Study on an Optimal Antiviral Treatment in HBeAg Positive Chronic Hepatitis B Patients

September 21, 2021 updated by: Xinxin Zhang, Ruijin Hospital

A Prospective, Randomized, Multicenter, Open-label Study of Optimal Antiviral Treatment in HBeAg Positive Chronic Hepatitis B Patients

The current study is a prospective, randomized, open, multi-center investigation. The aim of the study is to investigate whether the HBeAg seroconversion rate can be improved if applying combination therapy in HBeAg positive CHB patients who has achieved HBVDNA<105copies/ml，HBsAg≤5000IU/ml, ALT≥ 2ULN or Liver histology G2S2.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The HBeAg positive chronic hepatitis B(CHB) subjects who has achieved HBV DNA<10*5copies/ml，HBsAg≤5000IU/ml, ALT≥ 2ULN or Liver histology G2S2 will be randomized to three groups. The subjects who go into group A will be treated by tenofovir disoproxil fumarate (TDF) for 96 weeks; The subjects who go into group B will be treated by TDF in the first 48 weeks, then will be treated by the combination of TDF and Peginterferon alfa-2a for another 48 weeks; The subjects who go into group C will be treated by the combination of TDF and Peginterferon alfa-2a for the first 48 weeks, then will be treated by TDF for another 48 weeks.

Study Type

Interventional

Enrollment (Anticipated)

180

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
      • Hangzhou, China
        • Recruiting
        • Xixi hospital of Hangzhou
        • Contact:
          • Xiaoqing Fu
      • Shanghai, China
      • Shanghai, China
      • Shanghai, China
        • Recruiting
        • Hua shan Hospital,Fudan University
        • Contact:
      • Shanghai, China
        • Recruiting
        • Infectious diesease hospital of Huangpu district in Shanghai
        • Contact:
          • Hailin Liang
      • Shanghai, China
      • Shanghai, China
      • Shanghai, China
        • Recruiting
        • Tongren Hospital Shanghai Jiaotong University School of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Male and female patients with age ≥18 and ≤65 years;
  2. There should be evidences that HBsAg and HBeAg have been positive for more than 6 months with HBsAb and HBeAb negative;HBsAg≤50000IU/ml, ALT≥ 2ULN,Liver histology above G2S2 and HBV DNA≥10*5 copies/mL;
  3. Women without ongoing pregnancy or breast feeding and both women and men willing to take an effective contraceptive measure during the treatment;
  4. Agree to participate in the study and sign the patient informed consent form.

Exclusion Criteria:

  1. Treated by immunosuppressant,immunomodulator,Systemic cytotoxic drug,herbs or HBIg within 6 months prior to the first dose of treatment;
  2. ALT≥10 X ULN or total bilirubin ≥2 X ULN;
  3. Allergic history to interferon;
  4. Co-infection with active hepatitis A, hepatitis C, hepatitis D and/or human immunodeficiency virus (HIV);
  5. Child-Pugh scores >7;
  6. History or other evidence of a medical condition associated with chronic liver disease other than viral hepatitis (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures, thalassemia);
  7. Pregnant or breast-feeding Women;
  8. Consuming alcohol in excess of 20g/day for women and 30g/day for men within 6 months prior to enrollment or drug taking history;
  9. ANC(absolute neutrophil count)<1.5x 10^9/L or PLT(platelet count)<90x 10^9/L
  10. Creatinine over upper limit of normal;
  11. History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as major depression or psychosis that treated with antidepressant medication or a major tranquilizer at therapeutic doses respectively at any time prior to 3 months or any history of the following: a suicidal attempt hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease;
  12. History of immunologically mediated disease, (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, rheumatoid arthritis etc.);
  13. History of esophageal varices bleeding or other evidence of esophageal varices bleeding or other symptoms consistent with decompensated liver disease;
  14. History of severe cardiac disease (e.g., New York Heart Association Functional Class III or IV, myocardial infarction within 6 months, ventricular tachyarrhythmias requiring ongoing treatment, unstable angina or other significant cardiovascular diseases);
  15. Hemodialysis patients or patients with renal insufficiency;
  16. History of a severe seizure disorder or current anticonvulsant use;
  17. Major organ transplantation or other evidence of severe illness, malignancy, or any other conditions, which would make the patient, in the opinion of the investigator, unsuitable for the study;
  18. History of thyroid disease poorly controlled on prescribed medications;
  19. Evidence of severe retinopathy or clinically relevant ophthalmologic disorder;
  20. History of other severe disease or evidence of other severe disease or any other illness or conditions that the investigator believe that patients are not suitable to join in the study;
  21. Patients included in another trial or having been given investigational drugs within 12 weeks prior to screening;
  22. AFP(alpha feto protein)>50ng/ml and/or evidence of hepatocellular carcinoma;
  23. Other disease should exclusive considered by the investigator.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group A,TDF
The subjects in group A will be treated by TDF for 96 weeks
Drug: Group A, TDF
TDF for 96 weeks
Other Names:
  • tenofovir
Experimental: Group B,TDF+PEG
The subjects in group B will be treated by TDF in the first 48 weeks, then will be treated by the combination of TDF and Peginterferon alfa-2a for another 48 weeks
Drug: Group B:TDF then TDF and Peginterferon alfa-2a
Subjects will be treated by TDF in the first 48 weeks, then will be treated by the combination of TDF and Peginterferon alfa-2a for another 48 weeks
Other Names:
  • tenofovir,pegasys
Experimental: Group C,TDF+PEG
The subjects in group C will be treated by the combination of TDF and Peginterferon alfa-2a for the first 48 weeks, then will be treated by TDF for another 48 weeks
Drug: Group C:TDF and Peginterferon alfa-2a then TDF
Subjects will be treated by the combination of TDF and Peginterferon alfa-2a for the first 48 weeks, then will be treated by TDF for another 48 weeks.
Other Names:
  • tenofovir,pegasys

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of subjects who achieve HBeAg seroconversion
Time Frame: at 96 week
The number of subjects with HBeAg seroconversion at week 96 will be measured
at 96 week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of participants who achieve HBeAg seroconversion
Time Frame: at 48 week;at 72 week
The number of subjects with HBeAg seroconversion at week 48 and 72 will be measured
at 48 week;at 72 week
The percentage decrease of HBsAg level at group A,B,C
Time Frame: at 48 week;at 72 week;at 96 week
The level of HBsAg in group A,B,C at week 48 ,72 and 96 will be measured,changing from baseline
at 48 week;at 72 week;at 96 week
Number of participants who achieve HBeAg loss
Time Frame: at 48 week;at 72 week;at 96 week
The number of subjects with HBeAg loss at week48.72 and 96 will be measured
at 48 week;at 72 week;at 96 week
The number of subjects who achieve HBVDNA undetectable
Time Frame: at 24 week;48 week;at 72 week;at 96 week
The number of subjects with HBVDNA undetectable at week 24,48,72 and 96 will be measured
at 24 week;48 week;at 72 week;at 96 week
The factor such as HBsAg level related to responsible rate
Time Frame: at week 48,72,96
The HBsAg level at week 48,72,96 will be measured, to assess whether the quantitative HBsAg level related to the responsible rate
at week 48,72,96
The number of subjects who achieve ALT back to normal
Time Frame: at 48 week;at 72 week;at 96 week
The number of subjects with normal ALT at week 48,72 and 96 will be measured
at 48 week;at 72 week;at 96 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ruijin Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2016

Primary Completion (Anticipated)

December 30, 2021

Study Completion (Anticipated)

December 31, 2021

Study Registration Dates

First Submitted

December 16, 2016

First Submitted That Met QC Criteria

January 5, 2017

First Posted (Estimate)

January 6, 2017

Study Record Updates

Last Update Posted (Actual)

September 22, 2021

Last Update Submitted That Met QC Criteria

September 21, 2021

Last Verified

September 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SHDC12016101

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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