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Sofosbuvir With Pegylated Interferon and Ribavirin Hepatitis C Virus (HCV) Genotypes 1,4,5,6 (ATOMIC)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Gilead Sciences
ClinicalTrials.gov Identifier:
NCT01329978
First received: March 30, 2011
Last updated: April 24, 2014
Last verified: April 2014
Results First Received: January 6, 2014  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Safety/Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Open Label;   Primary Purpose: Treatment
Condition: Hepatitis C, Chronic
Interventions: Drug: Sofosbuvir
Drug: RBV
Drug: PEG

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
Participants were enrolled in a total of 42 study sites in the United States. The first participant was screened on 23 March 2011. The last participant observation was on 27 August 2012.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
589 participants were screened and 332 were randomized and treated, and comprise the Safety Analysis Set.

Reporting Groups
  Description
SOF+PEG+RBV 12 Weeks Participants were randomized to receive sofosbuvir (SOF) 400 mg+pegylated interferon alfa-2a (PEG) 180 µg+ribavirin (RBV) 1000-1200 mg for 12 weeks.
SOF+PEG+RBV 24 Weeks Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 24 weeks.
SOF+PEG+RBV 12 Week/Rerandomization Group Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 12 weeks, then were rerandomized to receive SOF monotherapy or SOF+RBV for 12 additional weeks.
SOF Rerandomization Group This group includes participants in the SOF+PEG+RBV 12 week/Rerandomization Group who were rerandomized to receive SOF 400 mg monotherapy for 12 additional weeks.
SOF+RBV Rerandomization Group This group includes participants in the SOF+PEG+RBV 12 week/Rerandomization Group who were rerandomized to receive SOF 400 mg+RBV 1000-1200 for 12 additional weeks.

Participant Flow for 2 periods

Period 1:   Sofosbuvir+PEG+RBV Treatment Period
    SOF+PEG+RBV 12 Weeks   SOF+PEG+RBV 24 Weeks   SOF+PEG+RBV 12 Week/Rerandomization Group   SOF Rerandomization Group   SOF+RBV Rerandomization Group
STARTED   52   125   155   0   0 
COMPLETED   48 [1]   112 [1]   150 [2]   0   0 
NOT COMPLETED   4   13   5   0   0 
Adverse Event                1                2                0                0                0 
Lost to Follow-up                2                8                2                0                0 
Withdrawal by Subject                1                1                3                0                0 
Subject Was Incarcerated                0                1                0                0                0 
Subject Moved Out of State                0                1                0                0                0 
[1] Participants in this group were not re-randomized for further treatment
[2] 150 participants were re-randomized after 12 weeks of treatment.

Period 2:   Rerandomization Treatment Period
    SOF+PEG+RBV 12 Weeks   SOF+PEG+RBV 24 Weeks   SOF+PEG+RBV 12 Week/Rerandomization Group   SOF Rerandomization Group   SOF+RBV Rerandomization Group
STARTED   0   0   0   75 [1]   75 [1] 
COMPLETED   0   0   0   70   71 
NOT COMPLETED   0   0   0   5   4 
Lost to Follow-up                0                0                0                5                3 
Withdrawal by Subject                0                0                0                0                1 
[1] This group includes participants rerandomized from the SOF+PEG+RBV 12 week/Rerandomization Group.



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
Safety Analysis Set: participants who were randomized and received at least 1 dose of study drug

Reporting Groups
  Description
SOF+PEG+RBV 12 Weeks Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 12 weeks.
SOF+PEG+RBV 24 Weeks Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 24 weeks.
SOF+PEG+RBV 12 Week/Rerandomization Group Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 12 weeks, then were rerandomized to receive SOF monotherapy or SOF+RBV for 12 additional weeks.
Total Total of all reporting groups

Baseline Measures
   SOF+PEG+RBV 12 Weeks   SOF+PEG+RBV 24 Weeks   SOF+PEG+RBV 12 Week/Rerandomization Group   Total 
Overall Participants Analyzed 
[Units: Participants]
 52   125   155   332 
Age 
[Units: Years]
Mean (Standard Deviation)
 51  (9.8)   50  (11.0)   50  (10.8)   50  (10.7) 
Gender 
[Units: Participants]
       
Female   17   52   49   118 
Male   35   73   106   214 
Ethnicity (NIH/OMB) 
[Units: Participants]
       
Hispanic or Latino   10   26   31   67 
Not Hispanic or Latino   42   99   124   265 
Unknown or Not Reported   0   0   0   0 
Race/Ethnicity, Customized 
[Units: Participants]
       
Black   2   17   16   35 
Not Black   50   108   139   297 
Hepatitis C Virus (HCV) genotype [1] 
[Units: Participants]
       
Genotype 1a   40   85   116   241 
Genotype 1b   12   24   39   75 
Genotype 4   0   11   0   11 
Genotype 6   0   2   0   2 
Genotype 6e   0   2   0   2 
Genotype 6o   0   1   0   1 
[1] There are variations of HCV which are all similar enough to be called HCV, but are distinct enough to be referred to as HCV genotypes 1 (a or b), 2, 3, 4, 5, or 6 (e or o).
HCV RNA 
[Units: Log10 copies/mL]
Mean (Standard Deviation)
 6.5  (0.66)   6.3  (0.73)   6.4  (0.79)   6.4  (0.75) 
HCV RNA Category 
[Units: Participants]
       
< 800,000 IU/mL   7   33   28   68 
> 800,000 IU/mL   45   92   127   264 
Liver Biopsy Fibrosis Score 
[Units: Participants]
       
Missing   0   1   13   14 
Bridging Fibrosis   7   17   23   47 
None or Minimal Fibrosis   9   14   20   43 
Portal Fibrosis   36   93   99   228 
Alanine Aminotransferase (ALT) 
[Units: U/L]
Mean (Standard Deviation)
 80.5  (71.61)   83.7  (77.18)   76.4  (55.91)   79.8  (66.98) 
ALT Category [1] 
[Units: Participants]
       
≤ 1.5 × the upper limit of the normal range (ULN)   37   87   115   239 
> 1.5 × ULN   15   38   40   93 
[1] The ULN for ALT was 60 IU/mL before March 26, 2012, then 56 IU/mL (males) and 45 IU/mL (females).
IL28b Genotype [1] 
[Units: Participants]
       
CC   13   36   39   88 
CT   33   63   88   184 
TT   6   26   28   60 
[1] CC, CT, and TT alleles are different forms of the IL28b gene.


  Outcome Measures
  Show All Outcome Measures

1.  Primary:   Percentage of Participants With Sustained Virologic Response 24 Weeks Following Completion of Treatment (SVR24)   [ Time Frame: Post-treatment Week 24 ]

2.  Primary:   Percentage of Participants Who Experienced Adverse Events   [ Time Frame: Baseline (Day 1) to post-treatment Day 30 ]

3.  Secondary:   Percentage of Participants With Sustained Virologic Response 12 Weeks Following Completion of Treatment (SVR12)   [ Time Frame: Post-treatment Week 12 ]

4.  Secondary:   Change in HCV RNA at Week 2   [ Time Frame: Baseline (Day 1) to Week 2 ]

5.  Secondary:   Change in HCV RNA at Week 4   [ Time Frame: Baseline (Day 1) to Week 4 ]

6.  Secondary:   Change in HCV RNA at Week 8   [ Time Frame: Baseline (Day 1) to Week 8 ]

7.  Secondary:   Change in HCV RNA at Week 12   [ Time Frame: Baseline (Day 1) to Week 12 ]

8.  Secondary:   Percentage of Participants With HCV RNA < LOD at Week 2   [ Time Frame: Week 2 ]

9.  Secondary:   Percentage of Participants With HCV RNA Below < LOD at Week 4   [ Time Frame: Week 4 ]

10.  Secondary:   Percentage of Participants With HCV RNA Below < LOD at Week 8   [ Time Frame: Week 8 ]

11.  Secondary:   Percentage of Participants With HCV RNA Below < LOD at Week 12   [ Time Frame: Week 12 ]

12.  Secondary:   Percentage of Participants With HCV RNA Below < LOD at Week 24   [ Time Frame: Week 24 ]

13.  Secondary:   Percentage of Participants With ALT Normalization at Week 12   [ Time Frame: Baseline (Day 1) to Week 12 ]

14.  Secondary:   Percentage of Participants With ALT Normalization at Week 24   [ Time Frame: Baseline (Day 1) to Week 24 ]

15.  Secondary:   Percentage of Participants With ALT Normalization at Post-treatment Week 4   [ Time Frame: Baseline (Day 1) to Post-treatment Week 4 ]

16.  Secondary:   Percentage of Participants With Virologic Failure During Treatment   [ Time Frame: Baseline (Day 1) to Week 24 ]

17.  Secondary:   Percentage of Participants With Virologic Failure Following Treatment (Viral Relapse).   [ Time Frame: End of treatment to Post-treatment Week 24 ]
  Hide Outcome Measure 17

Measure Type Secondary
Measure Title Percentage of Participants With Virologic Failure Following Treatment (Viral Relapse).
Measure Description Viral relapse was defined as HCV RNA < 15 IU/mL at end of treatment, confirmed with 2 consecutive values or last available measurement.
Time Frame End of treatment to Post-treatment Week 24  
Safety Issue No  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
Participants in the Safety Analysis Set with available data were analyzed.

Reporting Groups
  Description
SOF+PEG+RBV 12 Weeks Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 12 weeks.
SOF+PEG+RBV 24 Weeks Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 24 weeks.
SOF+PEG+RBV 12 Week/Rerandomization Group Participants were randomized to receive SOF 400 mg+PEG 180 µg+RBV 1000-1200 mg for 12 weeks, then were rerandomized to receive SOF monotherapy or SOF+RBV for 12 additional weeks.
SOF Rerandomization Group This group includes participants in the SOF+PEG+RBV 12 week/Rerandomization Group who were rerandomized to receive SOF 400 mg monotherapy for 12 additional weeks.
SOF+RBV Rerandomization Group This group includes participants in the SOF+PEG+RBV 12 week/Rerandomization Group who were rerandomized to receive SOF 400 mg+RBV 1000-1200 for 12 additional weeks.

Measured Values
   SOF+PEG+RBV 12 Weeks   SOF+PEG+RBV 24 Weeks   SOF+PEG+RBV 12 Week/Rerandomization Group   SOF Rerandomization Group   SOF+RBV Rerandomization Group 
Participants Analyzed 
[Units: Participants]
 51   124   153   75   75 
Percentage of Participants With Virologic Failure Following Treatment (Viral Relapse). 
[Units: Percentage of participants]
 5.9   1.6   3.9   2.7   2.7 

No statistical analysis provided for Percentage of Participants With Virologic Failure Following Treatment (Viral Relapse).




  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
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  More Information
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Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The agreement is:
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.


Results Point of Contact:  
Name/Title: Clinical Trial Disclosures
Organization: Gilead Sciences, Inc.
e-mail: ClinicalTrialDisclosures@gilead.com


Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Responsible Party: Gilead Sciences
ClinicalTrials.gov Identifier: NCT01329978     History of Changes
Other Study ID Numbers: P7977-0724
Study First Received: March 30, 2011
Results First Received: January 6, 2014
Last Updated: April 24, 2014
Health Authority: United States: Food and Drug Administration