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Elbasvir (EBR)/Grazoprevir (GZR) in Pediatric Participants With Chronic Hepatitis C Infection (MK-5172-079)

Primary Purpose

HCV Infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
EBR/GZR FDC Tablet
Placebo
Grazoprevir Oral Granules
Elbasvir Oral Granules
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HCV Infection

Eligibility Criteria

3 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Has documented chronic HCV genotype (GT) 1 or GT4 infection
  • Has the following liver disease staging assessment: absence of cirrhosis or compensated cirrhosis
  • Has one of the following HCV treatment statuses:
  • GT1 and GT4: treatment-naïve (TN), defined as no prior exposure to any interferon (IFN)-containing regimen, ribavirin (RBV), or other HCV-specific direct acting antiviral (DAA) agent
  • GT1 only: treatment-experienced (TE) with no previous treatment with HCV specific DAA agents.
  • If female is not pregnant, not breastfeeding, and is either not of childbearing potential or follows the contraceptive guidance during the treatment period and for at least 14 days after the last dose of study treatment.

Exclusion Criteria:

  • Has evidence of decompensated liver disease manifested by the presence of or history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy, or other signs or symptoms of advanced liver disease.
  • Is cirrhotic AND has a Child-Turcotte-Pugh score >6, corresponding to a Child Class B or C.
  • Is co-infected with Human Immunodeficiency Virus (HIV).
  • Has evidence of past or present hepatitis B infection.
  • Has a history of malignancy ≤5 years prior to signing informed consent or is under evaluation for other active or suspected malignancy.
  • Female expects to conceive or donate eggs from Day 1 through at least 14 days after the last dose of study treatment or longer.
  • Has any of the following conditions: organ transplants other than cornea and hair; poor venous access; history of gastric surgery or malabsorption disorders; any clinically significant cardiac abnormalities/dysfunction that may interfere with participant treatment, assessment, or compliance; any major medical condition which might interfere with participant treatment, assessment, or compliance; history of a medical/surgical condition that resulted in hospitalization within the 3 months prior to enrollment; medical/surgical conditions that may result in a need for hospitalization during the study duration; any medical condition requiring, or likely to require, chronic systemic administration of corticosteroids, tumor necrosis factor antagonists, or immunosuppressant drugs; life-threatening serious adverse event (SAE) during the screening period; history of chronic hepatitis not caused by HCV.
  • If female has a positive urine pregnancy test within 24 hours before the first dose of study treatment.
  • Is taking or plans to take prohibited medications, or is taking herbal supplements.
  • Has had previous HCV direct acting antiviral (DAA) treatment.
  • Is currently participating or has participated in a study with an investigational compound within prior 30 days
  • Has significant emotional problems or a clinically significant psychiatric disorder that may interfere with participant treatment, assessment, or compliance with the protocol.
  • Has clinically relevant drug or alcohol abuse within prior 12 months that may interfere with participant treatment, assessment, or compliance.

Sites / Locations

  • University of California San Francisco ( Site 0020)
  • Florida Hospital ( Site 0006)
  • Children's Center for Advanced Pediatrics ( Site 0204)
  • Children's Hospital Boston ( Site 0009)
  • Cincinnati Children's Hospital Medical Center ( Site 0003)
  • Children's Hospital of Pittsburgh ( Site 0024)
  • American Research Corporation ( Site 0200)
  • Children's Hospital and Regional Medical Center ( Site 0017)
  • Medizinische Hochschule Hannover Kinderklinik K10 ( Site 0105)
  • Klinikum Starnberg ( Site 0107)
  • Helios Klinikum Wuppertal GmbH ( Site 0104)
  • WSOZ im.T.Browicza w Bydgoszczy ( Site 0800)
  • Wojewodzki Specjalistyczny Szpital im. dr W. Bieganskiego w Lodzi ( Site 0810)
  • MED-POLONIA Sp. z o.o. ( Site 0808)
  • Karolinska Universitetssjukhuset Huddinge. ( Site 0062)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EBR/GZR

Arm Description

Pediatric participants receive EBR/GZR as either FDC tablets or oral granules once daily for 12 weeks. A 24-week follow-up period will follow the 12-week treatment regimen.

Outcomes

Primary Outcome Measures

Area Under the Plasma Concentration-Time Curve From Dosing to 24 Hours Postdose (AUC0-24hr) of EBR at Steady State
The AUC0-24hr of EBR at steady state (Week 4) was determined in each cohort.
Maximum Plasma Concentration (Cmax) of EBR
The Cmax of EBR at steady state (Week 4) was determined in each cohort.
Steady State Predose Drug Concentration (Ctrough) of EBR
The Ctrough of EBR at steady state (Week 4) was determined at steady state prior to dosing in each cohort.
Apparent Clearance (CL/F) of EBR at Steady State
The CL/F of EBR at steady state (Week 4) was determined in each cohort.
AUC0-24hr of GZR at Steady State
The AUC0-24hr of GZR at steady state (Week 4) was determined in each cohort.
Cmax of GZR
The Cmax of GZR at steady state (Week 4) was determined in each cohort.
Ctrough of GZR
The Ctrough of GZR at steady state (Week 4) was determined at steady state prior to dosing in each cohort.
CL/F of GZR at Steady State
The CL/F of GZR at steady state (Week 4) was determined in each cohort.

Secondary Outcome Measures

Percentage of Participants With ≥1 Adverse Event (AE)
The percentage of participants with ≥1 AE is reported in each cohort. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Percentage of Participants Discontinuing Study Treatment Due to an AE
The percentage of participants discontinuing study therapy due to an AE is reported in each cohort. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Percentage of Participants With Sustained Virologic Response 12 Weeks After Completing Treatment (SVR12)
The percentage of participants achieving SVR12, defined as hepatitis C virus (HCV) ribonucleic acid (RNA) < lower limit of quantification (LLOQ) 12 weeks after completing study therapy, was determined in each cohort.

Full Information

First Posted
December 13, 2017
Last Updated
May 3, 2023
Sponsor
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03379506
Brief Title
Elbasvir (EBR)/Grazoprevir (GZR) in Pediatric Participants With Chronic Hepatitis C Infection (MK-5172-079)
Official Title
A Phase IIb Clinical Study to Assess the Pharmacokinetics, Safety, and Efficacy of the Combination Regimen of Elbasvir (EBR)/Grazoprevir (GZR) in Participants Aged 3 to Less Than 18 Years With Chronic Hepatitis C Infection
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
January 25, 2018 (Actual)
Primary Completion Date
October 28, 2019 (Actual)
Study Completion Date
July 23, 2020 (Actual)

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
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the pharmacokinetics (PK), safety, and efficacy of oral MK-5172 (a fixed dose combination [FDC] tablet containing elbasvir [EBR] 50 mg and grazoprevir [GZR] 100 mg) and EBR/GZR (varying doses) pediatric granules in pediatric hepatitis C virus (HCV)-infected participants who are 3 to <18 years of age. Within each age cohort (Cohort 1: 12 to <18 years of age; Cohort 2: 7 to <12 years of age; and Cohort 3: 3 to <7 years of age), a Mini Cohort of 7 participants will be enrolled first. For the oldest cohort (Cohort 1), the Mini Cohort will assess ability to swallow a placebo tablet prior to administering active FDC tablets; participants in Cohorts 2 and 3 will take pediatric granules instead of a tablet.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HCV 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
57 (Actual)

8. Arms, Groups, and Interventions

Arm Title
EBR/GZR
Arm Type
Experimental
Arm Description
Pediatric participants receive EBR/GZR as either FDC tablets or oral granules once daily for 12 weeks. A 24-week follow-up period will follow the 12-week treatment regimen.
Intervention Type
Drug
Intervention Name(s)
EBR/GZR FDC Tablet
Other Intervention Name(s)
MK-5172A, ZEPATIER®
Intervention Description
Participants who are 12 to <18 years of age will receive oral FDC tablets with EBR 50 mg/GZR 100 mg once daily by mouth.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablet matched to EBR/GZR FDC tablet.
Intervention Type
Drug
Intervention Name(s)
Grazoprevir Oral Granules
Other Intervention Name(s)
MK-5172
Intervention Description
Participants 3 to <12 years of age take grazoprevir granules 0.5 mg by mouth in a soft food vehicle at a dose not to exceed 50 mg.
Intervention Type
Drug
Intervention Name(s)
Elbasvir Oral Granules
Other Intervention Name(s)
MK-8742
Intervention Description
Participants 3 to <12 years of age take elbasvir oral granules 1 mg by mouth in a soft food vehicle at a dose not to exceed 100 mg.
Primary Outcome Measure Information:
Title
Area Under the Plasma Concentration-Time Curve From Dosing to 24 Hours Postdose (AUC0-24hr) of EBR at Steady State
Description
The AUC0-24hr of EBR at steady state (Week 4) was determined in each cohort.
Time Frame
Week 4: Predose and 0.5, 1, 2, 3, 4, 6, 8, 10, and 24 hours postdose
Title
Maximum Plasma Concentration (Cmax) of EBR
Description
The Cmax of EBR at steady state (Week 4) was determined in each cohort.
Time Frame
Week 4: Predose and 0.5, 1, 2, 3, 4, 6, 8, 10, and 24 hours postdose
Title
Steady State Predose Drug Concentration (Ctrough) of EBR
Description
The Ctrough of EBR at steady state (Week 4) was determined at steady state prior to dosing in each cohort.
Time Frame
Week 4: Predose
Title
Apparent Clearance (CL/F) of EBR at Steady State
Description
The CL/F of EBR at steady state (Week 4) was determined in each cohort.
Time Frame
Week 4: Predose and 0.5, 1, 2, 3, 4, 6, 8, 10, and 24 hours postdose
Title
AUC0-24hr of GZR at Steady State
Description
The AUC0-24hr of GZR at steady state (Week 4) was determined in each cohort.
Time Frame
Week 4: Predose and 0.5, 1, 2, 3, 4, 6, 8, 10, and 24 hours postdose
Title
Cmax of GZR
Description
The Cmax of GZR at steady state (Week 4) was determined in each cohort.
Time Frame
Week 4: Predose and 0.5, 1, 2, 3, 4, 6, 8, 10, and 24 hours postdose
Title
Ctrough of GZR
Description
The Ctrough of GZR at steady state (Week 4) was determined at steady state prior to dosing in each cohort.
Time Frame
Week 4: Predose
Title
CL/F of GZR at Steady State
Description
The CL/F of GZR at steady state (Week 4) was determined in each cohort.
Time Frame
Week 4: Predose and 0.5, 1, 2, 3, 4, 6, 8, 10, and 24 hours postdose
Secondary Outcome Measure Information:
Title
Percentage of Participants With ≥1 Adverse Event (AE)
Description
The percentage of participants with ≥1 AE is reported in each cohort. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Time Frame
Up to 36 weeks
Title
Percentage of Participants Discontinuing Study Treatment Due to an AE
Description
The percentage of participants discontinuing study therapy due to an AE is reported in each cohort. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Time Frame
Up to 12 weeks
Title
Percentage of Participants With Sustained Virologic Response 12 Weeks After Completing Treatment (SVR12)
Description
The percentage of participants achieving SVR12, defined as hepatitis C virus (HCV) ribonucleic acid (RNA) < lower limit of quantification (LLOQ) 12 weeks after completing study therapy, was determined in each cohort.
Time Frame
Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has documented chronic HCV genotype (GT) 1 or GT4 infection Has the following liver disease staging assessment: absence of cirrhosis or compensated cirrhosis Has one of the following HCV treatment statuses: GT1 and GT4: treatment-naïve (TN), defined as no prior exposure to any interferon (IFN)-containing regimen, ribavirin (RBV), or other HCV-specific direct acting antiviral (DAA) agent GT1 only: treatment-experienced (TE) with no previous treatment with HCV specific DAA agents. If female is not pregnant, not breastfeeding, and is either not of childbearing potential or follows the contraceptive guidance during the treatment period and for at least 14 days after the last dose of study treatment. Exclusion Criteria: Has evidence of decompensated liver disease manifested by the presence of or history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy, or other signs or symptoms of advanced liver disease. Is cirrhotic AND has a Child-Turcotte-Pugh score >6, corresponding to a Child Class B or C. Is co-infected with Human Immunodeficiency Virus (HIV). Has evidence of past or present hepatitis B infection. Has a history of malignancy ≤5 years prior to signing informed consent or is under evaluation for other active or suspected malignancy. Female expects to conceive or donate eggs from Day 1 through at least 14 days after the last dose of study treatment or longer. Has any of the following conditions: organ transplants other than cornea and hair; poor venous access; history of gastric surgery or malabsorption disorders; any clinically significant cardiac abnormalities/dysfunction that may interfere with participant treatment, assessment, or compliance; any major medical condition which might interfere with participant treatment, assessment, or compliance; history of a medical/surgical condition that resulted in hospitalization within the 3 months prior to enrollment; medical/surgical conditions that may result in a need for hospitalization during the study duration; any medical condition requiring, or likely to require, chronic systemic administration of corticosteroids, tumor necrosis factor antagonists, or immunosuppressant drugs; life-threatening serious adverse event (SAE) during the screening period; history of chronic hepatitis not caused by HCV. If female has a positive urine pregnancy test within 24 hours before the first dose of study treatment. Is taking or plans to take prohibited medications, or is taking herbal supplements. Has had previous HCV direct acting antiviral (DAA) treatment. Is currently participating or has participated in a study with an investigational compound within prior 30 days Has significant emotional problems or a clinically significant psychiatric disorder that may interfere with participant treatment, assessment, or compliance with the protocol. Has clinically relevant drug or alcohol abuse within prior 12 months that may interfere with participant treatment, assessment, or compliance.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
Facility Information:
Facility Name
University of California San Francisco ( Site 0020)
City
San Francisco
State/Province
California
ZIP/Postal Code
94158
Country
United States
Facility Name
Florida Hospital ( Site 0006)
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Facility Name
Children's Center for Advanced Pediatrics ( Site 0204)
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Children's Hospital Boston ( Site 0009)
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center ( Site 0003)
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Children's Hospital of Pittsburgh ( Site 0024)
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
American Research Corporation ( Site 0200)
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Facility Name
Children's Hospital and Regional Medical Center ( Site 0017)
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Medizinische Hochschule Hannover Kinderklinik K10 ( Site 0105)
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Klinikum Starnberg ( Site 0107)
City
Starnberg
ZIP/Postal Code
82319
Country
Germany
Facility Name
Helios Klinikum Wuppertal GmbH ( Site 0104)
City
Wuppertal
ZIP/Postal Code
42283
Country
Germany
Facility Name
WSOZ im.T.Browicza w Bydgoszczy ( Site 0800)
City
Bydgoszcz
ZIP/Postal Code
85-030
Country
Poland
Facility Name
Wojewodzki Specjalistyczny Szpital im. dr W. Bieganskiego w Lodzi ( Site 0810)
City
Lodz
ZIP/Postal Code
91-347
Country
Poland
Facility Name
MED-POLONIA Sp. z o.o. ( Site 0808)
City
Poznan
ZIP/Postal Code
60-693
Country
Poland
Facility Name
Karolinska Universitetssjukhuset Huddinge. ( Site 0062)
City
Stockholm
ZIP/Postal Code
141 86
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Citations:
PubMed Identifier
36790337
Citation
Gonzalez-Peralta RP, Wirth S, Squires RH, Mutschler F, Lang T, Pawlowska M, Sluzewski W, Majda-Stanislawska E, Fischler B, Balistreri WF, Jonas MM, Blondet N, Rosenthal P, Alkhouri N, Romero R, Grandhi A, Castronuovo P, Caro L, Du L, Rosenbloom DIS, Haber BA. Elbasvir/grazoprevir in children aged 3-18 years with chronic HCV genotype 1 or 4 infection: a pharmacokinetic modeling study. Hepatol Commun. 2023 Feb 14;7(3):e0031. doi: 10.1097/HC9.0000000000000031. eCollection 2023 Mar 1.
Results Reference
result

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Elbasvir (EBR)/Grazoprevir (GZR) in Pediatric Participants With Chronic Hepatitis C Infection (MK-5172-079)

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