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This is a randomized, open label, single center safety and efficacy study. At least 40 cirrhotic subjects with HCV genotype 3 will receive standard of care treatment of sofosbuvir and ribavirin (SOF/RBV) as well as 60 mg daily of Daclatasvir (investigational product). Subjects will be randomized in a 1:1 to receive either:
Subjects will return to the study center at various time points throughout the 16 or 24 weeks of treatment in addition to 12 weeks post taking last dose of study drug to monitor safety and efficacy. These visits will be according to standard of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A - 16 weeks | Experimental | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 16 weeks |
|
| Group B - 24 weeks | Active Comparator | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 24 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| daclatasvir | Drug |
|
| |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Adverse Events | This field states the number of participants who had an adverse event | From baseline (start of study drugs) to last day of taking study drugs; an average of 20 weeks. |
| Number of Participants With Abnormal Safety Laboratory Tests (ALT and/or Total Bilirubin) That Required Discontinuing Study Drugs | This field states the number of participants who had an abnormal ALT that required discontinuing study drugs and/or abnormal Total Bilirubin that required discontinuing study drugs. | From baseline (start of study drugs) to last day of taking study drugs; an average of 20 weeks. |
| Number of Participants With Undetectable HCV Virus 12 Weeks After Stopping Study Drugs | Sustained Virologic Response (SVR) defined as undetectable HCV RNA 12 weeks after stopping study drugs. | From baseline (start of study drugs) until 12 weeks after stopping study drugs |
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Inclusion Criteria:
Signed, written, informed consent must be available from the subject before any study-specific procedures are performed;
Male or female 18-75 years of age;
All of the following at least 6 months prior to screening visit:
Subjects with evidence of cirrhosis defined by either a liver biopsy <= 3 years from screening demonstrating a Metavir Fibrosis Score of F4 (or equivalent); OR Fibroscan® <= 1 year from screening > 12.5 kPa. If a subject is evaluated by more than one testing method, then the liver biopsy results take precedence;
Women of childbearing potential (WOCBP) must:
At minimum the subject agrees to the use of two methods of contraception, with at least one method being highly effective as listed below:
Highly Effective Methods of Contraception
Less Effective Methods of Contraception
Azoospermic males, women who are not of childbearing potential and WOCBP who abstain from heterosexual activity on a continuous basis, are exempt from contraceptive requirements. However, WOCBP who abstain from heterosexual activity on a continuous basis must still undergo pregnancy testing.
Exclusion Criteria:
Subjects who lack capacity to consent for themselves;
HCV Genotypes other than GT-3 infection; mixed genotype infections are not permitted;
Liver histology consistent with any other co-existing cause of chronic liver disease (apart from fatty liver and/or Chronic Hepatitis B Virus);
Body Mass Index > 40 at the Screening visit;
Any of the following within one month of screening:
Any of the following within 6 months of screening visit, any of the following:
QTcF ≥ 500 ms at the baseline visit.
Any of the following laboratory abnormalities within 8 weeks of the baseline visit:
Prior exposure to NS5A inhibitors is prohibited but other classes and pegIFN/RBV are acceptable for treatment-experienced subjects;
Use of any prohibited or restricted treatment at least is five half-lives or 14 days (whichever is longer) of the first dose of study drug (refer to section 4.5);
History of cancer within 1 year of the screening visit with the exception of localized basal or squamous cell carcinoma;
Any gastrointestinal disease or surgical procedure that may impact the absorption of study drug. (Subjects who have had cholecystectomy are permitted to enter the study);
Known HIV infection;
Confirmed, uncontrolled hypertension (any screening systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg should be excluded);
Presence or history of non-HCV chronic liver disease, including autoimmune hepatitis, alpha-1-antitrypsin deficiency, hemochromatosis, Wilson's disease, drug- or toxin-induced liver disease, alcohol-related liver disease, primary biliary cirrhosis and sclerosing cholangitis. Subjects with fatty liver and/or chronic hepatitis B virus in addition to HCV may be considered in the study;
Uncontrolled seizures disorder;
History of hemoglobinopathies, (e.g., thalassemia, sickle cell anemia, spherocytosis) or other cause of hemolytic anemia, including autoimmune causes;
Active disease at screening visit known to cause significant alteration in immunologic function including hematologic malignancy, sarcoidosis or autoimmune disorder (e.g., rheumatoid arthritis, systemic lupus erythematosis, leukemia, lymphoma, autoimmune thyroid disease, scleroderma, unstable psoriasis, and multiple sclerosis);
Pregnant or lactating women or women who plan to become pregnant during the study;
History of hypersensitivity to drugs with a similar biochemical structure to DCV or SOF or RBV;
Any other criteria or known contraindication that would exclude the subject from receiving SOF or RBV (per the local label) or DCV;
Inability to tolerate oral medication;
Subjects, who in the opinion of the Investigator, are not suitable candidates for enrollment or who would not comply with the requirements of the study.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Southern California Research Center | Coronado | California | 92118 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Group A - 16 Weeks | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 16 weeks daclatasvir, Daklinza Sofosbuvir, Sovaldi Ribavirin |
| FG001 | Group B - 24 Weeks |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Sep 5, 2015 |
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| Sofosbuvir, Sovaldi |
| Drug |
|
|
| Ribavirin | Drug |
|
|
Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 24 weeks
daclatasvir, Daklinza
Sofosbuvir, Sovaldi
Ribavirin
| COMPLETED |
|
| NOT COMPLETED |
|
A total of 39 participants started treatment with sofosbuvir, ribavirin and daclatasvir. 21 were randomized to Group A (16 weeks of treatment). 18 were randomized to Group B (24 weeks of treatment).
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| ID | Title | Description |
|---|---|---|
| BG000 | Group A - 16 Weeks | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 16 weeks daclatasvir, Daklinza Sofosbuvir, Sovaldi Ribavirin |
| BG001 | Group B - 24 Weeks | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 24 weeks daclatasvir, Daklinza Sofosbuvir, Sovaldi Ribavirin |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Pre-treatment HCV RNA (viral load) | Mean | Standard Deviation | IU/mL |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Adverse Events | This field states the number of participants who had an adverse event | Posted | Count of Participants | Participants | From baseline (start of study drugs) to last day of taking study drugs; an average of 20 weeks. |
|
|
| ||||||||||||||||||||||||||||||
| Primary | Number of Participants With Abnormal Safety Laboratory Tests (ALT and/or Total Bilirubin) That Required Discontinuing Study Drugs | This field states the number of participants who had an abnormal ALT that required discontinuing study drugs and/or abnormal Total Bilirubin that required discontinuing study drugs. | Posted | Count of Participants | Participants | From baseline (start of study drugs) to last day of taking study drugs; an average of 20 weeks. |
|
| |||||||||||||||||||||||||||||||
| Primary | Number of Participants With Undetectable HCV Virus 12 Weeks After Stopping Study Drugs | Sustained Virologic Response (SVR) defined as undetectable HCV RNA 12 weeks after stopping study drugs. | The analysis covers only the subjects who reached the 12 weeks after stopping study drugs time point. 19 of 21 participants randomized to Group A reached that timepoint and 16 of 18 participants randomized to Group B reached that timepoint. | Posted | Count of Participants | Participants | From baseline (start of study drugs) until 12 weeks after stopping study drugs |
|
|
From start of treatment to 12 weeks after stopping treatment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Group A - 16 Weeks of Treatment | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 16 weeks daclatasvir, Daklinza Sofosbuvir, Sovaldi Ribavirin | 1 | 21 | 0 | 21 | 21 | 21 |
| EG001 | Group A - 24 Weeks of Treatment | Combination of sofosbuvir 400 mg daily, ribavirin 1000-1200 mg daily (weight based) and daclatasvir 60 mg daily for 24 weeks daclatasvir, Daklinza Sofosbuvir, Sovaldi Ribavirin | 1 | 18 | 2 | 18 | 18 | 18 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Infection | Infections and infestations | Non-systematic Assessment |
| ||
| Violence | Social circumstances | Non-systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Flu-like symptoms | General disorders | Non-systematic Assessment |
| ||
| Mood Changes | Psychiatric disorders | Non-systematic Assessment |
| ||
| Fatigue | General disorders | Non-systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Abdominal Pain | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Insomnia | Psychiatric disorders | Non-systematic Assessment |
| ||
| Decompensation | Hepatobiliary disorders | Non-systematic Assessment |
| ||
| Decreased Appetite | General disorders | Non-systematic Assessment |
| ||
| Rash | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Headache | Nervous system disorders | Non-systematic Assessment |
| ||
| Dyspnea | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
| ||
| Dizziness | Nervous system disorders | Non-systematic Assessment |
| ||
| Vomiting | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Anemia | Blood and lymphatic system disorders | Non-systematic Assessment |
| ||
| Pruritus | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
| ||
| Dehydration | Metabolism and nutrition disorders | Non-systematic Assessment |
|
Study received IND approval in November 2014. Daclatasvir received initial FDA approval in July 2015. Participants were randomized to receive daclatasvir for either 16 or 24 weeks and were followed per standard of care.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Tarek Hassanein | Southern California Research Center | 619-319-3993 | thassanein@livercenters.com |
| Feb 3, 2018 |
| Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Nov 23, 2015 | Feb 3, 2018 | ICF_001.pdf |
| ID | Term |
|---|---|
| D006526 | Hepatitis C |
| D005355 | Fibrosis |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D006525 | Hepatitis, Viral, Human |
| D014777 | Virus Diseases |
| D018178 | Flaviviridae Infections |
| D012327 | RNA Virus Infections |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C549273 | daclatasvir |
| D000069474 | Sofosbuvir |
| D012254 | Ribavirin |
| ID | Term |
|---|---|
| D014542 | Uridine Monophosphate |
| D014500 | Uracil Nucleotides |
| D011742 | Pyrimidine Nucleotides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D009711 | Nucleotides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012265 | Ribonucleotides |
| D012263 | Ribonucleosides |
| D009705 | Nucleosides |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
|
| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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