Skip to content

A Study of Combination Therapy With PEGASYS (Pegylated Interferon Alfa-2a (40KD)) and Copegus (Ribavirin) in Patients With Chronic Hepatitis C Genotype 2 or 3 Who Do Not Achieve a Rapid Viral Response

A Randomized, Open-label Study of the Effects of 24 vs 48 Weeks of Combination Therapy With PEGASYS (Peginterferon Alfa-2a 40KD) Plus COPEGUS (Ribavirin) on Sustained Virological Response in Patients With Chronic Hepatitis C, Genotype 2 or 3 Who do Not Achieve a Rapid Viral Response

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00623428
Enrollment
235
Registered
2008-02-26
Start date
2008-06-30
Completion date
2012-05-31
Last updated
2013-07-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hepatitis C, Chronic

Brief summary

This study will evaluate the efficacy and safety of peginterferon alfa-2a 40KD + ribavirin combination therapy given for 24 weeks versus 48 weeks in patients with chronic hepatitis C, genotype 2/3.

Detailed description

During a pre-study run-in phase patients with chronic hepatitis C genotype 2/3, who had started therapy with PEG-IFN alfa-2a plus ribavirin according to local standard of care and did not achieve a rapid viral response (RVR) (defined as Hepatitis C virus (HCV) RNA \<15 IU/mL at Week 4 of treatment measured with the Roche COBAS AmpliPrep / COBAS TaqMan® HCV Test) were eligible for the study and entered the screening phase between treatment Week 4 and 8 as soon as the result of the Week 4 HCV RNA test was available. Eligible patients entered the study and continued with the dose regimens of PEG-IFN alfa-2a and ribavirin they were taking prior to enrolment into the trial up to Week 24 of treatment. Patients who achieved at least a 2-log10 drop of HCV RNA at Week 12 (as compared to HCV RNA levels prior to treatment initiation) or had HCV RNA \<15 IU/mL, and who were still taking study medication at treatment Week 24, were randomized at treatment Week 24 to one of the two study groups. Upon randomization, participants either stopped treatment (equaling 24 weeks of treatment) or continued treatment for another 24 weeks (equaling 48 weeks of treatment). A treatment free follow-up period of 24 weeks (for participants in the 48-week treatment group) or 48 weeks (participants in the 24-week treatment group) completed the study.

Interventions

DRUGpeginterferon alfa-2a
DRUGRibavirin

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* adult patients, \>=18 years of age; * serological evidence of chronic hepatitis C (CHC); * CHC genotype 2 or 3; * receiving PEGASYS + Copegus according to local standard of care and no rapid viral response (RVR); * compensated liver disease.

Exclusion criteria

* pegylated interferon, standard interferon or ribavirin therapy at any time prior to initiation of current therapy with PEGASYS + Copegus; * coinfection with hepatitis A or B, or human immunodeficiency virus (HIV); * history or other evidence of decompensated liver disease.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With a Sustained Virologic Response 24 Weeks After Scheduled Completion of Treatment24 weeks after scheduled treatment completion (approximately Week 48 for participants in the 24-week treatment group and Week 72 for participants in the 48-week treatment group.Sustained virological response (SVR) is defined as a single last HCV RNA measurement \<15 IU/ml (measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test) 24 weeks after scheduled treatment completion, defined as Week 44 or later for participants randomized to the 24-week treatment period or Week 68 or later for participants randomized to the 48-week treatment period. Participants without measurements at the end of the 24-week untreated follow-up period were considered non-responders in the analysis.
Percentage of Participants With a Sustained Virologic Response 24 Weeks After Actual End of Treatment24 weeks after actual end of treatment (range from Week 48 to Week 72).Sustained virological response (SVR) is defined as a single last HCV RNA measurement \<15 IU/ml (measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test) at 24 weeks after actual end of study treatment. For participants in the 48-week treatment group who stopped study treatment prior to Week 48 for any reason, the HCV RNA measurements 24 weeks after actual end of treatment were used in the analysis. Participants without a 24-week post treatment measurement are considered non-responders.

Secondary

MeasureTime frameDescription
Percentage of Participants With Virological RelapseEnd of treatment (Weeks 24 or 48) and 24 weeks after the end of treatment (weeks 48 and 72 in each treatment group respectively).Virological relapse defined as the percentage of participants with a virological response at end of treatment but who did not have a sustained virological response 24 weeks after the end of treatment. Virological response at end of treatment is defined as a single last HCV RNA measurement \<15 IU/ml measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test at the day of last dose of study medication. Sustained virological response 24 weeks after the actual treatment end (SVR24) is defined as a single last HCV RNA measurement \<15 IU/ml at least 20 weeks after treatment end.
Percentage of Participants With Virological Response 72 Weeks After Treatment InitiationWeek 72Virological response 72 weeks after treatment initiation is defined as the percentage of participants with HCV RNA \<15 IU/mL as measured by the Roche COBAS AmpliPrep / COBAS TaqMan® HCV Test at 48 weeks post completion of the 24 week treatment period and 24 weeks post completion of the 48 week treatment period. Participants without Week 72 measurements were considered non-responders in the analysis.
Number of Participants With Adverse Events (AEs)From Week 1 through Week 72.An AE was defined as a sign or symptom, including intercurrent illness, that occurred during the course of the clinical study after treatment had started. A related AE is an event assessed by the Investigator to be remotely, possibly, or probably related to study treatment according to criteria provided in the protocol. A severe AE was an event graded by the Investigator as incapacitating with inability to work or perform normal daily activity. A serious AE (SAE) was defined as any experience that suggests a significant hazard, contraindication, side effect or precaution. This includes any experience which was fatal; was life-threatening; required inpatient hospitalization or prolongation of an existing hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/ birth defect; was medically significant or required intervention to prevent one or other of the outcomes listed above.
Percentage of Participants With a Sustained Virologic Response 12 Weeks After Actual End of Treatment12 weeks after actual end of treatment (range from Week 36 to Week 60)Sustained virological response (SVR) is defined as a single last HCV RNA measurement \<15 IU/ml (measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test) at 12 weeks after actual end of study treatment. For participants in the 48-week treatment group who stopped study treatment prior to Week 48 for any reason, the HCV RNA measurements 12 weeks after actual end of treatment were used in the analysis. Participants without a 12-week post treatment measurement are considered non-responders.
Percentage of Participants With Virological Response at End of TreatmentEnd of Treatment (Week 24 and Week 48 for each treatment group respectively).Virological response at the end of treatment was defined as the percentage of participants with HCV RNA \<15 IU/mL as measured by the Roche COBAS AmpliPrep / COBAS TaqMan® HCV Test after the last dose of study medication.

Countries

Australia, Austria, Belgium, Brazil, Canada, Germany, Mexico, Puerto Rico, Switzerland, United States

Participant flow

Recruitment details

Patients with Chronic Hepatitis C, Genotype 2 or 3 who had started therapy with PEG-IFN alfa-2a plus ribavirin according to local standard of care during a pre-study run-in phase and did not achieve a rapid viral response defined as HCV RNA \<15 IU/mL at Week 4 of treatment were eligible and entered the screening phase between treatment Weeks 4-8.

Pre-assignment details

235 patients enrolled and continued with the dose regimens they were taking prior to enrolment up to Week 24 of treatment. Patients who achieved at least a 2-log10 drop of HCV RNA at Week 12 (compared to HCV RNA prior to treatment initiation) or had HCV RNA \<15 IU/mL and who were still taking study medication at Week 24, were randomized at Week 24.

Participants by arm

ArmCount
PEG-IFN Alfa-2a + Ribavirin for 24 Weeks
After 24 weeks of treatment with peginterferon alfa-2a (PEG-IFN alfa-2a) 180 μg/week plus ribavirin 800-1200 mg/day participants who achieved at least a 2-log10 drop of hepatitis C virus (HCV) ribonucleic acid (RNA) at Week 12 (as compared to HCV RNA levels prior to treatment initiation) or had HCV RNA \<15 IU/mL, and who were still taking study medication at treatment Week 24 were randomized into the study, at which time treatment was stopped. Participants were followed for an additional 48 weeks during the treatment-free follow-up period.
95
PEG-IFN Alfa-2a + Ribavirin for 48 Weeks
After 24 weeks of treatment with PEG-IFN alfa-2a 180 μg/week plus ribavirin 800-1200 mg/day participants who achieved at least a 2-log10 drop of HCV RNA at Week 12 (as compared to HCV RNA levels prior to treatment initiation) or had HCV RNA \<15 IU/mL, and who were still taking study medication at treatment Week 24 were randomized into the study, and continued treatment for another 24 weeks (for a total of 48 weeks of treatment). Participants were followed for an additional 24 weeks during the treatment-free follow-up period.
93
Total188

Withdrawals & dropouts

PeriodReasonFG000FG001
Follow-up PeriodDeath01
Follow-up PeriodDid not cooperate03
Follow-up PeriodFailure to return102
Follow-up PeriodHCV-RNA detectable at end of treatment21
Follow-up PeriodPatient withdrew consent54
Follow-up PeriodReason not specified11
Follow-up PeriodRelapse post-treatment113
Treatment PeriodAdverse event/intercurrent illness09
Treatment PeriodDeath01
Treatment PeriodDid not cooperate / refused treatment013
Treatment PeriodInsufficient therapeutic response02
Treatment PeriodOther01
Treatment PeriodWithdrawal by Subject01

Baseline characteristics

CharacteristicTotalPEG-IFN Alfa-2a + Ribavirin for 48 WeeksPEG-IFN Alfa-2a + Ribavirin for 24 Weeks
Age Continuous48.7 years
STANDARD_DEVIATION 9.95
48.6 years
STANDARD_DEVIATION 10.12
48.8 years
STANDARD_DEVIATION 9.83
Age, Customized
≤ 50 years
100 participants53 participants47 participants
Age, Customized
> 50 years
88 participants40 participants48 participants
Hepatitis C virus (HCV) genotype
HCV Genotype 2
38 participants19 participants19 participants
Hepatitis C virus (HCV) genotype
HCV Genotype 3
150 participants74 participants76 participants
Pre-treatment HCV ribonucleic acid (RNA)6.14 log10 IU/mL
STANDARD_DEVIATION 0.7
6.17 log10 IU/mL
STANDARD_DEVIATION 0.773
6.11 log10 IU/mL
STANDARD_DEVIATION 0.624
Race/Ethnicity, Customized
Asian or oriental
3 participants2 participants1 participants
Race/Ethnicity, Customized
Black
14 participants6 participants8 participants
Race/Ethnicity, Customized
Caucasian or white
163 participants81 participants82 participants
Race/Ethnicity, Customized
Other
8 participants4 participants4 participants
Region
Non-U.S.
167 participants82 participants85 participants
Region
U.S.
21 participants11 participants10 participants
Sex: Female, Male
Female
79 Participants39 Participants40 Participants
Sex: Female, Male
Male
109 Participants54 Participants55 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
81 / 9587 / 93
serious
Total, serious adverse events
4 / 9511 / 93

Outcome results

Primary

Percentage of Participants With a Sustained Virologic Response 24 Weeks After Actual End of Treatment

Sustained virological response (SVR) is defined as a single last HCV RNA measurement \<15 IU/ml (measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test) at 24 weeks after actual end of study treatment. For participants in the 48-week treatment group who stopped study treatment prior to Week 48 for any reason, the HCV RNA measurements 24 weeks after actual end of treatment were used in the analysis. Participants without a 24-week post treatment measurement are considered non-responders.

Time frame: 24 weeks after actual end of treatment (range from Week 48 to Week 72).

Population: All randomized patients.

ArmMeasureValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksPercentage of Participants With a Sustained Virologic Response 24 Weeks After Actual End of Treatment52 percentage of participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksPercentage of Participants With a Sustained Virologic Response 24 Weeks After Actual End of Treatment61 percentage of participants
p-value: 0.193495% CI: [0.38, 1.21]Cochran-Mantel-Haenszel
Primary

Percentage of Participants With a Sustained Virologic Response 24 Weeks After Scheduled Completion of Treatment

Sustained virological response (SVR) is defined as a single last HCV RNA measurement \<15 IU/ml (measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test) 24 weeks after scheduled treatment completion, defined as Week 44 or later for participants randomized to the 24-week treatment period or Week 68 or later for participants randomized to the 48-week treatment period. Participants without measurements at the end of the 24-week untreated follow-up period were considered non-responders in the analysis.

Time frame: 24 weeks after scheduled treatment completion (approximately Week 48 for participants in the 24-week treatment group and Week 72 for participants in the 48-week treatment group.

Population: All randomized patients.

ArmMeasureValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksPercentage of Participants With a Sustained Virologic Response 24 Weeks After Scheduled Completion of Treatment52 percentage of participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksPercentage of Participants With a Sustained Virologic Response 24 Weeks After Scheduled Completion of Treatment57 percentage of participants
Comparison: In order to detect an improvement in SVR rate across all strata equivalent to an odds ratio of 2 (i.e. an increase in SVR by 15 to 16 percentage points at a power of 80% and a two-sided significance level of 0.05, 160 patients per treatment group (320 patients in total) were required.p-value: 0.455795% CI: [0.45, 1.43]Cochran-Mantel-Haenszel
Secondary

Number of Participants With Adverse Events (AEs)

An AE was defined as a sign or symptom, including intercurrent illness, that occurred during the course of the clinical study after treatment had started. A related AE is an event assessed by the Investigator to be remotely, possibly, or probably related to study treatment according to criteria provided in the protocol. A severe AE was an event graded by the Investigator as incapacitating with inability to work or perform normal daily activity. A serious AE (SAE) was defined as any experience that suggests a significant hazard, contraindication, side effect or precaution. This includes any experience which was fatal; was life-threatening; required inpatient hospitalization or prolongation of an existing hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/ birth defect; was medically significant or required intervention to prevent one or other of the outcomes listed above.

Time frame: From Week 1 through Week 72.

ArmMeasureGroupValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)Any AE81 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)Severe AE13 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)AE related to PEG-IFN alfa-2a78 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)AE related to ribavirin72 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)Serious AE4 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)SAE related to PEG-IFN alfa-2a0 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)SAE related to ribavirin0 participants
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksNumber of Participants With Adverse Events (AEs)Deaths0 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)Deaths1 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)Any AE88 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)Serious AE11 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)Severe AE24 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)SAE related to ribavirin4 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)AE related to PEG-IFN alfa-2a86 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)SAE related to PEG-IFN alfa-2a7 participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksNumber of Participants With Adverse Events (AEs)AE related to ribavirin83 participants
Secondary

Percentage of Participants With a Sustained Virologic Response 12 Weeks After Actual End of Treatment

Sustained virological response (SVR) is defined as a single last HCV RNA measurement \<15 IU/ml (measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test) at 12 weeks after actual end of study treatment. For participants in the 48-week treatment group who stopped study treatment prior to Week 48 for any reason, the HCV RNA measurements 12 weeks after actual end of treatment were used in the analysis. Participants without a 12-week post treatment measurement are considered non-responders.

Time frame: 12 weeks after actual end of treatment (range from Week 36 to Week 60)

Population: All randomized patients.

ArmMeasureValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksPercentage of Participants With a Sustained Virologic Response 12 Weeks After Actual End of Treatment52 percentage of participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksPercentage of Participants With a Sustained Virologic Response 12 Weeks After Actual End of Treatment61 percentage of participants
p-value: 0.193495% CI: [0.38, 1.21]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With Virological Relapse

Virological relapse defined as the percentage of participants with a virological response at end of treatment but who did not have a sustained virological response 24 weeks after the end of treatment. Virological response at end of treatment is defined as a single last HCV RNA measurement \<15 IU/ml measured using the Roche COBAS AmpliPrep / COBAS TaqMan HCV Test at the day of last dose of study medication. Sustained virological response 24 weeks after the actual treatment end (SVR24) is defined as a single last HCV RNA measurement \<15 IU/ml at least 20 weeks after treatment end.

Time frame: End of treatment (Weeks 24 or 48) and 24 weeks after the end of treatment (weeks 48 and 72 in each treatment group respectively).

Population: Randomized patients with virological response at the end of treatment and at least one post-treatment HCV RNA measurement.

ArmMeasureValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksPercentage of Participants With Virological Relapse41 percentage of participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksPercentage of Participants With Virological Relapse29 percentage of participants
Secondary

Percentage of Participants With Virological Response 72 Weeks After Treatment Initiation

Virological response 72 weeks after treatment initiation is defined as the percentage of participants with HCV RNA \<15 IU/mL as measured by the Roche COBAS AmpliPrep / COBAS TaqMan® HCV Test at 48 weeks post completion of the 24 week treatment period and 24 weeks post completion of the 48 week treatment period. Participants without Week 72 measurements were considered non-responders in the analysis.

Time frame: Week 72

Population: All randomized patients.

ArmMeasureValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksPercentage of Participants With Virological Response 72 Weeks After Treatment Initiation44 percentage of participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksPercentage of Participants With Virological Response 72 Weeks After Treatment Initiation57 percentage of participants
p-value: 0.078895% CI: [0.33, 1.06]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With Virological Response at End of Treatment

Virological response at the end of treatment was defined as the percentage of participants with HCV RNA \<15 IU/mL as measured by the Roche COBAS AmpliPrep / COBAS TaqMan® HCV Test after the last dose of study medication.

Time frame: End of Treatment (Week 24 and Week 48 for each treatment group respectively).

Population: All randomized patients. A backward imputation approach was used when the HCV RNA measurement at end of treatment was missing and HCV RNA was \<15 IU/mL at the first measurement after the end of treatment time window (the patient was regarded as having virological response at end of treatment).

ArmMeasureValue (NUMBER)
PEG-IFN Alfa-2a + Ribavirin for 24 WeeksPercentage of Participants With Virological Response at End of Treatment93 percentage of participants
PEG-IFN Alfa-2a + Ribavirin for 48 WeeksPercentage of Participants With Virological Response at End of Treatment90 percentage of participants
p-value: 0.565495% CI: [0.48, 3.87]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026