E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic Hepatitis C Virus Infection |
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E.1.1.1 | Medical condition in easily understood language |
Hepatitis C Virus Infection |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10019751 |
E.1.2 | Term | Hepatitis C virus |
E.1.2 | System Organ Class | 100000004848 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- To determine the antiviral efficacy of ledipasvir/sofosbuvir (LDV/SOF) +/- ribavirin (RBV) in subjects with chronic HCV infection as measured by the proportion of subjects in each treatment group with sustained viral response 12 weeks after discontinuation of therapy (SVR12)
- To assess the safety and tolerability of LDV/SOF +/- RBV in subjects with chronic HCV infection as measured by review of the accumulated safety data |
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E.2.2 | Secondary objectives of the trial |
- To determine the proportion subjects in each treatment group who attain SVR at 4 and 24 weeks after discontinuation of therapy (SVR4 and SVR24)
- To evaluate the kinetics of circulating HCV RNA during treatment and after treatment discontinuation
- To evaluate the emergence of viral resistance to SOF and/or LDV, as relevant, during treatment and after treatment discontinuation
- To assess the proportion of HIV/HCV coinfected subjects that maintain HIV-1 RNA <50 copies/mL while on HCV treatment and at Post-Treatment Week 4
- To assess the change from baseline in CD4 T-cell count at the end of treatment and at Post-Treatment Week 4 |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
All subjects will be eligible to participate in the Pharmacogenomic Substudy. A blood sample should be drawn at the Day 1 visit if consent is obtained for this Substudy. If not obtained at Day 1, the sample may be drawn at any time during the study. |
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E.3 | Principal inclusion criteria |
1. Willing and able to provide written informed consent.
2. Male or female, age ≥ 18 years.
4. Confirmed chronic HCV infection documented by medical history or, if available, liver biopsy
5. HCV genotype:
a. Groups 1 and 2: HCV genotype 1 at screening as determined by the Central Laboratory. Any non-definitive results will exclude the subject from study participation.
b. Group 3: HCV genotype 1 or 3; historical genotype results from GS-US-334-0119 is acceptable.
6. Subjects in Groups 1 and 2 may not have cirrhosis at screening. Subjects in Group 3 may have compensated cirrhosis at screening
7. Body mass index (BMI) ≥ 18 kg/m2
8. Screening ECG without clinically significant abnormalities.
9. Subjects must have the following laboratory parameters at screening:
a. ALT ≤ 10 x the upper limit of normal (ULN)
b. AST ≤ 10 x ULN
c. Hemoglobin ≥ 12 g/dL for male, ≥ 11 g/dL for female subjects
d. Platelets ≥ 50,000 cells/mL
e. INR ≤ 1.5 x ULN unless subject has known hemophilia or is stable on an anticoagulant regimen affecting INR
f. Albumin ≥ 3 g/dL
g. Direct bilirubin ≤ 1.5 x ULN
h. HbA1c ≤ 10%
i. Creatinine clearance (CLcr) ≥ 60 mL/min, as calculated by the Cockcroft- Gault equation
Subjects being screened for Group 3 who currently do not fulfill all of the above laboratory
requirements may be enrolled at the request of the Investigator and with the approval of the
Gilead Medical Monitor or Study Director.
10. Subject has not been treated with any investigational drug or device within 30 days of the screening visit.
11. A female subject is eligible to enter the study if it is confirmed that she is:
- Not pregnant or nursing
- Of non-childbearing potential
- Of childbearing potential agreeing to the terms described in the protocol.
12. All male study participants must agree to consistently and correctly use a condom from Baseline until 7 months after the last dose of RBV (or 90 days after their last dose of LDV/SOF if not taking RBV) . If their female partner is of childbearing potential, their female partner must use 1 of the methods of birth control as described in the protocol
13. Subject must be of generally good health as determined by the Investigator.
14. Subject must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments.
15. For HIV/HCV coinfected subjects
a. If subject is ARV-naïve, CD4 T-cell count must be > 500 cells/mL.
b. Subjects receiving ARV therapy must:
- have completed at least 6 months of any prior HIV ARV therapy and maintained HIV RNA < 50 copies/mL (or < LLOQ if the local laboratory assay’s LLOQ is ≥50 copies/mL) prior to Screening
- be on a stable protocol-approved ARV regimen for at least 8 weeks, or for at least 6 months for abacavir-containing regimens, prior to Screening and expected to maintain the same ARV regimen for the duration of the study. Subjects on abacavir-containing regimens must also have had a negative test for HLA-B*5701 and not have experienced any hypersensitivity reaction to abacavir.
- have a CD4 T-cell count > 200 cells/mm3 at Screening.
Subjects with an isolated or unconfirmed HIV RNA > 50 copies/mL (or > LLOQ if the local laboratory assay’s LLOQ is ≥ 50 copies/mL) are not excluded. |
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E.4 | Principal exclusion criteria |
1. Groups 1 and 2: Prior exposure to IFN, RBV, or other approved or experimental direct-acting antiviral targeting the HCV. Group 3: Prior exposure to any HCV treatment within the last 12 weeks prior to screening or who have received treatment with an NS5A inhibitor at any time.
Subject did not participate in study GS-US-334-0119 or achieved SVR12 following treatment with SOF+RBV in study GS-US-334-0119.
2. Pregnant or nursing female or male with pregnant female partner.
3. Chronic liver disease of a non-HCV etiology
4. Infection with hepatitis B virus (HBV).
5. Groups 1 and 3: Infection with human immunodeficiency virus (HIV).
6. Group 3: Contraindication to RBV therapy, eg, history of clinically significant hemoglobinopathy.
7. History of malignancy diagnosed or treated within 5 years.
8. Chronic use of systemically administered immunosuppressive agents
9. Clinically-relevant drug or alcohol abuse within 12 months of screening.
10. Excessive alcohol ingestion.
11. History of solid organ transplantation.
12. Current or prior history of clinical hepatic decompensation.
13. History of clinically-significant illness or any other major medical disorder that may interfere with subject treatment, assessment or compliance with the protocol.
14. History of a gastrointestinal disorder (or post-operative condition) that could interfere with the absorption of the study drug.
15. History of significant pulmonary disease, significant cardiac disease or porphyria.
16. History of difficulty with blood collection and/or poor venous access for the purposes of phlebotomy.
17. Use of any prohibited concomitant medications as described in teh protocol.
18. Known hypersensitivity to RBV, the study investigational medicinal product, the metabolites, or formulation excipients, as applicable.
19. For HIV/HCV coinfected subjects:
a. Opportunistic infection within 6 months prior to Screening
b. Active, serious infection (other than HIV-1 or HCV) requiring parenteral antibiotics, antivirals or antifungals within 30 days prior to baseline
c. For subjects receiving ARV therapy, treatment with a regimen other than one of those listed in the protocol. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is SVR12 (HCV RNA < LLOQ 12 weeks after discontinuation of therapy) in the Full Analysis Set (FAS). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
12 weeks after discontinuation of therapy. |
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E.5.2 | Secondary end point(s) |
Secondary efficacy endpoints include the proportion of subjects with HCV RNA < LLOQ at 4 and 24 weeks after discontinuation of therapy (SVR4 and SVR24), the proportion of subjects with HCV RNA < LLOQ on treatment, HCV RNA change from Day 1, and the proportion of subjects with virologic failure. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
4 and 24 weeks after discontinuation of therapy. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | 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
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The date that the last subject has completed the protocol defined activities. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |