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HepNet Pilot Trial: Multicenter Trial for the Treatment of Chronic Hepatitis E With Sofosbuvir (SofE)

Primary Purpose

Hepatitis E, Hepatitis Chronic Viral

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Sofosbuvir
Sponsored by
Hannover Medical School
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis E focused on measuring Hepatitis E

Eligibility Criteria

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

Inclusion Criteria:

  1. Willing and able to provide written informed consent
  2. Male or female, age ≥ 18 years
  3. Confirmation of chronic HEV infection documented by: Positive HEV RNA at least 3 months before Screening, and positive for HEV RNA at the time of Screening
  4. Documented previous ribavirin therapy or documented contraindication for full dose (≥ 600mg qd) ribavirin monotherapy for at least 3 months
  5. Body mass index (BMI) ≥ 18 kg/m2
  6. Screening ECG without clinically significant abnormalities
  7. Subjects must have the following laboratory parameters at screening:

    • Platelets ≥ 60,000/μL
    • INR ≤2.0 x ULN unless subject has known hemophilia or is stable on an anticoagulant regimen affecting INR
    • HbA1c ≤ 10%
    • Creatinine clearance (CLcr) ≥ 30 mL/min, as calculated by the Cockcroft-Gault equation (using actual body weight)
  8. Subject has not been treated with any investigational drug or device within 42 days of the Screening visit
  9. A negative serum pregnancy test is required for female subjects (unless surgically sterile or women ≥ 54 years of age with cessation for 24 ≥ months of previously occurring menses).

    Complete abstinence from intercourse. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) is not permitted.

    Or

    Consistent and correct use of 1 of the following methods of birth control listed below, in addition to a male partner who correctly uses a condom, from the date of Screening until 30 days after last dose of study drug:

    • intrauterine device (IUD) with a failure rate of < 1% per year
    • female barrier method: cervical cap or diaphragm with spermicidal agent
    • tubal sterilization
    • vasectomy in male partner
    • hormone-containing contraceptive:

      • implants of levonorgestrel
      • injectable progesterone
      • oral contraceptives (either combined or progesterone only)
      • contraceptive vaginal ring
      • transdermal contraceptive patch
  10. Subject must be able to comply with the dosing instructions for study drug administration and be able to complete the study schedule of assessments.

Exclusion Criteria:

  1. Clinically-significant illness (other than HEV) or any other major medical disorder that, in the opinion of the investigator, may interfere with subject treatment, assessment or compliance with the protocol.
  2. Ribavirin administration within the last 28 days.
  3. Infection with the hepatitis C virus (defined as HCV RNA positive)
  4. Gastrointestinal disorder or post-operative condition that could interfere with the absorption of the study drug (for example, gastric bypass or severe ulcerative colitis).
  5. Difficulty with blood collection and/or poor venous access for the purposes of phlebotomy.
  6. Psychiatric hospitalization, suicide attempt, and/or a period of disability as a result of their psychiatric illness within the last 2 years. Subjects with psychiatric illness that is wellcontrolled on a stable treatment regimen for at least 12 months prior to screening or has not required medication in the last 12 months may be included.
  7. Significant drug allergy (such as anaphylaxis or hepatotoxicity).
  8. Pregnant or nursing female
  9. Clinically-relevant drug or alcohol abuse within 12 months of screening including any uncontrolled drug use within 6 months of screening. A positive drug screen will exclude subjects unless it can be explained by a prescribed medication; the diagnosis and prescription must be approved by the investigator. Uncontrolled users of intravenous drugs will not be permitted to enroll in the study.
  10. Use of any prohibited concomitant medications within 21 days of the Baseline/Day 1 visit.

    Use of Amiodaron as concomitant medication is prohibited within 60 days of Baseline/Day1 visit.

  11. Known hypersensitivity to SOF or formulation excipients.

Sites / Locations

  • Hannover Medical School, Clinic for Gastroenterology, Hepatology, and Endocrinology
  • Charité, Campus Virchow-Klinikum, Medical Department, Division of Hepatology and Gastroenterology
  • University Medical Center Hamburg-Eppendorf, Center for Internal Medicine, I. Medical Clinic and Polyclinic

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sofosbuvir

Arm Description

Sofosbuvir 400 MG film-coated tablet, oral administration of one tablet once daily for 24 weeks.

Outcomes

Primary Outcome Measures

Proportion of subjects who become HEV RNA negative after 24 weeks of therapy
Measured by the proportion of subjects who become HEV RNA negative (HEV RNA undetectable)

Secondary Outcome Measures

Proportion of subjects who are HEV RNA negative 12 weeks after discontinuation of therapy
Viral load measurement
Additional efficacy evaluations include HEV RNA change from baseline during therapy
Viral load and laboratory measurements
Comparison of proportion of patients who are HEV RNA negative after rapid or slow decline of HEV viral load after 24 weeks of therapy
Viral load measurement
Proportion of subject who reached ALT normalization after 12 weeks and 24 weeks of therapy and 12 weeks after discontinuation of therapy
Laboratory measurement
Assessment of safety: Adverse events and safety laboratory tests will be collected throughout the study
Collection of adverse events and safety laboratory tests

Full Information

First Posted
September 12, 2017
Last Updated
March 7, 2019
Sponsor
Hannover Medical School
Collaborators
HepNet Study House, German Liverfoundation, Gilead Sciences, German Center for Infection Research
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1. Study Identification

Unique Protocol Identification Number
NCT03282474
Brief Title
HepNet Pilot Trial: Multicenter Trial for the Treatment of Chronic Hepatitis E With Sofosbuvir (SofE)
Official Title
HepNet Pilot Trial: Multicenter Trial for the Treatment of Chronic Hepatitis E With Sofosbuvir (SofE)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
December 7, 2017 (Actual)
Primary Completion Date
November 26, 2018 (Actual)
Study Completion Date
February 18, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hannover Medical School
Collaborators
HepNet Study House, German Liverfoundation, Gilead Sciences, German Center for Infection Research

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
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
This is a single arm multicenter pilot study to provide preliminary evidence whether sofosbuvir (SOF) is efficacious and can be safely used in patients with chronic Hepatitis E virus infection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis E, Hepatitis Chronic Viral
Keywords
Hepatitis E

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Prospective, open-label, single-arm multicenter, phase II pilot trial
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sofosbuvir
Arm Type
Experimental
Arm Description
Sofosbuvir 400 MG film-coated tablet, oral administration of one tablet once daily for 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Sofosbuvir
Other Intervention Name(s)
Sovaldi
Intervention Description
Sofosbuvir 400 MG Oral Tablet [Sovaldi]
Primary Outcome Measure Information:
Title
Proportion of subjects who become HEV RNA negative after 24 weeks of therapy
Description
Measured by the proportion of subjects who become HEV RNA negative (HEV RNA undetectable)
Time Frame
after 24 weeks of therapy
Secondary Outcome Measure Information:
Title
Proportion of subjects who are HEV RNA negative 12 weeks after discontinuation of therapy
Description
Viral load measurement
Time Frame
12 weeks after discontinuation of therapy (week 36)
Title
Additional efficacy evaluations include HEV RNA change from baseline during therapy
Description
Viral load and laboratory measurements
Time Frame
after 2 days, 4 days, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks,16 weeks, 20 weeks, and 24 weeks of therapy
Title
Comparison of proportion of patients who are HEV RNA negative after rapid or slow decline of HEV viral load after 24 weeks of therapy
Description
Viral load measurement
Time Frame
after 24 weeks of therapy
Title
Proportion of subject who reached ALT normalization after 12 weeks and 24 weeks of therapy and 12 weeks after discontinuation of therapy
Description
Laboratory measurement
Time Frame
after 12 and 24 weeks of therapy and 12 weeks after discontinuation of therapy (week 36)
Title
Assessment of safety: Adverse events and safety laboratory tests will be collected throughout the study
Description
Collection of adverse events and safety laboratory tests
Time Frame
through study completion, an average of 36 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent Male or female, age ≥ 18 years Confirmation of chronic HEV infection documented by: Positive HEV RNA at least 3 months before Screening, and positive for HEV RNA at the time of Screening Documented previous ribavirin therapy or documented contraindication for full dose (≥ 600mg qd) ribavirin monotherapy for at least 3 months Body mass index (BMI) ≥ 18 kg/m2 Screening ECG without clinically significant abnormalities Subjects must have the following laboratory parameters at screening: Platelets ≥ 60,000/μL INR ≤2.0 x ULN unless subject has known hemophilia or is stable on an anticoagulant regimen affecting INR HbA1c ≤ 10% Creatinine clearance (CLcr) ≥ 30 mL/min, as calculated by the Cockcroft-Gault equation (using actual body weight) Subject has not been treated with any investigational drug or device within 42 days of the Screening visit A negative serum pregnancy test is required for female subjects (unless surgically sterile or women ≥ 54 years of age with cessation for 24 ≥ months of previously occurring menses). Complete abstinence from intercourse. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) is not permitted. Or Consistent and correct use of 1 of the following methods of birth control listed below, in addition to a male partner who correctly uses a condom, from the date of Screening until 30 days after last dose of study drug: intrauterine device (IUD) with a failure rate of < 1% per year female barrier method: cervical cap or diaphragm with spermicidal agent tubal sterilization vasectomy in male partner hormone-containing contraceptive: implants of levonorgestrel injectable progesterone oral contraceptives (either combined or progesterone only) contraceptive vaginal ring transdermal contraceptive patch Subject must be able to comply with the dosing instructions for study drug administration and be able to complete the study schedule of assessments. Exclusion Criteria: Clinically-significant illness (other than HEV) or any other major medical disorder that, in the opinion of the investigator, may interfere with subject treatment, assessment or compliance with the protocol. Ribavirin administration within the last 28 days. Infection with the hepatitis C virus (defined as HCV RNA positive) Gastrointestinal disorder or post-operative condition that could interfere with the absorption of the study drug (for example, gastric bypass or severe ulcerative colitis). Difficulty with blood collection and/or poor venous access for the purposes of phlebotomy. Psychiatric hospitalization, suicide attempt, and/or a period of disability as a result of their psychiatric illness within the last 2 years. Subjects with psychiatric illness that is wellcontrolled on a stable treatment regimen for at least 12 months prior to screening or has not required medication in the last 12 months may be included. Significant drug allergy (such as anaphylaxis or hepatotoxicity). Pregnant or nursing female Clinically-relevant drug or alcohol abuse within 12 months of screening including any uncontrolled drug use within 6 months of screening. A positive drug screen will exclude subjects unless it can be explained by a prescribed medication; the diagnosis and prescription must be approved by the investigator. Uncontrolled users of intravenous drugs will not be permitted to enroll in the study. Use of any prohibited concomitant medications within 21 days of the Baseline/Day 1 visit. Use of Amiodaron as concomitant medication is prohibited within 60 days of Baseline/Day1 visit. Known hypersensitivity to SOF or formulation excipients.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Markus Cornberg, Prof. Dr.
Organizational Affiliation
Hannover Medical School, Clinic for Gastroenterology, Hepatology, and Endocrinology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hannover Medical School, Clinic for Gastroenterology, Hepatology, and Endocrinology
City
Hanover
State/Province
Lower Saxony
ZIP/Postal Code
30625
Country
Germany
Facility Name
Charité, Campus Virchow-Klinikum, Medical Department, Division of Hepatology and Gastroenterology
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
University Medical Center Hamburg-Eppendorf, Center for Internal Medicine, I. Medical Clinic and Polyclinic
City
Hamburg
ZIP/Postal Code
20246
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32624195
Citation
Cornberg M, Pischke S, Muller T, Behrendt P, Piecha F, Benckert J, Todt D, Steinmann E, Papkalla A, von Karpowitz M, Koch A, Lohse A, Hardtke S, Manns MP, Wedemeyer H. Sofosbuvir monotherapy fails to achieve HEV RNA elimination in patients with chronic hepatitis E - The HepNet SofE pilot study. J Hepatol. 2020 Sep;73(3):696-699. doi: 10.1016/j.jhep.2020.05.020. Epub 2020 Jul 2. No abstract available.
Results Reference
derived

Learn more about this trial

HepNet Pilot Trial: Multicenter Trial for the Treatment of Chronic Hepatitis E With Sofosbuvir (SofE)

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