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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03117569
Registration number
NCT03117569
Ethics application status
Date submitted
7/04/2017
Date registered
18/04/2017
Titles & IDs
Public title
Trial of Simplified Treatment Monitoring for 8 Weeks Glecaprevir/Pibrentasvir in Chronic Hepatitis C Patients
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Scientific title
A Phase IIIb, Open-label, Multicentre, International Randomised Controlled Trial of Simplified Treatment Monitoring for 8 Weeks Glecaprevir (300mg)/Pibrentasvir (120mg) in Chronic HCV Treatment naïve Patients Without Cirrhosis
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Secondary ID [1]
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VHCRP1701
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Universal Trial Number (UTN)
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Trial acronym
SMART-C
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hepatitis C, Chronic
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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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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - glecaprevir (300mg)/pibrentasvir (120mg)
Other: Standard monitoring schedule - Participants will have on-treatment clinic visits at weeks 4 and 8. Participants have also phone contact-based visits at weeks 4 and 8 (1-2 days prior to scheduled clinic visits).
Experimental: Simplified monitoring schedule - Participants will have no on-treatment clinic visits at weeks 4 and 8. Participants have phone contact-based visits at weeks 4 and 8.
Treatment: Drugs: glecaprevir (300mg)/pibrentasvir (120mg)
glecaprevir (300mg)/pibrentasvir (120mg) for 8 weeks
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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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Undetectable HCV RNA (ITT Population)
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Assessment method [1]
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Number of participants with undetectable HCV RNA based on ITT population.
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Timepoint [1]
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12 weeks post end of treatment (SVR12)
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Secondary outcome [1]
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Undetectable HCV RNA (mITT Population)
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Assessment method [1]
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Number of participants with undetectable HCV RNA based on mITT population.
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Timepoint [1]
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12 weeks post end of treatment (SVR12)
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Secondary outcome [2]
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Treatment and Study Visits Adherence
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Assessment method [2]
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Number adherent to treatment and study visits (on-treatment adherence and early treatment discontinuation).
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Timepoint [2]
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12 weeks post end of treatment (SVR12)
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Secondary outcome [3]
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Health-related Quality of Life
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Assessment method [3]
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Change in health-related quality of life score pre and post-treatment (measured by EQ-5D-3L). The EQ visual analogue scale records the patient's self-rated health on a vertical visual analogue scale where the endpoints are labelled 'Best imaginable health state' (value of 100) and 'Worst imaginable health state' (value of 0). The VAS can be used as a quantitative measure of health outcome that reflects the patient's own judgement. Higher scores indicate better outcomes.
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Timepoint [3]
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Screening and 12 weeks post end of treatment (SVR12)
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Secondary outcome [4]
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Number of Virological Failure Participants With NS3 and NS5A Polymorphisms at Baseline and Post-treatment Week 12
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Assessment method [4]
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Distribution of baseline resistance associated substitutions (RAS) in participants with virological failures. Baseline polymorphisms were detected by Sanger sequencing at the following amino acid positions:
NS3: 36, 56, 80, 155, 156, 166, 168 NS5A: 24, 28, 30, 31, 58, 93
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Timepoint [4]
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Baseline and 12 weeks post-treatment
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Secondary outcome [5]
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Patient Treatment Satisfaction
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Assessment method [5]
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Patient was satisfied with their treatment follow-up plan.
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Timepoint [5]
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12 weeks post end of treatment (SVR12)
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Eligibility
Key inclusion criteria
1. Have voluntarily signed the informed consent form.
2. 18 years of age or older.
3. Chronic HCV infection as defined by anti-HCV antibody or HCV RNA detection for greater than 6 months.
4. HCV RNA plasma = 10,000 IU/ml at screening.
5. HCV genotype 1-6.
6. HCV treatment naïve (no prior treatment with an approved or investigation anti-HCV medication).
7. Stage F0-3, based on: hepatic elastography <12.5 kPa on Fibroscan® or APRI <1.0.
8. If co-infection with HIV is documented, the subject must meet the following criteria:
* ART naïve with CD4 T cell count >500 cells/mm3; OR
* On a stable ART regimen (containing only permissible ART - see protocol section 3.2) for >8 weeks prior to screening visit, with CD4 T cell count >200 cells/mm3 and a plasma HIV RNA level below the limit of detection.
9. Negative pregnancy test at screening and baseline (females of childbearing potential only).
10. All fertile females must be using effective contraception during treatment and during the 30 days after treatment end.
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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
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. Clinical hepatic decompensation (i.e. ascites, encephalopathy or variceal haemorrhage).
3. Solid organ transplant.
4. History of severe, life-threatening or other significant sensitivity to any excipients of the study drugs.
2. Any of the following lab parameters at screening:
1. ALT > 10 x ULN
2. AST > 10 x ULN
3. Direct bilirubin > ULN
4. Platelets < 90,000/µL (cells/mm3) if Fibroscan® <12.5 kPa OR < 150,000/µL (cells/mm3) if Fibroscan® is unavailable and patient is included with APRI <1
5. Creatinine clearance (CLcr) < 50 mL/min
6. Haemoglobin < 12g/dL for males; <11g/dL for females
7. Albumin < LLN
8. INR > 1.5 ULN unless subject has known haemophilia or is stable on an anticoagulant regimen affecting INR
3. Pregnant or breastfeeding female.
4. HBV infection (HBsAg positive).
5. Use of prohibited concomitant medications as described in protocol section 5.2.
6. Chronic use of systemically administered immunosuppressive agents (e.g. prednisone equivalent > 10 mg/day for >2 weeks).
7. 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.
8. Any investigational drug =6 weeks prior to the first dose of study drug.
9. Ongoing severe psychiatric disease as judged by the treating physician.
10. Positive result of a urine drug screen at the Screening Visit for opiates, barbiturates, amphetamines, cocaine, benzodiazepines, phencyclidine, propoxyphene, or alcohol, with the exception of a positive result (including methadone) associated with documented short-term use or chronic stable use of a prescribed medication in that class.
11. Injecting drug use within the previous six months.
12. 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
Parallel
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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
21/08/2017
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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
19/12/2018
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Sample size
Target
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Accrual to date
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Final
380
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Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
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Recruitment hospital [1]
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East Sydney Doctors - Sydney
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Recruitment hospital [2]
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St Vincent's Hospital Sydney - Sydney
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Recruitment hospital [3]
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Holdsworth House Medical Practice - 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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St Vincent's Hospital Melbourne - Melbourne
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Recruitment postcode(s) [1]
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2010 - Sydney
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Recruitment postcode(s) [2]
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- Sydney
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Recruitment postcode(s) [3]
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- Adelaide
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Recruitment postcode(s) [4]
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3004 - Melbourne
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Recruitment postcode(s) [5]
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3065 - Melbourne
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Massachusetts
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United States of America
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New York
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United States of America
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North Carolina
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United States of America
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Wisconsin
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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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France
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Créteil
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France
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Marseille
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France
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Paris
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Germany
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Berlin
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Germany
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Düsseldorf
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Germany
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Hanover
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Germany
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Münster
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New Zealand
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Auckland
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New Zealand
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Christchurch
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New Zealand
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Dunedin
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Switzerland
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Bern
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Switzerland
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Zürich
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United Kingdom
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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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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The aim of this study is to determine if treatment monitoring schedule for chronic HCV patients treated with glecaprevir (300mg)/pibrentasvir (120mg) can be simplified. Data has shown that direct acting antiviral (DAA) regimen of glecaprevir (300mg)/pibrentasvir (120mg), a protease inhibitor and NS5A inhibitor respectively , provides key features for HCV treatment simplification. Eligible participants (naïve pre-cirrhosis chronic HCV patients) will be randomized (1:2) to the standard or simplified monitoring arm and will receive treatment for 8 weeks. One post treatment visit will be conducted 12 weeks after the final dose of study medication to evaluate the proportion of patients with undetectable HCV RNA at this timepoint (SVR12).
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Trial website
https://clinicaltrials.gov/study/NCT03117569
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Trial related presentations / publications
Dore GJ, Feld JJ, Thompson A, Martinello M, Muir AJ, Agarwal K, Mullhaupt B, Wedemeyer H, Lacombe K, Matthews GV, Schultz M, Klein M, Hezode C, Mercade GE, Kho D, Petoumenos K, Marks P, Tatsch F, Dos Santos AGP, Gane E; SMART-C Study Group. Simplified monitoring for hepatitis C virus treatment with glecaprevir plus pibrentasvir, a randomised non-inferiority trial. J Hepatol. 2020 Mar;72(3):431-440. doi: 10.1016/j.jhep.2019.10.010. Epub 2019 Oct 23.
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Public notes
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Contacts
Principal investigator
Name
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Gregory Dore
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Address
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Kirby Institute, University of New South Wales Sydney, Australia
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Phone
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Fax
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Contact person for public queries
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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)
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When will data be available (start and end dates)?
Submitted as part of J Hepatology accepted publication
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Available to whom?
Access via the J Hepatology accepted publication
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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/69/NCT03117569/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/69/NCT03117569/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/NCT03117569