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Thalidomide Plus Peginterferon and Ribavirin in Patients With Interferon Resistance (TRITAL)

Primary Purpose

Hepatitis C

Status
Unknown status
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
thalidomide
Sponsored by
Valme University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis C focused on measuring Thalidomide, Hepatitis C, Interferon resistance, Immunomodulators

Eligibility Criteria

45 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Men and women in non fertile age.
  • HCV RNA detectable in serum.
  • Chronic hepatitis C virus with non-cirrhotic compensated liver disease (clinical classification according to Child-Pugh Grade A) (Appendix 1).
  • Genotype 1.
  • Not responding to treatment with peginterferon alfa-2a in combination with Ribavirin.
  • Effective contraceptive measures during treatment and for 6 months after treatment.

Exclusion Criteria:

Patients with any of the following will not be selected for treatment:

  • Patients with liver biopsy compatible with cirrhosis F4 Metav classification.
  • Patients diagnosed with diabetes or basal glycemia higher than 126 mg / dl
  • Women and men of childbearing age
  • Treatment with systemic antineoplastic or immunomodulatory (including suprafisiológicas doses of steroids and radiotherapy) 6 months before the first dose of treatment.
  • Treatment with any investigational drug 6 weeks before the first dose of treatment.
  • History or other evidence of any pathology associated with chronic liver disease than HCV.
  • Signs or symptoms of hepatocellular carcinoma.
  • History or other evidence of bleeding due to esophageal varices or other conditions consistent with decompensated liver disease.
  • neutrophil count <1500 células/mm3 or platelet count <90,000 células/mm3 at Screening.
  • Hb <12 g / dL in women or <13 g / dL in men, at the time of evaluation.
  • Patients with baseline increased risk of anemia (eg thalassemia, spherocytosis, history of gastrointestinal bleeding, etc.). Or where the presence of anemia would be a medical problem.
  • Patients with documented or presumed coronary artery disease or cerebrovascular disease should not be treated if in the opinion of the investigator, could not tolerate an adequately sharp decline in hemoglobin.
  • serum creatinine> 1.5 times above the normal upper limit at the time of valuation.
  • History of severe psychiatric illness, particularly depression. Is defined as a serious psychiatric illness requiring treatment with antidepressants or major tranquilizers in therapeutic doses required for major depression or psychosis, respectively, for at least 3 months at any time before or any of the following background: attempted suicide, hospitalization due to of psychiatric illness, or period of disability due to psychiatric illness.
  • History of seizure disorder or current use of major anticonvulsants.
  • History of immune disease, chronic lung disease associated with limited functionality, serious heart disease, congestive heart failure, advanced atherosclerosis, increased organ transplant or other signs of serious disease, neoplasia, or any other condition deemed by the investigator, prevent the patient is suitable for the study.
  • A history of thyroid disease poorly controlled with medications prescribed, elevated concentrations of thyroid stimulating hormone (TSH) with increased thyroid peroxidase antibodies and any clinical manifestation of thyroid disease.
  • Pathology involving a risk of acute renal function: dehydration (diarrhea, vomiting), fever, infectious states and / or hypotonic severe (shock, sepsis, urinary infection, neuropathy).
  • Evidence of severe retinopathy (eg CMV retinitis, macular degeneration).
  • Exploration programanada radiation with intravenous administration of contrast media (IVU, angiography).
  • Evidence of drug use in the year prior to study.
  • Consumption of alcohol.
  • Inability or unwillingness to give informed consent or to comply with the requirements of the study.

Sites / Locations

  • Hospital de ValmeRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1

Arm Description

thalidomide added to peg-interferon + ribavirina

Outcomes

Primary Outcome Measures

Virological response at week 12

Secondary Outcome Measures

Sustained virological response 24 weeks after the end of therapy
Safety of using thalidomide together with SOC.

Full Information

First Posted
March 3, 2009
Last Updated
March 5, 2009
Sponsor
Valme University Hospital
Collaborators
University of Seville
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1. Study Identification

Unique Protocol Identification Number
NCT00856804
Brief Title
Thalidomide Plus Peginterferon and Ribavirin in Patients With Interferon Resistance
Acronym
TRITAL
Official Title
Usefulness of Adding Thalidomide to Peginterferon and Ribavirin in Patients With Hepatitis C and Resistance to Interferon. Phase II
Study Type
Interventional

2. Study Status

Record Verification Date
March 2009
Overall Recruitment Status
Unknown status
Study Start Date
March 2009 (undefined)
Primary Completion Date
June 2009 (Anticipated)
Study Completion Date
June 2012 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Valme University Hospital
Collaborators
University of Seville

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
INDICATION: Patients with chronic hepatitis C, genotype 1 and non-responders to standard treatment for hepatitis C. OBJECTIVES: ascertain the rate of sustained response in patients with hepatitis C, genotype 1 with peginterferon + ribavirin resistance. To know the response rate in 12 weeks Describe the tolerance and safety of thalidomide in combination with peginterferon and ribavirin. DESIGN OF TEST Pilot Study: The single arm study will: 1. Thalidomide 200 mg and peg-interferon alfa 2b (based on weight: 50-120 mcg / week) + ribavirin (based on weight: 1000-1200mg / day) Be tracked for 24 weeks after treatment. Suspended treatment of 12 weeks in patients who have failed a drop of HCV RNA> 2 log. Patients who have been suspended for any reason, the treatment will be followed during 24 weeks, to assess safety parameters. SUBJECT NUMBER: 10

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis C
Keywords
Thalidomide, Hepatitis C, Interferon resistance, Immunomodulators

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
thalidomide added to peg-interferon + ribavirina
Intervention Type
Drug
Intervention Name(s)
thalidomide
Other Intervention Name(s)
thalidomide adding to peginterferon + ribavirin
Intervention Description
Open-label pilot study analyzing the impact of adding thalidomide (200 mg/d)to SOC on 12 weeks virological response in patients with chronic hepatitis C and interferon resistance.
Primary Outcome Measure Information:
Title
Virological response at week 12
Time Frame
36 months
Secondary Outcome Measure Information:
Title
Sustained virological response 24 weeks after the end of therapy
Time Frame
36 months
Title
Safety of using thalidomide together with SOC.
Time Frame
36 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women in non fertile age. HCV RNA detectable in serum. Chronic hepatitis C virus with non-cirrhotic compensated liver disease (clinical classification according to Child-Pugh Grade A) (Appendix 1). Genotype 1. Not responding to treatment with peginterferon alfa-2a in combination with Ribavirin. Effective contraceptive measures during treatment and for 6 months after treatment. Exclusion Criteria: Patients with any of the following will not be selected for treatment: Patients with liver biopsy compatible with cirrhosis F4 Metav classification. Patients diagnosed with diabetes or basal glycemia higher than 126 mg / dl Women and men of childbearing age Treatment with systemic antineoplastic or immunomodulatory (including suprafisiológicas doses of steroids and radiotherapy) 6 months before the first dose of treatment. Treatment with any investigational drug 6 weeks before the first dose of treatment. History or other evidence of any pathology associated with chronic liver disease than HCV. Signs or symptoms of hepatocellular carcinoma. History or other evidence of bleeding due to esophageal varices or other conditions consistent with decompensated liver disease. neutrophil count <1500 células/mm3 or platelet count <90,000 células/mm3 at Screening. Hb <12 g / dL in women or <13 g / dL in men, at the time of evaluation. Patients with baseline increased risk of anemia (eg thalassemia, spherocytosis, history of gastrointestinal bleeding, etc.). Or where the presence of anemia would be a medical problem. Patients with documented or presumed coronary artery disease or cerebrovascular disease should not be treated if in the opinion of the investigator, could not tolerate an adequately sharp decline in hemoglobin. serum creatinine> 1.5 times above the normal upper limit at the time of valuation. History of severe psychiatric illness, particularly depression. Is defined as a serious psychiatric illness requiring treatment with antidepressants or major tranquilizers in therapeutic doses required for major depression or psychosis, respectively, for at least 3 months at any time before or any of the following background: attempted suicide, hospitalization due to of psychiatric illness, or period of disability due to psychiatric illness. History of seizure disorder or current use of major anticonvulsants. History of immune disease, chronic lung disease associated with limited functionality, serious heart disease, congestive heart failure, advanced atherosclerosis, increased organ transplant or other signs of serious disease, neoplasia, or any other condition deemed by the investigator, prevent the patient is suitable for the study. A history of thyroid disease poorly controlled with medications prescribed, elevated concentrations of thyroid stimulating hormone (TSH) with increased thyroid peroxidase antibodies and any clinical manifestation of thyroid disease. Pathology involving a risk of acute renal function: dehydration (diarrhea, vomiting), fever, infectious states and / or hypotonic severe (shock, sepsis, urinary infection, neuropathy). Evidence of severe retinopathy (eg CMV retinitis, macular degeneration). Exploration programanada radiation with intravenous administration of contrast media (IVU, angiography). Evidence of drug use in the year prior to study. Consumption of alcohol. Inability or unwillingness to give informed consent or to comply with the requirements of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Manuel Romero-Gomez, M.D.Ph.D
Phone
+34 955 015761
Email
mromerogomez@us.es
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Manuel Romero-Gomez, Prof.
Organizational Affiliation
Valme University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital de Valme
City
Sevilla
ZIP/Postal Code
41014
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Manuel Romero-Gomez, M.D. Ph.D
Phone
+34 955015761
Email
mromerogomez@us.es

12. IPD Sharing Statement

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Thalidomide Plus Peginterferon and Ribavirin in Patients With Interferon Resistance

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