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Phase 3 Efficacy and Safety Study of Peginterferon Lambda-1a and Ribavirin With Telaprevir

A Phase 3 Blinded Randomized Study of Peginterferon Lambda-1a and Ribavirin Compared to Peginterferon Alfa-2a and Ribavirin, Each Administered With Telaprevir in Subjects With Genotype-1 Chronic Hepatitis C Who Are Treatment-naive or Relapsed on Prior Treatment With Peginterferon Alfa-2a and Ribavirin

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01598090
Acronym
PEDESTAL
Enrollment
881
Registered
2012-05-15
Start date
2012-06-14
Completion date
2015-05-15
Last updated
2019-07-31

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

Conditions

Hepatitis C Virus

Brief summary

The purpose of this study is to determine whether Peginterferon Lambda-1a (Lambda) combined with Ribavirin (RBV) and Telaprevir (TVR) is effective in the treatment of chronic Hepatitis C (CHC) compared to Peginterferon Alfa-2a (alfa-2a) combined with RBV and Telaprevir.

Interventions

Syringes, subcutaneous (SC), 180μg, Once weekly, 24 or 48 weeks depending on response

BIOLOGICALPeginterferon Alfa-2a

Syringes, SC, 180μg, Once weekly, 24 or 48 weeks depending on response

DRUGRibavirin

Tablets, Oral, 1000 or 1200 mg based on weight, twice daily, 24 or 48 weeks depending on response

DRUGTelaprevir

Tablets, Oral, 750 mg, three times a day, 12 weeks only

Sponsors

Bristol-Myers Squibb
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

For more information regarding BMS clinical trial participation, please visit www.BMSStudyConnect.com. Inclusion Criteria: * Chronic hepatitis C genotype 1. GT-1b Capped at 50 % of naïve subjects * Naives to prior anti-HCV therapy \[Interferon (IFN) and direct antiviral agent (DAA) based\] * Relapsers (defined as subjects who had undetectable HCV ribonucleic acid (RNA) on prior treatment regimen of alfa-2a/RBV and Hepatitis C Virus (HCV) RNA \> 25IU/mL after discontinuation of treatment). Capped at 20% * HCV RNA ≥ 100,000 IU/mL * Subjects with compensated cirrhosis can be enrolled and will be capped at approximately 10% * Seronegative for human immunodeficiency virus (HIV) and hepatitis B surface antigen (HBsAg) * Men or women, 18-70 years of age

Exclusion criteria

* Chronic liver disease due to causes other than chronic HCV * Current or past evidence of decompensation * Conditions that preclude the use of Alfa/RBV/TVR per respective labels * Diagnosed or suspected hepatocellular carcinoma

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Extended Rapid Virologic Response (eRVR) - Part AAssessed at Week 4 and Week 12, week 12 reportedeRVR was defined as Hepatitis C virus (HCV) RNA level below the lower limit of quantitation, target not detected at Weeks 4 and 12 of treatment. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).
Percentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part BFollow-up Week 12SVR12 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation, target detected or not detected at Week 12 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).
Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ADay 1 of treatment up to Week 48An AE was defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a participant or clinical investigation participant administered an investigational (medicinal product. An SAE was defined as any untoward medical occurrence that at any dose resulted in death, was life-threatening, required inpatient hospitalization or caused prolongation of existing hospitalization.

Secondary

MeasureTime frameDescription
Percentage of Participants With Treatment Emergent Cytopenic Abnormalities - Part BAfter Day 1 of treatment up to Week 48Cytopenic abnormalities included anemia defined as hemoglobin \<10 grams/decilitre; neutropenia defined as Absolute neutrophil count (ANC) \<750 cubic millimetre (mm\^3); thrombocytopenia defined as platelets \<50,000 mm\^3.
Percentage of Participants With Extended Rapid Virologic Response (eRVR) - Part BWeek 4 and Week 12eRVR was defined as Hepatitis C virus (HCV) RNA level below the lower limit of quantitation, target not detected at Weeks 4 and 12 of treatment. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).
Percentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part AFollow-up Week 12SVR12 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation (LLOQ), target detected or not detected at Week 12 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (LLOQ =25 IU/mL; limit of detection \ 10 IU/mL).
Percentage of Participants With Sustained Virologic Response at Follow- upWeek 24 (SVR24) - Part BFollow-up Week 24SVR24 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation (LLOQ), target detected or not detected at Week 24 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (LLOQ) =25 IU/mL; limit of detection \ 10 IU/mL).
Percentage of Participants With RashAfter Day 1 of treatment up to Week 48All skin reactions involving rash or rash-like events that occurred on treatment were reported.
Percentage of Participants With On-Treatment Flu-Like Symptoms And Musculoskeletal Symptoms- Part BAfter Day 1 of treatment up to Week 48Flu-like symptoms included pyrexia, chills, and pain. Musculoskeletal symptoms included arthralgia, myalgia, and back pain.
Percentage of Subjects With Sustained Virologic Response at Follow-Up Week 24 (SVR24) - Part AFollow up week 24SVR24 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation (LLOQ), target detected or not detected at Week 24 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (LLOQ) =25 IU/mL; limit of detection \ 10 IU/mL). The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.
Percentage of Treatment-Naïve Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part BFollow-up Week 12SVR12 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation, target detected or not detected at Week 12 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).

Countries

Austria, Belgium, Brazil, Canada, Czechia, France, Germany, Israel, Italy, Poland, Russia, Spain, Switzerland, United Kingdom, United States

Participant flow

Pre-assignment details

Out of 881 participants who were enrolled, 648 were randomized and only 644 were treated. 27 participants were treated in Part A and 617 participants were treated in Part B of the study.

Participants by arm

ArmCount
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)
Participants with genotype (GT) -1 chronic Hepatitis C virus infection received Peginterferon Lambda-1a 180 mcg subcutaneously, once weekly for 24 or 48 weeks depending on the extended rapid virologic response (eRVR); Ribavirin 1000 or 1200 mg (based on weight) tablets, orally daily in 2 divided doses for 24 or 48 weeks depending on the eRVR response; Telaprevir 750 mg tablets, orally three times a day for 12 weeks. Participants were followed-up for 48 weeks after treatment period.
27
Part B: Peginterferon Lambda-1a + RBV + TVR
Participants who were either treatment naive or who were relapsers to previous Peginterferon alfa- 2a/ribavirin treatment received Peginterferon Lambda-1a 180 mcg subcutaneously, once weekly for 24 or 48 weeks depending on the extended rapid virologic response (eRVR); Ribavirin 1000 or 1200 mg (based on weight) tablets, orally daily in 2 divided doses for 24 or 48 weeks depending on the eRVR response; Telaprevir 750 mg tablets, orally three times a day for 12 weeks. Participants were followed-up for 48 weeks after treatment period.
411
Part B: Peginterferon Alfa-2a + RBV + TVR
Participants who were either treatment naive or who were relapsers to previous Peginterferon alfa- 2a/ribavirin treatment received Peginterferon alfa-2a 180 mcg subcutaneously, once weekly for 24 or 48 weeks depending on the extended rapid virologic response (eRVR); Ribavirin 1000 or 1200 mg (based on weight) tablets, orally daily in 2 divided doses for 24 or 48 weeks depending on the eRVR response; Telaprevir 750 mg tablets, orally three times a day for 12 weeks. Participants were followed-up for 48 weeks after treatment period.
206
Total644

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Follow-up PeriodDeath010
Follow-up PeriodLost to Follow-up21012
Follow-up PeriodNo longer required per protocol132
Follow-up PeriodNot reported0104
Follow-up PeriodOther reasons288
Follow-up PeriodWithdrawal by Subject032
Treatment PeriodAdverse Event23317
Treatment PeriodLack of Efficacy5146
Treatment PeriodLost to Follow-up151
Treatment PeriodNo longer meet study criteria010
Treatment PeriodOther reasons041
Treatment PeriodPoor/non-compliance020
Treatment PeriodWithdrawal by Subject31310

Baseline characteristics

CharacteristicTotalPart A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Part B: Peginterferon Lambda-1a + RBV + TVRPart B: Peginterferon Alfa-2a + RBV + TVR
Age, Customized
21 - <65 years
616 Participants27 Participants392 Participants197 Participants
Age, Customized
<21 years
7 Participants0 Participants5 Participants2 Participants
Age, Customized
>=65 years
21 Participants0 Participants14 Participants7 Participants
Sex: Female, Male
Female
241 Participants9 Participants152 Participants80 Participants
Sex: Female, Male
Male
403 Participants18 Participants259 Participants126 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 271 / 4111 / 206
other
Total, other adverse events
26 / 27369 / 411197 / 206
serious
Total, serious adverse events
6 / 2743 / 41120 / 206

Outcome results

Primary

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part A

An AE was defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a participant or clinical investigation participant administered an investigational (medicinal product. An SAE was defined as any untoward medical occurrence that at any dose resulted in death, was life-threatening, required inpatient hospitalization or caused prolongation of existing hospitalization.

Time frame: Day 1 of treatment up to Week 48

Population: Safety analysis included all treated participants.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part AAEs26 Participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ASAEs6 Participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ADrug related AEs12 Participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ADiscontinuation due to AEs2 Participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ADeath0 Participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ADose reductions - Lambda3 Participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Drug Related AEs, Discontinuation Due to AEs, Dose Reductions and Death - Part ADose reductions - RBV7 Participants
Primary

Percentage of Participants With Extended Rapid Virologic Response (eRVR) - Part A

eRVR was defined as Hepatitis C virus (HCV) RNA level below the lower limit of quantitation, target not detected at Weeks 4 and 12 of treatment. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).

Time frame: Assessed at Week 4 and Week 12, week 12 reported

Population: The analysis was performed using Modified Intent-to-Treat method, defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Extended Rapid Virologic Response (eRVR) - Part A51.9 Percentage of participants
Primary

Percentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part B

SVR12 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation, target detected or not detected at Week 12 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).

Time frame: Follow-up Week 12

Population: The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part B76.2 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part B82 Percentage of participants
p-value: 0.0855Mantel Haenszel
Secondary

Percentage of Participants With Extended Rapid Virologic Response (eRVR) - Part B

eRVR was defined as Hepatitis C virus (HCV) RNA level below the lower limit of quantitation, target not detected at Weeks 4 and 12 of treatment. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).

Time frame: Week 4 and Week 12

Population: The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Extended Rapid Virologic Response (eRVR) - Part B64 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With Extended Rapid Virologic Response (eRVR) - Part B70.9 Percentage of participants
Secondary

Percentage of Participants With On-Treatment Flu-Like Symptoms And Musculoskeletal Symptoms- Part B

Flu-like symptoms included pyrexia, chills, and pain. Musculoskeletal symptoms included arthralgia, myalgia, and back pain.

Time frame: After Day 1 of treatment up to Week 48

Population: The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

ArmMeasureGroupValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With On-Treatment Flu-Like Symptoms And Musculoskeletal Symptoms- Part BFlu-Like Symptoms14.4 Percentage of participants
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With On-Treatment Flu-Like Symptoms And Musculoskeletal Symptoms- Part BMusculoskeletal symptoms21.4 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With On-Treatment Flu-Like Symptoms And Musculoskeletal Symptoms- Part BFlu-Like Symptoms36.4 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With On-Treatment Flu-Like Symptoms And Musculoskeletal Symptoms- Part BMusculoskeletal symptoms30.6 Percentage of participants
Secondary

Percentage of Participants With Rash

All skin reactions involving rash or rash-like events that occurred on treatment were reported.

Time frame: After Day 1 of treatment up to Week 48

Population: The analysis was performed in all treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Rash63 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With Rash36.3 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With Rash38.3 Percentage of participants
Secondary

Percentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part A

SVR12 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation (LLOQ), target detected or not detected at Week 12 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (LLOQ =25 IU/mL; limit of detection \ 10 IU/mL).

Time frame: Follow-up Week 12

Population: The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part A48.1 Percentage of participants
Secondary

Percentage of Participants With Sustained Virologic Response at Follow- upWeek 24 (SVR24) - Part B

SVR24 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation (LLOQ), target detected or not detected at Week 24 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (LLOQ) =25 IU/mL; limit of detection \ 10 IU/mL).

Time frame: Follow-up Week 24

Population: Analysis was performed using Observed value method, defined as proportions of participants meeting response criteria in numerator and denominator - all treated participants with HCV RNA measured at follow-up Week 24. Analysis was performed in all treated participants with HCV RNA measured at follow-up Week 24 due to early study termination.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Sustained Virologic Response at Follow- upWeek 24 (SVR24) - Part B83 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With Sustained Virologic Response at Follow- upWeek 24 (SVR24) - Part B87 Percentage of participants
Secondary

Percentage of Participants With Treatment Emergent Cytopenic Abnormalities - Part B

Cytopenic abnormalities included anemia defined as hemoglobin \<10 grams/decilitre; neutropenia defined as Absolute neutrophil count (ANC) \<750 cubic millimetre (mm\^3); thrombocytopenia defined as platelets \<50,000 mm\^3.

Time frame: After Day 1 of treatment up to Week 48

Population: The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Participants With Treatment Emergent Cytopenic Abnormalities - Part B11.7 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Participants With Treatment Emergent Cytopenic Abnormalities - Part B55.8 Percentage of participants
Secondary

Percentage of Subjects With Sustained Virologic Response at Follow-Up Week 24 (SVR24) - Part A

SVR24 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation (LLOQ), target detected or not detected at Week 24 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (LLOQ) =25 IU/mL; limit of detection \ 10 IU/mL). The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treated participants.

Time frame: Follow up week 24

Population: Analysis was performed using Observed value method, defined as proportions of participants meeting response criteria in numerator and denominator - all treated participants with HCV RNA measured at follow-up Week 24. Analysis was performed in all treated participants with HCV RNA measured at follow-up Week 24 due to early study termination.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Subjects With Sustained Virologic Response at Follow-Up Week 24 (SVR24) - Part A40.7 Percentage of participants
Secondary

Percentage of Treatment-Naïve Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part B

SVR12 was defined as Hepatitis C virus (HCV) RNA level below lower limit of quantitation, target detected or not detected at Week 12 of post-treatment follow-up. HCV RNA level was measured using the Roche COBAS® TaqMan HCV Test v.2.0 (lower limit of quantitation =25 IU/mL; limit of detection \ 10 IU/mL).

Time frame: Follow-up Week 12

Population: The analysis was performed using Modified Intent-to-Treat method defined as the proportions of participants meeting the response criteria in numerator and denominator based on all treated participants. The analysis was performed in all treatment-naive treated participants.

ArmMeasureValue (NUMBER)
Part A: Peginterferon Lambda-1a + RBV + TVR (Open Label)Percentage of Treatment-Naïve Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part B73.6 Percentage of participants
Part B: Peginterferon Alfa-2a + RBV + TVRPercentage of Treatment-Naïve Participants With Sustained Virologic Response at Follow-up Week 12 (SVR12) - Part B81.9 Percentage of participants

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