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Efficacy and Safety of SOF/VEL + RBV and SOF/VEL/VOX for 12 Weeks in HCV Subjects With GT3b and Compensated Cirrhosis

Primary Purpose

Hepatitis C, Cirrhosis

Status
Not yet recruiting
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Sofosbuvir/Velpatasvir + Ribavirin
Sofosbuvir/Velpatasvir/Voxilaprevir
Sponsored by
Peking University People's Hospital
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:

  1. Willing and able to provide written informed consent
  2. Male or female, age ≥18 years
  3. Body mass index (BMI) between 18.0-35.0kg/m2 and bodyweight ≥ 40 kg
  4. Chronic HCV infection (≥ 6 months) documented by prior medical history or liver biopsy
  5. Anti-HCV positive at screening
  6. HCV RNA 104 IU/mL at screening by the Central Laboratory
  7. HCV genotype 3b assessed at screening by the Central Laboratory
  8. DAA treatment naïve defined as having never been exposed to approved or experimental HCV-specific direct-acting antiviral agents. Pegylated interferon/interferon based prior treatment is allowed.
  9. Cirrhosis Determination: cirrhosis is defined as any one of the following:

    1. Liver biopsy showing cirrhosis (e.g., Metavir score = 4 or Ishak score ≥5) in 24 months before screening, or
    2. Fibroscan® with a result of >12.5 kPa in 6 months before screening
  10. The lab test at screening should meet all the criterion below: a) ALT ≤ 10 the upper limit of normal (ULN); b) AST ≤ 10 ULN; c) Total bilirubin ≤ 2 ULN; d) Platelets ≥ 60,000/L; e) Neutrophile ≥ 1,500/L; f) HbA1c ≤ 8.5%; g) Creatinine clearance (CLcr) ≥ 60 mL /min as calculated by the Cockcroft-Gault equation; h) Hemoglobin ≥ 11 g/dL for female subjects; ≥ 12 g/dL for male subjects; i) Albumin ≥ 3 g/dL; j) INR ≤ 1.7 x ULN; k) AFP <100ng/mL;if 20ng/mL≤AFP≤100ng/mL,HCC should be exclude by liver ultrasound
  11. Females of childbearing potential must have a negative serum pregnancy test at screening
  12. Male subjects and female subjects of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception
  13. Male subjects must agree to avoid donating sperm in 6 months after the last dose of drug
  14. Subject must be of generally good health, with the exception of chronic HCV infection, as determined by the Investigator
  15. Subject must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments

Exclusion Criteria:

  1. Decompensated cirrhosis, including but not limited to: prior or current ascites, variceal hemorrhage and/or hepatic encephalopathy; prior or current Child-Pugh B or C
  2. HBsAg posititve at screening
  3. Anti-HIV positive at screening
  4. Alcohol abuse
  5. Contraindication of ribavirin, including but not limited to hemoglobinapathy
  6. Pregnant or nursing female or male with pregnant female partner
  7. Use of any prohibited concomitant medications as described in Section before screening
  8. Known hypersensitivity to SOF, VEL, RBV or formulation excipients
  9. Subjects who has any of the following history: a) Chronic liver disease of a non-HCV etiology (e.g., hemochromatosis, Wilson's disease, alfa-1 antitrypsin deficiency, cholangitis); b) Solid organ transplantation; c) Significant pulmonary disease, significant cardiac disease or porphyria; d) Pancreatitis; e) Autoimmune diseases (e.g., systemic lupus erythematosus, sarcoidosis, psoriasis); f) Psychiatric hospitalization, suicide attempt, and/or a period of disability as a result of their psychiatric illness within the last 5 years; g) 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). Subjects under evaluation for possible malignancy are not eligible; h) Significant drug allergy (such as anaphylaxis or hepatotoxicity).
  10. Assessed as ineligible by investigators

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Arm 1

    Arm 2

    Arm Description

    Sofosbuvir 400mg/velpatasvir 100mg + ribavirin 1000mg/1200mg for 12 weeks

    Sofosbuvir 400mg/velpatasvir 100mg/voxilaprevir 100mg for 12 weeks

    Outcomes

    Primary Outcome Measures

    The proportion of participants with SVR12
    To evaluate the efficacy of treatment with SOF/VEL plus RBV for 12 weeks or SOF/VEL/VOX for 12 weeks in DAA treatment naïve HCV participants with GT3b, participants initiated on treatment will be assessed for viral load response at 12 weeks post treatment (SVR12). We use the proportion of participants with SVR12 as primary outcome measure.

    Secondary Outcome Measures

    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
    Number of Participants With treatment-related adverse events as assessed by CTCAE v4.0- SOF/VEL plus RBV vs. SOF/VEL/VOX.

    Full Information

    First Posted
    July 18, 2022
    Last Updated
    July 20, 2022
    Sponsor
    Peking University People's Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05467826
    Brief Title
    Efficacy and Safety of SOF/VEL + RBV and SOF/VEL/VOX for 12 Weeks in HCV Subjects With GT3b and Compensated Cirrhosis
    Official Title
    Efficacy and Safety of Sofosbuvir/Velpatasvir Plus Ribavirin for 12 Weeks or Sofosbuvir/Velpatasvir/Voxilaprevir for 12 Weeks in DAA Treatment Naïve HCV Subjects With GT3b, Compensated Cirrhosis in China
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    September 1, 2022 (Anticipated)
    Primary Completion Date
    November 30, 2023 (Anticipated)
    Study Completion Date
    December 31, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Peking University People's Hospital

    4. Oversight

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

    5. Study Description

    Brief Summary
    Direct-acting antiviral agents (DAAs) targeting HCV have revolutionized the treatment of HCV. The efficacy of DAA-based therapy can depend on patient-related factors such as treatment experience, cirrhosis, but also on viral genotype. The high prevalence of genotype 3, which is considered difficult to cure, remains a challenge because many oral DAAs are less effective for this genotype, particularly subtype 3b than for others. Current guidance generally recommends sofosbuvir (SOF)/velpatasvir (VEL) ± ribavirin (RBV), glecaprevir/pibrentasvir and SOF/VEL/voxilaprevir (VOX) as first-line therapy for genotype 3, and an interferon-based regimen - SOF plus pegylated interferon and ribavirin is still recommended as an alternative treatment option. These recommendations are based on clinical data generated in regions where genotype 3a predominates. Our recent study indicated that sofosbuvir plus ribavirin for 24 weeks in subjects with HCV genotype 3 infection resulted in high rates of SVR. However, the SVR12 rate among subjects with genotype 3b was lower than that observed in subjects with genotype 3a infection, particularly among treatment-experienced subjects with cirrhosis. Our study aimed to investigate the efficacy and safety of SOF/VEL plus RBV for 12 weeks or SOF/VEL/VOX for 12 weeks in DAAs treatment naïve HCV subjects with GT3b, compensated cirrhosis in China.
    Detailed Description
    Chronic hepatitis C virus (HCV) infection, which may lead to cirrhosis and hepatocellular carcinoma, is a major cause of chronic liver disease worldwide. Genotype 3 is the second most common genotype globally, accounting for approximately 18% of all adult HCV infections. Subjects with HCV genotype 3 infection, particularly genotype 3b, have a greater risk of developing hepatic steatosis, more rapid progression of hepatic fibrosis and cirrhosis, and hepatocellular carcinoma. Although there is only a small percentage of HCV subjects with genotype 3 in East Asia (5.4%) and China (8.7%), genotype 3b represents more than 50% of genotype 3 subjects in China,compared to most other regions of the world where genotype 3a predominates. In certain provinces of China, such as Yunnan Guizhou, and Chongqing, genotype 3b is the predominant HCV subtype among genotype 3 subjects. Direct-acting antiviral agents (DAAs) targeting HCV have revolutionized the treatment of HCV. The efficacy of DAA-based therapy can depend on patient-related factors such as treatment experience, cirrhosis, but also on viral genotype. The high prevalence of genotype 3, which is considered difficult to cure, remains a challenge because many oral DAAs are less effective for this genotype, particularly subtype 3b than for others. Current guidance generally recommends sofosbuvir (SOF)/velpatasvir (VEL) ± ribavirin (RBV), glecaprevir/pibrentasvir and SOF/VEL/voxilaprevir (VOX) as first-line therapy for genotype 3, and an interferon-based regimen - SOF plus pegylated interferon and ribavirin is still recommended as an alternative treatment option. These recommendations are based on clinical data generated in regions where genotype 3a predominates. Our recent study indicated that sofosbuvir plus ribavirin for 24 weeks in subjects with HCV genotype 3 infection resulted in high rates of SVR. However, the SVR12 rate among subjects with genotype 3b was lower than that observed in subjects with genotype 3a infection, particularly among treatment-experienced subjects with cirrhosis. Our study aimed to investigate the efficacy and safety of SOF/VEL plus RBV for 12 weeks or SOF/VEL/VOX for 12 weeks in DAAs treatment naïve HCV subjects with GT3b, compensated cirrhosis in China.

    6. Conditions and Keywords

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

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Arm 1
    Arm Type
    Experimental
    Arm Description
    Sofosbuvir 400mg/velpatasvir 100mg + ribavirin 1000mg/1200mg for 12 weeks
    Arm Title
    Arm 2
    Arm Type
    Experimental
    Arm Description
    Sofosbuvir 400mg/velpatasvir 100mg/voxilaprevir 100mg for 12 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Sofosbuvir/Velpatasvir + Ribavirin
    Other Intervention Name(s)
    Epclusa
    Intervention Description
    Sofosbuvir 400mg/velpatasvir 100mg + ribavirin 1000mg/1200mg for 12 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Sofosbuvir/Velpatasvir/Voxilaprevir
    Other Intervention Name(s)
    Vosevi
    Intervention Description
    Sofosbuvir 400mg/velpatasvir 100mg/voxilaprevir 100mg for 12 weeks
    Primary Outcome Measure Information:
    Title
    The proportion of participants with SVR12
    Description
    To evaluate the efficacy of treatment with SOF/VEL plus RBV for 12 weeks or SOF/VEL/VOX for 12 weeks in DAA treatment naïve HCV participants with GT3b, participants initiated on treatment will be assessed for viral load response at 12 weeks post treatment (SVR12). We use the proportion of participants with SVR12 as primary outcome measure.
    Time Frame
    12 weeks post treatment.
    Secondary Outcome Measure Information:
    Title
    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
    Description
    Number of Participants With treatment-related adverse events as assessed by CTCAE v4.0- SOF/VEL plus RBV vs. SOF/VEL/VOX.
    Time Frame
    Treatment start date through treatment completion (up to 24 weeks).

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Willing and able to provide written informed consent Male or female, age ≥18 years Body mass index (BMI) between 18.0-35.0kg/m2 and bodyweight ≥ 40 kg Chronic HCV infection (≥ 6 months) documented by prior medical history or liver biopsy Anti-HCV positive at screening HCV RNA 104 IU/mL at screening by the Central Laboratory HCV genotype 3b assessed at screening by the Central Laboratory DAA treatment naïve defined as having never been exposed to approved or experimental HCV-specific direct-acting antiviral agents. Pegylated interferon/interferon based prior treatment is allowed. Cirrhosis Determination: cirrhosis is defined as any one of the following: Liver biopsy showing cirrhosis (e.g., Metavir score = 4 or Ishak score ≥5) in 24 months before screening, or Fibroscan® with a result of >12.5 kPa in 6 months before screening The lab test at screening should meet all the criterion below: a) ALT ≤ 10 the upper limit of normal (ULN); b) AST ≤ 10 ULN; c) Total bilirubin ≤ 2 ULN; d) Platelets ≥ 60,000/L; e) Neutrophile ≥ 1,500/L; f) HbA1c ≤ 8.5%; g) Creatinine clearance (CLcr) ≥ 60 mL /min as calculated by the Cockcroft-Gault equation; h) Hemoglobin ≥ 11 g/dL for female subjects; ≥ 12 g/dL for male subjects; i) Albumin ≥ 3 g/dL; j) INR ≤ 1.7 x ULN; k) AFP <100ng/mL;if 20ng/mL≤AFP≤100ng/mL,HCC should be exclude by liver ultrasound Females of childbearing potential must have a negative serum pregnancy test at screening Male subjects and female subjects of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception Male subjects must agree to avoid donating sperm in 6 months after the last dose of drug Subject must be of generally good health, with the exception of chronic HCV infection, as determined by the Investigator Subject must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments Exclusion Criteria: Decompensated cirrhosis, including but not limited to: prior or current ascites, variceal hemorrhage and/or hepatic encephalopathy; prior or current Child-Pugh B or C HBsAg posititve at screening Anti-HIV positive at screening Alcohol abuse Contraindication of ribavirin, including but not limited to hemoglobinapathy Pregnant or nursing female or male with pregnant female partner Use of any prohibited concomitant medications as described in Section before screening Known hypersensitivity to SOF, VEL, RBV or formulation excipients Subjects who has any of the following history: a) Chronic liver disease of a non-HCV etiology (e.g., hemochromatosis, Wilson's disease, alfa-1 antitrypsin deficiency, cholangitis); b) Solid organ transplantation; c) Significant pulmonary disease, significant cardiac disease or porphyria; d) Pancreatitis; e) Autoimmune diseases (e.g., systemic lupus erythematosus, sarcoidosis, psoriasis); f) Psychiatric hospitalization, suicide attempt, and/or a period of disability as a result of their psychiatric illness within the last 5 years; g) 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). Subjects under evaluation for possible malignancy are not eligible; h) Significant drug allergy (such as anaphylaxis or hepatotoxicity). Assessed as ineligible by investigators
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Rui Huang, Dr.
    Phone
    +86 13601208547
    Email
    strangehead@163.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Huiying Rao, Dr.
    Email
    rao.huiying@163.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Huiying Rao, Dr.
    Organizational Affiliation
    Peking University People's Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Efficacy and Safety of SOF/VEL + RBV and SOF/VEL/VOX for 12 Weeks in HCV Subjects With GT3b and Compensated Cirrhosis

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