Samatasvir (IDX719) in Combinations With Simeprevir and/or TMC647055/Ritonavir With or Without Ribavirin for 12 Weeks in Participants With Chronic Hepatitis C Infection (MK-1894-005)

Study Overview
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Brief Summary
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Parts A and B of this study are designed to evaluate the safety, tolerability, efficacy and pharmacokinetic profiles of samatasvir and simeprevir when administered in combination with ribavirin (RBV) for 12 weeks in treatment-naïve, Genotype (GT) 1b, 4 and 6 hepatitic C virus (HCV)-infected participants. Part C of this study is designed to evaluate the safety, tolerability, efficacy and pharmacokinetic profiles of samatasvir, simeprevir, TMC647055 and ritonavir (RTV) when administered in combination with or without RBV for 12 weeks in treatment-naïve or interferon/RBV-treatment relapsed, GT 1a and 1b HCV-infected participants.

Detailed Description
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Part A of this study is randomized and double-blind. Parts B and C are randomized and open-label.

Official Title
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A Randomized Study to Evaluate the Safety and Efficacy of IDX719 in Combinations With Simeprevir and/or TMC647055/Ritonavir With or Without Ribavirin for 12 Weeks in Subjects With Chronic Hepatitis C Infection

Conditions
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Chronic Hepatitis C Virus

Intervention / Treatment
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* Drug: Samatasvir
* Drug: Simeprevir
* Drug: Ribavirin (RBV)
* Drug: TMC647055
* Drug: Ritonavir (RTV)
* Biological: Pegylated interferon (Peg-IFN)
* Other: Samatasvir matching placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must have Genotype 1a, 1b, 4 or 6 HCV infection. Documented clinical history compatible with chronic hepatitis C HCV treatment-naïve or interferon/RBV-treatment relapsed (Part C) Must agree to use an acceptable double method of birth control (one of which must be a barrier method) for at least 6 months after the last dose of study drugs. Exclusion Criteria: Female participants who are pregnant or breastfeeding. Body Mass Index (BMI) > 36 kg/m2. Co-infected with hepatitis B virus or human immunodeficiency virus (HIV). History of hepatocellular carcinoma (HCC) or findings suggestive of possible HCC. History or signs of decompensated liver disease: ascites, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, or other clinical signs of portal hypertension or hepatic insufficiency. Has one or more known primary or secondary causes of liver disease, other than hepatitis C History of, or active, acute or chronic, liver or biliary injury due to drugs, toxins, non-HCV viral hepatitis, gallstones or other etiologies Donated blood or had significant blood loss 30 days prior to dosing

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Part A: GT 1b, 4 - samatasvir 50/simeprevir/RBV<br>Part A: Participants with genotype 1b or 4 received samatasvir 50 mg and samatasvir matching placebo once daily, plus simeprevir 150 mg capsule once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Other: Samatasvir matching placebo<br>* Samatasvir matching placebo will be supplied for the 50 mg tablets used in Part A.<br>|
| Experimental: Part A: GT 1b, 4 - samatasvir 100/simeprevir/RBV<br>Part A: Participants with genotype 1b or 4 received samatasvir 100 mg and samatasvir matching placebo once daily, plus simeprevir 150 mg capsule once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Other: Samatasvir matching placebo<br>* Samatasvir matching placebo will be supplied for the 50 mg tablets used in Part A.<br>|
| Experimental: Part A: GT 1b, 4 - samatasvir 150/simeprevir/RBV<br>Part A: Participants with genotype 1b or 4 received samatasvir 150 mg once daily, plus simeprevir 150 mg capsule once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>|
| Experimental: Part B: GT 1b, 4 - samatasvir 25/simeprevir/RBV<br>Part B: Participants with genotype 1b or 4 received samatasvir 25 mg once daily, plus simeprevir 150 mg capsule once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>|
| Experimental: Part B: GT 1b, 4 - samatasvir 100/simeprevir/RBV<br>Part B: Participants with genotype 1b or 4 received samatasvir 100 mg once daily, plus simeprevir 150 mg capsule once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>|
| Experimental: Part B: GT 6 - samatasvir 100/simeprevir/RBV<br>Part B: Participants with Genotype 6 received samatasvir 100 mg once daily, plus simeprevir 150 mg capsule once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>|
| Experimental: Part C: GT 1a, 1b - samatasvir 50/simeprevir/TCM647055/RTV<br>Part C: Participants with Genotype 1a or 1b received samatasvir 50 mg once daily, plus simeprevir 75 mg capsule once daily, plus TMC647055 450 mg once daily plus RTV 30 mg once daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Drug: TMC647055<br>* TMC647055 will be supplied as 150 mg oral capsules.<br>Drug: Ritonavir (RTV)<br>* Ritonavir will be supplied as 80 mg/mL oral solution.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>|
| Experimental: Part C: GT 1a, 1b - samatasvir 50/simeprivir/TCM647055/RTV/RBV<br>Part C: Participants with Genotype 1a or 1b received samatasvir 50 mg once daily, plus simeprevir 75 mg capsule once daily, plus TMC647055 450 mg once daily, plus RTV 30 mg once daily, plus RBV (dosing weight-based, according to product label) twice daily for 12 weeks | Drug: Samatasvir<br>* Samatasvir (IDX719) will be supplied as 25 mg and 50 mg oral tablets.<br>Drug: Simeprevir<br>* Simeprevir will be supplied as 75 and 150 mg oral capsules.<br>Drug: Ribavirin (RBV)<br>* Ribavirin will be supplied as 200 mg oral tablets. Participants in the RBV-free arms experiencing non-response or virologic breakthrough during the treatment period will be offered RBV dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>Drug: TMC647055<br>* TMC647055 will be supplied as 150 mg oral capsules.<br>Drug: Ritonavir (RTV)<br>* Ritonavir will be supplied as 80 mg/mL oral solution.<br>Biological: Pegylated interferon (Peg-IFN)<br>* Participants experiencing non-response or virologic breakthrough during the treatment period will be offered Peg-IFN (subcutaneous injection) dosed according to the product label as an add-on to the participant's randomized treatment assignment.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of participants who experienced an adverse event (AE) |  | Up to approximately 95 weeks | 
| Percentage of participants who experienced a serious adverse event (SAE) |  | Up to approximately 95 weeks | 
| Percentage of participants who experienced a Grade 1-4 laboratory abnormality |  | Up to 66 weeks | 
| Percentage of participants who experienced sustained virologic response 4 weeks after the end of treatment (SVR4) |  | Up to 16 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of participants who experienced rapid virologic response (RVR) |  | Week 4 | 
| Percentage of participants who experienced early virologic response (EVR) |  | Week 12 | 
| Percentage of participants who experienced sustained virologic response 8 weeks after the end of treatment (SVR8) |  | Up to 20 weeks | 
| Percentage of participants who experienced sustained virologic response 12 weeks after the end of treatment (SVR12) |  | Up to 24 weeks | 
| Percentage of participants who experienced sustained virologic response 24 weeks after the end of treatment (SVR24) |  | Up to 36 weeks | 
| Pharmacokinetic Parameter:Area under the concentration-time curve from time zero to t |  | Days 1, 4, 7, 10, 14, 21, 28, 42, 56 and 84 | 
| Pharmacokinetic Parameter: Maximum observed drug concentration (Cmax) |  | Days 1, 4, 7, 10, 14, 21, 28, 42, 56 and 84 | 
| Pharmacokinetic Parameter: Trough drug concentration (Ctrough) |  | Days 1, 4, 7, 10, 14, 21, 28, 42, 56 and 84 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HCV, Hepatitis C, chronic hepatitis C, antiviral