Efficacy and Safety of Peg-Interferon Alpha-2a Plus Ribavirin in Genotype 1 Chronic Hepatitis C Participants Co-Infected With Human Immunodeficiency Virus

Overview

This randomized, multi-center, Phase IV, comparative study will assess the efficacy and safety of combined peg-interferon alpha-2a (Peg-IFN-Alpha-2A) and ribavirin therapy for 48 or 72 weeks of treatment and 24 weeks of follow-up in participants with Genotype 1 chronic hepatitis C (CHC), co-infected with human immunodeficiency virus type 1 (HIV-1).

Full Title of Study: “Randomized, Multi-Center, Phase IV, Comparative Study to Assess the Efficacy and Safety of Combined Peg-Interferon Alpha-2a (40 kD) With Ribavirin Combined Therapy for 48 or 72 Weeks of Treatment and 24 Weeks of Follow-Up in Patients With Chronic Hepatitis C, Genotype 1, Co-Infected With Human Immunodeficiency Virus”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: May 2008

Interventions

  • Drug: Peg-Interferon Alpha-2A
    • Peg-IFN-Alpha-2A will be administered at 180 micrograms (mcg) once weekly via subcutaneous injection.
  • Drug: Ribavirin
    • Ribavirin will be administered as either 1000 milligrams (mg) (2*200 mg tablets in morning and 3*200 mg tablets in evening) for participants weighing less than (<) 75 kilograms (kg) or as 1200 mg (3*200 mg tablets in morning and 3*200 mg tablets in evening) for participants weighing greater than or equal to (>/=) 75 kg.

Arms, Groups and Cohorts

  • Experimental: Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks
    • Participants will receive Peg-IFN-Alpha-2A and ribavirin for 48 weeks.
  • Active Comparator: Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks
    • Participants will receive Peg-IFN-Alpha-2A and ribavirin for 72 weeks.

Clinical Trial Outcome Measures

Primary Measures

  • Percentage of Participants With Sustained Virologic Response (SVR)
    • Time Frame: 24 weeks after completion of study treatment (up to Week 72 for “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm and up to Week 96 for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm)
    • SVR was defined as having un-detectable hepatitis C virus (HCV) ribonucleic acid (RNA) levels 24 weeks after completion of study treatment. HCV RNA levels were measured using Roche COBAS AMPLICOR HCV Test (limit of detection: 50 International Units per milliliter [IU/mL]). Participants with detectable HCV RNA or without measurement at the end of the 24 week after completion of study treatment were considered as non-responders.

Secondary Measures

  • Percentage of Participants With Undetectable HCV RNA
    • Time Frame: For “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm: Weeks 4, 12, 24, and 48; for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm: Weeks 4, 12, 24, 48, and 72
    • HCV RNA levels were measured using Roche COBAS AMPLICOR HCV Test (limit of detection: 50 IU/mL). Data for this outcome measure was to be reported up to end of treatment visit (Week 48 for ‘Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks’ arm and Week 72 for ‘Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks’ arm).
  • Percentage of Participants With Undetectable HCV RNA 12 Weeks After the Last Dose of Peg-IFN-Alpha-2A
    • Time Frame: 12 weeks after the last dose of Peg-IFN-Alpha-2A (up to Week 60 for “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm and up to Week 84 for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm)
    • HCV RNA levels were measured using Roche COBAS AMPLICOR HCV Test (limit of detection: 50 IU/mL). Participants with detectable HCV RNA or without measurement at the end of 12 weeks after the last dose of Peg-IFN-Alpha-2A were considered as non-responders.
  • Percentage of Participants Without SVR Among Participants With Undetectable HCV RNA at the End of Treatment
    • Time Frame: 24 weeks after completion of study treatment (up to Week 72 for “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm and up to Week 96 for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm)
    • SVR was defined as having undetectable HCV RNA levels 24 weeks after completion of study treatment. HCV RNA levels were measured using Roche COBAS AMPLICOR HCV Test (limit of detection: 50 IU/mL). Percentage of participants without SVR among participants with undetectable HCV RNA at the end of treatment was reported (end of treatment = Week 48 for “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm and Week 72 for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm).
  • Serum Human Immunodeficiency Virus (HIV) RNA Levels
    • Time Frame: For “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm: Weeks 4, 12, 24, 48, and 72; for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm: Weeks 4, 12, 24, 48, 72, and 96
    • HIV RNA levels were measured using Roche AMPLICOR MONITOR HIV-1 Test (limit of detection: 400 HIV-1 RNA copies/mL). Data for this outcome measure was to be reported up to 24 weeks after end of treatment visit (Week 72 for ‘Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks’ arm and Week 96 for ‘Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks’ arm).
  • Change From Baseline in Cluster of Differentiation (CD) 4 (CD4) Cell Counts at Weeks 4, 12, 24, 48, 72, and 96
    • Time Frame: For “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm: Baseline, Weeks 4, 12, 24, 48, and 72; for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm: Baseline, Weeks 4, 12, 24, 48, 72, and 96
    • Data for this outcome measure was to be reported up to 24 weeks after end of treatment visit (Week 72 for ‘Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks’ arm and Week 96 for ‘Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks’ arm).
  • Change From Baseline in CD4/CD8 Ratio at Weeks 4, 12, 24, 48, 72, and 96
    • Time Frame: For “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm: Baseline, Weeks 4, 12, 24, 48, and 72; for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm: Baseline, Weeks 4, 12, 24, 48, 72, and 96
    • Data for this outcome measure was to be reported up to 24 weeks after end of treatment visit (Week 72 for ‘Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks’ arm and Week 96 for ‘Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks’ arm).
  • Percentage of Participants With Alanine Aminotransferase (ALT) Level Categories
    • Time Frame: For “Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks” arm: Weeks 4, 12, 24, 48, and 72; for “Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks” arm: Weeks 4, 12, 24, 48, 72, and 96
    • ALT levels were classified as: Normal Limit (NL) (as per laboratory standard), >1-2 Upper Normal Limit (ULN), >2-5 ULN, >5-10 ULN, and >10 ULN. Percentage of participants in each of these ALT level categories was reported. Data for this outcome measure was to be reported up to 24 weeks after end of treatment visit (Week 72 for ‘Peg-IFN-Alpha-2A+Ribavirin – 48 Weeks’ arm and Week 96 for ‘Peg-IFN-Alpha-2A+Ribavirin – 72 Weeks’ arm).

Participating in This Clinical Trial

Inclusion Criteria

  • Serological evidence of chronic hepatitis C infection by anti-hepatitis C virus (HCV) test – Detectable HCV-ribonucleic acid (RNA) plasma level testing by Roche AMPLICOR HCV (<50 International Units per milliliter [IU/mL]) (qualitative test) – Chronic liver disease consistent with infection of CHC – Compensated liver disease (Child-Pugh Grade A) – Serological evidence of infection by HIV-1 test, anti-HIV-1 or HIV-1 RNA detection – Negative pregnancy urine or blood test (for women in childbearing age); additionally, all men and women of childbearing potential must agree to use two effective forms of contraception during the treatment and during the 6 months after the end of treatment Exclusion Criteria:

  • Pregnant or nursing women and male partners of pregnant women – Prior therapy with interferon (IFN) or ribavirin and any investigational medication less than or equal to (</=) 6 weeks before the first dose of the study drug – History or other evidence of a medical condition associated with chronic liver disease further than HCV – Active opportunistic infection associated with HIV and / or cancer requiring systemic therapy – History of any other significant illness which in the investigator's opinion, could result in the participant's inability to meet the Protocol requirements

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Hoffmann-La Roche
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Clinical Trials, Study Chair, Hoffmann-La Roche

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