Trial Outcomes & Findings for An Observational Study on Predictive Factors of Response in Patients With Chronic Hepatitis C Treated With Pegasys (Peginterferon Alfa-2a) and Ribavirin (NCT NCT01392742)

NCT ID: NCT01392742

Last Updated: 2017-04-10

Results Overview

SVR was defined as undetectable Hepatitis C Virus Ribonucleic Acid (HCV RNA) 24 weeks after completion of the actual treatment period (a single last undetectable HCV RNA Polymerase Chain Reaction \[PCR\] measured greater than or equal to \>=140 days post-treatment).

Recruitment status

COMPLETED

Target enrollment

443 participants

Primary outcome timeframe

24 weeks after End of treatment (EOT) (up to Week 96)

Results posted on

2017-04-10

Participant Flow

Participant milestones

Participant milestones
Measure
Hepatitis C Virus (HCV) Infected Participants
Participants who were infected by HCV and receiving pegylated interferon alfa-2a (PEG-IFN alfa-2a) 180 micrograms per week (µg/week) subcutaneously, plus ribavirin tablets 1000 milligrams (mg) (those weighing less than \[\<\] 75 kilograms \[kg\]) or 1200 mg (those weighing greater than \[\>\] 75 kg) orally; were observed for approximately up to 24 weeks after end of treatment (EOT). Dose change was as per investigators' discretion.
Overall Study
STARTED
443
Overall Study
COMPLETED
242
Overall Study
NOT COMPLETED
201

Reasons for withdrawal

Reasons for withdrawal
Measure
Hepatitis C Virus (HCV) Infected Participants
Participants who were infected by HCV and receiving pegylated interferon alfa-2a (PEG-IFN alfa-2a) 180 micrograms per week (µg/week) subcutaneously, plus ribavirin tablets 1000 milligrams (mg) (those weighing less than \[\<\] 75 kilograms \[kg\]) or 1200 mg (those weighing greater than \[\>\] 75 kg) orally; were observed for approximately up to 24 weeks after end of treatment (EOT). Dose change was as per investigators' discretion.
Overall Study
Premature study termination
42
Overall Study
Failure to return
35
Overall Study
No treatment/no cooperation/withdrew
12
Overall Study
Lost to Follow-up
34
Overall Study
Insufficient therapeutic response (ITR)
30
Overall Study
ITR and Protocol deviation
1
Overall Study
Adverse event/intercurrent illness
17
Overall Study
Protocol Violation
14
Overall Study
Other
3
Overall Study
Missing information
13

Baseline Characteristics

An Observational Study on Predictive Factors of Response in Patients With Chronic Hepatitis C Treated With Pegasys (Peginterferon Alfa-2a) and Ribavirin

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
HCV Infected Participants
n=443 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Age, Continuous
40.61 years
STANDARD_DEVIATION 12.32 • n=5 Participants
Sex: Female, Male
Female
182 Participants
n=5 Participants
Sex: Female, Male
Male
261 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 24 weeks after End of treatment (EOT) (up to Week 96)

Population: Per Protocol (PP) population included all participants without any protocol violation.

SVR was defined as undetectable Hepatitis C Virus Ribonucleic Acid (HCV RNA) 24 weeks after completion of the actual treatment period (a single last undetectable HCV RNA Polymerase Chain Reaction \[PCR\] measured greater than or equal to \>=140 days post-treatment).

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=331 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Percentage of Participants With Sustained Virological Response (SVR)
38.7 percentage of participants

PRIMARY outcome

Timeframe: Up to 24 weeks after EOT (up to Week 96)

Population: PP population.

Relapse was define as аn undetectable HCV RNA during the treatment period, but without such during the follow-up.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=331 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Percentage of Participants With Relapse
8.2 percentage of participants

PRIMARY outcome

Timeframe: Up to 24 weeks after EOT (up to Week 96)

Population: PP population.

Non-responders were those participants who had not reached аn undetectable HCV RNA during the treatment period.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=331 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Percentage of Participants Who Were Non-Responders
25.1 percentage of participants

SECONDARY outcome

Timeframe: Week 4

Population: PP population. Here "number of participants analyzed" included participants who were evaluable for this outcome measure and "n" signified evaluable participants for specific group.

Predictive value determined the relationship of the virological response at specified time to the total response. Positive predicted value= number of true positives/(number of true positives+ number of false positives). SVR was defined as undetectable HCV RNA 24 weeks after end of treatment. Percentage of participants who showed positive predictive value in treatment naive and those who failed previous treatment with interferon were reported.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=187 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Percentage of Participants With Positive Predictive Value on SVR at Week 4
Treatment naive(n=182)
64.8 percentage of participants
Percentage of Participants With Positive Predictive Value on SVR at Week 4
Failed previous treatment(n=5)
20.0 percentage of participants

SECONDARY outcome

Timeframe: Week 12

Population: PP population. Here "number of participants analyzed" included participants evaluable for the outcome measure and "n" signified evaluable participants for specific group.

Predictive value determined the relationship of the virological response at specified time to the total response. Positive predicted value= number of true positives/( number of true positives+ number of false positives). SVR was defined as undetectable HCV RNA 24 weeks after end of treatment. Percentage of participants who showed positive predictive value in treatment naive and those who failed previous treatment with interferon were reported.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=186 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Percentage of Participants With Positive Predictive Value on SVR at Week 12
Treatment naive(n=182)
69.8 percentage of participants
Percentage of Participants With Positive Predictive Value on SVR at Week 12
Failed previous treatment(n=4)
25.0 percentage of participants

SECONDARY outcome

Timeframe: Up to 24 weeks after EOT (up to Week 96)

Population: PP population. Here "number of participants analyzed" included participants who were evaluable for this outcome measure.

Correlation of SVR with RVR was based on 3 symmetric measures; Kendall's tau-b, Kendall's tau-c and Gamma. SVR was defined as undetectable HCV RNA 24 weeks after end of treatment. RVR was defined as having undetectable HCV RNA 4 weeks after start of treatment.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=238 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Correlation of SVR With Rapid Virological Response (RVR)
Kendall's tau-b
0.378 correlation coefficient
Correlation of SVR With Rapid Virological Response (RVR)
Kendall's tau-c
0.310 correlation coefficient
Correlation of SVR With Rapid Virological Response (RVR)
Gamma
0.782 correlation coefficient

SECONDARY outcome

Timeframe: Up to 24 weeks after EOT (up to Week 96)

Population: PP population. Here "number of participants analyzed" included participants who were evaluable for this outcome measure.

Correlation of SVR with EVR was based on 3 symmetric measures; Kendall's tau-b, Kendall's tau-c and Gamma. SVR was defined as undetectable HCV RNA 24 weeks after end of treatment. EVR was defined as having undetectable HCV RNA 12 weeks after start of treatment.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=238 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Correlation of SVR With Early Virological Response (EVR)
Kendall's tau-b
0.570 correlation coefficient
Correlation of SVR With Early Virological Response (EVR)
Kendall's tau-c
0.470 correlation coefficient
Correlation of SVR With Early Virological Response (EVR)
Gamma
1.000 correlation coefficient

SECONDARY outcome

Timeframe: Week 4 and 12

Population: PP population. Here "number of participants analyzed" included participants who were evaluable for this outcome measure

Predictive value determined the relationship of host factors to virological response. Host factors included; RVR (EVR for Week 12), gender, liver fibrosis, HCV genotype, height and treatment duration for Week 4 after EOT excluding HCV genotype at Week 12 EOT. RVR was defined as having undetectable HCV RNA 4 weeks after start of treatment and EVR was defined as having undetectable HCV RNA 12 weeks after start of treatment.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=238 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 4: RVR
2.540 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 4: gender
1.390 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 4: liver fibrosis
7.030 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 4: HCV genotype
2.320 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 4: height
-0.091 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 4: treatment duration
0.020 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 12: EVR
5.860 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 12: gender
1.291 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 12: liver fibrosis
4.774 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 12: height
-0.071 predictive value
Predictive Power Values of Host-, Virus- and Treatment-related Factors and Virological Response
Week 12: treatment duration
0.006 predictive value

SECONDARY outcome

Timeframe: Up to Week 72

Population: PP population. Here "number of participants analyzed" included participants evaluable for the outcome measure and "n" signified evaluable participants for specific HCV genotype.

SVR was defined as undetectable HCV RNA 24 weeks after end of treatment.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=128 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Duration of Treatment in Participants With SVR by HCV Genotype
HCV genotype 1(n=111)
329.95 days
Interval 116.0 to 365.0
Duration of Treatment in Participants With SVR by HCV Genotype
HCV genotype 3(n=16)
173.25 days
Interval 140.0 to 337.0
Duration of Treatment in Participants With SVR by HCV Genotype
HCV genotype 4(n=1)
335.00 days
Interval 335.0 to 335.0

SECONDARY outcome

Timeframe: Up to Week 72

Population: PP population. Here "number of participants analyzed" included participants evaluable for the outcome measure and "n" signified evaluable participants for specific HCV genotype.

SVR was defined as undetectable HCV RNA 24 weeks after end of treatment.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=128 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Cumulative PEG-IFN Alfa-2a Dose in Participants With SVR by HCV Genotype
HCV genotype 1(n=111)
24701.70 µg
Interval 6711.43 to 28157.14
Cumulative PEG-IFN Alfa-2a Dose in Participants With SVR by HCV Genotype
HCV genotype 3(n=16)
13030.71 µg
Interval 10800.0 to 25997.14
Cumulative PEG-IFN Alfa-2a Dose in Participants With SVR by HCV Genotype
HCV genotype 4(n=1)
25842.86 µg
Interval 25842.86 to 25842.86

SECONDARY outcome

Timeframe: Up to Week 72

Population: PP population. Here "number of participants analyzed" included participants evaluable for the outcome measure and "n" signified evaluable participants for specific HCV genotype.

SVR was defined as undetectable HCV RNA 24 weeks after end of treatment.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=128 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Cumulative Ribavirin Dose in Participants With SVR by HCV Genotype
HCV genotype 1(n=111)
1062607 mg
Interval 348000.0 to 1314000.0
Cumulative Ribavirin Dose in Participants With SVR by HCV Genotype
HCV genotype 3(n=16)
538812.50 mg
Interval 100800.0 to 1011000.0
Cumulative Ribavirin Dose in Participants With SVR by HCV Genotype
HCV genotype 4(n=1)
1005000 mg
Interval 1005000.0 to 1005000.0

SECONDARY outcome

Timeframe: 4 weeks after EOT (up to Week 76)

Population: PP population.

The Virological response at the end of treatment was defined as the percentage of participants with undetectable HCV RNA, HCV test (based on a single last undetectable HCV RNA PCR falling in the 4 weeks' time window at end of treatment), is basically the sum of participants with SVR and with relapse.

Outcome measures

Outcome measures
Measure
HCV Infected Participants
n=331 Participants
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately up to 24 weeks after EOT. Dose change was as per investigators' discretion.
Percentage of Participants With Virological Response
46.8 percentage of participants

Adverse Events

HCV Infected Participants

Serious events: 17 serious events
Other events: 273 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
HCV Infected Participants
n=440 participants at risk
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately 24 weeks. Dose change was as per investigators' discretion.
Blood and lymphatic system disorders
Anaemia
0.91%
4/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Blood and lymphatic system disorders
Anaemia haemolytic
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Blood and lymphatic system disorders
Astenia
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Blood and lymphatic system disorders
Leucopenia
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Blood and lymphatic system disorders
Neutropenia
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Cardiac disorders
Angina pectoris
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Cardiac disorders
Tachycardia
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Gastrointestinal disorders
Chronic gastritis
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Gastrointestinal disorders
Nausea
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Gastrointestinal disorders
Pancreatitis chronic
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Gastrointestinal disorders
Stomatitis
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Gastrointestinal disorders
Vomiting
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
General disorders
Pyrexia
0.45%
2/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Immune system disorders
Drug reaction with eosinophilia and systemic symptoms
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Infections and infestations
Latent tuberculosis
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Infections and infestations
Pulmonary tuberculosis
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Nervous system disorders
Cerebral infarction
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Nervous system disorders
Encephalopathy
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Nervous system disorders
Ischeamic stroke
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Psychiatric disorders
Psychotic disorder
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Renal and urinary disorders
Renal abcess
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Renal and urinary disorders
Renal sepsis
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Respiratory, thoracic and mediastinal disorders
Cough
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Respiratory, thoracic and mediastinal disorders
Pneumonia
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Skin and subcutaneous tissue disorders
Rash
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Vascular disorders
Hypotonia
0.23%
1/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.

Other adverse events

Other adverse events
Measure
HCV Infected Participants
n=440 participants at risk
Participants who were infected by HCV and receiving PEG-IFN alfa-2a 180 µg/week subcutaneously, plus ribavirin tablets 1000 mg (those weighing \<75 kg) or 1200 mg (those weighing \> 75 kg) orally; were observed for approximately 24 weeks. Dose change was as per investigators' discretion.
Blood and lymphatic system disorders
Anaemia
25.9%
114/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Blood and lymphatic system disorders
Leucopenia
26.1%
115/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
Blood and lymphatic system disorders
Thrombocytopenia
25.2%
111/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
General disorders
Fever
15.5%
68/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.
General disorders
Fatigue
7.0%
31/440 • 24 weeks after EOT (up to Week 96)
Safety population included all participants with any therapy assessment.

Additional Information

Medical Communications

Hoffmann-La Roche

Phone: 800-821-8590

Results disclosure agreements

  • Principal investigator is a sponsor employee The Study being conducted under this Agreement is part of the Overall Study. Investigator is free to publish in reputable journals or to present at professional conferences the results of the Study, but only after the first publication or presentation that involves the Overall Study. The Sponsor may request that Confidential Information be deleted and/or the publication be postponed in order to protect the Sponsor's intellectual property rights.
  • Publication restrictions are in place

Restriction type: OTHER