Clinical Pharmacokinetics of Daclatasvir/Sofosbuvir in Adolescents With Hepatitis C Virus

Ain Shams University50 enrolled

Overview

This is an interventional Phase II/III, single center, single arm clinical trial to assess the pharmacokinetics, efficacy, safety and tolerance of daclatasvir plus sofosbuvir in treatment-naïve, non-cirrhotic adolescents with chronic HCV GT-4 infection. A single-arm evaluation of daclatasvir/sofosbuvir will focus on the pharmacokinetics, efficacy and safety All enrolled patients will receive daclatasvir 60 mg orally once daily plus sofosbuvir at a dose of 400 mg orally once daily for 12 weeks.

This is an interventional Phase II/III, single center, single arm clinical trial to assess the pharmacokinetics efficacy, safety, and tolerance of daclatasvir plus sofosbuvir in treatment-naïve, non-cirrhotic adolescents with chronic HCV GT-4 infection. A single-arm evaluation of daclatasvir/sofosbuvir will focus on the efficacy, safety and pharmacokinetics, confirm the favorable pharmacological profile. All enrolled patients will receive daclatasvir 60 mg orally once daily plus sofosbuvir at a dose of 400 mg orally once daily for 12 weeks. Patients will be followed closely for disease progression and any hypersensitivity or adverse reactions due to therapy. Laboratory values to be monitored at baseline: Serum creatinine, bilirubin, AST, ALT, HCV viral load (VL). Fifty patients will be included; the first twenty patients will be candidates for pharmacokinetic assessment. All patients (50), will be candidates for safety and efficacy assessment after verifying the PK results ''phase II''. Patients will be recruited at Ain Shams University hospitals, Egypt. The study will be conducted after approval of the corresponding research ethical committee and obtaining an informed consent from the parents/guardians and an assent from the patients. Patients will be requested to come for 2 screening visits, at the first day of therapy, weekly during the first four weeks, at the end of week 8 and week 12. Patients who will complete their treatment schedule will be scheduled for a visit after 12 weeks from end of therapy for assessment of sustained virological response (SVR). The total number of visits are 9. Duration of follow up will be 24 weeks from treatment initiation in addition to the screening period (2-4 weeks).

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Chronic HCV Infection

Interventions

Daclatasvir and sofosbuvirDRUG

Daclatasvir is a DAAs that can inhibit the HCV non-structural (NS) 5A protein when used in combination with other HCV-therapies. It has a linear, non-time-dependent pharmacokinetic profile and nanomolar potency in vitro against HCV genotypes 1-6. It is excreted primarily via faeces, about 88% in an unchanged form while renal excretion accounts for approximately 7% of its elimination. DOSE OF SOFOSBUVIR: 400 mg tablet orally once daily with food (in the morning) for 12 weeks for adolescents with liver fibrosis Metavir score F0-F2. DOSE OF DACLTASVIR: 60 mg tablet orally once daily with food (in the morning) for 12 weeks for adolescents with liver fibrosis Metavir score F0-F2.

Eligibility

Sex: ALLMin age: 10 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Adolescents (ages 12- 18 years) and/ or weight ≥ 35 kg 2. HCV genotype 4 infected 3. Naïve non-cirrhotic population with FIB Score: F0 to F3. 4. Screening laboratory values within define thresholds 5. Both sex 6. Evidence of HCV infection determined by positive anti-HCV antibody and HCV RNA by polymerase chain reaction (PCR) 7. HCV treatment-naïve 8. Absolute neutrophil count ≥ 1,500/mm3 9. Hemoglobin level ≥ 10 g/dL 10. Platelets \> 75000 cells/mm3 11. Albumin \> 3.5 mg/dL 12. PT \< 3 sec above control and INR within accepted range 13. Random glucose level within normal range 14. Serum creatinine \< 1.5 mg/dL 15. Biopsy is not required for study entry. 16. Signing informed consent by parents and patient assent Exclusion Criteria: 1. Previous treatment for HCV. 2. History of clinically significant illness or any other medical condition that may interfere with individuals' treatment, assessment, or compliance with protocol. 3. Co-infection with HIV, acute hepatitis A virus, or hepatitis B virus 4. Clinical hepatic decompensation (i.e., ascites, encephalopathy or variceal hemorrhage) 5. Pregnant or nursing females 6. Use of any illicit concomitant medications as within 28 days of the Day 1 7. Renal dysfunction 8. Ongoing treatment with Prohibited drugs. 9. Chronic liver disease due to a cause other than HCV e.g. autoimmune disease, Wilson disease,…etc. 10. Alfa-fetoprotein level \>50 ng/mL 11. Serum creatinine \>1.5 mg/dL 12. Simultaneous acute hepatitis A infection 13. Known hypersensitivity to daclatasvir or sofosbuvir 14. History of gastrointestinal disease or surgical procedure 15. Blood /blood product transfusion within 4 weeks prior to study 16. Systemic corticosteroid use for more than 2 weeks (pulmonary/nasal administration was permitted) 17. Psychiatric hospitalization, suicide attempt or disability resulting from psychiatric illness within the prior 5 years 18. Clinically relevant alcohol or drug abuse within 12 months of screening 19. Ongoing treatment with any medications interacting with daclatasvir/sofosbuvir

Locations (1)

Pediatric Department, Faculty of Medicine, Ain Shams University

Cairo, Non-US, Egypt

RECRUITING

Outcomes

Primary Outcomes

Measurement of the pharmacokinetics of DCV-SOF

Blood samples (3 mL) will be collected to measure dactalasvir concentrations from pediatric patients using a nine-point plasma schedule (pre-dose, 0.5,1, 2, 4, 8, 12, and 24 h post-dose) on day 8 of therapy. (This will be a total of 27 mL/patient, which is well below the maximum allowed internationally recognized value of blood loss is 2.4mL/kg in a 4 month period. Any deviations from nominal sampling times should be recorded. AUCtau which is defined as the concentration of drug over time (area under the plasma concentration versus time curve over the dosing interval will be calculated

Time frame: Blood samples will be collected on day 8 of therapy

Secondary Outcomes

Measurement of Number of Participants With sustained virological response (SVR12), 12 weeks after discontinuation of therapy with daclatasvir-sofosbuvir (DCV-SOF).

Number of Participants With sustained virological response at 12 Weeks after end of study drug treatment (SVR12) will be recorded, participant will be considered to have achieved SVR12 if HCV RNA is less than the lower limit of quantification of \<15 IU/ml) at 12 weeks after the end of treatment.

Time frame: 12 weeks after discontinuation of therapy with daclatasvir-sofosbuvir (DCV-SOF).

Central Contacts

Manal H El-Sayed, MD

CONTACT

00201227461120 manalhelsayed@yahoo.co.uk

Fatma SE Ebeid, MD

CONTACT

00201095569596 dr.fatma_ebeid@yahoo.com

Data from ClinicalTrials.gov

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