An Open-label, Dose-ranging Study to Evaluate the Safety and Efficacy of Lonafarnib with Ritonavir Boosting +/- Peginterferon alfa-2a in Patients Chronically Infected with Delta Hepatitis (HDV) (LOWR-2).
Chronic delta hepatitis is a serious form of chronic liver disease caused by infection with the hepatitis D virus (HDV), a small RNA virus that requires farnesylation of its major structural protein (HDV antigen) for replication. Up to sixty subjects with chronic delta hepatitis will be randomized to receive one of ten different doses of lonafarnib. Dosing will occur over 12-48 weeks, and during that time, evidence of antiviral response will be assessed by frequent measurements of HDV-RNA. The primary therapeutic endpoint will be an improvement in quantitative serum HDV RNA levels after treatment with lonafarnib therapy. The primary safety endpoint will be the ability to tolerate the drug at the prescribed dose for the treatment duration. Several secondary endpoints will be measured, including side effects, ALT levels, and symptoms. Therapy will be stopped for intolerance to lonafarnib. This study is designed as a Phase 2a study assessing the safety, tolerance and antiviral activity of nine dosing combinations of lonafarnib with ritonavir boosting with and without peginterferon alfa-2a (PEG IFN-a).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
55
antiviral farnesyl transferase inhibitor
CYP 3A4 inhibitor, lonafarnib booster
immunomodulator
Ankara University Medical School
Ankara, Turkey (Türkiye)
≥2 log10 Decline of HDV RNA From Baseline at End of Treatment (EOT)
Proportion of intent to treat patients with ≥2 log10 decline of HDV RNA from baseline at end of treatment (EOT)
Time frame: 12-48 weeks
< LLOQ in HDV RNA at End of Treatment (EOT)
Proportion of intent to treat patients with HDV RNA below the limit of quantitation at end of treatment
Time frame: 12-48 weeks
ALT Normalization at End of Treatment
Proportion of intent to treat population who normalize ALT at end of treatment
Time frame: 12-48 weeks
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