Hepatitis C, Chronic
Conditions
Keywords
Chronic HCV infection, raised ALT, transaminitis, HCV infection
Brief summary
This study will evaluate the effect of PF-04136309 in patients with chronic hepatitic C virus infection and abnormal liver enzymes.
Detailed description
Study recruitment was stopped on Dec 15, 2011 due to difficulty in enrolling the targeted number of patients. Subjects currently enrolled into the study will complete the study as per protocol. There were no safety concerns involved in the decision to stop enrollment. The new anticipated Last Subject Last Visit (LSLV) is February 2012.
Interventions
Take 4 capsules twice daily 12 hours apart with water. Swallow whole.
Take 4 capsules twice daily 12 hours apart with water. Swallow whole.
Sponsors
Study design
Eligibility
Inclusion criteria
* Chronic HCV infection * ALT \>1.5 but \<10 times upper limit of normal
Exclusion criteria
* Decompensated or severe liver disease defined by one or more of the following criteria: Prior liver biopsy showing cirrhosis. * International Normalized Ratio (INR) greater than or equal to 1.5. * Total bilirubin greater than or equal to 1.5X ULN, or \>2X ULN for unconjugated bilirubin. * Serum albumin below normal. * ALT or aspartate aminotransferase (AST) \>10 x ULN. * Evidence of portal hypertension including splenomegaly, ascites, encephalopathy, and/or esophageal varices. * Presence of human immunodeficiency virus (HIV). * Co-infection with hepatitis B virus (HBV). * Co-infection with Epstein Barr Virus (EBV) and/or Cytomegalovirus (CMV).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With a Response in Serum Alanine Aminotransferase (ALT) Level at Week 4 | Week 4 | Responder was defined as a participant who experienced reduction in ALT of greater than or equal to (\>=) 30 percent (%) of the baseline value. Baseline ALT value was defined as mean of measurements collected at screening visits 1 and 2 and pre-dose Day 1. ALT levels were determined at central lab. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Baseline, Weeks 1, 2, 3 and 4 | Baseline ALT value was defined as mean of measurements collected at screening visits 1 and 2 and pre-dose Day 1. |
| Serum ALT at Baseline | Baseline | Baseline ALT level was defined as the mean of measurements collected on Screening visits 1 and 2 and pre-dose Day 1. |
| Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Baseline, Weeks 1, 2, 3 and 4 | Baseline AST level was defined as the mean of measurements collected on screening visit 1 and pre-dose Day 1. |
| Serum AST at Baseline | Baseline | Baseline AST level was defined as the mean of measurements collected on screening visit 1 and pre-dose Day 1. |
| Change From Baseline in Methacetin Breath Test (BreathID) at Weeks 1 and 4 | Baseline, Weeks 1 and 4 | After drinking 13ˆC-methacetin, participants breath was collected using a BreathID® collection system for approximately 60 minutes and the ratio of 13ˆCO2:12ˆCO2 were determined to monitor the function of the liver. Results to be reported in ratio. |
| Change From Baseline in Enhanced Liver Fibrosis Test (ELF) at Week 4 | Baseline, Week 4 | Markers of fibrosis assessed in the ELF test comprise hyaluronic acid (HA), tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), and amino terminal peptide of pro-collagen III (PIIINP). The HA ranges from 0 to 1000 in ng/mL; the TIMP-1 ranges from 0 to 3000 ng/mL; and the PIIINP tissue ranges from 0 to 151 in nanograms/milliliter (ng/mL). ELF algorithm calculates a discriminant score (DS) specified by DS = -7.412 plus (+) 0.681 times (\*)ln(HA)+ 0.494 \* ln(TIMP1)+ 0.775 \* ln(PIIINP). Results to be reported in discriminant score. |
| Percentage of Participants With a Response in Serum Aspartate Aminotransferase (AST) Level From Baseline at Week 4 | Week 4 | AST responder status was defined as a reduction in AST \>= 30% of the baseline value and or normalization. Baseline AST level was defined as the mean of measurements collected on screening visit 1 and pre-dose Day 1. AST levels were determined at central lab. |
| Plasma Decay Half-Life (t1/2) of PF-04136309 | Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28 | Plasma decay half-life was the time measured for the plasma concentration to decrease by one half. |
| Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) of PF-04136309 | Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28 | AUCtau was defined as area under the concentration curve from time zero to end of dosing interval of PF-04136309. |
| Time to Reach Maximum Observed Plasma Concentration (Tmax) of PF-04136309 | Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28 | Tmax was defined as time to reach maximum observed plasma concentration of PF-04136309. |
| Change From Baseline in Phosphorylated Extracellular Signal- Regulated Kinase (p-ERK) Levels at Week 2 and 4 | Baseline, Week 2 and 4 | p-ERK is a biomarker used to assess bioavailability of PF-04136309. Baseline p-ERK level defined as the last pre-dose measurement. |
| Baseline p-ERK | Baseline | p-ERK is a biomarker used to assess bioavailability of PF-04136309. Baseline p-ERK level defined as the last pre-dose measurement. |
| Maximum Observed Plasma Concentration (Cmax) of PF-04136309 | Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28 | Cmax was defined as maximum observed plasma concentration of PF-04136309. |
Countries
Hong Kong, India, Singapore, South Korea, Taiwan
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| PF-04136309 PF-04136309 administered orally as four 125 mg capsules twice daily for up to 4 weeks. | 12 |
| Placebo PF-04136309 matched placebo capsules administered as four capsules twice daily for up to 4 weeks. | 12 |
| Total | 24 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 |
| Overall Study | No longer willing to participate | 1 | 0 |
| Overall Study | Protocol Violation | 0 | 1 |
Baseline characteristics
| Characteristic | PF-04136309 | Placebo | Total |
|---|---|---|---|
| Age, Customized 18 to 44 years | 1 Participants | 2 Participants | 3 Participants |
| Age, Customized 45 to 64 years | 11 Participants | 10 Participants | 21 Participants |
| Sex: Female, Male Female | 6 Participants | 7 Participants | 13 Participants |
| Sex: Female, Male Male | 6 Participants | 5 Participants | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 8 / 12 | 3 / 12 |
| serious Total, serious adverse events | 2 / 12 | 0 / 12 |
Outcome results
Percentage of Participants With a Response in Serum Alanine Aminotransferase (ALT) Level at Week 4
Responder was defined as a participant who experienced reduction in ALT of greater than or equal to (\>=) 30 percent (%) of the baseline value. Baseline ALT value was defined as mean of measurements collected at screening visits 1 and 2 and pre-dose Day 1. ALT levels were determined at central lab.
Time frame: Week 4
Population: Full Analysis Set (FAS): all randomized participants who had a baseline value and at least 1 post-baseline value. Missing data was imputed using last observation carried forward (LOCF).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PF-04136309 | Percentage of Participants With a Response in Serum Alanine Aminotransferase (ALT) Level at Week 4 | 25.00 Percentage of participants |
| Placebo | Percentage of Participants With a Response in Serum Alanine Aminotransferase (ALT) Level at Week 4 | 36.36 Percentage of participants |
Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) of PF-04136309
AUCtau was defined as area under the concentration curve from time zero to end of dosing interval of PF-04136309.
Time frame: Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28
Population: PK parameter analysis set included all enrolled participants treated and who had at least 1 of the PK parameters of interest. Here, Overall Number of Participants Analyzed signifies number of participants who were evaluable for this outcome measure.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| PF-04136309 | Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) of PF-04136309 | 12940 Nanograms*hour per milliliter | Standard Deviation 6945.8 |
Baseline p-ERK
p-ERK is a biomarker used to assess bioavailability of PF-04136309. Baseline p-ERK level defined as the last pre-dose measurement.
Time frame: Baseline
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value; Observed data
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PF-04136309 | Baseline p-ERK | 29.63 Percentage of p-ERK | Standard Deviation 24.451 |
| Placebo | Baseline p-ERK | 23.94 Percentage of p-ERK | Standard Deviation 16.435 |
Change From Baseline in Enhanced Liver Fibrosis Test (ELF) at Week 4
Markers of fibrosis assessed in the ELF test comprise hyaluronic acid (HA), tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), and amino terminal peptide of pro-collagen III (PIIINP). The HA ranges from 0 to 1000 in ng/mL; the TIMP-1 ranges from 0 to 3000 ng/mL; and the PIIINP tissue ranges from 0 to 151 in nanograms/milliliter (ng/mL). ELF algorithm calculates a discriminant score (DS) specified by DS = -7.412 plus (+) 0.681 times (\*)ln(HA)+ 0.494 \* ln(TIMP1)+ 0.775 \* ln(PIIINP). Results to be reported in discriminant score.
Time frame: Baseline, Week 4
Population: Data for this outcome measure was not collected because there was a change in planned analysis owing to low enrolment number in the study.
Change From Baseline in Methacetin Breath Test (BreathID) at Weeks 1 and 4
After drinking 13ˆC-methacetin, participants breath was collected using a BreathID® collection system for approximately 60 minutes and the ratio of 13ˆCO2:12ˆCO2 were determined to monitor the function of the liver. Results to be reported in ratio.
Time frame: Baseline, Weeks 1 and 4
Population: Data for this outcome measure was not collected because there was a change in planned analysis owing to low enrolment number in the study.
Change From Baseline in Phosphorylated Extracellular Signal- Regulated Kinase (p-ERK) Levels at Week 2 and 4
p-ERK is a biomarker used to assess bioavailability of PF-04136309. Baseline p-ERK level defined as the last pre-dose measurement.
Time frame: Baseline, Week 2 and 4
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value. Missing data was imputed using LOCF.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| PF-04136309 | Change From Baseline in Phosphorylated Extracellular Signal- Regulated Kinase (p-ERK) Levels at Week 2 and 4 | Change at Week 2 | -19.00 Percentage of p-ERK |
| PF-04136309 | Change From Baseline in Phosphorylated Extracellular Signal- Regulated Kinase (p-ERK) Levels at Week 2 and 4 | Change at Week 4 | -19.39 Percentage of p-ERK |
| Placebo | Change From Baseline in Phosphorylated Extracellular Signal- Regulated Kinase (p-ERK) Levels at Week 2 and 4 | Change at Week 2 | 3.06 Percentage of p-ERK |
| Placebo | Change From Baseline in Phosphorylated Extracellular Signal- Regulated Kinase (p-ERK) Levels at Week 2 and 4 | Change at Week 4 | -3.05 Percentage of p-ERK |
Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4
Baseline ALT value was defined as mean of measurements collected at screening visits 1 and 2 and pre-dose Day 1.
Time frame: Baseline, Weeks 1, 2, 3 and 4
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value. Missing data was imputed using LOCF.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| PF-04136309 | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 1 | 11.75 International units per liter |
| PF-04136309 | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 2 | -9.40 International units per liter |
| PF-04136309 | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 3 | -9.90 International units per liter |
| PF-04136309 | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 4 | -8.25 International units per liter |
| Placebo | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 4 | -32.87 International units per liter |
| Placebo | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 1 | -13.70 International units per liter |
| Placebo | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 3 | -25.08 International units per liter |
| Placebo | Change From Baseline in Serum ALT at Weeks 1, 2, 3 and 4 | Change at Week 2 | -22.89 International units per liter |
Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4
Baseline AST level was defined as the mean of measurements collected on screening visit 1 and pre-dose Day 1.
Time frame: Baseline, Weeks 1, 2, 3 and 4
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value. Missing data was imputed using LOCF.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) |
|---|---|---|---|
| PF-04136309 | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 1 | 5.90 International units per liter |
| PF-04136309 | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 2 | -5.60 International units per liter |
| PF-04136309 | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 3 | -1.65 International units per liter |
| PF-04136309 | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 4 | 5.22 International units per liter |
| Placebo | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 4 | -23.97 International units per liter |
| Placebo | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 1 | -15.98 International units per liter |
| Placebo | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 3 | -15.74 International units per liter |
| Placebo | Change From Baseline in Serum AST at Weeks 1, 2, 3 and 4 | Change at Week 2 | -14.89 International units per liter |
Maximum Observed Plasma Concentration (Cmax) of PF-04136309
Cmax was defined as maximum observed plasma concentration of PF-04136309.
Time frame: Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28
Population: Pharmacokinetic (PK) parameter analysis set included all enrolled participants treated and who had at least 1 of the PK parameters of interest. Here, Overall Number of Participants Analyzed signifies number of participants who were evaluable for this outcome measure.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| PF-04136309 | Maximum Observed Plasma Concentration (Cmax) of PF-04136309 | 3448 Nanogram per milliliter | Standard Deviation 1098.8 |
Percentage of Participants With a Response in Serum Aspartate Aminotransferase (AST) Level From Baseline at Week 4
AST responder status was defined as a reduction in AST \>= 30% of the baseline value and or normalization. Baseline AST level was defined as the mean of measurements collected on screening visit 1 and pre-dose Day 1. AST levels were determined at central lab.
Time frame: Week 4
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value. Missing data was imputed using LOCF.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PF-04136309 | Percentage of Participants With a Response in Serum Aspartate Aminotransferase (AST) Level From Baseline at Week 4 | 8.33 Percentage of participants |
| Placebo | Percentage of Participants With a Response in Serum Aspartate Aminotransferase (AST) Level From Baseline at Week 4 | 36.36 Percentage of participants |
Plasma Decay Half-Life (t1/2) of PF-04136309
Plasma decay half-life was the time measured for the plasma concentration to decrease by one half.
Time frame: Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28
Population: PK parameter analysis set included all enrolled participants treated and who had at least 1 of the PK parameters of interest. Here, Overall Number of Participants Analyzed signifies number of participants who were evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PF-04136309 | Plasma Decay Half-Life (t1/2) of PF-04136309 | 14.71 Hours | Standard Deviation 1.4594 |
Serum ALT at Baseline
Baseline ALT level was defined as the mean of measurements collected on Screening visits 1 and 2 and pre-dose Day 1.
Time frame: Baseline
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value; Observed data
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PF-04136309 | Serum ALT at Baseline | 132.2 International units per liter | Standard Deviation 61.57 |
| Placebo | Serum ALT at Baseline | 154.7 International units per liter | Standard Deviation 81.47 |
Serum AST at Baseline
Baseline AST level was defined as the mean of measurements collected on screening visit 1 and pre-dose Day 1.
Time frame: Baseline
Population: FAS population included all randomized participants who had a baseline value and at least 1 post-baseline value; Observed data
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PF-04136309 | Serum AST at Baseline | 96.6 International units per liter | Standard Deviation 47.29 |
| Placebo | Serum AST at Baseline | 110.6 International units per liter | Standard Deviation 48.47 |
Time to Reach Maximum Observed Plasma Concentration (Tmax) of PF-04136309
Tmax was defined as time to reach maximum observed plasma concentration of PF-04136309.
Time frame: Pre-dose, 0.5, 1, 2, 4, 6, 8 and 12 hours post-dose on Day 28
Population: PK parameter analysis set included all enrolled participants treated and who had at least 1 of the PK parameters of interest. Here, Overall Number of Participants Analyzed signifies number of participants who were evaluable for this outcome measure.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| PF-04136309 | Time to Reach Maximum Observed Plasma Concentration (Tmax) of PF-04136309 | 0.500 Hours |