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Study of Therapeutic Vaccination With Intensified Schedule Plus Pegasys Dual Therapy on Chronic Hepatitis B Infection (E+VIP)

Primary Purpose

Hepatitis B, Chronic

Status
Completed
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Peginterferon alfa-2a
HBV vaccination
Entecavir
Sponsored by
Seoul National University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis B, Chronic focused on measuring chronic hepatitis B, Pegasys, Euvax B, Baracrude

Eligibility Criteria

20 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age between 20 and 75 year-old
  2. HBsAg-positive for > 6 months apart (medical history can be alternative)
  3. Currently being treated with entecavir 0.5 mg/day for more than 18 months
  4. Undetectable HBV DNA in serum (<20IU/mL) and HBeAg-negative or positive for > 1year
  5. HBsAg titer < 3,000 IU/mL
  6. ALT<300 IU/L
  7. Signed written informed consent after being instructed about the objective and procedure of the clinical study

Exclusion Criteria:

  1. Patients with decompensated liver cirrhosis, any one of the following ① Serum bilirubin > 3 mg/dL

    ② Prothrombin time > 6 seconds prolonged or INR >2.3

    ③ Serum albumin < 2.8 g/dL

    ④ History of ascites, variceal hemorrhage, or hepatic encephalopathy

    ⑤ Child-Pugh score ≥7 (Child-Pugh class B or C)

  2. Patients who have evidence of renal insufficiency defined as serum creatinine>1.5 mg/dL
  3. Patients with psychological problem including depression
  4. Patients who have previous/current significant co-morbidities including congestive heart failure, chronic kidney disease, hematologic disease and malignancy including hepatocellular carcinoma(patients with malignancy cured 5 years before screening can be enrolled)
  5. Patients with seropositivity for anti-HCV, anti-HDV or anti-HIV
  6. Patients who have excessive alcohol consumption (> 30 g/day)
  7. Patients who have evidence of autoimmune hepatitis, hemochromatosis or Wilson's disease
  8. Pregnant or breast feeding females or plan for pregnancy or no contraception
  9. Patients with disease may deteriorate with interferon therapy(eg, autoimmune thyroiditis)
  10. Patients who have an psoriasis
  11. Patients who have history of antiviral-resistant HBV after previous treatment with oral antiviral agents
  12. Previous diagnosis with immunodeficiency or concomitant treatment of immune suppressive agent or previous organ transplantation Recipients
  13. Patients who have a history of hypersensitivity to study drug
  14. Uncontrollable seizure, convulsion and/or central nervous system disorders
  15. Patients with severe bone marrow disorder or with history of hypersensitivity to biologic agent such as vaccine.
  16. Neutrophil count < 1,500/mm3 or platelet count < 75,000/mm3 or hemoglobin < 10 g/dl
  17. Patients with Pulmonary disease (in case of history of pulmonary disease with complete recovery, enrollment is on investigator's discretion)
  18. Patients who have a fever ≥ 38 °C at the baseline
  19. Patients who have a risk of febrile response or systemic reaction
  20. Patients who the investigator deems inappropriate to participate in this study

Sites / Locations

  • Seoul National University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Concomitant:Pegasys, Euvax B, Baracrude

Sequential:Pegasys, Euvax B, Baracrude

Control Group

Arm Description

Peginterferon alfa-2a: once weekly 180 μg subcutaneous injection for 48 weeks HBV vaccination (Euvax B Inj): 1.0 mL (20 μg) intramuscular injection at 4, 8, 12 and 28 weeks Continue Entecavir(0.5mg) for 100 weeks(once daily)

Peginterferon alfa-2a: once weekly 180 μg or weight base dose subcutaneous injection for 48 weeks HBV vaccination (Euvax B Inj): 1.0 mL (20 μg) intramuscular injection at 52, 56, 60 and 76 weeks Continue Entecavir(0.5mg) for 100 weeks(once daily)

Continue Entecavir(0.5mg) for 100 weeks(once daily) After EOS(100W), injection(once weekly) a Peginterferon alfa-2a for 48 weeks

Outcomes

Primary Outcome Measures

The rate of HBsAg-seroclearance
The rate of HBsAg-seroclearance at the time point of at weeks 100 in the sequential treatment group (24 weeks after termination of treatment) versus control group(ETV monotherapy) at weeks 100.

Secondary Outcome Measures

The rate of HBsAg-seroconversion
The rate of HBsAg-seroconversion at weeks 100 in the sequential treatment group versus control group(ETV monotherapy) at weeks 100.
The change of HBsAg level from baseline
The change of HBsAg level from baseline at weeks 100 in the sequential treatment group versus control group(ETV monotherapy) at weeks 100.
The change of HBsAg-seroclearance
The change of HBsAg-seroclearance in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment.
The change of HBsAg-seroconversion
The change of HBsAg-seroconversion in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment.
The change of HBsAg level
The change of HBsAg level in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment.

Full Information

First Posted
March 23, 2014
Last Updated
May 3, 2018
Sponsor
Seoul National University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02097004
Brief Title
Study of Therapeutic Vaccination With Intensified Schedule Plus Pegasys Dual Therapy on Chronic Hepatitis B Infection
Acronym
E+VIP
Official Title
Phase4, to Compare Efficacy and Safety of Therapeutic Vaccination With Intensified Schedule Plus Pegylated Interferon Dual Therapy on Seroclearance of HBS Antigen in Patients With Complete Virological Response Induced by Entecavir
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
April 2014 (Actual)
Primary Completion Date
January 2018 (Actual)
Study Completion Date
March 13, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Seoul National University Hospital

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A randomized, Open label, Single center, Prospective study to compare efficacy and safety of Therapeutic Vaccination with Intensified schedule plus Pegylated Interferon dual Therapy on Seroclearance of Hepatitis B virus Surface Antigen in Patients with Complete Virological Response Induced by Entecavir
Detailed Description
A randomized, Open label, Single center, Prospective study to compare efficacy and safety of Therapeutic Vaccination with Intensified schedule plus Pegylated Interferon dual Therapy on Seroclearance of Hepatitis B virus Surface Antigen in Patients with Complete Virological Response Induced by Entecavir (E + VIP)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis B, Chronic
Keywords
chronic hepatitis B, Pegasys, Euvax B, Baracrude

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
111 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Concomitant:Pegasys, Euvax B, Baracrude
Arm Type
Experimental
Arm Description
Peginterferon alfa-2a: once weekly 180 μg subcutaneous injection for 48 weeks HBV vaccination (Euvax B Inj): 1.0 mL (20 μg) intramuscular injection at 4, 8, 12 and 28 weeks Continue Entecavir(0.5mg) for 100 weeks(once daily)
Arm Title
Sequential:Pegasys, Euvax B, Baracrude
Arm Type
Experimental
Arm Description
Peginterferon alfa-2a: once weekly 180 μg or weight base dose subcutaneous injection for 48 weeks HBV vaccination (Euvax B Inj): 1.0 mL (20 μg) intramuscular injection at 52, 56, 60 and 76 weeks Continue Entecavir(0.5mg) for 100 weeks(once daily)
Arm Title
Control Group
Arm Type
Active Comparator
Arm Description
Continue Entecavir(0.5mg) for 100 weeks(once daily) After EOS(100W), injection(once weekly) a Peginterferon alfa-2a for 48 weeks
Intervention Type
Biological
Intervention Name(s)
Peginterferon alfa-2a
Other Intervention Name(s)
Pegasys
Intervention Description
once weekly 180 μg subcutaneous injection for 48 weeks
Intervention Type
Biological
Intervention Name(s)
HBV vaccination
Other Intervention Name(s)
Euvax B Inj
Intervention Description
1.0 mL (20 μg) intramuscular injection at 4, 8, 12 and 28 weeks
Intervention Type
Drug
Intervention Name(s)
Entecavir
Other Intervention Name(s)
Baracrude
Intervention Description
Continue Entecavir(0.5mg) for 100 weeks
Primary Outcome Measure Information:
Title
The rate of HBsAg-seroclearance
Description
The rate of HBsAg-seroclearance at the time point of at weeks 100 in the sequential treatment group (24 weeks after termination of treatment) versus control group(ETV monotherapy) at weeks 100.
Time Frame
The rate of HBsAg-seroclearance at the time point of at weeks 100
Secondary Outcome Measure Information:
Title
The rate of HBsAg-seroconversion
Description
The rate of HBsAg-seroconversion at weeks 100 in the sequential treatment group versus control group(ETV monotherapy) at weeks 100.
Time Frame
The rate of HBsAg-seroconversion at weeks 100
Title
The change of HBsAg level from baseline
Description
The change of HBsAg level from baseline at weeks 100 in the sequential treatment group versus control group(ETV monotherapy) at weeks 100.
Time Frame
The change of HBsAg level from baseline at weeks 100
Title
The change of HBsAg-seroclearance
Description
The change of HBsAg-seroclearance in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment.
Time Frame
The change of HBsAg-seroclearance at weeks 4, weeks 12, weeks 24, weeks 36, weeks 48, weeks 60, weeks 72, weeks 96, weeks 100, weeks 148
Title
The change of HBsAg-seroconversion
Description
The change of HBsAg-seroconversion in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment.
Time Frame
The change of HBsAg-seroconversion at weeks 4, weeks 12, weeks 24, weeks 36, weeks 48, weeks 60, weeks 72, weeks 96, weeks 100, weeks 148
Title
The change of HBsAg level
Description
The change of HBsAg level in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment.
Time Frame
The change of HBsAg level at weeks 4, weeks 12, weeks 24, weeks 36, weeks 48, weeks 60, weeks 72, weeks 96, weeks 100, weeks 148

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age between 20 and 75 year-old HBsAg-positive for > 6 months apart (medical history can be alternative) Currently being treated with entecavir 0.5 mg/day for more than 18 months Undetectable HBV DNA in serum (<20IU/mL) and HBeAg-negative or positive for > 1year HBsAg titer < 3,000 IU/mL ALT<300 IU/L Signed written informed consent after being instructed about the objective and procedure of the clinical study Exclusion Criteria: Patients with decompensated liver cirrhosis, any one of the following ① Serum bilirubin > 3 mg/dL ② Prothrombin time > 6 seconds prolonged or INR >2.3 ③ Serum albumin < 2.8 g/dL ④ History of ascites, variceal hemorrhage, or hepatic encephalopathy ⑤ Child-Pugh score ≥7 (Child-Pugh class B or C) Patients who have evidence of renal insufficiency defined as serum creatinine>1.5 mg/dL Patients with psychological problem including depression Patients who have previous/current significant co-morbidities including congestive heart failure, chronic kidney disease, hematologic disease and malignancy including hepatocellular carcinoma(patients with malignancy cured 5 years before screening can be enrolled) Patients with seropositivity for anti-HCV, anti-HDV or anti-HIV Patients who have excessive alcohol consumption (> 30 g/day) Patients who have evidence of autoimmune hepatitis, hemochromatosis or Wilson's disease Pregnant or breast feeding females or plan for pregnancy or no contraception Patients with disease may deteriorate with interferon therapy(eg, autoimmune thyroiditis) Patients who have an psoriasis Patients who have history of antiviral-resistant HBV after previous treatment with oral antiviral agents Previous diagnosis with immunodeficiency or concomitant treatment of immune suppressive agent or previous organ transplantation Recipients Patients who have a history of hypersensitivity to study drug Uncontrollable seizure, convulsion and/or central nervous system disorders Patients with severe bone marrow disorder or with history of hypersensitivity to biologic agent such as vaccine. Neutrophil count < 1,500/mm3 or platelet count < 75,000/mm3 or hemoglobin < 10 g/dl Patients with Pulmonary disease (in case of history of pulmonary disease with complete recovery, enrollment is on investigator's discretion) Patients who have a fever ≥ 38 °C at the baseline Patients who have a risk of febrile response or systemic reaction Patients who the investigator deems inappropriate to participate in this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yoon Jun Kim, MD, PhD
Organizational Affiliation
Seoul National University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul National University
City
Seoul
ZIP/Postal Code
ASI|KR|KS013
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
32556157
Citation
Lee JH, Lee YB, Cho EJ, Yu SJ, Yoon JH, Kim YJ. Entecavir Plus Pegylated Interferon and Sequential Hepatitis B Virus Vaccination Increases Hepatitis B Surface Antigen Seroclearance: A Randomized Controlled Proof-of-Concept Study. Clin Infect Dis. 2021 Nov 2;73(9):e3308-e3316. doi: 10.1093/cid/ciaa807.
Results Reference
derived

Learn more about this trial

Study of Therapeutic Vaccination With Intensified Schedule Plus Pegasys Dual Therapy on Chronic Hepatitis B Infection

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