Cirrhosis Clinical Trial
Official title:
Comparative Effectiveness and Tolerability of Boceprevir vs Telaprevir and Re-assessment of Treatment Duration in Patients With Chronic Hepatitis C
1. The primary objective is to study the comparative effectiveness and tolerability of
boceprevir vs. telaprevir in HCV treatment, within the VA population.
2. The secondary objective:
- Resource use: recording of differences in resource use, such as direct costs
(e.g., drug acquisition costs) and other indirect cost (e.g., staff utilization
etc.) as the study will not only derive data by comparing those two drugs but also
study the effect on different treatment lengths.
This is a randomized clinical trial comparing the effectiveness and safety of boceprevir and
telaprevir.
Recruitment of current eligible subjects will occur during their regular appointments at the
Hepatitis C clinic. Eligible patients will have already been cleared for Hepatitis C
treatment through their screening period which is including blood work, liver biopsy, urine
collection/analysis, pregnancy screening and behavioral/mental health screening. On one of
their standard visits to the Hepatitis C clinic, the health care provider(who is also
research staff) or research staff will provide a consent form that the patient may take home
and read more about the study.
On the day of enrollment, which will also be the first day of treatment, health care
providers within the Hepatitis C clinic will describe the study to the patient or refer them
to one of the research for completion of these tasks. The consent form will be explained in
detail at this meeting, and the patient will have the opportunity to ask questions and make
comments about the study.
Study subjects will initially be stratified into 6 groups (1a. treatment naives without
cirrhosis and b. with compensated cirrhosis ; 2a. prior treatment experienced non-responders
without cirrhosis and b. with cirrhosis; 3a. prior treatment experienced relapsers without
cirrhosis and b. with cirrhosis). Patients in each of these groups will be randomized using
random number table and allocation concealment will be achieved by using serially numbered,
opaque, sealed envelopes into one of two study groups. The first group will receive
boceprevir with Peg-IFN and ribavirin as indicated by package insert, and the second group
will receive telaprevir with Peg-IFN and ribavirin as indicated by its package insert. All
other stratified groups will receive protease inhibitor therapy as indicated by the FDA
product labeling.
Safety and effectiveness assessments will be conducted at study entry, PI therapy week 0, 2,
4, 8, 12, 16, 20, 24, 28, 32, 36, 42 and 48, if applicable. Those are SOC visits during the
treatment period and they will include blood tests, complete review of systems, and physical
exams. Patients in all groups will be assessed for sustained viral response (SVR) at 12 and
24 weeks after the last dose of the medication is administered.
Identical to SOC, safety and effectiveness assessments will be determine by health care
providers and the adjudication committee, the latter of which will be unaware of the
treatment arm of the patients. Members of the adjudication committee will be independent of
the treating clinicians, and will be responsible for adjudicating the following outcomes:
- Viral response
- Adverse effects
- Decision regarding treatment discontinuation, based on adverse effect or virological
failure
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