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Efficacy, Safety and Tolerability of Ribavirin Monotherapy Followed by Combined Treatment With Ribavirin and Hydroxychloroquine in Patients Infected With Hepatitis C

Primary Purpose

Hepatitis C

Status
Terminated
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Ribavirin
Hydroxychloroquine
Sponsored by
BioLineRx, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C focused on measuring HCV, Hepatitis C, Hep-C

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female, age ≥ 18.
  2. Subjects diagnosed to have positive HCV antibodies.
  3. Subject is diagnosed to have detectable HCV RNA by PCR.
  4. FibroTest or FibroScan or liver biopsy showing a METAVIR score ≤ F2 and/or

    ≤ A2 within 2 years of the screening visit.

  5. Subject is a non-responder (null or partial ) OR relapsed following prior Peg-IFN and RBV based treatment lasting for at least 12 consecutive weeks.
  6. Platelet count greater than or equal to 100,000 cells/mm3.
  7. Absolute neutrophil count (ANC) greater than or equal to 1500 cells/mm3.
  8. Subjects able to comprehend and give written informed consent for participation in this study.
  9. Women of childbearing potential and all men must agree to use an approved form of contraception (e.g., oral, transdermal patch, implanted contraceptives, intrauterine device, diaphragm, condom, abstinence or surgical sterility) prior to study entry and for the duration of study participation through 7 months after the last dose of study medication. Confirmation that the female patient is not pregnant must be established by a negative serum β-human chorionic gonadotropin (β-hCG) pregnancy test result obtained during screening. Pregnancy testing is not required for post-menopausal or surgically sterilized women.
  10. Subject is willing to be treated and commit to all visits

Exclusion Criteria:

  1. Contraindication or hypersensitivity to one of the study drugs (HCQ or RBV).
  2. Patient has anemia (male <13 g/dL; female <12 g/dL), elevated ALT and/or AST >10 x ULN or elevated creatinine (>1.5 mg/dL).
  3. Concomitant liver disease other than hepatitis C: alcoholic liver disease, autoimmune hepatitis, Wilson's disease, hemochromatosis, alpha-1 antitrypsin deficiency.
  4. Decompensated cirrhosis (Child Pugh >A).
  5. Ongoing hepatocellular carcinoma (suggestive imaging study or alpha-fetoprotein (AFP) >50 ng/mL).
  6. Hepatitis B or Human Immunodeficiency Virus (HIV1 or HIV2) co-infection.
  7. Clinically relevant ECG abnormalities on screening or baseline 12-lead ECG, e.g.,

    • QTc interval (QTcB or QTcF > 450 ms in males and > 470 ms in females);
    • Notable resting bradycardia (HR < 40 bpm);
    • Any other significant abnormality suggestive of structural heart disease.
  8. Family history of congenital long QT syndrome.
  9. Clinically significant abnormalities on ophthalmic examination.
  10. Major uncontrolled psychiatric illness. Minor or situational depressions are allowed.
  11. History of hemoglobinopathy (e.g., thalassemia) or any other cause of or tendency to hemolysis (e.g., G-6-PD deficiency).
  12. Active illicit drug or alcohol abuse.
  13. Serious co-morbid conditions such as: heart failure, significant coronary heart disease, chronic obstructive pulmonary disease, poorly controlled diabetes, autoimmune disorders and any malignant diseases (except in situ carcinomas or basal cell carcinoma) in the previous 5 years.
  14. Patients with chronic renal insufficiency, creatinine clearance < 50 mL/minute and/or undergoing haemodialysis.
  15. Patients with porphyria or psoriasis.
  16. Ongoing concomitant treatment with azathioprine, digoxin or medications known to prolong QT interval.
  17. History of organ transplantation.
  18. Pregnancy, breast-feeding or unwillingness to practice double contraception or abstinence by the subject of childbearing potential or partner.
  19. Concurrent participation in any other clinical study or within 180 days 20.Patients with inability to communicate well with the Investigators and staff (i.e., language problem, poor mental development or impaired cerebral function) or any other condition that in the opinion of the Investigator will place the patient at risk or prevent protocol compliance.

    -

Sites / Locations

  • Hospital St. Joseph
  • Cochin Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ribavirin+HCQ

Arm Description

Administration of RBV monotherapy for a period of 8 weeks following administration of up to 16 weeks combination therapy with ribavirin(RBV) plus Hydroxychloroquine(HCQ).

Outcomes

Primary Outcome Measures

Efficacy
To evaluate the effect of 16-week combination therapy with RBV plus HCQ following 8 weeks of monotherapy with RBV in HCV-infected patients.
Safety: Number of Participants With Adverse Events
Safety was assessed throughout study by collection of adverse event and concomitant medication data, and routine monitoring of lab safety tests, physical exams, ophthalmic examination, vital signs and 12 lead electrocardiograms.

Secondary Outcome Measures

Efficacy
To evaluate the efficacy of 8 weeks monotherapy with RBV in HCV-infected patients.

Full Information

First Posted
April 15, 2013
Last Updated
August 27, 2014
Sponsor
BioLineRx, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01833845
Brief Title
Efficacy, Safety and Tolerability of Ribavirin Monotherapy Followed by Combined Treatment With Ribavirin and Hydroxychloroquine in Patients Infected With Hepatitis C
Official Title
An Open-Label Study to Evaluate the Efficacy, Safety and Tolerability of Ribavirin Monotherapy Followed by Combined Treatment With Ribavirin and Hydroxychloroquine in Patients Infected With Hepatitis C
Study Type
Interventional

2. Study Status

Record Verification Date
August 2014
Overall Recruitment Status
Terminated
Why Stopped
due to failure to recruit subjects
Study Start Date
April 2013 (undefined)
Primary Completion Date
April 2014 (Actual)
Study Completion Date
April 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioLineRx, Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Proof-of Concept, Open-Label, Two-Stage Study without Direct Individual Benefit The proposed study design consists of two treatment periods and one treatment arm. Treatment Period 1 involves the administration of RBV monotherapy for a period of 8 weeks and Treatment Period 2 involves administration of up to 16 weeks combination therapy with RBV plus HCQ.
Detailed Description
Patients who provide their informed consent and conform to all the inclusion and none of the exclusion criteria will be enrolled into the study and will receive RBV monotherapy for 8 weeks. Subjects will receive weight-based doses (1000 mg/day administered BID [twice daily] for subjects ≤ 75 kg and 1200 mg/day administered BID for subjects > 75 kg). Those subjects receiving 1000 mg/day RBV will take 2 tablets of 200 mg/tablet in the morning and 3 tablets in the evening, and those subjects receiving 1200 mg/day RBV will take 3 tablets morning and evening. During Treatment Period 2, subjects will receive HCQ 575 mg administered as a single tablet once daily (QD), in addition to continuing the same dose of RBV that was administered during Treatment Period 1, as combination therapy for up to 16 weeks. Subjects will undergo regular blood sampling throughout Treatment Periods 1 and 2 to measure viral response (HCV RNA). Safety will be assessed throughout the study by collection of adverse event (AE) and concomitant medication data, and routine monitoring of laboratory safety tests, vital signs and 12-lead electrocardiograms (ECG). Subjects will have their viral response tested following 12 weeks of combination therapy; those who show < 1 log decline in viral load during the combination therapy will have the opportunity to withdraw and transfer to standard of care (SoC) treatment following performance of the "End of Study Treatment" visit. On completion of study treatment, subjects will be allowed to transfer immediately to SoC treatment in order to maximize the benefit of any reduced viral load resulting from combination therapy with RBV plus HCQ. Subjects will attend the clinical site for an "End of Study Treatment" visit within 2 weeks of the final dose of combination treatment with RBV plus HCQ during which they will undergo a final measurement of HCV RNA, safety assessments as described above and a full physical and ophthalmic examination. The "End of Study Treatment" visit may take place on the same day as the final study visit at week 24. In the event of subjects achieving viral undetectability during combination therapy, the relevant subjects may be administered additional combination therapy to achieve a total of 24 weeks of viral undetectability. If combination dosing with RBV plus HCQ continues for more than 16 weeks, subjects will continue to attend the clinical site and undergo assessment of safety and viral load at the discretion of the Investigator. However, treatment beyond 16 weeks of combination therapy will be considered compassionate use and will not be considered part of the study. In these subjects, the "End of Study Treatment" visit will take place no more than 2 weeks after the Week 24 visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C
Keywords
HCV, Hepatitis C, Hep-C

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ribavirin+HCQ
Arm Type
Experimental
Arm Description
Administration of RBV monotherapy for a period of 8 weeks following administration of up to 16 weeks combination therapy with ribavirin(RBV) plus Hydroxychloroquine(HCQ).
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Other Intervention Name(s)
RBV
Intervention Description
weight-based doses (1000 mg/day administered BID [twice daily] for subjects ≤ 75 kg and 1200 mg/day administered BID for subjects > 75 kg). Those subjects receiving 1000 mg/day RBV will take 2 tablets of 200 mg/tablet in the morning and 3 tablets in the evening, and those subjects receiving 1200 mg/day RBV will take 3 tablets morning and evening.
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine
Other Intervention Name(s)
HCQ
Intervention Description
subjects will receive HCQ 575 mg administered as a single tablet once daily (QD)
Primary Outcome Measure Information:
Title
Efficacy
Description
To evaluate the effect of 16-week combination therapy with RBV plus HCQ following 8 weeks of monotherapy with RBV in HCV-infected patients.
Time Frame
24 weeks
Title
Safety: Number of Participants With Adverse Events
Description
Safety was assessed throughout study by collection of adverse event and concomitant medication data, and routine monitoring of lab safety tests, physical exams, ophthalmic examination, vital signs and 12 lead electrocardiograms.
Time Frame
all 24 weeks
Secondary Outcome Measure Information:
Title
Efficacy
Description
To evaluate the efficacy of 8 weeks monotherapy with RBV in HCV-infected patients.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, age ≥ 18. Subjects diagnosed to have positive HCV antibodies. Subject is diagnosed to have detectable HCV RNA by PCR. FibroTest or FibroScan or liver biopsy showing a METAVIR score ≤ F2 and/or ≤ A2 within 2 years of the screening visit. Subject is a non-responder (null or partial ) OR relapsed following prior Peg-IFN and RBV based treatment lasting for at least 12 consecutive weeks. Platelet count greater than or equal to 100,000 cells/mm3. Absolute neutrophil count (ANC) greater than or equal to 1500 cells/mm3. Subjects able to comprehend and give written informed consent for participation in this study. Women of childbearing potential and all men must agree to use an approved form of contraception (e.g., oral, transdermal patch, implanted contraceptives, intrauterine device, diaphragm, condom, abstinence or surgical sterility) prior to study entry and for the duration of study participation through 7 months after the last dose of study medication. Confirmation that the female patient is not pregnant must be established by a negative serum β-human chorionic gonadotropin (β-hCG) pregnancy test result obtained during screening. Pregnancy testing is not required for post-menopausal or surgically sterilized women. Subject is willing to be treated and commit to all visits Exclusion Criteria: Contraindication or hypersensitivity to one of the study drugs (HCQ or RBV). Patient has anemia (male <13 g/dL; female <12 g/dL), elevated ALT and/or AST >10 x ULN or elevated creatinine (>1.5 mg/dL). Concomitant liver disease other than hepatitis C: alcoholic liver disease, autoimmune hepatitis, Wilson's disease, hemochromatosis, alpha-1 antitrypsin deficiency. Decompensated cirrhosis (Child Pugh >A). Ongoing hepatocellular carcinoma (suggestive imaging study or alpha-fetoprotein (AFP) >50 ng/mL). Hepatitis B or Human Immunodeficiency Virus (HIV1 or HIV2) co-infection. Clinically relevant ECG abnormalities on screening or baseline 12-lead ECG, e.g., QTc interval (QTcB or QTcF > 450 ms in males and > 470 ms in females); Notable resting bradycardia (HR < 40 bpm); Any other significant abnormality suggestive of structural heart disease. Family history of congenital long QT syndrome. Clinically significant abnormalities on ophthalmic examination. Major uncontrolled psychiatric illness. Minor or situational depressions are allowed. History of hemoglobinopathy (e.g., thalassemia) or any other cause of or tendency to hemolysis (e.g., G-6-PD deficiency). Active illicit drug or alcohol abuse. Serious co-morbid conditions such as: heart failure, significant coronary heart disease, chronic obstructive pulmonary disease, poorly controlled diabetes, autoimmune disorders and any malignant diseases (except in situ carcinomas or basal cell carcinoma) in the previous 5 years. Patients with chronic renal insufficiency, creatinine clearance < 50 mL/minute and/or undergoing haemodialysis. Patients with porphyria or psoriasis. Ongoing concomitant treatment with azathioprine, digoxin or medications known to prolong QT interval. History of organ transplantation. Pregnancy, breast-feeding or unwillingness to practice double contraception or abstinence by the subject of childbearing potential or partner. Concurrent participation in any other clinical study or within 180 days 20.Patients with inability to communicate well with the Investigators and staff (i.e., language problem, poor mental development or impaired cerebral function) or any other condition that in the opinion of the Investigator will place the patient at risk or prevent protocol compliance. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stanislas Pol, MD
Organizational Affiliation
Cochin Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Marc Bourliere, MD
Organizational Affiliation
S.Joseph Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital St. Joseph
City
Marseille
Country
France
Facility Name
Cochin Hospital
City
Paris
Country
France

12. IPD Sharing Statement

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Efficacy, Safety and Tolerability of Ribavirin Monotherapy Followed by Combined Treatment With Ribavirin and Hydroxychloroquine in Patients Infected With Hepatitis C

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