Clinical Trial to Assess Safety and Efficacy of Combination Therapy: Hydroxychloroquine, Pegylated Interferon Alpha-2a and Ribavirin in Chronic Hepatitis C Subjects Non-responders to the Standard of Care Therapy.
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Purpose
The study is aimed to investigate the safety, tolerability and efficacy of a fixed dose combination therapy of: Hydroxychloroquine (HCQ), Pegylated Interferon Alpha-2a (PEG-IFN alpha-2a) and Ribavirin (RBV) in Chronic Hepatitis C Genotype 1 Infected adult subjects who failed to respond following a course of PEG-IFN and RBV Therapy.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Hepatitis C |
Biological: Hydroxychloroquine (HCQ), Pegylated Interferon Alpha-2a (Peg-IFN alpha-2a) and Ribavirin |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase I/II, Open Clinical Trial to Assess the Safety, Tolerability and Efficacy of a Fixed Dose Combination Therapy of: Hydroxychloroquine (HCQ), Pegylated Interferon Alpha-2a (Peg-IFN Alpha-2a) and Ribavirin (RBV) in Chronic Hepatitis C Genotype 1 Infected Subjects Who Failed to Respond Following a Course of Peg-IFN and RBV Therapy (SoC). |
- Change from baseline in physical examination [ Time Frame: Twice on study first week , once a week during treatment initiation at weeks 2,3 ,4, later during treatment period once a month at weeks 8-48 and at weeks 60 and 72 follow up visits post treatment ] [ Designated as safety issue: Yes ]Body system screaning
- Change from baseline in vital Signs [ Time Frame: Twice on study first week , once a week during treatment initiation at weeks 2,3 ,4, later during treatment period once a month at weeks 8-48 and at weeks 60 and 72 follow up visits post treatment ] [ Designated as safety issue: No ]Heart Rate, Blood Presure, Respiratory Rate , Body temperature
- Change from baseline in clinical laboratory parameters [ Time Frame: Twice on study first week , once a week during treatment initiation at weeks 2,3 ,4, later during treatment period once a month at weeks 8-48 and at weeks 60 and 72 follow up visits post treatment ] [ Designated as safety issue: Yes ]Hematology, Blood Chemistry, Coagulation parameters, Urinalysis
- Change from baseline in adverse events [ Time Frame: Twice on study first week , once a week during treatment initiation at weeks 2,3 ,4, later during treatment period once a month at weeks 8-48 and at weeks 60 and 72 follow up visits post treatment ] [ Designated as safety issue: Yes ]All observed and or reported adverse events
- HCV RNA level [ Time Frame: at 4,12, 24, 48 and 72 weeks after treatment ] [ Designated as safety issue: No ]Changes in HCV RNA levels, monitored along the study period. The efficacy of a HCQ-containing treatment regimen defined as the proportion of subjects with SVR i.e. undetectable HCV RNA <50 IU/ml) at 5 different time points: cEVR at 12 weeks, 4 weeks, 24 weeks, 48 weeks after treatment initiation and at 24 weeks after end of treatment (week 72).
| Estimated Enrollment: | 36 |
| Study Start Date: | January 2011 |
| Estimated Study Completion Date: | July 2013 |
| Estimated Primary Completion Date: | January 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Combination therapy |
Biological: Hydroxychloroquine (HCQ), Pegylated Interferon Alpha-2a (Peg-IFN alpha-2a) and Ribavirin
HCQ will be taken daily as an oral tablet of 200 mg b.i.d. Pegylated Interferon Alpha-2a - (180 µg) will be administered as weekly subcutaneous (s.c.) injections of 0.5 ml. Ribavirin - will be taken daily based on the patient body weight. If body weight is < 75 kg, the total daily dose of Copegus® is 1000 mg, administered as 400 mg (2 tablets of 200 mg, morning intake) and 600 mg (3 tablets of 200 mg, evening intake). If body weight is >= 75 kg, the total daily dose is 1200 mg administered as twice 600 mg (3 tablets of 200 mg per intake, morning and evening). Other Names:
|
Detailed Description:
This is a phase I/II, open clinical trial to assess the safety, tolerability and preliminary efficacy data of a fixed dose combination therapy of: HCQ, Peg-IFN alpha-2a and RBV in chronic hepatitis C genotype 1 infected subjects who failed to respond following a course of Peg-IFN and RBV Therapy (SoC). The study is a single center trial to be conducted at the Department of Gastroenterology & Hepatology, at Sheba Medical Center, Tel Hashomer, Israel.
Overall, thirty six (36) patients will be recruited. All patients enrolled will have a documented history of chronic HCV disease and being non-responder on earlier Peg-IFN based treatment lasting for at least 12 consecutive weeks prior to study enrolment.
The expected duration of patient screening period prior to enrollment into this study is in-between six weeks (42 days) up to 2 days prior to the study enrollment day at visit 2 (verification of compliance with inclusion/exclusion criteria including clinical laboratory results). Eligible patients will be enrolled into the study and will be observed twice on the first week of the study, once a week during the initiation of the treatment period at weeks 2,3 and week 4, later during the treatment period once a month at weeks 8-48 and at two follow up visits post treatment to take place at week 60 and 72 (allowing a time window of ± 5 days for all visits).
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males and females between 18 and 70 years old.
- Subjects diagnosed to have positive HCV antibodies using a third generation test.
- Subject is diagnosed to have detectable HCV RNA by PCR.
- Liver biopsy or FibroTest showing a METAVIR score ≥F2 and/or ≥A2.
- Subject diagnosed to have compensated liver disease.
- Subject is non-responder (null or partial) on prior Peg-IFN and RBV based treatment lasting for at least 12 consecutive weeks.
- Treatment not discontinued due to intolerability to Peg-IFN or RBV.
- Subjects able to comprehend and give informed consent for participation in this study.
- Subject is willing to be treated and commit to all visits.
Exclusion Criteria:
- Anti HCV therapy contraindications.
- Subject is identified as a relapser on prior Peg-IFN and RBV based treatment.
- Hypersensitivity to one of the three drugs (HCQ, Peg-IFN, RBV).
- Patient has Anaemia,neutropenia, thrombocytopenia, elevated bilirubin levels, elevated ALT and/or AST, or elevated creatinin and INR greater than 1.5.
- Concomitant liver disease other than hepatitis C: chronic hepatitis B, alcoholic liver disease, autoimmune hepatitis, Wilson's disease, hemochromatosis, alpha-1 antitrypsin deficiency.
- Decompensated cirrhosis (Child Pugh >A).
- Clinical evidence for hepatocellular carcinoma.
- Human immunodeficiency virus co-infection.
- Major uncontrolled psychiatric illness. Minor or situational depressions are allowed.
- Active elicit drug or alcohol abuse.
- Serious co-morbid conditions as: heart failure, significant coronary heart disease, chronic obstructive pulmonary disease, renal insufficiency, poorly controlled diabetes, autoimmune disorders, and malignant diseases in the previous 5 years.
- Immunosuppressive treatment including corticosteroids,
- Untreated or uncontrolled or thyroid disease.
- Solid transplant organ (renal, heart, or lung).
- Pregnancy or unwillingness to practice double contraception or abstinence by the subject of childbearing potential or partner.
- Subject objects to the study protocol.
- Concurrent participation in any other clinical study within 30 days prior to enrollment.
Contacts and Locations| Contact: Yaakov Maor, Dr | 97235302906 | yaakov.maor@sheba.health.gov.il |
More Information
No publications provided
| Responsible Party: | Dr. Yaakov Maor, Sheba Medical Center |
| ClinicalTrials.gov Identifier: | NCT01272310 History of Changes |
| Other Study ID Numbers: | SHEBA-10-8033-YM-CTIL, HCQ-001-IL |
| Study First Received: | January 3, 2011 |
| Last Updated: | January 6, 2011 |
| Health Authority: | Israel: Israeli Health Ministry Pharmaceutical Administration |
Keywords provided by Sheba Medical Center:
|
Chronic Hepatitis C Combination Therapy Hydroxychloroquine |
Pegylated Interferon Alpha-2a Ribavirin Chronic Hepatitis C Genotype 1 infected adult subjects |
Additional relevant MeSH terms:
|
Hepatitis, Chronic Hepatitis Hepatitis A Hepatitis C Hepatitis C, Chronic Liver Diseases Digestive System Diseases Hepatitis, Viral, Human Virus Diseases Enterovirus Infections Picornaviridae Infections RNA Virus Infections Flaviviridae Infections Interferon-alpha Interferon Alfa-2a |
Interferons Ribavirin Peginterferon alfa-2a Hydroxychloroquine Antiviral Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Immunologic Factors Physiological Effects of Drugs Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 19, 2013