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    Summary
    EudraCT Number:2014-003347-35
    Sponsor's Protocol Code Number:MK-3682-012
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2016-09-12
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2014-003347-35
    A.3Full title of the trial
    A Phase II, Randomized, Open-Label Clinical Trial to Study the Efficacy and Safety of the Combination Regimen of MK-5172 and MK-3682 with Either MK-8742 or MK-8408 in Subjects with Chronic HCV GT3 Infection
    Studio clinico di fase 2 randomizzato in aperto per valutare l’efficacia e la sicurezza del regime terapeutico combinato di MK5172 e MK3682 con MK8742 o MK8408 in soggetti affetti da epatite cronica C genotipo 3
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    MK-5172/MK-3682 with MK-8742 or MK-8408 in HCV GT3 Infected Subjects
    MK5172/ MK3682 con MK8742 o MK8408 in soggetti affetti da epatite cronica C genotipo 3
    A.3.2Name or abbreviated title of the trial where available
    MK-5172/MK-3682 with MK-8742 or MK-8408 in HCV GT3 Infected Subjects
    MK5172/ MK3682 con MK8742 o MK8408 in soggetti affetti da epatite cronica C genotipo 3
    A.4.1Sponsor's protocol code numberMK-3682-012
    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 SponsorMERCK SHARP & DOHME CORP. UNA SUSSIDIARIA DI 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 supportAzienda Farmaceutica: Merck Sharp & Dhome Corp.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMSD Italia Srl
    B.5.2Functional name of contact pointDivisione Ricerca Clinica
    B.5.3 Address:
    B.5.3.1Street AddressVia Fratelli Cervi, snc – Centro Direzionale Milano Due – Palazzo Canova
    B.5.3.2Town/ citySegrate (MI)
    B.5.3.3Post code20090
    B.5.3.4CountryItaly
    B.5.4Telephone number+39 02 21018402
    B.5.5Fax number+39 02 21018629
    B.5.6E-mailgcto.italy@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 No
    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 nameMK-3682
    D.3.2Product code MK-3682
    D.3.4Pharmaceutical form Tablet
    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 INNMK-3682
    D.3.9.2Current sponsor codeMK-
    D.3.9.3Other descriptive nameMK-3682
    D.3.9.4EV Substance CodeSUB168240
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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 No
    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 nameMK-5172
    D.3.2Product code MK-5172
    D.3.4Pharmaceutical form Tablet
    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 INNMK-5172
    D.3.9.2Current sponsor codeMK-5172
    D.3.9.3Other descriptive nameMK-5172
    D.3.9.4EV Substance CodeSUB30825
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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: 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 No
    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 nameMK-8408
    D.3.2Product code MK-8408
    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 INNMK-8408
    D.3.9.2Current sponsor codeMK-8408
    D.3.9.3Other descriptive nameMK-8408
    D.3.9.4EV Substance CodeSUB126012
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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: 4
    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 No
    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 nameMK-8742
    D.3.2Product code MK-8742
    D.3.4Pharmaceutical form Tablet
    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 INNMK-8742
    D.3.9.2Current sponsor codeMK-8742
    D.3.9.3Other descriptive nameMK-8742
    D.3.9.4EV Substance CodeSUB125792
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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
    Chronic Hepatitis C infected patient
    Pazienti affetti da epatite C cronica
    E.1.1.1Medical condition in easily understood language
    Hepatitis C
    Epatite 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 19.0
    E.1.2Level LLT
    E.1.2Classification code 10047457
    E.1.2Term Viral hepatitis C
    E.1.2System Organ Class 100000004862
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The following applies to Part A and Part B (unless otherwise specified):
    1) To evaluate the efficacy of the combination regimens of MK-5172 and MK-3682 (300 mg or 450 mg) with either MK-8742 (Part A only) or MK-8408 as assessed by the proportion of subjects in each arm achieving SVR12 (Sustained Virologic Response 12 weeks after the end of all study therapy), defined as HCV RNA <LLOQ (either TD[u] or TND) 12 weeks after the end of all study therapy.
    2) To evaluate the safety and tolerability of the combination regimens of MK- 5172 and MK-3682 (300 mg or 450 mg) with either MK-8742 (Part A only) or MK-8408 to subjects in each arm.

    Quanto segue è applicabile alla Parte A e alla Parte B (se non diversamente specificato):
    1) Valutare l'efficacia dei regimi con combinazioni di MK-5172 e MK-3682 (300 mg o 450 mg), sia con MK-8742 (solo Parte A) che con MK-8408, valutata in base alla proporzione di soggetti in ciascun braccio che raggiunge l’SVR12 (risposta virologica sostenuta, 12 settimane dopo la conclusione di tutte le terapie dello studio), definita come HCV RNA <LLOQ (TD[u], Target Detected but unquantifiable o TND, Target Not Detected) 12 settimane dopo la conclusione di tutte le terapie in studio.
    2) valutare la sicurezza e la tollerabilità dei regimi con combinazioni di MK-5172 e MK-3682 (300 mg o 450 mg), o con MK-8742 (solo Parte A) o con MK-8408, per i soggetti in ciascun braccio.
    E.2.2Secondary objectives of the trial
    The following applies to Part A and Part B (unless otherwise specified):
    1) To evaluate the efficacy of the combination regimens of MK-5172 and MK-3682 (300 mg or 450 mg) with either MK-8742 (Part A only) or MK-8408 as assessed by the proportion of subjects in each arm achieving SVR4 (Sustained Virologic Response 4 weeks after the end of all study therapy), defined as HCV RNA <LLOQ (either TD(u) or TND) 4 weeks after the end of all study therapy.
    In Part B, the following objectives will also be evaluated for the HIV co-infected population:
    2) to evaluate the proportion of subjects who develop HIV-1 virologic failure (HIV-1 RNA 200 copies/mL, confirmed on two consecutive tests at least 2 weeks apart, in subjects compliant with thei r HIV antiretroviral therapy [ART]).
    3) to evaluate the effect of the study regimens on CD4+ T-cell counts.
    Quanto segue è applicabile alla Parte A e alla Parte B (se non diversamente specificato):
    1) Valutare l'efficacia dei regimi con combinazioni di MK-5172 e MK-3682 (300 mg o 450 mg) o con MK-8742 (solo Parte A) o con MK-8408, valutata in base alla percentuale di soggetti in ciascun braccio che raggiunge l’SVR4 (risposta virologica sostenuta, 4 settimane dopo la conclusione di tutte le terapie dello studio), definita come HCV RNA <LLOQ (TD[u] o TND) 4 settimane dopo la conclusione di tutte le terapie in studio.
    Nella Parte B, saranno valutati anche i seguenti obiettivi per la popolazione con co-infezione da HIV:
    2) valutare la proporzione di soggetti nei quali si verifica fallimento virologico di HIV-1 (HIV-1 RNA 200 copie/ml, confermato da due esami consecutivi eseguiti ad almeno 2 settimane di distanza, in soggetti che si attengono alla loro terapia antiretrovirale per HIV [ART]).
    3) Valutare l'effetto dei regimi in studio sulla conta di T-cellule CD4+.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Merck will conduct Future Biomedical Research on DNA (blood) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time. Intensive Viral Kinetic Sub-study: A subgroup of the study population will be included in an intensive viral kinetic sub-study. The purpose of this sub-study is to determine whether early viral kinetics can aid in developing a PK/PD model that can predict combinations which may be efficacious with shorter treatment durations. These subjects will have HCV RNA samples collected during Week 1 as described in the Study Flow Chart (Section 6.0) and in Table 13 (Intensive Viral Kinetic Week 1 Sampling Timepoints). In addition, PK samples will be collected as described in Table 11 (Pharmacokinetic Sampling Timepoints). These samples will be used to evaluate the PK/PD relationships of MK-5172, MK-3682 (and metabolites), MK-8742, and MK-8408, as appropriate
    1.Merck condurrà una Ric Biom Fut su campioni di DNA(estratti dal sangue)raccolti nel corso di questo studio clinico.Tale ricerca ha lo scopo di esamin vari biomarc per risp a domande che stanno emergendo e che non sono descritte in altre parti del prot(nell’ambito dello studio principale),e verrà condotta solo su campioni di sogg che abbiano rilasciato apposito consenso.L'obiett della raccolta dei camp per la Ric Biom Fut è quello di esplorare e identificare biomarc che contribuiscano scientific alla comprensione delle malattie e/o della relative terapie.L'obiett ultimo è quello di utilizzare tali info per sviluppare farmaci più sicuri e più efficaci, e/o per garantire che i sogg ricevano la dose giusta del giusto farmaco al momento giusto.2.Un sottogruppo della popol in studio sarà incluso in un intens sotto-studio di cinetica virale.Lo scopo di questo sotto-studio è quello di determinare se le cinetiche virali iniziali possono essere d'aiuto nello sviluppo di un modello PK/PD capace di predire combinaz che potrebbero essere efficaci in trattamenti di più breve durata.I campioni di HCV RNA saranno raccolti da questi sogg durante la sett1 come descritto nel diagr di flusso dello studio e nella Tab13(Intensive Viral Kinetic Week 1 Sampling Timepoints).Inoltre, saranno raccolti campioni per PK come descritto in Tab11(Pharmacokinetic Sampling Timepoints). Questi camp saranno utilizzati per valutare i rapporti di di MK5172, MK3682(e metaboliti), MK8742 e MK8408,ove appropriato
    E.3Principal inclusion criteria
    Part A and B:
    1. be ≥18 years
    2. HCV RNA ≥ 10,000 IU/mL
    3. have documented chronic HCV GT3 infection:
    •anti-HCV Ab,+ HCV RNA+ , or + to HCV GT 3 at least 6 mo before screening, or
    •anti-HCV Ab + or HCV RNA + at the time of screening with a liver biopsy consistent with chronic HCV infection
    4. Be otherwise healthy as determined by medical history, physical examination, ECG, and lab measurements performed at the time of screening.
    5. have liver disease staging assessment as follows:
    Absence of cirrhosis is defined as any one of the following (Part A and B):
    •Liver biopsy performed within 24 mo of Day 1 showing absence of cirrhosis
    •Fibroscan performed within 12 mo of Day 1 with a result of ≤12.5 kPa
    •A Fibrosure® (Fibrotest®) score of ≤0.48 and APRI of ≤1 during Screening
    Compensated cirrhosis is defined as any one of the following (Part B only):
    •A liver biopsy performed prior to Day 1 showing cirrhosis (F4)
    •Fibroscan performed within 12 calendar mo of Day 1 with a result >12.5 kPa
    •A FibroSure® (Fibrotest®) performed during Screening with a score of >0.75 and an APRI of >2.
    6. Have a prior treatment history of:
    a. HCV treatment-naïve (Part A and B)
    b. Prior virologic failure after a Peg-IFN/RBV regimen (Part B only):
    i. P/R Null Responder
    ii. P/R Partial Responder
    iii. P/R Relapser
    7. meet one of the following categories: a. not of reproductive potential, b. of reproductive potential and agrees to avoid becoming pregnant or impregnating a partner beginning at least 2weeks prior to administration of the initial dose of study drug, and for 90 days after the last dose of study drug by complying with one of the following: (1) practice abstinence† OR (2) use (or have their partner use) two forms of acceptable barrier contraception
    8. understand the study procedures, alternative treatments available, risks involved with the study, and voluntarily agrees to participate by giving written informed consent.
    9. provide written informed consent for the trial. The subject may also provide consent for FBR. However, the subject may participate in the main trial without participating in FBR.
    Part B only:
    For HIV coinfected subjects these additional criteria must also be met.
    10. have HIV-1 infection documented by any licensed rapid HIV test or HIV E/CIA test kit at any time prior to Day 1 and confirmed by a licensed Western blot or a second Ab test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 p24 Ag, or plasma HIV-1 RNA viral load.
    11. meet one of the following criteria:
    a. not currently and have no plans to initiate ART while in this study.
    i. subjects not on ART must have CD4+ T-cell count >500 cells/mm3 at screening
    b. have well controlled HIV on ART, defined as:
    i. must have achieved virologic suppression (defined as confirmed HIV RNA level below the LLOQ of available assay) on HIV ART at least 8 weeks prior to study entry (Day 1).
    1. the ART regimen must contain only tenofovir, abacavir, lamivudine, emtricitabine, raltegravir, dolutegravir and rilpivirine
    2. dose modifications or changes in drugs during the 4 weeks prior to Day 1 are not permitted
    ii. have HIV RNA <LLOQ at screening
    iii. have not experienced virologic failure (defined as confirmed HIV RNA ≥200 copies/mL after virologic suppression) for at least 8 weeks prior to screening
    iv. subjects on ART must have a CD4+ T-cell count >200 cells/mm3 at screening
    12. have at least one viable antiretroviral regimen alternative beyond their current regimen in the event of HIV virologic failure and the development of resistance.
    For Part C only:
    13. Enrollment in Part C will be open only to subjects in Parts A or B who relapse following completion of therapy.
    Parte A e B
    1. Avere ≥18 anni
    2. HCV RNA ≥ 10.000 UI/ml
    3. avere un'infezione cronica documentata da HCV GT3:
    • anti-HCV Ab+, HCV RNA+ o GT 3 HCV+ almeno 6 mesi prima dello screening, oppure
    • anti-HCV Ab+ o HCV RNA al momento dello screening con biopsia epatica compatibile con infezione cronica da HCV
    4. Essere ad ogni modo sani come dimostrato dall'anamnesi, esame obiettivo, ECG, e esami di lab eseguiti al momento dello screening.
    5. Avere una valutazione della stadiazione della malattia epatica come segue:
    assenza di cirrosi, definita come una delle seguenti condizioni (Parti A e B):
    •biopsia epatica eseguita nei 24 mesi precedenti il G. 1 che mostra assenza di cirrosi
    •Fibroscan eseguito nei 12 mesi precedenti il G. 1 con un risultato ≤ 12,5 kPa
    •Punteggio FibroSure® (Fibrotest®) ≤0,48 e APRI ≤1 eseguito durante lo screening
    Cirrosi compensata, definita come una qualsiasi delle seguenti condizioni (Parte B):
    •biopsia epatica eseguita prima del G. 1 che evidenzia cirrosi (F4)
    •Fibroscan eseguito nei 12 mesi precedenti al G. 1 dello studio con risultato >12,5 kPa
    •FibroSure® (Fibrotest®) eseguito durante lo screening con un punteggio >0,75 e APRI >2.
    6. Avere un'anamnesi relativa al precedente trattamento:
    a. essere naïve al trattamento per HCV (Parti A e B)
    b. Precedente fallimento virologico dopo un regime Peg-IFN/RBV (Parte B):
    i. Non rispondenti a P/R
    ii. Risposta parziale a P/R
    iii. Recidiva dopo P/R
    7. rientrare in una delle seguenti categorie: a. potenziale riproduttivo assente; b: potenzialmente fertile che accetta di evitare la gravidanza, o fecondare la partner, per almeno 2 settimane prima dell’assunzione della prima dose e per 90 gg dopo l’ultima dose del farmaco in studio adeguandosi ad uno dei seguenti mezzi: (1) praticando l’astinenza O (2) usando (o facendo usare) due forme di barriera contraccettiva
    8. Comprendere le procedure dello studio, i trattamenti alternativi, i rischi correlati allo studio e acconsentire volontariamente a partecipare fornendo il CI scritto.
    9. Fornire il CI scritto. Il soggetto può inoltre decidere di fornire il consenso per l’FBR. Tuttavia, il soggetto può partecipare allo studio principale senza prendere parte all’FBR.
    Parte B:
    Criteri addizionali soddisfatti dai soggetti co-infetti da HIV.
    10. Devono avere un’infezione HIV-1, documentata da qualsiasi test rapido HIV approvato o kit E/CIA in qualunque momento prima del G.1 e confermata da un immunoblot autorizzato o un test dell'Ab II approvato con un metodo diverso dal test HIV rapido e/o E/CIA iniziale o da Ag p24 HIV-1 o da HIV-1 RNA nel plasma.
    11. Soddisfare uno dei seguenti criteri:
    a. non essere e non avere intenzione di iniziare un ART durante questo studio,
    i. soggetti che non sono in ART devono avere una conta T CD4+ >500 cell/mm3 al momento dello screening,
    b. avere HIV sotto controllo tramite ART, definito come:
    i. avere raggiunto soppressione virologica (definita come livelli di RNA di HIV confermati al di sotto del LLOQ, dei test disponibili), essere in terapia antiretrovirale (ART) per almeno 8 settimane prima del G. 1
    1. Il regime di ART deve contenere solo tenofovir, abacavir, lamivudina, emtricitabina, raltegravir, dolutegravir e rilpivirina.
    2. Non sono permessi, modifiche alle dosi o cambi di farmaci durante le 4 settimane prma del G. 1
    ii. avere HIV RNA <LLOQ al momento dello screening
    iii. non avere riscontrato fallimento virologico (definito come HIV RNA ≥200 copie/ml dopo la soppressione virologica) per almeno 8 settimane precedenti lo screening
    iv. soggetti in ART devono avere una conta T CD4+ >200 cell/mm3 al momento dello screening.
    12 avere l'alternativa di almeno un ART, oltre al loro regime attuale, in caso di fallimento virologico di HIV e l'insorgenza di resistenza.
    Solo per la Parte C:
    13. L’arruolamento nella Parte C sarà aperto solo a soggetti delle Parti A o B relapser dopo il completamento della terapia.
    E.4Principal exclusion criteria
    advanced liver disease
    3. For cirrhotics (Parts B and C ):
    a. Child-Pugh B or C, or CPT >5
    4. HBVcoinfected (HBsAg +).
    5. HIV coinfected (Part A)
    6. If HIV+, opportunistic infection < 6 mo prior to screening
    7. malignancy ≤5 years prior to signing IC except for treated basal cell or squamous cell skin cancer or in situ cervical cancer or carcinoma in situ; or under evaluation for other active/ suspected malignancy
    8. cirrhosis and liver imaging < 6 mo of D1 showing evidence of HCC or under evaluation for HCC
    9. taking/ plans to take prohibited medications listed in the protocol or taking supplements < 2 weeks of D1
    10. is currently or has participated in an experimental study < 30 Ds of signing IC and is not willing to refrain from participating
    11. drug or alcohol abuse < 12 mo of screening.
    12. pregnant or breast-feeding, or expecting to conceive or donate eggs OR expecting to donate sperm from at least 2 weeks prior to D1 until 90 Ds after the last dose of study medication or longer if dictated by local regulations.
    13. has any of the following conditions: a. Organ transplants (including HSCT) other than
    cornea and hair. b. Poor venous access that precludes routine peripheral blood sampling c. history of gastric surgery (e.g., stapling, bypass) or malabsorption disorders (e.g., celiac sprue disease). d. Current or history of any clinically significant cardiac abnormalities/dysfunction, including: angina, congestive heart failure, myocardial infarction, pulmonary hypertension, complex congenital heart disease, cardiomyopathy, significant arrhythmia, uncontrolled hypertension, a history of use of antianginal agents for cardiac conditions, prolonged ECG QTc interval (>470 ms for males or >480 ms for females by either the Bazett or Fridericia formula) at the screening visit, personal or family history of Torsade de pointes. e. Chronic pulmonary disease, including: clinical chronic obstructive pulmonary disease, interstitial lung disease, pulmonary fibrosis, sarcoidosis f. CNS trauma requiring intubation, intracranial pressure monitoring, brain meningeal or skull surgery, or resulting in seizure, coma, permanent neurologic deficits, abnormal brain imaging, or CSF leak. Prior brain hemorrhage and/or intracranial aneurysms g. Current or history of seizure disorder unless seizure was >10 years ago, an isolated event, no anti-seizure medications prescribed, and a normal neurological examination is documented < 6 mo of D1 h. History of stroke or transient ischemic attack. i. History of a medical/surgical condition that resulted in hospitalization < the 3 mo prior to enrollmentj. Medical/surgical conditions that may result in a need for hospitalization during the study k.Any medical condition requiring, or likely to require, chronic systemic administration of corticosteroids, TNF antagonists, or other immunosuppressants during trial. l. condition, prestudy laboratory or ECG abnormality or history of any illness, which might confound the results of the study or pose additional risk in administering the study drugs to the subject. m. had a life-threatening SAE during the screening period.n. has evidence of history of chronic hepatitis not caused by HCV
    14. has exclusionary laboratory values at the screening visit as listed in the protocol
    15. For Part C only a) virologic rebound b) virologic breakthrough c) withdrawn from the study due to reasons other than virologic failure d) meet other criteria for exclusion
    16. is or has an immediate family member who is investigational site or sponsor staff directly involved with this trial
    Parti A, B e C
    1. <18 anni, è mentalmente o legalmente incapace, ha o si attendono importanti problemi emotivi o ha un’anamnesi di malattia psichiatrica che interferirebbe con lo studio
    2. malattia epatica scompensata, con presenza o anamnesi di ascite, varici esofagee o gastriche sanguinanti, encefalopatia epatica o altri sintomi di epatopatia avanzata.
    3. Per cirrotici (Parti B e C):
    a. sono esclusi soggetti con Child-Pugh B o C o CPT>5.
    4. co-infettato da HBV (HBsAg+)
    5. co-infettato da HIV (Parte A)
    6. Per soggetti HIV+, infezione opportunistica < 6 mesi dallo screening
    7. anamnesi di tumore maligno ≤5 aa prima di firmare il CI, ad eccezione del carcinoma a cellule basali o cutaneo a cellule squamose trattato o cancro della cervice in situ o carcinoma in situ; o è in corso di valutazione per altri tumori maligni attivi o sospetti
    8. sottoposto a imaging del fegato per cirrosi, < 6 mesi dal G.1, che dimostra HCC o in valutazione per HCC
    9. Sta o ha intenzione di assumere uno dei farmaci vietati dal protocollo o integratori < 2 sett. dal G.1
    10. Sta o ha partecipato a uno studio sperimentale nei 30 gg precedenti la firma del CI e non ha intenzione di interrompere la partecipazione
    11. ha un’anamnesi di tossicodipendenza o abuso di alcool < 12 mesi dallo screening
    12. è in gravidanza o allattamento, o in attesa di concepire o donare ovuli, O è in attesa di donare sperma da almeno 2 sett. prima del G.1 e per 90 gg dopo l'ultima dose di farmaco, o oltre se previsto dalla legge
    13. Presenta: a. Trapianti d'organo (inclusi HSCT) diversi da quello della cornea o di capelli.b. Difficile accesso venoso che preclude il prelievo di sangue c. anamnesi di chirurgia gastrica (sutura con punti metallici, bypass) o di disturbi da malassorbimento (celiachia) d. Anamnesi o attuali anomalie/disfunzioni cardiache incluse: angina, insufficienza cardiaca congestizia, infarto del miocardio, ipertensione polmonare, cardiopatie congenite complesse, cardiomiopatie, aritmie significative, ipertensione incontrollata, un'anamnesi di uso di agenti anti angina per condizioni cardiache, intervallo QT prolungato nell'ECG (>470 ms per uomini o >480 ms per donne sia da Bazett che da formula Fridericia) allo screening, storia di Torsione di Punta anche familiare.e. Malattia cronica polmonare, incluse: malattia clinica polmonare ostruttiva cronica, malattia polmonare interstiziale, fibrosi polmonare, sarcoidosi f. Trauma al SNC che necessita intubazione, monitoraggio della pressione intracranica, chirurgia meningea o cranica, o risultante in crisi epilettiche, coma, deficit neurologici permanenti, imaging cerebrale anomalo, o perdita di CSF. Precedente emorragia cerebrale e/o aneurismi g. Anamnesi o attuale disturbo epilettico esclusi attacchi avvenuti > 10 anni prima o isolati o senza prescrizione di anti-epilettici e con esame neurologico normale < 6 mesi dal G.1 h. Anamnesi di ictus o di attacco ischemico transitorio i. Anamnesi di una condizione medica/chirurgica con ospedalizzazione < 3 mesi dall'arruolamento. j. Condizioni mediche/chirurgiche con potenziale ospedalizzazione durante lo studio. k. condizione medica che richieda, o potrebbe richiedere, corticosteroidi sistemici cronici, antagonisti del TNF o altri immunosoppressivi durante lo studio.l. Presenta condizione o anomalia di laboratorio o dell’ECG pre-studio, o anamnesi di patologie che potrebbe confondere i risultati oppure sottoporre a rischio il soggetto m. SAE potenzialmente fatale durante lo screening n. evidenza o anamnesi di epatite cronica non da HCV
    14. valori di laboratorio anomali allo screening come da protocollo
    15. Parte C
    a. Presenza di rebound virologico
    b. Presenza di ricaduta virologica
    c. uscita dallo studio per cause diverse dal insufficienza virologica
    d. Soddisfano altri criteri di esclusione
    16. È o ha un familiare stretto che è membro del personale del centro di sperimentazione o dello Sponsor direttamente coinvolto in questa sperimentazione.
    E.5 End points
    E.5.1Primary end point(s)
    The primary efficacy endpoint will be the proportion of subjects achieving SVR12 in each treatment arm
    L’endpoint di efficacia primario è rappresentato dalla proporzione di soggetti che raggiunge l’SVR12 in ogni braccio di trattamento
    E.5.1.1Timepoint(s) of evaluation of this end point
    12 weeks after completion of therapy
    12 settimane dopo il completamento della terapia
    E.5.2Secondary end point(s)
    The secondary endpoint of this study is to estimate the SVR4 rates for each of the treatment arms. A two-sided 95% confidence interval will be constructed for SVR4 for each arm separately
    L’endpoint secondario di questo studio è costituito dalla proporzione di soggetti in ciascun braccio che raggiunge l’SVR4. Per l'SVR4 verrà costruito un intervallo di confidenza al 95% two-sided separato per ogni braccio.
    E.5.2.1Timepoint(s) of evaluation of this end point
    4 weeks after completion of therapy
    4 settimane dopo il completamento della terapia
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    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
    MK-8742 verso MK-8408
    MK-8742 versus MK-8408
    E.8.2.4Number of treatment arms in the trial7
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA21
    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
    Australia
    Canada
    Denmark
    France
    Germany
    Israel
    Italy
    New Zealand
    Switzerland
    United Kingdom
    United States
    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
    LSLV
    LSLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months4
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months4
    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: 150
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 70
    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 state11
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 84
    F.4.2.2In the whole clinical trial 220
    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)
    None. A retreatment option for subjects is part of the protocol.
    Nessuno. E’ prevista dal protocollo una opzione di ritrattamento per i soggetti.
    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 Decision2015-06-01
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-02-11
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2017-05-03
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