Study of CTS-1027 in Combination With Pegylated Interferon and Ribavirin in Hepatitis C Virus (HCV) Null-Responders (CTS-1027-04)
Hepatitis C

About this trial
This is an interventional treatment trial for Hepatitis C focused on measuring HCV, Null Responder
Eligibility Criteria
Inclusion Criteria:
- Male or female patients of minimum adult legal age (according to local laws for signing the informed consent document), able to provide written informed consent, and understand and comply with the requirements of the trial
HCV genotype 1 infected null responders to prior therapy comprised of pegylated interferon and ribavirin (standard of care, SOC) defined as:
- Failure to achieve an early virologic response (< 2 log decline in HCV-RNA by Week 12), or
- If Week 12 HCV-RNA was not obtained but Week 24 was obtained, Week 24 response was < 2 log decline
- Alpha-fetoprotein (AFP) <= 50 ng/mL
- Hemoglobin ≥ 12 g/dL, platelet count ≥ 125 x 10^9/L, and white blood cell count ≥ 1.5 x 10^9/L
- In the opinion of the Principal Investigator, the patient met the 80%/80%/80% rule during the previous pegylated interferon and ribavirin therapy (i.e., received at least 80% of the pegylated interferon and ribavirin doses, at least 80% of the dose size, for at least 80% of the treatment duration)
- Willingness to utilize two reliable forms of contraception (for both males and females of childbearing potential) from screening to at least six months after the completion of the trial.
Exclusion Criteria:
- < 2 log decline in HCV-RNA at Week 12 but > 2 log decline at any time from Week 12 to Week 24 during prior therapy with pegylated interferon and ribavirin (prior standard of care therapy)
Decompensated or severe liver disease defined by one or more of the following criteria:
- Prothrombin time 3 seconds > control
- Direct bilirubin ≥ 1.5 x ULN
- Serum albumin below normal limits
- AST or ALT > 7 x ULN at screening
Evidence of portal hypertension including:
- Varices on esophagogastroduodenoscopy (EGD) with or without a history of gastrointestinal bleeding; or
- Ascites
Cirrhosis defined by one or both of the following criteria:
- Liver biopsy showing cirrhosis
- Other clinical signs and symptoms suggestive of cirrhosis
- Hepatocellular carcinoma (HCC) or suspicion of HCC clinically or on ultrasound (or other imaging techniques)
- Clinically significant ocular findings such as retinopathy, cotton wool spots, optic nerve disorder, retinal hemorrhage, or other abnormality
- Known history or presence of human immunodeficiency virus (HIV) infection
- Co-infection with hepatitis B virus (HBV)
- If female: pregnant, lactating, or positive serum or urine pregnancy test
- Male partners of women who are currently pregnant
- Renal impairment (creatinine > 1.5 x ULN), creatinine clearance < 50 mL/min, or hepatorenal syndrome with ascites
- Hospitalization for liver disease within 60 days of screening
- History of alcohol abuse (> 50 g per day) within the past year
History of severe psychiatric disease, especially depression, characterized by:
- Suicide attempt
- Hospitalization for psychiatric disease
- Period of disability as a result of psychiatric disease
- Prior exposure to CTS-1027
- Prior triple treatment comprised of pegylated interferon, ribavirin, and protease and/or polymerase inhibitors
- History or presence of clinically concerning cardiac arrhythmias or prolongation of pre-dose QTc interval of > 450 milliseconds
- Other concomitant disease or condition likely to significantly decrease life expectancy (e.g., moderate to severe congestive heart failure) or any malignancy other than curatively treated skin cancer (basal cell or squamous cell carcinomas), unless adequately treated or in complete remission for ten or more years
- Any patient who has received any investigational drug or device within 30 days of dosing, or who is scheduled to receive another investigational drug or device during the course of this trial.
Sites / Locations
- Scripps Clinic
- VA Medical Center, San Diego
- University of Colorado Health Science Center
- South Denver Gastroenterology
- Digestive Healthcare of Georgia
- Tulane University Health Sciences Center
- Henry Ford Medical Center-Columbus
- MN Clinical Research Center
- St. Louis University
- Consultants of Clinical Research, Ohio GI and Liver Institute
- Advanced Liver Therapies - Baylor College of Medicine
- VA Medical Center, Houston
- University of Utah Health Science Center
- Liver Institute of Virginia
- Fundacion de Investigacion de Diego
Arms of the Study
Arm 1
Experimental
CTS-1027, Peg IFN, Ribavirin
Study drug (CTS-1027) plus Standard of Care treatment (pegylated interferon and ribavirin). CTS-1027, 15 mg taken twice daily. Pegylated interferon, 180 μg injected once a week. Ribavirin, 1000 mg or 1200 mg daily (depending on patient weight), taken in two divided doses.