Efficacy and Safety of Sofosbuvir+Ribavirin in Genotype 2 HCV-infected U.S. Veterans With Cirrhosis

Study Overview
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Brief Summary
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This study will examine the safety, tolerability, and antiviral efficacy of sofosbuvir (SOF)+ribavirin (RBV) in treatment-naive and treatment-experienced United States Veterans with compensated cirrhosis and genotype 2 HCV infection.

Official Title
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A Phase 4, Multicenter, Open Label Study to Investigate the Efficacy and Safety of an All Oral Combination of Sofosbuvir+Ribavirin in Genotype 2 HCV-infected U.S. Veterans With Cirrhosis VALOR-HCV: Veterans Affairs alL Oral Regimen of SOF+RBV in GT2 HCV

Conditions
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Hepatitis C Virus Infection

Intervention / Treatment
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* Drug: Sofosbuvir
* Drug: RBV


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Willing and able to provide written informed consent. Treatment-naive or treatment-experienced adult, U.S. Veteran Chronic genotype 2 (GT2) HCV infection Classified as: Eligible for treatment with interferon (IFN)-based therapy Ineligible for IFN treatment Intolerant to IFN. Cirrhosis determination Laboratory parameters within prespecified ranges at screening: A negative serum pregnancy test is required for females of childbearing potential Males and females of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception Lactating females must agree to discontinue nursing before study drug is administered. Males must agree to refrain from sperm donation from the date of screening until at least 7 months after the last dose of RBV, or 90 days after their last dose of study drug if not taking RBV. Must be able to comply with the dosing instructions for study drug administration and able to complete the study schedule of assessments. Must be of generally good health as determined by the Investigator. Exclusion Criteria: Current participation in an interventional clinical trial. Infection with hepatitis B virus (HBV) or human immunodeficiency virus (HIV). History of any other clinically significant chronic liver disease (e.g., hemochromatosis; Wilson's disease; α1-antitrypsin deficiency), except nonalcoholic steatohepatitis (NASH). Decompensated liver History of hemoglobinopathies Contraindication or hypersensitivity to RBV History or current evidence of any condition, therapy, laboratory abnormality or other circumstance that might confound the results of the study, or interfere with the participation for the full duration of the study, such that it is not in the best interest of the individual to participate. Clinically significant ECG abnormality at screening. History of solid organ transplantation. Presence of hepatocellular carcinoma (HCC) Malignancy within 5 years prior to screening, with the exception of specific cancers that are entirely cured by surgical resection (basal cell skin cancer and prostate cancer in remission). Individuals under evaluation for possible malignancy are not eligible. Prior treatment with an NS5B polymerase inhibitor. Chronic use of systemic immunosuppressive agents or immunomodulatory agents (e.g., prednisone equivalent > 10 mg/day). Concomitant disallowed as per the Sovaldi Packet Insert. Known hypersensitivity to the study drug, the metabolites, or formulation excipient. History of difficulty with blood collection and/or poor venous access for the purposes of phlebotomy. Use of any prohibited concomitant medications as described in the study protocol Gastrointestinal disorder or post-operative condition that could interfere with the absorption of the study drug. Male with pregnant female partner. In the judgment of the investigator any clinically-relevant drug or alcohol abuse within 12 months of screening that may interfere with treatment, assessment or compliance with the protocol.

Ages Eligible for Study
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Minimum Age: 18 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Sofosbuvir+RBV 12 weeks<br>Participants will receive sofosbuvir+RBV for 12 weeks. | Drug: Sofosbuvir<br>* Sofosbuvir 400 mg tablet administered orally once daily<br>* Other names: PSI-7977;Drug: RBV<br>* Ribavirin (RBV) tablets administered orally in a divided daily dose according to package insert weight-based dosing recommendations (< 75 kg = 1000 mg and ≥ 75 kg = 1200 mg)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Participants With Sustained Virologic Response (SVR) 12 Weeks After Discontinuation of Therapy | SVR12 was defined as HCV RNA < the lower limit of quantitation (LLOQ; ie, 25 IU/mL) at 12 weeks after stopping study treatment. | Posttreatment Week 12 | 
| Percentage of Participants Who Permanently Discontinued Any Study Drug Due to an Adverse Event |  | Up to 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Participants With Sustained Virologic Response at 4 Weeks After Discontinuation of Therapy (SVR4) | SVR4 was defined as HCV RNA < LLOQ at 4 weeks following the last dose of study drug. | Posttreatment Week 4 | 
| Percentage of Participants Experiencing Viral Breakthrough | Viral breakthrough was defined as either: HCV RNA ≥ LLOQ after having previously had HCV RNA < LLOQ while receiving treatment HCV RNA ≥ LLOQ at the last available on-treatment measurement with no subsequent follow-up values | Up to Posttreatment Weak 12 | 
| Percentage of Participants Experiencing Viral Relapse | Viral relapse was defined as HCV RNA ≥ LLOQ during the posttreatment period after having achieved HCV RNA < LLOQ at end of treatment. | Up to Posttreatment Week 12 | 
| Number of Participants With Nonstructural Protein 5B (NS5B) Nucleoside Inhibitor (NI) Resistance-Associated Variants (RAVs) and RBV RAVs at Pretreatment and Posttreatment | Deep sequencing of the HCV NS5B gene was attempted for all participants who had virologic failure at pretreatment and posttreatment time points if the level of HCV RNA in the plasma sample was ≥ 1000 IU/L. | Pretreatment and Posttreatment Week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Veterans HCV