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A Phase 2, Multicenter, Randomized, Open-label, Dose-ranging Study to Evaluate the Efficacy and Safety of TG-2349 in Combination with Peg-interferon and Ribavirin in Treatment Naïve East Asian Subjects with Chronic Hepatitis C Virus Genotype 1b Infection.
It is a multicenter, randomized, open-label study to evaluate the safety, tolerability, and antiviral efficacy of two different doses of TG-2349 combined with Peg-interferon (IFN) and Ribavirin (RBV) in HCV-GT1b treatment naïve East Asian subjects. The treatment duration of TG-2349+IFN+RBV is 12 weeks, with or without an additional 12-week treatment of IFN+RBV, depending on HCV RNA level at On-Treatment Week 4. Approximately 24 subjects will be randomized (1:1) to one of the following 2 treatment groups:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | Experimental | 200 mg TG-2349 (2 capsules) + Interferon or Peg-interferon + Ribavirin |
|
| Group II | Experimental | 400 mg TG-2349 (4 capsules) + Interferon or Peg-interferon + Ribavirin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TG-2349 | Drug | TG-2349 (Furaprevir) is available as a Swedish orange capsule (size 0) for oral administration. Each capsule contains an equivalent of 100 mg of TG-2349 spray dried solid (SDD) and the following inactive ingredients: microcrystalline cellulose, croscarmellose sodium, sodium lauryl sulfate, magnesium stearate, and colloidal silicon oxide. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Subjects Achieving Sustained Viral Response at 12 Weeks After the End of Treatment. | Proportion of subjects with HCV RNA< LLOQ (lower limit of quantification), TD (target detected) or TND (target not detected) at 12 weeks after the end of treatment (SVR12) in the Full Analysis Set (FAS) population, which include subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | 12 weeks after the end of treatment (SVR12), after 12-week treatments |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Subjects Achieving Sustained Viral Response at 4, 8, and 24 Weeks After the End of Treatment (SVR4, SVR8, and SVR24) | 4, 8, 24 weeks after the end of treatment (SVR4, 8, 24), after 12-week treatments | |
| Proportion of Subjects Achieving HCV RNA < Lower Limit of Quantification, Target Detected or Target Not Detected (< LLOQ, TD or TND) |
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Inclusion Criteria:
(1) A positive anti-HCV antibody test or positive HCV RNA or positive HCV genotyping test at least 6 months prior to the Baseline/Day 1 visit or (2) A liver biopsy or FibroTest performed prior to the Baseline/Day 1 visit with evidence of chronic HCV infection, such as the presence of fibrosis and/or inflammation.
5. Positive for anti-HCV antibody at Screening. 6. Presence of an HCV RNA level ≥ 1 x 10000 IU/mL at Screening as determined by the Central Laboratory.
7. Presence of genotype 1b HCV-infection at Screening as determined by the Central Laboratory. Any non-definitive results will exclude the subject from study participation.
8. HCV treatment naïve defined as no prior therapy with any interferon (IFN), ribavirin (RBV), or other approved or investigational HCV-specific agent.
9. Absence of cirrhosis
Cirrhosis as defined as any one of the following:
If no definitive diagnosis of cirrhosis by the above criteria, a liver biopsy is required; liver biopsy results will supersede non-invasive testing results and be considered definitive.
10. Screening ECG without clinically significant abnormalities. 11. Subjects must have the following laboratory parameters at Screening:
13. Subject must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments, including all required Post-Treatment visits.
14. A female subject is eligible to enter the study if it is confirmed that she is:
(1) Not pregnant or nursing. (2) Of non-childbearing potential (i.e., women who have had a hysterectomy, have both ovaries removed or medically documented ovarian failure, or are postmenopausal - women > 50 years of age with cessation (for ≥12 months) of previously occurring menses), or (3) Of childbearing potential (i.e., women who have not had a hysterectomy, have not had both ovaries removed, and have not had medically documented ovarian failure).
Women ≤ 50 years of age with amenorrhea will be considered to be of childbearing potential. These women must have a negative serum pregnancy test at Screening and a negative urine pregnancy test at the Baseline/Day 1 visit prior to randomization. They must also agree to one of the following from Screening until 6 months after the last dose of study drug(s):
- Complete abstinence from intercourse. Periodic abstinence from intercourse (e.g., calendar, ovulation, symptothermal, post-ovulation methods) is not permitted.
Or - Consistent and correct use of 1 of the following methods of birth control listed below, in addition to a male partner who correctly uses a condom, from Screening until 6 months after the last dose of study drug(s):
i. implants of levonorgestrel ii. injectable progesterone iii. oral contraceptives (either combined or progesterone only) iv. contraceptive vaginal ring v. transdermal contraceptive patch. 15. Male subjects must agree to consistently and correctly use a condom, while their female partner agrees to use 1 of the methods of birth control listed above, from Screening until 6 months after the last dose of study drug(s).
16. Male subjects must agree to refrain from sperm donation from Screening until at least 6 months after the last dose of study drug(s).
Exclusion Criteria:
(1) Hematologic stimulating agents (e.g., erythropoiesis-stimulating agents [ESAs], granulocyte colony stimulating factor [G-CSF], and thrombopoietin [TPO] mimetics) (2) Chronic use of systemic immunosuppressants including, but not limited to, corticosteroids (prednisone equivalent of > 10 mg/day for > 2 weeks), azathioprine, or monoclonal antibodies (eg, infliximab) (3) Investigational agents or devices for any indication (4) Drugs disallowed per prescribing information of RBV or IFN (5) Any prohibited medications listed in Table 6-2. 11. Known hypersensitivity to RBV, IFN, TG-2349, sulfa drugs, or formulation excipients.
12. Current or prior history of any of the following:
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| Name | Affiliation | Role |
|---|---|---|
| Ming-Lung Yu | Kaohsiung Medical University Chung-Ho Memorial Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kaohsiung Medical University Chung-Ho Memorial Hospital | Kaohsiung City | Taiwan |
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| ID | Title | Description |
|---|---|---|
| FG000 | 200 mg TG-2349 | 200 mg TG-2349 (2 capsules) + Interferon or Peg-interferon + Ribavirin |
| FG001 | 400 mg TG-2349 | 400 mg TG-2349 (4 capsules) + Interferon or Peg-interferon + Ribavirin |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs.
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| ID | Title | Description |
|---|---|---|
| BG000 | 200 mg TG-2349 | 200 mg TG-2349 (2 capsules) + Interferon or Peg-interferon + Ribavirin |
| BG001 | 400 mg TG-2349 | 400 mg TG-2349 (4 capsules) + Interferon or Peg-interferon + Ribavirin |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Proportion of Subjects Achieving Sustained Viral Response at 12 Weeks After the End of Treatment. | Proportion of subjects with HCV RNA< LLOQ (lower limit of quantification), TD (target detected) or TND (target not detected) at 12 weeks after the end of treatment (SVR12) in the Full Analysis Set (FAS) population, which include subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Posted | Count of Participants | Participants | 12 weeks after the end of treatment (SVR12), after 12-week treatments |
|
through study completion, up to 48 weeks
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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 I | 200 mg TG-2349 (2 capsules) + Interferon or Peg-interferon + Ribavirin |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Neutropenia | Blood and lymphatic system disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Li-Wen Chang | TaiGen Biotechnology Co., Ltd. | +886-2-8177-7020 | 1227 | lwchang@taigenbiotech.com |
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| ID | Term |
|---|---|
| D019698 | Hepatitis C, Chronic |
| ID | Term |
|---|---|
| D006526 | Hepatitis C |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D012254 | Ribavirin |
| D000077190 | Interferon alpha-2 |
| ID | Term |
|---|---|
| D012263 | Ribonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D016898 | Interferon-alpha |
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|
| Ribavirin | Drug | RBV (Ribavirin or COPEGUS®) is available as a light pink to pink colored, flat, oval-shaped, film-coated tablet for oral administration. Each tablet contains 200 mg of ribavirin and the following inactive ingredients: pregelatinized starch, microcrystalline cellulose, sodium starch glycolate, cornstarch, and magnesium stearate. The coating of the tablet contains Chromatone-P® or Opadry® Pink (made by using hydroxypropyl methyl cellulose, talc, titanium dioxide, synthetic yellow iron oxide, and synthetic red iron oxide), ethyl cellulose (ECD-30), and triacetin. |
|
| Interferon Alfa-2a | Drug | IFN (Interferon, Peg-interferon alpha-2a or PEGASYS®) is available as a sterile, preservative-free, colorless to light yellow injectable solution administered subcutaneously. Each prefilled syringe of 180 μg/0.5 mL IFN (expressed as the amount of interferon alfa-2a) also contains acetic acid (0.0231 mg), benzyl alcohol (5 mg), polysorbate 80 (0.025 mg), sodium acetate trihydrate (1.3085 mg), and sodium chloride (4 mg) at pH 6 ± 0.5. |
|
| The whole treatment period, 12 weeks |
| Proportion of Subjects Achieving HCV RNA < LLOQ, TND | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
| Mean Absolute Values in HCV RNA (log10 IU/mL) | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
| Proportion of Subjects Experiencing Virologic Failure During Treatment and Viral Relapse After the End of Treatment. | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
| Proportion of Subjects With Abnormal Alanine Aminotransferase (ALT) Levels at Baseline Who Achieved Normal Limit of ALT at Final Treatment Visit. | From baseline (day 1) to the final treatment visit (week 12 or week 24) |
| Change From Baseline in HCV RNA (log10 IU/mL) | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Weight | Mean | Standard Deviation | kilogram |
|
| OG001 |
| 400 mg TG-2349 |
400 mg TG-2349 (4 capsules) + Interferon or Peg-interferon + Ribavirin |
|
|
| Secondary | Proportion of Subjects Achieving Sustained Viral Response at 4, 8, and 24 Weeks After the End of Treatment (SVR4, SVR8, and SVR24) | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Posted | Count of Participants | Participants | 4, 8, 24 weeks after the end of treatment (SVR4, 8, 24), after 12-week treatments |
|
|
|
| Secondary | Proportion of Subjects Achieving HCV RNA < Lower Limit of Quantification, Target Detected or Target Not Detected (< LLOQ, TD or TND) | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. Missing data were excluded in the dominator of on-treatment visits. | Posted | Count of Participants | Participants | The whole treatment period, 12 weeks |
|
|
|
| Secondary | Proportion of Subjects Achieving HCV RNA < LLOQ, TND | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. Missing data were excluded in the dominator of on-treatment visits, while imputation was performed at post-treatment visits and the dominator for post-treatment visits was the total population. | Posted | Count of Participants | Participants | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
|
|
|
| Secondary | Mean Absolute Values in HCV RNA (log10 IU/mL) | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Posted | Mean | Standard Deviation | log10 IU/mL | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
|
|
|
| Secondary | Proportion of Subjects Experiencing Virologic Failure During Treatment and Viral Relapse After the End of Treatment. | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Posted | Count of Participants | Participants | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
|
|
|
| Secondary | Proportion of Subjects With Abnormal Alanine Aminotransferase (ALT) Levels at Baseline Who Achieved Normal Limit of ALT at Final Treatment Visit. | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Posted | Count of Participants | Participants | From baseline (day 1) to the final treatment visit (week 12 or week 24) |
|
|
|
| Secondary | Change From Baseline in HCV RNA (log10 IU/mL) | Full Analysis Set (FAS) population includes subjects with genotype 1b HCV infection who were enrolled and received at least one dose of study drugs. | Posted | Mean | Standard Deviation | log10 IU/mL | Treatment period (12 to 24 weeks) and after the end of treatment (12 to 24 weeks) |
|
|
|
| 0 |
| 13 |
| 2 |
| 13 |
| 13 |
| 13 |
| EG001 | Group II | 400 mg TG-2349 (4 capsules) + Interferon or Peg-interferon + Ribavirin | 0 | 12 | 2 | 12 | 12 | 12 |
| Cellulitis | Infections and infestations | Systematic Assessment |
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| Lower limb fracture | Injury, poisoning and procedural complications | Systematic Assessment |
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| Bladder cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | Systematic Assessment |
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| Leukopenia | Blood and lymphatic system disorders | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Dry skin | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Eczema | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Papule | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Rash pruritic | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Seborrhoeic dermatitis | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Vesicle | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Pain | General disorders | Systematic Assessment |
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| Pyrexia | General disorders | Systematic Assessment |
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| Chest discomfort | General disorders | Systematic Assessment |
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| Fatigue | General disorders | Systematic Assessment |
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| Chest pain | General disorders | Systematic Assessment |
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| Feeling cold | General disorders | Systematic Assessment |
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| Asthenia | General disorders | Systematic Assessment |
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| Injection site erythema | General disorders | Systematic Assessment |
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| Injection site rash | General disorders | Systematic Assessment |
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| Local swelling | General disorders | Systematic Assessment |
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| Malaise | General disorders | Systematic Assessment |
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| Thirst | General disorders | Systematic Assessment |
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| Dizziness | Nervous system disorders | Systematic Assessment |
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| Headache | Nervous system disorders | Systematic Assessment |
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| Memory impairment | Nervous system disorders | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | Systematic Assessment |
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| Mouth ulceration | Gastrointestinal disorders | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | Systematic Assessment |
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| Abdominal distension | Gastrointestinal disorders | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
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| Dry mouth | Gastrointestinal disorders | Systematic Assessment |
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| Faeces soft | Gastrointestinal disorders | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | Systematic Assessment |
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| Abdominal pain upper | Gastrointestinal disorders | Systematic Assessment |
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| Toothache | Gastrointestinal disorders | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | Systematic Assessment |
|
| Cellulitis | Infections and infestations | Systematic Assessment |
|
| Upper respiratory tract infection | Infections and infestations | Systematic Assessment |
|
| Folliculitis | Infections and infestations | Systematic Assessment |
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| Gingivitis | Infections and infestations | Systematic Assessment |
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| Infected dermal cyst | Infections and infestations | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | Systematic Assessment |
|
| Otitis media | Infections and infestations | Systematic Assessment |
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| Pyuria | Infections and infestations | Systematic Assessment |
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| Tonsillitis | Infections and infestations | Systematic Assessment |
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| Insomnia | Psychiatric disorders | Systematic Assessment |
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| Anxiety | Psychiatric disorders | Systematic Assessment |
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| Attention deficit/hyperactivity disorder | Psychiatric disorders | Systematic Assessment |
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| Depression | Psychiatric disorders | Systematic Assessment |
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| Irritability | Psychiatric disorders | Systematic Assessment |
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| Sleep disorder | Psychiatric disorders | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Dyspnoea | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Productive cough | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | Systematic Assessment |
|
| Musculoskeletal and connective tissue disorders | Metabolism and nutrition disorders | Systematic Assessment |
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| Back pain | Metabolism and nutrition disorders | Systematic Assessment |
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| Plantar fasciitis | Metabolism and nutrition disorders | Systematic Assessment |
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| Blood bilirubin increased | Investigations | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | Systematic Assessment |
|
| Aspartate aminotransferase increased | Investigations | Systematic Assessment |
|
| Blood creatine phosphokinase increased | Investigations | Systematic Assessment |
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| Gamma-glutamyltransferase increased | Investigations | Systematic Assessment |
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| Platelet count decreased | Investigations | Systematic Assessment |
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| Contusion | Injury, poisoning and procedural complications | Systematic Assessment |
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| Limb injury | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Road traffic accident | Injury, poisoning and procedural complications | Systematic Assessment |
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| Wound | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Dry eye | Eye disorders | Systematic Assessment |
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| Vertigo | Ear and labyrinth disorders | Systematic Assessment |
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| Hyperthyroidism | Endocrine disorders | Systematic Assessment |
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| Hypertension | Vascular disorders | Systematic Assessment |
|
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| D006525 |
| Hepatitis, Viral, Human |
| D014777 | Virus Diseases |
| D018178 | Flaviviridae Infections |
| D012327 | RNA Virus Infections |
| D006521 | Hepatitis, Chronic |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007370 | Interferon Type I |
| D007372 | Interferons |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
| SVR24 |
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| Post-Treatment Week 4 |
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| Post-Treatment Week 4 |
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| Post-Treatment Week 8 |
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| Post-Treatment Week 24 |
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| Post-Treatment relapse |
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| ALT normalization |
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