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Nitazoxanide Plus Ribavirin and Peginterferon for Therapy of Treatment Naive HCV Genotype 1 and HIV Coinfected Subjects

The Activity of Nitazoxanide in Addition to Peginterferon Alfa-2a and Ribavirin in Chronic Hepatitis C Treatment-Naive Genotype 1 Subjects With HIV Coinfection

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00991289
Enrollment
68
Registered
2009-10-08
Start date
2010-01-31
Completion date
2012-01-31
Last updated
2021-11-04

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

Conditions

Hepatitis C Infection, HIV Infection

Keywords

Hepatitis C genotype 1, HCV treatment naive, HCV/HIV coinfection, Antiretroviral, Ribavirin, Pegylated Interferon alfa, Nitazoxanide

Brief summary

Infection with hepatitis C virus (HCV) can cause liver scarring, or cirrhosis, and this usually occurs more rapidly among people infected with both HCV and human immunodeficiency virus (HIV). People infected with both HCV and HIV have poor response to the current HCV treatments. This phase II pilot study evaluated whether adding a new HCV medication improves response to the current standard HCV treatment with pegylated interferon and ribavirin in people with both HCV and HIV.

Detailed description

Chronic hepatitis C virus (HCV) is a significant cause of liver scarring, or cirrhosis, and accounts for up to 30% of all liver transplants in the United States. People infected with HIV are at a high risk of coinfection with HCV, and the combination of these two infections appears to accelerate progression to cirrhosis. Current treatment for HCV infection includes a 48-week course of two medications taken together, peginterferon alfa-2a (PEG) and ribavirin (RBV). This combination is only effective in 14% to 29% of people infected with both HIV and HCV genotype 1 (the genotype most common in the United States). Further complicating treatment, antiretrovirals (which are used to treat HIV) and HCV medications can often have high toxicity when taken together, limiting dosing. Nitazoxanide (NTZ) is a medication currently approved to treat intestinal infections that is being investigated for use in treating HCV. NTZ has few side effects and has been shown to increase effectiveness of HCV treatment when combined with PEG and RBV among HCV monoinfected people. This study will test whether adding NTZ to PEG+RBV regimen for people coinfected with HCV and HIV improves HCV treatment outcomes. Participation in this study will last up to 76 weeks. At study entry, participants completed a brief physical exam, provided a urine sample for a routine safety test, provided a blood sample, and completed a pregnancy test. Participants then initiated NTZ, which they took twice a day with food for up to a year. After 4 weeks on NTZ, participants completed the second study visit, at which they completed the same assessments as at study entry and were asked about the medications they were taking. At this visit, participants initiated the other two study drugs, PEG and RBV. PEG was delivered via injection weekly and RBV was taken orally twice a day with dose dependent on participant's weight at entry. Participants took NTZ, PEG and RBV together for up to 48 weeks. During this time, participants completed study visits every 4 weeks until Week 52 and then completed follow-up visits at Weeks 64 and 76. At these visits, participants completed the same assessments as at previous visits, and, at certain weeks, also fasted for 8 hours before blood draw. Additional blood samples were collected and stored at Weeks 4, 8, 16, 52 and 76 in order to do future testing. Participants who did not achieve an early virologic response to the study treatment (at least a 2-log10 decrease in HCV viral load or undetectable HCV viral load at Week 16), or had detectable HCV viral load at Week 28), stopped study treatment and discontinued study early, at about 20 or 32 weeks, respectively.

Interventions

500 mg twice daily, taken orally with food

DRUGPegylated interferon alfa-2a (PEG)

180 micrograms via subcutaneous injection once weekly

DRUGRibavirin (RBV)

Weight-based dosing; 1,000 mg daily, taken orally, for people weighing less than 75 kg or 1,200 mg for people weighing at least 75 kg.

Sponsors

National Institute of Allergy and Infectious Diseases (NIAID)
Lead SponsorNIH

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* HIV-1 infection * Documentation of hepatitis C virus (HCV) genotype 1 infection prior to entry * Chronic HCV infection for at least 180 days * CD4+ cell count greater than 200 cells/mm3 obtained within 90 days prior to study entry * Detectable HCV viral load obtained within 90 days prior to study entry * Any change in antiretroviral (ARV) regimen, including initiation of antiretroviral therapy (ART), a switch in ART regimen, or a discontinuation of ART, had to have occurred more than 60 days prior to study entry. Breaks in therapy for a maximum of 14 days total during the 60-day period were allowed. Participants not on ART should have had no plans to initiate therapy during the first 24 weeks after study entry. Participants who did start ART did not have to discontinue study treatment. Participants on ART should have planned to remain on the same therapy for at least 12 weeks after study entry. Changes in formulation or dosage were permitted. * Certain laboratory values obtained within 42 days prior to study entry * Agreement to use contraception, if participating in sexual activity that could lead to pregnancy, for the duration of study and for 6 months afterward * Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase less than or equal to five times the upper limit of normal (ULN) * Hemoglobin \>=11 g/dl for men and \>=10 g/dl for women

Exclusion criteria

* Use of the ARV didanosine (ddI) * Receipt of any interferon * Receipt of any therapy for HCV, including ribavirin (RBV) or experimental treatment * Decompensated cirrhosis * Currently active or other known causes of significant liver disease, including chronic or acute hepatitis B, acute hepatitis A, hemochromatosis, or homozygous alpha-1 antitrypsin deficiency * Pregnancy or breastfeeding * Men with pregnant sexual partners or men planning pregnancy with any sexual partner during treatment or for 24 weeks after treatment completion * Uncontrolled or active depression, other psychiatric disorder, or any hospitalization within the past 52 weeks that, in the opinion of the site investigator, would prevent participation * Prior suicide attempt * Active thyroid disease (use of thyroid hormone replacement therapy permitted if thyroid stimulating hormone \[TSH\] or free thyroxine \[T4\] in the normal range) * History of autoimmune processes, including Crohn's disease, ulcerative colitis, severe psoriasis, or rheumatoid arthritis, that may be exacerbated by interferon use * Systemic antineoplastic or immunomodulatory treatment or radiation within 24 weeks prior to study entry * Serious illness, including malignancy or active coronary artery disease, within 24 weeks prior to study entry * Chronic medical condition that, in the site investigator's opinion, might preclude completion of the protocol * Presence of acute or active opportunistic infections within 24 weeks prior to study entry * Evidence of hepatocellular carcinoma (HCC) or alpha-fetoprotein level of greater than 50 ng/ml unless an imaging procedure (e.g., computed tomography \[CT\] scan or magnetic resonance imaging \[MRI\]) showed no evidence of a hepatic tumor. Each may have been obtained up to 24 weeks before study entry. * History of hemoglobinopathy (e.g., thalassemia) or any other cause of or tendency toward hemolysis * History of major organ transplantation with an existing functional graft * Known allergy, sensitivity, or any hypersensitivity to components of study drugs or their formulations * Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Complete Early Virologic Response (cEVR)Week 16Complete early virologic response (cEVR) was defined as undetectable HCV viral load (\<43 IU/ml) at week 16, where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test).
Percentage of Participants With Early Virologic Response (EVR)Weeks 0, 16Early virologic response (EVR) was defined as undetectable HCV viral load (\<43 IU/ml) at Week 16 or at least a 2-log10 decrease in HCV viral load from study entry at Week 16, where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test).

Secondary

MeasureTime frameDescription
Percentage of Participants With Sustained Virologic Response (SVR)24 weeks after treatment discontinuationSustained virologic response (SVR) was defined as undetectable HCV viral load (\<43 IU/ml) at 24 weeks after treatment discontinuation, where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test). Participants who failed to achieve EVR or had detectable HCV RNA at Week 28 and per protocol discontinued study, and participants without HCV RNA from 24 weeks after treatment discontinuation, were considered non-responders.
Percentage of Participants With Rapid Virologic Response (RVR)Week 8Rapid virologic response (RVR) was defined as undetectable HCV viral load (\<43 IU/ml) at Week 8 where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test).
Number of Participants With Adverse Events of Grade 2 or HigherFrom study entry to up to week 76Number of participants who experienced an adverse event of Grade 2 or higher at any time after study entry. Grading of adverse events (signs and symptoms and laboratory toxicities) was according to Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 1.0, December 2004.
Change in Hemoglobin Level From Study EntryWeeks 0, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 76.Change in hemoglobin (HGB) was calculated as HGB at later time point (Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 76) minus HGB at study entry.
Percent Change in Fasting Insulin Level From Study EntryWeeks 0, 16, 28, 52, and 76Percent Change in fasting insulin (FINS) was calculated as FINS at later time point (16, 28, 52, 76) minus FINS at study entry, divided by FINS at study entry x 100%. Study protocol required fasting for at least 8 hours (nothing by mouth except medications and water) prior to specimen collection for fasting insulin testing.
Percent Change in Fasting Glucose Level From Study EntryWeeks 0, 16, 28, 52, and 76Percent Change in fasting glucose (FGLUC) was calculated as FGLUC at later time point (16, 28, 52, 76) minus FGLUC at study entry, divided by FGLUC at study entry x 100%. Study protocol required fasting for at least 8 hours (nothing by mouth except medications and water) prior to specimen collection for fasting glucose testing.
Percent Change in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) From Study EntryWeeks 0, 16, 28, 52, and 76HOMA-IR was calculated as \[fasting glucose (mg/dL) x fasting insulin (uIU/mL)\]/405. Percent Change in HOMA-IR was calculated as HOMA-IR at later time point (16, 28, 52, 76) minus HOMA-IR at study entry, divided by HOMA-IR at study entry x 100%. Study protocol required fasting for at least 8 hours (nothing by mouth except medications and water) prior to specimen collection for fasting insulin and fasting glucose testing.
Change in log10 HCV Viral Load After 4 Weeks of Nitazoxanide (NTZ) Monotherapy.Weeks 0, 4Change in log10 HCV viral load was calculated as log10-transformed HCV viral load at Week 4 minus log10-transformed HCV viral load at study entry. HCV viral load testing was done using Cobas AmpliPrep/Taqman HCV Test.
Number of Participants With HCV Genotype 1Week 0Confirmatory HCV genotyping was performed on stored plasma from entry using VERSANT HCV Genotype assay v2.0 (LiPA, RUO, Siemens Healthcare Diagnostics Inc., Tarrytown, NY).

Countries

Puerto Rico, United States

Participant flow

Recruitment details

Men and women at least 18 years of age with genotype 1 hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection and naive to previous HCV treatment were recruited for participation in this study.

Participants by arm

ArmCount
NTZ/PEG/RBV
Participants received nitazoxanide (NTZ) alone for 4 weeks followed by up to 48 weeks of NTZ with pegylated interferon (PEG) and ribavirin (RBV). Participants who did not achieve early virologic response (EVR) at Week 16 or had detectable hepatitis C virus (HCV) viral load at Week 28 discontinued treatment.
67
Total67

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event1
Overall StudyLost to Follow-up4
Overall StudyPhysician Decision2
Overall StudyProtocol Violation2
Overall StudyWithdrawal by Subject3

Baseline characteristics

CharacteristicNTZ/PEG/RBV
Age, Continuous48.1 years
STANDARD_DEVIATION 8.5
Age, Customized
25 to <30 years
1 participants
Age, Customized
<25 years
1 participants
Age, Customized
30 to <35 years
4 participants
Age, Customized
35 to <40 years
3 participants
Age, Customized
40 to <45 years
11 participants
Age, Customized
45 to <50 years
13 participants
Age, Customized
50 to <55 years
18 participants
Age, Customized
55 to 60 years
13 participants
Age, Customized
>=60 years
3 participants
CD4+ T cell count452 cells/mm3
HCV viral load level6.4 log10 IU/ml
HIV Antiretroviral therapy (ART) status
Not on ART
6 participant
HIV Antiretroviral therapy (ART) status
On ART
61 participant
Number of participants with indicated HIV viral load
Detectable HIV viral load
16 participants
Number of participants with indicated HIV viral load
Undetectable HIV viral load
49 participants
Number of participants with indicated HIV viral load
Unknown
2 participants
Race/Ethnicity, Customized
Black, Non-Hispanic
32 Participants
Race/Ethnicity, Customized
Hispanic, Regardless of Race
12 Participants
Race/Ethnicity, Customized
Other/Unknown
2 Participants
Race/Ethnicity, Customized
White, Non-Hispanic
21 Participants
Region of Enrollment
United States
67 participants
Sex: Female, Male
Female
15 Participants
Sex: Female, Male
Male
52 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
67 / 67
serious
Total, serious adverse events
13 / 67

Outcome results

Primary

Percentage of Participants With Complete Early Virologic Response (cEVR)

Complete early virologic response (cEVR) was defined as undetectable HCV viral load (\<43 IU/ml) at week 16, where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test).

Time frame: Week 16

Population: All participants who enrolled, except one participant who was found to have been ineligible after entry. The analysis was intention to treat wherein participants who dropped out early without Week 16 HCV viral load result were considered non-responders.

ArmMeasureValue (NUMBER)
NTZ/PEG/RBVPercentage of Participants With Complete Early Virologic Response (cEVR)38.8 percentage of participants
Primary

Percentage of Participants With Early Virologic Response (EVR)

Early virologic response (EVR) was defined as undetectable HCV viral load (\<43 IU/ml) at Week 16 or at least a 2-log10 decrease in HCV viral load from study entry at Week 16, where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test).

Time frame: Weeks 0, 16

Population: All participants who enrolled, except one participant who was found to have been ineligible after entry. The analysis was intention to treat wherein participants who dropped out early without Week 16 HCV viral load result were considered non-responders.

ArmMeasureValue (NUMBER)
NTZ/PEG/RBVPercentage of Participants With Early Virologic Response (EVR)65.7 percentage of participants
Secondary

Change in Hemoglobin Level From Study Entry

Change in hemoglobin (HGB) was calculated as HGB at later time point (Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 76) minus HGB at study entry.

Time frame: Weeks 0, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 76.

Population: All participants who enrolled (except one participant who was found to have been ineligible after entry) and had HGB measurements available at entry and at the respective post-entry time point.

ArmMeasureGroupValue (MEDIAN)
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 4-0.1 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 8-2.1 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 12-2.5 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 16-2.5 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 20-2.5 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 24-2.4 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 28-2.5 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 32-2.7 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 36-2.5 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 40-2.6 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 44-2.6 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 48-2.7 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 52-2.9 g/dL
NTZ/PEG/RBVChange in Hemoglobin Level From Study EntryChange in HGB at Week 76-0.9 g/dL
Secondary

Change in log10 HCV Viral Load After 4 Weeks of Nitazoxanide (NTZ) Monotherapy.

Change in log10 HCV viral load was calculated as log10-transformed HCV viral load at Week 4 minus log10-transformed HCV viral load at study entry. HCV viral load testing was done using Cobas AmpliPrep/Taqman HCV Test.

Time frame: Weeks 0, 4

Population: All participants who enrolled, except one participant who was found to have been ineligible after entry, and had HCV viral load measurements available at entry and at Week 4 were analyzed.

ArmMeasureValue (MEDIAN)
NTZ/PEG/RBVChange in log10 HCV Viral Load After 4 Weeks of Nitazoxanide (NTZ) Monotherapy.-0.12 log10 IU/mL
Secondary

Number of Participants With Adverse Events of Grade 2 or Higher

Number of participants who experienced an adverse event of Grade 2 or higher at any time after study entry. Grading of adverse events (signs and symptoms and laboratory toxicities) was according to Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 1.0, December 2004.

Time frame: From study entry to up to week 76

Population: All participants who enrolled, except one participant who was found to have been ineligible after entry.

ArmMeasureValue (NUMBER)
NTZ/PEG/RBVNumber of Participants With Adverse Events of Grade 2 or Higher65 participants
Secondary

Number of Participants With HCV Genotype 1

Confirmatory HCV genotyping was performed on stored plasma from entry using VERSANT HCV Genotype assay v2.0 (LiPA, RUO, Siemens Healthcare Diagnostics Inc., Tarrytown, NY).

Time frame: Week 0

Population: All participants who enrolled, except one participant who was found to have been ineligible after entry.

ArmMeasureValue (NUMBER)
NTZ/PEG/RBVNumber of Participants With HCV Genotype 167 participants
Secondary

Percentage of Participants With Rapid Virologic Response (RVR)

Rapid virologic response (RVR) was defined as undetectable HCV viral load (\<43 IU/ml) at Week 8 where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test).

Time frame: Week 8

Population: All participants who enrolled, except one participant who was found to have been ineligible after entry. The analysis was intention to treat wherein participants who dropped out early without Week 8 HCV viral load result were considered non-responders.

ArmMeasureValue (NUMBER)
NTZ/PEG/RBVPercentage of Participants With Rapid Virologic Response (RVR)10.4 percentage of participants
Secondary

Percentage of Participants With Sustained Virologic Response (SVR)

Sustained virologic response (SVR) was defined as undetectable HCV viral load (\<43 IU/ml) at 24 weeks after treatment discontinuation, where 43 is the lower limit of quantification of the assay (Cobas AmpliPrep/Taqman HCV Test). Participants who failed to achieve EVR or had detectable HCV RNA at Week 28 and per protocol discontinued study, and participants without HCV RNA from 24 weeks after treatment discontinuation, were considered non-responders.

Time frame: 24 weeks after treatment discontinuation

Population: All participants who enrolled, except one who was found to have been ineligible after entry. The analysis was intention to treat wherein participants who dropped out early without HCV RNA from 24 weeks after treatment discontinuation, non-EVRs and those with detectable HCV RNA at Week 28, were considered non-responders.

ArmMeasureValue (NUMBER)
NTZ/PEG/RBVPercentage of Participants With Sustained Virologic Response (SVR)32.8 percentage of participants
Secondary

Percent Change in Fasting Glucose Level From Study Entry

Percent Change in fasting glucose (FGLUC) was calculated as FGLUC at later time point (16, 28, 52, 76) minus FGLUC at study entry, divided by FGLUC at study entry x 100%. Study protocol required fasting for at least 8 hours (nothing by mouth except medications and water) prior to specimen collection for fasting glucose testing.

Time frame: Weeks 0, 16, 28, 52, and 76

Population: All participants who enrolled (except one participant who was found to have been ineligible after entry) and had FGLUC measurements available at entry and the respective post-entry time point.

ArmMeasureGroupValue (MEDIAN)
NTZ/PEG/RBVPercent Change in Fasting Glucose Level From Study EntryPercent change in FGLUC at Week 16-3.2 percentage of FGLUC at study entry
NTZ/PEG/RBVPercent Change in Fasting Glucose Level From Study EntryPercent change in FGLUC at Week 28-5.3 percentage of FGLUC at study entry
NTZ/PEG/RBVPercent Change in Fasting Glucose Level From Study EntryPercent change in FGLUC at Week 521.1 percentage of FGLUC at study entry
NTZ/PEG/RBVPercent Change in Fasting Glucose Level From Study EntryPercent change in FGLUC at Week 760 percentage of FGLUC at study entry
Secondary

Percent Change in Fasting Insulin Level From Study Entry

Percent Change in fasting insulin (FINS) was calculated as FINS at later time point (16, 28, 52, 76) minus FINS at study entry, divided by FINS at study entry x 100%. Study protocol required fasting for at least 8 hours (nothing by mouth except medications and water) prior to specimen collection for fasting insulin testing.

Time frame: Weeks 0, 16, 28, 52, and 76

Population: All participants who enrolled (except one participant who was found to have been ineligible after entry) and had FINS measurements available at entry and the respective post-entry time point.

ArmMeasureGroupValue (MEDIAN)
NTZ/PEG/RBVPercent Change in Fasting Insulin Level From Study EntryPercent change in FINS at Week 160 percentage of FINS at study entry
NTZ/PEG/RBVPercent Change in Fasting Insulin Level From Study EntryPercent change in FINS at Week 288.8 percentage of FINS at study entry
NTZ/PEG/RBVPercent Change in Fasting Insulin Level From Study EntryPercent change in FINS at Week 5228.2 percentage of FINS at study entry
NTZ/PEG/RBVPercent Change in Fasting Insulin Level From Study EntryPercent change in FINS at Week 768.3 percentage of FINS at study entry
Secondary

Percent Change in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) From Study Entry

HOMA-IR was calculated as \[fasting glucose (mg/dL) x fasting insulin (uIU/mL)\]/405. Percent Change in HOMA-IR was calculated as HOMA-IR at later time point (16, 28, 52, 76) minus HOMA-IR at study entry, divided by HOMA-IR at study entry x 100%. Study protocol required fasting for at least 8 hours (nothing by mouth except medications and water) prior to specimen collection for fasting insulin and fasting glucose testing.

Time frame: Weeks 0, 16, 28, 52, and 76

Population: All participants who enrolled (except one participant who was found to have been ineligible after entry) and had fasting insulin and fasting glucose measurements available at entry and the respective post-entry time point.

ArmMeasureGroupValue (MEDIAN)
NTZ/PEG/RBVPercent Change in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) From Study EntryPercent change in HOMA-IR at Week 76 (n=22)9.5 percentage of HOMA-IR at study entry
NTZ/PEG/RBVPercent Change in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) From Study EntryPercent change in HOMA-IR at Week 16 (n=56)-13.0 percentage of HOMA-IR at study entry
NTZ/PEG/RBVPercent Change in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) From Study EntryPercent change in HOMA-IR at Week 28 (n=39)-6.3 percentage of HOMA-IR at study entry
NTZ/PEG/RBVPercent Change in Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) From Study EntryPercent change in HOMA-IR at Week 52 (n=27)23.2 percentage of HOMA-IR at study entry

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