| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| PILOT STUDY TO EVALUATE THE EFFECTS OF PARITAPREVIR/r, DASABUVIR AND OMBITASVIR ON LIVER FUNCTION AND SYSTEMIC HEMODYNAMIC IN PATIENTS WITH DECOMPENSATED HCV-CIRRHOSIS |
| Estudio piloto para la evaluación de los efectos de PARITAPREVIR/r, DASABUVIR y OMBITASVIR sobre la función hepática y la hemodinamia sistémica en pacientes con compensación hepática e infección por VHC |
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| E.1.1.1 | Medical condition in easily understood language |
| THE EFFECTS OF PARITAPREVIR/r, DASABUVIR AND OMBITASVIR ON LIVER FUNCTION AND SYSTEMIC HEMODYNAMIC IN PATIENTS WITH DECOMPENSATED HCV-CIRRHOSIS |
| evaluación de los efectos de PARITAPREVIR/r, DASABUVIR y OMBITASVIR sobre la función hepática y la hemodinamia sistémica en pacientes con desconpensación hepática e infección por VHC |
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| E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 20.0 |
| E.1.2 | Level | LLT |
| E.1.2 | Classification code | 10024667 |
| E.1.2 | Term | Liver cirrhosis |
| E.1.2 | System Organ Class | 10019805 - Hepatobiliary disorders |
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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 investigate the effects of treatment on liver function and systemic hemodynamics in patients with decompensated HCV-related cirrhosis |
| Investigar los efectos del tratamiento en la hemodinamia h y lafunción hepáticas en pacientes con cirrosis descompensada y VHC |
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| E.2.2 | Secondary objectives of the trial |
- To investigate the efficacy (SVR12) of Ombitasvir/Paritaprevir/ritonavir + Dasabuvir + Ribavirin in patients with Child B cirrhosis. - To evaluate the effect of treatment on the development of complications of cirrhosis. - To investigate the effect of treatment on systemic inflammation and endothelial function. - To evaluate the effect of treatment on quality of life. - To determine the safety of this antiviral combination in patients with decompensated cirrhosis. - To investigate the effect of SVR12 on changes of gut microbiota in patients with decompensated cirrhosis. - To assess the effects of SVR12 on cirrhosis regression |
-Para investigar la eficacia (SVR12) de OmbitasvirParitaprevirritonavir Dasabuvir ribavirina en pacientes con cirrosis infantil B. -Evaluar el efecto del tratamiento sobre el desarrollo de complicaciones de la cirrosis. -Para investigar el efecto del tratamiento sobre la inflamación sistémica y la función endotelial. -Evaluar el efecto del tratamiento sobre la calidad de vida. -Para determinar la seguridad de esta combinación de antivirales en pacientes con cirrosis descompensada. -Para investigar el efecto de SVR12 sobre los cambios de la microbiota intestinal en pacientes con cirrosis descompensada. -Para evaluar los efectos de SVR12 en la regresión de cirrosis |
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| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
- Age between 18 and 75 year- old. - Child B cirrhosis (7-9 points) with present or previous history of decompensation (ascites, hepatic encephalopathy or bacterial infection). - Genotype 1b infection. - Inclusion after 4 weeks of resolution of hepatic encephalopathy, gastrointestinal bleeding or bacterial infection. - Viral load VHC?10000 UI/L |
-Edad entre 18 y 75 años de edad. -Cirrosis infantil B (7-9 puntos) con historia actual o anterior de la descompensación (ascitis, encefalopatía hepática o infección bacteriana). -Infección de genotipo 1b. -Incorporación después de 4 semanas de la resolución de la encefalopatía hepática, hemorragia gastrointestinal o infección bacteriana. -Carga viral UIL VHC?10000 |
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| E.4 | Principal exclusion criteria |
- Compensated cirrhosis. - Hepatocellular carcinoma. - Serum creatinine > 1.5 mg/dL. - Complications of cirrhosis associated with very poor outcome: refractory ascites, acute-on-chronic liver failure, hepatorenal syndrome, hyponatremia (serum sodium < 125 mEq/L), chronic persistent hepatic encephalopathy. - Total bilirubin > 10 mg/dL. - Severe extrahepatic diseases: cardiovascular, respiratory, cerebrovascular and poorly controlled diabetes that according to the investigator can difficult the antiviral therapy. - Platelets < 30 x 109 cells/L. - Neutrophil count < 0.5 x 109 cells/L. - Hemoglobin < 9 g/dL. - HIV infection. - Hepatitis B infection. - Active intake of toxic amounts of alcohol or recreational drugs. - Use of any medication listed in the following table |
- cirrosis Compensada -Hepatocarcinoma. -Suero creatinina 1.5 mgdL. -Complicaciones de la cirrosis asociada con muy mal resultado: ascitis refractaria, insuficiencia hepática aguda-crónica, síndrome hepatorrenal, hiponatremia (suero sodio 125 mEqL), encefalopatía hepática persistente crónica. -Total bilirrubina 10 mgdL. -Enfermedades extrahepáticas graves: cardiovascular, respiratoria, cerebrovascular y mal controlada la diabetes que según el investigador puede difícil la terapia antiviral. -Plaquetas 30 x 109 cellsL. -Recuento neutrófilos 0,5 x 109 cellsL. -GdL hemoglobina 9. -La infección por VIH. -Hepatitis B infección. -Activa ingesta de cantidades tóxicas de alcohol o drogas recreativas. -Uso de los medicamentos enumerados en la tabla anexa |
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| E.5 End points |
| E.5.1 | Primary end point(s) |
| Improvement of liver function defined by a decrease in ?2 points in Child-Pugh score at 3 months after the end of antiviral therapy. |
| Mejora de la función hepática, definida por una disminución ? 2 puntos en la puntuación de Child-Pugh a los 3 meses después del final de la terapia antiviral. |
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| E.5.1.1 | Timepoint(s) of evaluation of this end point |
decrease in ?2 points in Child-Pugh score at 3 months after the end of antiviral therapy - |
| disminucion de ?2 points in Child-Pugh a los 3 meses tras finalizar el tratamiento |
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| E.5.2 | Secondary end point(s) |
- Decrease in portal pressure 6 months after the end of treatment. - Decrease in the incidence of complications of cirrhosis during treatment and for a 6-months follow up period after treatment. A composite end point of complications of cirrhosis will be analyzed, including ascites, hepatic encephalopathy , bacterial infections and gastrointestinal bleeding. The development of the first of any of these five complications described above will define the occurrence of the end-point. - Changes in circulatory function assessed by plasma renin activity (PRA) and noradrenalin at the end of treatment and 6 months after the end of treatment with respect to baseline. - Changes in systemic inflammatory response and endothelial function assessed by cytokine, endotoxin and von Willebrand factor levels at the end of treatment and 6 months after the end of treatment with respect to baseline. - Improvement in quality of life evaluated by Short-form 36 (SF-36) and Chronic Liver Disease (CLDQ) questionnaires 6 months after the end of treatment with respect to baseline. - Changes in gut microbiota will be evaluated by analysis of fecal phylogenetic profiles before and after treatment. - Effects of SVR12 on cirrhosis regression will be assessed by transcriptome analysis of liver tissue samples before and 12w after treatment. |
-Disminución de la presión portal 6 meses después del final del tratamiento. -Disminución en la incidencia de complicaciones de la cirrosis durante el tratamiento y un seguimiento de 6 meses plazo después del tratamiento. Se analizará un punto final compuesto de complicaciones de la cirrosis, incluyendo ascitis, encefalopatía hepática, las infecciones bacterianas y sangrado gastrointestinal. El desarrollo de la primera de cualquiera de estas cinco complicaciones descritas anteriormente define la ocurrencia del punto final. -Cambios en la función circulatoria, determinado por la actividad de renina plasmática (PRA) y noradrenalina al final del tratamiento y 6 meses después del final del tratamiento con respecto a la línea de base. -Cambios en la respuesta inflamatoria sistémica y la función endotelial evaluada por los niveles de citoquinas, endotoxinas y von Willebrand factor al final del tratamiento y 6 meses después del final del tratamiento con respecto a la línea de base. -Mejora en la calidad de vida evaluada por Short-form 36 (SF-36) y cuestionarios de enfermedad del hígado crónica (CLDQ) 6 meses después del final del tratamiento con respecto a la línea de base. -Cambios en la microbiota intestinal se evaluará mediante el análisis de los perfiles filogenéticos fecales antes y después del tratamiento. -Efectos del SVR12 en la regresión de cirrosis serán evaluadas por análisis de transcriptoma de muestras de tejido del hígado antes y 12w después del tratamiento. |
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| E.5.2.1 | Timepoint(s) of evaluation of this end point |
Virological end-points - SVR4 (sustained virological response 4 weeks the end of all study therapy). The subject has HCV RNA < 15 IU/ml 4 weeks after the end of all study therapy. - SVR12 (sustained virological response 12 weeks the end of all study therapy). The subject has HCV RNA < 15 IU/ml 12 weeks after the end of all study therapy |
SVR4 (sostenida respuesta virológica 4 semanas al final de todo estudio terapia). El sujeto tiene VHC ARN 15 IUml 4 semanas después del final de todo estudio terapia. -SVR12 (sostenida respuesta virológica 12 semanas al final de todo estudio terapia). El sujeto tiene VHC ARN 15 IUml 12 semanas después del final de la terapia de estudio todos |
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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 | No |
| 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 | No |
| 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 | Yes |
| E.8.1.1 | Randomised | Yes |
| 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 | No |
| 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) | Yes |
| E.8.2.2 | Placebo | No |
| E.8.2.3 | Other | No |
| E.8.2.4 | Number of treatment arms in the trial | 2 |
| E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
| E.8.4 | The trial involves multiple sites in the Member State concerned | No |
| 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 | No |
| E.8.6.2 | Trial being conducted completely outside of the EEA | No |
| 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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| 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 | 0 |
| 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 | 0 |
| E.8.9.2 | In all countries concerned by the trial days | 0 |