Safety and Efficacy of Ledipasvir/Sofosbuvir Fixed Dose Combination +/- Ribavirin in Adolescents and Children With Chronic HCV-Infection

Gilead Sciences

Status and phase: Completed; Phase 2

Conditions: Hepatitis C Virus Infection

Treatments: Drug: RBV; Drug: LDV/SOF

Study type: Interventional

Funder types: Industry

Identifiers

NCT02249182

GS-US-337-1116

2014-003578-17 (EudraCT Number)

Details and patient eligibility

About

The primary objective of the PK Lead-in Phase of the study is to evaluate the steady state pharmacokinetics (PK) and confirm the dose of ledipasvir/sofosbuvir (LDV/SOF) fixed dose combination (FDC) in hepatitis C virus (HCV)-infected pediatric participants. The PK Lead-in Phase will also evaluate the safety, tolerability, and antiviral activity of 10 days of dosing of LDV/SOF FDC in HCV-infected pediatric participants.

The Treatment Phase will be initiated by age cohort after confirmation of age-appropriate LDV/SOF FDC dosage levels. Participants from the PK Lead-in Phase will immediately rollover into the Treatment Phase with no interruption of study drug administration. The primary objective of the Treatment Phase is to evaluate the antiviral efficacy, safety, and tolerability of LDV/SOF FDC +/- ribavirin (RBV) for 12 or 24 weeks in pediatric participants with HCV.

During screening, participants will receive placebo to match LDV/SOF FDC to assess ability to swallow tablets.

Enrollment: 226 patients

Sex: All

Ages: 3 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Key Inclusion Criteria:

• Consent of parent or legal guardian required
• Chronic HCV infection
• Screening laboratory values within defined thresholds

Key Exclusion Criteria:

• History of clinically significant illness or any other medical disorder that may interfere with individual's treatment, assessment or compliance with the protocol.
• Co-infection with HIV, acute hepatitis A virus, or hepatitis B virus
• Clinical hepatic decompensation (i.e., ascites, encephalopathy or variceal hemorrhage)
• Pregnant or nursing females
• Known hypersensitivity to study medication
• Use of any prohibited concomitant medications as within 28 days of the Day 1 visit

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

226 participants in 3 patient groups

12 to < 18 Years Old

Experimental group

Description:

Participants between 12 to \< 18 years of age weighing ≥ 45 kg will receive LDV/SOF FDC (90/400 mg tablet or 4 x 22.5 mg/100 mg tablets or 8 x 11.25/50 mg granules based on swallowability assessment during screening). Treatment duration will be dependent on HCV genotype, prior treatment experience, cirrhosis status, and country of enrollment. United Kingdom: * HCV genotypes (GT) 1, 4, 5, or 6 treatment-naive (TN) with or without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 treatment-experienced (TE) without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE with cirrhosis = LDV/SOF 24 weeks * HCV GT 3 TE with or without cirrhosis = LDV/SOF+RBV 24 weeks United States/Australia/New Zealand: * HCV GT 1, 4, 5, or 6 TN with or without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE without cirrhosis = LDV/SOF 12 weeks * HCV GT 1 TE with cirrhosis = LDV/SOF 24 weeks * HCV GT 4, 5, or 6 TE with cirrhosis = LDV/SOF 12 weeks

Treatment:

Drug: LDV/SOF

Drug: RBV

6 to < 12 Years Old

Experimental group

Description:

Participants between 6 to \< 12 years of age weighing ≥ 17 kg and \< 45 kg will receive LDV/SOF FDC (45/200 mg as 2 x 22.5/100 mg tablets or 4 x 11.25/50 mg granules based on swallowability assessment during screening). Treatment duration will be dependent on HCV genotype, prior treatment experience, cirrhosis status, and country of enrollment. United Kingdom: * HCV GT 1, 4, 5, or 6 TN with or without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE with cirrhosis = LDV/SOF 24 weeks * HCV GT 3 TE with or without cirrhosis = LDV/SOF+RBV 24 weeks United States/Australia/New Zealand: * HCV GT 1, 4, 5, or 6 TN with or without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE without cirrhosis = LDV/SOF 12 weeks * HCV GT 1 TE with cirrhosis = LDV/SOF 24 weeks * HCV GT 4, 5, or 6 TE with cirrhosis = LDV/SOF 12 weeks

Treatment:

Drug: LDV/SOF

Drug: RBV

3 to < 6 Years Old

Experimental group

Description:

Participants between 3 to \< 6 years of age weighing ≥ 17 kg will receive LDV/SOF FDC (45/200 mg granules as 4 x 11.25/50 mg packets) and participants weighing \< 17 kg will receive LDV/SOF FDC (33.75/150 mg oral granules as 3 x 11.25/50 mg packets). Treatment duration will be dependent on HCV genotype, prior treatment experience, cirrhosis status, and country of enrollment. United Kingdom: * HCV GT 1, 4, 5, or 6 TN with or without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE with cirrhosis = LDV/SOF 24 weeks * HCV GT 3 TE with or without cirrhosis = LDV/SOF+RBV 24 weeks United States/Australia/New Zealand: * HCV GT 1, 4, 5, or 6 TN with or without cirrhosis = LDV/SOF 12 weeks * HCV GT 1, 4, 5, or 6 TE without cirrhosis = LDV/SOF 12 weeks * HCV GT 1 TE with cirrhosis = LDV/SOF 24 weeks * HCV GT 4, 5, or 6 TE with cirrhosis = LDV/SOF 12 weeks

Treatment:

Drug: LDV/SOF

Drug: RBV