This is a Phase II/III, multicenter, multi-country, trial to assess the efficacy, safety, tolerance and pharmacokinetics of sofosbuvir plus ravidasvir for the treatment of HCV infection.
This is a Phase II/III, multicenter, multi-country trial to assess the efficacy, safety, tolerance and pharmacokinetics of SOF-RDV for the treatment of HCV infection, across genotypes 1,2,3,6, among non-cirrhotic and cirrhotic with CTP class A, interferon/ribavirin naïve or experienced, HCV mono-infected and HCV/HIV co-infected subjects. It will also study the pharmacokinetics of RDV and, in HCV/HIV co-infected subjects, possible drug-drug interactions with antiretrovirals. The treatment duration will be 12 weeks for subjects with no cirrhosis (Metavir F0 to F3) and 24 weeks for subjects with compensated cirrhosis (Metavir F4, CTP class A). The study is performed in 2 stages. Stage 1 has been completed. Efficacy and safety results from Stage 1 were reviewed and approved by the independent Data and Safety Monitoring Board (DSMB) which provided the recommendation to proceed with the study stage 2. On-going stage 2 aims to supplement Stage 1 results and provide additional information on the performance of SOF-RDV in the main genotypes found in Malaysia and Thailand.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
603
combination of sofosbuvir + ravidasvir
Hospital Sultanah Aminah
Johor Bahru, Johor, Malaysia
Hospital Raja Perempuan Zainab II
Kota Bharu, Kelantan, Malaysia
Sustained Virological Response at 12 weeks post treatment completion (SVR12), as evidenced by HCV RNA level less than the lower limit of quantification
Related objective: to assess the efficacy of sofosbuvir-ravidasvir (SOF-RDV) at 12 weeks after the end of study treatment
Time frame: 12 weeks after the end of the study treatment
Sustained virologic response at 4 and 24 weeks post treatment completion (SVR4 and SVR24), as evidenced by HCV RNA level less than the lower limit of quantification
Related objective: to assess the efficacy of SOF-RDV at 4 and 24 weeks after the end of study treatment
Time frame: 4 and 24 weeks after the end of the study treatment
Occurrence of on-treatment virologic failure among subjects not achieving SVR12
Defined as HCV RNA ≥ LLOQ at the end of the treatment period. Related objective: to assess the efficacy of SOF-RDV 12 weeks after the end of study treatment.
Time frame: 12 weeks after the end of the study treatment
Occurrence of virologic breakthrough among subjects not achieving SVR12
Defined as either confirmed ≥ 1 log10 IU/mL increase in HCV RNA from nadir while on treatment or confirmed HCV RNA ≥ LLOQ if HCV RNA previously declined to \< LLOQ while on treatment. Related objective: to assess the efficacy of SOF-RDV 12 weeks after the end of study treatment.
Time frame: 12 weeks after the end of the study treatment
Occurrence of virologic relapse among subjects not achieving SVR12
Defined as HCV RNA \< LLOQ at the end of the treatment period but HCV RNA ≥ LLOQ during the post-treatment period. Related objective: to assess the efficacy of SOF-RDV 12 weeks after the end of study treatment.
Time frame: 12 weeks after the end of the study treatment
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Department of Hepatology, Hospital Selayang
Batu Caves, Selangor, Malaysia
Hospital Sultanah Nur Zahirah
Kuala Terengganu, Terengganu, Malaysia
Department of Medicine/Gastroenterology, Hospital Sultanah Bahiyah
Alor Star, Malaysia
Department of Medicine/ Gastroenterology, Hospital Ampang
Ampang, Malaysia
Department of Medicine/Gastroenterology, University Malaya Medical Centre
Kuala Lumpur, Malaysia
Hospital Tengku Ampuan Afzan ,Pusat Penyelidikan Klinikal,Aras Bawah ,Bangunan Pengurusan,Jalan Tanah Putih
Kuantan, Malaysia
Department of Medicine/Infectious Disease, Hospital Sungai Buloh
Sungai Buloh, Malaysia
King Chulalongkorn Memorial Hospital/HIV-NAT, Faculty of Medicine, Chulalongkorn University
Bangkok, Thailand
...and 3 more locations
Occurrence of non-virologic failure among subjects not achieving SVR12
Defined as any failure that does not meet the virologic failure criteria (e.g. adverse event, lost to follow-up). Related objective: to assess the efficacy of SOF-RDV 12 weeks after the end of study treatment.
Time frame: 12 weeks after the end of the study treatment
Occurrence of premature treatment discontinuation and occurrence of premature study discontinuation (overall and by reason for premature discontinuation)
Related objective: to assess the safety of SOF-RDV
Time frame: Through study completion (up to 36 weeks for non-cirrhotic patients and up to 48 weeks for cirrhotic patients)
Time to premature treatment discontinuation and time to premature study discontinuation
Related objective: to assess the safety of SOF-RDV
Time frame: Through study completion (up to 36 weeks for non-cirrhotic patients and up to 48 weeks for cirrhotic patients)
Occurrence of the following events: TEAE, TEAE considered to be at least possibly related to at least one of the study drugs, TEAE leading to premature treatment discontinuation, TE laboratory abnormality, grade 3/4 TEAE, TESAE and death
Related objective: to assess the safety of SOF-RDV. TEAE: Treatment Emergent Adverse Event TESAE: Treatment Emergent Serious Adverse Event
Time frame: Through study completion (up to 36 weeks for non-cirrhotic patients and up to 48 weeks for cirrhotic patients)
Time to first TEAE, time to first grade 3/4 TEAE and time to first TESAE
Related objective: to assess the safety of SOF-RDV. TEAE: Treatment Emergent Adverse Event TESAE: Treatment Emergent Serious Adverse Event
Time frame: Through study completion (up to 36 weeks for non-cirrhotic patients and up to 48 weeks for cirrhotic patients)
Maximum plasma concentration (Cmax) of ravidasvir (and sofosbuvir if needed)
Related objective: to study the pharmacokinetics (PK) of SOF and RDV and to evaluate potential drug-drug interactions with antiretrovirals and, as needed, interactions with concomitant prescribed or non-prescribed drugs.
Time frame: Intensive PK (stage 1 only): 4 weeks after treatment initiation; Sparse PK: 4, 8 and 12 weeks after treatment initiation
Baseline factors associated with SVR12 outcome
Related objective: to describe the subjects' demographic, clinical and biological characteristics and their relationship with SVR12.
Time frame: Baseline and 12 weeks after the end of the study treatment
Change in the PROQOL-HCV domain scores from treatment initiation to 12 weeks after treatment completion
Related objective: to assess the subjects' quality of life before and after therapy. PROQOL-HCV: Patient Reported Outcome Quality of Life survey for HCV, questionnaire that evaluates 7 domains, each domain scores range 0 to 100, where 100 corresponds to the best quality of life.
Time frame: 12 weeks after the end of the study treatment
Changes in HCV NS5A sequences from treatment initiation in subjects not achieving SVR12
Related objective: to evaluate the presence of viral resistance-associated variants (RAVs) to SOF-RDV in patients with virological failure 12 weeks after treatment completion
Time frame: 12 weeks after the end of the study treatment