E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Approximately 72 subjects with chronic hepatitis C (treatment naive, genotype 1) will be included in a 12 week open label randomized trial with 2 panels (approximately 40 subjects in PANEL A and approximately 32 subjects in PANEL B) at approximately 25 sites in Israel and Europe. Subjects will be randomized at a 1:1 ratio in both PANEL A and PANEL B. Randomization will be stratified by site. |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10019752 |
E.1.2 | Term | Hepatitis C virus (HCV) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess in subjects with chronic hepatitis C (treatment-naïve, genotype 1) receiving weight-based doses of ribavirin: virologic response to the 480 ug dose level of Locteron™, dosed every 2 weeks, in comparison with 1.5 ug/kg PEG-Intron™ dosed weekly.
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E.2.2 | Secondary objectives of the trial |
Safety, tolerability and immunogenicity of Locteron™ 480 ug versus PEG-Intron™ 1.5 ug/kg and intensity and duration of flu-like symptoms Rates of dose reduction and discontinuation for tolerability of Locteron vs PEG-Intron PK profiles of Locteron™ 480 ug and PEG-Intron™ 1.5 ug/kg Impact on general Health-related QoL with Locteron or PEG-Intron; impact on the onset of depression and depressive symptoms with Locteron or PEG-Intron; impact on days missed from work during treatment with Locteron and PEG-Intron Incidence of binding and neutralizing antibodies to IFNa2b of Locteron and PEG-Intron Compare each outcome above in patients on Locteron™ containing IFNa2b from the IFN53 Lemna plant line vs those on Locteron™ containing IFNa2b from the IFN61 Lemna plant line; compare each outcome above in patients on Locteron containing IFNa2b produced in the IFN61 Lemna plant line when the 480 ug dose is injected in a single injection site vs 2 injection sites of 160 ug and 320 ug |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
PANEL B of this protocol, includes a sub-study, to examine the pharmacokinetics, pharmacodynamics, and viral dynamics of both the new cell line and the single subcutaneous injection. |
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E.3 | Principal inclusion criteria |
• Willing and able to provide written informed consent • Male and female subjects 18 through 69 years of age, inclusive • Chronic hepatitis C genotype 1 • HCV ribonucleic acid (RNA) level > 10,000 IU/mL (by RT-PCR) at screening • Creatine clearance more than or equal to 50 mL/min • Neutrophil count > 1500 cells/mm3 • Platelet count > 90,000/mm3 • Hemoglobin > 12 g/dL for females and > 13 g/dL for males • Female subjects of child-bearing potential agreeing to use dual methods for contraception (oral or parenteral contraceptive drugs + barrier method) for the duration of the study and up to 24 weeks after stopping study drug • Male subjects with female sexual partners agreeing to use effective birth control methods for the total duration of the study and up to 28 weeks after stopping study drug • Negative serum pregnancy test for women of child-bearing potential at screening and confirmed by negative urine pregnancy test within the 24-hour period prior to the first dose of study drug • Compensated liver disease defined as INR < 1.5, conjugated bilirubin < 1.5 ULN, serum albumin > 3.0 g/dL.
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E.4 | Principal exclusion criteria |
• Prior antiviral treatment for hepatitis C (defined as more than one dose of interferon based therapy and any administration of a targeted antiviral therapy) • Co-infection with HIV or hepatitis B virus (HBsAg positive), acute hepatitis A (HAV IgM positive) • Subjects with a body mass index (BMI) above 32 kg/m2 • Current or prior history of clinical hepatic decompensation (e.g., ascites, jaundice, encephalopathy, variceal hemorrhage) • Evidence of HCC; for example, alfa-fetoprotein more than 50 ng/mL or by any other standard of care measure • Uncontrolled diabetes mellitus as evidenced by HbA1C ≥ 8.5% at screening • Known hypersensitivity to interferon alfa or ribavirin, or with any other contraindications to these medications, e.g. after use of these agents for non-hepatitis C disorders • Chronic liver disease other than HCV not limited to HBV, hemochromatosis, auto-immune hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease • Clinically significant hemoglobinopathy such as thalassemia major and sickle cell anemia • History of moderate, severe or uncontrolled psychiatric disease including depression and prior suicide attempts • History of immune-mediated disease (e.g., inflammatory bowel disease, immune thrombocytopenic purpura, systemic lupus erythematosus, autoimmune hemolytic anemia, scleroderma, moderate to severe psoriasis, rheumatoid arthritis, antinuclear antibody (ANA) titer more than or equal to 1:640 at screening) • Significant renal or neurological disease • Severe degree (> GOLD stage III) of chronic pulmonary disease (COPD) or active, severe asthma • Subjects with severe cardiac disease (e.g., heart failure, recent [i.e., within 6 months prior to first dosing] myocardial infarction, angina, serious arrhythmias, including prolonged QTc [> 450 mSec], uncontrolled hypertension) • History of significant central nervous system (including CNS trauma) or seizure disorders • Cancer within the last 5 years, or previous cancer with a high risk of recurrence, including metastatic breast cancer; non-melanoma skin cancer is not an exclusion criterion • History of solid organ or bone marrow transplantation • Clinical or laboratory evidence of uncontrolled thyroid disease, e.g., by thyroid stimulating hormone (TSH) level > 1.2 x upper limit of normal • Clinically significant retinopathy; this needs to have been excluded by an eye exam performed by an ophthalmologist within the last 6 months prior to screening for subjects with hypertension or diabetes mellitus • Drug abuse or alcohol consumption within the last 6 months which, in the opinion of the investigator, may affect study participation or outcome. Subjects in a supervised methadone treatment program on a stable regimen for > 6 months may be considered • Taken any experimental agent within 12 weeks prior to screening • More than 30 days of systemic immunosuppressive medication to include steroids in doses equivalent to or greater than 10 mg prednisone per day within 30 days prior to screening (inhaled corticosteroids are allowed) • Nursing mother or male partner of pregnant female.
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E.5 End points |
E.5.1 | Primary end point(s) |
1. The primary efficacy endpoint for this study is the proportion of subjects exhibiting an early virologic response (EVR) defined as at least a 2 log drop in HCV RNA from baseline after 12 weeks of treatment
1.1. Secondary efficacy endpoints: * The proportion of subject in each treatment arm (TA) that achieve: -sustained virologic response (undetectable(<10 IU/mL) HCV RNA at the end of the follow-up period) -rapid virologic response (undetectable HCV RNA after 4 W of therapy) -end of treatment response (undetectable HCV RNA after 12 W of therapy) * The Log decreases from baseline in HCV RNA level overtime for each TA.
2. Safety and tolerability endpoints will be based on the following criteria: • The number, severity, and relatedness of adverse events spontaneously reported and queried by the investigator • The proportion of subjects undergoing dose reduction for tolerability reasons • The proportion of subjects undergoing treatment discontinuation for tolerability reasons • The proportion of subjects undergoing dose reduction or treatment discontinuation for tolerability reasons • Physical examination findings, including injection site reactions • Laboratory test results • Changes in ECG recordings when compared to pre-treatment baseline • Change in the SF-36v2 Quality of Life Questionnaire subscale (physical function, bodily pain, physical role, general health, vitality social function, emotional role, mental health) and component scores (physical component summary and mental component summary) after 4, 8 and 12 weeks of treatment • Change in Beck Depression Inventory (BDI) scale scores at after 4, 8 and 12 weeks of treatment • Mean number of days missed form work after 12 weeks of treatment • Intensity and duration of flu-like symptoms (i.e., fever, chills, myalgia, arthralgia, and headaches) as reported through ePRO and clinic visits during the 12 week treatment period
3. PK/PD endpoints: Pharmacokinetic parameters for each treatment arm will be evaluated based on pre-dose serum IFNa2b levels. Additionally, rich PK sampling will be evaluated in PANEL B in both treatment arms. Sampling times in PANEL B for both Locteron™ and PEG-Intron™ in the first seven days will be Baseline, 1 hour, 3 hours, 6 hours, 24 hours, 48 hours, 72 hours, 96 hours, 120 hours, and 144 hours. Locteron™ subjects in PANEL B will also have PK samples drawn at 168 hour, 192 hours, 216 hours, 240 hours, 268 hours and 288 hours. Pharmacodynamic parameters will be evaluated on serum 2’,5’ OAS and neopterin levels in PANEL B for each treatment arm at Baseline, 1 hour, 3 hour, 6 hours, 24 hours, 48 hours, 72 hours and 144 hours. Locteron™ subjects will have an additional 2’,5’ OAS and neopterin sample taken at Day 14 (312 hours)
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 7 |