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Safety Study of Low Dose Interleukin 2 (IL-2) Plus PEG-IFN/RBV In Chronic Hepatitis C Virus Genotype I
This study has been terminated.
( Insufficient rate of volunteer accrual. )
First Received: January 12, 2006   Last Updated: March 6, 2008   History of Changes
Sponsors and Collaborators: Weill Medical College of Cornell University
National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: Weill Medical College of Cornell University
ClinicalTrials.gov Identifier: NCT00277758
  Purpose

This is a treatment study trial, in which we will assess the safety and tolerability of daily dose IL-2, as monotherapy for 12 weeks, followed by IL2 in combination with PEG-IFN and RBV for 48 weeks in the treatment of chronic Hepatitis C.


Condition Intervention Phase
Hepatitis C
Biological: Interleukin 2
Drug: Ribavirin
Biological: Pegylated Interferon Alpha
Biological: Inteleukin-2
Drug: Ribavirin + Pegylated interferon-alpha
Phase I

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase I Study of Low Dose Interleukin 2 (IL-2)Monotherapy, Followed by IL-2 Plus PEG-IFN/RBV In Chronic Hepatitis C Virus Genotype I Infection

Resource links provided by NLM:


Further study details as provided by Weill Medical College of Cornell University:

Primary Outcome Measures:
  • Determination of the safety and tolerability of 12 weeks IL2 monotherapy followed by 48 weeks of IL2 combined with PEG-IFN/RBV [ Time Frame: 60 weeks of therapy followed by 24 weeks off therapy ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Determination of specific immunologic responses to HCV. Immunologic assessment will be performed as the sme time intervals as the assays for plasma virus. [ Time Frame: 60 weeks of therapy followed by 24 weeks off therapy ] [ Designated as safety issue: No ]

Enrollment: 18
Study Start Date: March 2004
Study Completion Date: August 2006
Primary Completion Date: July 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
Interventions: 12 weeks of interleukin-2 administration, followed by 48 weeks of interleukin-2 + Ribavirin + interferon-alpha therapy, followed by 24 weeks off therapy
Biological: Interleukin 2
Interleukin-2 at 1.2 mU/M2 administered subcutaneously daily
Drug: Ribavirin
Ribavirin @ 800 mg daily (< 65 kg body weight), 1000 mg (65-85 kg), and 1200 mg (> 85 kg)
Biological: Pegylated Interferon Alpha
Pegylated-Interferon-alpha 1.5 ug/kg weekly subcutaneously.
Biological: Inteleukin-2
Interleukin-2 administered as a daily subcutaneous injection at 1.2 mU/M2 BSA
2: Active Comparator
48 weeks of therapy with Ribavirin + interferon-alpha, followed by 24 weeks off therapy
Drug: Ribavirin
Ribavirin @ 800 mg daily (< 65 kg body weight), 1000 mg (65-85 kg), and 1200 mg (> 85 kg)
Biological: Pegylated Interferon Alpha
Pegylated-Interferon-alpha 1.5 ug/kg weekly subcutaneously.
Drug: Ribavirin + Pegylated interferon-alpha
Pegylated interferon-alpha administered 1.5 ug/kg weekly. Ribivirin 800 mg daily for body weight <65 kg, 1000 mg for body weight 65-85 kg, and 1200 mg for body weight >85 kg.

Detailed Description:

This is a single center study of 12 weeks of IL-2 lead in immunotherapy followed by 48 weeks of IL2 immunotherapy in combination with Pegylated Interferon Alpha (PEG-IFN-alpha) /Ribavirin (RBV) antiviral therapy for the treatment of individuals infected with Hepatitis C virus (HCV) genotype I. The study is designed to determine whether immunotherapy immunotherapy with low dose daily IL-2 can be safely added to the standard antiviral therapy of 48 weeks of PEG-IFN and RBV. Because IL-2 targets recently antigen- activated T cells, IL-2 therapy will be initiated 12 weeks before PEG-IFN/RBV therapy, when HCV antigen load is high, to activate and expand HCV antigen-specific T cells prior to the initiation of antiviral therapy.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men and women, age >18 years to < 65 years.
  • Ability and willingness to sign an informed consent.
  • Hepatitis C antibody positive status confirmed by the NYPH laboratory.
  • Genotype 1 HCV confirmed by the NYPH laboratory using the DupliType assay as performed by Quest Diagnostics.
  • Liver biopsy demonstrating chronic hepatitis but without cirrhosis within 2 years of enrollment.
  • Prothrombin time < 3 seconds longer than control.
  • Platelet count ≥75,000 mm3
  • Neutrophil count ≥ 1000/mm3
  • Hemoglobin ≥12 g/dL for women and ≥13 g/dL for men
  • Subject must agree not to participate in a conception process (defined as active attempt to become pregnant or to impregnate, donate sperm, in vitro fertilization etc.) while on study drugs and for 6 months following permanent discontinuation of study therapy.

Women of reproductive potential (defined for this study as sexually mature women who have not been post-menopausal for at least 24 consecutive months, or have not undergone hysterectomy or oophorectomy) must have a negative serum or urine pregnancy test with a sensitivity of at least 50 MIU/mL performed within 30 days prior to enrollment and again within 24 hours before initiating study therapy.

All subjects must not participate in a conception process, and if participating in sexual activity that could lead to pregnancy, male subjects must take every precaution to avoid risk of pregnancy for their female partners, women subjects/male partners must use two reliable methods of contraception simultaneously, while receiving study therapy and for 6 months following permanent discontinuation of study therapy.

NOTE A: Reliable forms of contraception are a combination of two of the following methods: 1) condoms (male or female) with or without a spermicidal agent. 2) diaphragm or cervical cap with spermicide, 3) IUD, or 4) hormonal-based contraception.

NOTE B: An IUD is an adequate method of contraception but increases the risk of pelvic inflammatory disease.

Exclusion Criteria:

  • Previous IFN-alpha, RBV or IL2 therapy
  • Any active viral hepatitis other than hepatitis C virus infection, as defined by the presence of IgM antibody to Hepatitis A Virus (HAV) within 30 days of enrollment, or Hepatitis B Virus Surface Antigen (HBsAg) positivity, or positive plasma HBV DNA by PCR methodology when HB core antibody is the only serologic marker of HBV infection within 30 days of entry.
  • ALT and AST > 5x ULN, total bilirubin > 1.5 x ULN
  • Signs/symptoms of advanced liver disease.
  • Uncontrolled infection, except hepatitis C
  • HIV infection as determined by HIV ELISA & Western blot assay, and confirmed by plasma HIV assay (PCR or bDNA)
  • Cardiac condition that cannot be controlled by medication: Because of the risk of anemia associated with RBV use and the potential to induce cardiac ischemia, subjects with a positive cardiac stress test are ineligible.

Therefore, subjects > 40 years of age with ≥ 1 risk factor for ASHD (i.e., hyperlipidemia, hypertension, smoking history, family history) should have an EKG preformed. If the EKG is abnormal and consistent with ischemic heart disease, the subject should have a cardiac stress test to R/O ASHD.

  • CNS or psychiatric illness uncontrolled by medication. In particular, psychiatric illness, especially depression. Subjects with a psychiatric illness, a previous suicide attempt or hospitalization for a psychiatric Dx Will be enrolled at the discretion of the investigator.
  • Concurrent therapy with any immune-modulating agents, e.g,. interleukins, interferons, therapeutic vaccines, corticosteroids, immunosuppressive agents (azathioprine, 6-mercaptopurine, Cyclosporine-A, FK506, Rapamycin, antilymphocyte antibodies).
  • Pregnant or nursing women (all women of child bearing age should be using effective contraception)
  • History of malignancy with receipt of cancer therapy within 24 weeks.
  • Any severe illness that would make the subject unsuitable for the study.
  • Active asthma, or asthma uncontrolled by medication.
  • Any immunologically mediated disease, including Crohn's disease, ulcerative colitis, rheumatoid arthritis, lupus erythematosis, ITP, autoimmune hemolytic anemia, eczema, psoriasis.
  • Untreated thyroid disease.
  • Heroin or cocaine use within 9 months of enrollment.
  • Inadequate venous access.

NOTE: If screening TSH is abnormal, obtain free thyroxin index. If the free thyroxine index is normal, the subject may enter the study. If the free thyroxin index is low, the subject may be treated with thyroid hormone replacement medication and enter the study once the free thyroxin index is corrected. If the free thyroxin index is elevated indicating hyperthyroidism, the subject should not enroll in the study.

Patients with preexistent antibodies against thyroid peroxidase or thyroglobulin should not be enrolled.

  • Allergy to any of the medications to be used in the study (i.e., IL2, PEG-IFN/RBV), or other components of the study products. Peg Intron: benzyl alcohol, NaCl, Na-phosphate, EDTA, polysorbate 80, m-cresol, IL2; phosphate buffer, SDS, mannitol. RBV: cellulose, lactose, croscarmellose, magnesium stearate, Blue pharmaceutical ink: shellac, anhydrous ethyl alcohol, isopropyl alcohol, n-butyl alcohol, propylene glycol, ammonium hydroxide, Blue # 2 aluminum lake.
  • Alcohol dependency, for example, current alcohol use of more than 1 drink/day any time during the previous 6 months. One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1-¼ ounces of hard liquor.
  • Severe retinopathy due to diabetes, hypertension, CMV, or macular degeneration
  • Acute therapy for a serious infection or other serious medical illness that is potentially life threatening and requires systemic therapy and/or hospitalization within 14 days of study entry.
  • Serum creatinine > 2.0 mg/dL or creatinine clearance < 50 mL/min as estimated by the Cockcroft-Gault equation. This screening value must be obtained within 30 days of enrollment.
  • History of major organ transplantation with an existing graft.
  • Subject judged by the investigator to be at significant risk of failing to comply with the provisions of the protocol as to cause harm to self or seriously interfere with the validity of the study results.
  • Subjects with biopsy proven liver disease other than HCV infection.
  • Subjects with hemoglobinopathies or any other causes or tendencies toward hemolysis.
  • Subjects with chronic pulmonary disease with functional limitations.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00277758

Locations
United States, New York
Weill Medical College of Cornell University
New York, New York, United States, 10021
Sponsors and Collaborators
Weill Medical College of Cornell University
Investigators
Principal Investigator: Kendall A Smith, MD Weill Medical College of Cornell University
  More Information

No publications provided

Responsible Party: weill Medical College of Cornell University ( Kendall A. Smith, Professor of Medicine )
Study ID Numbers: 00-092, UO1 AI48224
Study First Received: January 12, 2006
Last Updated: March 6, 2008
ClinicalTrials.gov Identifier: NCT00277758     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Weill Medical College of Cornell University:
Interleukin-2

Study placed in the following topic categories:
Antimetabolites
Anti-Infective Agents
Liver Diseases
Interferon Type I, Recombinant
Hepatitis, Chronic
Immunologic Factors
Ribavirin
Hepatitis, Viral, Human
Hepatitis C
Analgesics
Interferon-alpha
Interferons
Antiviral Agents
Angiogenesis Inhibitors
Virus Diseases
Hepatitis
Aldesleukin
Digestive System Diseases
Interleukin-2
Analgesics, Non-Narcotic
Peginterferon alfa-2b
Peripheral Nervous System Agents
Interferon Alfa-2a
Interferon Alfa-2b
Hepatitis C, Chronic

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Interferon Type I, Recombinant
Liver Diseases
Molecular Mechanisms of Pharmacological Action
Flaviviridae Infections
Hepatitis, Chronic
Immunologic Factors
Antineoplastic Agents
Ribavirin
Physiological Effects of Drugs
Hepatitis, Viral, Human
Sensory System Agents
Therapeutic Uses
Analgesics
Growth Inhibitors
Hepatitis C
Angiogenesis Modulating Agents
Interferon-alpha
RNA Virus Infections
Growth Substances
Interferons
Antiviral Agents
Angiogenesis Inhibitors
Pharmacologic Actions
Virus Diseases
Hepatitis
Digestive System Diseases
Analgesics, Non-Narcotic
Interleukin-2

ClinicalTrials.gov processed this record on September 11, 2009