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Paroxetine for the Treatment of Interferon Related Side Effects for Hepatitis C

Primary Purpose

Hepatitis C, Depression, Interferon-alpha Associated Side Effects

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
paroxetine
Sponsored by
Emory University
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hepatitis C focused on measuring Hepatitis C, Interferon-alpha associated side effects, Antidepressants, Prevention

Eligibility Criteria

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

Inclusion Criteria: age 18-65 years including males, females and minorities serum positive for either anti-HCV antibodies or HCV-RNA positive by PCR compensated liver disease with the following minimum hematologic and biochemical criteria: hemoglobin 3 g/dl for males; 12 g/dl for females, white blood cell count > 3,000/mm3, neutrophil count >1,5000/mm3, platelets > 100,000/mm3, prothrombin time 2 seconds prolonged compared to control, or equivalent INR ratio, albumin stable and within normal limits, serum creatinine within normal limits, thyroid-stimulating hormone (TSH) within normal limits, direct bilirubin 0.3 mg/dl or within 20% of upper limit of normal (ULN) for local laboratory, indirect bilirubin 0.8 mg/dl or within 20% of ULN for local laboratory, fasting blood sugar 115 mg/dl or within 20% of ULN for non-diabetic patients serum hepatitis B surface antigen (HbsAg) negative, antinuclear antibodies (ANA) 1:320 normal pre-therapy ocular examination if a history of diabetes or hypertension hemoglobin A1C <8.5% if a history of diabetes negative pregnancy test for women of childbearing potential, and consent to adhere to adequate contraception or monogamous relationship with a male partner who has had a vasectomy during the treatment period and for 6 months after discontinuation of therapy not breast feeding documentation and confirmation of adequate contraception in sexually active males free from all psychotropic medications for a minimum of 14 days prior to baseline visit (8 weeks for fluoxetine) Exclusion Criteria: actively meet criteria for major depression within the past six months active, effective treatment of depression with an antidepressant within the past three months meet criteria for schizophrenia or bipolar disorder (mania) past or present actively meet DSM IV criteria for substance abuse/dependence within the past six months psychotropic medications within 14 days prior to baseline visit (8 weeks for fluoxetine) evidence of untreated or poorly controlled endocrine, cardiovascular, hematological, renal, or neurological disease evidence of decompensated liver disease (such as a history or presence of ascites, bleeding varices, spontaneous encephalopathy) history of CNS trauma or active seizure disorder requiring medication any cause for liver disease other than chronic hepatitis C, such as co-infection with hepatitis B virus and/or human immunodeficiency virus, hemochromatosis, or Wilson's disease prior treatment with other (other than IFN-alpha or ribavirin) immunomodulatory drugs, including corticosteroids within 6 months of entry into protocol clinical gout known hypersensitivity to alpha interferon or ribavirin hemoglobinopathies (e.g. thalassemia) a positive pregnancy test clinically significant retinal abnormalities organ transplants a score of <24 on the Mini Mental Status Exam (MMSE) prior history of severe adverse events associated with paroxetine any other condition which in the opinion of the investigator would make the patient unsuitable for enrollment, or could interfere with participating in or completing the protocol

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Depressive Symptom Scores
    Development of Major Depression

    Secondary Outcome Measures

    neurotoxicity
    dosage reduction
    discontinuation

    Full Information

    First Posted
    September 14, 2005
    Last Updated
    April 7, 2016
    Sponsor
    Emory University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00209118
    Brief Title
    Paroxetine for the Treatment of Interferon Related Side Effects for Hepatitis C
    Official Title
    Paroxetine for the Prevention of IFN-Alpha Associated Depression in Patients With Chronic Hepatitis C
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2016
    Overall Recruitment Status
    Completed
    Study Start Date
    undefined (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    July 2005 (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Emory University

    4. Oversight

    5. Study Description

    Brief Summary
    A.OVERVIEW This is a 26 week study examining the ability of paroxetine (Paxil) to prevent the development of depression and neurotoxicity in patients receiving either 3 million units of subcutaneous IFN(interferon-alpha-2b) 3 times/week (plus ribavirin, 1000-1200 mg/d)) or PEG (polyethylene glycol) interferon-alpha-2b (1.5 micrograms/kg one time a week) and ribavirin (800 to 1,400 mg a day) for chronic hepatitis C (CHC). The IFN plasma half life (t1/2 of 24 to 34 hours) of PEG, a CHC treatment recently approved by the FDA, is significantly prolonged allowing for once a week dosing. Studies indicate that the side effect profile of the two forms of IFN-alpha treatment are very similar. CHC patients will be screened for study eligibility, and a total of 100 CHC patients between the ages of 18 and 65 years old will be enrolled across three sites (30 at Emory site and a combination of 30 from the University of Pennsylvania, Rush-Presbyterian-Saint Lukes Medical Center in Chicago and Montefiore Medical Center in New York.) Two weeks prior to treatment with subcutaneous IFN-alpha-2b, patients who meet inclusion and exclusion criteria will be stratified on the basis of a history of major depression and then randomly assigned to paroxetine or placebo in double blind fashion.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hepatitis C, Depression, Interferon-alpha Associated Side Effects
    Keywords
    Hepatitis C, Interferon-alpha associated side effects, Antidepressants, Prevention

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Double
    Allocation
    Randomized
    Enrollment
    60 (false)

    8. Arms, Groups, and Interventions

    Intervention Type
    Drug
    Intervention Name(s)
    paroxetine
    Primary Outcome Measure Information:
    Title
    Depressive Symptom Scores
    Title
    Development of Major Depression
    Secondary Outcome Measure Information:
    Title
    neurotoxicity
    Title
    dosage reduction
    Title
    discontinuation

    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: age 18-65 years including males, females and minorities serum positive for either anti-HCV antibodies or HCV-RNA positive by PCR compensated liver disease with the following minimum hematologic and biochemical criteria: hemoglobin 3 g/dl for males; 12 g/dl for females, white blood cell count > 3,000/mm3, neutrophil count >1,5000/mm3, platelets > 100,000/mm3, prothrombin time 2 seconds prolonged compared to control, or equivalent INR ratio, albumin stable and within normal limits, serum creatinine within normal limits, thyroid-stimulating hormone (TSH) within normal limits, direct bilirubin 0.3 mg/dl or within 20% of upper limit of normal (ULN) for local laboratory, indirect bilirubin 0.8 mg/dl or within 20% of ULN for local laboratory, fasting blood sugar 115 mg/dl or within 20% of ULN for non-diabetic patients serum hepatitis B surface antigen (HbsAg) negative, antinuclear antibodies (ANA) 1:320 normal pre-therapy ocular examination if a history of diabetes or hypertension hemoglobin A1C <8.5% if a history of diabetes negative pregnancy test for women of childbearing potential, and consent to adhere to adequate contraception or monogamous relationship with a male partner who has had a vasectomy during the treatment period and for 6 months after discontinuation of therapy not breast feeding documentation and confirmation of adequate contraception in sexually active males free from all psychotropic medications for a minimum of 14 days prior to baseline visit (8 weeks for fluoxetine) Exclusion Criteria: actively meet criteria for major depression within the past six months active, effective treatment of depression with an antidepressant within the past three months meet criteria for schizophrenia or bipolar disorder (mania) past or present actively meet DSM IV criteria for substance abuse/dependence within the past six months psychotropic medications within 14 days prior to baseline visit (8 weeks for fluoxetine) evidence of untreated or poorly controlled endocrine, cardiovascular, hematological, renal, or neurological disease evidence of decompensated liver disease (such as a history or presence of ascites, bleeding varices, spontaneous encephalopathy) history of CNS trauma or active seizure disorder requiring medication any cause for liver disease other than chronic hepatitis C, such as co-infection with hepatitis B virus and/or human immunodeficiency virus, hemochromatosis, or Wilson's disease prior treatment with other (other than IFN-alpha or ribavirin) immunomodulatory drugs, including corticosteroids within 6 months of entry into protocol clinical gout known hypersensitivity to alpha interferon or ribavirin hemoglobinopathies (e.g. thalassemia) a positive pregnancy test clinically significant retinal abnormalities organ transplants a score of <24 on the Mini Mental Status Exam (MMSE) prior history of severe adverse events associated with paroxetine any other condition which in the opinion of the investigator would make the patient unsuitable for enrollment, or could interfere with participating in or completing the protocol
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Andrew H. Miller, MD
    Organizational Affiliation
    Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    17451562
    Citation
    Raison CL, Woolwine BJ, Demetrashvili MF, Borisov AS, Weinreib R, Staab JP, Zajecka JM, Bruno CJ, Henderson MA, Reinus JF, Evans DL, Asnis GM, Miller AH. Paroxetine for prevention of depressive symptoms induced by interferon-alpha and ribavirin for hepatitis C. Aliment Pharmacol Ther. 2007 May 15;25(10):1163-74. doi: 10.1111/j.1365-2036.2007.03316.x.
    Results Reference
    derived

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    Paroxetine for the Treatment of Interferon Related Side Effects for Hepatitis C

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