Study of ARC-520 With or Without Other Drugs Used in the Treatment of Chronic Chronic Hepatitis B Virus (HBV) (MONARCH)
Hepatitis B, Hepatitis D
About this trial
This is an interventional treatment trial for Hepatitis B
Eligibility Criteria
Inclusion Criteria:
- Male or female, 18 to 75 years of age
- Written informed consent
- No clinically significant abnormalities at screening/pre-dose 12-lead ECG assessment
- Diagnosis of HBeAg negative or positive chronic HBV infection.
- Must be HBsAg (+) during screening.
- Must be treatment naïve: never on PEG IFN alpha 2a and/or ETV or TDF; and
- Have not used nucleoside/nucleotide analogs (NUCs) within the last 2 years prior to dosing on Day 1
- Must use 2 effective methods of contraception (double barrier contraception or hormonal contraceptive along with a barrier contraceptive) (both male and female partners)
Exclusion Criteria:
- Pregnant or lactating
- Acute signs of hepatitis/other severe infections within 4 weeks of screening
- Use within the last 14 days or anticipated requirement for anticoagulants, systemic corticosteroids, immunomodulators, or immunosuppressants
- Use of prescription medication within 14 days prior to treatment administration except: topical products without systemic absorption, statins (except rosuvastatin), hypertension medications, over-the-counter (OTC) and prescription pain medication or hormonal contraceptives
- History of poorly controlled autoimmune disease or any history of autoimmune hepatitis
- History of heterozygous or homozygous familial hypercholesterolemia.
- Human immunodeficiency virus (HIV) infection
- Is sero-positive for Hepatitis C Virus (HCV), or has a history of delta virus hepatitis (except for cohort in which delta virus infection is acceptable)
- Has hypertension: blood pressure > 170/100 mmHg; well-controlled blood pressure on hypertensive medication allowed
- History of cardiac rhythm disturbances
- Family history of congenital long QT syndrome, Brugada syndrome or unexplained sudden cardiac death
- Symptomatic heart failure, unstable angina, myocardial infarction, severe cardiovascular disease within 6 months prior to study entry
- History of malignancy, except for adequately treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer
- Has had major surgery within 1 month of screening
- Regular use of alcohol within 6 months prior to screening (ie, more than 14 units of alcohol per week)
- Use of recreational drugs such as cocaine, phencyclidine (PCP), and methamphetamines, within 1 year prior to the screening
- History of allergy to bee sting
- Clinically significant history of any alcoholic liver disease, cirrhosis, Wilson's disease, hemochromatosis, or alpha-1 antitrypsin deficiency
- Presence of cholangitis, cholecystitis, cholestasis, or duct obstruction
- Clinically significant history or presence of poorly controlled/uncontrolled systemic disease
- Presence of any medical or psychiatric condition or social situation that impacts compliance or results in additional safety risk
- History of coagulopathy/stroke within past 6 months, and/or concurrent anticoagulant medication(s)
Sites / Locations
- Royal Prince Alfred Hospital
- Concord Repatriation General Hospital, Gastroenterology & Liver Services
- St. Vincent's Hospital Sydney
- Westmead Hospital
- Royal Adelaide Hospital
- Monash Health Clayton Campus
- St. Vincent's Hospital Melbourne
- Royal Melbourne Hospital
- Linear Clinical Research Ltd.
- MHAT St. Pantaleimon OOD, Department of Gastroenterology
- UMHAT St. Ivan Rilski EAD, Clinic of Gastroenterology
- Diagnostic and Consultative Center - Focus 5 - Outpatient Medical Center, EOOD
- Diagnostic and Consultative Center Mladost-M Varna
- Queen Mary Hospital, Department of Medicine
- Pusan National University Hospital
- Inje University Busan Paik Hospital
- Kyungpook National University Hospital
- Seoul National University Hospital
- Gangnam Severance Hospital, Yonsei University Health System
- Severance Hospital, Yonsei University Health System
- IMSP Spitalul Clinic de Boli Infectioase, Toma Ciorba
- Middlemore Clinical Trials, Middlemore Hospital
- Dunedin Hospital, Gastroenterology Research Unit
- Auckland Clinical Studies
- National Taiwan University Hospital, Yun-Lin Branch
- Changhua Christian Hospital
- Kaohsiung Medical University Chung-Ho Memorial Hospital
- King Chulalongkorn Memorial Hospital
- Hospital of Tropical Diseases
- Phramongkutklao Hospital, Division of Digestive and Liver Disease
- Maharaj Nakhon Chiang Mai Hospital, Gastroenterology Division
- Khon Kaen University
- Thammasat University Hospital, Gastroenterology Unit
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Cohort 1
Cohort 2
Cohort 3
Cohort 4
Cohort 5
Cohort 6
Cohort 7
Cohort 8
Treatment-naïve, hepatitis B "e" antigen (HBeAg)-positive participants with chronic hepatitis B (CHB) of any genotype administered ARC-520 (2 mg/kg intravenous [IV]) every 4 weeks for 48 weeks (13 doses).
Treatment-naïve, HBeAg-positive, Genotype B participants with CHB administered ARC-520 (2 mg/kg increasing to 4 mg/kg or 4 mg/kg IV) every 4 weeks for 48 weeks (13 doses) concomitantly with daily orally administered ETV or TDF for approximately 60 weeks starting Day 1 and weekly subcutaneously administered peginterferon (PEG IFN) alpha 2a for 48 weeks starting Day 87.
Treatment-naïve, HBeAg-negative, Genotype B participants with CHB administered ARC-520 (2 mg/kg increasing to 4 mg/kg or 4 mg/kg IV) every 4 weeks for 48 weeks (13 doses) concomitantly with daily orally administered ETV or TDF for approximately 60 weeks starting Day 1 and weekly subcutaneously administered PEG IFN alpha 2a for 48 weeks starting Day 87.
Treatment-naïve, HBeAg-positive, Genotype C participants with CHB administered ARC-520 (2 mg/kg increasing to 4 mg/kg or 4 mg/kg IV) every 4 weeks for 48 weeks (13 doses) concomitantly with daily orally administered ETV or TDF for approximately 60 weeks starting Day 1 and weekly subcutaneously administered PEG IFN alpha 2a for 48 weeks starting Day 87.
Treatment-naïve, HBeAg-negative, Genotype C participants with CHB administered ARC-520 (2 mg/kg increasing to 4 mg/kg or 4 mg/kg IV) every 4 weeks for 48 weeks (13 doses) concomitantly with daily orally administered ETV or TDF for approximately 60 weeks starting Day 1 and weekly subcutaneously administered PEG IFN alpha 2a for 48 weeks starting Day 87.
Treatment-naïve, HBeAg-negative, Genotype D participants with CHB administered ARC-520 (2 mg/kg increasing to 4 mg/kg or 4 mg/kg IV) every 4 weeks for 48 weeks (13 doses) concomitantly with daily orally administered ETV or TDF for approximately 60 weeks starting Day 1 and weekly subcutaneously administered PEG IFN alpha 2a for 48 weeks starting Day 87.
Treatment-naïve, HBeAg-negative or HBeAg-positive participants with hepatitis delta virus (HDV) administered ARC-520 (2 mg/kg increasing to 4 mg/kg or 4 mg/kg IV) every 4 weeks for 48 weeks (13 doses) and weekly subcutaneously administered PEG IFN alpha 2a for 48 weeks starting Day 15.
Treatment-naïve, HBeAg-positive participants with CHB of any genotype administered ARC-520 (4 mg/kg IV) every 4 weeks for 48 weeks (13 doses).