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

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Andrew H Miller, Emory University
ClinicalTrials.gov Identifier:
NCT00209118
First received: September 14, 2005
Last updated: November 19, 2013
Last verified: November 2013
  Purpose

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.


Condition Intervention
Hepatitis C
Depression
Interferon-alpha Associated Side Effects
Drug: paroxetine

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double-Blind
Primary Purpose: Prevention
Official Title: Paroxetine for the Prevention of IFN-Alpha Associated Depression in Patients With Chronic Hepatitis C

Resource links provided by NLM:


Further study details as provided by Emory University:

Primary Outcome Measures:
  • Depressive Symptom Scores
  • Development of Major Depression

Secondary Outcome Measures:
  • neurotoxicity
  • dosage reduction
  • discontinuation

Estimated Enrollment: 60
Estimated Study Completion Date: July 2005
  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
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
  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: NCT00209118

Sponsors and Collaborators
Emory University
Investigators
Principal Investigator: Andrew H. Miller, MD Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences
  More Information

No publications provided by Emory University

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Andrew H Miller, Principal Investigator, Emory University
ClinicalTrials.gov Identifier: NCT00209118     History of Changes
Other Study ID Numbers: 0112-1998
Study First Received: September 14, 2005
Last Updated: November 19, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Emory University:
Hepatitis C
Interferon-alpha associated side effects
Antidepressants
Prevention

Additional relevant MeSH terms:
Hepatitis
Hepatitis A
Depression
Depressive Disorder
Hepatitis C
Liver Diseases
Digestive System Diseases
Hepatitis, Viral, Human
Virus Diseases
Enterovirus Infections
Picornaviridae Infections
RNA Virus Infections
Behavioral Symptoms
Mood Disorders
Mental Disorders
Flaviviridae Infections
Paroxetine
Serotonin Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Serotonin Agents
Physiological Effects of Drugs
Antidepressive Agents, Second-Generation
Antidepressive Agents
Psychotropic Drugs
Central Nervous System Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on September 18, 2014