Treatment of HOsPitalised Inpatients for Hepatitis C (TOPIC): Therapeutic Intervention Enhancing Care Linkage in People Who Inject Drugs

NCT ID: NCT03981211

Last Updated: 2024-03-06

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-12

Study Completion Date

2025-02-12

Brief Summary

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This study will evaluate the proportion of patients achieving confirmed SVR12 (undetectable HCV RNA at time point 12 weeks plus post treatment commencement) in patients hospitalised for IRID (injecting related infectious diseases) and commencing inpatient DAA treatment within public hospital services.

Detailed Description

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This study will be conducted as a Phase IV, multicentre, sequential cohort trial.

60 participants will be enrolled from participating hospital inpatient services. They will be evaluated for eligibility by the use of rapid point-of-care (POC) confirmation of viraemia in people who inject drugs (PWID) hospitalised for IRID. The period of hospitalisation for management of IRID, particularly when prolonged, may represent an ideal opportunity to engage HCV-infected PWID and a potential important strategy for broader HCV elimination.

Eligible patients will be enrolled into one of two treatment cohorts A and B.

A) 30 patients will immediately commence treatment whilst an inpatient of G/P (glecaprevir/pibrentasvir) with continuation of therapy and follow-up in viral hepatitis services post discharge (standard duration therapy).

Following the successful completion of Cohort A, eligible patients will be enrolled into Cohort B.

B) 30 patients will immediately commence treatment whilst an inpatient of 4 weeks of SOF/G/P (sofosbuvir/glecaprevir/pibrentasvir) with continuation of therapy and follow-up in viral hepatitis services post discharge (short duration therapy).

Any patient with recurrent viraemia during follow-up will be genotyped +/- sequenced to exclude re-infection. If relapse is confirmed the patient will be offered re-treatment with standard of care (SOC) salvage therapy based on results of resistance testing.

Conditions

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Hepatitis C Liver Inflammation Liver Cirrhoses

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cohort A: 8 weeks G/P standard therapy

8 weeks treatment of a three fixed-dose combination of glecaprevir/pibrentasvir 100/40 mg tablets administered once daily with food (standard duration therapy).

Group Type EXPERIMENTAL

Glecaprevir/Pibrentasvir 100 MG-40 MG Oral Tablet

Intervention Type DRUG

8 weeks of 3 x co-formulated tablets of glecaprevir (100mg) and pibrentasvir (40mg) once daily or 4 weeks of 1 tablet sofosbuvir 400 mg and a three fixed-dose combination of glecaprevir/pibrentasvir 100/40 mg tablets administered once daily

Cohort B: 4 weeks SOF/G/P shortened therapy

4 weeks treatment of 1 tablet sofosbuvir 400 mg and a three fixed-dose combination of glecaprevir/pibrentasvir 100/40 mg tablets administered once daily with food (shortened duration therapy).

Group Type EXPERIMENTAL

Glecaprevir/Pibrentasvir 100 MG-40 MG Oral Tablet

Intervention Type DRUG

8 weeks of 3 x co-formulated tablets of glecaprevir (100mg) and pibrentasvir (40mg) once daily or 4 weeks of 1 tablet sofosbuvir 400 mg and a three fixed-dose combination of glecaprevir/pibrentasvir 100/40 mg tablets administered once daily

Sofosbuvir 400 MG + Glecaprevir/Pibrentasvir 100 MG-40 MG Oral Tablet

Intervention Type DRUG

4 weeks of 1 x sofosbuvir (400mg) tablet and 3 x co-formulated tablets of glecaprevir (100mg) and pibrentasvir (40mg) once daily

Interventions

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Glecaprevir/Pibrentasvir 100 MG-40 MG Oral Tablet

8 weeks of 3 x co-formulated tablets of glecaprevir (100mg) and pibrentasvir (40mg) once daily or 4 weeks of 1 tablet sofosbuvir 400 mg and a three fixed-dose combination of glecaprevir/pibrentasvir 100/40 mg tablets administered once daily

Intervention Type DRUG

Sofosbuvir 400 MG + Glecaprevir/Pibrentasvir 100 MG-40 MG Oral Tablet

4 weeks of 1 x sofosbuvir (400mg) tablet and 3 x co-formulated tablets of glecaprevir (100mg) and pibrentasvir (40mg) once daily

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Have voluntarily signed the informed consent form.
2. 18 years of age or older.
3. Injected drugs within the last 6 months
4. Hospitalised with an IRID with an anticipated inpatient stay of \> 1 week

5. HCV RNA positive
6. Compensated liver disease
7. Documented non-cirrhotic at enrolment with a qualifying liver FibroScan ≤ 9.5 kpA
8. If co-infection with HIV is documented, the subject must meet the following criteria:

1. ART naïve with CD4 T cell count \>500 cells/mm3; OR
2. On a stable ART regimen (containing only permissible ART) for \>4 weeks prior to screening visit, with CD4 T cell count ≥200 cells/mm3 and a plasma HIV RNA level below the limit of detection.

Exclusion Criteria

1. Inability or unwillingness to provide informed consent or abide by the requirements of the study
2. Actively intoxicated.

3. History of any of the following:

b. Clinical hepatic compensation (i.e. ascites, encephalopathy or variceal haemorrhage) c. Solid organ transplant d. History of severe, life-threatening or other significant sensitivity to study drugs (glecaprevir/pibrentasvir/sofosbuvir) or any excipients of the study drugs
4. Creatinine clearance (CLcr) \< 30 mL/min at screening (Cohort B only)
5. Pregnant or nursing female
6. Decompensated liver disease
7. Use of prohibited concomitant medications
8. Chronic use of systemically administered immunosuppressive agents (e.g. prednisone equivalent \> 10 mg/day for \>2 weeks)
9. Prior treatment failure with an NS5A based DAA regimen

Patients without an IRID but who fulfill all other criteria and are admitted with an expected duration of stay \> 1 week may also be included at discretion of study team.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kirby Institute

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status NOT_YET_RECRUITING

St Vincent's Hospital Sydney

Sydney, New South Wales, Australia

Site Status RECRUITING

Blacktown Mt Druitt Hospital

Sydney, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Westmead Hospital

Westmead, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status NOT_YET_RECRUITING

The Alfred Hospital

Melbourne, Victoria, Australia

Site Status NOT_YET_RECRUITING

St Vincent's Hospital

Melbourne, Victoria, Australia

Site Status NOT_YET_RECRUITING

Countries

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Australia

Central Contacts

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Amanda Erratt

Role: CONTACT

61 2 9385 0882

Pip Marks

Role: CONTACT

61 2 9385 0886

Facility Contacts

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Jeffrey Post

Role: primary

Gail Matthews

Role: primary

Golo Ahlenstiel, MD

Role: primary

Mark Douglas

Role: primary

Emily Rowe

Role: primary

Joseph Doyle

Role: primary

Alexander Thompson

Role: primary

Other Identifiers

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VHCRP1902

Identifier Type: -

Identifier Source: org_study_id

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