Induction of Fibrosis Regression on Patients With Chronic Hepatitis B Infection (INFIRE)

This study will examine whether 12 month treatment with entecavir(Baraclude®) has an effect on changes of liver stiffness measurement (LSM) and of hyaluronan measurement in patients with chronic hepatitis B infection.

Study Overview

• Status: Terminated
• Conditions: Hepatitis B, Chronic; Liver Fibrosis
• Intervention / Treatment: Drug: Treatment with entecavir(Baraclude®)

Detailed Description

Patients with chronic hepatitis B infection and relevant liver fibrosis will be treated with entecavir during 5 years or until anti-HBs seroconversion or 6-12 months after anti-HBe seroconversion and HBeAg loss. There are 9 visits during treatment for each patient. At all visits, each patient will consent to give 20 ml blood sample for study examination and 40 ml blood sample for research purposes.

• Study Type: Interventional
• Enrollment (Actual): 7
• Phase: Phase 4

Contacts and Locations

Study Locations

• Germany
  • NRW
    • Aachen, NRW, Germany, 52074
      • Department of Internal Medicin III, University Hospital Aachen

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• chronic hepatitis B infection with detectable HBV (hepatitis B virus)-DNA at baseline
• results of a current liver biopsy (date of liver biopsy must not be longer than 3 months as date of screening visit)
• detection of relevant liver fibrosis in liver histology after percutaneous or laparoscopic biopsy (histologically ≥ F2) after estimation by an experienced pathologist in the liver pathology and sufficient evaluability of the biopsy (usually evaluation of portal at least 8 fields)
• Therapy indication according to current guidelines cHBV infection ( any virus replication in the presence of liver cirrhosis, or detection of HBV-DNA ≥ 2000 IU / ml and/or liver histology with inflammatory Grade ≥2 / fibrosis stage 2 and presence of ALT <5 x ULN)

• non-pregnant and non-breastfeeding women, who fitful one of following criteria: * post-menopausal (12 months natural amenorrhea or 6 months amenorrhea with serum FSH (follicle stimulating hormone)> 40mlU/ml)

  • 6 weeks after surgical sterilization by bilateral tubal transection or after bilateral oophorectomy with or without hysterectomy
  • Correct application of two methods of sure contraception (any combination of a hormonal contraceptive (the pill, hormone IUD (intrauterine device), Depo-Provera, Implanon, contraceptive patch or vaginal ring) or IUD with a barrier contraceptive with spermicide (diaphragm, cervical cap, LEA contraceptive, female condoms or condom)or a spermicide.
  • Sexual abstinence for 2 weeks before the first administration of the study medication, during the study period and after the study during 30 days (time of elimination of study medication)
  • Patients, who have only female sexual partners
  • Male partner of a female patient, who before study inclusion, sterile and only one sexual partner of this female patient is
• Patients willing and able to complete the requirements of this study

Exclusion Criteria:

• anamnestic known hypersensitivity to Baraclude® or its ingredients or to drugs with similar chemical structure
• Participation of patients in another clinical study within last 4 weeks prior to the inclusion or simultaneous participation in another clinical study
• anamnestic known substance dependance or another diseases, which not allowed persons to understand essence and importance and possible consequences of the trial
• lack of cooperation and informed consent
• co-infection with hepatitis C, hepatitis D or HIV
• detection of hepatocellular carcinoma
• serious, chronic disease with an estimated prognosis for survival shorter than the study period of 5 years
• every previous therapy with lamivudine or telbivudine or previous therapy with other antiviral substance within last 6 months before study inclusion
• contraindications to the use of entecavir
• creatinine clearance <50 ml / min and / or need for hemodialysis
• MELD score >15 points and / or detection of ascites

Study Plan

How is the study designed?

Design Details

• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment Arm; Patients will be treated with entecavir	Drug: Treatment with entecavir(Baraclude®); Patient will be daily treated with 1 tablet of entecavir per oral

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes of liver stiffness measurement (LSM) and hyaluronan measurement in blood	Changes of liver stiffness measurement (LSM) and hyaluronan measurement in blood will be checked as markers of fibrous tissue in the liver after treatment with entecavir(Baraclude®) within 12 month.	12 Month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes on Pro-Collagen-III-N-Peptid, Tissue Inhibitor of Metalloproteinases (TIMP-1) and Chitinase-3-like protein 1(YKL-40) in serum	Changes on Pro-Collagen-III-N-Peptid, Tissue Inhibitor of Metalloproteinases (TIMP-1) and Chitinase-3-like protein 1(YKL-40) in serum will be checked after 12 month treatment.	12 Month
Sensitivity and specificity of non-invasive marker at the baseline in comparison to liver biopsy as a gold standard	Non-invasive marker(liver stiffness measurement(LSM) with FibroScan and serum parameter(hyaluronan measurement, Pro-Collagen-III-N-Peptid, Tissue Inhibitor of Metalloproteinases(TIMP-1) and Chitinase-3-like protein 1(YKL-40))) at the baseline will be compared with results of liver biopsy as gold standard after treatment with entecavir(Baraclude®) within 12 month.	12 Month
Changes on FibroScan-measurement (LSM) and serum parameter	Changes on FibroScan-measurement (LSM) and serum parameter (hyaluronan measurement, Pro-Collagen-III-N-Peptid, Tissue Inhibitor of Metalloproteinases(TIMP-1) and Chitinase-3-like protein 1(YKL-40))) will be checked at timepoints of 6,12,18,24,36,48 and 60 month after treatment with entecavir(Baraclude®) within 12 month.	6,12,18,24,36,48 and 60 month
Decrease of hepatitis B virus-DNA and quota of patients with non-detectable hepatitis B virus-DNA at separate timepoints.	Measurement of decrease of hepatitis B virus-DNA and quota of patients with non-detectable hepatitis B virus-DNA at several timepoints after treatment with entecavir(Baraclude®) within 12 month.	6, 12, 18, 24, 32, 48 and 60 month
Quota of patients with normalization of Alanine transaminase(ALT)-measurement in blood at separate timepoints	Quota of patients with normalization of Alanine transaminase(ALT)-measurement in blood will be checked at separate timepoints after treatment with entecavir(Baraclude®) within 12 month.	6,12, 18, 24, 32, 48 and 60 month
Quota of patients with hepatitis B viral protein loss, antibodies to the the hepatitis B 'e' antigen seroconversion, surface antigen of the Hepatitis-B-Virus loss and antibodies to the hepatitis B core antigen seroconversion at separate timepoints	Quota of patients with core antigen hepatitis B viral protein (HBeAg) loss, antibodies to the the hepatitis B 'e' antigen(anti-HBe) seroconversion, surface antigen of the Hepatitis-B-Virus(HBsAg) loss and antibodies to the hepatitis B core antigen(anti-HBs) seroconversion will be checked at separate timepoints after treatment with entecavir(Baraclude®) within 12 month.	6,12, 18, 24, 32, 48 and 60 month
Incidence of side effects	Incidence of appearance of side effects of after 12 month treatment with entecavir(Baraclude®)within whole study period of 60 month.	60 month

Collaborators and Investigators

• Sponsor: RWTH Aachen University
• Collaborators: Hannover Medical School
• Investigators: Principal Investigator: Christian Trautwein, Professor MD, Department of Internal Medicine III, University Hospital Aachen

Study record dates

Study Major Dates

• Study Start: April 1, 2011
• Primary Completion (Actual): January 1, 2015
• Study Completion (Actual): April 1, 2015

Study Registration Dates

• First Submitted: April 20, 2011
• First Submitted That Met QC Criteria: April 21, 2011
• First Posted (Estimate): April 25, 2011

Study Record Updates

• Last Update Posted (Estimate): September 23, 2015
• Last Update Submitted That Met QC Criteria: September 22, 2015
• Last Verified: September 1, 2015

More Information

Terms related to this study

• Keywords: liver fibrosis; chronic hepatitis B; treatment with Entecavir
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; RNA Virus Infections; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Liver Diseases; Hepatitis, Viral, Human; Hepadnaviridae Infections; DNA Virus Infections; Enterovirus Infections; Picornaviridae Infections; Fibrosis; Hepatitis B; Hepatitis; Hepatitis A; Hepatitis B, Chronic; Hepatitis, Chronic; Liver Cirrhosis; Anti-Infective Agents; Antiviral Agents; Entecavir
• Other Study ID Numbers: CTC-A 11-018; 2010-019884-12 (EudraCT Number); 11-018 (CTC-A)