Title

Evaluation of Unipeg® for Response and Ongoing Safety in Pakistani Population
Response Evaluation of Peginterferon Alfa-2a 180µg 20kDa (Unipeg®) Plus Ribavirin (Ribazole®) in Treatment naïve Pakistani Population With Chronic Hepatitis C Infection
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Study Participants

    64
Hepatitis C is a global problem, prevalent in developed as well as in the developing countries. New treatment regimens using PegInterferon in combination with ribavirin has led to improved sustained viral response rates for some genotypes. A single arm, open labeled, multicentre trial was conducted to evaluate the response rate and safety of PegInterferon alfa-2a (Unipeg®) plus ribavirin (Ribazole®) for the treatment of patients with chronic hepatitis C infection. RVR at 4 weeks, ETR at 24 weeks for genotype 3 and at 48 weeks for genotype 1 patients and SVR was determined at 24 weeks after completion of treatment. Quality of life at baseline and at follow-up visits were determined using SF-36.
A multicenter, phase IV, open labeled, single arm study was conducted. Total 110 patients were screened for recruitment. Out of which 67 subjects met the inclusion criteria, 3 failed to give the informed consent and were excluded. The final sample size of the study was 64 patients. The duration of study was August 2010 to September 2013. Peginterferon alfa-2a 180µg 20kDa (Unipeg®) solution for injection was administered as single dose sub-cutaneous once weekly for 24 weeks to patients with genotype 3 and 48 weeks in patients with genotype 1 at the site of recruitment. Ribavirin (Ribazole) orally were given in divided daily dose according to body weight-based dosing recommendations (< 75kg = 1000 mg and ≥ 75 kg = 1200 mg). Quality of life related Physical Component Score (PCS) & Mental Component Score (MCS) were measured through Health-Related Quality of Life (HRQOL) Questionnaire (SF-36). The SF-36 questionnaire was completed for all patients during their evaluations before treatment, at 4 weeks, at the end of treatment and at 24 weeks after completion of treatment.
Study Started
Aug 31
2010
Primary Completion
Sep 30
2012
Study Completion
Sep 30
2014
Results Posted
Sep 27
2018
Last Update
Sep 27
2018

Drug Peginterferon alfa-2a

PegInterferon alfa-2a 180mcg 20kDa administered subcutaneously once weekly for 24 weeks in genotype 3 and for 48 weeks in genotype 1 patients.

  • Other names: Unipeg

Drug Ribavirin

Ribavirin administered orally in a divided daily dose according to body weight-based dosing recommendations (< 75kg = 1000 mg and ≥ 75 kg = 1200 mg)

  • Other names: Ribazole

PegInterferon alfa-2a and Ribavirin Experimental

PegInterferon alfa-2a subcutaneously once weekly Ribavirin administered orally according to the body weight

Criteria

Inclusion Criteria:

Written Informed consent
Treatment naïve patients
Serological evidence of hepatitis C infection by an anti-HCV antibody test
HCV positive by PCR
Genotype 1,2 and 3
BMI 20-28
Participants were the resident of city where he /she enrolled at their respective centre
No evidence of liver cirrhosis
No other significant hepatic or systemic disease
No evidence of hepatic encephalopathy
Normal thyroid functions (By testing TSH)

Adequate bone marrow, liver and renal functions test

Hematology: ANC≥1,000/mm3, Platelet count ≥100,000 mm3, Hemoglobin≥11.0g/dl in female and ≥ 12.0 g/dl in male
Blood Chemistry: Total Bilirubin≤2.0mg/dl, AST and ALT <3 times normal
Creatinine Clearance >50 ml/min
Proteinuria: ≤ 0.5 g per 24h.
Prothrombin Time or partial-thromboplastin time if ≤1.5 times the upper limit of the normal range.

Exclusion Criteria:

Unable to give consent
Prior treatment for Hepatitis C
Co-infection with HBV and HCV
Obesity
Iron overload
Other Genotypes e.g. 4, 5, 6 with their sub-types
Pregnant and lactating women
History of medical condition associated with chronic liver disease other than CHC (e.g. hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposure)
Uncontrolled Hypertension
Uncontrolled Diabetes
Severe Depression
Clinically significant cardio-vascular disease
Symptomatic peripheral vascular disease
Oral or parenteral anticoagulants or anti platelet agents
History of systemic anti-viral therapy at least three months prior to first dose of study medication

Summary

PegInterferon Alfa-2a and Ribavirin

All Events

Event Type Organ System Event Term PegInterferon Alfa-2a and Ribavirin

Number of Participants With Sustained Virological Response (SVR)

To determine the SVR at 24 weeks after completion of treatment, among those who achieved ETR

PegInterferon Alfa-2a and Ribavirin

Number of Participants With End Treatment Response

To determine the End Treatment Response (ETR) rate of all patients treated with PegInterferon alfa-2a plus Ribavirin

PegInterferon Alfa-2a and Ribavirin

Number of Participants Who Reported Adverse Events

To determine the number of patients treated with PegInterferon Alfa-2a plus Ribavirin who experience any adverse drug reaction. All ADR are reported as per patient information leaflet

PegInterferon Alfa-2a and Ribavirin

Number of Participants With Rapid Virological Response (RVR)

To evaluate the Rapid Virological Response (RVR) of all patients treated with PegInterferon Alfa-2a plus Ribavirin at 4 weeks of treatment

PegInterferon Alfa-2a and Ribavirin

Mean of Physical Component Score & Mental Component Score to Determine Quality of Life

To determine and compare the changes in quality of life (QOL) from baseline to end of the treatment. Health-Related Quality of Life (HRQOL) Questionnaire (SF-36) was used to measure the quality of life. The SF-36 is a widely used questionnaire, and consists of 36 questions measuring eight concepts: Physical Function (PF), Role Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Function (SF), Role Emotional (RE), and Mental Health (MH). The scoring of the SF-36 questionnaire in our study was conducted upon a 0-100 scale, with higher scores reflecting better health status.

PegInterferon Alfa-2a and Ribavirin

Mental Component Score

54.89
score on a scale (Mean)
Standard Deviation: 9.61

Physical Component Score

50.62
score on a scale (Mean)
Standard Deviation: 8.22

Number of HCV Patients confirmed through Polymerase Chain Reaction

64
participants

Age, Customized

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

PegInterferon Alfa-2a and Ribavirin