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    Clinical Trial Results:
    An Open-Label Study to Evaluate the Safety, Antiviral Activity and Pharmacokinetics of Direct-Acting Antiviral Agent (DAA) Treatment in Combination with Peginterferon Alpha-2a and Ribavirin (pegIFN/RBV) in Chronic Hepatitis C Virus (HCV) Infected Subjects Who Have Experienced Virologic Failure in a Previous Abbott DAA Combination Study

    Summary
    EudraCT number
    2011-005393-32
    Trial protocol
    GB   ES   DE   BE   HU   SE   AT   NL   IT   CZ   IE   SK   PT  
    Global end of trial date
    08 May 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    09 May 2018
    First version publication date
    09 May 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    M13-101
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01609933
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AbbVie Deutschland GmbH & Co. KG
    Sponsor organisation address
    AbbVie House, Vanwall Business Park, Vanwall Road, Maidenhead, Berkshire, United Kingdom, SL6-4UB
    Public contact
    Global Medical Services, AbbVie, 001 800-633-9110,
    Scientific contact
    Mariem Charafeddine, AbbVie, mariem.charafeddine@abbvie.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    08 May 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    08 May 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    A study to evaluate the safety and effect of treatment with experimental antiviral drugs in combination with peginterferon alpha-2a and ribavirin in people with hepatitis C virus who did not respond to treatment in a previous AbbVie/Abbott combination study.
    Protection of trial subjects
    Subject read and understood the information provided about the study and gave written permission.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    18 Dec 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 4
    Country: Number of subjects enrolled
    Slovakia: 1
    Country: Number of subjects enrolled
    Spain: 2
    Country: Number of subjects enrolled
    United Kingdom: 1
    Country: Number of subjects enrolled
    Hungary: 3
    Country: Number of subjects enrolled
    Argentina: 1
    Country: Number of subjects enrolled
    Australia: 1
    Country: Number of subjects enrolled
    Romania: 2
    Country: Number of subjects enrolled
    United States: 17
    Worldwide total number of subjects
    32
    EEA total number of subjects
    13
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    32
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    All subjects who received at least 1 dose of study drug were included in the intent-to-treat (ITT) population; the safety population is the same as the ITT population.

    Pre-assignment
    Screening details
    The study included a 42-day screening period.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    2-DAA + PegIFN/RBV
    Arm description
    2-direct-acting antiviral (2-DAA: ABT-450 [paritaprevir] 200 mg once daily [QD], ritonavir 100 mg QD, ABT-267 [ombitasvir] 25 mg QD) plus pegylated interferon alpha-2a (pegIFN) 180 mcg once weekly and Ribavirin (RBV) weight-based dosing, 1000 to 1200 mg divided twice daily (BID) for 24 weeks (Substudy 1) and followed by pegIFN and RBV alone for an additional 24 weeks (Substudy 2).
    Arm type
    Experimental

    Investigational medicinal product name
    ABT-450/r
    Investigational medicinal product code
    Other name
    ABT-450 also known as paritaprevir and r is also know as ritonavir
    Pharmaceutical forms
    Capsule, Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    ABT-450 (tablets) dosed with ritonavir (capsules or tablets) administered orally

    Investigational medicinal product name
    ABT-267
    Investigational medicinal product code
    Other name
    ABT-267 also known as ombitasvir
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    ABT-267 (tablets)

    Investigational medicinal product name
    pegylated interferon alpha-2a (pegIFN)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    pegIFN alpha-2a (syringe)

    Investigational medicinal product name
    Ribavirin (RBV)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Ribavirin (tablets)

    Number of subjects in period 1
    2-DAA + PegIFN/RBV
    Started
    32
    Completed
    28
    Not completed
    4
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    2-DAA + PegIFN/RBV
    Reporting group description
    2-direct-acting antiviral (2-DAA: ABT-450 [paritaprevir] 200 mg once daily [QD], ritonavir 100 mg QD, ABT-267 [ombitasvir] 25 mg QD) plus pegylated interferon alpha-2a (pegIFN) 180 mcg once weekly and Ribavirin (RBV) weight-based dosing, 1000 to 1200 mg divided twice daily (BID) for 24 weeks (Substudy 1) and followed by pegIFN and RBV alone for an additional 24 weeks (Substudy 2).

    Reporting group values
    2-DAA + PegIFN/RBV Total
    Number of subjects
    32 32
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    51.4 ( 9.77 ) -
    Gender categorical
    Units: Subjects
        Female
    7 7
        Male
    25 25
    Race categorical
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    0 0
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    2 2
        White
    30 30
        More than one race
    0 0
        Unknown or Not Reported
    0 0

    End points

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    End points reporting groups
    Reporting group title
    2-DAA + PegIFN/RBV
    Reporting group description
    2-direct-acting antiviral (2-DAA: ABT-450 [paritaprevir] 200 mg once daily [QD], ritonavir 100 mg QD, ABT-267 [ombitasvir] 25 mg QD) plus pegylated interferon alpha-2a (pegIFN) 180 mcg once weekly and Ribavirin (RBV) weight-based dosing, 1000 to 1200 mg divided twice daily (BID) for 24 weeks (Substudy 1) and followed by pegIFN and RBV alone for an additional 24 weeks (Substudy 2).

    Primary: Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post Treatment (SVR12)

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    End point title
    Percentage of Participants Achieving Sustained Virologic Response 12 Weeks Post Treatment (SVR12) [1]
    End point description
    SVR12 was defined as hepatitis C virus ribonucleic acid (HCV RNA) level less than lower limit of quantitation [LLOQ] 12 weeks after the last dose of study drugs (DAAs plus pegIFN alpha-2a and RBV).
    End point type
    Primary
    End point timeframe
    12 weeks after last dose of study drugs (DAAs plus pegIFN alpha-2a and RBV)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive data are summarized for this end point per protocol.
    End point values
    2-DAA + PegIFN/RBV
    Number of subjects analysed
    32
    Units: percentage of participants
        number (confidence interval 95%)
    81.3 (64.7 to 91.1)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving Virologic Response 24 Weeks Post Treatment (SVR24)

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    End point title
    Percentage of Participants Achieving Virologic Response 24 Weeks Post Treatment (SVR24)
    End point description
    SVR24 was defined as HCV RNA level less than the LLOQ 24 weeks after the last dose of study drugs (DAAs plus pegIFN alpha-2a and RBV).
    End point type
    Secondary
    End point timeframe
    24 weeks after last dose of study drugs (DAAs plus pegIFN alpha-2a and RBV)
    End point values
    2-DAA + PegIFN/RBV
    Number of subjects analysed
    32
    Units: Percentage of participants
        number (confidence interval 95%)
    78.1 (61.2 to 89.0)
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Extended Rapid Virologic Response (eRVR)

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    End point title
    Percentage of Participants With Extended Rapid Virologic Response (eRVR)
    End point description
    eRVR was defined as HCV RNA level < LLOQ at Substudy 1 treatment weeks 4 through 12 without a confirmed HCV RNA >= LLOQ
    End point type
    Secondary
    End point timeframe
    Treatment weeks 4 through 12 of Substudy 1 (DAAs plus pegIFN alpha-2a and RBV)
    End point values
    2-DAA + PegIFN/RBV
    Number of subjects analysed
    32
    Units: Percentage of participants
        number (confidence interval 95%)
    87.5 (71.9 to 95.0)
    No statistical analyses for this end point

    Secondary: Number of Subjects With Adverse Events

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    End point title
    Number of Subjects With Adverse Events
    End point description
    An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. The investigator assessed the relationship of each event to the use of study drug as either probably related, possibly related, probably not related or not related. A serious adverse event (SAE) is an event that results in death, is lifethreatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the subject and may require medical or surgical intervention to prevent any of the outcomes listed above. Treatment-emergent events (TEAEs/TESAEs) are defined as any event that began or worsened in severity after initiation of study drug through 30 days post-DAA dosing. For more details on AEs, see the AE section.
    End point type
    Secondary
    End point timeframe
    From first dose of study drug through 30 days after last dose of study drug (DAAs plus pegIFN alpha-2a and RBV) (up to 28 weeks).
    End point values
    2-DAA + PegIFN/RBV
    Number of subjects analysed
    32
    Units: subjects
        2-DAA TEAE
    29
        2-DAA TESAE
    1
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events (TEAEs) and serious adverse events (TESAEs) were collected from first dose of study drug through 30 days after the last dose of DAA (2-DAA + pegIFN alpha-2a and RBV) dosing (up to 28 weeks).
    Adverse event reporting additional description
    TEAEs and TESAEs are defined as any AE with an onset date that is after the first dose of study drug through 30 days after the last dose of DAAs (up to 28 weeks) and were collected whether elicited or spontaneously reported by the participant.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    2-DAA + PegIFN/RBV
    Reporting group description
    2-direct-acting antiviral (2-DAA: ABT-450 [paritaprevir] 200 mg once daily [QD], ritonavir 100 mg QD, ABT-267 [ombitasvir] 25 mg QD) plus pegylated interferon alpha-2a (pegIFN) 180 mcg once weekly and Ribavirin (RBV) weight-based dosing, 1000 to 1200 mg divided twice daily (BID) for 24 weeks and followed by pegIFN and RBV alone for an additional 24 weeks.

    Serious adverse events
    2-DAA + PegIFN/RBV
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 32 (3.13%)
         number of deaths (all causes)
    1
         number of deaths resulting from adverse events
    Cardiac disorders
    Myocardial infarction
         subjects affected / exposed
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    2-DAA + PegIFN/RBV
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    28 / 32 (87.50%)
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    7
    Weight decreased
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    White blood cell count decreased
         subjects affected / exposed
    5 / 32 (15.63%)
         occurrences all number
    7
    Nervous system disorders
    Disturbance in attention
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    3
    Headache
         subjects affected / exposed
    14 / 32 (43.75%)
         occurrences all number
    27
    Blood and lymphatic system disorders
    Lymphopenia
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Neutropenia
         subjects affected / exposed
    7 / 32 (21.88%)
         occurrences all number
    10
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Chills
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    3
    Fatigue
         subjects affected / exposed
    11 / 32 (34.38%)
         occurrences all number
    13
    Feeling abnormal
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Influenza like illness
         subjects affected / exposed
    6 / 32 (18.75%)
         occurrences all number
    6
    Pain
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    4
    Pyrexia
         subjects affected / exposed
    4 / 32 (12.50%)
         occurrences all number
    4
    Eye disorders
    Vision blurred
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    3
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    3
    Anal pruritus
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Diarrhoea
         subjects affected / exposed
    6 / 32 (18.75%)
         occurrences all number
    7
    Dry mouth
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Nausea
         subjects affected / exposed
    9 / 32 (28.13%)
         occurrences all number
    9
    Hepatobiliary disorders
    Jaundice
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    4 / 32 (12.50%)
         occurrences all number
    4
    Dyspnoea
         subjects affected / exposed
    4 / 32 (12.50%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    4 / 32 (12.50%)
         occurrences all number
    6
    Pruritus
         subjects affected / exposed
    6 / 32 (18.75%)
         occurrences all number
    8
    Rash
         subjects affected / exposed
    8 / 32 (25.00%)
         occurrences all number
    9
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Depression
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Insomnia
         subjects affected / exposed
    8 / 32 (25.00%)
         occurrences all number
    10
    Irritability
         subjects affected / exposed
    4 / 32 (12.50%)
         occurrences all number
    4
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Back pain
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    4
    Muscle spasms
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Myalgia
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    3
    Upper respiratory tract infection
         subjects affected / exposed
    3 / 32 (9.38%)
         occurrences all number
    3
    Viral infection
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2
    Viral upper respiratory tract infection
         subjects affected / exposed
    2 / 32 (6.25%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    08 Feb 2012
    The purpose of this amendment included the following: to add text to the benefit and risks section; clarify screening procedures; clarify that that subjects continue into Substudy 2 after completing or discontinuing Substudy 1; clarify that sites may substitute serum pregnancy testing for urine pregnancy testing only if required per local regulations; added clinical laboratory and IP-10 testing to Table 2 at the Discontinuation visit; added subgenotypes to the exploratory analyses text.
    17 Apr 2012
    The purpose of this amendment included the following: to exclude subjects with prior null or partial response to PegIFN/RBV in whom resistant variants associated with decreased susceptibility to ABT-450 and/or ABT-267 were detected; increased the enrollment time up to 1 year after virologic failure in the previous study; revised the Screening Visit procedures; clarified inclusion criteria text for woman of child bearing potential and define postmenopausal state; clarified inclusion criteria for male subjects who had partners of childbearing potential; added exclusion criteria to exclude use of herbal supplements and colony stimulating factors; added non-efficacy (futility) criteria; added information for the management of neuropsychiatric complications; added text to provide information on managing complications due to peginterferon therapy; and removed Abbott Realtime HCV testing, as exploratory analysis of HCV RNA results using 2 platforms was no longer planned.
    26 Jul 2012
    The purpose of this amendment included the following: added a pre-screening visit to study procedures; updated the number of weeks of treatment with ABT-450 and ABT-267 in active clinical trials to 24 weeks; added inclusion criteria and exclusion criteria text to limit the enrollment to subjects with genotype 1 chronic HCV infection; added inclusion criteria text regarding HCV RNA level at pre-screening; clarified exclusion criteria text to align with how population sequencing was performed; added exclusion criteria related to the gap between the time the subject failed treatment in the previous AbbVie/Abbott DAA combination study and the start of this study; clarified that medical history will only be an update at the Screening Visit and Substudy 1 Day 1 Visit of new information that was not already recorded in the previous Abbott study; added text to clarify what treatment was planned after the subject ended their participation in this study; clarified physical examination procedures; added text regarding clinical laboratory tests to confirm post-menopausal status; corrected centrifuge speed text; added storage condition instructions for ritonavir; clarified text regarding assigning subjects; clarified drug accountability documentation; and updated references to include the newest versions of ABT-450 and ABT-267 Investigator's Brochures.
    22 Mar 2013
    The purpose of this amendment included the following: revised inclusion/exclusion criteria and study procedures; revised the number of participating subjects in the study from 250 to 150; updated the description of the Treatment Period and the Post-Treatment Period including descriptions of study visits; modified inclusion criteria regarding effective contraceptive methods for female subjects; clarified exclusion criteria text to indicate that pregnancy should be avoided within 7 months after last dose of RBV study drug; added a table of medications contraindicated for use with ABT-450 and ABT-267 to exclusion criteria text; added urine albumin test to Substudy 1 Day 1 visit; deleted comprehensive physical examination from the Post Treatment Period; deleted the 1-year restriction for subjects to enroll into this study from discontinuation of the previous study; added clarifying text to the following sections: Prohibited Therapy, Pregnancy, Discontinuation of Individual Subject, Method of Assigning Subjects to Treatment Groups, Treatment Compliance, Drug Accountability, and Appropriateness of Measurements; updated the Toxicity Management; updated the Statistical Methods and Determination of Sample Size text; updated the Resistance Variables text; incorporated Administrative Changes 2 and 3; and provided clarifying text to address the Sponsor change from Abbott Laboratories (Abbott) to AbbVie.
    09 Apr 2013
    The purpose of this amendment was to add text that prohibited the use of hormonal contraceptives during study drug administration.
    17 Jun 2013
    The purpose of this amendment included the following: updated the Introduction text; updated the discussion text regarding the risk of treatment failure for subjects who previously failed pegIFN/RBV plus telaprevir; updates throughout to include subjects who failed pegIFN/RBV plus telaprevir in the previous AbbVie/Abbott study; clarified the expectations for rescreening procedures and eligibility; updated and clarified eligibility determination for both male and female subjects; amended the eligibility determination for subjects who failed telaprevir plus PegIFN/RBV therapy in the previous AbbVie study; updated the eligibility criterion for contraindicated medications; modified the hemoglobin exclusion criterion text; amended the prohibited therapy text; modified the study activities table and text; amended the treatment compliance and drug accountability text; updated the primary contact information for protocol deviations; and updated the resistance analyses to be performed; and added an appendix with clinical toxicity grade information.
    25 Sep 2013
    The purpose of this amendment included the following: Amended the Pre-Screening and Screening sections regarding timing of the discontinuation visit from the previous AbbVie/Abbott DAA combination study; revised the assessments not required to be re-tested during the re-screening visit; clarified subjects that would not be permitted to re-screen and were excluded from the study; updated the Post-Treatment follow-up period text to allow subjects the ability to enroll in a follow-up study; amended the post-treatment therapy section; modified the study activities table and text; amended the information provided to the subjects; modified the Medication Event Monitoring System caps distribution text; amended the Non-Efficacy (Futility) Criteria text; updated the type of treatments dispensed in this study to include the possibility of receiving ritonavir tablets; for PegIFN, amended the treatment compliance and drug accountability text; amended the hematologic toxicities table to remove extra management criteria and to add another management criterion; amended the Statistical Methods and Resistance Analyses text; and corrected the protocol signatories in Appendix B.
    11 Jun 2014
    The purpose of this amendment included the following: amended the number of subjects from approximately 150 to up to 150; updated the Introduction text to ensure that the most current drug development information was included; amended the toxicity management for Grades 1 and 2 laboratory abnormalities and modified instructions regarding the management of total bilirubin and/or hepatic transaminase and creatinine clearance decreases.
    25 Jul 2014
    The purpose of this amendment included the following: updated the section for hormonal contraception to more clearly define the acceptable approaches to contraception during the study, and updated the information about the medication that is contraindicated for use with the study drug regimen.
    26 Jun 2015
    The purpose of this amendment included the following: corrected the number of subjects to be enrolled; updated the Study Designated Physician details; updated the collection time point for HCV RNA level at screening and changed the collection time for archive plasma samples; removed the collection of Medication Event Monitoring System caps data; removed interim analyses; clarified in the protocol how and when samples were to be disposed of; corrected RBV dispensing text; updated the SAE section; and added contact information for subject safety concerns or medical emergencies.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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