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Trial registered on ANZCTR
Registration number
ACTRN12620000794909
Ethics application status
Approved
Date submitted
15/06/2020
Date registered
7/08/2020
Date last updated
7/08/2020
Date data sharing statement initially provided
7/08/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
An efficacy study of combined oral doses of glecaprevir/pibrentasvir and sofosbuvir for 16 weeks in hepatitis C patients with documented NS5A resistance who did not respond to previous treatment
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Scientific title
A retreatment study to determine the efficacy of MAVIRET (Glecaprevir/Pibrentasvir) and generic sofosbuvir for 16 weeks in hepatitis C patients with NS5A resistance who did not respond to previous VIEKIRA PAK or MAVIRET or ZEPATIER treatment.
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Secondary ID [1]
301506
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Nil known
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Universal Trial Number (UTN)
U1111-1251-7898
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hepatitis C
317838
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Condition category
Condition code
Infection
315894
315894
0
0
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Other infectious diseases
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Oral and Gastrointestinal
316211
316211
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
MAVIRET (Glecaprevir 300mg / Pibrentasvir 120mg) and generic sofosbuvir 400mg once daily, oral for 16 weeks.
Mode of administration is oral capsule.
Adherence will be monitored at wk 4, wk 8, wk 12 and wk 16 visits when pills are returned for compliance assessment.
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Intervention code [1]
317812
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
324106
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Proportion of subjects who commence retreatment with Maviret and sofosbuvir (intention-to-treat [ITT] and per-protocol [PP] population) who achieve sustained virological response. This is defined as HCV RNA below the lower limit of quantitation (target not detected or target detected, not quantifiable). Presence of HCV RNA in blood sample will be assessed by running Polymerase Chain Reaction using primers that are specifically designed to bind to the HCV.
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Assessment method [1]
324106
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Timepoint [1]
324106
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Sample for HCV RNA detection will be collected at a single time point that is greater than or equal to (=) 12 weeks following last dose of treatment. When the result is HCV RNA negative then the patient will have achieved sustained virologic response (SVR12) and clinically judged as cured from HCV.
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Secondary outcome [1]
383773
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On-treatment adherence: calculated by subtracting the number of missed doses from the total number of doses of scheduled treatment and dividing by the total intended therapy duration. This measures the proportion of doses received from treatment initiation until treatment was discontinued or completed. This will be recorded by the study nurse on a drug tablet return checklist.
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Assessment method [1]
383773
0
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Timepoint [1]
383773
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On treatment Wk4, Wk8, Wk12, Wk16 (End of Treatment).
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Secondary outcome [2]
383774
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Proportion with early treatment discontinuation: Discontinuation of therapy prior to the per-protocol planned end of treatment. Patient will be determined as an early discontinuation following 3 failed attempts to contact patient or if they withdraw consent while they are still on treatment.
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Assessment method [2]
383774
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Timepoint [2]
383774
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Between Day 1 to Week 16 (End of Treatment)
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Secondary outcome [3]
383775
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Toxicity: number of participants with AEs that are deemed to be treatment-related by the clinical team at the domicile DHB compared to those with no treatment-related AEs reported. Patients will self-report AEs at visits. There are no mandatory laboratory tests during treatment but they may be performed at Investigator-discretion based on self-reported AEs.
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Assessment method [3]
383775
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Timepoint [3]
383775
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AE will be collected at wk 4, 8, 12, 16 (end of treatment) .
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Secondary outcome [4]
384553
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Toxicity: number of participants with SAEs compared to those with no SAEs reported. SAEs may be reported by the patient or through data linkage to medical records or GP.
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Assessment method [4]
384553
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Timepoint [4]
384553
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SAE reporting Day 1 to Wk 16 (End of Treatment)
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Eligibility
Key inclusion criteria
- Confirmed prior treatment with VIEKIRA PAK or MAVIRET or ZEPATIER
- Confirmed failure of VIEKIRA PAK or MAVIRET or ZEPATIER as demonstrated by positive viral load at greater than or equal to (=) 12 weeks after end of treatment (SVR12) and no history of continued injecting drug use to suggest reinfection
- Confirmed NS5A resistance demonstrated
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Severe hepatic impairment classed as Child-Pugh C decompensated cirrhosis. Patients with moderate hepatic impairment classed as Child-Pugh B decompensated cirrhosis will be considered on a case-by-case basis.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Descriptive statistics
- Proportion of patients achieving sustained virologic response (Intention-to-Treat and Per-Protocol)
- Adherence %
- Early discontinuation %
- Toxicity (descriptive and % Serious Adverse Events and Adverse Events)
- Descriptive analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/09/2020
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Actual
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Date of last participant enrolment
Anticipated
30/11/2021
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Actual
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Date of last data collection
Anticipated
30/06/2022
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Actual
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Sample size
Target
75
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
22672
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New Zealand
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State/province [1]
22672
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Auckland
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Funding & Sponsors
Funding source category [1]
305947
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Hospital
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Name [1]
305947
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Auckland District Health Board
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Address [1]
305947
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2 Park Road
Grafton
Auckland
1023
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Country [1]
305947
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New Zealand
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Primary sponsor type
Hospital
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Name
Auckland District Health Board
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Address
2 Park Road
Grafton
Auckland
1023
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Country
New Zealand
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Secondary sponsor category [1]
306407
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None
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Name [1]
306407
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Address [1]
306407
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Country [1]
306407
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306190
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Northern A Health and Disability Ethics Committee
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Ethics committee address [1]
306190
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
306190
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New Zealand
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Date submitted for ethics approval [1]
306190
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17/03/2020
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Approval date [1]
306190
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10/07/2020
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Ethics approval number [1]
306190
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Summary
Brief summary
Direct Acting Antivirals (DAAs) target specific steps in the Hepatitis C (HCV) life cycle and they are most effective when delivered as combination therapies. Cure rates are high for the DAAs funded in New Zealand (95% for VIEKIRA PAK and 98% for MAVIRET). For those who did not respond to these treatments, approximately half will have developed dual resistance to NS5A inhibitors and protease inhibitors. The only appropriate retreatment for these patients who did not respond to prior treatment and have NS5A resistance is with a triple DAA combination comprising of sofosbuvir plus an NS5A inhibitor plus a protease inhibitor. In this study, a regimen with 16 week generic sofosburvir + MAVIRET will be tested to see if it can achieve sustained virologic response in treatment experienced patients with NS5A resistance. Previous Phase II and III studies in other countries have demonstrated >95% cure rates following this regimen. Most participants will be recruited via the doctor or nurse that managed their first (unsuccessful) treatment. The study will involve one screening visit at the participant’s local hospital or clinic during which the participant will consent, have safety blood and other tests to assess eligibility. For example, additional blood tests for NS5A resistance or amount of HCV RNA if not tested previously or the extent of scar tissue in the liver. Once confirmed eligible, MAVIRET will be prescribed via Pharmac and dispensed from a local pharmacy. Generic sofosbuvir will be couriered from Auckland City Hospital to participant’s homes. Participants will attend four weekly visits during treatment where adverse events, concomitant medication and compliance will be reviewed. 12 weeks after the last dose, HCV RNA viral load will be tested to determine if the patient has been cured.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
103026
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Prof Ed Gane
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Address
103026
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Level 15, Building 1
Auckland District Health Board
2 Park Road
Grafton
Auckland
1023
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Country
103026
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New Zealand
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Phone
103026
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+64 9 307 4949
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Fax
103026
0
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Email
103026
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[email protected]
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Contact person for public queries
Name
103027
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Ed Gane
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Address
103027
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Level 15, Building 1
Auckland District Health Board
2 Park Road
Grafton
Auckland
1023
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Country
103027
0
New Zealand
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Phone
103027
0
+64 9 307 4949
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Fax
103027
0
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Email
103027
0
[email protected]
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Contact person for scientific queries
Name
103028
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Ed Gane
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Address
103028
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Level 15, Building 1
Auckland District Health Board
2 Park Road
Grafton
Auckland
1023
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Country
103028
0
New Zealand
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Phone
103028
0
+64 9 307 4949
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Fax
103028
0
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Email
103028
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No budget allocated to prepare the dataset for IPD.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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