Background: \- Hepatitis C is a liver disease caused by the hepatitis C virus. It is the most common cause of serious liver disease in the United States. Many people have few if any symptoms. It can lead to cirrhosis, which can cause liver failure and cancer. Researchers want to study how a medicine called chlorcyclizine works in patients with hepatitis C. They want to see if it can be used to treat hepatitis C alone or when used with the standard hepatitis C treatment drug ribavirin. Objectives: \- To see if chlorcyclizine can be used to treat hepatitis C alone or in combination with the drug ribavirin. Eligibility: \- Adults with chronic hepatitis C who either have never been treated for it or have relapsed after prior treatment. Design: * Participants will be screened with medical history, physical exam, blood and urine tests, and a questionnaire. They will also have an ultrasound of their abdomen and electrocardiogram. Some of these tests will be repeated throughout the study. * Participants will spend 3 days as an inpatient to be monitored while starting study drug. They will be assigned randomly to a group and will begin taking the study drug. Blood will be taken frequently. * Group I will take the study drug twice a day for 28 days. * Group II will take the study drug twice a day and ribavirin twice a day for 28 days. * Participants will visit the clinic every 7 days for 28 days. * After participants stop taking the study drug, they will have 5 follow-up visits over 3 months.
Up to 50 patients with chronic hepatitis C, who are treatment na(SqrRoot) ve or relapsers to any interferon/ribavirin regimen will be enrolled into this pilot study evaluating chlorcyclizine HCl with or without ribavirin (RBV) as antiviral therapy. Adult patients (greater than or equal to18 years of age) with evidence of active chronic hepatitis C infection (all genotypes) with detectable HCV RNA in serum \>10,000 IU/mL without contraindications to chlorcyclizine HCl or ribavirin or evidence/history of hepatic decompensation will be enrolled. Patients will be monitored for at least two months with regular testing for ALT and HCV RNA quantitative levels before treatment and will undergo admission to start therapy, which includes a thorough medical evaluation and timed blood sampling. Patients will be randomized to one of two treatment groups; one with chlorcyclizine HCl (75 mg twice daily) and the other with RBV+ chlorcyclizine HCl (75 mg twice daily). For all genotypes, RBV will be dosed based on weight (1000 mg daily \<75 kg and 1200 mg daily greater than or equal to 75 kg). At each clinic visit, patients will be questioned about side effects and symptoms, undergo a focused physical examination, and have blood taken for complete blood counts, HCV RNA, PT/INR and routine liver tests (ALT, AST, alkaline phosphatase, direct and total bilirubin, and albumin). At the end of 28 days of treatment, patients will undergo a repeat thorough medical evaluation inclusive of a complete physical exam, symptom scale evaluation, complete blood counts, routine liver tests, and HCV serology panels. The primary endpoint of therapy will be a decline in quantitative HCV RNA viral levels after 28 days of treatment as compared to baseline viral titers and between groups. Several secondary endpoints will be measured, including side effects of therapy, ALT levels, quantification of chlorcyclizine HCl and its metabolites in serum, and quality of life. Therapy will be stopped for intolerance to RBV and/or chlorcyclizine HCl (which will be carefully defined).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Chlorcyclizine HCl (75 mg twice daily)
RBV was dosed via a weight-based regimen of 1000 mg daily\<75 kg and 1200 mg daily ≥75 kg.
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States
Change in Serum HCV RNA Viral Titer From Baseline to 28 Days
Time frame: Baseline and 28 days
Number of Participants Who Tolerated the Drug at the Prescribed Dose for the Duration of Therapy
Time frame: 28 days
Change in Alanine Aminotransferase (ALT) Levels From Baseline to 28 Days
Time frame: Baseline and 28 days
Maximum Chlorcyclizine HCL Weeks 1-4
Chlorcyclizine HCL concentration was measured once a week in the morning. This outcome is the maximum over the four weeks.
Time frame: Weeks 1-4
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