The Impact of Tenofovir Alafenamide on Profiles of Body Weight and Metabolic Features in Chronic Hepatitis B Patients. (HBV)
The Impact of Tenofovir Alafenamide on Profiles of Body Weight and Metabolic Features in Chronic Hepatitis B Patients
The aim of this study is to compare the BW and metabolic profiles of CHB patient before and after shifting to TAF therapy.
In this study, investigators will enroll 100 entecavir and 100 TDF treated CHB patients who will switch to TAF and then follow for one year. Demographic, liver function tests, sugar profiles, lipid profiles, ASCVD risk score, body weight, body weight, body height, and waist circumference will be checked and recorded periodically.
Investigators anticipated that body weight will change significantly after switching to TAF in both entecavir and TDF group and may associated with increased risk of cardiovascular risk.
研究概览
地位
条件
详细说明
Currently, three oral nucleoside/tides analogues (NUC), including entecavir(ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), are available as the first line of treatment option for chronic hepatitis B (CHB) in Taiwan. Among them, TDF exhibits a greater decline of cholesterol, High-density lipoprotein(HDL), and low-density lipoprotein (LDL) levels than entecavir, while the impact of such general lipid-lowering effects on the risk of atherosclerotic cardiovascular diseases (ASCVD) remains unclear. For metabolic features, the evidence comes from HIV patients treated with TDF or TAF containing anti-retroviral therapy (ART). In one study revealed that a 0.45 kg/m2 increase of body mass index (BMI) and a 13% of increase in ASCVD risk score after switching from TDF-containing to TAF-containing ART. Weight gain after starting ART has been reported to associate with lower mortality in initial under-weight or normal-weight HIV patients. However, a study compared the efficacy and safety of dolutegravir/TAF/emtricitabine, dolutegravir/TDF/emtricitabine, and EFV/TDF/emtricitabine and revealed that patients receiving TAF and TDF containing regimens significantly increased body weight. The subsequent body composition analysis showed weight gain mainly resulted from increased lean muscle and fat of trunk and limb. A previous study also showed that the ART-associated increase in muscle area, regardless of regimen, is likely a reflection of increased fat within the muscle that may associate with weakness of muscle strength, risk of fall, and a decline of physical activities.
Overall, in HIV-infected patients, TAF-containing regimens had been shown to increase body weight resulting from increased fat and muscle of trunk and limb. However, it remains unknown whether all these findings in HIV infected patients could be similarly observed in CHB patient receiving TAF therapy, which is commonly encountered in Asia-Pacific region. Moreover, the mechanisms underlying these changes are still unclear. The long-term clinical impact of the BW gain and associated metabolic derangement is also unknown.
研究类型
注册 (预期的)
联系人和位置
学习地点
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Tainan、台湾、704
- 招聘中
- National Cheng-Kung University Hospital
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接触：
- Pin-Nan Cheng, PhD
- 电话号码：+886-972401223
- 邮箱：pncheng@mail.ncku.edu.tw
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接触：
- Li-Chen Lin
- 电话号码：+886-910819731
- 邮箱：lichenlin516@gmail.com
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首席研究员：
- Pin-Nan Cheng
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
Chronic hepatitis B patients who have been treated with TDF (n=100) or entecavir (n=100) will switch to TAF.
In entecavir switch group, at least 30 patients should have baseline BW data before entecavir treatment. The indications of entecavir switching to TAF include suboptimal HBV suppression (defined as detectable HBV DNA after at least one year of entecavir treatment), adverse events due to entecavir, patient's decision, and physician's judgement according to clinical conditions.
The scheduled treatment duration from enrolment should be greater than one year. Treatment indications for HBeAg-positive chronic hepatitis B, HBeAg-negative chronic hepatitis B and liver cirrhosis are based on reimbursement criteria of Taiwan government.
描述
Inclusion Criteria:
- Age more than 20 years.
- Chronic hepatitis B virus infection defined as presence of positive HBsAg more than 6 months.
- TAF naïve.
- Patients already receiving TDF or entecavir treatment, and the scheduled NUC treatment from enrolment being greater than one year.
Exclusion Criteria:
- Other etiology of chronic hepatitis.
- Severe comorbid disorders.
- Patients with History of acute coronary syndrome, myocardial infarction, stable angina, coronary/other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease from atherosclerosis.
- Uncontrolled diabetes mellitus (HBA1c > 8.5%).
- Current evidence or suspicious of malignancy.
- eGFR <50 ml/min/1.73m2.
- Any one of following hematology or biochemical or clinical abnormalities indicating the presence of liver decompensation: Albumin <3.5g/dL, Total Bilirubin >2.5mg/dL, prothrombin time prolongation >4 sec or INR >1.7, platelet count <100 x 103 uL, and history or presence of ascites or hepatic encephalopathy.
- Child-bearing age women without the willing to contraceptive control, or lactating or pregnant women.
学习计划
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
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Tenofovir Disoproxil Fumarate(TDF) switch to TAF
The indications of TDF switching to TAF due to adverse events of TDF or physician's judgement according to clinical conditions.
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Entecavir(ETV)switch to Tenofovir Alafenamide(TAF)
In entecavir switch group, at least 30 patients should have baseline BW data before entecavir treatment.
The indications of entecavir switching to TAF include suboptimal HBV suppression (defined as detectable HBV DNA after at least one year of entecavir treatment), adverse events due to entecavir, physician's judgement according to clinical conditions.
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observation groups with take either entecavir (25patients) or TDF (25 patients).
observation groups with total 50 patients who continuously take either entecavir (25patients) or TDF (25 patients) will be enrolled.Examination schedules for these two additional groups are the same as switching groups.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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1.Body weight changes after shifting to TAF treatment.
大体时间：48 weeks
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Collection Body weight data before and after treatment.
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48 weeks
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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2.Changes of lipid and sugar profiles before and after shifting to TAF treatment.
大体时间：48 weeks.
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Collection lipid( include TG<mg/dl>/Chol<mg/dl>,/LDL<mg/dl>/ HDL<mg/dl>) data and sugar profiles(include Insulin<uU/ml>, fasting sugar<mg/dl>, glycosylated hemoglobin<%>) data before and after treatment.
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48 weeks.
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3.Virologic responses following TAF treatment.
大体时间：48 weeks.
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Collection Virologic data (e.g HBV DNA<IU/ml>,)before and after treatment.
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48 weeks.
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4.Renal function after shifting to TAF treatment.
大体时间：48 weeks.
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Collection Renal function(include Cr<mg/dL>/eGFR<ml/min/1.73m2>)data before and after treatment.
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48 weeks.
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5. ASCVD score changes before and after shifting to TAF treatment.
大体时间：48 weeks.
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Collection ASCVD score before and after treatment.
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48 weeks.
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合作者和调查者
调查人员
- 首席研究员：Pin-Nan Cheng, PhD、National Cheng-Kung University Hospital
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
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