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Hepatitis C, ChronicPhase 4D3FEATNCT02498015

A Phase IV Trial of Paritaprevir/Ritonavir, Ombitasvir, Dasabuvir for Chronic Hepatitis C Genotype 1 Virus Infection

A Phase 4 study testing "3D" regimen and "3D" regimen with ribavirin in people with Hepatitis C, Chronic, run by Kirby Institute at 1 site in Australia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A total of 100 people with chronic HCV and recent injection drug use or recipients of opioid substitution therapy will be enrolled in 5 countries and 21 study sites. Participants with genotype 1a infection or cirrhosis will receive 12 weeks of open-label paritaprevir/ritonavir/ombitasvir and dasabuvir ("3D"), and… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hepatitis C, Chronic
What is being tested?
"3D" regimen and "3D" regimen with ribavirin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
87 participants
Where
1 siteAustralia
Study dates
Aug 2016to Mar 2019
Phase
Phase 4
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

Who may be able to join

  • Detectable HCV RNA in plasma (>1,000 IU/ml).
  • Evidence of positive HCV antibody >6 months prior to screening.
  • HCV Genotype 1 infection.
  • Recent IDU (previous 6 months) or receiving stable OST (stable dose for >2 weeks).
  • Never received treatment for HCV infection.
  • Compensated liver disease. Enrolment of patients with cirrhosis (FibroScan >14.6 kPa or FIB-4 > 3.25) will be capped to 60% of the total enrolment (maximum 3 per site).
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  • Participants with FibroScan > 12KPa or AFP >50 ng/mL must have abdominal ultrasound or CT scan without evidence of hepatocellular carcinoma within 2 months before screening.
  • Negative pregnancy test (for women of childbearing potential) within the 24-hour period before the first dose of study drug.
  • All fertile participants must be using effective contraception during treatment and 24 weeks post treatment (patients treated with ribavirin) or 2 weeks post treatment (patients not treated with ribavirin).

Who cannot join

  • Any systemic anti-viral, anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) ≤6 months before the first dose of study drug.
  • Any investigational drug ≤6 weeks before the first dose of study drug.
  • HIV infection.
  • History or other evidence of decompensated liver disease.
  • Neutrophil <1000 cells/mm3 or platelet <50,000 cells/mm3 at screening.
  • Serum creatinine >1.5 x upper limit of normal at screening.
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  • Ongoing severe psychiatric disease as judged by the treating physician.
  • Frequent IDU that is judged by the treating physician to compromise treatment safety.
  • Hemoglobin <12 g/dL (<7.4 mmol/L) in women or <13 g/dL (<8.1 mmol/L) in men at screening.
  • Any exclusion specific to paritaprevir/ritonavir/ombitasvir, dasabuvir or ribavirin.
  • Pregnancy/lactation or male subjects whose female partners are pregnant.
  • Subject has current or past clinical evidence of decompensated liver disease, such as ascites, hepatic encephalopathy, oesophageal varices, and/or any of the following screening laboratory results;
  • International normalised ration (INR) >1.5; i. Patients with a known inherited blood disorder and INR > 1.5 may be enrolled after discussion with the Principal Investigator b. Serum albumin <3.3 g/dL; c. Serum total bilirubin >1.8 x ULN, unless isolated in subjects with Gilbert's syndrome.
  • Subject shows evidence of significant liver disease in addition to HCV, which may include but is not limited to drug- or alcohol-related cirrhosis, autoimmune hepatitis, hemochromatosis, Wilson's disease, non-alcoholic steatohepatitis (NASH), or primary biliary cirrhosis.
  • Subject has active malignant disease or history of malignant disease within the past 5 years (except treated basal cell carcinoma).
  • History of chronic pulmonary disease associated with functional limitation, severe cardiac disease, major organ transplantation or other evidence of severe illness, malignancy, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study.
  • Poorly controlled diabetes mellitus as evidenced by haemoglobin A1c (HbA1c) ≥8.5%.
  • Positive test at screening for anti-HAV IgM Ab, anti-HBc IgM Ab or HBsAg.
  • Confirmed presence of hepatocellular carcinoma indicated on imaging techniques such as computed tomography (CT) scan or magnetic resonance imaging (MRI) within 3 months prior to screening or on an ultrasound performed at screening (a positive ultrasound result will be confirmed with CT scan or MRI).
  • Subject has history of organ transplant that requires chronic immunosuppression.
  • Corneal, skin, and hair grafts are allowed.
  • History of severe psychiatric disease that in the opinion of the investigator is unstable enough to compromise treatment adherence.
  • Prohibited medications and herbal remedies as detailed in the study protocol.

Trial locations and contacts

1 site in 1 country.

Australia1 site
  • The Kirby Institute, University of New South Wales Australia

    Sydney, New South Wales, 2052

Other trials in Australia

About this study

Official title: A Phase IV Open-label, Multicentre, International Trial of Paritaprevir/Ritonavir, Ombitasvir, Dasabuvir ±Ribavirin for Chronic Hepatitis C Virus Genotype 1 Infection and Recent Injection Drug Use or Receiving Opioid Substitution Therapy

A total of 100 people with chronic HCV and recent injection drug use or recipients of opioid substitution therapy will be enrolled in 5 countries and 21 study sites. Participants with genotype 1a infection or cirrhosis will receive 12 weeks of open-label paritaprevir/ritonavir/ombitasvir and dasabuvir ("3D"), and twice-daily ribavirin. Participants with genotype 1b infection without cirrhosis will receive 12 weeks of open-label "3D". The study consists of a screening phase (6 weeks), treatment phase (12 weeks) and follow-up phase (96 weeks) to evaluate treatment response and reinfection.

Read the detailed description

A total of 100 people with recent injection drug use or recipients of opioid substitution therapy will be enrolled from drug and alcohol clinics, tertiary liver and infectious diseases clinics and community health centres across Canada, Europe, New Zealand, France, and Australia. This will include at least 30 participants with F3/F4 liver disease. Participants will be considered recent injection drug users if they have used injection drugs in the 6 months prior to consent. Participants receiving stable opioid substitution therapy (stable dose for >2 weeks) will also be included. Patients with frequent drug use that is judged by the treating physician to compromise treatment safety will be excluded. The study drugs consisting of two tablets of the co-formulated paritepravir/ritonavir/ombitasvir (75/50/12.5 mg) once daily, one dasabuvir tablet (250 mg) twice daily, ribavirin (1000 mg) daily in two divided doses (genotype 1a only and/or cirrhosis). Electronic blister packs will be used to improve and monitor treatment adherence. This innovative strategy with the "3D" interferon-free regimen could considerably enhance the capacity to scale-up HCV treatment among PWID, and is therefore being evaluated in this phase IV study within a well-defined PWID population.

Being tested
"3D" regimen, "3D" regimen with ribavirin
Medical subject headings
Hepatitis C, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • "3D" regimenDrug

    Also called Viekira pack

    The "3D" regimen contain paritaprevir/ritonavir/ombitasvir (75/50/12.5mg) once daily, dasabuvir 250mg twice daily for genotype 1b without cirrhosis.

  • "3D" regimen with ribavirinDrug

    Also called Viekira pack with ribavirin

    The "3D" regimen with ribavirin contain paritaprevir/ritonavir/ombitasvir (75/50/12.5mg) once daily, dasabuvir 250mg twice daily, and ribavirin (1000 mg regardless of weight) daily in two divided doses for genotype 1a and genotype 1b with cirrhosis.

Study groups in NCT02498015
Study groupRoleWhat they receive
"3D" regimenExperimentalThe "3D" regimen contain two tablets of co-formulated paritepravir/ritonavir/ombitasvir (75/50/12.5 mg) once daily, and one dasabuvir tablet (250 mg) twice daily for genotype 1b without cirrhosis. Treatment will be 12 weeks.
Receives: Drug: "3D" regimen
"3D" regimen with ribavirinExperimentalThe "3D" regimen with ribavirin contain two tablets of co-formulated paritepravir/ritonavir/ombitasvir (75/50/12.5 mg) once daily, one dasabuvir tablet (250 mg) twice daily, and ribavirin (1000 mg regardless of weight) daily in two divided doses for genotype 1a (with/without) and genotype 1b with cirrhosis. Treatment will be for 12 weeks.
Receives: Drug: "3D" regimen with ribavirin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The proportion of participants with undetectable HCV RNA at 12 weeks post end of treatment (SVR12)

    To evaluate the proportion of participants with undetectable HCV RNA 12 weeks post end of treatment (SVR12) following the "3D" regimen with or without ribavirin for 12 weeks in people with chronic HCV genotype 1 infection.

    Measured: 12 weeks post treatment

Secondary outcomes (15)
  1. The proportion of participants with undetectable HCV RNA at 2 weeks following the initiation of treatment - week 2

    To evaluate the proportion of participants with undetectable HCV RNA after receiving 2 weeks of "3D" regimen with or without ribavirin.

    Measured: 2 weeks following the initiation of treatment

  2. The proportion of participants with undetectable HCV RNA at 4 weeks following the initiation of treatment - week 4

    To evaluate the proportion of participants with undetectable HCV RNA after receiving 4 weeks of "3D" regimen with or without ribavirin.

    Measured: 4 weeks following the initiation of treatment

  3. The proportion of participants with undetectable HCV RNA at the end of treatment - week 12

    To evaluate the proportion of participants with undetectable HCV RNA at the end of treatment after receiving 12 weeks of "3D" regimen with or without ribavirin.

    Measured: End of treatment week 12

  4. The proportion of participants with undetectable HCV RNA at 24 weeks post end of treatment (SVR24)

    To evaluate the proportion of participants with undetectable HCV RNA 24 weeks (SVR24) post end of treatment.

    Measured: 24 weeks post treatment

  5. Treatment adherence

    To evaluate the proportion of participants adherent to treatment (both on-treatment adherence and treatment discontinuation).

    Measured: Baseline to week 12

  6. Association between adherence and response to treatment

    To evaluate the association between adherence and response to treatment [including an evaluation of the impact of early (0-3 weeks), mid (4-7 weeks) and late (8-11 weeks) missed doses on response to treatment]; adherence will be measured via a self report questionnaire and pill count via return of the weekly blister packs. The impact of the number and timing of the missed pills will be evaluated.

    Measured: Early (0-3 weeks), mid (4-7 weeks), late (8-11 weeks) during treatment

  7. Safety and tolerability (number and type of adverse events and serious adverse events)

    To evaluate the number and type of adverse events and serious adverse

    Measured: Baseline to week 24 (SVR24)

  8. Change in injecting drug use and injecting risk behaviour

    To evaluate the change in injecting drug use and injecting risk behaviours during and following treatment. Change in injecting drug use and injecting risk behaviour will be measured via a self report behavioural questionnaire completed by participants at baseline, week 4 during treatment, week 8 during treatment and end of treatment.

    Measured: Baseline to week 12

  9. Change in mental health

    To evaluate the change in mental health during treatment. Change in mental health will be measured by self report mental health questionnaire (Kessler10) at baseline, week 4 during treatment and end of treatment.

    Measured: Baseline to week 12

  10. Change in health-related quality of life Questionnaire

    To evaluate the change in health-related quality of life during treatment. Change in health-related quality of life will be measured by self report questionnaire (EQ-5D) at baseline, week 4 during treatment and end of treatment.

    Measured: Baseline to week 12

  11. Impact of mixed HCV infection on treatment response

    To evaluate the rate of mixed HCV infection at baseline and among those with treatment non-response

    Measured: Baseline to SVR12

  12. Change in opioid substitution therapy

    To evaluate the change in OST during treatment (dose and any discontinuation)

    Measured: Baseline to week 12

  13. HCV reinfection rate

    To evaluate the rate of HCV reinfection during and following treatment

    Measured: Week 108

  14. Emergence of viral resistance-associated variants (RAVs)

    To evaluate the emergence of viral resistance-associated variants (RAVs). HCV sequencing will be performed on the baseline EDTA plasma samples of all participants at baseline to detect any baseline RAVs and will be preformed on the EDTA plasma samples of the participants who experienced virological failure to detect the emergence of RAVs.

    Measured: Baseline to week 12

  15. Utility of HCV core antigen testing as a simple method for HCV monitoring

    To evaluate the utility of HCV core antigen testing as a simple method for HCV monitoring including treatment response. HCV RNA will be measured using the HCV core antigen test and then compared to HCV RNA levels measured using standard methods (EDTA plasma samples and Roche TaqMan).

    Measured: Week 108

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jul 2015 (estimated)
  2. Study startAug 2016
  3. Primary completionAug 2017
  4. Study completionMar 2019

Resources

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 4
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
87 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02498015
Sponsor's protocol ID
VHCRP1405
Acronym
D3FEAT
Status last verified
Jun 2019
First submitted
26 Jun 2015
Last updated
13 Jun 2019
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Cunningham EB, Hajarizadeh B, Amin J, Hellard M, Bruneau J, Feld JJ, Cooper C, Powis J, Litwin AH, Marks P, Dalgard O, Conway B, Moriggia A, Stedman C, Read P, Bruggmann P, Lacombe K, Dunlop A, Applegate TL, Matthews GV, Fraser C, Dore GJ, Grebely J. Reinfection Following Successful Direct-acting Antiviral Therapy for Hepatitis C Virus Infection Among People Who Inject Drugs. Clin Infect Dis. 2021 Apr 26;72(8):1392-1400. doi: 10.1093/cid/ciaa253.

    PubMed 32166305
  • Artenie AA, Cunningham EB, Dore GJ, Conway B, Dalgard O, Powis J, Bruggmann P, Hellard M, Cooper C, Read P, Feld JJ, Hajarizadeh B, Amin J, Lacombe K, Stedman C, Litwin AH, Marks P, Matthews GV, Quiene S, Erratt A, Bruneau J, Grebely J. Patterns of Drug and Alcohol Use and Injection Equipment Sharing Among People With Recent Injecting Drug Use or Receiving Opioid Agonist Treatment During and Following Hepatitis C Virus Treatment With Direct-acting Antiviral Therapies: An International Study. Clin Infect Dis. 2020 May 23;70(11):2369-2376. doi: 10.1093/cid/ciz633.

    PubMed 31300820

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing "3D" regimen and "3D" regimen with ribavirin in people with Hepatitis C, Chronic, run by Kirby Institute 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?

The sponsor lists 9 inclusion and 23 exclusion criteria. 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: finished, as of the sponsor's last update on 13 Jun 2019. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The proportion of participants with undetectable HCV RNA at 12 weeks post end of treatment (SVR12) (time frame: 12 weeks post treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02498015, which also lists 2 linked publications.

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 13 Jun 2019.

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