Individualized Duration of Peg-interferon/Ribavirin Treatment of Hepatitis C

NCT ID: NCT00910975

Last Updated: 2012-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-11-30

Study Completion Date

2011-09-30

Brief Summary

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The purpose of the study is to investigate if the duration of treatment of hepatitis C with pegylated interferon and ribavirin can be individualized on the basis of how fast the hepatitis C virus concentration in the blood decreases, and if this is more cost-efficient than standard treatment.

Detailed Description

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The current standard regimen for patients with chronic hepatitis C virus (HCV) infection, i.e., 48 weeks of pegylated interferon and ribavirin, needs to be further improved because of high costs and side-effects; in addition, the treatment is curative in only 50% of patients with genotype 1 of HCV. According to the current guidelines treatment with pegylated interferon and ribavirin is given for 24, 48 or 72 weeks depending on the time point when HCV-RNA becomes undetectable (week 4, 12 or 24). Patients with a very poor response may also be identified by applying a stopping rule at week 12 and 24. Still, most patients are treated for 48 weeks and a substantial number of those relapse after discontinuation.

In this study, standard treatment is compared with "tailored treatment", when the treatment duration is based on the time point when HCV RNA level is calculated to be 1 copy/mL, according measurements of HCV RNA on day 14, 21, 28 and 49. This arm also includes an earlier stopping rule: If the HCV RNA does not decline significantly between day 14 and 28, treatment is stopped after 5 weeks.

The advantage of tailored treatment is hypothesised to be that unnecessary side-effects and costs are avoided by an earlier identification of non-response and a treatment duration that is optimised for each patient.

Conditions

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Chronic Hepatitis C, Genotype 1

Keywords

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Hepatitis C virus Real-time PCR Treatment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard of care

Treatment with Pegasys 180 µg/week and ribavirin 1000/1200 mg per day. Treatment is given for 24, 48 or 72 weeks depending on the time point (week 4, 12 or 24) when HCV RNA becomes undetectable by the Cobas Taqman assay. If HCV RNA has not declined 2 logs by week 12 or is detectable at week 24, treatment is stopped.

Group Type ACTIVE_COMPARATOR

Peg-interferon-alfa2a (Pegasys)

Intervention Type DRUG

Peg-interferon-alfa2a 180 µg per week

Ribavirin (Copegus)

Intervention Type DRUG

Ribavirin 1000 or 1200 mg per day depending on if body weight is below or above 75 kg

Tailored treatment

Treatment with Pegasys 180 µg/week and ribavirin 1000/1200 mg per day. Treatment duration is flexible, 24-72 weeks, depending on the time point when the HCV RNA level is calculated to be 1 copy/mL. If the decline between day 14 and 28 is poor, treatment is stopped after 5 weeks.

Group Type EXPERIMENTAL

Peg-interferon-alfa2a (Pegasys)

Intervention Type DRUG

Peg-interferon-alfa2a 180 µg per week

Ribavirin (Copegus)

Intervention Type DRUG

Ribavirin 1000 or 1200 mg per day depending on if body weight is below or above 75 kg

Interventions

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Peg-interferon-alfa2a (Pegasys)

Peg-interferon-alfa2a 180 µg per week

Intervention Type DRUG

Ribavirin (Copegus)

Ribavirin 1000 or 1200 mg per day depending on if body weight is below or above 75 kg

Intervention Type DRUG

Other Intervention Names

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Pegasys

Eligibility Criteria

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Inclusion Criteria

* Anti-HCV positive for \> 6 months
* Genotype 1
* Clinical indication for treatment, preferably a liver biopsy showing significant inflammation and/or fibrosis
* Negative pregnancy test (for fertile women)

Exclusion Criteria

* Pregnancy or breast-feeding
* Antiviral or immune modulating treatment the last 6 months
* Hepatitis B or HIV infection (HBsAg, anti-HIV)
* Other significant chronic liver disease
* History of bleeding esophageal varices or other signs of decompensation
* Neutrophiles \< 1.0 x 109/L or platelets \< 50 x 109/L. S-creatinine \> 2 x ULN
* History of severe psychiatric disorder
* Autoimmune disease, severe heart disease, previous organ or stem cell transplantation, malignancy, thyroid disease, severe retinopathy
* Drug abuse, current or during the last year
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Sodra Alvsborgs Hospital

OTHER

Sponsor Role collaborator

Skaraborg Hospital

OTHER_GOV

Sponsor Role collaborator

Uddevalla Hospital

UNKNOWN

Sponsor Role collaborator

Skane University Hospital

OTHER

Sponsor Role collaborator

Lund University Hospital

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Göteborg University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Magnus Lindh, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Sahlgrenska University Hospital

Locations

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Sahlgrenska University Hospital

Gothenburg, Västra Götaland County, Sweden

Site Status

Countries

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Sweden

References

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Lindh M, Alestig E, Arnholm B, Eilard A, Hellstrand K, Lagging M, Wahlberg T, Wejstal R, Westin J, Norkrans G. Response prediction and treatment tailoring for chronic hepatitis C virus genotype 1 infection. J Clin Microbiol. 2007 Aug;45(8):2439-45. doi: 10.1128/JCM.00577-07. Epub 2007 Jun 20.

Reference Type BACKGROUND
PMID: 17581934 (View on PubMed)

Other Identifiers

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TTG1_081119

Identifier Type: -

Identifier Source: org_study_id