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CompletedNCT03416491KW-136_IIUpdated Jan 31, 2018

Safety and Efficacy of KW-136 and Sofosbuvir for Treatment of Chronic Hepatitis C

A Phase 2 interventional study of KW-136 and Sofosbuvir in Hepatitis C, Chronic, sponsored by Kawin Technology Share-holding Co., Ltd.. Completed at 12 sites in China. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2018-01-31.

Sponsored by Kawin Technology Share-holding Co., Ltd. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
110
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study aimed to evaluate the safety and efficacy of KW-136, an investigational anti-hepatitis C virus (HCV) drug, combined with sofosbuvir for treatment of Chinese adults chronically infected with HCV. Thirty (30) non-cirrhotic subjects were medicated with KW-136 30 mg daily, 60 non-cirrhotic subjects with KW-136 60 mg daily, and 30 cirrhotic subjects with KW-136 60 mg daily; all the 120 subjects received sofosbuvir 400 mg daily. The treatment course lasted 12 successive weeks and thereafter all the study participants entered into a 12-week treatment-free follow-up period.

Read the detailed description

It is estimated that China has a population of over 10 million infected with HCV and also a highly variable HCV genotype geographic distribution. A simple, universal, non-genotype-specific treatment regimen is preferred for anti-HCV treatment in clinical practice and public health. KW-136 and sofosbuvir are potent anti-HCV agents targeting at different HCV proteins, namely, nonstructural protein 5A and 5B, respectively. The combination regimen of KW-136 and sofosbuvir is expected to completely suppress HCV replication in subjects chronically infected with HCV and achieve a sustained virologic response, namely, HCV not detected or below a predefined limit in plasma, 12 or 24 weeks after cessation of treatment.

As KW-136 and sofosbuvir are both pan-genotypic anti-HCV agents (in simple words, effective for all known common genotypes of HCV), the combination of these two agents is also supposed to be efficacious for treatment of subjects chronically infected with HCV of all major genotypes and subtypes. An apparent clinical benefit of this pan-genotypic anti-HCV treatment regimen is that no complex, delicate HCV genotype sequencing is required before initiation of treatment to determine genotype-specific treatment alternatives of choice. This advantage is of great significance in the primary care setting.

02

Conditions studied

  • Hepatitis C, Chronic

Keywords

  • Chronic hepatitis C
  • Hepatitis C virus
  • KW-136
  • sofosbuvir
  • nonstructural protein 5A
  • nonstructural protein 5B
  • panogentypic regimen
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • aged between 18 and 65 years (inclusive) at the time of informed consenting and of either sex
  • with a body mass index (BMI) between 18 and 30 kg/m\^2 (inclusive)
  • chronically infected with HCV, namely, with positive anti-HCV, HCV RNA or genotyping results at least six (6) months before the baseline, or with a liver biopsy confirming chronic hepatitis at most twelve (12) months before the baseline or during the screening period
  • anti-HCV positivity and at least once testing result with HCV RNA equaling to or above 10\^4 IU/mL
  • genotyped to be gentoype (GT-1) or non-GT-1(including GT-2, 3, 6 or others) by the centralized laboratory
  • naive to anti-HCV treatment, defined as being not previously treated with any interferon (including interferon alfa or beta or peginterferon), ribavirin, or other approved, investigational or any other not approved anti-HCV regimens of any source
  • with or without cirrhosis (cirrhosis defined as FibroScan liver stiffness modulus (LSM) at least 14.6 kPa on screening, or liver biopsy confirming presence of cirrhosis within twelve (12) months before screening or within screening; no cirrhosis defined as FibroScan LSM below 14.6 kPa or liver biopsy confirming absence of cirrhosis within twelve (12) before screening or within screening; liver biopsy result takes priority over FibroScan LSM)
  • women of childbearing potential (including postmenopausal women at or under 50 years of age) with negative blood pregnancy test results; subjects of childbearing potential (including male subjects and their female partners) have no childbearing plan from screening, initiation of treatment until six (6) months after end of treatment and consent to use effective contraceptive measures
  • voluntary participation in the study and being able to understand and sign the informed consent form

Exclusion criteria

Exclusion Criteria:

  • having previously used any investigational or experimental direct antiviral agents against HCV, including protease, NS5B polymerase or NS5A inhibitors, before screening
  • having received any interferon-based anti-HCV regimens before screening
  • having been exposed to any systemic potent immunomodulators , such as steroids or thymosin alfa (excluding use of nasal, inhalational, topical steroids and/or others) for more than two weeks within six (6) months before screening, or anticipated to be exposed to these agents during the study period
  • with hepatitis B virus surface antigen (HBsAg) or anti-human immunodeficient virus (HIV) positivity
  • with evidence of decompensatory liver function, including but not limited to total serum bilirubin (TBIL) above twice (2) of the upper limit of normal (ULN), serum albumin (ALB) below 35 g/L, or prothrombin activity (PTA) below 60% confirmed on repeated testing; emergence of ascites, upper gastrointestinal bleeding and/or hepatic encephalopathy; with liver function reserve Child-Pugh class B or C
  • with primary liver cancer confirmed or evidenced by serum alfa-fetoprotein above 100 ng/ml or liver imaging study showing suspected nodules
  • with a previous history of liver disease of other causes, including alcoholic liver disease, nonalcoholic steatohepatitis, drug-induced hepatitis, autoimmune hepatitis, Wilson disease or hemochromatosis
  • with serum alaine aminotransferase (ALT) or asparate aminotransferase (AST) above ten (10) times of ULN confirmed on repeated testing
  • with white blood cell (WBC) count below 3x10\^9 per liter, neutrophil count below 1.5x10\^9 per liter (or below 1.25x10\^9 per liter for cirrhotics), platelet count below 50x10\^9 per liter, or hemoglobin below 120 g/L (for males) or 110 g/L (for females) confirmed on repeated testing
  • with serum creatinine clearance (CLcr) below 50 ml/min using the Cockcroft-Gault formula confirmed on repeated testing
  • with uncontrolled diabetes mellitus (hemoglobin A1c[HbA1c] above 7.0% confirmed on repeated testing)
  • with psychiatric or neurologic disorders, including previous or family history of psychiatric disorders (especially depression, depressive state, epilepsy or hysteria)
  • with serious cardiovascular disorders, including uncontrolled hypertension (systolic blood pressure at or above 160 mmHg and/or diastolic blood pressure at or above 100 mmHg), heart insufficiency of New York Heart Association class III or above, history of myocardial infarction within six (6) months before screening, history of percutaneous transluminal coronary angioplasty within six (6) months before screening, unstable angina pectoris, QTc interval (Fridericia correction formula QTc = QTxRR\^-1/3) at or above 450 msec or second- or third-grade atrioventricular block or any other uncontrolled arrhythmias confirmed on repeated electrocardiography on screening
  • with serious hematologic disorders (such as anemia, hemophilia and others)
  • with serious kidney diseases (such as chronic kidney disease, kidney insufficiency and others)
  • with serious gastrointestinal disorders (such as peptic ulcer, colitis and others)
  • with serious respirator disorders (such as active pulmonary tuberculosis, lung infection, chronic obstructive pulmonary disease, pulmonary interstitial disease and others)
  • with active or suspected malignant tumors or with a previous history of malignant tumors (excluding skin basal cell carcinoma or cervical carcinoma in situ) within five (5) years before screening
  • with a history of major organ transplantation
  • being known to be severely hypersensitive or allergic to any drugs, especially the testing medications and other constituents
  • with a history of active alcohol or drug abuse within six (6) months before screening
  • being pregnant or lactating
  • being unable to discontinue prohibited medications as defined by the protocol
  • having participated in any other clinical studies within three (3) months before screening
  • being unable or unwilling to provide informed consent or unable to follow the protocol requirements
  • any other conditions of excluding a potential participant at the discretion of the investigators
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
110 participants (actual)

Study arms

  • Experimental
    NC_30

    Non-cirrhotic subjects were medicated with KW-136 capsules 30 mg once daily and fixed-dose (400 mg once daily) sofosbuvir tablets for 12 successive weeks.

    Drug: KW-136 · Drug: Sofosbuvir

  • Experimental
    NC_60

    Non-cirrhotic subjects were medicated with KW-136 capsules 60 mg once daily and fixed-dose (400 mg once daily) sofosbuvir tablets for 12 successive weeks.

    Drug: KW-136 · Drug: Sofosbuvir

  • Experimental
    LC_60

    Cirrhotic subjects were medicated with KW-136 capsules 60 mg once daily and fixed-dose (400 mg once daily) sofosbuvir tablets for 12 successive weeks.

    Drug: KW-136 · Drug: Sofosbuvir

Interventions

  • DrugKW-136

    KW-136 30 mg was provided in 3 capsules, 10 mg each, and KW-136 60 mg in a single capsule of 60 mg.

    Also known as: Coblopasvir

  • DrugSofosbuvir

    Sofosbuvir was provided in a single tablet of 400 mg.

05

What researchers measure

Primary outcomes

  1. Sustained virologic response at 12 weeks after end of treatment (SVR12)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 12 weeks after end of treatment

Secondary outcomes

  1. Sustained virologic response at 4 weeks after end of treatment (SVR4)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 4 weeks after end of treatment

  2. Rapid virologic response at 1 week after initiation of treatment (RVR1)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 1 week after initiation of treatment

  3. Rapid virologic response at 2 weeks after initiation of treatment (RVR2)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 2 weeks after initiation of treatment

  4. Rapid virologic response at 4 weeks after initiation of treatment (RVR4)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 4 weeks after initiation of treatment

  5. Rapid virologic response at 8 weeks after initiation of treatment (RVR8)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 8 weeks after initiation of treatment

  6. Rapid virologic response at 12 weeks after initiation of treatment (RVR12)

    Percentage of subjects with plasma HCV not detected or below the lower limit of quantitation (15 IU/mL)

    Time frame: 12 weeks after initiation of treatment

Other outcomes

  1. Virologic breakthrough

    Percentage of subjects with on-treatment re-detected plasma HCV RNA after HCV RNA below the lower limit of quantitation

    Time frame: 2, 4, 8 and 12 weeks after initiation of treatment

  2. Virologic relapse

    Percentage of subjects with off-treatment re-detected plasma HCV RNA after end-of-treatment HCV RNA below the lower limit of quantitation

    Time frame: 4 and 12 weeks after end of treatment

06

Study locations

12 sites
  • Peking University People's Hospital
    Beijing, Beijing 100044, China
  • Capital Medical University Affiliated Beijing Youyi Hospital
    Beijing, Beijing 100050, China
  • Capital Medical University Affiliated Beijing You'an Hospital
    Beijing, Beijing 100069, China
  • Chinese PLA Third Military Medical University First Affiliated Hospital
    Chongqing, Chongqing 400038, China
  • Guangzhou Municipal Eighth People's Hospital
    Guanzhou, Guangdong 510060, China
  • He'nan Provincial Hospital of Infectious Disease (Zhengzhou Municipal Sixth People's Hospital)
    Zhengzhou, Henan 450015, China
  • Nanjing Municipal Second Hospital
    Nanjing, Jiangsu 210003, China
  • Jilin University First Hospital
    Changchun, Jilin 130021, China
  • Dalian Municipal Sixth People's Hospital
    Dalian, Liaoning 450015, China
  • Shenyang Municipal Sixth People's Hospital
    Shenyang, Liaoning 110006, China
  • Ji'nan Municipal Hospital of Infectious Disease
    Ji'nan, Shandong 250021, China
  • Qingdao Municipal Hospital
    Qingdao, Shandong 266011, China
07

References and documents

Publications

  • Rao H, Song G, Li G, Yang Y, Wu X, Guan Y, Mao Q, Jiang X, Wang C, Zhang Y, Jia J, Guo X, Li C, Ning J, Qin H, Pan H, Wei L. Safety and efficacy of coblopasvir and sofosbuvir in patients with genotypes 1, 2, 3 and 6 HCV infections without or with compensated cirrhosis. J Viral Hepat. 2020 Jan;27(1):45-51. doi: 10.1111/jvh.13208. Epub 2019 Oct 2. PubMed 31520460 ↗

Individual participant data

Plan to share: No — No IPD plan is included in the study protocol.

08

Registry details

Key details

Study ID
NCT03416491
Lead sponsor
Kawin Technology Share-holding Co., Ltd.
Collaborators
KawinGreen Biotech Co., Ltd.
Responsible party
Sponsor
First posted
Jan 31, 2018
Start date
Feb 15, 2017
Primary completion
Sep 17, 2017
Completion
Nov 8, 2017
Last update
Jan 31, 2018

Study contacts

Lai Wei, M.D.
principal investigator · Peking University People's Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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