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Concentration-Controlled Ribavirin for the Treatment of Patients With Chronic Hepatitis C Virus Infection

Primary Purpose

Hepatitis C Virus

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
ribavirin
Sponsored by
University of Colorado, Denver
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C Virus focused on measuring ribavirin, pharmacokinetics, Hepatitis C virus

Eligibility Criteria

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

Inclusion Criteria:

  • Chronic HCV-infected men and women
  • 18-70 years
  • HCV genotype 1
  • Deemed ready for HCV treatment by hepatology provider and patient
  • Allowed medications: all those not specifically listed in the exclusion criteria below including medications for peginterferon / ribavirin - related adverse effects: acetaminophen, ibuprofen, diphenhydramine, selective serotonin reuptake inhibitors, darbepoeitin, erythropoietin, GCSF

Exclusion Criteria:

  • previous treatment with interferon, peginterferon, investigational HCV drugs, boceprevir, or ribavirin;
  • baseline absolute neutrophil count (ANC) < 1000/mm3,
  • platelets < 100,000/mm3,
  • hemoglobin < 12 g/dL for women and < 13 g/dL for men;
  • HIV positive serostatus;
  • HBV positive serostatus;
  • decompensated liver disease (i.e., ascites, history of esophageal variceal bleeding, hepatic encephalopathy);
  • autoimmune hepatitis
  • hemoglobinopathy (e.g., sickle cell anemia, thalassemia)
  • Cockcroft and Gault estimated creatinine clearance < 50 mL/min;
  • alcohol or illicit drug use that in the opinion of the investigator would interfere with study participation and/or impact study results
  • for females, active pregnancy or any intent to become pregnant during study period or for up to 6 months after completing treatment
  • for males, a pregnant female partner or intent to impregnate a female during study period or for up to 6 months after completing treatment
  • for both sexes an unwillingness to use two forms of contraception during the study period and for 6 months after completing treatment. While on telaprevir and for 2 weeks following discontinuation of telaprevir, females must use two non-hormonal forms of contraception;
  • history of significant or unstable cardiac disease including severe coronary artery disease (unstable angina, recent myocardial infarction, chest pain with exertion) or congestive heart failure;
  • receipt of an organ transplant;
  • malignant neoplastic disease;
  • chronic pulmonary disease that in the opinion of the study hepatologists would preclude treatment with peginterferon and ribavirin (e.g., pulmonary function tests ≤70% within the previous 2 years);
  • history of admission to a psychiatric facility within the previous year;
  • suicide attempt within the previous 3 years;
  • concomitant medications including: amantadine, mycophenolate mofetil, and investigational HCV compounds, alfuzosin, alfentanil, ergot derivatives (dihydroergotamine/ergotamine/ergonovine/methylergonovine), meperidine, anti-arrhythmics (quinidine, flecainide, propafenone, amiodarone, bepridil), astemizole, terfenadine, buspirone, diazepam, estazolam, oral midazolam, triazolam, budesonide, domperidone, eletriptan, eplerenone, fluticasone, pimozide, salmeterol, calcium channel blockers (diltiazem, felodipine, nifedipine, nisoldipine, verapamil), cisapride, cyclosporine, sirolimus, systemic tacrolimus, atorvastatin, lovastatin, simvistatin, sildenafil, tadalafil, verdenafil, antibiotics (clarithromycin, erythromycin, telithromycin, troleandomycin), carbamazepine, Phenobarbital, phenytoin, nefazodone, St. Johns Wort, antifungals (fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole), rifampin, rifabutin, aprepitant, cholestyramine, fluvoxamine, mifepreistone, modafinil, systemic dexamethasone. With the exception of St. Johns Wort, investigators may use their discretion on use of herbal and dietary supplements.
  • Evidence of severe retinopathy or clinically relevant ophthalmologic disorders

Sites / Locations

  • University of Colorado Denver

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Standard Weight-Based Ribavirin Dosing

Concentration-Controlled Ribavirin Dosing

Arm Description

1000 mg daily in patients weighing <75 kg and 1200 mg daily in patients weighing ≥ 75 kg

Dose adjusted based on first dose AUC0-12

Outcomes

Primary Outcome Measures

Ribavirin AUC-12 Variability
Demonstrate that concentration-controlled ribavirin dosing can achieve a targeted level of plasma exposure with reduced variability in the steady-state area-under-the-concentration-time curve (AUC0-12) compared with standard weight-based ribavirin dosing

Secondary Outcome Measures

Safety - Absolute Hemoglobin Declines
Sustained Virologic Response (i.e., Cure)
Compare proportions with SVR in standard weight-based vs. concentration-guided ribavirin dosing groups. Number of participants with sustained virologic response is reported.

Full Information

First Posted
March 30, 2010
Last Updated
August 20, 2021
Sponsor
University of Colorado, Denver
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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1. Study Identification

Unique Protocol Identification Number
NCT01097395
Brief Title
Concentration-Controlled Ribavirin for the Treatment of Patients With Chronic Hepatitis C Virus Infection
Official Title
Concentration-Controlled Ribavirin for the Treatment of Patients With Chronic Hepatitis C Virus Infection
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
February 2010 (undefined)
Primary Completion Date
August 2015 (Actual)
Study Completion Date
August 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Colorado, Denver
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

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.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if concentration-controlled ribavirin dosing can achieve a targeted level of plasma exposures and if it appears safe and effective compared with standard weight-based ribavirin dosing. Forty, previously treatment-naive participants with genotype 1 disease will be randomized to receive concentration-guided or standard weight-based ribavirin. Peginterferon alfa 2a,ribavirin, and telaprevir will be provided through the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C Virus
Keywords
ribavirin, pharmacokinetics, Hepatitis C virus

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Standard Weight-Based Ribavirin Dosing
Arm Type
Active Comparator
Arm Description
1000 mg daily in patients weighing <75 kg and 1200 mg daily in patients weighing ≥ 75 kg
Arm Title
Concentration-Controlled Ribavirin Dosing
Arm Type
Experimental
Arm Description
Dose adjusted based on first dose AUC0-12
Intervention Type
Drug
Intervention Name(s)
ribavirin
Intervention Description
Randomization to standard weight based ribavirin dosing (1000 or 1200 mg daily) or concentration-guided dosing based on first dose AUC0-12
Primary Outcome Measure Information:
Title
Ribavirin AUC-12 Variability
Description
Demonstrate that concentration-controlled ribavirin dosing can achieve a targeted level of plasma exposure with reduced variability in the steady-state area-under-the-concentration-time curve (AUC0-12) compared with standard weight-based ribavirin dosing
Time Frame
steady state (~weeks 9-10)
Secondary Outcome Measure Information:
Title
Safety - Absolute Hemoglobin Declines
Time Frame
from baseline through end of treatment, up to 48 weeks
Title
Sustained Virologic Response (i.e., Cure)
Description
Compare proportions with SVR in standard weight-based vs. concentration-guided ribavirin dosing groups. Number of participants with sustained virologic response is reported.
Time Frame
assessed 12 weeks after stopping treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Chronic HCV-infected men and women 18-70 years HCV genotype 1 Deemed ready for HCV treatment by hepatology provider and patient Allowed medications: all those not specifically listed in the exclusion criteria below including medications for peginterferon / ribavirin - related adverse effects: acetaminophen, ibuprofen, diphenhydramine, selective serotonin reuptake inhibitors, darbepoeitin, erythropoietin, GCSF Exclusion Criteria: previous treatment with interferon, peginterferon, investigational HCV drugs, boceprevir, or ribavirin; baseline absolute neutrophil count (ANC) < 1000/mm3, platelets < 100,000/mm3, hemoglobin < 12 g/dL for women and < 13 g/dL for men; HIV positive serostatus; HBV positive serostatus; decompensated liver disease (i.e., ascites, history of esophageal variceal bleeding, hepatic encephalopathy); autoimmune hepatitis hemoglobinopathy (e.g., sickle cell anemia, thalassemia) Cockcroft and Gault estimated creatinine clearance < 50 mL/min; alcohol or illicit drug use that in the opinion of the investigator would interfere with study participation and/or impact study results for females, active pregnancy or any intent to become pregnant during study period or for up to 6 months after completing treatment for males, a pregnant female partner or intent to impregnate a female during study period or for up to 6 months after completing treatment for both sexes an unwillingness to use two forms of contraception during the study period and for 6 months after completing treatment. While on telaprevir and for 2 weeks following discontinuation of telaprevir, females must use two non-hormonal forms of contraception; history of significant or unstable cardiac disease including severe coronary artery disease (unstable angina, recent myocardial infarction, chest pain with exertion) or congestive heart failure; receipt of an organ transplant; malignant neoplastic disease; chronic pulmonary disease that in the opinion of the study hepatologists would preclude treatment with peginterferon and ribavirin (e.g., pulmonary function tests ≤70% within the previous 2 years); history of admission to a psychiatric facility within the previous year; suicide attempt within the previous 3 years; concomitant medications including: amantadine, mycophenolate mofetil, and investigational HCV compounds, alfuzosin, alfentanil, ergot derivatives (dihydroergotamine/ergotamine/ergonovine/methylergonovine), meperidine, anti-arrhythmics (quinidine, flecainide, propafenone, amiodarone, bepridil), astemizole, terfenadine, buspirone, diazepam, estazolam, oral midazolam, triazolam, budesonide, domperidone, eletriptan, eplerenone, fluticasone, pimozide, salmeterol, calcium channel blockers (diltiazem, felodipine, nifedipine, nisoldipine, verapamil), cisapride, cyclosporine, sirolimus, systemic tacrolimus, atorvastatin, lovastatin, simvistatin, sildenafil, tadalafil, verdenafil, antibiotics (clarithromycin, erythromycin, telithromycin, troleandomycin), carbamazepine, Phenobarbital, phenytoin, nefazodone, St. Johns Wort, antifungals (fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole), rifampin, rifabutin, aprepitant, cholestyramine, fluvoxamine, mifepreistone, modafinil, systemic dexamethasone. With the exception of St. Johns Wort, investigators may use their discretion on use of herbal and dietary supplements. Evidence of severe retinopathy or clinically relevant ophthalmologic disorders
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jennifer J Kiser, PharmD
Organizational Affiliation
University of Colorado, Denver
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Colorado Denver
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25645847
Citation
Wu LS, Rower JE, Burton JR Jr, Anderson PL, Hammond KP, Baouchi-Mokrane F, Everson GT, Urban TJ, D'Argenio DZ, Kiser JJ. Population pharmacokinetic modeling of plasma and intracellular ribavirin concentrations in patients with chronic hepatitis C virus infection. Antimicrob Agents Chemother. 2015 Apr;59(4):2179-88. doi: 10.1128/AAC.04618-14. Epub 2015 Feb 2.
Results Reference
derived

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Concentration-Controlled Ribavirin for the Treatment of Patients With Chronic Hepatitis C Virus Infection

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