A Pilot Study to Treat Patients With Chronic Hepatitis C Virus (HCV) Genotype 1 and End-Stage Renal Disease (ESRD)

NCT ID: NCT01731301

Last Updated: 2012-11-22

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2015-01-31

Brief Summary

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1. A maximally tolerated dose of ribavirin can be defined in each patient with ESRD undergoing hemodialysis.
2. Patients with Chronic Hepatitis C Virus (HCV)and End-Stage Renal Disease (ESRD)undergoing hemodialysis will be able to tolerate and remain on treatment with peginterferon alfa-2b, the maximally tolerated dose of ribavirin and boceprevir.
3. A significant percentage of patients with chronic HCV and ESRD undergoing hemodialysis can achieve rapid virologic response (RVR), extended virologic response (eRVR) and sustained virologic response (SVR) when treated with peginterferon alfa-2b, the maximally tolerated dose of ribavirin and boceprevir.

Detailed Description

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Patients with ESRD will be treated with a dose escalation of ribavirin starting from 200 mg everyday (QD) to a maximal tolerated dose. Peginterferon will then be added. Ribavirin will be dose adjusted as needed. Boceprevir will then be added. Ribavirin will be dose adjusted as needed. Patients will be monitored for eRVR and SVR. The study end-point is eRVR.

Conditions

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Chronic Hepatitis C End Stage Renal Disease

Keywords

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Chronic hepatitis C HCV End stage renal disease ESRD Boceprevir Ribavirin Peg-interferon Triple therapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ribavirin, peginterferon, boceprevir

The efficacy and safety of HCV treatment in patients with ESRD will be assessed with a maximal tolerated dose of ribavirin, peginterferon and boceprevir.

Group Type EXPERIMENTAL

Ribavirin

Intervention Type DRUG

Ribavirin monotherapy will be started at a dose of 100 mg daily. After each successive week the dose of ribavirin will be increased by 100 mg increments daily as long as the hemoglobin remains greater than 10 gm/dl and/or there has not been a decline in the hemoglobin by more than 2 gms/dl from the pretreatment baseline.

Peginterferon

Intervention Type DRUG

After the patient has remained on their maximal tolerated dose of ribavirin for 1 week peginterferon alpha-2b will be initiated at a dose of 1.0 mcg/kg/week. This dose was chosen because it is known to be equivalent in achieving SVR when compared to the 1.5 mcg/kg/dose and is associated with less bone marrow suppression. The dose of ribavirin will be adjusted as needed.

Boceprevir

Intervention Type DRUG

Boceprevir will be added after the patient is on stable doses of ribavirin and peginterferon. The dose of ribavirin will be adjusted as needed.

Interventions

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Ribavirin

Ribavirin monotherapy will be started at a dose of 100 mg daily. After each successive week the dose of ribavirin will be increased by 100 mg increments daily as long as the hemoglobin remains greater than 10 gm/dl and/or there has not been a decline in the hemoglobin by more than 2 gms/dl from the pretreatment baseline.

Intervention Type DRUG

Peginterferon

After the patient has remained on their maximal tolerated dose of ribavirin for 1 week peginterferon alpha-2b will be initiated at a dose of 1.0 mcg/kg/week. This dose was chosen because it is known to be equivalent in achieving SVR when compared to the 1.5 mcg/kg/dose and is associated with less bone marrow suppression. The dose of ribavirin will be adjusted as needed.

Intervention Type DRUG

Boceprevir

Boceprevir will be added after the patient is on stable doses of ribavirin and peginterferon. The dose of ribavirin will be adjusted as needed.

Intervention Type DRUG

Other Intervention Names

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Rebetol PegIntron, Rebetol and Victrelis Victralis

Eligibility Criteria

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Inclusion Criteria

* Chronic HCV defined by:
* A history of a positive anti-HCV or HCV RNA for \> 6 months or
* A liver biopsy demonstrating at least portal fibrosis
* HCV genotype 1
* No prior treatment with any interferon or peginterferon preparation
* ESRD undergoing hemodialysis for at least 6 months
* Willingness not to conceive a child during treatment and for 6 months following discontinuation of treatment.

Exclusion Criteria

* Histologic evidence of cirrhosis
* Any co-existent liver disease
* A platelet count \< 90,000
* A total white blood cell (WBC) \< 2.5
* An absolute neutrophil count \< 1.5
* Hemoglobin \< 11 gm/dl on Epoetin-alpha
* Positive test for anti-HIV
* Pregnancy of the patient or their intimate partner
* Women who are breast feeding
* Significant cardiovascular disease
* History of suicide intent, severe depression requiring hospitalization or significant psychiatric disease
* Malignancy within 5 years of enrollment except for squamous or basal cell skin cancer
* Co-existent immune disorder such as lupus, rheumatoid as arthritis, colitis, Crohns disease, sarcoidosis, etc.
* Any patient in the opinion of the investigator who would not be a satisfactory study candidate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Chronic Liver Disease Foundation

OTHER

Sponsor Role collaborator

Liver Institute of Virginia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mitchell L Shiffman, MD

Role: PRINCIPAL_INVESTIGATOR

Liver Institute of Virginia, Bon Secours Health System

Locations

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Liver Institute of Virginia

Richmond, Virginia, United States

Site Status

Countries

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United States

Central Contacts

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Mitchell L Shiffman, MD

Role: CONTACT

Phone: 804-977-8920

Email: [email protected]

April G. Long, NP

Role: CONTACT

Phone: 804-977-8920

Email: [email protected]

Facility Contacts

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Mitchell L Shiffman, MD

Role: primary

Other Identifiers

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LIV01

Identifier Type: -

Identifier Source: org_study_id