Clinical Pharmacokinetics of Daclatasvir/Sofosbuvir in Adolescents With Hepatitis C Virus
Primary Purpose
Chronic HCV Infection
Status
Recruiting
Phase
Phase 2
Locations
Egypt
Study Type
Interventional
Intervention
Daclatasvir and sofosbuvir
Sponsored by
About this trial
This is an interventional treatment trial for Chronic HCV Infection
Eligibility Criteria
Inclusion Criteria:
- Adolescents (ages 12- 18 years) and/ or weight ≥ 35 kg
- HCV genotype 4 infected
- Naïve non-cirrhotic population with FIB Score: F0 to F3.
- Screening laboratory values within define thresholds
- Both sex
- Evidence of HCV infection determined by positive anti-HCV antibody and HCV RNA by polymerase chain reaction (PCR)
- HCV treatment-naïve
- Absolute neutrophil count ≥ 1,500/mm3
- Hemoglobin level ≥ 10 g/dL
- Platelets > 75000 cells/mm3
- Albumin > 3.5 mg/dL
- PT < 3 sec above control and INR within accepted range
- Random glucose level within normal range
- Serum creatinine < 1.5 mg/dL
- Biopsy is not required for study entry.
- Signing informed consent by parents and patient assent
Exclusion Criteria:
- Previous treatment for HCV.
- History of clinically significant illness or any other medical condition that may interfere with individuals' treatment, assessment, or compliance with protocol.
- Co-infection with HIV, acute hepatitis A virus, or hepatitis B virus
- Clinical hepatic decompensation (i.e., ascites, encephalopathy or variceal hemorrhage)
- Pregnant or nursing females
- Use of any illicit concomitant medications as within 28 days of the Day 1
- Renal dysfunction
- Ongoing treatment with Prohibited drugs.
- Chronic liver disease due to a cause other than HCV e.g. autoimmune disease, Wilson disease,…etc.
- Alfa-fetoprotein level >50 ng/mL
- Serum creatinine >1.5 mg/dL
- Simultaneous acute hepatitis A infection
- Known hypersensitivity to daclatasvir or sofosbuvir
- History of gastrointestinal disease or surgical procedure
- Blood /blood product transfusion within 4 weeks prior to study
- Systemic corticosteroid use for more than 2 weeks (pulmonary/nasal administration was permitted)
- Psychiatric hospitalization, suicide attempt or disability resulting from psychiatric illness within the prior 5 years
- Clinically relevant alcohol or drug abuse within 12 months of screening
- Ongoing treatment with any medications interacting with daclatasvir/sofosbuvir
Sites / Locations
- Pediatric Department, Faculty of Medicine, Ain Shams UniversityRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Daclatasvir and sofosbuvir
Arm Description
Daclatasvir and sofosbuvir Single arm intervention open label trial for single tablet (Daclatasvir 90 mg and Sofosbuvir 400mg and ) Daclatasvir 90 mg for 12 weeks
Outcomes
Primary Outcome Measures
Measurement of the pharmacokinetics of DCV-SOF
Blood samples (3 mL) will be collected to measure dactalasvir concentrations from pediatric patients using a nine-point plasma schedule (pre-dose, 0.5,1, 2, 4, 8, 12, and 24 h post-dose) on day 8 of therapy.
(This will be a total of 27 mL/patient, which is well below the maximum allowed internationally recognized value of blood loss is 2.4mL/kg in a 4 month period. Any deviations from nominal sampling times should be recorded.
AUCtau which is defined as the concentration of drug over time (area under the plasma concentration versus time curve over the dosing interval will be calculated
Secondary Outcome Measures
Measurement of Number of Participants With sustained virological response (SVR12), 12 weeks after discontinuation of therapy with daclatasvir-sofosbuvir (DCV-SOF).
Number of Participants With sustained virological response at 12 Weeks after end of study drug treatment (SVR12) will be recorded, participant will be considered to have achieved SVR12 if HCV RNA is less than the lower limit of quantification of <15 IU/ml) at 12 weeks after the end of treatment.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03540212
Brief Title
Clinical Pharmacokinetics of Daclatasvir/Sofosbuvir in Adolescents With Hepatitis C Virus
Official Title
Clinical Pharmacokinetics, Safety and Efficacy Study of Daclatasvir/Sofosbuvir in Adolescents Aged 12 to 18 Years Old With Hepatitis C Virus: A Preliminary Study
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 10, 2017 (Actual)
Primary Completion Date
April 1, 2023 (Anticipated)
Study Completion Date
April 1, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ain Shams University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is an interventional Phase II/III, single center, single arm clinical trial to assess the pharmacokinetics, efficacy, safety and tolerance of daclatasvir plus sofosbuvir in treatment-naïve, non-cirrhotic adolescents with chronic HCV GT-4 infection.
A single-arm evaluation of daclatasvir/sofosbuvir will focus on the pharmacokinetics, efficacy and safety
All enrolled patients will receive daclatasvir 60 mg orally once daily plus sofosbuvir at a dose of 400 mg orally once daily for 12 weeks.
Detailed Description
This is an interventional Phase II/III, single center, single arm clinical trial to assess the pharmacokinetics efficacy, safety, and tolerance of daclatasvir plus sofosbuvir in treatment-naïve, non-cirrhotic adolescents with chronic HCV GT-4 infection.
A single-arm evaluation of daclatasvir/sofosbuvir will focus on the efficacy, safety and pharmacokinetics, confirm the favorable pharmacological profile.
All enrolled patients will receive daclatasvir 60 mg orally once daily plus sofosbuvir at a dose of 400 mg orally once daily for 12 weeks.
Patients will be followed closely for disease progression and any hypersensitivity or adverse reactions due to therapy. Laboratory values to be monitored at baseline: Serum creatinine, bilirubin, AST, ALT, HCV viral load (VL).
Fifty patients will be included; the first twenty patients will be candidates for pharmacokinetic assessment. All patients (50), will be candidates for safety and efficacy assessment after verifying the PK results ''phase II''. Patients will be recruited at Ain Shams University hospitals, Egypt. The study will be conducted after approval of the corresponding research ethical committee and obtaining an informed consent from the parents/guardians and an assent from the patients.
Patients will be requested to come for 2 screening visits, at the first day of therapy, weekly during the first four weeks, at the end of week 8 and week 12. Patients who will complete their treatment schedule will be scheduled for a visit after 12 weeks from end of therapy for assessment of sustained virological response (SVR). The total number of visits are 9. Duration of follow up will be 24 weeks from treatment initiation in addition to the screening period (2-4 weeks).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic HCV Infection
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Daclatasvir and sofosbuvir
Arm Type
Experimental
Arm Description
Daclatasvir and sofosbuvir
Single arm intervention open label trial for single tablet (Daclatasvir 90 mg and Sofosbuvir 400mg and ) Daclatasvir 90 mg for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Daclatasvir and sofosbuvir
Other Intervention Name(s)
DCV-SOF, Sofosbuvir-Daclatasvir
Intervention Description
Daclatasvir is a DAAs that can inhibit the HCV non-structural (NS) 5A protein when used in combination with other HCV-therapies. It has a linear, non-time-dependent pharmacokinetic profile and nanomolar potency in vitro against HCV genotypes 1-6. It is excreted primarily via faeces, about 88% in an unchanged form while renal excretion accounts for approximately 7% of its elimination.
DOSE OF SOFOSBUVIR: 400 mg tablet orally once daily with food (in the morning) for 12 weeks for adolescents with liver fibrosis Metavir score F0-F2.
DOSE OF DACLTASVIR: 60 mg tablet orally once daily with food (in the morning) for 12 weeks for adolescents with liver fibrosis Metavir score F0-F2.
Primary Outcome Measure Information:
Title
Measurement of the pharmacokinetics of DCV-SOF
Description
Blood samples (3 mL) will be collected to measure dactalasvir concentrations from pediatric patients using a nine-point plasma schedule (pre-dose, 0.5,1, 2, 4, 8, 12, and 24 h post-dose) on day 8 of therapy.
(This will be a total of 27 mL/patient, which is well below the maximum allowed internationally recognized value of blood loss is 2.4mL/kg in a 4 month period. Any deviations from nominal sampling times should be recorded.
AUCtau which is defined as the concentration of drug over time (area under the plasma concentration versus time curve over the dosing interval will be calculated
Time Frame
Blood samples will be collected on day 8 of therapy
Secondary Outcome Measure Information:
Title
Measurement of Number of Participants With sustained virological response (SVR12), 12 weeks after discontinuation of therapy with daclatasvir-sofosbuvir (DCV-SOF).
Description
Number of Participants With sustained virological response at 12 Weeks after end of study drug treatment (SVR12) will be recorded, participant will be considered to have achieved SVR12 if HCV RNA is less than the lower limit of quantification of <15 IU/ml) at 12 weeks after the end of treatment.
Time Frame
12 weeks after discontinuation of therapy with daclatasvir-sofosbuvir (DCV-SOF).
10. Eligibility
Sex
All
Minimum Age & Unit of Time
10 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adolescents (ages 12- 18 years) and/ or weight ≥ 35 kg
HCV genotype 4 infected
Naïve non-cirrhotic population with FIB Score: F0 to F3.
Screening laboratory values within define thresholds
Both sex
Evidence of HCV infection determined by positive anti-HCV antibody and HCV RNA by polymerase chain reaction (PCR)
HCV treatment-naïve
Absolute neutrophil count ≥ 1,500/mm3
Hemoglobin level ≥ 10 g/dL
Platelets > 75000 cells/mm3
Albumin > 3.5 mg/dL
PT < 3 sec above control and INR within accepted range
Random glucose level within normal range
Serum creatinine < 1.5 mg/dL
Biopsy is not required for study entry.
Signing informed consent by parents and patient assent
Exclusion Criteria:
Previous treatment for HCV.
History of clinically significant illness or any other medical condition that may interfere with individuals' treatment, assessment, or compliance with protocol.
Co-infection with HIV, acute hepatitis A virus, or hepatitis B virus
Clinical hepatic decompensation (i.e., ascites, encephalopathy or variceal hemorrhage)
Pregnant or nursing females
Use of any illicit concomitant medications as within 28 days of the Day 1
Renal dysfunction
Ongoing treatment with Prohibited drugs.
Chronic liver disease due to a cause other than HCV e.g. autoimmune disease, Wilson disease,…etc.
Alfa-fetoprotein level >50 ng/mL
Serum creatinine >1.5 mg/dL
Simultaneous acute hepatitis A infection
Known hypersensitivity to daclatasvir or sofosbuvir
History of gastrointestinal disease or surgical procedure
Blood /blood product transfusion within 4 weeks prior to study
Systemic corticosteroid use for more than 2 weeks (pulmonary/nasal administration was permitted)
Psychiatric hospitalization, suicide attempt or disability resulting from psychiatric illness within the prior 5 years
Clinically relevant alcohol or drug abuse within 12 months of screening
Ongoing treatment with any medications interacting with daclatasvir/sofosbuvir
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Manal H El-Sayed, MD
Phone
00201227461120
Email
manalhelsayed@yahoo.co.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Fatma SE Ebeid, MD
Phone
00201095569596
Email
dr.fatma_ebeid@yahoo.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Manal H El-Sayed, MD
Organizational Affiliation
Professor of Pediatric, Faculty of Medicine, Ain Shams University, Egypt
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pediatric Department, Faculty of Medicine, Ain Shams University
City
Cairo
State/Province
Non-US
ZIP/Postal Code
11556
Country
Egypt
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Manal H El-Sayed, MD
Phone
00201227461120
Email
mamalhelsayed@yahoo.co.uk
First Name & Middle Initial & Last Name & Degree
Fatma Soliman E Ebeid, MD
Phone
1095569596
Ext
Ebeid
Email
dr.fatma_ebeid@yahoo.com
First Name & Middle Initial & Last Name & Degree
Manal H El-Sayed, MD
First Name & Middle Initial & Last Name & Degree
Fatma SE Ebeid, MD
First Name & Middle Initial & Last Name & Degree
Aya M Kamal, MD
First Name & Middle Initial & Last Name & Degree
Mohamed Hassany, MD
First Name & Middle Initial & Last Name & Degree
Mogeb M Saif, MD
First Name & Middle Initial & Last Name & Degree
Samar F Farid
First Name & Middle Initial & Last Name & Degree
Maggie M Abbassi
First Name & Middle Initial & Last Name & Degree
Sara Makkeyah, MD
First Name & Middle Initial & Last Name & Degree
Mary Akhnokh, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
32367815
Citation
Al-Nahari MM, Abbassi MM, Ebeid FS, Hassany M, El-Sayed MH, Farid SF. Pharmacokinetics of daclatasvir in Egyptian adolescents with genotype-4 HCV infection. Antivir Ther. 2020;25(2):101-110. doi: 10.3851/IMP3357.
Results Reference
derived
Learn more about this trial
Clinical Pharmacokinetics of Daclatasvir/Sofosbuvir in Adolescents With Hepatitis C Virus
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