Hepatitis CPhase 3TAPNCT02363517
The TAP Study: Treating People Who Inject Drugs in Community-Based Settings Using a Social Network Approach
A Phase 3 study testing Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) in people with Hepatitis C and Drug Abuse, Intravenous, run by Macfarlane Burnet Institute for Medical Research and Public Health Ltd at 1 site in Australia.
Trial summary
This study will investigate the feasibility of treating people who inject drugs (PWID) with hepatitis C virus (HCV) in community-based settings with a 12-week course of oral therapy combination of sofosbuvir plus ledipasvir. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hepatitis C, Drug Abuse, Intravenous
- What is being tested?
- Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 420 participants
- Where
- 1 siteAustralia
- Study dates
- Feb 2015to Dec 2019
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
SECONDARY PARTICIPANTS INCLUSION AND EXCLUSION CRITERIA
Study INCLUSION criteria for primary participants are as follows:
- Current PWID (i.e., injected any drug at least once during the previous six months);
- Evidence of chronic HCV infection (detectable plasma HCV RNA viral load above 1000 IU/ml on two occasions ≥ 6 months apart)
- Willing and able to provide written informed consent.
Subjects must have the following laboratory parameters at screening:
- ALT <10 times the upper limit of normal (ULN)
- AST <10 times ULN
- Haemoglobin ≥12g/dL for males, ≥11g/dL for female subjects
- INR ≤1.5 times ULN unless is stable on an anticoagulant regimen affecting INR
- Albumin ≥3g/dL
- Direct bilirubin ≤1.5 times ULN
- Creatinine clearance (CLcr) ≥60mL/min, as calculated by the Cockcroft-Gault Equation.
EXCLUSION criteria for all primary participants are as follows:
- Testing positive for HIV
- History of, or current, decompensated liver disease
- Testing positive for HBsAg
- HCC
- Women who are pregnant or breastfeeding, or men with female partners who are pregnant at screening or baseline, or who were pregnant in the six months prior to screening
- Already enrolled in the TAP Study as a secondary participant (see below)
- Evidence of any condition, therapy, laboratory abnormality or other circumstance (current or prior) that may confound the study's results, or interfere with participation for the full duration of the study, such that it is not in the best interest of the participant;
- Use of concomitant medications.
Additional EXCLUSION criteria for primary participants with HCV genotypes 2-6:
- Increased baseline risk for anaemia (e.g., a history of thalassemia, spherocytosis, history of GI bleeding), or for whom anaemia would be medically problematic;
- Documented or presumed coronary artery disease or cerebrovascular disease if, in the judgment of the investigator, an acute decrease in haemoglobin by up to 4g/dL (as may be seen with ribavirin therapy) would not be well-tolerated.
SECONDARY PARTICIPANTS INCLUSION AND EXCLUSION CRITERIA
The INCLUSION criteria for secondary participants are as follows:
- Is nominated by a primary participant as a current injecting partner (i.e., has engaged in IDU with a primary participant in the previous six months)
- Willing and able to provide written informed consent.
There are no exclusion criteria for secondary participants who are not receiving HCV therapy in this protocol:
EXCLUSION criteria for treated secondary participants (i.e., those in Group C who are HCV positive) are as follows:
- History of, or current, decompensated liver disease
- Women who are pregnant or breastfeeding, or men with female partners who are pregnant at screening or baseline, or who were pregnant in the six months prior to screening
- Testing positive for HIV
- Testing positive for HBsAg
- HCC
- Evidence of any condition, therapy, laboratory abnormality or other circumstance (current or prior) that may confound the study's results, or interfere with participation for the full duration of the study, such that it is not in the best interest of the participant
- Use of concomitant medications.
Additional EXCLUSION criteria for secondary participants with HCV genotypes 2-6:
- Increased baseline risk for anaemia (e.g. a history of thalassemia, spherocytosis, history of GI bleeding) or for whom anaemia would be medically problematic
- Documented or presumed coronary artery disease or cerebrovascular disease if, in the judgment of the investigator, an acute decrease in haemoglobin by up to 4g/dL (as may be seen with ribavirin therapy) would not be well-tolerated.
Trial locations and contacts
1 site in 1 country.
Australia1 site, 1 recruiting
- Recruiting
Burnet Institute
Melbourne, Victoria, 3004
About this study
Official title: The Treatment And Prevention (TAP) Study: Treating People Who Inject Drugs (PWID) in Community-based Settings Using a Social Network Approach
This study will investigate the feasibility of treating people who inject drugs (PWID) with hepatitis C virus (HCV) in community-based settings with a 12-week course of oral therapy combination of sofosbuvir plus ledipasvir. It will also measure the effectiveness of using a social network-based approach to reduce HCV incidence among PWID.
Read the detailed description
This study will investigate the feasibility of treating people who inject drugs (PWID) with hepatitis C virus (HCV) in community-based settings with a 12-week course of oral therapy combination of sofosbuvir plus ledipasvir (SOF + LDP). It will also measure the effectiveness of using a social network-based approach ("bring your friends") to reduce HCV incidence among PWID. Participants will initially be sourced from the Burnet Institute's existing SuperMIX cohort (N= 757). This cohort comprises PWID followed for between two and six years (median=1057 days), of whom 299 have chronic HCV infection. The HCV genotype distribution in the SuperMIX cohort is: HCV-1 (55%); HCV-3 (40%) and HCV-6 (<5%).
Participants will be randomly allocated to three groups:
Group 1: Primary (n=40) and secondary (n=100) participants will receive supportive care only.
Group 2: Primary participants (n=40) will be treated with SOF + LDP for 12 weeks. Secondary participants (n=100) will receive supportive care only.
Group 3: Primary (n=40) and secondary participants with chronic HCV infection (n=50%*100) will be treated with SOF + LDP for 12 weeks. Participants in Group C who have evidence of HCV re-infection will be offered re-treatment with SOF + LDP for 12 weeks.
Treatment participants will have a clinical review, questionnaire and blood sample collected at baseline, weeks 4, 8 and 12 (end-of-treatment), and at weeks 12 (SVR12), 24 (SVR24), 36, 48, 60 and 72 post-treatment. Non-treatment participants will have a clinical review, questionnaire and blood sample collected at baseline and weeks 12, 24, 36, 48, 60, 72 and 84.
- Conditions
- Hepatitis C, Drug Abuse, Intravenous
- Being tested
- Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP)
- Keywords
- Hepatitis, Viral, Non-A, Non-B, Parenterally-Transmitted
- Medical subject headings
- Hepatitis C, Substance Abuse, Intravenous, Hepatitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP)Drug
Also called Standard of care
SOF + LDV tablets contain 400mg of SOF and 90mg of LDV.
| Study group | Role | What they receive |
|---|---|---|
| Group A | No intervention | Primary (n=40) and secondary (n=100) participants will receive supportive care only (includes a clinical review, questionnaire and blood sample collected at baseline and weeks 12, 24, 36, 48, 60, 72 and 84). Participants with HCV not allocated to treatment arms will receive deferred treatment at the end of the follow-up period. |
| Group B | Active comparator | Primary participants (n=40) will be treated with 'Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) for 12 weeks. Secondary participants (n=100) will receive supportive care only.
Participants with HCV not allocated to treatment arms will receive deferred treatment at the end of the follow-up period. Receives: Drug: Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) |
| Group C | Active comparator | Primary (n=40) and secondary participants with chronic HCV infection (approx. n=50%*100) will be treated with 'Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) for 12 weeks. Participants in Group C who have evidence of HCV re-infection will be offered re-treatment with SOF + LDP for 12 weeks. Receives: Drug: Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) |
What is being measured
The primary outcome is the main question the study is designed to answer.
The efficacy of treating PWID with HCV using 12 weeks of oral therapy via a community-based, nurse-led treatment model, as measured by SVR rates
Measured: Change in sustained viral response rates at weeks 12 and 24 post-treatment. Participant retention rate at weeks 4, 8 and 12 (end of treatment).
The effectiveness of treating PWID on rates of HCV primary infection and reinfection among their social networks, as measured by HCV incidence rates among primary and secondary participants
Hypothesis: Offering HCV treatment to PWID will lead to a lower incidence of transmission of HCV from primary participants to their injecting partners, compared to not treating any PWID.
Measured: Changes in rates of HCV primary infection and reinfection at weeks 12, 24, 36, 48, 60, 72 and 84
The effectiveness of treating PWID using a "bring your friends" strategy on rates of HCV primary infection and reinfection, as measured by HCV incidence rates among participants
Measured: Changes in rates of HCV primary infection and reinfection at weeks 12, 24, 36, 48, 60, 72 and 84
The feasibility of treating PWID with HCV using 12 weeks of oral therapy via a community-based, nurse-led treatment model, as measured by SVR rates and participant retention
Measured: Change in participant retention rates at weeks 4, 8 and 12 (end of treatment)
Secondary outcomes (4)
Changes in levels of injecting risk behaviours among participants following HCV treatment, as measured by self-reported frequency of risky injecting behaviours among participants
Measured: Weeks 12, 24, 36, 48, 60, 72 and 84
Changes to Quality of Life (QoL) among treated participants versus non-treated participants, as measured by self-reported responses to validated QoL scales
Measured: Weeks 12, 24, 36, 48, 60, 72 and 84
The prevalence of HCV resistance associated variants among treated participants who do not achieve SVR12
Measured: At 12 weeks post-treatment (SVR12) and weeks 24 (SVR24), 36, 48, 60 and 72 post-treatment
Changes in the level of transient liver elastography readings (measured using Fibroscan®) among treated participants versus non-treated participants
Measured: Up to 84 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Feb 2015 (estimated)
- Study startFeb 2015
- Primary completionDec 2018 (estimated)
- Study completionDec 2019 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hepatitis CStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 420 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Macfarlane Burnet Institute for Medical Research and Public Health Ltd
- Sponsor type
- University, hospital or other
- Collaborators
- St Vincent's Hospital Melbourne
- Responsible party
- Sponsor
- Investigators
- Prof Margaret Hellard, Principal investigator, Burnet InstituteProf Alexander Thompson, Principal investigator, St Vincent's Hospital Melbourne
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02363517
- Sponsor's protocol ID
- MacfarlaneBIMRPH
- Acronym
- TAP
- Status last verified
- Apr 2018
- First submitted
- 21 Dec 2014
- Last updated
- 10 Apr 2018
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 10 Apr 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Treatment And Prevention (TAP) Study: Treating People Who Inject Drugs (PWID) in Community-based Settings Using a Social Network Approach
- ClinicalTrials.gov ID
- NCT02363517
- Acronym / sponsor ID
- TAP / MacfarlaneBIMRPH
- Conditions
- Hepatitis C, Drug Abuse, Intravenous
- Keywords
- Hepatitis, Viral, Non-A, Non-B, Parenterally-Transmitted
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 420 participants (estimated)
- Lead sponsor
- Macfarlane Burnet Institute for Medical Research and Public Health LtdUniversity, hospital or other
- Collaborators
- St Vincent's Hospital Melbourne
- Study start
- Feb 2015 (actual)
- Primary completion
- Dec 2018 (estimated)
- Study completion
- Dec 2019 (estimated)
- First posted
- 16 Feb 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will investigate the feasibility of treating people who inject drugs (PWID) with hepatitis C virus (HCV) in community-based settings with a 12-week course of oral therapy combination of sofosbuvir plus ledipasvir. It will also measure the effectiveness of using a social network-based approach to reduce HCV incidence among PWID.
Detailed description
This study will investigate the feasibility of treating people who inject drugs (PWID) with hepatitis C virus (HCV) in community-based settings with a 12-week course of oral therapy combination of sofosbuvir plus ledipasvir (SOF + LDP). It will also measure the effectiveness of using a social network-based approach ("bring your friends") to reduce HCV incidence among PWID. Participants will initially be sourced from the Burnet Institute's existing SuperMIX cohort (N= 757). This cohort comprises PWID followed for between two and six years (median=1057 days), of whom 299 have chronic HCV infection. The HCV genotype distribution in the SuperMIX cohort is: HCV-1 (55%); HCV-3 (40%) and HCV-6 (<5%).
Participants will be randomly allocated to three groups:
Group 1: Primary (n=40) and secondary (n=100) participants will receive supportive care only.
Group 2: Primary participants (n=40) will be treated with SOF + LDP for 12 weeks. Secondary participants (n=100) will receive supportive care only.
Group 3: Primary (n=40) and secondary participants with chronic HCV infection (n=50%*100) will be treated with SOF + LDP for 12 weeks. Participants in Group C who have evidence of HCV re-infection will be offered re-treatment with SOF + LDP for 12 weeks.
Treatment participants will have a clinical review, questionnaire and blood sample collected at baseline, weeks 4, 8 and 12 (end-of-treatment), and at weeks 12 (SVR12), 24 (SVR24), 36, 48, 60 and 72 post-treatment. Non-treatment participants will have a clinical review, questionnaire and blood sample collected at baseline and weeks 12, 24, 36, 48, 60, 72 and 84.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Group A | No intervention | –Primary (n=40) and secondary (n=100) participants will receive supportive care only (includes a clinical review, questionnaire and blood sample collected at baseline and weeks 12, 24, 36, 48, 60, 72 and 84). Participants with HCV not allocated to treatment arms will receive deferred treatment at the end of the follow-up period. |
| Group B | Active comparator | Drug: Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP)Primary participants (n=40) will be treated with 'Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) for 12 weeks. Secondary participants (n=100) will receive supportive care only. Participants with HCV not allocated to treatment arms will receive deferred treatment at the end of the follow-up period. |
| Group C | Active comparator | Drug: Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP)Primary (n=40) and secondary participants with chronic HCV infection (approx. n=50%*100) will be treated with 'Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) for 12 weeks. Participants in Group C who have evidence of HCV re-infection will be offered re-treatment with SOF + LDP for 12 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP)Also: Standard of careSOF + LDV tablets contain 400mg of SOF and 90mg of LDV. | Drug | Group B, Group C |
Primary outcome
The efficacy of treating PWID with HCV using 12 weeks of oral therapy via a community-based, nurse-led treatment model, as measured by SVR rates
Time frame: Change in sustained viral response rates at weeks 12 and 24 post-treatment. Participant retention rate at weeks 4, 8 and 12 (end of treatment).
The effectiveness of treating PWID on rates of HCV primary infection and reinfection among their social networks, as measured by HCV incidence rates among primary and secondary participants
Time frame: Changes in rates of HCV primary infection and reinfection at weeks 12, 24, 36, 48, 60, 72 and 84
Hypothesis: Offering HCV treatment to PWID will lead to a lower incidence of transmission of HCV from primary participants to their injecting partners, compared to not treating any PWID.
The effectiveness of treating PWID using a "bring your friends" strategy on rates of HCV primary infection and reinfection, as measured by HCV incidence rates among participants
Time frame: Changes in rates of HCV primary infection and reinfection at weeks 12, 24, 36, 48, 60, 72 and 84
The feasibility of treating PWID with HCV using 12 weeks of oral therapy via a community-based, nurse-led treatment model, as measured by SVR rates and participant retention
Time frame: Change in participant retention rates at weeks 4, 8 and 12 (end of treatment)
4 secondary outcomes
Changes in levels of injecting risk behaviours among participants following HCV treatment, as measured by self-reported frequency of risky injecting behaviours among participants
Time frame: Weeks 12, 24, 36, 48, 60, 72 and 84
Changes to Quality of Life (QoL) among treated participants versus non-treated participants, as measured by self-reported responses to validated QoL scales
Time frame: Weeks 12, 24, 36, 48, 60, 72 and 84
The prevalence of HCV resistance associated variants among treated participants who do not achieve SVR12
Time frame: At 12 weeks post-treatment (SVR12) and weeks 24 (SVR24), 36, 48, 60 and 72 post-treatment
Changes in the level of transient liver elastography readings (measured using Fibroscan®) among treated participants versus non-treated participants
Time frame: Up to 84 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Apr 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Prof Margaret Hellard principal investigator
Burnet Institute
Prof Alexander Thompson principal investigator
St Vincent's Hospital Melbourne
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Sofosbuvir/ledispasvir fixed dose combination (SOF + LDP) in people with Hepatitis C and Drug Abuse, Intravenous, run by Macfarlane Burnet Institute for Medical Research and Public Health Ltd at 1 site in Australia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 10 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Dr Joseph Doyle (+61392822111, j.doyle@burnet.edu.au), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The efficacy of treating PWID with HCV using 12 weeks of oral therapy via a community-based, nurse-led treatment model, as measured by SVR rates (time frame: Change in sustained viral response rates at weeks 12 and 24 post-treatment. Participant retention rate at weeks 4, 8 and 12 (end of treatment).). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Apr 2018.