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IdB 1016 Treatment for Hepatitis C Disease

Primary Purpose

Hepatitis C, Chronic

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
IdB 1016
Sponsored by
National Center for Complementary and Integrative Health (NCCIH)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C, Chronic focused on measuring Complementary Therapies, IdB 1016, Silybin, Antioxidant, Hepatitis C Virus, Phosphatidylcholine

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: HCV infection according to ELISA-2 Detectable HCV RNA PCR as measured within the previous 6 months Poor responders to, inadequate candidates for, or unwilling to use interferon-based therapies Serum ALT >= 1.3 times above normal Persistently elevated serum ALT levels according to two measures in the previous 12 months Evidence of stage II (periportal fibrosis), III (bridging fibrosis), or IV (compensated cirrhosis) in the Batts-Ludwig scoring system according to a liver biopsy performed in the last 2 (stage II and III patients) to 5 (stage IV patients) years. Patients with clinical signs of compensated cirrhosis (portal hypertension, non-bleeding varices) do not require a biopsy. Able and willing to follow protocol directions for the duration of the study Able and willing to maintain a consistent lifestyle routine (e.g., diet, exercise, medications, and dietary supplements) and sleep schedule for the duration of the study Able and willing to stop taking dietary supplements outside the study protocol for the duration of the study Able and willing to practice two methods of contraception during the study period, including the 4 week follow-up. This applies to women with childbearing potential and men whose sexual partners have childbearing potential. Exclusion Criteria: Pregnant or breastfeeding Liver synthetic dysfunction (albumin < 3.2 g/dL, total bilirubin > 3.0 mg/dL, prothrombin time > 1.5 seconds prolonged) History of ascites, variceal bleeding, encephalopathy, jaundice, or extrahepatic biliary obstruction History of uncontrolled diabetes mellitus Known concomitant acute or chronic viral liver infections (e.g., hepatitis A, hepatitis B, Epstein-Barr, or cytomegalovirus) Concomitant autoimmune and inflammatory disease (e.g., rheumatoid arthritis, lupus) Other types of concomitant liver disease HIV-1 coinfection Chronic use of hepatotoxic drugs (e.g., acetaminophen) Interferon-based therapies in the past 6 months Alcohol consumption within 3 months prior to entry. Patients with a history of alcohol abuse should be at least 2 years into recovery. Use of recreational oral or IV drugs. Patients with a history of drug addiction should be at least 2 years into recovery. History of untreated malignancy Remission from previous malignant neoplasms <= 6 months History of significant renal, endocrine, cardiac, or pulmonary disease Use of supplements containing compounds derived from milk thistle Proven allergy to milk thistle or any derived compounds Subjects taking warfarin or coumadin due to silybin's potential interactions with cytochrome CYP 29C Any condition or concomitant medication or supplement that could hinder the outcomes of the study or the safety of the patient as determined by the principal investigator

Sites / Locations

  • University of Washington Medical Center

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
March 3, 2003
Last Updated
August 17, 2006
Sponsor
National Center for Complementary and Integrative Health (NCCIH)
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1. Study Identification

Unique Protocol Identification Number
NCT00055445
Brief Title
IdB 1016 Treatment for Hepatitis C Disease
Official Title
IdB 1016 in Hepatitis C
Study Type
Interventional

2. Study Status

Record Verification Date
July 2006
Overall Recruitment Status
Completed
Study Start Date
November 2003 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
April 2006 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
National Center for Complementary and Integrative Health (NCCIH)

4. Oversight

5. Study Description

Brief Summary
This study will measure the safety and tolerability of three different doses of IdB 1016 in patients with hepatitis C disease who have not responded to or are poor candidates for interferon-based therapies. NOTE: THE STUDY WILL ONLY RECRUIT STUDY PARTICIPANTS AT UNIVERSITY OF WASHINGTON MEDICAL CENTER IN SEATTLE
Detailed Description
Results from two open label and four randomized placebo-controlled studies in patients with liver disease of diverse etiology suggest that IdB 1016 (oral silybin-phosphatidylcholine phytosome) is well tolerated and significantly improves serum liver enzyme levels. However, IdB 1016 dosing in these studies ranged from 314 mg bid to 314 mg tid, which is below Phase I doses that were well tolerated in healthy volunteers. None of the studies tested the safety and efficacy of IdB 1016 strictly in patients with chronic hepatitis C disease or measured post-treatment histologic changes. This study will be an open label, randomized, dose-finding study. There will be three arms corresponding to three different IdB 1016 doses: 314 mg, 624 mg, and 942 mg tid. Each arm will have 15 patients diagnosed with chronic hepatitis C and will be stratified to five patients with fibrosis stage II (periportal fibrosis), five patients with fibrosis stage III (bridging fibrosis), and five patients with fibrosis stage IV (compensated cirrhosis). The treatment duration will be 12 weeks. Patients will be followed for an additional 4 weeks after treatment cessation to assess residual effects of measured parameters. Patients will have clinic visits on Day -21 (screening), Day 1 (treatment initiation), Day 29, Day 57, Day 85 (end of treatment), and Day 113 (follow-up after washout).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C, Chronic
Keywords
Complementary Therapies, IdB 1016, Silybin, Antioxidant, Hepatitis C Virus, Phosphatidylcholine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
45 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
IdB 1016

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HCV infection according to ELISA-2 Detectable HCV RNA PCR as measured within the previous 6 months Poor responders to, inadequate candidates for, or unwilling to use interferon-based therapies Serum ALT >= 1.3 times above normal Persistently elevated serum ALT levels according to two measures in the previous 12 months Evidence of stage II (periportal fibrosis), III (bridging fibrosis), or IV (compensated cirrhosis) in the Batts-Ludwig scoring system according to a liver biopsy performed in the last 2 (stage II and III patients) to 5 (stage IV patients) years. Patients with clinical signs of compensated cirrhosis (portal hypertension, non-bleeding varices) do not require a biopsy. Able and willing to follow protocol directions for the duration of the study Able and willing to maintain a consistent lifestyle routine (e.g., diet, exercise, medications, and dietary supplements) and sleep schedule for the duration of the study Able and willing to stop taking dietary supplements outside the study protocol for the duration of the study Able and willing to practice two methods of contraception during the study period, including the 4 week follow-up. This applies to women with childbearing potential and men whose sexual partners have childbearing potential. Exclusion Criteria: Pregnant or breastfeeding Liver synthetic dysfunction (albumin < 3.2 g/dL, total bilirubin > 3.0 mg/dL, prothrombin time > 1.5 seconds prolonged) History of ascites, variceal bleeding, encephalopathy, jaundice, or extrahepatic biliary obstruction History of uncontrolled diabetes mellitus Known concomitant acute or chronic viral liver infections (e.g., hepatitis A, hepatitis B, Epstein-Barr, or cytomegalovirus) Concomitant autoimmune and inflammatory disease (e.g., rheumatoid arthritis, lupus) Other types of concomitant liver disease HIV-1 coinfection Chronic use of hepatotoxic drugs (e.g., acetaminophen) Interferon-based therapies in the past 6 months Alcohol consumption within 3 months prior to entry. Patients with a history of alcohol abuse should be at least 2 years into recovery. Use of recreational oral or IV drugs. Patients with a history of drug addiction should be at least 2 years into recovery. History of untreated malignancy Remission from previous malignant neoplasms <= 6 months History of significant renal, endocrine, cardiac, or pulmonary disease Use of supplements containing compounds derived from milk thistle Proven allergy to milk thistle or any derived compounds Subjects taking warfarin or coumadin due to silybin's potential interactions with cytochrome CYP 29C Any condition or concomitant medication or supplement that could hinder the outcomes of the study or the safety of the patient as determined by the principal investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kris V. Kowdley, M.D.
Organizational Affiliation
University of Washington
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Washington Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
1599497
Citation
Carini R, Comoglio A, Albano E, Poli G. Lipid peroxidation and irreversible damage in the rat hepatocyte model. Protection by the silybin-phospholipid complex IdB 1016. Biochem Pharmacol. 1992 May 28;43(10):2111-5. doi: 10.1016/0006-2952(92)90168-i.
Results Reference
background
PubMed Identifier
7488251
Citation
Comoglio A, Tomasi A, Malandrino S, Poli G, Albano E. Scavenging effect of silipide, a new silybin-phospholipid complex, on ethanol-derived free radicals. Biochem Pharmacol. 1995 Oct 12;50(8):1313-6. doi: 10.1016/0006-2952(95)02001-s.
Results Reference
background
PubMed Identifier
1287266
Citation
Conti M, Malandrino S, Magistretti MJ. Protective activity of silipide on liver damage in rodents. Jpn J Pharmacol. 1992 Dec;60(4):315-21. doi: 10.1254/jjp.60.315.
Results Reference
background
PubMed Identifier
11054841
Citation
Edwards J, Grange LL, Wang M, Reyes E. Fetoprotectivity of the flavanolignan compound siliphos against ethanol-induced toxicity. Phytother Res. 2000 Nov;14(7):517-21. doi: 10.1002/1099-1573(200011)14:73.0.co;2-w.
Results Reference
background
PubMed Identifier
8149949
Citation
Morazzoni P, Montalbetti A, Malandrino S, Pifferi G. Comparative pharmacokinetics of silipide and silymarin in rats. Eur J Drug Metab Pharmacokinet. 1993 Jul-Sep;18(3):289-97. doi: 10.1007/BF03188811.
Results Reference
background
PubMed Identifier
1499596
Citation
Morazzoni P, Magistretti MJ, Giachetti C, Zanolo G. Comparative bioavailability of Silipide, a new flavanolignan complex, in rats. Eur J Drug Metab Pharmacokinet. 1992 Jan-Mar;17(1):39-44. doi: 10.1007/BF03189986. Erratum In: Eur J Drug Metab Pharmacokinet 1992 Apr-Jun;17(2):165.
Results Reference
background
PubMed Identifier
2074043
Citation
Comoglio A, Leonarduzzi G, Carini R, Busolin D, Basaga H, Albano E, Tomasi A, Poli G, Morazzoni P, Magistretti MJ. Studies on the antioxidant and free radical scavenging properties of IdB 1016 a new flavanolignan complex. Free Radic Res Commun. 1990;11(1-3):109-15. doi: 10.3109/10715769009109673.
Results Reference
background
PubMed Identifier
2088770
Citation
Barzaghi N, Crema F, Gatti G, Pifferi G, Perucca E. Pharmacokinetic studies on IdB 1016, a silybin- phosphatidylcholine complex, in healthy human subjects. Eur J Drug Metab Pharmacokinet. 1990 Oct-Dec;15(4):333-8. doi: 10.1007/BF03190223.
Results Reference
background
PubMed Identifier
7924893
Citation
Schandalik R, Perucca E. Pharmacokinetics of silybin following oral administration of silipide in patients with extrahepatic biliary obstruction. Drugs Exp Clin Res. 1994;20(1):37-42.
Results Reference
background
PubMed Identifier
1329780
Citation
Schandalik R, Gatti G, Perucca E. Pharmacokinetics of silybin in bile following administration of silipide and silymarin in cholecystectomy patients. Arzneimittelforschung. 1992 Jul;42(7):964-8.
Results Reference
background
PubMed Identifier
8225695
Citation
Buzzelli G, Moscarella S, Giusti A, Duchini A, Marena C, Lampertico M. A pilot study on the liver protective effect of silybin-phosphatidylcholine complex (IdB1016) in chronic active hepatitis. Int J Clin Pharmacol Ther Toxicol. 1993 Sep;31(9):456-60.
Results Reference
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IdB 1016 Treatment for Hepatitis C Disease

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