search
Back to results

Effects of Pegylated Interferon Alfa-2b and Ribavirin After Orthotopic Liver Transplantation in Subjects With Chronic Hepatitis C Recurrence (P04590AM3)(COMPLETED)

Primary Purpose

Liver Transplantation, Hepatitis C, Chronic, Liver Cirrhosis

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Combination of (a) pegylated interferon alfa-2b and (b) rebetol
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Liver Transplantation

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects must confirm that all prior medication washout times have been observed.
  • Subject must be 18 - 70 years of age of either gender and of any race.
  • Subject must be transplanted for end-stage hepatitis C or fulminant hepatitis C.
  • Subject must have documented:

    • persistent HCV viremia after OLT as defined by plasma positive for HCV RNA by quantitative reverse transcription-polymerase chain reaction (RT-PCR),
    • A liver transplant performed at least 3 months prior to screening but not more than 3 years prior to screening.
  • Subject must be on stable doses of immunosuppression for at least 1 month.
  • Compensated liver disease with minimum hematologic, biochemical, and serologic criteria at the (Day 1) baseline visit.

    • Alpha-fetoprotein value (AFP) less than or equal to 250ng/mL. If AFP greater than 100 ng/mL, patient will need evidence of normal liver (magnetic resonance imaging) MRI and normal chest computerized tomography (CT) scan within the last 3 months or during the screening period.
  • For subjects with a history of diabetes or hypertension, clearance from an ophthalmologist has to be obtained prior to treatment start (Day 1/Visit 2).
  • Subjects with a history of mild depression may be considered for entry into this study.
  • Female subjects cannot be pregnant or breastfeeding and must be either postmenopausal, surgically sterile or using 2 methods of birth control.
  • Sexually active male subjects are practicing an acceptable, method of contraception.
  • Contraceptive measures will be reviewed with female subjects at each visit. Dual methods of contraception must be used for 1 month prior to the start of treatment and 6 months after treatment discontinuation.
  • Pregnancy tests obtained at Screen Visit and Day 1 Visit prior to the initiation of treatment must be negative.

Exclusion Criteria:

  • Pregnant women, women who plan to become pregnant, male subjects whose partner wants to become pregnant, and breastfeeding women (during study and up to 6 months after study completion).
  • Subject has used any investigational product within 30 days prior to Screening or is participating in any other clinical study.
  • Prior treatment for chronic hepatitis C post-liver transplant, including but not limited to antiviral or immunomodulatory product, any interferon product, or RBV, either as monotherapy or in combination.
  • Subjects with other organ transplants.
  • Any subject who received a positive hepatitis C core antibody (HBcAb) or HCV positive donor liver graft.
  • Retransplantation of the liver for rejection or graft failure.
  • Evidence of decompensated liver disease.
  • Known coagulopathies including hemophilia.
  • Known hemoglobinopathies.
  • Known glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Hypersensitivity to alpha interferon and/or RBV.
  • Co-infection with hepatitis B virus (HBV) and/or human immunodeficiency virus (HIV).
  • Evidence of active or suspected malignancy or a history of malignancy within the last 5 years (with the exception of pre-transplant hepatocellular carcinoma histologically within the Milan criteria, and adequately treated basal or squamous cell carcinoma of the skin).
  • Any known pre-existing medical condition that could interfere with the subject's participation in and completion of the study.
  • Subject is or was a substance abuser. Subjects treated with buprenorphine (Subutex) who have been stable for 6 months may be included.
  • Patients weighing over 135 kg;

Is participating in any other clinical study(ies);

Is allergic to or has sensitivity to the study drug or its excipients.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    PEG-Intron plus Rebetol (RBV)

    Arm Description

    PEG-Intron plus RBV treatment for up to 48 weeks with 24-week follow up. SCH 54031 PEG-Intron 1.5 ug/kg SC per week plus SCH 18908 REBETOL twice daily (BID) PO with food, dosed as followed: Weeks 1 and 2, RBV Dose 400 mg (2 capsules, 1 AM and 1 PM). At the end of Weeks 2 and 4 of Treatment (tx), a complete blood count (CBC) was performed. An increase in RBV dose was permitted only if the hemoglobin was >10 g/dL. At Weeks 3 and 4, RBV dose was 800 mg (4 capsules, 2 AM and 2 PM). From Weeks 5 to 48, RBV doses could be increased based on subject body weight. For subjects weighing <65 kg, maximum dose of RBV was to be 800 mg (4 capsules, 2 AM and 2 PM), for subjects weighing 65-85 kg, max dose of RBV was 1000 mg/day (5 capsules, 2 AM and 3 PM), for subjects weighing >85 kg, max dose of RBV was 1200 mg/day, 6 capsules, 3 AM and 3 PM).

    Outcomes

    Primary Outcome Measures

    A Sustained Virologic Response (SVR), Defined as a Plasma HCV RNA Level Below the Lower Level of Quantitation (LLQ) at 24 Weeks Post-treatment
    Number of participants with SVR at 24-week follow up after treatment with PEG-Intron and Ribavirin in post-orthotopic liver transplant recipients with recurrent HCV.

    Secondary Outcome Measures

    Full Information

    First Posted
    September 18, 2006
    Last Updated
    March 8, 2017
    Sponsor
    Merck Sharp & Dohme LLC
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT00378599
    Brief Title
    Effects of Pegylated Interferon Alfa-2b and Ribavirin After Orthotopic Liver Transplantation in Subjects With Chronic Hepatitis C Recurrence (P04590AM3)(COMPLETED)
    Official Title
    PROTECT - Pegylated Interferon Alfa-2b and Ribavirin After Orthotopic Liver Transplantation: Efficacy and Safety in Hepatitis C Recurrence Therapy
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    May 2006 (undefined)
    Primary Completion Date
    July 2009 (Actual)
    Study Completion Date
    July 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This is an exploratory study and is a Phase 3, single-arm, multi-center, open-label study of pegylated interferon alfa-2b, PEG-IFN alpha-2b (PEG-Intron) and ribavirin (RBV) to determine the sustained virologic response (SVR) at 24-week follow-up to 48 week in subjects after orthotopic liver transplantation (OLT) with chronic hepatitis C (HCV) recurrence.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    125 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    PEG-Intron plus Rebetol (RBV)
    Arm Type
    Experimental
    Arm Description
    PEG-Intron plus RBV treatment for up to 48 weeks with 24-week follow up. SCH 54031 PEG-Intron 1.5 ug/kg SC per week plus SCH 18908 REBETOL twice daily (BID) PO with food, dosed as followed: Weeks 1 and 2, RBV Dose 400 mg (2 capsules, 1 AM and 1 PM). At the end of Weeks 2 and 4 of Treatment (tx), a complete blood count (CBC) was performed. An increase in RBV dose was permitted only if the hemoglobin was >10 g/dL. At Weeks 3 and 4, RBV dose was 800 mg (4 capsules, 2 AM and 2 PM). From Weeks 5 to 48, RBV doses could be increased based on subject body weight. For subjects weighing <65 kg, maximum dose of RBV was to be 800 mg (4 capsules, 2 AM and 2 PM), for subjects weighing 65-85 kg, max dose of RBV was 1000 mg/day (5 capsules, 2 AM and 3 PM), for subjects weighing >85 kg, max dose of RBV was 1200 mg/day, 6 capsules, 3 AM and 3 PM).
    Intervention Type
    Drug
    Intervention Name(s)
    Combination of (a) pegylated interferon alfa-2b and (b) rebetol
    Other Intervention Name(s)
    (a) SCH 54031, PEG-Intron, (b) SCH 18908, Rebetol
    Intervention Description
    Powder for injection in vials and Redipen (50, 80, 120, and 150 microgram strengths), subcutaneous, dose of 1.5 micrograms/kg, weekly for up to 48 weeks 200 mg capsules, oral, weight based dose of 400-1200 mg, daily for up to 48 weeks
    Primary Outcome Measure Information:
    Title
    A Sustained Virologic Response (SVR), Defined as a Plasma HCV RNA Level Below the Lower Level of Quantitation (LLQ) at 24 Weeks Post-treatment
    Description
    Number of participants with SVR at 24-week follow up after treatment with PEG-Intron and Ribavirin in post-orthotopic liver transplant recipients with recurrent HCV.
    Time Frame
    24 weeks after completion of up to 48 weeks of therapy

    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: Subjects must confirm that all prior medication washout times have been observed. Subject must be 18 - 70 years of age of either gender and of any race. Subject must be transplanted for end-stage hepatitis C or fulminant hepatitis C. Subject must have documented: persistent HCV viremia after OLT as defined by plasma positive for HCV RNA by quantitative reverse transcription-polymerase chain reaction (RT-PCR), A liver transplant performed at least 3 months prior to screening but not more than 3 years prior to screening. Subject must be on stable doses of immunosuppression for at least 1 month. Compensated liver disease with minimum hematologic, biochemical, and serologic criteria at the (Day 1) baseline visit. Alpha-fetoprotein value (AFP) less than or equal to 250ng/mL. If AFP greater than 100 ng/mL, patient will need evidence of normal liver (magnetic resonance imaging) MRI and normal chest computerized tomography (CT) scan within the last 3 months or during the screening period. For subjects with a history of diabetes or hypertension, clearance from an ophthalmologist has to be obtained prior to treatment start (Day 1/Visit 2). Subjects with a history of mild depression may be considered for entry into this study. Female subjects cannot be pregnant or breastfeeding and must be either postmenopausal, surgically sterile or using 2 methods of birth control. Sexually active male subjects are practicing an acceptable, method of contraception. Contraceptive measures will be reviewed with female subjects at each visit. Dual methods of contraception must be used for 1 month prior to the start of treatment and 6 months after treatment discontinuation. Pregnancy tests obtained at Screen Visit and Day 1 Visit prior to the initiation of treatment must be negative. Exclusion Criteria: Pregnant women, women who plan to become pregnant, male subjects whose partner wants to become pregnant, and breastfeeding women (during study and up to 6 months after study completion). Subject has used any investigational product within 30 days prior to Screening or is participating in any other clinical study. Prior treatment for chronic hepatitis C post-liver transplant, including but not limited to antiviral or immunomodulatory product, any interferon product, or RBV, either as monotherapy or in combination. Subjects with other organ transplants. Any subject who received a positive hepatitis C core antibody (HBcAb) or HCV positive donor liver graft. Retransplantation of the liver for rejection or graft failure. Evidence of decompensated liver disease. Known coagulopathies including hemophilia. Known hemoglobinopathies. Known glucose-6-phosphate dehydrogenase (G6PD) deficiency. Hypersensitivity to alpha interferon and/or RBV. Co-infection with hepatitis B virus (HBV) and/or human immunodeficiency virus (HIV). Evidence of active or suspected malignancy or a history of malignancy within the last 5 years (with the exception of pre-transplant hepatocellular carcinoma histologically within the Milan criteria, and adequately treated basal or squamous cell carcinoma of the skin). Any known pre-existing medical condition that could interfere with the subject's participation in and completion of the study. Subject is or was a substance abuser. Subjects treated with buprenorphine (Subutex) who have been stable for 6 months may be included. Patients weighing over 135 kg; Is participating in any other clinical study(ies); Is allergic to or has sensitivity to the study drug or its excipients.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    22739223
    Citation
    Gordon FD, Kwo P, Ghalib R, Crippin J, Vargas HE, Brown KA, Schiano T, Chaudhri E, Pedicone LD, Brown RS Jr. Peginterferon-alpha-2b and ribavirin for hepatitis C recurrence postorthotopic liver transplantation. J Clin Gastroenterol. 2012 Sep;46(8):700-8. doi: 10.1097/MCG.0b013e31825833be.
    Results Reference
    result

    Learn more about this trial

    Effects of Pegylated Interferon Alfa-2b and Ribavirin After Orthotopic Liver Transplantation in Subjects With Chronic Hepatitis C Recurrence (P04590AM3)(COMPLETED)

    We'll reach out to this number within 24 hrs