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Grazoprevir/Elbasvir for Treatment of Hepatitis C Virus Genotype 4 Post Kidney Transplant

Primary Purpose

Hepatitis C

Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Grazoprevir/Elbasvir
Sponsored by
King Faisal Specialist Hospital & Research Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C

Eligibility Criteria

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

Inclusion Criteria:

In order to be eligible for participation in this trial, the subject must be:

  • Male or female > 18 years on the day of consent signature.
  • Post renal transplant with stable graft function divided into 2 groups according to Creatinine Clearance (CrCl <30 mL/min Or CrCl ≥30 mL/min).
  • Positive HCV infection post renal transplant defined as: Positive HCV RNA with documented HCV Genotype 4 (including those with mixed infections with Genotype 4 & Genotype 1 or Genotype 4 & Genotype 6).
  • Fibro scan (Liver Elastography) performed prior to the baseline with evidence of chronic HCV infection.
  • Liver Cirrhosis subjects may be included but will be limited to those with compensated liver disease (Child Pugh-A)
  • Patient understands the study procedures, alternative treatments available, risks involved with the study and voluntarily agree to participate by giving written informed consent.
  • Reproductive potential patient agrees to avoid becoming pregnant or impregnating a partner until at least 6 months after the last dose of medication. Acceptable methods of contraception (IUD or contraceptive rod implanted into the skin may, or combination of two: diaphragm with spermicide (cannot be used in conjunction with cervical cap/spermicide); cervical cap with spermicide (women only), male condom or female condom (cannot be used together), oral contraceptive pills: estrogen/progestine or progestin-only pill, contraceptive skin patch, vaginal contraceptive ring, or subcutaneous contraceptive injection. Abstinence can be used as a sole method of contraception if it is consistently employed and considered acceptable by the patient and Institutional Review Board.

Exclusion Criteria:

The subject must be excluded from participating in the trial if the subject:

  • Is under the age of legal consent, is mentally or legally incapacitated, has significant emotional problems at the time of pre-study screening visit or expected during the conduct of the study or has a history of a clinically significant psychiatric disorder which, in the opinion of the investigator, would interfere with the study procedures.
  • Is infected with HCV Genotypes 1,2,3,5 or 6 except those with Genotype 1 or 6 with mixed infection with Genotype 4.
  • Is co-infected with Hepatitis B Virus or HIV.
  • Has evidence of decompensated liver disease manifested by the presence of or history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy or other signs or symptoms of advanced liver disease (Child Pugh-B or Child Pugh-C based on a platelet count below 75000 or an albumin below 3 g/dL)
  • Pregnant or nursing female or male patient with pregnant female partner.
  • Contraindications for Grazoprevir/Elbasvir.
  • Is currently participating or has participated in a study with an investigational compound within 30 days of signing informed consent and is not willing to refrain from participating in another such study during the course of this study.
  • Has any condition or pre-study laboratory abnormality, ECG abnormality, or history of any illness, which, according to the opinion of the investigator, might confound the results of the study or pose additional risk in administering the study drugs to the subject.
  • Patient has not signed informed consent form

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Treatment Group

    Arm Description

    This is a prospective, interventional, case-control study at King Faisal Specialist Hospital & Research Centre in post-renal transplant patients who are receiving Grazoprevir/Elbasvir combination. Data will be compared with matched historical controls, which will be selected according to the following matching criteria: age, time from transplant to initiation of therapy. Only patients who completed at least 48 weeks of pegylated Interferon + Ribavirin therapy in the control group and 12 weeks of therapy on the case group will be enrolled. Any patient who received at least one dose of Grazoprevir/Elbasvir combination will be included in the safety analysis.

    Outcomes

    Primary Outcome Measures

    Percentage of participants achieving sustained virologic response at 12 weeks after the end of all treatment (SVR12)
    SVR12 was defined as HCV RNA below the lower limit of quantification (<LLOQ) at 12 weeks after the end of all study therapy. The primary efficacy hypothesis for this study is that the percentage of participants with Hepatitis C Virus (HCV) Genotype 4 post renal transplant achieving SVR12 with Grazoprevir/Elbasvir combination

    Secondary Outcome Measures

    Percentage of participants with change in circulating HCV RNA during treatment and after treatment discontinuation as compared to baseline.
    Hepatitis C viral load refers to the amount of hepatitis C virus in a person's blood. The results of this test (known as a viral RNA test or HCV RNA test) are usually expressed as International Units/mL (IU/mL) or RNA copies/mL. The percentage of participants with change in circulating HCV RNA during treatment and after treatment discontinuation as compared to baseline will be reported.
    Percentage of participants with a decrease, no change, or increase between baseline and post treatment week 12 in kidney function as measured by Estimated Glomerular Filtration Rate and Albumin Creatinine Ratio (ACR)
    Any worsening of a preexisting condition related to kidney function that was associated with the use of Elbasvir/Grazoprevir. The Percentage of participants with a decrease, no change, or increase between baseline and post treatment week 12 in kidney function as measured by Estimated Glomerular Filtration Rate and Albumin Creatinine Ratio (ACR) will be reported.
    Percentage of participants experiencing acute kidney transplant rejection compared to historical control.
    Any worsening of a preexisting condition related to kidney transplant rejection that was associated with the use of Elbasvir/Grazoprevir. The percentage of participants experiencing acute kidney transplant rejection compared to historical control will be reported.

    Full Information

    First Posted
    October 11, 2017
    Last Updated
    November 27, 2017
    Sponsor
    King Faisal Specialist Hospital & Research Center
    Collaborators
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03359746
    Brief Title
    Grazoprevir/Elbasvir for Treatment of Hepatitis C Virus Genotype 4 Post Kidney Transplant
    Official Title
    Grazoprevir/Elbasvir for Treatment of Hepatitis C Virus Genotype 4 Post Kidney Transplant
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2017
    Overall Recruitment Status
    Unknown status
    Study Start Date
    December 15, 2017 (Anticipated)
    Primary Completion Date
    October 31, 2018 (Anticipated)
    Study Completion Date
    December 31, 2018 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    King Faisal Specialist Hospital & Research Center
    Collaborators
    Merck Sharp & Dohme LLC

    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
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a prospective, interventional, case-control study at King Faisal Specialist Hospital & Research Centre in post-renal transplant patients who are receiving Grazoprevir/Elbasvir combination. Data will be compared with matched historical controls, which will be selected according to the following matching criteria: age, time from transplant to initiation of therapy. Only patients who completed at least 48 weeks of pegylated Interferon + Ribavirin therapy in the control group and 12 weeks of therapy on the case group will be enrolled. Any patient who received at least one dose of Grazoprevir/Elbasvir combination will be included in the safety analysis.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hepatitis C

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    40 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Treatment Group
    Arm Type
    Experimental
    Arm Description
    This is a prospective, interventional, case-control study at King Faisal Specialist Hospital & Research Centre in post-renal transplant patients who are receiving Grazoprevir/Elbasvir combination. Data will be compared with matched historical controls, which will be selected according to the following matching criteria: age, time from transplant to initiation of therapy. Only patients who completed at least 48 weeks of pegylated Interferon + Ribavirin therapy in the control group and 12 weeks of therapy on the case group will be enrolled. Any patient who received at least one dose of Grazoprevir/Elbasvir combination will be included in the safety analysis.
    Intervention Type
    Drug
    Intervention Name(s)
    Grazoprevir/Elbasvir
    Other Intervention Name(s)
    No other intervention
    Intervention Description
    Medication for treatment of patient
    Primary Outcome Measure Information:
    Title
    Percentage of participants achieving sustained virologic response at 12 weeks after the end of all treatment (SVR12)
    Description
    SVR12 was defined as HCV RNA below the lower limit of quantification (<LLOQ) at 12 weeks after the end of all study therapy. The primary efficacy hypothesis for this study is that the percentage of participants with Hepatitis C Virus (HCV) Genotype 4 post renal transplant achieving SVR12 with Grazoprevir/Elbasvir combination
    Time Frame
    12 weeks after end of all therapy
    Secondary Outcome Measure Information:
    Title
    Percentage of participants with change in circulating HCV RNA during treatment and after treatment discontinuation as compared to baseline.
    Description
    Hepatitis C viral load refers to the amount of hepatitis C virus in a person's blood. The results of this test (known as a viral RNA test or HCV RNA test) are usually expressed as International Units/mL (IU/mL) or RNA copies/mL. The percentage of participants with change in circulating HCV RNA during treatment and after treatment discontinuation as compared to baseline will be reported.
    Time Frame
    12 weeks during therapy
    Title
    Percentage of participants with a decrease, no change, or increase between baseline and post treatment week 12 in kidney function as measured by Estimated Glomerular Filtration Rate and Albumin Creatinine Ratio (ACR)
    Description
    Any worsening of a preexisting condition related to kidney function that was associated with the use of Elbasvir/Grazoprevir. The Percentage of participants with a decrease, no change, or increase between baseline and post treatment week 12 in kidney function as measured by Estimated Glomerular Filtration Rate and Albumin Creatinine Ratio (ACR) will be reported.
    Time Frame
    12 weeks during therapy
    Title
    Percentage of participants experiencing acute kidney transplant rejection compared to historical control.
    Description
    Any worsening of a preexisting condition related to kidney transplant rejection that was associated with the use of Elbasvir/Grazoprevir. The percentage of participants experiencing acute kidney transplant rejection compared to historical control will be reported.
    Time Frame
    12 weeks during therapy

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: In order to be eligible for participation in this trial, the subject must be: Male or female > 18 years on the day of consent signature. Post renal transplant with stable graft function divided into 2 groups according to Creatinine Clearance (CrCl <30 mL/min Or CrCl ≥30 mL/min). Positive HCV infection post renal transplant defined as: Positive HCV RNA with documented HCV Genotype 4 (including those with mixed infections with Genotype 4 & Genotype 1 or Genotype 4 & Genotype 6). Fibro scan (Liver Elastography) performed prior to the baseline with evidence of chronic HCV infection. Liver Cirrhosis subjects may be included but will be limited to those with compensated liver disease (Child Pugh-A) Patient understands the study procedures, alternative treatments available, risks involved with the study and voluntarily agree to participate by giving written informed consent. Reproductive potential patient agrees to avoid becoming pregnant or impregnating a partner until at least 6 months after the last dose of medication. Acceptable methods of contraception (IUD or contraceptive rod implanted into the skin may, or combination of two: diaphragm with spermicide (cannot be used in conjunction with cervical cap/spermicide); cervical cap with spermicide (women only), male condom or female condom (cannot be used together), oral contraceptive pills: estrogen/progestine or progestin-only pill, contraceptive skin patch, vaginal contraceptive ring, or subcutaneous contraceptive injection. Abstinence can be used as a sole method of contraception if it is consistently employed and considered acceptable by the patient and Institutional Review Board. Exclusion Criteria: The subject must be excluded from participating in the trial if the subject: Is under the age of legal consent, is mentally or legally incapacitated, has significant emotional problems at the time of pre-study screening visit or expected during the conduct of the study or has a history of a clinically significant psychiatric disorder which, in the opinion of the investigator, would interfere with the study procedures. Is infected with HCV Genotypes 1,2,3,5 or 6 except those with Genotype 1 or 6 with mixed infection with Genotype 4. Is co-infected with Hepatitis B Virus or HIV. Has evidence of decompensated liver disease manifested by the presence of or history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy or other signs or symptoms of advanced liver disease (Child Pugh-B or Child Pugh-C based on a platelet count below 75000 or an albumin below 3 g/dL) Pregnant or nursing female or male patient with pregnant female partner. Contraindications for Grazoprevir/Elbasvir. Is currently participating or has participated in a study with an investigational compound within 30 days of signing informed consent and is not willing to refrain from participating in another such study during the course of this study. Has any condition or pre-study laboratory abnormality, ECG abnormality, or history of any illness, which, according to the opinion of the investigator, might confound the results of the study or pose additional risk in administering the study drugs to the subject. Patient has not signed informed consent form
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Faisal Abaalkhail, MD
    Phone
    966114424982
    Ext
    24982
    Email
    abaalkhail@kfshrc.edu.sa
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Faisal Abaalkhail, Md
    Organizational Affiliation
    King Faisal Specialist Hospital & Research Centre, Riyadh
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

    Learn more about this trial

    Grazoprevir/Elbasvir for Treatment of Hepatitis C Virus Genotype 4 Post Kidney Transplant

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