Title

Study of Nitazoxanide, Peginterferon Alfa-2a and Ribavirin in Treatment-Naive Hepatitis C Patients
Phase II, Randomized, Double-blind, Placebo-controlled Study of Nitazoxanide in Combination With Peginterferon Alfa-2a and Ribavirin in Treatment-Naive Patients With Hepatitis C
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    112
The purpose of this study is to determine if nitazoxanide in combination with peginterferon alfa-2a and ribavirin is safe and effective in treating chronic hepatitis C in treatment-naive patients.
Study Started
Mar 31
2008
Primary Completion
Apr 30
2010
Study Completion
Apr 30
2010
Results Posted
Jan 06
2014
Estimate
Last Update
Feb 10
2014
Estimate

Drug Nitazoxanide

One nitazoxanide 500 mg tablet orally with food twice daily (b.i.d.) for 4 weeks followed by 500 mg nitazoxanide b.i.d. plus one weekly injection of 180µg of peginterferon α-2a plus weight-based ribavirin for 48 weeks.

  • Other names: Alinia

Drug Placebo

One placebo tablet orally with food twice daily (b.i.d.) for 4 weeks followed by placebo b.i.d. plus one weekly injection of 180µg of peginterferon α-2a plus weight-based ribavirin for 48 weeks.

Biological Peginterferon alfa-2a

One weekly injection of 180µg of peginterferon α-2a for 48 weeks.

  • Other names: PEGASYS

Drug Ribavirin

Weight-based ribavirin for 48 weeks.

  • Other names: COPEGUS

1 Experimental

One nitazoxanide 500 mg tablet orally with food twice daily (b.i.d.) for 4 weeks followed by 500 mg nitazoxanide b.i.d. plus one weekly injection of 180µg of peginterferon α-2a plus weight-based ribavirin for 48 weeks.

2 Placebo Comparator

One placebo tablet orally with food twice daily (b.i.d.) for 4 weeks followed by placebo b.i.d. plus one weekly injection of 180µg of peginterferon α-2a plus weight-based ribavirin for 48 weeks.

Criteria

Inclusion Criteria:

Chronic hepatitis C genotype 1.

Exclusion Criteria:

Patients that have previously received treatment with any interferon or interferon-based treatment for chronic hepatitis C.
Females of child-bearing age who are either pregnant, breast-feeding or not using birth control and are sexually active.
Males whose female partners are either pregnant or of child-bearing potential or not using birth control and are sexually active.
Other causes of liver disease including autoimmune hepatitis.
Transplant recipients receiving immune suppression therapy.
Screening tests positive for Anti-Hepatitis A Virus Immunoglobulin M Antibody (anti-HAV IgM Ab), Hepatitis B's antigen (HBsAg), Anti-Hepatitis B core Immunoglobulin M Antibody (anti-HBc IgM Ab) or Anti-Human Immunodeficiency Virus Antibody (anti-HIV Ab).
Decompensated cirrhosis, history of variceal bleeding, ascites, hepatic encephalopathy, Child-Turcotte-Pugh (CTP) score >6 or Model for End-stage Liver Disease (MELD) score >8.
Alcohol consumption of >40 grams per day or an alcohol use pattern that will interfere with the study.
Absolute neutrophil count <1500 cells/mm3; platelet count <135,000 cells/mm3; hemoglobin <12 g/dL for women and <13 g/dL for men; or serum creatinine concentration ≥1.5 times Upper Limit of Normal (ULN).
Hypothyroidism or hyperthyroidism not effectively treated with medication.
Hemoglobin A1C (HgbA1c) >7.5 or history of diabetes mellitus.
Body Mass Index (BMI) >34.
History or other clinical evidence of significant or unstable cardiac disease.
History or other clinical evidence of chronic pulmonary disease associated with functional impairment.
Serious or severe bacterial infection(s).
Ulcerative or hemorrhagic/ischemic colitis.
Pancreatitis.
History of severe or uncontrolled psychiatric disease, including severe depression, history of suicidal ideation, suicidal attempts or psychosis requiring medication and/or hospitalization.
History of uncontrolled severe seizure disorder.
Requires concomitant theophylline or methadone.
History of immunologically mediated disease requiring more than intermittent anti-inflammatory medications for management or that requires frequent or prolonged use of corticosteroids.
History or other evidence of severe retinopathy or clinically relevant ophthalmological disorder due to diabetes mellitus or hypertension.
Hemoglobinopathies.
History of hypersensitivity or intolerance to nitazoxanide or any of the excipients comprising the nitazoxanide tablets, peginterferon alfa-2a injectable solution or ribavirin tablets.

Summary

NTZ+PR

Placebo+PR

All Events

Event Type Organ System Event Term NTZ+PR Placebo+PR

Sustained Virologic Response (HCV RNA Below Lower Limit of Detection)

Hepatitis C Virus Ribonucleic Acid (HCV RNA) below lower limit of detection 24 weeks after the end of treatment. All others were considered non-responders.

NTZ+PR

Non-responders

43.0
participants

Responders

32.0
participants

Placebo+PR

Non-responders

24.0
participants

Responders

13.0
participants

End of Treatment Response (HCV RNA Below Lower Limit of Detection)

Hepatitis C Virus Ribonucleic Acid (HCV RNA) below lower limit of detection at the end of treatment. All others were considered non-responders.

NTZ+PR

Non-responders

29.0
participants

Responders

46.0
participants

Placebo+PR

Non-responders

19.0
participants

Responders

18.0
participants

Early Virologic Response (HCV RNA Below Lower Limit of Detection)

Hepatitis C Virus Ribonucleic Acid (HCV RNA) below lower limit of detection after 12 weeks of combination therapy.

Placebo+PR

Non-responders

19.0
participants

Responders

18.0
participants

NTZ+PR

Non-responders

30.0
participants

Responders

45.0
participants

Rapid Virologic Response (HCV RNA Below Lower Limit of Detection)

Hepatitis C Virus Ribonucleic Acid (HCV RNA) below lower limit of detection after 4 weeks of combination therapy.

NTZ+PR

Non-responders

66.0
participants

Responders

9.0
participants

Placebo+PR

Non-responders

30.0
participants

Responders

7.0
participants

Changes in ALT

This analysis was conducted using a comparison of changes in Alanine aminotransferase (ALT) from baseline through week 8, week 16, end of treatment and end of follow up.

NTZ+PR

Elevated to Normal

29.0
participants

Normal to Elevated

3.0
participants

Remains Elevated

23.0
participants

Remains Normal

16.0
participants

Placebo+PR

Elevated to Normal

11.0
participants

Normal to Elevated

2.0
participants

Remains Elevated

5.0
participants

Remains Normal

17.0
participants

Changes in ALT

This analysis was conducted using a comparison of changes in Alanine aminotransferase (ALT) from baseline through week 8, week 16, end of treatment and end of follow up

NTZ+PR

Elevated to Normal

38.0
participants

Normal to Elevated

1.0
participants

Remains Elevated

12.0
participants

Remains Normal

17.0
participants

Placebo+PR

Elevated to Normal

11.0
participants

Normal to Elevated

1.0
participants

Remains Elevated

4.0
participants

Remains Normal

15.0
participants

Changes in ALT

This analysis was conducted using a comparison of changes in Alanine aminotransferase (ALT) from baseline through week 8, week 16, end of treatment and end of follow up.

NTZ+PR

Elevated to Normal

28.0
participants

Normal to Elevated

Remains Elevated

4.0
participants

Remains Normal

13.0
participants

Placebo+PR

Elevated to Normal

6.0
participants

Normal to Elevated

Remains Elevated

3.0
participants

Remains Normal

9.0
participants

Changes in ALT

This analysis was conducted using a comparison of changes in Alanine aminotransferase (ALT) from baseline through week 8, week 16, end of treatment and end of follow up.

NTZ+PR

Elevated to Normal

23.0
participants

Normal to Elevated

Remains Elevated

9.0
participants

Remains Normal

13.0
participants

Placebo+PR

Elevated to Normal

7.0
participants

Normal to Elevated

1.0
participants

Remains Elevated

2.0
participants

Remains Normal

8.0
participants

Total

112
Participants

Age, Continuous

50
years (Mean)
Standard Deviation: 7

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

NTZ+PR

Placebo+PR