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Different Ribavirin Dosages and Different Duration of Treatment in Combination With PegInterferon in Patients With Genotype 2 and 3 (WRITE)

Phase 3
Completed
Conditions
Chronic Hepatitis
Interventions
Registration Number
NCT01380938
Lead Sponsor
Casa Sollievo della Sofferenza IRCCS
Brief Summary

WRITE study aim at identifying the effectiveness of an innovative individualized schedule of treatment as compared to standard regimen in patients with chronic HCV genotype 2 and 3.

Detailed Description

The investigators are going to compare weight-based dosages of ribavirin, in combination with Peginterferon alpha-2a, with standard fixed dosages of 800 mg. Patients will be evaluated at week 4 with an assay of sensitivity of 15 IU/ml. Patients with week 4 response will discontinue treatment at week 12 in both arms. Patients with HCV RNA still detectable at week 4 and receiving 1000-1200 mg of ribavirin in arm A will discontinue treatment at week 24, whereas patients with HCV RNA still detectable at week 4 and receiving 800 mg of ribavirin in arm B will be treated till week 48.

A standard treatment arm (C) including patients treated for 24 weeks with Peginterferon alpha-2a and fixed 800 mg ribavirin dosage will be used as control arm.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1150
Inclusion Criteria
  • Patients with chronic hepatitis C virus (HCV) infection (both HCVAb and HCV RNA positive)
  • Patients with HCV genotype 2 or 3
  • Age 18-70 years
  • Naïve patients or previously treated only with standard interferon monotherapy
  • Female patients of childbearing age who agree to avoid pregnancy during the period of treatment and 24 weeks after the end of treatment
Exclusion Criteria
  • Previous treatment with ribavirin
  • Cirrhosis (CHILD PUGH B and C)
  • Evidence of Hepatocellular carcinoma
  • Pregnancy
  • Retinopathy class I or II
  • Alcohol consumption > 40 gr/day
  • Chronic cardiac or respiratory diseases
  • HIV or HBsAg or HDV positivity
  • Hemoglobin < 8.5 gr/dL
  • WBC < 3.500/mm3
  • PLT < 80.000/mm3

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm APeginterferon alpha-2a + RibavirinPatients enrolled in Arm A will receive Peginterferon alpha-2a at a dosage of 180 mcg weekly in combination with oral ribavirin administered at a dosage of 1000 mg/day for patients with a body weight \< 75 kg or 1200 mg/day for those with a body weight \> 75 kg. Patients with week 4 viral clearance (labelled as rapid virological responders, RVR) will be allocated to 12 week treatment duration (Arm A), whereas those without RVR will be treated for 24 weeks (Arm A)
Arm BPeginterferon alpha-2a + RibavirinPatients enrolled in Arm B will receive Peginterferon alpha-2a at a dosage of 180 mcg weekly in combination with oral ribavirin administered at a dosage of 800 mg/day. Patients with week 4 viral clearance (labelled as rapid virological responders, RVR) will be allocated to 12 week treatment duration (Arm B), whereas those without RVR will be treated for 48 weeks (Arm B)
Primary Outcome Measures
NameTimeMethod
Sustained virological Response (SVR)6 months after the end of treatment

The primary measure of efficacy will be HCV RNA not detectable in serum samples 24 weeks after the end of therapy (SVR).

Secondary Outcome Measures
NameTimeMethod
Rapid virological response (RVR)On treatment week 4

proportion of patients with undetectable HCV RNA 4 weeks after the start of treatment

Trial Locations

Locations (24)

Infectious Diseases Unit

🇮🇹

Catania, Italy

Clinical Medicine Unit "Mater Dei"

🇮🇹

Bari, Italy

Università di Bari

🇮🇹

Bari, Italy

Medicine Unit

🇮🇹

Venosa, Italy

Infectious Diseases Unit "V. Emanuele"

🇮🇹

Bisceglie, Italy

Hepatology Unit

🇮🇹

Catania, Italy

IRCCS "De Bellis"

🇮🇹

Castellana, Italy

Gastroenterology Unit

🇮🇹

Mottola, Italy

Infectious Diseases

🇮🇹

Siracusa, Italy

Gastroenterology Unit Arcispedale "S. Anna"

🇮🇹

Ferrara, Italy

Gastroenterology Unit "Cardarelli"

🇮🇹

Napoli, Italy

Internal Medicine University of Firenze

🇮🇹

Firenze, Italy

Hospital "V. Cervello"

🇮🇹

Palermo, Italy

Infectious Diseases Unit IRCCS "San Matteo"

🇮🇹

Pavia, Italy

USL Napoli 1

🇮🇹

Napoli, Italy

Campus Biomedico University

🇮🇹

Roma, Italy

Hepatology Unit "san Camillo"

🇮🇹

Roma, Italy

Hepatology Unit "S. Pertini"

🇮🇹

Roma, Italy

Ospedale "Villa Betania"

🇮🇹

Roma, Italy

IRCCS "L. Spallanzani"

🇮🇹

Rome, Italy

Infectious Diseases Unit Ospedale Civile

🇮🇹

Sassari, Italy

IRCCS "Casa Sollievo della Sofferenza"

🇮🇹

San Giovanni Rotondo, Italy

SS. Annunziata

🇮🇹

Taranto, Italy

Medical Clinic University of Palermo

🇮🇹

Palermo, Italy

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