Study of Nitazoxanide Compared to Placebo in Subjects With HBeAG-Negative Chronic Hepatitis B
Primary Purpose
Chronic Hepatitis B
Status
Unknown status
Phase
Phase 2
Locations
Singapore
Study Type
Interventional
Intervention
Placebo Oral Tablet
Nitazoxanide
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Hepatitis B
Eligibility Criteria
Inclusion Criteria:
- Age at least 21 years
- CHB virus infection (serum HBsAg-positive for at least 6 months or serum HBsAg-positive and negative immunoglobulin M (IgM) antibodies to Hepatitis B Virus (HBV) core antigen (IgM anti-HBc))
- Hepatitis B e Antigen (HBeAg) negative
- Virologically suppressed (HBV DNA less than the lower limit of quantitation) for at least 12 months on Tenofovir Disoproxil Fumarate (TDF), Tenofovir Alafenamide (TAF) or Entecavir (ETV) therapy
- Quantitative HBsAg greater than 100 IU/mL
- Alanine Aminotransferase (ALT) below 1.5 times the upper limit of normal
- Able to comply with the study requirements
Exclusion Criteria:
- Unable to take oral medications
- Females who are pregnant, breast-feeding or not using birth control. A double barrier method, oral birth control pills administered for at least 2 monthly cycles prior to study drug administration, an intrauterine device (IUD), or medroxyprogesterone acetate administered intramuscularly for a minimum of one month prior to study drug administration are acceptable methods of birth control for inclusion into the study. In addition, female subjects should have a baseline pregnancy test and should agree to continue an acceptable method of birth control for the duration of the study (including follow-up) if sexually active.
- Any investigational drug therapy within 30 days prior to enrollment
- Other causes of liver disease
- Co-infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis D virus (HDV) based on an enzyme immunoassay (EIA)
- History of alcoholism or with an alcohol consumption of greater than 40 g per day
- Clinically unstable
- Any concomitant condition that, in the opinion of the investigator would preclude evaluation of response or make it unlikely that the contemplated course of therapy and follow-up could be completed
- History of hypersensitivity or intolerance to NTZ or any of the excipients comprising the NTZ tablets
- Hepatocellular carcinoma
- Decompensated liver disease including history of ascites, bleeding esophageal varices, portal hypertension or hepatic encephalopathy
- FibroScan® score greater than 11 or history of cirrhosis on liver biopsy
- Creatinine clearance <65 ml/minute (by the Cockcroft-Gault equation using ideal body weight)
- History of clinically relevant psychiatric disease, seizures, central nervous system dysfunction, severe pre-existing cardiac, renal, pathologic bone fracture or other risk factors for osteoporosis, hematological disease or medical illness that in the investigator's opinion might interfere with therapy
- Malignant disease within 3 years of trial entry
- Rheumatological conditions, inflammatory bowel disease or psoriasis requiring or anticipated to require biological/immunosuppressive therapies
- Subjects taking or anticipated to need medications considered to be major CYP2C8 substrates
Sites / Locations
- National University Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Placebo Comparator
Active Comparator
Active Comparator
Active Comparator
Arm Label
Group 1
Group 2
Group 3
Group 4
Arm Description
Three placebo tablets administered orally twice daily with food in addition to continuing TDF, TAF or ETV therapy
Two 300 mg NTZ tablets and one placebo tablet administered orally in the morning and three placebo tablets in the evening in addition to continuing TDF, TAF or ETV therapy
Two 300 mg NTZ tablets and one placebo tablet administered orally twice daily with food in addition to continuing TDF, TAF or ETV therapy
Three 300 mg NTZ tablets administered orally twice daily with food in addition to continuing TDF, TAF or ETV therapy
Outcomes
Primary Outcome Measures
Mean change in quantitative Hepatitis B Surface Antigen (qHBsAg)
Mean change in qHBsAg
Secondary Outcome Measures
Full Information
NCT ID
NCT03905655
First Posted
April 4, 2019
Last Updated
February 5, 2021
Sponsor
Romark Laboratories L.C.
1. Study Identification
Unique Protocol Identification Number
NCT03905655
Brief Title
Study of Nitazoxanide Compared to Placebo in Subjects With HBeAG-Negative Chronic Hepatitis B
Official Title
Randomized Double-Blind Study of Nitazoxanide Compared to Placebo in Subjects With HBeAG-Negative Chronic Hepatitis B Virologically Suppressed for at Least Twelve Months on Tenofovir Disoproxil Fumarate, Tenofovir Alafenamide or Entecavir
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Unknown status
Study Start Date
October 22, 2019 (Actual)
Primary Completion Date
December 1, 2022 (Anticipated)
Study Completion Date
December 1, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Romark Laboratories L.C.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This randomized controlled trial is designed to evaluate safety, effectiveness and pharmacokinetic-pharmacodynamic (PK/PD) relationships associated with three different Nitazoxanide (NTZ) treatment regimens added to Tenofovir Disoproxil Fumarate (TDF), Tenofovir Alafenamide (TAF) or Entecavir (ETV) in treating Chronic Hepatitis B (CHB).
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 2
Interventional Study Model
Parallel Assignment
Model Description
Patients are randomized 1:1:1:1 (12 subjects per group)
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
51 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group 1
Arm Type
Placebo Comparator
Arm Description
Three placebo tablets administered orally twice daily with food in addition to continuing TDF, TAF or ETV therapy
Arm Title
Group 2
Arm Type
Active Comparator
Arm Description
Two 300 mg NTZ tablets and one placebo tablet administered orally in the morning and three placebo tablets in the evening in addition to continuing TDF, TAF or ETV therapy
Arm Title
Group 3
Arm Type
Active Comparator
Arm Description
Two 300 mg NTZ tablets and one placebo tablet administered orally twice daily with food in addition to continuing TDF, TAF or ETV therapy
Arm Title
Group 4
Arm Type
Active Comparator
Arm Description
Three 300 mg NTZ tablets administered orally twice daily with food in addition to continuing TDF, TAF or ETV therapy
Intervention Type
Drug
Intervention Name(s)
Placebo Oral Tablet
Intervention Description
Number of placebo tablets administered orally depends on the arm
Intervention Type
Drug
Intervention Name(s)
Nitazoxanide
Other Intervention Name(s)
NTZ, NT-300
Intervention Description
Number of Nitazoxanide 300 mg extended release tablets administered orally depends on the arm
Primary Outcome Measure Information:
Title
Mean change in quantitative Hepatitis B Surface Antigen (qHBsAg)
Description
Mean change in qHBsAg
Time Frame
Baseline to 12 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age at least 21 years
CHB virus infection (serum HBsAg-positive for at least 6 months or serum HBsAg-positive and negative immunoglobulin M (IgM) antibodies to Hepatitis B Virus (HBV) core antigen (IgM anti-HBc))
Hepatitis B e Antigen (HBeAg) negative
Virologically suppressed (HBV DNA less than the lower limit of quantitation) for at least 12 months on Tenofovir Disoproxil Fumarate (TDF), Tenofovir Alafenamide (TAF) or Entecavir (ETV) therapy
Quantitative HBsAg greater than 100 IU/mL
Alanine Aminotransferase (ALT) below 1.5 times the upper limit of normal
Able to comply with the study requirements
Exclusion Criteria:
Unable to take oral medications
Females who are pregnant, breast-feeding or not using birth control. A double barrier method, oral birth control pills administered for at least 2 monthly cycles prior to study drug administration, an intrauterine device (IUD), or medroxyprogesterone acetate administered intramuscularly for a minimum of one month prior to study drug administration are acceptable methods of birth control for inclusion into the study. In addition, female subjects should have a baseline pregnancy test and should agree to continue an acceptable method of birth control for the duration of the study (including follow-up) if sexually active.
Any investigational drug therapy within 30 days prior to enrollment
Other causes of liver disease
Co-infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis D virus (HDV) based on an enzyme immunoassay (EIA)
History of alcoholism or with an alcohol consumption of greater than 40 g per day
Clinically unstable
Any concomitant condition that, in the opinion of the investigator would preclude evaluation of response or make it unlikely that the contemplated course of therapy and follow-up could be completed
History of hypersensitivity or intolerance to NTZ or any of the excipients comprising the NTZ tablets
Hepatocellular carcinoma
Decompensated liver disease including history of ascites, bleeding esophageal varices, portal hypertension or hepatic encephalopathy
FibroScan® score greater than 11 or history of cirrhosis on liver biopsy
Creatinine clearance <65 ml/minute (by the Cockcroft-Gault equation using ideal body weight)
History of clinically relevant psychiatric disease, seizures, central nervous system dysfunction, severe pre-existing cardiac, renal, pathologic bone fracture or other risk factors for osteoporosis, hematological disease or medical illness that in the investigator's opinion might interfere with therapy
Malignant disease within 3 years of trial entry
Rheumatological conditions, inflammatory bowel disease or psoriasis requiring or anticipated to require biological/immunosuppressive therapies
Subjects taking or anticipated to need medications considered to be major CYP2C8 substrates
Facility Information:
Facility Name
National University Hospital
City
Singapore
Country
Singapore
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study of Nitazoxanide Compared to Placebo in Subjects With HBeAG-Negative Chronic Hepatitis B
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