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Long-term Pegylated Alfa-2b Interferon Therapy of Patients With Hepatitis C-related Cirrhosis and High Liver Cell Proliferation: a Multicenter Study of Hepatocellular Carcinoma Prevention in Patients Non-responders to Combined Therapy With Alpha Interferon + Ribavirin or Peginterferon Alpha + Ribavirin or to Interferon Monotherapy


Phase 3
18 Years
70 Years
Not Enrolling
Both
Carcinoma, Hepatocellular

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Trial Information

Long-term Pegylated Alfa-2b Interferon Therapy of Patients With Hepatitis C-related Cirrhosis and High Liver Cell Proliferation: a Multicenter Study of Hepatocellular Carcinoma Prevention in Patients Non-responders to Combined Therapy With Alpha Interferon + Ribavirin or Peginterferon Alpha + Ribavirin or to Interferon Monotherapy


Inclusion Criteria:



- Cirrhotic participants, both sexes, Child Pugh A, B, HCV-RNA positive, age < 70 years

- Participants non-responders to IFN + Ribavirin or PegIFN + Ribavirin or IFN
monotherapy

- Pre-therapy liver biopsy (< 36 months) with PCNA-LI > 2.0

- Fibrosis score 5-6 (Ishak)

- Initial portal hypertension, such as gastroesophageal varices or one of the following
US sign:

- Collateral circles

- Spleen longitudinal diameter > 12 cm

- Portal vein diameter at hilus > 12 mm

- Portal flow > 12 cm/sec

- Participants must have the following minimum hematologic and biochemical
criteria:

- Hemoglobin >= 11 g/dL

- Granulocyte count > 1,000/mm^3

- Platelets > 70,000/mm^3

- Prothrombin activity > 50%

- Total bilirubin <3 mg/dL

- Albumin >= 3.5 g/dL

- Serum creatinine within normal limits

- Uric Acid within normal limits

- Thyroid Stimulating Hormone (TSH), within normal limits

- Antinuclear antibodies (ANA) < 1:160

- Written informed consent

- Women of childbearing potential must have a negative pregnancy test

- Acceptance of patients of both sexes of proper contraceptive measures for the study
period

Exclusion Criteria:

- Pregnant or breast-feeding women

- Co-infection with HIV and/or HBV

- Autoimmune hepatitis or history of autoimmune disease

- Alcoholic liver disease

- Metabolic disease

- HCC

- Participants with liver and kidney transplants

- Evidence of decompensated liver disease such as history or presence of ascites,
bleeding varices, spontaneous encephalopathy

- Chronic renal failure or creatinine clearance < 50 mL/min

- Pre-existing thyroid disease unless it can be controlled with conventional treatment

- History or presence of psychiatric condition, especially depression, or a history of
severe psychiatric disorder, such as major psychoses, suicidal ideation and/or
suicidal attempt

- Epilepsy and/or compromised central nervous system (CNS) function

- Significant cardiovascular dysfunction within the previous 6 months before the study
starts (eg, angina, congestive heart failure, recent myocardial infarction, moderate
or severe hypertension, significant arrhythmia)

- Hemoglobinopathies

- Poorly controlled diabetes mellitus

- Chronic pulmonary disease (eg, chronic obstructive pulmonary disease)

- Clinical gout

- Hypersensitivity to interferons or any component of the drug

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Outcome Measure:

Number of Participants With the Development of Hepatocellular Carcinoma (HCC)

Outcome Description:

Participants were tested for focal lesions by liver ultrasound and for AFP levels every 6 months the during study (treatment and follow-up). The development of hepatocellular carcinoma was determined by: the appearance of a focal lesion detected by liver ultrasound with metastases confirmed by fine needle biopsy, or the appearance of a focal lesion detected by ultrasound + alphafetoprotein (AFP) levels in blood >400 ng/mL.

Outcome Time Frame:

During 3 years of treatment and 2 years of follow-up

Safety Issue:

No

Authority:

Italy: Ministry of Health

Study ID:

P02733

NCT ID:

NCT00759109

Start Date:

January 2002

Completion Date:

November 2009

Related Keywords:

  • Carcinoma, Hepatocellular
  • Carcinoma
  • Hepatitis
  • Hepatitis C
  • Fibrosis
  • Carcinoma, Hepatocellular

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