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A multicenter prospective study on the cost / benefit / safety of Sofosbuvir administered to patients with chronic hepatitis C virus and Mixed Cryoglobulinemia

Phase 1
Conditions
HCV chronic hepatitis and Mixed Cryoglobulinemia
MedDRA version: 17.1Level: PTClassification code 10008912Term: Chronic hepatitis CSystem Organ Class: 10021881 - Infections and infestations
MedDRA version: 17.1Level: LLTClassification code 10027756Term: Mixed cryoglobulinemiaSystem Organ Class: 100000004866
Therapeutic area: Diseases [C] - Virus Diseases [C02]
Registration Number
EUCTR2014-004134-26-IT
Lead Sponsor
Centro Masve -Università degli Studi di Firenze-AOUC
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
30
Inclusion Criteria

1)Signed Written Informed Consent
Freely given informed consent must be obtained from patients prior to clinical trial participation including informed consent for any screening procedures conducted to establish patient eligibility for the study.

2)Target Population
•Diagnosis of HCV-associated MC syndrome (type II or III) according to published criteria (10)
•Seronegative for HIV-Ab and HBsAg;
•Eligibility: age>18 yrs.
•No limitation for HCV genotype (GT 1, 2, 3, 4, 5, 6) or treatment history (naïve or experienced to IFN-based therapies)

3)Age and Reproductive Status
a) Males and females, = 18 years of age;
b) Women of childbearing potential (WOCBP) and men must be using an acceptable method of contraception to avoid pregnancy throughout the study. Contraception requirements for WOCBP (see Section 4.2.3 for definition of WOCBP) and men who are sexually active with WOCBP:

i. Two (2) separate forms of non-hormonal contraception are required from time of screening, throughout the duration of the on-treatment study period and for at least 24 weeks after the last dose of RBV (or the duration specified by the country-specific RBV label, whichever is longer) in such a manner that pregnancy is minimized. Oral contraceptive pills (OCPs) may not be used in this study as 1 of the 2 effective forms of contraception. Examples of acceptable methods of contraception include: tubal ligation, diaphragm, female condom, intrauterine devices (IUDs), condom with spermicide.

ii. Exceptions include:
I. WOCBP who are not heterosexually active or who have male partners who have been vasectomized for a minimum of 6 months;
II. Sexually active men who are vasectomized for a minimum of 6 months with a history of confirmed azoospermia.

c) WOCBP must have a negative serum or urine pregnancy test [minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin (HCG)] within 24 hours prior to the start of investigational product. Female patients must agree to the pregnancy testing requirements of this protocol;

d) Women must not be breastfeeding;

e) Male patients: Requirements (based on RBV label):
i. Male patients (unless vasectomized for at least 6 months and with a history of confirmed azoospermia) with female partners who are WOCBP must agree to inform their female partners of the protocol-specified contraception requirement and pregnancy testing recommendations during treatment and post-treatment (ie, 2 forms of contraception and monthly pregnancy testing while the patient is enrolled in the study and 6 months following discontinuation of RBV [or for the post-treatment duration specified in the country-specific RBV label]), and agree to adhere to these recommendations both on-treatment and during the post-treatment follow-up period;
ii. Male patients must confirm that their female sexual partners are not pregnant at the
time of screening.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 20
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 10

Exclusion Criteria

1) Medical History and Concurrent Diseases
a) Liver transplant recipients;
b) Evidence of decompensated liver disease including, but not limited to, a history or presence of ascites, bleeding varices, or hepatic encephalopathy;
c) Documented or suspected HCC as evidenced by previously obtained imaging studies or liver biopsy (or on a screening imaging study/liver biopsy if this was performed);
d) Evidence of a medical condition contributing to chronic liver disease other than HCV (such as, but not limited to: hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures);
e) History of chronic hepatitis B virus (HBV) as documented by HBV serology (eg, HBsAg-seropositive). Patients with resolved HBV infection may participate (eg, HBsAb-seropositive with concurrent HBsAg-seronegative);
f) History of HIV infection;
g) Current or known history of cancer (except in situ carcinoma of the cervix or adequately treated basal or squamous cell carcinoma of the skin) within 5 years prior to enrollment;
h) Any gastrointestinal disease or surgical procedure that may impact the absorption of study drug;
i) Active substance abuse as defined by DSM-IV, Diagnostic Criteria for Drug and Alcohol Abuse (Appendix 1), which in the opinion of the investigator would make the candidate inappropriate for participation in this study;
j) Organ transplants (including hematopoietic stem cell transplants) other than cornea and hair;
k) Uncontrolled diabetes (any patient with screening HgA1c = 8.5% must be excluded);
l) Confirmed uncontrolled hypertension (any screening systolic blood pressure =160 mmHg or diastolic blood pressure =100 mmHg should be excluded unless discussed with the central medical monitor);
m) Inability to tolerate oral medication;
n) Any other medical, psychiatric and/or social reason which, in the opinion of the investigator, would make the patient inappropriate for the study.
o) Coexistence of life-threatening condition(s) unrelated to MC
p) Any ongoing infection (eligible after eradication of infection)
q)Patient with decompensated cirrhosis

2) Physical and Laboratory Test Findings
1.Confirmed Alanine amino transferase (ALT) > 5xULN
2.Confirmed Total Bilirubin =2 mg/dL, unless subject has a documented history of Gilbert’s disease;
3.Confirmed INR =1.7;
4.Confirmed Albumin < 3.5 g/dL (35 g/L);
5.Confirmed Platelets < 50 ×109 cells/L;
6.Confirmed Hemoglobin < 12 g/dL (120 g/L) for women and < 13 g/dL (130 g/L) for men;
7.Confirmed Creatinine Clearance (CrCl) =50 mL/min (as estimated by MDRD);
8.Alpha fetoprotein (AFP):
a.AFP > 100 ng/mL (>121IU/ml)
b.AFP =50 and =100 ng/mL (> 60.5 IU/ml and < 121 IU/ml) requires a second level imaging procedure.
9.Positive HBsAg, HIV-1 or HIV-2 Ab.

3) Allergies and Adverse Drug Reaction
a) History of hypersensitivity to drugs with a similar biochemical structure to Sofosbuvir, or RBV.

4) Prohibited Treatment and/or Therapies
a)Treatment with anti-CD20 in the previous 6 months.
b)Plasmapheresis course in the 2 months preceding enrollment
c)High dose corticosteroids and/or immunosuppressive drugs in the 2 months preceding enrollment
6) Sex and Reproductive Status
a) Those males and females who do not or cannot meet the requirements outlined in Inclusion Criteria 3;
b) Sexually active fertile men whose partners are pregnant at screening are excluded from this study (a contraindication for RBV use).

7) Other Exclusion Criteria
a) Patients who are co

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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