Study of Combivir for Patients With Primary Biliary Cirrhosis

This study has been completed.
Sponsor:
Collaborators:
GlaxoSmithKline
Axcan Pharma
Information provided by:
University of Alberta
ClinicalTrials.gov Identifier:
NCT00490620
First received: June 21, 2007
Last updated: October 31, 2007
Last verified: October 2007

June 21, 2007
October 31, 2007
January 2004
Not Provided
The percentage of patients with either (i) normalized alkaline phosphatase, (ii) normalized AST and ALT or (iii) normal alkaline phosphatase, AST and ALT will be recorded. [ Time Frame: During the 6 months of therapy ]
Same as current
Complete list of historical versions of study NCT00490620 on ClinicalTrials.gov Archive Site
50% improvement towards baseline for alkaline phosphatase, AST and ALT, changes in symptoms using an objective graded clinical parameter scale, serum AMA titers, quantitative immunoglobulins and virologic parameters. [ Time Frame: During the 6 months of therapy ]
Same as current
Not Provided
Not Provided
 
Study of Combivir for Patients With Primary Biliary Cirrhosis
Randomized Controlled Pilot Study of Combivir for Patients With Primary Biliary Cirrhosis

This is a proof of principal study to determine whether combination anti-viral therapy with Combivir impacts on hepatic biochemistry in patients with primary biliary cirrhosis

A novel human retrovirus has been cloned from a cDNA library derived from biliary epithelia cells extracted from patients with Primary Biliary Cirrhosis. Although there is no formal proof that this virus is etiologically related to the disease, we have found evidence for viral infection in the majority of patients with PBC using standard serologic and hybridization assays. In order to address the hypotheses that PBC is etiologically related to a retrovirus infection and that anti-retroviral therapy may be beneficial for patients with PBC, we have conducted 2 pilot studies using lamivudine and Combivir (lamivudine 150mg and Zidovudine 300mg). On the whole, little clinical improvement was observed in patients on lamivudine therapy alone, whereas those on Combivir had significant reductions of hepatic biochemistry studies and histologic improvement. Moreover, 4 of 10 Combivir patients completely normalized their liver function tests and the anti-viral therapy was well tolerated. We now propose a larger randomized trial to assess the short term (6 months) safety and efficacy of Combivir for patients with PBC. Efficacy in this study will be defined using both liver biochemistries and virologic endpoints.

Interventional
Phase 2
Phase 3
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Primary Biliary Cirrhosis
  • Drug: Combination antiviral therapy
    Zidovudine 300mg and lamivudine 150mg BID for 6 months
    Other Name: Combivir
  • Drug: Placebo
    placebo BID for 6 months
  • Placebo Comparator: 1
    blinded placebo control
    Intervention: Drug: Placebo
  • Active Comparator: 2
    Antiretroviral therapy
    Intervention: Drug: Combination antiviral therapy

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
59
April 2007
Not Provided

Inclusion Criteria:

  • Patients 18 years old of either sex will be recruited for this study.
  • Persistently elevated alkaline phosphatase or serum aminotransferases of at least 1.5 times normal after a minimum of 6 months UDCA therapy.
  • Positive serum AMA (titer > 1:20).
  • Liver biopsy histology compatible with PBC obtained at any time prior to study.
  • Maintained on UDCA at a dose of 13-15 mg/kg for 6 or more months.
  • Patients must read and sign informed consent form.

Exclusion Criteria:

  • Patients treated with immunosuppressive or anti-inflammatory agents such as colchicine, methotrexate, D-penicillamine, cyclosporine, tacrolimus, mycophenolate mofetil, corticosteroid therapy will be excluded but may enter the study after a 3 month period off immunosuppressive and anti-inflammatory therapy.
  • Advanced liver disease: Childs Pugh class B or C cirrhosis, recurrent variceal hemorrhage, spontaneous encephalopathy, diuretic resistant ascites, need for liver transplantation within the year.
  • Patients with a secondary hepatic diagnosis such as viral hepatitis, drug induced liver injury, extrahepatic biliary obstruction, primary sclerosing cholangitis, metabolic liver diseases or alcoholic liver disease.
  • Regular use of more than 30 g of alcohol per day in the last year.
  • Patients with a predicted survival of less than 3 years from malignant or other potentially life threatening disease.
  • Creatinine clearance less than < 70 mL/min using the Cockcroft Gault equation:
  • Clinically apparent pancreatitis.
  • Serum amylase > 3 x upper limit of normal (patients with sicca syndrome and salivary gland disease may have elevated amylase levels)
  • Pregnancy or breast-feeding a child.
  • Sexually active patients of child bearing age and not using effective contraception.
  • Allergic reaction to Combivir like drugs
  • Clinical evidence of myositis
  • Weight of < 50 Kg
Both
18 Years to 75 Years
No
Contact information is only displayed when the study is recruiting subjects
United States,   Canada,   United Kingdom
 
NCT00490620
Col40296
No
Not Provided
University of Alberta
  • GlaxoSmithKline
  • Axcan Pharma
Principal Investigator: Andrew L Mason, MBBS MRCPI University of Alberta
Principal Investigator: Bruce Bacon, MD St. Louis University
Principal Investigator: Keith Lindor, MD Mayo Clinic Foundation
Principal Investigator: James Neuberger, MD FRCP University of Birmingham
Principal Investigator: Catherine Vincent, MD FRCPC Université de Montréal
University of Alberta
October 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP