Infergen, Ribavirin & Avandia in Previous Relapsers or Nonresponders to Pegylated Interferon and Ribavirin

This study has been completed.
Sponsor:
Collaborator:
InterMune
Information provided by (Responsible Party):
Stephen A Harrison, Brooke Army Medical Center
ClinicalTrials.gov Identifier:
NCT00207402
First received: September 13, 2005
Last updated: February 13, 2012
Last verified: February 2012
  Purpose

Genotype 1 hepatitis C virus (HCV) patients who did not respond (did not lose virus during treatment) or relapsed (virus went away on treatment but came back after treatment was stopped) after treatment with at least twelve weeks of a pegylated (long-acting) interferon and ribavirin will be considered for this study. There are two purposes to this study: first, to determine how rosiglitazone, a medicine used to treat diabetes, affects the HCV viral load; and second, to determine if treatment of insulin resistance with rosiglitazone prior to therapy for HCV will improve sustained virologic response (loss of virus that continues beyond six months after completion of HCV therapy) to HCV therapy.


Condition Intervention Phase
Hepatitis C
Drug: rosiglitazone
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Pilot Trial of Combination Therapy With Interferon Alfacon1, Ribavirin, & Rosiglitazone in a Group of Insulin Resistant, Chronic Hepatitis C, GT 1 Patients Who Are Previous Relapsers or Nonresponders to Pegylated Interferon and Ribavirin

Resource links provided by NLM:


Further study details as provided by Brooke Army Medical Center:

Primary Outcome Measures:
  • There is change in viral kinetics with improvement of insulin sensitivity [ Time Frame: 104 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • There is significant improvement in the SVR obtained when treating insulin resistant patients with the insulin sensitizing medication, Avandia, prior to and during treatment with Infergen and ribavirin when compared to Infergen [ Time Frame: 72 weeks ] [ Designated as safety issue: No ]

Enrollment: 34
Study Start Date: October 2005
Study Completion Date: July 2010
Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: rosiglitazone
Treatment with rosiglitazone 4 mg twice a day for 3 months prior to and during the course of 48 weeks of treatment with interferon alfacon-1 15mcg/0.5ml SQ daily and weight-based ribavirin.
Drug: rosiglitazone
Infergen 15mcg/ d Avandia qd Ribavirin bid
Other Names:
  • Infergen (interferon alfacon-1)
  • Avandia (rosiglitazone)
  • Ribavirin
No Intervention: No Avandia
Monitoring period without rosiglitazone for 3 months prior to 48 weeks of interferon alfacon-1 15mcg/0.5ml SQ daily and weight-based ribavirin

Detailed Description:

This study will demonstrate the efficacy of treating insulin resistance with rosiglitazone in CHC, genotype 1 patients who have failed previous treatment with pegylated interferon and ribavirin. Pre-treatment with rosiglitazone may become the new standard of care prior to HCV therapy for those patients who are insulin resistant, increasing their chance for achieving an SVR on interferon alfacon-1 combination therapy and decreasing the morbidity and mortality associated with chronic hepatitis C.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Participants willing to give written informed consent and able to adhere to dose and visit schedules.
  • Adult participants 18 years of age or older of either gender or any race. Participants who are over 65 years of age must be in generally good health.
  • HCV-antibody (Ab) or HCV-RNA positive by polymerase chain reaction (PCR) for at least 6 months.
  • Serum positive for HCV-RNA by PCR assay.
  • Subjects must be previous nonresponders or relapsers on pegylated interferon and ribavirin therapy.
  • Liver biopsy within 24 months prior to enrollment into the protocol.
  • Compensated liver disease with the following minimum hematological, biochemical, and serologic criteria at the Screening Visit (WNL = within normal limits):

    • Hemoglobin values of < 12 gm/dL for females and < 13 gm/dL for males.
    • White blood cells (WBC) < 3,000/mm3
    • Neutrophil count < 1,500/mm3
    • Platelets < 65,000/mm3
    • Direct bilirubin, within 20% of upper limits of normal (ULN)
    • Indirect bilirubin, (WNL) (unless non-hepatitis related factors such as Gilbert's disease explain an indirect bilirubin rise. In such cases indirect bilirubin must be < 3.0 mg/dL [< 51.3 µmol/L]).
    • Albumin > 3 gm/dL
    • Serum creatinine < 20% of ULN
    • Thyroid stimulating hormone (TSH) WNL
    • Alpha fetoprotein value < 100 ng/mL.
  • Reconfirmation and documentation that sexually active female subjects of childbearing potential are practicing adequate contraception during the treatment period and for 6 months following the last dose of study medication. Female subjects must not be breast-feeding.
  • Reconfirmation that sexually active male subjects are practicing two acceptable methods of contraception during the treatment period and for 6 months following the last dose of study medication.

Exclusion Criteria:

  • Inability or unwillingness to provide informed consent or abide by the requirements of the study
  • Participants on insulin are excluded.
  • Participants on metformin or another thiazolidinedione must have a three-month wash-out period to be considered for the study.
  • Women who are pregnant or breast-feeding
  • Males whose female partner is pregnant
  • No other thiazolidinedione after liver biopsy and/or during the entire study (other than those subjects randomized to receive rosiglitazone during the study)
  • Hepatitis C of non-genotype 1
  • Suspected hypersensitivity to interferon, ribavirin, or rosiglitazone
  • Any cause for liver disease other than chronic hepatitis C, insulin resistance, or non-alcoholic fatty liver disease (NAFLD), including but not limited to:

    • Hemochromatosis
    • Alpha-1 antitrypsin deficiency
    • Co-infection with hepatitis B virus (HBV) [serum hepatitis B surface antigen (HBsAg) positive]
    • Wilson's disease
    • Autoimmune hepatitis
    • Alcoholic liver disease (consumption of greater than 2 drinks a day on average)
    • Drug-related liver disease
  • Any condition that would prevent the subject from having a liver biopsy.
  • Hemoglobinopathies that could potentially compromise patient safety (e.g., beta thalassemia major, sickle cell disease)
  • Evidence of advanced liver disease
  • Participants with organ transplants other than cornea and hair transplant
  • Any known preexisting medical condition that could interfere with the subject's participation in and completion of the protocol such as:

    • Preexisting psychiatric condition, especially severe depression, or a history of severe psychiatric disorder, such as major psychoses, suicidal ideation and/or suicidal attempt.
    • Participants with a history of mild depression may be considered for entry into the protocol provided that a pretreatment assessment of the subject's mental status supports that the participant is clinically stable.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00207402

Locations
United States, Texas
Brooke Army Medical Center
Ft. Sam Houston, Texas, United States, 78234
Sponsors and Collaborators
Brooke Army Medical Center
InterMune
Investigators
Principal Investigator: Stephen A Harrison, MD Brooke Army Medical Center
Principal Investigator: Shane Mills, MD Brooke Army Medical Center
  More Information

No publications provided

Responsible Party: Stephen A Harrison, Principal Investigator, Brooke Army Medical Center
ClinicalTrials.gov Identifier: NCT00207402     History of Changes
Other Study ID Numbers: C2005.143
Study First Received: September 13, 2005
Last Updated: February 13, 2012
Health Authority: United States: Federal Government

Keywords provided by Brooke Army Medical Center:
Hepatitis C
Insulin resistance

Additional relevant MeSH terms:
Hepatitis
Hepatitis A
Hepatitis C
Liver Diseases
Digestive System Diseases
Hepatitis, Viral, Human
Virus Diseases
Enterovirus Infections
Picornaviridae Infections
RNA Virus Infections
Flaviviridae Infections
Interferons
Ribavirin
Interferon alfacon-1
Interferon-alpha
Rosiglitazone
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Antiviral Agents
Anti-Infective Agents
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Physiological Effects of Drugs
Hypoglycemic Agents

ClinicalTrials.gov processed this record on August 28, 2014