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Hepatitis C, ChronicNCT03764345

Eight Weeks Sofosbovir/Ledipasvir in HCV Infected Children Aged 4 to 10 Years

A study testing Sofosbovir/Lepipasvir (200/45mg) tablet (Heterosofir) in people with Hepatitis C, Chronic and Children, Only, run by National Liver Institute, Egypt at 1 site in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Recently the era of direct-acting antiviral drugs for hepatitis C treatment has changed the world map of HCV. Results in adults are promising. FDA approved only two drugs in the pediatric age group 12 to 17 years. Younger children are still on the wait list for treatment. Read more about this study

Who is it for?
Ages 3 to 12 years
Conditions the study is for
Hepatitis C, Chronic, Children, Only
What is being tested?
Sofosbovir/Lepipasvir (200/45mg) tablet (Heterosofir)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteEgypt
Study dates
6 Dec 2018to 2 Jul 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 3 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Children with chronic HCV
  • age 3- 12 y old
  • weight 17- 35kg
  • Basal HCV viremia less than 6.8 log IU/mL
  • Treatment-naive
  • No cirrhosis

Who cannot join

  • Patients with dual HBV and HCV infection or associated with chronic hepatitis other than chronic HCV
  • age below 3 years or above 12 years
  • body weight less than 17 or more than 35 Kg
  • HCV/HIV coinfection.
  • Patients with HCV infection and HCC.
  • Patients with HCV infection and underlying cardiac comorbidities
Show all 12Show fewer
  • Decompensated patients with HCV
  • Hypoalbuminemia of < 3.5g/dL.
  • International normalised ratio (INR) >2.
  • Advanced fibrosis scoring by transient elastography (F 4 broScan)
  • Any concomitant malignancy.
  • Parents' refusal for participation of their children in the study.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menoufia University

    Shebin El-Koom, Menofiya, 32511

Other trials in Egypt

About this study

Official title: Sofosbovir/Ledipasvir in HCV Infected Children Aged From 4 to 10 Years

Recently the era of direct-acting antiviral drugs for hepatitis C treatment has changed the world map of HCV. Results in adults are promising. FDA approved only two drugs in the pediatric age group 12 to 17 years. Younger children are still on the wait list for treatment. The current study aimed to treat children aged between 3 and 12 years with half the adult dose of Sofosbuvir/Ledipasvir combination (Heterosofir).

Read the detailed description

The WHO has declared hepatitis C a global health problem, with ∼ 3% of the world's population (roughly 170-200 million individuals) infected with HCV. Egypt has the highest prevalence of HCV in the world, ranging from 6 to 28%, with an average of ∼ 13.8% in the general population. Ap-proximately 90% of Egyptian HCV isolates belong to a single subtype, 4a.

Hepatitis C virus (HCV) is a major cause of chronic liver disease and a prin-cipal reason for liver transplant; approximately 170 million people worldwide are chronically infected. There is general consensus that HCV elimination is associated with strong and sustained CD4+ and CD8+ T cell res-ponses that target multiple epitopes within the different HCV proteins, however, they are not maintained in patients who develop chronic disease . A variety of factors purportedly contribute to the dimi-nished T cell responses observed in chronically infected patients, including an im-paired dendritic cell (DC) function.

The successful development of direct-acting antivirals (DAAs) that are active against hepatitis C virus has transformed chronic hepatitis C infection from a con-dition requiring complex therapies with unsatisfactory outcomes to one that can be easily treated with few contraindications and side-effects. Since 2011, the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have approved eight oral DAA regimens for the treatment of adults with chronic hepatitis C. Investigation into DAAs for children has been slower.

For adolescents aged 12-17 years, the safety and efficacy of the fixed-dose combination sofosbuvir and ledipasvir for genotype 1 or 4 infection and of combination sofosbuvir plus ribavirin for genotype 2 or 3 infection have been described in full-length articles.

A recent study explored the safety and efficacy of combination sofosbuvirplus ribavirin in Pakistani children (aged 5-18 years) with hepatitis C virus genotype 1, 2, or 3 infection. Further results have been presented as ab-stracts for the fixed-dose combination sofosbuvir and ledipasvir in children aged 6-11 years for the fixed-dose combination ombitasvir, pari-taprevir, and ritonavir with or without dasabuvir and with or without ribavirin in adolescents aged 12-17 years with genotype 1 or 4 infection and for combination sofosbuvir plus daclatasvir with or without ribavirin in Egyp-tian adolescents aged 12-17 years with genotype 4 infection.

Dendritic cells are professional antigen presenting cells characterized by a po-tent capacity to elicit primary T cell responses. Two major subsets of DC can be identified from human peripheral blood: plasmacytoid (p) DC and conventional or myeloid (m) DC. Each subset represents 0.3-0.5% of the normal human peripheral blood mononuclear cell (PBMC) population.

Being tested
Sofosbovir/Lepipasvir (200/45mg) tablet (Heterosofir)
Medical subject headings
Hepatitis C, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sofosbovir/Lepipasvir (200/45mg) tablet (Heterosofir)Drug

    Patients receive oral daily dose of Sofosbovir/Ledipasvir (200/45mg) daily for 8 weeks

Study groups in NCT03764345
Study groupRoleWhat they receive
Sofosbovir/Ledipasvir DailyExperimentalPatients receive oral daily dose of Sofosbovir/Ledipasvir (200/45mg) daily for 8 weeks
Receives: Drug: Sofosbovir/Lepipasvir (200/45mg) tablet (Heterosofir)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Side effect 1 Number of patients with fatigue

    Number of patients with fatigue

    Measured: 8 weeks

  2. Side effect 2 Number of patients with Headache

    Number of patients with Headache

    Measured: 8 weeks

  3. Side effect 3 Number of patients with nausea

    Number of patients with nausea

    Measured: 8 weeks

  4. Side effect 4 Number of patients with diarrhea

    Number of patients with diarrhea

    Measured: 8 weeks

  5. Side effect 5 Number of patients with insomnia

    Number of patients with insomnia

    Measured: 8 weeks

  6. Side effect 6 Number of patients with weakness

    Number of patients with weakness

    Measured: 8 weeks

  7. Side effect 7 Number of patients with bradycardia

    Number of patients with bradycardia

    Measured: 8 weeks

  8. Side effect 8 Number of patients with cough

    Number of patients with cough

    Measured: 8 weeks

  9. Side effect 9 Number of patients with myalgia

    Number of patients with myalgia

    Measured: 8 weeks

  10. Side effect 10 Number of patients with dysapnea

    Number of patients with dysapnea

    Measured: 8 weeks

  11. Side effect 11 Number of patients with irritability

    Number of patients with irritability

    Measured: 8 weeks

  12. Side effect 12 Number of patients with dizziness

    Number of patients with dizziness

    Measured: 8 weeks

  13. Side effect 13 Number of patients with depression

    Number of patients with depression

    Measured: 8 weeks

  14. Side effect 14 Number of patients with skin rash

    Number of patients with skin rash

    Measured: 8 weeks

Secondary outcomes (2)
  1. HCV-RNA PCR by the end of therapy

    HCV-RNA PCR at week 8

    Measured: 8 weeks

  2. HCV-RNA PCR after 20 weeks for SVR

    HCV-RNA PCR at week 20

    Measured: 20 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2018
  2. Study start6 Dec 2018
  3. Primary completion2 Jul 2019
  4. Study completion2 Jul 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03764345
Sponsor's protocol ID
Sof-Led-HCV-Ped
Status last verified
Sep 2019
First submitted
28 Nov 2018
Last updated
17 Sep 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Balistreri WF, Murray KF, Rosenthal P, Bansal S, Lin CH, Kersey K, Massetto B, Zhu Y, Kanwar B, German P, Svarovskaia E, Brainard DM, Wen J, Gonzalez-Peralta RP, Jonas MM, Schwarz K. The safety and effectiveness of ledipasvir-sofosbuvir in adolescents 12-17 years old with hepatitis C virus genotype 1 infection. Hepatology. 2017 Aug;66(2):371-378. doi: 10.1002/hep.28995. Epub 2017 Jun 19.

    PubMed 27997679
  • Deuffic-Burban S, Mohamed MK, Larouze B, Carrat F, Valleron AJ. Expected increase in hepatitis C-related mortality in Egypt due to pre-2000 infections. J Hepatol. 2006 Mar;44(3):455-61. doi: 10.1016/j.jhep.2005.08.008. Epub 2005 Sep 15.

    PubMed 16310281
  • El-Sayed M, Hassany M, Asem N. A pilot study for safety and efficacy of 12 weeks sofosbuvir plus daclatasvir with or without ribavirin in Egyptian adoles-cents with chronic hepatitis C virus Infection. Journal of Hepatology 2017,66:S178

  • El-Serag HB. Hepatocellular carcinoma and hepatitis C in the United States. Hepatology. 2002 Nov;36(5 Suppl 1):S74-83. doi: 10.1053/jhep.2002.36807.

    PubMed 12407579
  • Gowans EJ, Jones KL, Bharadwaj M, Jackson DC. Prospects for dendritic cell vaccination in persistent infection with hepatitis C virus. J Clin Virol. 2004 Aug;30(4):283-90. doi: 10.1016/j.jcv.2004.03.006.

    PubMed 15163415
  • Hashmi MA, Cheema HA. Effectiveness and Safety of Sofosbuvir in Treatment-NaiveChildren with Hepatitis C Infection. J Coll Physicians Surg Pak. 2017 Jul;27(7):423-426.

    PubMed 28818165
  • Indolfi G, Serranti D, Resti M. Direct-acting antivirals for children and adolescents with chronic hepatitis C. Lancet Child Adolesc Health. 2018 Apr;2(4):298-304. doi: 10.1016/S2352-4642(18)30037-3. Epub 2018 Feb 24.

    PubMed 30169301
  • Kamal SM, Madwar MA, Peters T, Fawzy R, Rasenack J. Interferon therapy in patients with chronic hepatitis C and schistosomiasis. J Hepatol. 2000 Jan;32(1):172-4. doi: 10.1016/s0168-8278(00)80207-x. No abstract available.

    PubMed 10673085
  • Murray KF, Balistreri W, Bansal S, Whitworth S, Evans H, Gonzalez-Peralta R, et al. Ledipasvir/sofosbuvir±ribavirin for 12 or 24 weeks is safe and effective in children 6-11 years old with chronic hepatitis C infection. Journal of Hepatology 2017,66:S57-S58

  • O'Doherty U, Peng M, Gezelter S, Swiggard WJ, Betjes M, Bhardwaj N, Steinman RM. Human blood contains two subsets of dendritic cells, one immunologically mature and the other immature. Immunology. 1994 Jul;82(3):487-93.

    PubMed 7525461
  • Takaki A, Wiese M, Maertens G, Depla E, Seifert U, Liebetrau A, Miller JL, Manns MP, Rehermann B. Cellular immune responses persist and humoral responses decrease two decades after recovery from a single-source outbreak of hepatitis C. Nat Med. 2000 May;6(5):578-82. doi: 10.1038/75063.

    PubMed 10802716
  • Thorne C, Indolfi G, Turkova A, Giaquinto C, Nastouli E. Treating hepatitis C virus in children: time for a new paradigm. J Virus Erad. 2015 Jul 1;1(3):203-5. doi: 10.1016/S2055-6640(20)30500-8.

    PubMed 27482412
  • Wirth S, Rosenthal P, Gonzalez-Peralta RP, Jonas MM, Balistreri WF, Lin CH, Hardikar W, Kersey K, Massetto B, Kanwar B, Brainard DM, Shao J, Svarovskaia E, Kirby B, Arnon R, Murray KF, Schwarz KB. Sofosbuvir and ribavirin in adolescents 12-17 years old with hepatitis C virus genotype 2 or 3 infection. Hepatology. 2017 Oct;66(4):1102-1110. doi: 10.1002/hep.29278. Epub 2017 Aug 26.

    PubMed 28543053
  • Schulze Zur Wiesch J, Ciuffreda D, Lewis-Ximenez L, Kasprowicz V, Nolan BE, Streeck H, Aneja J, Reyor LL, Allen TM, Lohse AW, McGovern B, Chung RT, Kwok WW, Kim AY, Lauer GM. Broadly directed virus-specific CD4+ T cell responses are primed during acute hepatitis C infection, but rapidly disappear from human blood with viral persistence. J Exp Med. 2012 Jan 16;209(1):61-75. doi: 10.1084/jem.20100388. Epub 2012 Jan 2.

    PubMed 22213804

Questions about this trial

What is this clinical trial studying?

A study testing Sofosbovir/Lepipasvir (200/45mg) tablet (Heterosofir) in people with Hepatitis C, Chronic and Children, Only, run by National Liver Institute, Egypt at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Side effect 1 Number of patients with fatigue (time frame: 8 weeks). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03764345, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Sep 2019.

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