Different Ribavirin Dosages and Different Duration of Treatment in Combination With PegInterferon in Patients With Genotype 2 and 3 (WRITE)

NCT ID: NCT01380938

Last Updated: 2022-03-24

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

PHASE3

Total Enrollment

1150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-01

Study Completion Date

2019-11-30

Brief Summary

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WRITE study aim at identifying the effectiveness of an innovative individualized schedule of treatment as compared to standard regimen in patients with chronic HCV genotype 2 and 3.

Detailed Description

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The investigators are going to compare weight-based dosages of ribavirin, in combination with Peginterferon alpha-2a, with standard fixed dosages of 800 mg. Patients will be evaluated at week 4 with an assay of sensitivity of 15 IU/ml. Patients with week 4 response will discontinue treatment at week 12 in both arms. Patients with HCV RNA still detectable at week 4 and receiving 1000-1200 mg of ribavirin in arm A will discontinue treatment at week 24, whereas patients with HCV RNA still detectable at week 4 and receiving 800 mg of ribavirin in arm B will be treated till week 48.

A standard treatment arm (C) including patients treated for 24 weeks with Peginterferon alpha-2a and fixed 800 mg ribavirin dosage will be used as control arm.

Conditions

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Chronic Hepatitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Arm C. Standard duration

Patients will be randomly assigned in 3:3:1 ratio to three treatment arms. In the standard treatment group (Arm C), patients will be treated for 24 weeks independently of the HCV RNA status at week 4 with Peginterferon alpha-2a at a dose of 180 mcg weekly in combination with oral ribavirin administered at a dosage of 800 mg/day.

Patients enrolled in Arm C will be treated for standard 24 weeks duration of treatment.

Group Type NO_INTERVENTION

No interventions assigned to this group

Arm A

Patients enrolled in Arm A will receive Peginterferon alpha-2a at a dosage of 180 mcg weekly in combination with oral ribavirin administered at a dosage of 1000 mg/day for patients with a body weight \< 75 kg or 1200 mg/day for those with a body weight \> 75 kg.

Patients with week 4 viral clearance (labelled as rapid virological responders, RVR) will be allocated to 12 week treatment duration (Arm A), whereas those without RVR will be treated for 24 weeks (Arm A)

Group Type EXPERIMENTAL

Peginterferon alpha-2a + Ribavirin

Intervention Type DRUG

Administration of ribavirin at a dosage of 1000 or 1200 mg per day based on body weight \< or \> 75 kg for 24 weeks (Arm A).

Treatment duration of 48 weeks with standard fixed dose of ribavirin (800 mg/day) (Arm B).

These schedules will be compared with diagram of standard therapy with 800 mg daily of ribavirin for 24 weeks (Arm C)

Arm B

Patients enrolled in Arm B will receive Peginterferon alpha-2a at a dosage of 180 mcg weekly in combination with oral ribavirin administered at a dosage of 800 mg/day.

Patients with week 4 viral clearance (labelled as rapid virological responders, RVR) will be allocated to 12 week treatment duration (Arm B), whereas those without RVR will be treated for 48 weeks (Arm B)

Group Type EXPERIMENTAL

Peginterferon alpha-2a + Ribavirin

Intervention Type DRUG

Administration of ribavirin at a dosage of 1000 or 1200 mg per day based on body weight \< or \> 75 kg for 24 weeks (Arm A).

Treatment duration of 48 weeks with standard fixed dose of ribavirin (800 mg/day) (Arm B).

These schedules will be compared with diagram of standard therapy with 800 mg daily of ribavirin for 24 weeks (Arm C)

Interventions

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Peginterferon alpha-2a + Ribavirin

Administration of ribavirin at a dosage of 1000 or 1200 mg per day based on body weight \< or \> 75 kg for 24 weeks (Arm A).

Treatment duration of 48 weeks with standard fixed dose of ribavirin (800 mg/day) (Arm B).

These schedules will be compared with diagram of standard therapy with 800 mg daily of ribavirin for 24 weeks (Arm C)

Intervention Type DRUG

Other Intervention Names

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Peginterferon alpha-2a (40 kD) PEGASYS Copegus or Rebetol, Ribavirin Teva

Eligibility Criteria

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Inclusion Criteria

* Patients with chronic hepatitis C virus (HCV) infection (both HCVAb and HCV RNA positive)
* Patients with HCV genotype 2 or 3
* Age 18-70 years
* Naïve patients or previously treated only with standard interferon monotherapy
* Female patients of childbearing age who agree to avoid pregnancy during the period of treatment and 24 weeks after the end of treatment

Exclusion Criteria

* Previous treatment with ribavirin
* Cirrhosis (CHILD PUGH B and C)
* Evidence of Hepatocellular carcinoma
* Pregnancy
* Retinopathy class I or II
* Alcohol consumption \> 40 gr/day
* Chronic cardiac or respiratory diseases
* HIV or HBsAg or HDV positivity
* Hemoglobin \< 8.5 gr/dL
* WBC \< 3.500/mm3
* PLT \< 80.000/mm3
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Casa di Cura Mater Dei

UNKNOWN

Sponsor Role collaborator

IRCCS L. Spallanzani

UNKNOWN

Sponsor Role collaborator

Ospedale Francesco Ferrari

OTHER

Sponsor Role collaborator

Azienda Ospedaliero Universitaria di Sassari

OTHER

Sponsor Role collaborator

Fondazione IRCCS Policlinico San Matteo di Pavia

OTHER

Sponsor Role collaborator

Arcispedale S. Anna, Ferrara

UNKNOWN

Sponsor Role collaborator

Azienda Ospedaliero-Universitaria, Catania

UNKNOWN

Sponsor Role collaborator

Ospedale di Venosa

UNKNOWN

Sponsor Role collaborator

Ospedale Monsignor R. Dimiccoli, Barletta

OTHER

Sponsor Role collaborator

IRCCS De Bellis, Castellana

UNKNOWN

Sponsor Role collaborator

USL Napoli 1

UNKNOWN

Sponsor Role collaborator

Ospedale San Giuseppe Moscati, Avellino

UNKNOWN

Sponsor Role collaborator

Cardarelli Hospital

OTHER

Sponsor Role collaborator

Ospedale Civile Vittorio Emanuele II, Bisceglie

UNKNOWN

Sponsor Role collaborator

Azienda Ospedaliero-Universitaria Careggi

OTHER

Sponsor Role collaborator

Azienda Ospedaliera V. Cervello

OTHER

Sponsor Role collaborator

Ospedale Civile Spirito Santo

OTHER

Sponsor Role collaborator

Ospedale di Canosa di Puglia

UNKNOWN

Sponsor Role collaborator

University of Palermo

OTHER

Sponsor Role collaborator

San Camillo Hospital, Rome

OTHER

Sponsor Role collaborator

Campus Bio-Medico University

OTHER

Sponsor Role collaborator

Ospedale Sandro Pertini, Roma

OTHER

Sponsor Role collaborator

Ospedali Riuniti di Foggia

OTHER

Sponsor Role collaborator

Ospedale SS. Annunziata, Taranto

UNKNOWN

Sponsor Role collaborator

Ospedale di Mottola

UNKNOWN

Sponsor Role collaborator

Ospedale Santa Caterina Novella, Galatina

UNKNOWN

Sponsor Role collaborator

University of Florence

OTHER

Sponsor Role collaborator

Ospedale Valduce, Como

UNKNOWN

Sponsor Role collaborator

University of Bari

OTHER

Sponsor Role collaborator

Azienda Ospedaliera, Siracusa

UNKNOWN

Sponsor Role collaborator

Azienda Ospedaliera, Lucca

UNKNOWN

Sponsor Role collaborator

Casa Sollievo della Sofferenza IRCCS

OTHER

Sponsor Role lead

Responsible Party

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Alessandra Mangia

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alessandra Mangia, MD

Role: STUDY_DIRECTOR

IRCCS "Casa Sollievo della Sofferenza"

Locations

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Infectious Diseases Unit

Avellino, , Italy

Site Status

Clinical Medicine Unit "Mater Dei"

Bari, , Italy

Site Status

Università di Bari

Bari, , Italy

Site Status

Medicine Unit

Barletta, , Italy

Site Status

Infectious Diseases Unit "V. Emanuele"

Bisceglie, , Italy

Site Status

Medicine Unit

Canosa di Puglia, , Italy

Site Status

Hepatology Unit

Casarano, , Italy

Site Status

IRCCS "De Bellis"

Castellana Grotte, , Italy

Site Status

Hepatology Unit

Catania, , Italy

Site Status

Infectious Diseases Unit

Catania, , Italy

Site Status

Gastroenterology Unit

Como, , Italy

Site Status

Gastroenterology Unit Arcispedale "S. Anna"

Ferrara, , Italy

Site Status

Gastroenterology Unit

Florence, , Italy

Site Status

Internal Medicine University of Firenze

Florence, , Italy

Site Status

Gastroenterology Unit

Foggia, , Italy

Site Status

Infectious Diseases

Foggia, , Italy

Site Status

Gastroenterology Unit

Galatina, , Italy

Site Status

Infectious Diseases

Lucca, , Italy

Site Status

Gastroenterology Unit

Mottola, , Italy

Site Status

Gastroenterology Unit "Cardarelli"

Napoli, , Italy

Site Status

USL Napoli 1

Napoli, , Italy

Site Status

Hospital "V. Cervello"

Palermo, , Italy

Site Status

Medical Clinic University of Palermo

Palermo, , Italy

Site Status

Infectious Diseases Unit IRCCS "San Matteo"

Pavia, , Italy

Site Status

Campus Biomedico University

Roma, , Italy

Site Status

Hepatology Unit "S. Pertini"

Roma, , Italy

Site Status

Hepatology Unit "san Camillo"

Roma, , Italy

Site Status

Ospedale "Villa Betania"

Roma, , Italy

Site Status

IRCCS "L. Spallanzani"

Rome, , Italy

Site Status

IRCCS "Casa Sollievo della Sofferenza"

San Giovanni Rotondo, , Italy

Site Status

Infectious Diseases Unit Ospedale Civile

Sassari, , Italy

Site Status

Medicine Unit

Sassari, , Italy

Site Status

Infectious Diseases

Syracuse, , Italy

Site Status

SS. Annunziata

Taranto, , Italy

Site Status

Medicine Unit

Venosa, , Italy

Site Status

Countries

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Italy

References

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Mangia A, Dalgard O, Minerva N, Verbaan H, Bacca D, Ring-Larsen H, Copetti M, Carretta V, Piazzolla V, Cozzolongo R, Mottola L, Andriulli A. Ribavirin dosage in patients with HCV genotypes 2 and 3 who completed short therapy with peg-interferon alpha-2b and ribavirin. Aliment Pharmacol Ther. 2010 Jun;31(12):1346-53. doi: 10.1111/j.1365-2036.2010.04290.x. Epub 2010 Mar 8.

Reference Type BACKGROUND
PMID: 20222909 (View on PubMed)

Mangia A, Minerva N, Bacca D, Cozzolongo R, Agostinacchio E, Sogari F, Scotto G, Vinelli F, Ricci GL, Romano M, Carretta V, Petruzzellis D, Andriulli A. Determinants of relapse after a short (12 weeks) course of antiviral therapy and re-treatment efficacy of a prolonged course in patients with chronic hepatitis C virus genotype 2 or 3 infection. Hepatology. 2009 Feb;49(2):358-63. doi: 10.1002/hep.22679.

Reference Type BACKGROUND
PMID: 19072829 (View on PubMed)

Andriulli A, Mangia A, Iacobellis A, Ippolito A, Leandro G, Zeuzem S. Meta-analysis: the outcome of anti-viral therapy in HCV genotype 2 and genotype 3 infected patients with chronic hepatitis. Aliment Pharmacol Ther. 2008 Aug 15;28(4):397-404. doi: 10.1111/j.1365-2036.2008.03763.x. Epub 2008 Jun 11.

Reference Type BACKGROUND
PMID: 18549461 (View on PubMed)

Mangia A, Santoro R, Minerva N, Ricci GL, Carretta V, Persico M, Vinelli F, Scotto G, Bacca D, Annese M, Romano M, Zechini F, Sogari F, Spirito F, Andriulli A. Peginterferon alfa-2b and ribavirin for 12 vs. 24 weeks in HCV genotype 2 or 3. N Engl J Med. 2005 Jun 23;352(25):2609-17. doi: 10.1056/NEJMoa042608.

Reference Type BACKGROUND
PMID: 15972867 (View on PubMed)

Other Identifiers

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EPAT-01-2010

Identifier Type: -

Identifier Source: org_study_id

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