This is an exploratory study and is a Phase 3, single-arm, multi-center, open-label study of pegylated interferon alfa-2b, PEG-IFN alpha-2b (PEG-Intron) and ribavirin (RBV) to determine the sustained virologic response (SVR) at 24-week follow-up to 48 week in subjects after orthotopic liver transplantation (OLT) with chronic hepatitis C (HCV) recurrence.

Inclusion Criteria:

• Subjects must confirm that all prior medication washout times have been observed.

• Subject must be 18 - 70 years of age of either gender and of any race.

• Subject must be transplanted for end-stage hepatitis C or fulminant hepatitis C.

• Subject must have documented:

  • persistent HCV viremia after OLT as defined by plasma positive for HCV RNA by quantitative reverse transcription-polymerase chain reaction (RT-PCR),
  • A liver transplant performed at least 3 months prior to screening but not more than 3 years prior to screening.

• Subject must be on stable doses of immunosuppression for at least 1 month.

• Compensated liver disease with minimum hematologic, biochemical, and serologic criteria at the (Day 1) baseline visit.

  • Alpha-fetoprotein value (AFP) less than or equal to 250ng/mL. If AFP greater than 100 ng/mL, patient will need evidence of normal liver (magnetic resonance imaging) MRI and normal chest computerized tomography (CT) scan within the last 3 months or during the screening period.

• For subjects with a history of diabetes or hypertension, clearance from an ophthalmologist has to be obtained prior to treatment start (Day 1/Visit 2).

• Subjects with a history of mild depression may be considered for entry into this study.

• Female subjects cannot be pregnant or breastfeeding and must be either postmenopausal, surgically sterile or using 2 methods of birth control.

• Sexually active male subjects are practicing an acceptable, method of contraception.

• Contraceptive measures will be reviewed with female subjects at each visit. Dual methods of contraception must be used for 1 month prior to the start of treatment and 6 months after treatment discontinuation.

• Pregnancy tests obtained at Screen Visit and Day 1 Visit prior to the initiation of treatment must be negative.

Exclusion Criteria:

• Pregnant women, women who plan to become pregnant, male subjects whose partner wants to become pregnant, and breastfeeding women (during study and up to 6 months after study completion).
• Subject has used any investigational product within 30 days prior to Screening or is participating in any other clinical study.
• Prior treatment for chronic hepatitis C post-liver transplant, including but not limited to antiviral or immunomodulatory product, any interferon product, or RBV, either as monotherapy or in combination.
• Subjects with other organ transplants.
• Any subject who received a positive hepatitis C core antibody (HBcAb) or HCV positive donor liver graft.
• Retransplantation of the liver for rejection or graft failure.
• Evidence of decompensated liver disease.
• Known coagulopathies including hemophilia.
• Known hemoglobinopathies.
• Known glucose-6-phosphate dehydrogenase (G6PD) deficiency.
• Hypersensitivity to alpha interferon and/or RBV.
• Co-infection with hepatitis B virus (HBV) and/or human immunodeficiency virus (HIV).
• Evidence of active or suspected malignancy or a history of malignancy within the last 5 years (with the exception of pre-transplant hepatocellular carcinoma histologically within the Milan criteria, and adequately treated basal or squamous cell carcinoma of the skin).
• Any known pre-existing medical condition that could interfere with the subject's participation in and completion of the study.
• Subject is or was a substance abuser. Subjects treated with buprenorphine (Subutex) who have been stable for 6 months may be included.
• Patients weighing over 135 kg;

Is participating in any other clinical study(ies);

Is allergic to or has sensitivity to the study drug or its excipients.

http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final\_Updated%20July\_9\_2014.pdf

http://engagezone.msd.com/ds\_documentation.php