The purpose of this study is to evaluate sustained virologic response 12 weeks after the end of treatment (SVR12) following 12 weeks of simeprevir plus sofosbuvir with and without ribavirin (RBV) and 24 weeks of simeprevir plus sofosbuvir without RBV in post orthotopic liver transplant participants with recurrent hepatitis (inflammation of the liver) C virus (HCV) Genotype 1 infection.
This is a Phase 2, multicenter (when more than one hospital or medical school team work on a medical research study), partially randomized (study drug is assigned by chance), and open-label (all people know the identity of the intervention) study to explore the safety and efficacy of simeprevir plus sofosbuvir. The study will consist of a screening period (Screening and Baseline), followed by randomization. First 33 non-cirrhotic participants will be randomly assigned in a ratio of 1:1:1 into 1 of 3 treatment arms, and up to 12 cirrhotic participants will be enrolled and all will be assigned to Arm 3. All participants in treatment Arms 1 and 2 will return for treatment visits at Weeks 1, 2, 4, 8, 12, and post-treatment follow-up visits on Weeks 16 and 24. All participants in treatment Arm 3 will return for treatment visits at Weeks 1, 2, 4, 8, 12, 16, 20, and 24, and post-treatment follow-up visits on Weeks 28 and 36. Participants will receive simeprevir plus sofosbuvir and RBV for a 12-week treatment period in Arm 1, simeprevir plus sofosbuvir without RBV for a 12-week treatment period in Arm 2 and simeprevir plus sofosbuvir for a 24-week treatment period in Arm 3. Efficacy will primarily be evaluated by SVR12. Participants' safety will be monitored throughout the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
46
Participants will be administered simeprevir capsule 150 mg orally once daily up to 12 weeks.
Participants will be administered sofosbuvir 400 mg tablet orally once daily up to 12 weeks.
Participants will be administered ribavirin 2 x 200 mg tablets (for participants weighing less than 75 kilogram (\[kg\]) or 3 x 200 mg tablets (for participants weighing more than 75 kg) orally once daily up to 12 weeks.
Unnamed facility
Aurora, Colorado, United States
Unnamed facility
Gainesville, Florida, United States
Unnamed facility
Miami, Florida, United States
Unnamed facility
Boston, Massachusetts, United States
Percentage of Participants With Sustained Virologic Response After 12 Weeks of end of Treatment (SVR12)
Participants will be considered to have achieved SVR12 if the hepatitis C virus ribonucleic acid (HCV RNA) is less than (\<) 15 international unit per milliliter (IU/mL) (detectable or undetectable) at 12 weeks after the end of treatment. End of treatment is at Week 12 (for Arms 1 and 2) or Week 24 (for Arm 3); therefore, outcome will be measured at Week 24 (for Arms 1 and 2) or Week 36 (for Arm 3).
Time frame: Week 24 or Week 36
Percentage of Participants With Sustained Virologic Response After 4 Weeks of end of Treatment (SVR4)
Participants will be considered to have achieved SVR4 if the hepatitis C virus ribonucleic acid (HCV RNA) is \<15 IU/mL (detectable or undetectable) at 4 weeks after the end of treatment.
Time frame: Week 16 (for Arms 1 and 2) and Week 28 (for Arm 3)
Percentage of Participants With Undetectable Hepatitis C Virus Ribonucleic Acid (HCV-RNA)
Plasma HCV RNA will be determined using an in vitro nucleic acid amplification test for the quantification of HCV RNA in human plasma using a sensitive assay (COBAS® AmpliPrep/COBAS® TaqMan® HCV Test v2.0 , lower limit of quantification = limit of detection = 15 IU/mL).
Time frame: Weeks 2, 4, 8 and 12 (for all treatment arms) and Weeks 16 20, and 24 (for Arm 3)
Percentage of Participants With Viral Breakthrough
Viral breakthrough is defined as confirmed greater than (\>) 1.0 Log10 increase in HCV RNA from nadir or confirmed HCV RNA \>100 IU/mL in participants who had previously achieved HCV RNA \<15 IU/mL.
Time frame: Baseline up to Week 24 (for Arms 1 and 2) and Baseline up to Week 36 (for Arm 3)
Percentage of Participants With Viral Relapse
Participants will be considered to have viral relapse if they meet the following conditions: 1) HCV RNA \<15 IU/mL (undetectable) at the end of treatment; and 2) HCV RNA greater than or equal to (\>=) 15 IU/mL during the post-treatment follow-up period.
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Participants will be administered simeprevir capsule 150 mg orally once daily up to 24 weeks.
Participants will be administered sofosbuvir 400 mg tablet orally once daily up to 24 weeks.
Unnamed facility
Ann Arbor, Michigan, United States
Unnamed facility
Detroit, Michigan, United States
Unnamed facility
New York, New York, United States
Unnamed facility
Durham, North Carolina, United States
Unnamed facility
Philadelphia, Pennsylvania, United States
Unnamed facility
Pittsburgh, Pennsylvania, United States
...and 1 more locations
Time frame: Baseline up to Week 24 (for Arms 1 and 2) and Baseline up to Week 36 (for Arm 3)
Change From Baseline in Hepatitis C Symptom and Impact Questionnaire Version 4 (HCV-SIQv4) Score at Week 24 (for Arms 1 and 2) and Week 36 (for Arm 3)
The HCV-SIQv4 is a self-administered questionnaire containing 33 items classified as 3 categories of scores: 1) Symptom severity score (sum of responses to 29 questions to assess severity or frequency of symptoms associated with HCV or its treatment; 2) Time missed from work/school (sum of responses to 3 questions regarding the impact of symptoms on work/school attendance); 3) Daily activity score (response to 1 question regarding the impact of symptoms on daily activities). Higher HCV SIQv4 scores indicate worse symptom severity, more time missed from work/school, and more impairment in daily activities, respectively. The total score is the sum of scores of these 3 categories.
Time frame: Baseline, Week 24 (for Arms 1 and 2) and Week 36 (for Arm 3)
Change From Baseline in EuroQol 5 - Dimension (EQ-5D) Questionnaire Score at Weeks 4, 8, 12, 16, 20, 24 (for all treatment arms) and Week 36 (for Arm 3)
The EQ-5D questionnaire is a brief, generic health-related quality of life assessment (HRQOL) that can also be used to incorporate participant preferences into health economic evaluations. The EQ-5D questionnaire assesses HRQOL in terms of degree of limitation on 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and as overall health using a "thermometer" visual analog scale with response options ranging from 0 (worst imaginable health) to 100 (best imaginable health). Lower scores indicate worsening. EQ-5D scores include EQ-5D valuation index score (a weighted scoring of the 5 dimension scores with a possible range from 0 to 1), EQ-5D visual analog scale (VAS) is a 20 centimeter (cm) vertical VAS with scores ranging from 0 (worst imaginable health) to 100 (perfect health), and EQ5D descriptive system scores (five scores reflecting each of the 5 EQ-5D health dimensions ranging from 0 \[no limitation\] to 4 \[incapacity\]).
Time frame: Baseline, Weeks 4, 8, 12, 16, 20, 24 (for all treatment arms) and Week 36 (for Arm 3)