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    Summary
    EudraCT Number:2011-001345-32
    Sponsor's Protocol Code Number:3034-040
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2012-02-01
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2011-001345-32
    A.3Full title of the trial
    A Phase 3, Safety and Efficacy Study of Boceprevir/Peginterferon Alfa-2a/ribavirin in Chronic HCV Genotype 1 IL28B CC Subjects
    Estudio en fase 3 de la seguridad y la eficacia de boceprevir/peginterferón alfa-2a/ribavirina en sujetos IL28B CC con infección crónica por el VHC de genotipo 1 (protocolo n.º P07755) (también conocido como MK-3034-040-00)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study of Boceprevir/Peginterferon Alfa-2a/ribavirin in Chronic Hepatitis C Subjects
    Estudio en fase 3 de la seguridad y la eficacia de boceprevir/peginterferón alfa-2a/ribavirina en sujetos IL28B CC con infección crónica por el VHC de genotipo 1 (protocolo n.º P07755) (también conocido como MK-3034-040-00)
    A.4.1Sponsor's protocol code number3034-040
    A.5.4Other Identifiers
    Name:P07755Number:P07755
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorSchering-Plough Corporation, a Subsidiary of Merck & Co.,Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportSchering-Plough Corporation, a Subsidiary of Merck & Co.,Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationSchering-Plough Corporation, a Subsidiary of Merck & Co.,Inc.
    B.5.2Functional name of contact pointGlobal Clinical Trials Operations
    B.5.3 Address:
    B.5.3.1Street Address2015 Galloping Hill Road
    B.5.3.2Town/ cityKenilworth, NJ
    B.5.3.3Post code07033
    B.5.3.4CountryUnited States
    B.5.4Telephone number908740 5524
    B.5.5Fax numberN/AN/AN/A
    B.5.6E-mailmargaret.burroughs@merck.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Victrelis
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme Ltd
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameboceprevir
    D.3.2Product code MK-3034
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNboceprevir
    D.3.9.1CAS number 394730-60-0
    D.3.9.2Current sponsor codeMK-3034
    D.3.9.3Other descriptive nameVictrelis
    D.3.9.4EV Substance CodeSUB31579
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Pegasys
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration Limited
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namepeginterferon alfa-2a
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPEGINTERFERON ALFA-2A
    D.3.9.1CAS number 198153-51-4
    D.3.9.3Other descriptive namePegasys
    D.3.9.4EV Substance CodeSUB16452MIG
    D.3.10 Strength
    D.3.10.1Concentration unit µg/ml microgram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number180
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Rebetol
    D.2.1.1.2Name of the Marketing Authorisation holderSP Europe
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameribavirin
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRIBAVIRIN
    D.3.9.1CAS number 36791-04-5
    D.3.9.3Other descriptive nameRebetol
    D.3.9.4EV Substance CodeSUB10297MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Hepatitis C
    Hepatitis C
    E.1.1.1Medical condition in easily understood language
    Hepatitis C
    Hepatitis C
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.1
    E.1.2Level LLT
    E.1.2Classification code 10019183
    E.1.2Term HCV
    E.1.2System Organ Class 10022891 - Investigations
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of this study is to compare the efficacy of the two boceprevir (BOC) containing therapeutic regimens using non-inferiority in treatment naïve subjects with chronic hepatitis C genotype 1 who have the IL28B CC allele. The regimens differ in the treatment for subjects who achieve HCV RNA undetectability at the end of the Peginterferon Alfa-2a /ribavirin (PEG2a/R) 4 week lead-in. Subjects receive either PEG2a/R alone or boceprevir/PEG2a/R.
    El objetivo principal de este estudio consiste en comparar la eficacia de dos regímenes terapéuticos con boceprevir (BOC), mediante una estrategia de ausencia de inferioridad, en sujetos con infección crónica por el virus de la hepatitis C de genotipo 1 sin tratamiento previo que tengan el alelo IL28B CC. Los regímenes de tratamiento diferirán en función de que los sujetos logren un ARN del VHC indetectable al final de la preinclusión con peginterferón alfa-2a/ribavirina (PEG2a/R) de 4 semanas. Los sujetos recibirán PEG2a/R solos o boceprevir/PEG2a/R.
    E.2.2Secondary objectives of the trial
    To estimate the difference in the SVR rate in subjects who have undetectable HCV RNA at TW4 (rapid virologic response, RVR) in Arm 2a compared to Arm 1a. These subjects receive 4 weeks of PEG2a/R and then:

    1) Arm 1a: an additional 20 weeks of PEG2a/R for a 24 week regimen.
    2) Arm 2a: an additional 20 weeks of therapy with BOC plus PEG2a/R for a 24 week regimen.
    ? Calcular la diferencia en la tasa de RVS en los sujetos con ARN del VHC indetectable en la ST4 (respuesta virológica rápida, RVR) entre los grupos 2a y 1a. Estos sujetos recibirán PEG2a/R durante 4 semanas más y, a continuación:
    1)Grupo 1a: PEG2a/R durante 20 semanas más, lo que deparará un tratamiento de 24 semanas.
    2)Grupo 2a: BOC más PEG2a/R durante 20 semanas más, lo que deparará un tratamiento de 24 semanas.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    ICF (Versión: 00-Genetic General 27-Dec-2011)
    HIPyCI(Versión: 00-Genético General 27-Dec-2011)
    E.3Principal inclusion criteria
    1. Each subject must be willing and able to provide written informed consent for the trial.
    2. Subjects must be willing to give written informed consent for pharmacogenetic testing, and able to adhere to dose and visit schedules.
    Note: Subjects who are unwilling to sign the informed consent for pharmacogenetic testing may be included into the trial, however, pharmacogenetic samples must not be obtained.
    3. Each subject must be > or = to 18years of age.
    4. Each subject?s weight must be ? 40 kg and ? 125 kg
    5. Subject must have previously documented CHC genotype 1 infection. Subjects with other or mixed genotypes are not eligible. The HCV-RNA result obtained from the central laboratory at the Screening Visit must confirm HCV genotype 1 infection with HCV RNA > or = to 10,000 IU/mL
    6. Subjects must have IL28b CC allele gene (with SNP rs12979860)
    7. Subject has had a liver biopsy without evidence of cirrhosis and hepatocellular carcinoma. A liver biopsy done prior to screening is acceptable if:
    -Within 3 years of screening and the result was METAVIR (or equivalent) Stage 0 (F0) to 2 (F2).
    -Within 1 year of screening and the result was Stage 3 (F3).
    If the prior liver biopsy was obtained outside the acceptable windows, a repeat biopsy may be performed, and the results must show no evidence of cirrhosis and hepatocellular carcinoma in order for the subject to be randomized in the study.
    For countries where liver biopsy is not performed prior to treatment and where noninvasive tests (for e.g. FibroScan and/or FibroTest) are used for staging of liver disease, these results may be used to assess eligibility. Subjects with a documented FibroScan score of ?9.5 kPa, or FibroTest score of ?0.58 are allowed to be enrolled in the study. These non-invasive tests done prior to screening are acceptable if they were performed within 1 year of screening and meet the indicated cut-offs. If the prior non-invasive tests were not performed within 1 year of screening, results from one of these non-invasive tests is required before study drug dosing. If a subject has both liver biopsy and one of
    these non-invasive tests, whichever test demonstrates the presence of cirrhosis would be used to determine eligibility. In other words, if the liver biopsy shows cirrhosis, the subject is excluded, regardless of results of the non-invasive assay. If the liver biopsy does not show cirrhosis, but the non-invasive assay does, then the subject is still excluded.
    8. Subject has had a chest X-ray (unless prohibited by local regulations) within 6 months prior to the screening visit (or between the screening visit and Day 1).
    9. Subject has had an ECG within 6 months prior to the screening visit (or between the screening visit and Day 1).
    10.Subject and subject?s partner(s) must each agree to use acceptable methods of contraception as specified in Section 7.6.1 for at least 2 weeks prior to Day 1 and continue until at least 6 months after last dose of study medication, or longer if dictated by local regulations. Postmenopausal women are not required to use contraception. Postmenopausal is defined as at least 12 consecutive months without a spontaneous menstrual period. Each sexually active male subject with a female partner(s) of child-bearing potential must also provide written informed consent to provide information regarding any pregnancy.
    For the purposes of this protocol, a male subject who is not of reproductive potential is eligible without requiring the use of contraception. A male subject who is not of reproductive potential is defined as: one who has undergone a successful vasectomy. A successful vasectomy is defined as: (1) microscopic documentation of azoospermia, or (2) a vasectomy more than 2 years ago with no resultant pregnancy despite sexual activity postvasectomy.
    1.El sujeto debe estar dispuesto a otorgar su consentimiento informado por escrito para el ensayo y debe ser capaz de hacerlo.
    2.El sujeto debe estar dispuesto a otorgar su consentimiento informado por escrito para el análisis farmacogenético y estar capacitado para seguir los calendarios de administración y de visitas.
    Nota: los sujetos que no se muestren dispuestos a firmar el consentimiento informado para el análisis farmacogenético podrán participar en el ensayo, pero no podrán donar muestras para este fin.
    3.El sujeto debe tener una edad ? 18 años.
    4.El peso del sujeto debe estar entre ? 40 y ? 125 kg.
    5.El sujeto debe tener una HCC causada por el genotipo 1 del virus documentada previamente. Los sujetos con otros genotipos o con genotipos mixtos no podrán participar en este ensayo. El resultado de ARN del VHC obtenido por el laboratorio central en la visita de selección tendrá que confirmar la infección por el genotipo 1 del VHC con un ARN del VHC ? 10.000 UI/ml.
    6.El sujeto debe tener un alelo IL28B CC (con PSN rs12979860).
    7.El sujeto se ha sometido a una biopsia hepática sin signos de cirrosis o carcinoma hepatocelular. Una biopsia hepática realizada antes de la selección será aceptable siempre que:
    -Se practique en los 3 años previos a la selección y el resultado sea de estadio METAVIR (o equivalente) 0 (F0) a 2 (F2).
    -Se practique en el año previo a la selección y el resultado sea de estadio 3 (F3).
    Cuando la biopsia hepática previa se haya obtenido fuera de los plazos aceptables, podrá repetirse y los resultados no deben mostrar signos de cirrosis ni carcinoma hepatocelular para que el sujeto pueda ser aleatorizado en el estudio.
    En los países en que la biopsia hepática no se realice antes del tratamiento y en los que se empleen pruebas no invasoras (por ejemplo, FibroScan o FibroTest) para estadificar la hepatopatía podrán utilizarse estos resultados para determinar la elegibilidad. Podrán participar en el estudio los sujetos con una puntuación en el FibroScan documentada ? 9,5 kPa o una puntuación en el FibroTest ? 0,58. Estas pruebas no invasivas realizadas antes de la selección serán aceptables siempre que se realicen en el año previo a la selección y que cumplan los límites indicados. Cuando las pruebas no invasivas precedentes no se hayan realizado en el año previo a la selección, se exigirán los resultados de una de estas pruebas no invasivas antes de la administración del fármaco del estudio. Cuando un sujeto cuente con una biopsia hepática y una de estas pruebas no invasivas, aquella prueba que demuestre la presencia de cirrosis se utilizará para determinar la elegibilidad. En otras palabras, si la biopsia hepática revela cirrosis, se excluirá al sujeto, con independencia de los resultados de los análisis no invasivos. Si la biopsia hepática no revela cirrosis, pero sí lo hace el análisis no invasivo, también se excluirá al sujeto.
    8.El sujeto se ha sometido a una radiografía de tórax (a menos que lo prohíban las normas locales) en los 6 meses previos a la visita de selección (o entre la visita de selección y el día 1).
    9.El sujeto se ha sometido a un ECG en los 6 meses previos a la visita de selección (o entre la visita de selección y el día 1).
    10.El sujeto y su pareja deben comprometerse a usar métodos anticonceptivos aceptables, tal como se especifica en la sección 7.6, durante un mínimo de dos semanas antes del día 1 y hasta 6 meses después de recibir la última dosis de la medicación del estudio, o durante más tiempo si así lo exige la normativa local. Las mujeres posmenopáusicas no están obligadas a utilizar métodos anticonceptivos. La posmenopausia se define como un período de 12 meses seguidos, como mínimo, sin menstruación espontánea. Todo sujeto varón sexualmente activo con una pareja femenina en edad fértil también deberá dar su consentimiento informado por escrito para proporcionar información acerca de posibles embarazos.
    En este protocolo, un varón que no esté en edad fértil podrá participar sin tener que utilizar métodos anticonceptivos. Los varones que no están en edad fértil son aquellos que: se han sometido a una vasectomía eficaz. Una vasectomía eficaz se define como: (1) documentación microscópica de azoospermia o (2) vasectomía realizada más de 2 años antes sin embarazo resultante pese a tener actividad sexual tras la vasectomía.
    E.4Principal exclusion criteria
    1. Subject is under the age of legal consent, is mentally or legally incapacitated, has significant emotional problems at the time of pre-study screening visit or expected during the conduct of the study or has a history of a clinically significant psychiatric disorder which, in the opinion of the investigator, would interfere with the study procedures.
    2. Subjects co-infected with the human immunodeficiency virus (HIV) or hepatitis B virus (Hepatitis B surface antigen [HBsAg] or HIV positive).
    3. Subjects who were previously treated with an interferon or ribavirin regimen or HCV direct acting anti-viral regimen.
    4. Treatment for hepatitis C with any investigational medication. Prior treatments with herbal remedies with known hepatotoxity are exclusionary. All herbal remedies including but not limited to St. John?s Wort (Hypericum perforatum) used for hepatitis C treatment must be discontinued before Day 1. Only silibininbased products such as silymarin (milk thistle) are allowed during the trial.
    5. Subjects receiving any of the following medication(s) within 2 weeks prior to the Day 1 visit that are highly dependent on CYP3A4/5 for clearance, and for which elevated plasma concentrations could be associated with serious and/or lifethreatening events such as orally administered midazolam, pimozide, amiodarone, flecainide, propafenone, quinidine, and ergot derivatives (dihydroergotamine, ergonovine, ergotamine, methylergonovine). The following medications are also exclusionary if taken within 2 weeks prior to the Day 1 visit: alfuzosin, cisapride, triazolam, sildenafil, and tadalafil (the latter 2 only if they are used for the indication of chronic obstructive pulmonary disease (COPD).
    6. Participation in any other clinical trial within 30 days of the screening visit in this trial or intention to participate in another clinical trial during participation in this trial. Collection of additional blood, urine, or tissue samples or additional data, beyond that specified in this protocol, is prohibited (other than that related to the subject?s medical care).
    7. Evidence of decompensated liver disease including, but not limited to, a history or presence of clinical ascites, bleeding varices, or hepatic encephalopathy.
    8. Subject has evidence of hepatocellular carcinoma (HCC) or is under evaluation for HCC.
    9. Subject is diabetic and/or hypertensive with clinically significant ocular examination findings within 6 months prior to the screening visit or between the screening visit and Day 1: retinopathy, cotton wool spots, optic nerve disorder, retinal hemorrhage, or any other clinically significant abnormality.
    10. Subject has pre-existing psychiatric condition(s) including but not limited to:
    ?Current moderate or severe depression.
    ?History of depression associated with any of the following:
    a) Hospitalization for depression.
    b) Electroconvulsive therapy for depression.
    c) Depression that resulted in a prolonged absence from work and/or significant disruption of daily functions
    ?Suicidal or homicidal ideation and/or attempt.
    History of severe psychiatric disorders (including but not limited to schizophrenia, psychosis, bipolar disorder, post-traumatic stress disorder, or mania).
    ?Past history or current use of lithium.
    ?Past history or current use of antipsychotic drugs for those conditions listed above.

    (Cont. in the protocol)
    1. El sujeto no alcanza la edad de consentimiento legal, está incapacitado mental o legalmente, tiene problemas emocionales importantes en el momento de la visita de selección previa al estudio o se prevé que los tenga durante la realización del estudio o tiene antecedentes de un trastorno psiquiátrico clínicamente significativo que, en opinión del investigador, interferiría en los procedimientos del estudio.
    2. El sujeto está coinfectado por el virus de la inmunodeficiencia humana (VIH) o el virus de la hepatitis B (antígeno de superficie de la hepatitis B [HBsAg] positivo).
    3. El sujeto ha sido tratado previamente con un régimen de interferón alfa y ribavirina o con un régimen antiviral con acción directa sobre el VHC.
    4. Tratamiento contra la hepatitis C con cualquier producto en investigación. Los tratamientos previos con productos de fitoterapia con hepatotoxicidad conocida son motivo de exclusión. Todos los productos de fitoterapia, por ejemplo, hipérico (Hypericum perforatum), utilizados para el tratamiento de la hepatitis C tendrán que suspenderse antes del día 1. Durante el ensayo solo se permitirá el uso de productos basados en silibinina como silimarina (leche de cardo).
    5. El sujeto ha recibido, en las 2 semanas previas a la visita del día 1, alguno de los siguientes medicamentos cuya eliminación depende en gran medida de la enzima CYP3A4/5 y cuyas concentraciones plasmáticas elevadas podrían asociarse a acontecimientos graves o potencialmente mortales, como midazolam, pimozida, amiodarona, flecainida, propafenona, quinidina y derivados ergotamínicos (dihidroergotamina, ergonovina, ergotamina, metilergonovina) administrados por vía oral. Los siguientes medicamentos también son motivo de exclusión en caso de tomarse en las 2 semanas previas a la visita del día 1: alfuzosina, cisaprida, triazolam, sildenafilo y tadalafilo (estos dos últimos solo si se utilizan en la indicación de enfermedad pulmonar obstructiva crónica (EPOC)).
    6. Participación en otro ensayo clínico en los 30 días anteriores a la visita de selección de este ensayo o intención de participar en otro ensayo clínico durante su participación en éste. Se prohíbe la recogida de muestras adicionales de sangre, orina o tejidos, así como de otros datos además de los especificados en este protocolo (a excepción de los relacionados con la atención médica del sujeto).
    7. Signos de hepatopatía descompensada, como antecedentes o presencia de ascitis clínica, varices hemorrágicas o encefalopatía hepática.
    8. El sujeto muestra signos de un carcinoma hepatocelular (CHC) o se encuentra en evaluación por un CHC.
    9. El sujeto es diabético o hipertenso y presenta hallazgos clínicamente importantes en la exploración oftalmológica en los seis meses previos a la visita de selección o entre la visita de selección y el día 1: retinopatía, exudados algodonosos, alteraciones del nervio óptico, hemorragia retiniana o cualquier otra anomalía clínicamente significativa.
    10. El sujeto presenta un trastorno psiquiátrico preexistente, entre otros los siguientes:
    ? Depresión moderada o grave actual.
    ? Antecedentes de depresión asociada a alguna de las circunstancias siguientes:
    a) Hospitalización por depresión.
    b) Terapia electroconvulsiva por depresión.
    c) Depresión que causa una baja laboral prolongada o una alteración importante de las funciones cotidianas.
    ? Ideas o intento de suicidio u homicidio.
    ? Antecedentes de trastornos psiquiátricos graves (como esquizofrenia, psicosis, trastorno bipolar, trastorno por estrés postraumático o manía, entre otros).
    ? Antecedentes o uso actual de litio.
    ? Antecedentes o uso actual de antipsicóticos para tratar los trastornos mencionados anteriormente.
    (Cont. en el protocolo)
    E.5 End points
    E.5.1Primary end point(s)
    The Primary Efficacy Endpoint is the achievement of SVR, defined as undetectable plasma HCV-RNA at Follow-up Week (FW) 24 in all randomized subjects in two boceprevir containing therapeutic regimens arm 2 compared to arm 1. If a subject is missing data at FW 24 window and has undetectable HCV-RNA at FW 12, the subject will be considered a sustained virologic responder.
    El criterio de valoración principal de la eficacia está relacionado con el objetivo principal del ensayo, que consiste en comparar la eficacia de los dos grupos de tratamiento con boceprevir.
    El criterio de valoración principal de la eficacia es la consecución de una RVS, definida como un ARN del VHC indetectable en la semana de seguimiento (SS) 24, en todos los sujetos aleatorizados a dos regímenes terapéuticos con boceprevir, grupo 2 en comparación con el grupo 1. En caso de que falten los datos de la SS24 de un sujeto y el valor de ARN del VHC sea indetectable en la SS12, se considerará que el sujeto tiene una RVS.
    E.5.1.1Timepoint(s) of evaluation of this end point
    HCV-RNA at Follow-up Week (FW) 24
    Valor de ARN del VHC en la semana de seguimiento 24
    E.5.2Secondary end point(s)
    The Key Secondary Efficacy Endpoint is the achievement of SVR defined as undetectable HCV-RNA at FW 24 in randomized subjects who are HCV-RNA undetectable at TW 4 (RVR) and are assigned shorter treatment duration PEG2a/R for additional 20 weeks (Arm 1a) or BOC + PEG2a/R 20 weeks (Arm 2a).
    Other Secondary Efficacy Endpoints:
    The achievement of SVR12 defined as undetectable HCV-RNA at FW 12 in subjects in Arm 2 compared to Arm 1.
    The achievement of SVR12 defined as undetectable HCV-RNA at FW 12 in subjects who are HCV-RNA undetectable at TW 4, Arm 2a compared to Arm 1a
    The proportion of subjects with undetectable HCV-RNA at TW 4 in each Arm (1, 2)
    The proportion of subjects with an undetectable HCV RNA at TW 8, TW 12 for Arm 1a, and 4 and 8 weeks after the addition of Boceprevir in Arm 2 (2a and 2b) and Arm 1b,
    The SVR rates in subjects with an undetectable HCV RNA at TW 8 or TW 12 for Arm 1a, 2a and 2b, and at TW 10 or TW 14 for Arm 1b.
    The proportion of subjects in each Arm (1 and 2) and subarms (1a, 1b, 2a, 2b) who relapse as defined as having undetectable HCV RNA at the end of therapy with detectable HCV RNA in the follow-up period (post-treatment)
    Change from baseline in the log10 HCV RNA at TW 4, and SVR by log change from baseline at TW 4
    The proportion of subjects with HCV virologic breakthrough
    The proportion of subjects with incomplete virologic response/rebound
    El criterio de valoración secundario fundamental de la eficacia es la consecución de una RVS, definida como un ARN del VHC indetectable en la SS24, en los sujetos aleatorizados que presenten un ARN del VHC indetectable en la ST4 (RVR) y sean asignados a una menor duración del tratamiento, PEG2a/R durante 20 semanas más (grupo 1a) o BOC + PEG2a/R durante 20 semanas (grupo 2a). En caso de que falten los datos de la SS24 de un sujeto y el valor de ARN del VHC sea indetectable en la SS12, se considerará que el sujeto tiene una RVS.
    7.7.1.3 Otros criterios de valoración de la eficacia
    ? Consecución de una RVS12, definida como un ARN del VHC indetectable en la SS12, grupo 2 en comparación con el grupo 1.
    ? Consecución de una RVS12 en los sujetos con un ARN del VHC indetectable en la ST4, grupo 2a en comparación con el grupo 1a.
    ? Proporción de sujetos con un ARN del VHC indetectable en la ST4 en cada grupo (1, 2).
    ? Proporción de sujetos con un ARN del VHC indetectable en la ST8 y ST12 en el grupo 1a y 4 y 8 semanas después de la adición de boceprevir en los grupos 2 (2a y 2b) y 1b.
    ? Tasas de RVS en los sujetos con un ARN del VHC indetectable en la ST8 o ST12 en el grupo 1a, 2a y 2b y en la ST10 o ST14 en el grupo 1b.
    ? Proporción de sujetos de cada grupo (1 y 2) y subgrupo (1a, 1b, 2a, y 2b) que presenten una recaída, definida como un ARN del VHC indetectable al final del tratamiento con un ARN del VHC detectable durante el período de seguimiento (después del tratamiento).
    ? Variación con respecto al valor basal del log10 del ARN del VHC en la ST4 y RVS según la variación logarítmica con respecto al valor basal en la ST4.
    ? Proporción de sujetos con recaída virológica del VHC.
    ? Proporción de sujetos con respuesta virológica incompleta/rebote.
    E.5.2.1Timepoint(s) of evaluation of this end point
    For key secondary end point: HCV-RNA at Follow-up Week (FW) 24
    Other Secondary Efficacy Endpoints: HCV-RNA at Follow-up Week (FW) 12
    El criterio de valoración secundario:Valor de ARN del VHC en la semana de seguimiento 24.
    Otros criterios de valoración de la eficacia:Valor de ARN del VHC en la semana de seguimiento 12.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis Yes
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Boceprevir + Pegasys/ Ribavirin será comparado con solo Pegasys/ Ribavirin
    Boceprevir + Pegasys/ Ribavirin will be compared to only Pegasys/ Ribavirin
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA66
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    Austria
    Belgium
    Brazil
    Canada
    Chile
    Colombia
    Czech Republic
    Finland
    France
    Germany
    Guatemala
    Hong Kong
    India
    Israel
    Korea, Republic of
    Malaysia
    Mexico
    New Zealand
    Peru
    Philippines
    Poland
    Portugal
    Puerto Rico
    Russian Federation
    Singapore
    Spain
    Sweden
    Taiwan
    Thailand
    Turkey
    United Kingdom
    United States
    Venezuela, Bolivarian Republic of
    E.8.7Trial has a data monitoring committee No
    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
    LPLV
    LPLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 800
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 450
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 312
    F.4.2.2In the whole clinical trial 1250
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    If the patient achieves SVR- the patient is cured of the disease. If there is any viral failure no rescue arm will be provided.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2012-03-29
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2012-03-14
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2015-05-19
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