Hepatitis C, Chronic
Conditions
Brief summary
Study to assess the antiviral efficacy, pharmacokinetics and tolerability of BILN 2061 ZW in a polyethyleneglycol 400 (PEG 400: ethanol) drinking solution given for two days bid in patients with chronic Hepatitis C Virus (HCV) infection.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Female or male sex, age of 18 years or older * Active, chronic Hepatitis C virus (HCV) infection * Liver biopsy consistent with active HCV infection obtained within the last 12 months * Written informed consent consistent with International Committee on Harmonization (ICH) / Good Clinical Practice (GCP) and local legislation given prior to any study procedures * HCV of genotype I (Group 1, 2, 4 and 5) and non-genotype 1 (Group 3) * HCV load greater than 50,000 copies messenger ribonucleic acid (mRNA) per ml serum at screening * For Group 5 only: Histology showing moderate or severe fibrosis (portal fibrosis, septae, periportal and porto-central septae), no regenerative nodes and no incomplete or complete cirrhosis, corresponding to Ishak score 3 or 4, or Metavir F2 or F3 (if Ishak is not 5)
Exclusion criteria
* Women of childbearing potential or breastfeeding women. Postmenopausal women less than 6 months after last menses, surgically sterilized or hysterectomised patients less than 3 months after operation or without a negative serum pregnancy test * Males not using an adequate form of contraception (condom, sterilisation at least 6 months post operation) if their partner is of childbearing potential (criteria see above) and is not using an adequate form of contraception (hormonal contraceptives, oral or injectable/ implantable, intra-uterine device (IUD)) * Any other or additional plausible cause for chronic liver disease, including the presence of other viruses known or suspected to cause hepatitis * Ascites or other current evidence of portal hypertension * Histology showing signs of bridging or higher grade fibrosis (e.g. Fibrosis \>= Grade 3 (Ishak score) or \>= 2 (Metavir score) for treatment groups 1, 2, 3, 4 or for Treatment group 5: Histology showing less than moderate or severe fibrosis (portal fibrosis, septae, periportal and porto-central septae), or showing regenerative nodes or incomplete or complete cirrhosis, corresponding to other Ishak scores than 3 or 4 and to other Metavir scores than F2 or F3 (or F3 and Ishak 5) * History of abuse of alcohol within the past twelve months * Planned or concurrent usage of any other pharmacological therapy at screening, including any antiviral therapy * Any concurrent infectious disease requiring antimicrobial treatment * History of malignancy (except for previously cured squamous cell or basal cell carcinoma) * Usage of any investigational drug within thirty (30) days prior to enrolment; or the planned usage of an investigational drug during the course of the current study * Known hypersensitivity to drugs * Inability to comply with the protocol * Prior randomization into this trial * Child´s B or C liver diseases at screening (treatment groups 1, 2, 3, 4). Applicable for treatment group 5 only: * For Bilirubin - refer to following exclusion criterion * Quick (Prothrombin time) \< 70% * Albumin \< 3.5 g/dl * Clinical evidence of ascites * Clinical evidence of encephalopathy * Clinically apparent jaundice or a total bilirubin or alkaline phosphatase (AP) exceeding 1.5 x upper limit of normal (ULN) at screening (treatment groups 1, 2, 3, 4). Treatment group 5 (BILN 2061 ZW, 200 mg bid/2 days in patients with advanced liver fibrosis): Clinically apparent jaundice or a bilirubin \>= 2.0 mg/dl at screening. Increased alkaline phosphatase (AP) is allowed. * ALT or AST \> 5 x ULN at screening (treatment groups 1, 2, 3, 4). Treatment group 5: ALT or AST \>= 10 x ULN at screening * A platelet count of less than 100.000 platelets per mm3 at screening * White blood cell count of less than 2,000 cells per mm3 at screening * Positive test for human immunodeficiency Virus (HIV) at screening * Positive test for illicit or unprescribed drugs or medications at screening. Positive test for cannabis may be allowed if the investigator assesses this result not as clinically significant * Patients with any clinically significant laboratory abnormalities based on the investigator's medical assessment at screening
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Virus load (VL) determined by number of copies of HCV mRNA per ml serum | up to day 14 | Cobas Amplicor HCV Monitor v 2.0 (HCM-2.0, Roche Diagnostics) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total oral clearance of drug from plasma after oral administration, divided by F (CL/F) | up to day 4 | — |
| Number of patients with clinically relevant changes in alanine aminotransferase (ALT) | up to day 14 | — |
| Number of patients with clinically relevant changes in aspartate aminotransferase (AST) | up to day 14 | — |
| Number of patients with clinically relevant changes in vital signs | up to day 14 | pulse rate, systolic and diastolic blood pressure |
| Number of patients with clinically relevant changes in electrocardiography (ECG) | up to day 14 | — |
| Assessment of tolerability by investigator on a 4-point scale | day 3 | — |
| Number of patients with clinically relevant changes in routine laboratory tests | up to day 14 | — |
| Number of patients with adverse events | up to 35 days | — |
| Maximum concentration in plasma after a single dose administration (Cmax) | up to day 4 | — |
| Area under the plasma concentration-time curve from t = 0 to t = .τ rate (AUC0-τ) | up to day 4 | — |
| Time to reach Cmax following a single dose administration (tmax) | up to day 4 | — |
| Apparent volume of distribution during the terminal elimination phase (Vz/F) | up to day 4 | — |