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HerpesNCT04664127

Study of the Efficacy and Safety of Combined Treatment of Patients With Severe Herpes Simplex (HSV) Infection by Valacyclovir and Interferon Inducer Kagocel

An observational study of Herpes and Herpes Simplex, run by Nearmedic Plus LLC at 1 site in Russia.

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

This study examined the efficacy, safety and benefits of modern treatment and changes in the dynamics of the life of adult patients quality with severe herpes simplex in the current medical practice when combined therapy by acyclic nucleoside Valacyclovir and antiviral agent Kagocel versus monotherapy by Valacyclovir. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Herpes, Herpes Simplex, Herpes Oral
What is being tested?
Kagocel+Valacyclovir and Valacyclovir
Type of treatment
Pill or oral medicine
How many people
45 participants
Where
1 siteRussia
Study dates
30 Oct 2017to 29 Oct 2018
Phase
Observational
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 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult men and women with signs of severe herpes simplex.

Who may be able to join

  • Patients ≥ 18 years old
  • The absence of systemic etiotropic antiviral and immunosuppressive therapy for at least a year at the time of inclusion in this study
  • Severe herpes simplex (HSV infection with orolabial and / or genital localization) with a recurrence rate of 6 or more for last 12 months.
  • The first 6-48 hours after the exacerbation of herpes simplex.
  • The following diseases and conditions are missing, usually requiring combination therapy by more than 2 drugs: ophthalmic herpes, visceral herpes, herpetic encephalitis, Kaposi's herpetiform eczema, primary immunodeficiency (PID criteria are given below*), tuberculosis, ARVI and influenza symptoms (not related to herpesviruses), diabetes mellitus, hepatitis B and/or C, autoimmune diseases, HIV infection, other diseases requiring specific treatment (syphilis, gonorrhea), septic conditions, cancer (except of benign skin growths), mental illness, alcohol and/or drug addiction, artificial radiation and/or radiation therapy.
  • Standard Valacyclovir therapy prescribed by doctor, or combination therapy by Valacyclovir and Kagocel.

Who cannot join

  • Basic cytostatic therapy, taking systemic glucocorticoids for life indications. Treatment by immunoglobulins and any vaccines for 30 days prior to inclusion in the study.
  • Early period (up to 1 month) after any vaccination.
  • Pregnancy, including pregnancy planning for 3 months and lactation.
  • The presence of a genetic disease or verified primary immunodeficiency.
  • Anamnesis of transplantation of organs and tissues.
  • Plasmapheresis and blood donation for less than 6 months before the present study.
  • Severe kidney and liver damage.
  • Any other diseases or conditions that, by the opinion of the researcher, may interfere the patient from being included in the study.

Trial locations and contacts

1 site in 1 country.

Russia1 site
  • Scientific Information Center for Prevention and Treatment of Viral Infections

    Moscow, 117198

Other trials in Russia

About this study

Official title: Clinical and Immunological Study of the Efficacy and Safety of Combined Treatment of Patients With Severe Herpes Simplex (HSV) Infection) by Acyclic Nucleoside Valacyclovir and Interferon Inducer Kagocel

This study examined the efficacy, safety and benefits of modern treatment and changes in the dynamics of the life of adult patients quality with severe herpes simplex in the current medical practice when combined therapy by acyclic nucleoside Valacyclovir and antiviral agent Kagocel versus monotherapy by Valacyclovir. This study also evaluated the structure of herpesvirus infections and the rate of mixed variants of the course, the rate of exacerbations of herpes simplex, the time of disappearance of human herpesvirus isolation and the features of the immune phenotype of patients taking different types of therapy.

Read the detailed description

This study was a comparative post-registration prospective non-interventional (observational) scientific study.

This research did not include any procedures or medical interventions except those recommended in the local clinical guidelines and international standards of care. All procedures and evaluations were performed in accordance with routine clinical practice adopted in the Russian Federation and the instructions for the medical use of drugs that patients received.

The following data was collected and analyzed after the end of treatment:

  • demography
  • disease severity (mild, moderate, severe, continuous relapses)
  • data of anamnesis (hereditary and family anamnesis, duration of herpes simplex disease, previous illnesses, duration of treatment, previous treatment of herpes simplex and its efficacy, allergic anamnesis, epidemiological anamnesis, rate and duration of herpes relapses over the past year (with indication of the location of herpes simplex rashes), main diagnosis and complications, ICD-10 code, date and time of the last exacerbation, causes of exacerbation)
  • verification of inclusion criteria
  • verification of non-inclusion criteria
  • prescribed therapy (trade name and prescription scheme, rate, method of administration)
  • laboratory tests (4 timelines: 1 - first 6-48 hours; 2 - 6 days after starting of therapy; 3 - 30 days; 4 - 4 months): clinical and biochemical blood tests; serological diagnostics with determination of herpes virus infections's markers: IgM, IgG-HSV1, HSV2; hospital screening of venous blood: anti - HIV-1,2; anti-HCV-total, HBsAg, CSR; microbiological seeding from the tonsils, posterior pharyngeal wall with determination of drug sensitivity; PCR of blood, saliva and/or rash elements; immune status by laser flow cytometry: CD3+, CD4+, CD8+, CD4+/CD8+, CD16+, CD19+; serum immunoglobulins: IgA, IgM, IgG, IgE total.
  • medical anamnesis (4 timelines: 1 - first 6-48 hours; 2 - 6 days after starting of therapy; 3 - 30 days; 4 - 4 months) or clinical efficacy: the presence and rate of exacerbations of the disease orolabial, genital and other sites; local complaints; the rate of occurrence of and general symptoms; the rate of epithelialization of the rash's morphological elements; duration of recurrence of the herpes simplex virus and speed of onset of epithelialization; the rate of relapses and exacerbations of herpes simplex on the background of suppressive therapy
  • taking other drugs during the study (trade name, prescription scheme)
  • compliance with the drugs regimen
  • timelines: data of signing the informed consent, start date of the study, date of each patient visit, end date of the study, start date and end date of the taking medicines, duration of patient follow-up)
  • quality of life assessment at the end of the study (excellent / good / satisfactory / has not changed)
  • adverse events (yes/no, data description)
Being tested
Kagocel+Valacyclovir, Valacyclovir
Keywords
herpes simplex, HSV1, HSV2, Herpes Genitalis, Herpes Oral, herpes simplex viruses, Valaciclovir
Medical subject headings
Herpes Simplex, Herpes Genitalis

What participants receive

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

  • Kagocel+ValacyclovirDrug

    Group 1-patients with simple severe herpes (HSV-infection orolabial and / or genital localization) treatment [Valacyclovir + Kagocel ° ] (n= 25).

    Treatment: Valacyclovir, 1000 mg orally (2 tablets of 500 mg): 1 time per day for at least 4 months continuously (the rate of suppressive therapy). * Kagocel®, 24 mg orally (2 tablets of 12 mg): 3 times per day, 5 days continuously.

    • - During the study the minimum duration of Valacyclovir suppressive therapy in instruction for medical use that drag was changed from 4 (what was using in our reserch) to 6 months, and the optimal duration of continuous antiviral therapy with PG was changed from 6 to 12 months
  • ValacyclovirDrug

    Group 2 -patients with simple severe herpes (HSV-infection orolabial and/or genital localization) receiving treatment [Valacyclovir] (n= 20).

    Scheme of treatment: Valacyclovir, 1000 mg orally (2 tablets of 500 mg): 1 time per day for at least 4 months continuously (a course of suppressive therapy)*.

    • - During the study the minimum duration of Valacyclovir suppressive therapy in instruction for medical use that drag was changed from 4 (what was using in our reserch) to 6 months, and the optimal duration of continuous antiviral therapy with PG was changed from 6 to 12 months.
Study groups in NCT04664127
Study groupRoleWhat they receive
Combination therapy (Kagocel + Valacyclovir: n=25)Therapy according to routine practice (including Kagocel). Groups will be splitted during the final data analysis.
Receives: Drug: Kagocel+Valacyclovir
Monotherapy by Valacyclovir (n=20)Therapy according to routine practice. Groups will be splitted during the final data analysis.
Receives: Drug: Valacyclovir

What is being measured

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

  1. Change of the patients proportion with different localizations of herpes simplex exacerbations.

    Measured: 2 points: before and 6 months after the start of therapy

  2. Change of the rate of exacerbations of orolabial, genital and other localization herpes simplex

    Measured: 2 points: before and 6 months after the start of antiviral therapy

  3. Change of the number of patients with varying degrees of severity illness

    Measured: 2 points: before and 6 months after the start of therapy

  4. Change in the number of local complaints (pain, itching, burning, rash) against the background of a recurrence of herpes simplex

    Measured: up to 6 months

Secondary outcomes (11)
  1. Number of participants with treatment-related adverse events (AE) with regards to type and severity of AE (mild, moderate, severe; according to physician's opinion)

    Measured: up to 6 (12) mounts

  2. Change of the duration of each herpes simplex relapse and the rate of epithelialization

    Measured: 2 points: before and 6 days after the start of therapy

  3. Change of the occurrence rate of morphological elements of the rash and General symptoms

    Measured: 4 points: 1-before the start of therapy, 2-6 days after the start of therapy, 3-30 days, 4-4 months

  4. Change of the rate of herpes simplex rash (relapses)

    Measured: 4 points: 1 - before the start of therapy, 2 - 6 days after the start of therapy, 3 - 30 days, 4 - 4 months

  5. Change of the intensity of herpes simplex exacerbations in points

    Herpes simplex exacerbation were local symptoms (according to the patient's assessment: pain, itching, burning, rash); localization of the rash (according to the doctor's assessment: orolabial, genital, other); morphology of the rash (ulcer and / or erosion, vesicle, crust, spot); intensity of the rash (single element, several elements, multiple rashes); enlarged lymph nodes; general symptoms (weakness, drowsiness, decreased physical activity, increased body temperature).

    There was used subjective assessment: 1 point - min, 10 points - max intensity.

    Measured: 4 points: 1-before the start of therapy, 2-6 days after the start of therapy, 3-30 days, 4-4 months

  6. Change in the number of herpes viruses in saliva and blood by PCR

    Identification of herpes viruses type 1 and 2 (HSV1, HSV2), cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpesvirus type 6 (HHV6, HHV7, HHV8) and assessment of the duration of their isolation.

    Measured: 4 points: 1-before the start of therapy, 2-6 days after the start of therapy, 3-30 days, 4-4 months

  7. Change of antibodies titers to herpes simplex viruses type 1 and 2

    Detection of specific antibodies levels against herpes simplex virus (anti-HSV-1,2 IgM, anti-HSV-1,2 IgG) using ELISA in both groups

    Measured: 2 points: before the start of therapy and on the 30th day after the start of therapy

  8. Change of immune status parameters (flow cytometry)

    Determination of changes of serum immunoglobulin levels by laser flow cytometry (g / l, UL): IgA, IgM, IgG, IgE total

    Measured: 2 points: before treatment and at 30 days after initiation of therapy

  9. Change of immune status parameters (flow cytometry)

    Detection of changes of immune status parameters by laser flow cytometry (%): CD3+, CD4+, CD8+, CD4+/CD8+, CD16+, CD19+

    Measured: 2 points: before treatment and at 30 days after initiation of therapy

  10. Change of lymph nodes sizes (submandibular, axillary, inguinal) according to ultrasound data

    Measured: 2 points: before and 6 months after the start of therapy

  11. The assessment of quality of life according to questionnaire

    Criteria for evaluating the "Quality of life" indicator were:

    "excellent" - rashes and relapses of herpes simplex (HSV) are absent, physical and mental activity are above average, "good" - rare rashes of HSV (no more than 1-2 times per year), physical and mental activity are average, "satisfactory" - the rash of HSV were less likely (up to 3-4 times per year), physical and mental activity are below average, "has not changed" - the recurrence rate HSV for 6-12 months was same (as before the start of therapy and participation in the study), physical and mental activity are unsatisfactory.

    Measured: up to 6 months after initiation of therapy

Timeline

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

  1. First posted11 Dec 2020
  2. Study start30 Oct 2017
  3. Primary completion29 Oct 2018
  4. Study completion29 Oct 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04664127
Sponsor's protocol ID
version 1.0 from 20.10.2017
Status last verified
Jan 2019
First submitted
27 Nov 2020
Last updated
11 Dec 2020
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Herpes and Herpes Simplex, run by Nearmedic Plus LLC at 1 site in Russia.

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 6 inclusion and 8 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 11 Dec 2020. 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 Russia. 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.

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?

Change of the patients proportion with different localizations of herpes simplex exacerbations. (time frame: 2 points: before and 6 months after the start of therapy). 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 11 Dec 2020.

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