time Frame
    Week 24 (12 weeks after completing study therapy)
    Title
    Percentage of participants experiencing an adverse event (AE)
    Description
    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.
    Time Frame
    Up to 14 weeks
    Title
    Percentage of participants withdrawing from study therapy due to an AE
    Description
    An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.
    Time Frame
    Up to 12 weeks
    Secondary Outcome Measure Information:
    Title
    Percentage of participants achieving SVR 24 weeks after the end of all study therapy (SVR24)
    Description
    SVR24 will be declared when a participant has HCV RNA < LLOQ 24 weeks after the end of all study therapy. Levels of HCV RNA will be determined with the Roche COBAS® AmpliPrep/COBAS® TaqMan® HCV Test, v2.0, which has a LLoQ of 15 IU/mL.
    Time Frame
    Week 36 (24 weeks after completing study therapy)
    Title
    Emergence of viral resistance-associated variants (RAVs)
    Description
    The RAVs resistant to EBR or GZR, including the association of baseline RAVs with treatment outcomes (SVR12 and SVR24) and the emergence of RAVs in participants who fail to achieve SVR will be determined.
    Time Frame
    Up to 12 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Adult (≥ 18 years of age) male and female participants with chronic HCV GT1 infection who reside in Brazil HCV RNA (≥ 10,000 IU/mL in peripheral blood) at the time of screening Has documented chronic HCV GT1 (1a; 1b) infection (with no evidence of non-typeable or mixed genotype) infection. positive for anti HCV antibody, HCV RNA, or HCV GT1 at least 6 months before screening, or positive for anti-HCV antibody or HCV RNA at the time of screening with a liver biopsy consistent with chronic HCV infection (or a liver biopsy performed before enrollment with evidence of chronic hepatitis C (CHC) disease, such as the presence of fibrosis) Is otherwise healthy as determined by the medical history, physical examination, and clinical laboratory measurements at the time of screening Has a history of advanced fibrosis (F3 or F4) as follows: F4: FibroSure®/APRI + FibroTest® Liver biopsy result of METAVIR stage 3 or 4 fibrosis (or its grading system equivalency to advanced fibrosis) FibroScan® result > 9.5 kPa (F3 or F4) Has liver imaging within 6 months of Day 1 (start of treatment) with no evidence of hepatocellular carcinoma (HCC) Is TN or TE Is a male, is a female who is not of reproductive potential, or is a female of reproductive potential who agrees to avoid becoming pregnant from Day 1 (start of treatment) through 14 days after the last dose of study drug (or longer if dictated by local regulations) For HIV-infected participants, has HIV-1 infection documented prior to screening, and is either not currently on antiretroviral therapy (ART) and has no plans to initiate ART or has well-controlled HIV on ART as per study criteria Exclusion Criteria: Has prior treatment with direct acting antiviral (DAA) therapy with the exception of boceprevir, telaprevir, and simeprevir Has evidence of decompensated liver disease as manifested by the presence of or history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy, or other signs or symptoms of active advanced liver disease Is classified as Child-Pugh B or C or has a Child-Pugh-Turcotte score > 6 Is hepatitis B surface antigen (HBsAg) positive at screening Is under evaluation for HCC or other active or suspected malignancy Is currently participating or has participated in a study with an investigational compound within 1 year of signing informed consent and is not willing to refrain from participating in another such study during the course of this study Has clinically-relevant drug or alcohol abuse within 12 months of screening Is a female and is pregnant or breastfeeding, or expecting to conceive or donate eggs from Day 1 (start of treatment) through 14 days after the last dose of study drug or longer if dictated by local regulations; or is a male participant who is expecting to donate sperm from Day 1 (start of treatment) through 14 days after the last dose of study drug or longer if dictated by local regulations Has any clinically-significant illness (other than HCV) or any other major medical disorder that may interfere with treatment, assessment or compliance with the protocol or any medical/surgical conditions that may result in a need for hospitalization during the period of the study; or is currently under evaluation for a potentially clinically-significant illness (other than HCV)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

    Learn more about this trial

    Efficacy and Safety of Elbasvir/Grazoprevir in Brazilian Participants With Chronic Hepatitis C Virus (HCV) Genotype 1 Infection With Advanced Fibrosis (F3 and F4)

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