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Lamivudine Extending Therapy in Chronic Hepatitis B Patients After 3-year of Oral Antiviral Agents

Primary Purpose

Chronic Hepatitis B

Status
Unknown status
Phase
Phase 4
Locations
Taiwan
Study Type
Interventional
Intervention
Lamivudine
Sponsored by
Kaohsiung Medical University Chung-Ho Memorial Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Hepatitis B

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female patients >=18 years of age
  2. Negative serum HBV DNA within 3 months prior to entry
  3. ALT <1.5 ULN within 3 months prior to entry
  4. Negative urine or serum pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of test drug. Additionally, all fertile males with partners of childbearing age and females of the Lamivudine treatment arm must be using reliable contraception during the study and for 6 months after treatment completion.

Exclusion Criteria:

  1. Women with ongoing pregnancy or breast feeding
  2. Therapy with any systemic anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) *6 months prior to the first dose of study drug
  3. Any investigational drug *6 weeks prior to the first dose of study drug
  4. Co-infection with active hepatitis A, hepatitis C and/or human immunodeficiency virus (HIV)
  5. Patients who have virological evidence of Lamivudine-associated YMDD mutants.
  6. Patients who have clinical evidence of liver cirrhosis or hepatocellular carcinoma.
  7. History or other evidence of a medical condition associated with chronic liver disease other than HCV (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures)
  8. Signs or symptoms of hepatocellular carcinoma
  9. History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease
  10. Neutrophil count <1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening
  11. Serum creatinine level >1.5 times the upper limit of normal at screening
  12. History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt, hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease
  13. History of a severe seizure disorder or current anticonvulsant use
  14. History of immunologically mediated disease, chronic pulmonary disease associated with functional limitation, severe cardiac disease, 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
  15. Evidence of drug abuse (including excessive alcohol consumption) within one year of study entry
  16. Inability or unwillingness to provide informed consent or abide by the requirements of the study

Sites / Locations

  • Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

No Intervention

Arm Label

Arm A

Arm B

Arm Description

250 treatment-naïve CHB patients who received at least 3-year of oral antiviral agents will receive Lamivudine extending therapy for 5 years.

250 treatment-naïve CHB patients who received at least 3-year of oral antiviral agents will receive follow-up.

Outcomes

Primary Outcome Measures

Rate of HBV DNA recurrence

Secondary Outcome Measures

Associated predictive factors of HBV DNA recurrence
Rate of drug resistant mutation
Rate of clinical relapse in Group B (non-intervention)
clinical relapse means HBV DNA>2000 IU/mL plus ALT > 2 fold upper limit of normal (ULN) in end of entecavir (ETV) normal alanine aminotransferase (ALT) or 2 fold elevation in end of ETV abnormal ALT patients

Full Information

First Posted
December 1, 2014
Last Updated
January 8, 2015
Sponsor
Kaohsiung Medical University Chung-Ho Memorial Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02337127
Brief Title
Lamivudine Extending Therapy in Chronic Hepatitis B Patients After 3-year of Oral Antiviral Agents
Official Title
A Prospective, Open-label, Multicenter Study of Lamivudine Extending Therapy in Chronic Hepatitis B Patients After 3-year of Oral Antiviral Agents
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Unknown status
Study Start Date
June 2011 (undefined)
Primary Completion Date
May 2015 (Anticipated)
Study Completion Date
May 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kaohsiung Medical University Chung-Ho Memorial Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Current treatment guidelines indicate that oral antiviral agents for HBeAg-positive chronic hepatitis B virus infection (CHB) can be stopped if the patient has undergone HBeAg seroconversion with HBV-DNA loss measured at two consecutive occasions at least 6 months apart (primary treatment endpoint). Stopping treatment can be considered if undetectable HBV-DNA has been documented on three separate occasions 6 months apart in HBeAg-negative patients. However, oral antiviral drugs currently approved for the treatment of CHB have relatively limited sustained long-term efficacy and a large proportion of patients will suffer from HBV recurrence after stopping treatment.
Detailed Description
The purposes of this study are: To evaluate the long-term efficacy of Lamivudine extending therapy in CHB patients who received at least 3-year of oral antiviral agents. To evaluate the long-term outcomes and predictive factors of Lamivudine extending therapy in CHB patients who received at least 3-year of oral antiviral agents. A prospective, open-label, multicenter study will enroll 500 treatment-naïve CHB patients who received at least 3-year of oral antiviral agents. With their voluntary decision after consultation, 250 patients will receive Lamivudine extending therapy for 5 years and the other 250 patients will receive follow-up and serve as controls. The primary outcome measurement is HBV DNA recurrence, whilst the secondary outcome measurement is liver-related outcomes and associated predictive factors

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis B

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
500 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm A
Arm Type
Active Comparator
Arm Description
250 treatment-naïve CHB patients who received at least 3-year of oral antiviral agents will receive Lamivudine extending therapy for 5 years.
Arm Title
Arm B
Arm Type
No Intervention
Arm Description
250 treatment-naïve CHB patients who received at least 3-year of oral antiviral agents will receive follow-up.
Intervention Type
Drug
Intervention Name(s)
Lamivudine
Other Intervention Name(s)
Zeffix
Intervention Description
Lamivudine, 100mg/day, per os
Primary Outcome Measure Information:
Title
Rate of HBV DNA recurrence
Time Frame
up to 12 months
Secondary Outcome Measure Information:
Title
Associated predictive factors of HBV DNA recurrence
Time Frame
up to 12 months
Title
Rate of drug resistant mutation
Time Frame
up to 12 months
Title
Rate of clinical relapse in Group B (non-intervention)
Description
clinical relapse means HBV DNA>2000 IU/mL plus ALT > 2 fold upper limit of normal (ULN) in end of entecavir (ETV) normal alanine aminotransferase (ALT) or 2 fold elevation in end of ETV abnormal ALT patients
Time Frame
up to 12 months
Other Pre-specified Outcome Measures:
Title
Rate of severe reactivation or death
Description
severe reactivation means alanine aminotransferase (ALT) > 10 fold upper limit of normal plus either total bilirubin > 2 mg/dL or prothrombin time prolong > 3 seconds
Time Frame
up to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients >=18 years of age Negative serum HBV DNA within 3 months prior to entry ALT <1.5 ULN within 3 months prior to entry Negative urine or serum pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of test drug. Additionally, all fertile males with partners of childbearing age and females of the Lamivudine treatment arm must be using reliable contraception during the study and for 6 months after treatment completion. Exclusion Criteria: Women with ongoing pregnancy or breast feeding Therapy with any systemic anti-neoplastic or immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) *6 months prior to the first dose of study drug Any investigational drug *6 weeks prior to the first dose of study drug Co-infection with active hepatitis A, hepatitis C and/or human immunodeficiency virus (HIV) Patients who have virological evidence of Lamivudine-associated YMDD mutants. Patients who have clinical evidence of liver cirrhosis or hepatocellular carcinoma. History or other evidence of a medical condition associated with chronic liver disease other than HCV (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures) Signs or symptoms of hepatocellular carcinoma History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease Neutrophil count <1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening Serum creatinine level >1.5 times the upper limit of normal at screening History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt, hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease History of a severe seizure disorder or current anticonvulsant use History of immunologically mediated disease, chronic pulmonary disease associated with functional limitation, severe cardiac disease, 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 Evidence of drug abuse (including excessive alcohol consumption) within one year of study entry Inability or unwillingness to provide informed consent or abide by the requirements of the study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wan-Long Chuang
Email
waloch@kmu.edu.tw
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wan-Long Chuang
Organizational Affiliation
Kaohsiung Medical University Hospital, Internal Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital
City
Kaohsiung
State/Province
NRW
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wan-Long Chuang

12. IPD Sharing Statement

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Lamivudine Extending Therapy in Chronic Hepatitis B Patients After 3-year of Oral Antiviral Agents

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