Clinical trial NCT01121185: Study in Hepatitis C Virus (HCV) Infected Patients Undergoing Liver Transplantation to Evaluate a Human Monoclonal Antibody Against Hepatitis C
Official title: A Phase II Randomized, Double-Blind, Placebo Controlled Study of the Clinical Effectiveness of a Human Monoclonal Antibody Against Hepatitis C Virus E2 Glycoprotein (MBL-HCV1) in Hepatitis C Infected Patients Undergoing Liver Transplantation
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: HCV Infection
Liver Transplantation
Keywords: Hepatitis C virus (HCV)
Liver transplantation
Human Monoclonal Antibody
Lead sponsor: MassBiologics
Sponsor class: OTHER
First posted: 2010-05-12
Enrollment: 13
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The purpose of this study is to determine whether a human monoclonal antibody against Hepatitis C (MBL-HCV1) is effective in preventing detectable levels of Hepatitis C virus in patients undergoing liver transplantation due to chronic HCV infection. The study will also determine if MBL-HCV1 is effective in delaying or reducing the amount of detectable HCV in patients after transplant.

Detailed description: This is a Phase 2, randomized, double-blind, placebo controlled study in Hepatitis C (HCV) infected patients undergoing liver transplantation. Chronically infected patients with HCV genotype 1a scheduled to receive a liver transplant from either a deceased or living donor who satisfy all study inclusion or exclusion criteria will be approached to participate. The study will be conducted in two parts to test a human monoclonal antibody against Hepatitis C (MBL-HCV1). In Part 1, sixteen eligible patients will be randomized 1:1 to receive 50 mg/kg MBL-HCV1 or 0.9% sodium chloride placebo intravenously. Eleven doses will be given during the first 14 days post transplantation. Patients will be evaluated through day 56 for safety and clinical outcomes that include measurement of anti-HCV antibodies, anti-drug antibody and HCV viral load. On study visit day 42, a liver biopsy will be performed for evaluation of hepatitis. Physical examination, vital sign measurements, emergence of adverse events and concomitant medication usage will be assessed at scheduled visits and as needed during the 56 day study period.

The Data Safety and Monitoring Board will perform a futility analysis after the first 16 patients have been enrolled and completed study follow-up through study visit day 42 post transplant. Based on the results of the interim analysis, the dose of MBL-HCV1 for part 2 of the study will be determined. Part 2 of the study will be conducted in the same manner as Part 1.

Eligibility criteria: Inclusion Criteria:

* Patient ≥ 18 years of age with documented chronic hepatitis C virus infection of genotype 1a undergoing liver transplantation from either a deceased donor or living donor.
* Patient or legal guardian/health care proxy must have read, understood and provided written informed consent and HIPAA authorization after the nature of the study has been fully explained.

Exclusion Criteria:

* Positive serology for Hepatitis B surface Antigen
* Positive serology for HIV
* Pregnancy or breastfeeding
* Previous history of any organ transplant
* Planned receipt of combined organ transplant (e.g. liver and kidney)
* Receipt or planned receipt of immune globulin (IVIG) within 90 days of enrollment
* History of extrahepatic malignancy and/or receiving chemotherapy within 90 days prior to enrollment with the exception of chemoembolization for hepatocellular carcinoma
* Hepatocellular carcinoma with tumor burden outside of the Milan criteria
* History of chronic renal insufficiency or creatinine \> 2.5 for ≥ six months
* Personal or family history of deep venous thrombosis or pulmonary embolism
* Receipt of liver allograft from HCV positive donor or Hepatitis B core antibody positive donor
* Receipt of liver allograft donated after cardiac death of donor
* Receipt of any antiviral agents, licensed or investigational for hepatitis C virus within 90 days prior to enrollment
* Receipt of any other investigational study product within 30 days prior to enrollment
* Any other condition that in the opinion of the investigator would jeopardize the safety or rights of the patient participating in the study or make it unlikely that the patient could complete the study

Primary outcomes:
measure: Proportion of Subjects With Detectable Serum HCV RNA at Day 42 Post-Transplantation
timeFrame: At Day 42 post-transplantation
Secondary outcomes:
measure: The Incidence of Adverse Events and Treatment-Emergent Adverse Events Determined Through Medical History, Physical Examination and Laboratory Evaluation
timeFrame: Through Day 56
measure: Change in Serum HCV RNA Between Baseline and Day 3, 14, 28 and 42 Post-Transplantation
timeFrame: Baseline and Day 3, 14, 28 and 42 Post-Transplantation
measure: Histologic Evidence of Hepatitis by Histologic Activity Index (HAI) Score at Baseline and Day 42
timeFrame: Baseline Day 0 and Day 42
measure: Graft Function Assessed by Measurement of Biochemical and Synthetic Function at Multiple Time Points / International Normalized Ratio (INR)
timeFrame: Through Day 56
measure: Graft Function Assessed by Measurement of Biochemical and Synthetic Function at Multiple Time Points / Alanine Aminotransferase (ALT)
timeFrame: Through Day 56
measure: Graft Function Assessed by Measurement of Biochemical and Synthetic Function at Multiple Time Points / Total Bilirubin
timeFrame: Through Day 56
measure: Time to Onset of Recurrence of Detectable HCV RNA Post-Transplantation
timeFrame: Through Day 56
Other outcomes:
Locations:
city: New Haven
country: United States
facility: Yale-New Haven Hospital
state: Connecticut
city: Boston
country: United States
facility: Massachusetts General Hospital
state: Massachusetts
city: Boston
country: United States
facility: Beth Israel Deaconess Medical Center
state: Massachusetts
city: Burlington
country: United States
facility: Lahey Clinic
state: Massachusetts
city: Detroit
country: United States
facility: Henry Ford Health System
state: Michigan
city: New York
country: United States
facility: Mount Sinai Hospital
state: New York
city: Cleveland
country: United States
facility: Cleveland Clinic Foundation
state: Ohio
city: Memphis
country: United States
facility: Methodist Healthcare Foundation
state: Tennessee
Study officials:
affiliation: Massbiologics of University of Massachusetts Medical School
name: Deborah C. Molrine, MD
role: STUDY_DIRECTOR
References:
citation: Chung RT, Gordon FD, Curry MP, Schiano TD, Emre S, Corey K, Markmann JF, Hertl M, Pomposelli JJ, Pomfret EA, Florman S, Schilsky M, Broering TJ, Finberg RW, Szabo G, Zamore PD, Khettry U, Babcock GJ, Ambrosino DM, Leav B, Leney M, Smith HL, Molrine DC. Human monoclonal antibody MBL-HCV1 delays HCV viral rebound following liver transplantation: a randomized controlled study. Am J Transplant. 2013 Apr;13(4):1047-1054. doi: 10.1111/ajt.12083. Epub 2013 Jan 28.