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    Clinical Trial Results:
    A Phase 2, Multicenter, Open-Label Study to Investigate the Safety and Efficacy of GS-7977 and Ribavirin for 24 Weeks in Subjects with Recurrent Chronic HCV Post Liver Transplant

    Due to the EudraCT – Results system being out of service between 31 July 2015 and 12 January 2016, these results have been published in compliance with revised timelines.
    Summary
    EudraCT number
    2012-002417-19
    Trial protocol
    DE   ES  
    Global end of trial date
    14 Aug 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Feb 2016
    First version publication date
    20 Feb 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    GS-US-334-0126
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01687270
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Gilead Sciences
    Sponsor organisation address
    333 Lakeside Drive, Foster City, CA, United States, 94404
    Public contact
    Clinical Trial Information Desk, Gilead Sciences International Ltd, ClinicalTrialDisclosures@gilead.com
    Scientific contact
    Clinical Trial Information Desk, Gilead Sciences International Ltd, ClinicalTrialDisclosures@gilead.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
    14 Aug 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Aug 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This was an open-label, single-arm study of sofosbuvir (SOF; GS-7977) and ribavirin (RBV) in adults who had a liver transplant which became re-infected with hepatitis C. The treatment period was 24 weeks with up to 48 weeks of follow up. The total time in this study lasted up to 72 weeks not including the screening visit.
    Protection of trial subjects
    The protocol and consent/assent forms were submitted by each investigator to a duly constituted Independent Ethics Committee (IEC) or Institutional Review Board (IRB) for review and approval before study initiation. All revisions to the consent/assent forms (if applicable) after initial IEC/IRB approval were submitted by the investigator to the IEC/IRB for review and approval before implementation in accordance with regulatory requirements. This study was conducted in accordance with recognized international scientific and ethical standards, including but not limited to the International Conference on Harmonization guideline for Good Clinical Practice (ICH GCP) and the original principles embodied in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 Oct 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
    New Zealand: 3
    Country: Number of subjects enrolled
    United States: 28
    Country: Number of subjects enrolled
    Spain: 3
    Country: Number of subjects enrolled
    France: 3
    Country: Number of subjects enrolled
    Germany: 3
    Worldwide total number of subjects
    40
    EEA total number of subjects
    9
    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)
    33
    From 65 to 84 years
    7
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were enrolled at a total of 12 study sites in the United States, Europe, and New Zealand. The first participant was screened on 26 October 2012. The last participant observation occurred on 14 August 2014.

    Pre-assignment
    Screening details
    49 participants were screened.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    SOF+RBV
    Arm description
    Sofosbuvir (SOF) + ribavirin (RBV) for 24 weeks
    Arm type
    Experimental

    Investigational medicinal product name
    Sofosbuvir
    Investigational medicinal product code
    Other name
    Sovaldi®, GS-7977, PSI-7977
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Sofosbuvir (SOF) 400 mg tablet administered orally once daily

    Investigational medicinal product name
    Ribavirin
    Investigational medicinal product code
    Other name
    Ribasphere®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Ribavirin (RBV) 200-mg tablet(s) administered orally in a divided daily dose starting at 400 mg, subsequently adjusted (range: 200 to 1200 mg in a divided daily dose) based upon a number of factors including hemoglobin value, creatinine clearance, and weight.

    Number of subjects in period 1
    SOF+RBV
    Started
    40
    Completed
    28
    Not completed
    12
         Lost to follow-up
    1
         Lack of efficacy
    11

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall study
    Reporting group description
    SOF+RBV for 24 weeks

    Reporting group values
    Overall study Total
    Number of subjects
    40 40
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    59 ± 6.3 -
    Gender categorical
    Units: Subjects
        Female
    9 9
        Male
    31 31
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    1 1
        Not Hispanic or Latino
    39 39
        Unknown or Not Reported
    0 0
    Race
    Units: Subjects
        White
    34 34
        Black
    3 3
        Asian
    2 2
        Other
    1 1
    HCV RNA Category
    Units: Subjects
        < 6 log10 IU/mL
    8 8
        6 to 7 log10 IU/mL
    20 20
        > 7 log10 IU/mL
    12 12
    Prior HCV Treatment
    Units: Subjects
        No
    5 5
        Yes
    35 35
    HCV Genotype
    Units: Subjects
        Genotype 1A
    22 22
        Genotype 1B
    11 11
        Genotype 3A
    5 5
        Genotype 3B
    1 1
        Genotype 4
    1 1
    IL28b Status
    CC, CT, and TT alleles are different forms of the IL28b gene.
    Units: Subjects
        CC
    13 13
        CT
    16 16
        TT
    11 11
    HCV RNA
    Units: log10 IU/mL
        arithmetic mean (standard deviation)
    6.55 ± 0.751 -

    End points

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    End points reporting groups
    Reporting group title
    SOF+RBV
    Reporting group description
    Sofosbuvir (SOF) + ribavirin (RBV) for 24 weeks

    Primary: Percentage of Participants With Sustained Virologic Response 12 Weeks After Discontinuation of Therapy (SVR12)

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    End point title
    Percentage of Participants With Sustained Virologic Response 12 Weeks After Discontinuation of Therapy (SVR12) [1]
    End point description
    SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, < 25 IU/mL) 12 weeks following the last dose of study drug.
    End point type
    Primary
    End point timeframe
    Posttreatment Week 12
    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: No intergroup analysis was performed because the study was single-arm, and no analysis against a historic rate was performed because the study was not designed to demonstrate superiority or noninferiority.
    End point values
    SOF+RBV
    Number of subjects analysed
    40
    Units: percentage of participants
        number (not applicable)
    70
    No statistical analyses for this end point

    Primary: Percentage of Participants Who Discontinue Study Drug Due to an Adverse Event

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    End point title
    Percentage of Participants Who Discontinue Study Drug Due to an Adverse Event [2]
    End point description
    End point type
    Primary
    End point timeframe
    Baseline to Week 24
    Notes
    [2] - 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: No intergroup analysis was performed because the study was single-arm, and no analysis against a historic rate was performed because the study was not designed to demonstrate superiority or noninferiority.
    End point values
    SOF+RBV
    Number of subjects analysed
    40
    Units: percentage of participants
        number (not applicable)
    5
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Sustained Virologic Response (SVR) at 4, 24, and 48 Weeks After Discontinuation of Therapy (SVR4, SVR24, and SVR48)

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    End point title
    Percentage of Participants With Sustained Virologic Response (SVR) at 4, 24, and 48 Weeks After Discontinuation of Therapy (SVR4, SVR24, and SVR48)
    End point description
    SVR4, SVR 24, and SVR 48 were defined as HCV RNA < LLOQ 4, 24, and 48 weeks following the last dose of study drug, respectively.
    End point type
    Secondary
    End point timeframe
    Posttreatment Weeks 4, 24, and 48
    End point values
    SOF+RBV
    Number of subjects analysed
    40
    Units: percentage of participants
    number (not applicable)
        SVR4
    72.5
        SVR24
    70
        SVR48
    70
    No statistical analyses for this end point

    Secondary: Percentage of Participants With HCV RNA < LLOQ at Weeks 12 and 24

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    End point title
    Percentage of Participants With HCV RNA < LLOQ at Weeks 12 and 24
    End point description
    End point type
    Secondary
    End point timeframe
    Weeks 12 and 24
    End point values
    SOF+RBV
    Number of subjects analysed
    40
    Units: percentage of participants
    number (not applicable)
        Week 12 (n = 40)
    100
        Week 24 (n = 38)
    100
    No statistical analyses for this end point

    Secondary: HCV RNA and Change From Baseline at Weeks 2, 4, and 8

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    End point title
    HCV RNA and Change From Baseline at Weeks 2, 4, and 8
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline; Weeks 2, 4, and 8
    End point values
    SOF+RBV
    Number of subjects analysed
    40
    Units: log10 IU/mL
    arithmetic mean (standard deviation)
        Week 2 (n = 39)
    1.65 ± 0.37
        Change from baseline at Week 2 (n = 39)
    -4.89 ± 0.692
        Week 4 (n = 40)
    1.38 ± 0
        Change from baseline at Week 4 (n = 40)
    -5.17 ± 0.751
        Week 8 (n = 40)
    1.38 ± 0.005
        Change from baseline at Week 8 (n = 40)
    -5.17 ± 0.752
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Virologic Failure

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    End point title
    Percentage of Participants With Virologic Failure
    End point description
    Virologic failure was defined as on-treatment virologic failure or virologic relapse. • On-treatment virologic failure: HCV RNA < LLOQ during treatment with subsequent detectable HCV RNA while continuing treatment • Virologic relapse: HCV RNA < LLOQ at last observed on-treatment HCV RNA measurement and HCV RNA ≥ LLOQ after stopping treatment (2 consecutive HCV RNA measurements or last available HCV RNA measurement)
    End point type
    Secondary
    End point timeframe
    Up to Posttreatment Week 24
    End point values
    SOF+RBV
    Number of subjects analysed
    40
    Units: percentage of participants
    number (not applicable)
        On-treatment virologic failure
    0
        Virologic relapse
    30
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 24 weeks plus 30 days
    Adverse event reporting additional description
    Safety Analysis set
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    SOF+RBV
    Reporting group description
    SOF + RBV for 24 weeks

    Serious adverse events
    SOF+RBV
    Total subjects affected by serious adverse events
         subjects affected / exposed
    6 / 40 (15.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    Compression fracture
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Jaundice
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hallucination
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Haemarthrosis
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 40 (2.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    SOF+RBV
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    38 / 40 (95.00%)
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Fatigue
         subjects affected / exposed
    12 / 40 (30.00%)
         occurrences all number
    13
    Oedema peripheral
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Pyrexia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    7 / 40 (17.50%)
         occurrences all number
    7
    Dyspnoea
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    6
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    5
    Depression
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Insomnia
         subjects affected / exposed
    5 / 40 (12.50%)
         occurrences all number
    5
    Irritability
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    5
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Laceration
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Headache
         subjects affected / exposed
    10 / 40 (25.00%)
         occurrences all number
    11
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    8 / 40 (20.00%)
         occurrences all number
    8
    Lymphopenia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Abdominal pain upper
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Constipation
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Diarrhoea
         subjects affected / exposed
    11 / 40 (27.50%)
         occurrences all number
    12
    Dyspepsia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Nausea
         subjects affected / exposed
    8 / 40 (20.00%)
         occurrences all number
    9
    Oral lichen planus
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    9 / 40 (22.50%)
         occurrences all number
    12
    Back pain
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Muscle spasms
         subjects affected / exposed
    4 / 40 (10.00%)
         occurrences all number
    4
    Pain in extremity
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    3 / 40 (7.50%)
         occurrences all number
    3
    Candida infection
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Nasopharyngitis
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Sinusitis
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Hypomagnesaemia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Hypophosphataemia
         subjects affected / exposed
    2 / 40 (5.00%)
         occurrences all number
    2
    Increased appetite
         subjects affected / exposed
    2 / 40 (5.00%)
         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
    15 Aug 2012
    Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin criteria for discontinuation of study treatment (ie, stopping rules) were modified.

    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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/25304641
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