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Clinical Trial to eLiminate HCV-infection in Treatment-naïve, Renally Impaired EgyptiAn Patients on Renal Dialysis, With Chronic Hepatitis C Genotype 4 (CLEAR-C4)

Primary Purpose

Hepatitis C Virus Infection, Response to Therapy of

Status
Withdrawn
Phase
Phase 4
Locations
Egypt
Study Type
Interventional
Intervention
Elbasvir/Grazoprevir 50 MG-100 MG Oral Tablet [ZEPATIER]
Sponsored by
University of Maryland, Baltimore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C Virus Infection, Response to Therapy of focused on measuring Hepatitis C Virus, Genotype 4, End Stage Renal Disease

Eligibility Criteria

21 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed and dated informed consent obtained before undergoing any trial-related procedures
  2. Male and female patients; age between 21 and 70 years inclusive
  3. Chronic hepatitis C infection with genotype 4 confirmed by genotypic testing at screening or within 6 months of screening period
  4. Treatment naïve - absence of prior failed treatment for HCV with Interferon plus ribavirin therapy or directly acting antivirals (treatment experienced)
  5. Detectable HCV viral load (quantitative)
  6. Liver cirrhosis subjects may be included but will be limited to those with compensated liver disease
  7. Chronic kidney disease with end-stage liver disease (defined as glomerular filtration rate [eGFR] <=15 mL/min/1.73m2) on hemodialysis for at least 3 months, including individuals awaiting kidney transplant and those with failed kidney transplants but no longer on immunosuppressant therapy)
  8. Screening laboratory values within the defined protocol thresholds
  9. Women of child-bearing potential, must agree to abstinence or use of effective contraceptive methods (e.g. oral or injectable contraceptives, intra-uterine device (IUD), transdermal contraceptive patch) at least 2 weeks prior Day 1 through 14 days after the last dose of the study drug.
  10. Ability to communicate, participate, and comply with the requirements of the entire study

Exclusion Criteria:

  1. Patients didn't sign informed consent or under age of legal consent
  2. Pregnant or breastfeeding woman
  3. Has HCV genotypes other than G4
  4. On peritoneal dialysis for management of kidney disease
  5. Co-Infection with HIV and/or HBV (with positive HBsAg)
  6. Evidence of hepatocellular carcinoma (HCC)
  7. Evidence of hepatic decompensation as evidenced by presence or history of ascites, esophaegal or gastric bleeding, hepatic encelopathy or other signs of or symptoms of advanced liver disease, or cirrhotic subjects with Child-Pugh B or C, or who have a Purgh-Turcotte (CPT) score >6
  8. Active or suspected non-hepatic malignancy or history of any malignancy except for cured basal cell or squamous cell skin cancer or in situ cervical cancer
  9. Organ transplant (including hematopoietic stem cell transplant) other than kidney, cornea, and hair
  10. Conditions requiring, or likely to require, chronic systemic administration of corticosteroids during the course of the trial
  11. Uncontrolled or poorly controlled hypertension
  12. Pregnant, breast-feeding, expecting to conceive or donate eggs, or donate sperm from Day 1 through 14 days after the last study dose.
  13. Significant cardiovascular disorder (e.g. myocardial infarction or unstable angina) or interventional cardiovascular procedure within 3 months prior to signing informed consent
  14. Recent (within 3 months prior to signing informed consent) episode or recurrence of stroke, transient ischemic attack (TIA) or neurological disorder, including but not limited to seizures
  15. ALT or AST > 10-fold the upper limit of normal
  16. Evidence of liver disease due to causes other than chronic HCV infection
  17. Evidence of poorly controlled diabetes (defined as HbA1c > 8%)
  18. History of alcohol or drug abuse within the last 12 months
  19. Serum albumin level < 3.0 g/dL
  20. INR > 1.3 N
  21. Total Bilirubin levels > 2.0 mg/dL unless explained by Gilbert's disease
  22. Platelets Count <75,000/µL
  23. White blood cell count < 1500 µL (mm3)
  24. Clinically significant TSH and T4 level poorly controlled thyroid function
  25. Patients with any abnormality on physical examination, vital signs (sitting systolic blood pressure greater than 150 mmHg, sitting diastolic blood pressure greater than 90 mmHg and pulse greater than 90 bpm) and ECG, unless these abnormalities are judged to be not clinically significant by the Investigator
  26. Body Mass Index < 18.5 or > 35 kg/m2
  27. Use of other investigational drugs/treatments within the previous 3 months
  28. Known hypersensitivity to any of the test materials or related compounds.
  29. Active autoimmune disease.
  30. History of moderate, severe or uncontrolled psychiatric disease, especially severe depression and prior suicidal attempt.
  31. Unable to comply with research study visits.
  32. Poor venous access not allowing screening laboratory collection.
  33. Any other condition that, in the opinion of the Investigator, may be a contraindication to study participation or jeopardize the study conduct according to the protocol.

Sites / Locations

  • Kasr Alainy Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Arm

Arm Description

Patients to receive 12 weeks of Elbasvir (50mg) / Grazoprevir (100mg)

Outcomes

Primary Outcome Measures

SVR12
absence of HCV plasma RNA 12 weeks after end of treatment

Secondary Outcome Measures

Full Information

First Posted
December 18, 2017
Last Updated
April 16, 2020
Sponsor
University of Maryland, Baltimore
Collaborators
Merck Sharp & Dohme LLC, Cairo University
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1. Study Identification

Unique Protocol Identification Number
NCT03381859
Brief Title
Clinical Trial to eLiminate HCV-infection in Treatment-naïve, Renally Impaired EgyptiAn Patients on Renal Dialysis, With Chronic Hepatitis C Genotype 4
Acronym
CLEAR-C4
Official Title
A Single-site, Open-label, Non-comparator Clinical Trial to eLiminate HCV-infection in Treatment-naïve, EgyptiAn Patients With End-stage Renal Disease on Renal Dialysis, With Chronic Hepatitis C Genotype 4 Infection Using a 12-week Course of Once-daily Single Oral Tablet of Elbasvir (50mg)/Grazoprevir (100 mg)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Withdrawn
Why Stopped
HCV treatment expansion occurred in Egypt
Study Start Date
December 1, 2019 (Anticipated)
Primary Completion Date
June 1, 2020 (Anticipated)
Study Completion Date
June 1, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Maryland, Baltimore
Collaborators
Merck Sharp & Dohme LLC, Cairo University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
Primary Efficacy Objective -To assess whether a 12-week treatment course with oral 50 mg elbasvir plus 100 mg grazoprevir given in a single daily dose to treatment-naïve patients with end-stage renal disease (ESRD) and infected with genotype 4 (GT4) chronic HCV (CHC) infection can produce a sustained viral response (SVR), i.e. HCV RNA below the lower limit of quantification [LLOQ] for 12 weeks (SVR12) after completion of the study treatment course Secondary Objectives To assess the efficacy of elbasvir/grazoprevir in suppressing HCV viremia in treatment-naïve GT4 CHC patients at each scheduled visit and clinically meaningful endpoints (Week 2, 8 and 12 [End of Treatment - EOT]) and 24 (SVR12) To assess the safety and tolerability of a 12-week treatment course with elbasvir/grazoprevir in treatment-naïve patients with ESRD and infected with GT4 CHC. To assess liver fibrosis by non-invasive evaluation of liver stiffness (Fibroscan®) in the same patients before treatment and EOT and SVR12 Clinical hypotheses. Primary Efficacy Hypothesis - A 12-week treatment course with elbasvir/grazoprevir in treatment-naïve patients with ESRD and infected with GT4 CHC infection will result in an HCV RNA below the LLOQ in 95% of patients within 2 weeks of treatment, and at least 95% will have an SVR12. Secondary hypotheses A 12-week treatment course with elbasvir/grazoprevir in ESRD GT4 treatment-naïve patients will result in undetectable viremia in 95% patients at Week 2, 4, 8 and 12 (EOT) and 24 (SVR12) Treatment will be safe and well-tolerated in these patients, as determined by the type and number of adverse events identified through laboratory testing, vital signs and physical examinations. In these patients with liver fibrosis before treatment, the liver fibrosis as assessed by non-invasive evaluation of liver stiffness (Fibroscan®) will improve by EOT and SVR12

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C Virus Infection, Response to Therapy of
Keywords
Hepatitis C Virus, Genotype 4, End Stage Renal Disease

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
Treatment Arm
Arm Type
Experimental
Arm Description
Patients to receive 12 weeks of Elbasvir (50mg) / Grazoprevir (100mg)
Intervention Type
Drug
Intervention Name(s)
Elbasvir/Grazoprevir 50 MG-100 MG Oral Tablet [ZEPATIER]
Intervention Description
Hepatitis C Virus direct-acting antiviral
Primary Outcome Measure Information:
Title
SVR12
Description
absence of HCV plasma RNA 12 weeks after end of treatment
Time Frame
24 weeks from treatment initiation date

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated informed consent obtained before undergoing any trial-related procedures Male and female patients; age between 21 and 70 years inclusive Chronic hepatitis C infection with genotype 4 confirmed by genotypic testing at screening or within 6 months of screening period Treatment naïve - absence of prior failed treatment for HCV with Interferon plus ribavirin therapy or directly acting antivirals (treatment experienced) Detectable HCV viral load (quantitative) Liver cirrhosis subjects may be included but will be limited to those with compensated liver disease Chronic kidney disease with end-stage liver disease (defined as glomerular filtration rate [eGFR] <=15 mL/min/1.73m2) on hemodialysis for at least 3 months, including individuals awaiting kidney transplant and those with failed kidney transplants but no longer on immunosuppressant therapy) Screening laboratory values within the defined protocol thresholds Women of child-bearing potential, must agree to abstinence or use of effective contraceptive methods (e.g. oral or injectable contraceptives, intra-uterine device (IUD), transdermal contraceptive patch) at least 2 weeks prior Day 1 through 14 days after the last dose of the study drug. Ability to communicate, participate, and comply with the requirements of the entire study Exclusion Criteria: Patients didn't sign informed consent or under age of legal consent Pregnant or breastfeeding woman Has HCV genotypes other than G4 On peritoneal dialysis for management of kidney disease Co-Infection with HIV and/or HBV (with positive HBsAg) Evidence of hepatocellular carcinoma (HCC) Evidence of hepatic decompensation as evidenced by presence or history of ascites, esophaegal or gastric bleeding, hepatic encelopathy or other signs of or symptoms of advanced liver disease, or cirrhotic subjects with Child-Pugh B or C, or who have a Purgh-Turcotte (CPT) score >6 Active or suspected non-hepatic malignancy or history of any malignancy except for cured basal cell or squamous cell skin cancer or in situ cervical cancer Organ transplant (including hematopoietic stem cell transplant) other than kidney, cornea, and hair Conditions requiring, or likely to require, chronic systemic administration of corticosteroids during the course of the trial Uncontrolled or poorly controlled hypertension Pregnant, breast-feeding, expecting to conceive or donate eggs, or donate sperm from Day 1 through 14 days after the last study dose. Significant cardiovascular disorder (e.g. myocardial infarction or unstable angina) or interventional cardiovascular procedure within 3 months prior to signing informed consent Recent (within 3 months prior to signing informed consent) episode or recurrence of stroke, transient ischemic attack (TIA) or neurological disorder, including but not limited to seizures ALT or AST > 10-fold the upper limit of normal Evidence of liver disease due to causes other than chronic HCV infection Evidence of poorly controlled diabetes (defined as HbA1c > 8%) History of alcohol or drug abuse within the last 12 months Serum albumin level < 3.0 g/dL INR > 1.3 N Total Bilirubin levels > 2.0 mg/dL unless explained by Gilbert's disease Platelets Count <75,000/µL White blood cell count < 1500 µL (mm3) Clinically significant TSH and T4 level poorly controlled thyroid function Patients with any abnormality on physical examination, vital signs (sitting systolic blood pressure greater than 150 mmHg, sitting diastolic blood pressure greater than 90 mmHg and pulse greater than 90 bpm) and ECG, unless these abnormalities are judged to be not clinically significant by the Investigator Body Mass Index < 18.5 or > 35 kg/m2 Use of other investigational drugs/treatments within the previous 3 months Known hypersensitivity to any of the test materials or related compounds. Active autoimmune disease. History of moderate, severe or uncontrolled psychiatric disease, especially severe depression and prior suicidal attempt. Unable to comply with research study visits. Poor venous access not allowing screening laboratory collection. Any other condition that, in the opinion of the Investigator, may be a contraindication to study participation or jeopardize the study conduct according to the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shyamasundaran Kottilil, MD, PhD
Organizational Affiliation
University of Maryland, College Park
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kasr Alainy Hospital
City
Cairo
State/Province
Almanial
Country
Egypt

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Clinical Trial to eLiminate HCV-infection in Treatment-naïve, Renally Impaired EgyptiAn Patients on Renal Dialysis, With Chronic Hepatitis C Genotype 4

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