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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02625909
Registration number
NCT02625909
Ethics application status
Date submitted
7/12/2015
Date registered
9/12/2015
Titles & IDs
Public title
Randomised Study of Interferon-free Treatment for Recently Acquired Hepatitis C in PWID and People With HIV Coinfection.
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Scientific title
A Randomised Study of Interferon-free Treatment for Recently Acquired Hepatitis C in People Who Inject Drugs and People With HIV Coinfection.
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Secondary ID [1]
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VHCRP1401
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Universal Trial Number (UTN)
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Trial acronym
REACT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hepatitis C
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Condition category
Condition code
Infection
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Other infectious diseases
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Oral and Gastrointestinal
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Infection
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Acquired immune deficiency syndrome (AIDS / HIV)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - SOF/VEL for 6 weeks
Treatment: Drugs - SOF/VEL for 12 weeks
Experimental: Drug: SOF/VEL for 6 weeks - Open-label SOF/VEL 400mg/100mg co-formulated tablet once daily will be given to participants who are randomised into the short treatment duration arm (A) for 6 weeks.
Experimental: Drug: SOF/VEL for 12 weeks - Open-label SOF/VEL 400mg/100mg co-formulated tablet once daily will be given to participants who are randomised into the standard treatment duration arm (B) for 12 weeks.
Treatment: Drugs: SOF/VEL for 6 weeks
Open-label SOF/VEL 400mg/100mg once daily to be given to participants randomised to Arm A (6 weeks short treatment duration).
Treatment: Drugs: SOF/VEL for 12 weeks
Open-label SOF/VEL 400mg/100mg once daily to be given to participants randomised to Arm B (12 weeks standard treatment duration).
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of Participants With Undetectable HCV RNA at 12 Weeks Post End of Treatment (SVR12) Following SOF/VEL for 6 Weeks as Compared With 12 Weeks in People With Recent HCV Infection- Among Intention-to-treat (ITT) Population
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Assessment method [1]
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To evaluate the proportion of participants with HCV RNA below the level of quantification at 12 weeks post treatment following SOF/VEL for 6 weeks as compared with 12 weeks in people with recent HCV infection- among intention-to-treat (ITT) population The ITT population included all randomized participants, with loss to follow-up deemed treatment failure.
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Timepoint [1]
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12 weeks post treatment
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Secondary outcome [1]
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Number of Participants With Undetectable HCV RNA at 12 Weeks Post End of Treatment (SVR12) Following SOF/VEL for 6 Weeks as Compared With 12 Weeks in People With Recent HCV Infection- Among Modified Intention-to-treat (ITT) Population
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Assessment method [1]
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To evaluate the proportion of participants with HCV RNA below the level of quantification at 12 weeks post treatment following SOF/VEL for 6 weeks as compared with 12 weeks in people with recent HCV infection- among modified intention-to-treat (ITT) population The modified ITT population included participants in the ITT population, but excluded those with non-virological reasons for treatment failure (including death and loss to follow-up) and reinfection.
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Timepoint [1]
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12 Weeks Post End of Treatment
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Secondary outcome [2]
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Number of Participants With Undetectable HCV RNA at End of Treatment (ETR) of SOF/VEL for 6 Weeks as Compared With 12 Weeks in People With Recent HCV Infection- Among Intention-to-treat (ITT) Population
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Assessment method [2]
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To evaluate the proportion of participants with HCV RNA below the level of quantification at end of treatment of SOF/VEL for 6 Weeks as compared With 12 Weeks in People With Recent HCV Infection The ITT population included all randomized participants, with loss to follow-up deemed treatment failure.
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Timepoint [2]
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End of treatment - week 6 of the shortened treatment duration arm, and week 12 of the standard treatment duration arm
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Secondary outcome [3]
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Number of Participants With Undetectable HCV RNA at 12 Weeks Post End of Treatment (SVR12) Following SOF/VEL for 6 Weeks as Compared With 12 Weeks in People With Recent HCV Infection- Among Per Protocol (PP) Population
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Assessment method [3]
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To evaluate the proportion of participants with HCV RNA below the level of quantification at 12 weeks post treatment following SOF/VEL for 6 weeks as compared with 12 weeks in people with recent HCV infection- among Per Protocol (PP) population The per protocol population included participants who received \>90% of scheduled treatment for \>90% of the scheduled treatment period with follow-up virologic data at SVR12 (excluding reinfection and retreatments)
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Timepoint [3]
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12 weeks post treatment
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Eligibility
Key inclusion criteria
* Subjects must meet all of the following inclusion criteria to be eligible to participate in this study:
1. Participants have voluntarily signed the informed consent form.
2. 18 years of age or older.
3. Detectable HCV RNA at screening (>10,000 IU/ml), and in the opinion of the investigator is unlikely to demonstrate spontaneous viral clearance
4. HCV genotypes 1-6.
5. HBsAg negative
6. Compensated liver disease (Child-Pugh A)
7. Negative pregnancy test at baseline (females of childbearing potential only).
8. Medically stable on the basis of physical examination, medical history and vital signs
9. Adequate English to provide reliable responses to the study questionnaires
10. All fertile males and females must be using effective contraception during treatment and during the 30 days after treatment end.
11. Recently acquired HCV infection (estimated duration of infection =12 months)*
Recently acquired HCV infection as defined by:
A) i) First anti-HCV Ab or HCV RNA positive within the previous 3 months and ii) Documented anti-HCV Ab negative within the 12 months prior to anti-HCV antibody positive result
OR
B) i) First anti-HCV Ab or HCV RNA positive within the previous 3 months and ii) Acute clinical hepatitis [jaundice or alanine aminotransferase (ALT)] > 10 X ULN) within the previous 6 months prior to first positive HCV antibody or HCV RNA, with no other cause of acute hepatitis identifiable
OR
C) For cases of recent HCV reinfection the following criteria are required:
Documented prior HCV antibody positive with HCV RNA negative on at least 2 occasions 6 months apart AND new HCV RNA positive within the previous 6 months
*Estimated duration of infection based on midpoint between last antibody negative or HCV RNA and first antibody positive or HCV RNA in the case of seroconversion and 6 weeks prior to date of maximum ALT in the case of acute hepatitis.
If co-infection with HIV is documented, the subject must meet the following criteria:
1. Antiretroviral (ARV) untreated for >8 weeks preceding screening visit with cluster of differentiation 4 (CD4) T cell count >500 cells/mm3 OR
2. On a stable ARV regimen for >8 weeks prior to screening visit, with CD4 T cell count >200 cells/mm3 and an undetectable plasma HIV RNA level.
* Suitable ARV include:
* Tenofovir (TDF) and tenofovir alafenamide (TAF)
* Emtricitabine (FTC)
* Rilpivirine
* Dolutegravir
* Elvitegravir/cobicistat
* Contraindicated ARV include:
* Efavirenz 50% reduction in velpatasvir (GS-5816) exposure
* Didanosine
* Zidovudine
* Tipranavir Other ARV agents may be permissible at the time of study commencement pending further drug-drug interaction studies; please discuss with Study Principal Investigator.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
Subjects who meet any of the exclusion criteria are not to be enrolled in this study.
1. History of any of the following:
1. Clinically significant illness (other than HCV) or any other major medical disorder that may interfere with the participant treatment, assessment or compliance with the protocol; participants currently under evaluation for a potentially clinically significant illness (other than HCV) are also excluded.
2. History of chronic pulmonary disease associated with functional limitation, severe cardiac disease, major organ transplantation or other evidence of severe illness, malignancy, or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study
3. Solid organ transplant
4. Malignancy within 5 years prior to screening, with exception of specific cancers that may have been cured by surgical resection (basal cell skin cancer, etc.). Subjects under evaluation for possible malignancy are also excluded.
5. Significant drug allergy (such as anaphylaxis or hepatotoxicity).
2. Subject shows evidence of significant liver disease in addition to hepatitis C, which may include but is not limited to drug- or alcohol-related cirrhosis, autoimmune hepatitis, hemochromatosis, Wilson's disease, non-alcoholic steatohepatitis (NASH), or primary biliary cirrhosis
3. Subject has known cirrhosis
4. Any of the following lab parameters at screening:
1. Direct bilirubin > 1.5 x ULN
2. Platelets < 50,000/µL
3. Creatinine clearance (CLcr) < 60 mL/min
4. Haemoglobin < 11 g/dL for females ; < 12 g/dL for males
5. Albumin < 30g/L
5. Pregnant or nursing female.
6. Use of prohibited concomitant medications as described in section 5.2 in the protocol
7. Chronic use of systemically administered immunosuppressive agents (e.g. prednisone equivalent > 10 mg/day)
8. Known hypersensitivity to velpatasvir, sofosbuvir or formulation excipients.
9. Therapy with any anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) =6 months prior to the first dose of study drug.
10. Any investigational drug =6 weeks prior to the first dose of study drug.
11. Previous failure of therapy with sofosbuvir or an non-structural protein 5A (NS5A) inhibitor prior to the first dose of study drug.
12. Ongoing severe psychiatric disease as judged by the treating physician.
13. Frequent injecting drug use that is judged by the treating physician to compromise treatment safety.
14. Inability or unwillingness to provide informed consent or abide by the requirements of the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
9/03/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
23/03/2020
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Sample size
Target
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Accrual to date
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Final
222
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Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
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Recruitment hospital [1]
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Kirketon Road Centre - Sydney
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Recruitment hospital [2]
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St. Vincent's Hospital - Sydney
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Recruitment hospital [3]
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The Kirby Institute, University of New South Wales Australia - Sydney
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Recruitment hospital [4]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [5]
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The Alfred Hospital - Melbourne
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Recruitment hospital [6]
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Royal Melbourne Hospital - Melbourne
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Recruitment postcode(s) [1]
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1340 - Sydney
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Recruitment postcode(s) [2]
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2010 - Sydney
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Recruitment postcode(s) [3]
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2052 - Sydney
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Recruitment postcode(s) [4]
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5000 - Adelaide
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Recruitment postcode(s) [5]
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3004 - Melbourne
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Recruitment postcode(s) [6]
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3050 - Melbourne
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Recruitment outside Australia
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United States of America
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State/province [1]
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Maryland
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United States of America
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Massachusetts
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Canada
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British Columbia
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Canada
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Ontario
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Canada
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Quebec
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Germany
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Berlin
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Germany
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Bonn
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Germany
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Frankfurt
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Amsterdam
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New Zealand
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Auckland
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Switzerland
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Zurich
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Switzerland
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Bern
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Switzerland
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Lugano
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United Kingdom
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Brigton And Hove
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United Kingdom
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Lancashire
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United Kingdom
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State/province [16]
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London
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Funding & Sponsors
Primary sponsor type
Government body
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Name
Kirby Institute
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The aim of the study is to determine if treatment for recently acquired hepatitis C infection (with or without HIV coinfection) can be shortened when treating with the interferon-free therapy sofosbuvir/velpatasvir (SOF/VEL). SOF/VEL is a new treatment for hepatitis C called direct acting antiviral which targets the hepatitis C virus replication cycle and has been shown in phase II studies in chronic HCV to be highly effective (SVR12 \>95%) when given for 12 weeks. Data has shown that treatment can be shortened when treating recently acquired HCV with interferon containing treatments. It is not known whether treatment with SOF/VEL can be shortened. This study aims to find out if treatment for 6 weeks with open-label SOF/VEL is equivalent to treatment for 12 weeks with SOF/VEL in participants with recently acquired hepatitis C infection. The project is a randomised study where both participants and investigators would not find out the treatment duration of the participants until week 6 of treatment.
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Trial website
https://clinicaltrials.gov/study/NCT02625909
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Trial related presentations / publications
Matthews GV, Bhagani S, Van der Valk M, Rockstroh J, Feld JJ, Rauch A, Thurnheer C, Bruneau J, Kim A, Hellard M, Shaw D, Gane E, Nelson M, Ingiliz P, Applegate TL, Grebely J, Marks P, Martinello M, Petoumenos K, Dore GJ; REACT study group; Protocol Steering Committee; Coordinating Centre; Site Principal Investigators. Sofosbuvir/velpatasvir for 12 vs. 6 weeks for the treatment of recently acquired hepatitis C infection. J Hepatol. 2021 Oct;75(4):829-839. doi: 10.1016/j.jhep.2021.04.056. Epub 2021 May 21.
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Public notes
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Contacts
Principal investigator
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Gail V Matthews, MbChB, PhD
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Address
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The Kirby Institute, University of New South Wales Australia, Sydney, New South Wales, Australia, NSW 2052
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
No individual participant data will be shared. The results of the project will be presented at scientific meetings, and published in peer reviewed scientific literature. Sharing of data generated by this project is an essential part of our proposed activities and will be carried out in several different ways. We plan to make our results available to the community of scientists interested in recently acquired hepatitis C, community organisations representing the affected communities and participants. We also welcome collaboration with others who could make use of data and samples.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF), Clinical study report (CSR), Analytic code
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When will data be available (start and end dates)?
Available following publication of the primary manuscript, indefinitely
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Available to whom?
Submission of a research concept sheet proposal to the study Principal Investigator for review and approval by the protocol steering committee,
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
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Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/09/NCT02625909/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/09/NCT02625909/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT02625909