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Comparing P1101 to Entecavir in Patients With HBeAg(-) Hepatitis B Under Long-term Nucleos(t)Ide Analogue Therapy

Primary Purpose

Chronic Hepatitis B Virus Infection

Status
Recruiting
Phase
Not Applicable
Locations
Taiwan
Study Type
Interventional
Intervention
Ropeginterferon alfa-2b
Entecavir
Sponsored by
National Taiwan University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Hepatitis B Virus Infection focused on measuring Ropeginterferon alpha-2b, Hepatitis B, Entecavir, HBeAg-negative, Nucleoside Analogue Therapy

Eligibility Criteria

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

Inclusion Criteria:

  • Adults with age 20-75 years old; Subjects who are over 70 years of age must be in generally good health;
  • Confirmed diagnosis of chronic hepatitis B (CHB) virus infection: with positive HBsAg ≧ 6 months prior to the study entry;
  • Quantitative HBsAg level < 1,500 IU/ml at screening;
  • Confirmed HBeAg (-) at screening;
  • Stable disease: ALT < 3 x upper limit of normal (ULN), total bilirubin < 1.5 × ULN (except in Gilbert syndrome) and direct bilirubin < ULN at screening, serum HBV DNA < 50 IU/mL for ≧ 1 year prior to study entry;
  • Stable treatment with nucleos(t)ide regimen (adefovir, entecavir, tenofovir or one of the following combinations: entecavir/adefovir or entecavir/tenofovir) for at least 2 years prior to study entry;
  • Interferon treatment naïve;
  • Normal fundoscopic examination by ophthalmologist at screening; defined as no significant or major fundoscopic findings including but not limited to retinal exudates, hemorrhage, detachment, neovascularization, papilloedema, optic atrophy, microaneurysms and macular changes;
  • Be able to attend all scheduled visits and to comply with all study procedures;
  • Be able to provide written informed consent.

Exclusion Criteria:

  • HBeAg-positive chronic hepatitis B;
  • Documented history of drug resistance to any nucleoside/ nucleotide analogue;
  • History of treatment with lamivudine or telbivudine prior to the study entry;
  • Clinically significant abnormalities, other than HBV infection, based upon the results of a medical history, physical examination, vital signs, and a 12-lead electrocardiogram (ECG) at screening as determined by the investigator;
  • Other form of significant chronic liver disease apart from chronic hepatitis B infection; Severe steatohepatitis by ultrasound or other examinations at the discretion of investigators;
  • Liver cirrhosis;
  • Known positive for anti-HIV;
  • Positive for anti-hepatitis C virus(HCV), Subject could be enrolled if no HCV RNA detected within 1 year;
  • Co-infection with hepatitis D;
  • One of clinically significant abnormal laboratory test result at screening: white blood cell (WBC) < 3,000/mm^3, absolute neutrophil count (ANC) < 1500/mm^3, Hgb < 10g/dL, platelet < 90,000/mm^3, estimated Glomerular filtration rate < 60 mL/min;
  • History of significant alcohol or illicit drug abuse within six months prior to the screening visit (alcohol consumption of more than fourteen units of alcohol per week [1 Unit = 150 mL of wine, 360 mL of beer, or 45 mL of 40% alcohol]) or refusal to abstain from illicit drugs and minimize alcohol consumption throughout the study;
  • History of severe allergic or hypersensitivity reactions (e.g bronchospasm, angioedema), asthma, or anaphylaxis
  • Therapy with any systemic anti-viral treatment (except for treatment for HBV), anti-neoplastic, immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) and immunosuppressants within 1 month (3 months for those with long elimination half-lives) prior to the first dose of study drug;
  • Use of an investigational drug within the last 4 weeks;
  • Any history or presence of poorly controlled or clinically significant medical conditions that are not suitable to receive interferon-based treatment, at the discretion of the investigator: major psychiatric (including but not limited to those with severe depression, severe bipolar disorder, schizophrenia, suicidal ideation or history of suicidal attempt),neurological, cardiovascular (e.g. uncontrolled hypertension), pulmonary (including but not limited to chronic obstructive lung disease), hematological, immunologic, endocrine, metabolic (e.g. diabetes mellitus with HbA1C > 8.0%), autoimmune disease, thyroid or other uncontrolled systemic disease, coagulation disorders or blood dyscrasias;
  • A depot injection or an implant of any drug within 3 months prior to administration of study medication, other than contraception or hyaluronic acid injections in joints for osteoarthritis;
  • History of solid organ transplantation;
  • History of malignancy diagnosed or treated within 5 years prior to screening (except for recent localized treatment of squamous or noninvasive basal cell skin cancers; cervical carcinoma in situ), cancer survivors not on maintenance therapy within the past 5 years;
  • History of opportunistic infection (e.g., invasive candidiasis or pneumocystis pneumonia)
  • Serious localized infection (e.g., cellulitis, abscess) or systemic and life-threatening infection (e.g., septicemia) within the 3 months prior to screening;
  • Pregnant subjects. Female subjects or the spouse of male subjects, with child-bearing potential who are unwilling or unable to practice adequate contraception, defined as vasectomy in men, tubal ligation in women, or use of condoms and spermicides, or birth control pills, or intrauterine devices from 4 weeks prior to Day 1 until 90 days after the last dose of study drug.

Sites / Locations

  • Kaohsiung Medical University Chung-Ho Memorial Hospital
  • China Medical University Hospital
  • National Taiwan University HospitalRecruiting
  • Taipei Medical University Hospital
  • Taipei Veterans General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ropeginterferon alfa-2b monotherapy

Entecavir monotherapy

Arm Description

Subjects will be treated with 450 µg of Ropeginterferon alfa-2b every two weeks

Subjects will be treated with 0.5 mg of Entecavir monotherapy once per day

Outcomes

Primary Outcome Measures

Undetectable HBsAg
HBsAg loss at week 48

Secondary Outcome Measures

Undetectable HBsAg
HBsAg loss at weeks 72 and 96
HBsAg level
HBsAg reduction > 1 log from baseline to weeks 12, 24, 48, 72 and 96
HBsAg and anti-HBs level
HBsAg seroconversion at weeks 48, 72 and 96
HBsAg level
Mean HBsAg decline from baseline to weeks 12, 24, 48, 72, and 96
Reappearance of HBsAg
HBsAg seroreversion at weeks 72 and 96
HBV DNA level
Percentage of subjects with HBV DNA > 2,000 IU/ml at week 96
HBV DNA and alanine aminotransferase (ALT) level
Percentage of subjects with HBV DNA > 2,000 IU/ml and ALT > 2x ULN at week 96
Sustained suppression of HBV DNA
Sustained suppression of HBV DNA less than the lower limit of qualification at week 96.
HBeAg level
To compare the proportion of HBeAg seroreversion and seroconversion at weeks 72 and 96 across treatment arms.

Full Information

First Posted
August 8, 2022
Last Updated
December 23, 2022
Sponsor
National Taiwan University Hospital
Collaborators
PharmaEssentia
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1. Study Identification

Unique Protocol Identification Number
NCT05494528
Brief Title
Comparing P1101 to Entecavir in Patients With HBeAg(-) Hepatitis B Under Long-term Nucleos(t)Ide Analogue Therapy
Official Title
An, Open-label, Multicenter, Randomized, Active Control Study, Comparing P1101 Monotherapy to Entecavir Monotherapy in Patients With HBeAg-negative Chronic Hepatitis B Under Long-term Nucleos(t)Ide Analogue Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 4, 2021 (Actual)
Primary Completion Date
December 30, 2023 (Anticipated)
Study Completion Date
December 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Taiwan University Hospital
Collaborators
PharmaEssentia

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open-label, multicenter, randomized, active control study, comparing P1101 monotherapy to entecavir monotherapy in patients with HBeAg-negative chronic hepatitis B under long-term nucleos(t)ide analogue therapy.
Detailed Description
Eligible patients will be randomized in a 2:1 ratio (P1101 monotherapy vs. Entecavir monotherapy) using a computer-generated permuted block randomization scheme. Subjects will be treated with 450 µg of P1101 every two weeks or with 0.5 mg of Entecavir monotherapy once per day. Primary endpoint will be evaluated at week 48. Subjects will receive treatment with a total duration of 72 weeks. The follow-up (treatment-free) period is 24 weeks following completion of treatment. Switch from the other nucleos(t)ide analogue therapy to entecavir will occur at week 0 (Randomization), while the dose of Entecavir will be 0.5 mg.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis B Virus Infection
Keywords
Ropeginterferon alpha-2b, Hepatitis B, Entecavir, HBeAg-negative, Nucleoside Analogue Therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Ropeginterferon alfa-2b monotherapy
Arm Type
Experimental
Arm Description
Subjects will be treated with 450 µg of Ropeginterferon alfa-2b every two weeks
Arm Title
Entecavir monotherapy
Arm Type
Active Comparator
Arm Description
Subjects will be treated with 0.5 mg of Entecavir monotherapy once per day
Intervention Type
Drug
Intervention Name(s)
Ropeginterferon alfa-2b
Other Intervention Name(s)
P1101
Intervention Description
Ropeginterferon alfa-2b 450 µg subcutaneous injection every two weeks
Intervention Type
Drug
Intervention Name(s)
Entecavir
Intervention Description
Entecavir 0.5 mg once per day
Primary Outcome Measure Information:
Title
Undetectable HBsAg
Description
HBsAg loss at week 48
Time Frame
Week 48
Secondary Outcome Measure Information:
Title
Undetectable HBsAg
Description
HBsAg loss at weeks 72 and 96
Time Frame
weeks 72 and 96
Title
HBsAg level
Description
HBsAg reduction > 1 log from baseline to weeks 12, 24, 48, 72 and 96
Time Frame
weeks 12, 24, 48, 72 and 96
Title
HBsAg and anti-HBs level
Description
HBsAg seroconversion at weeks 48, 72 and 96
Time Frame
weeks 48, 72 and 96
Title
HBsAg level
Description
Mean HBsAg decline from baseline to weeks 12, 24, 48, 72, and 96
Time Frame
weeks 12, 24, 48, 72, and 96
Title
Reappearance of HBsAg
Description
HBsAg seroreversion at weeks 72 and 96
Time Frame
weeks 72 and 96
Title
HBV DNA level
Description
Percentage of subjects with HBV DNA > 2,000 IU/ml at week 96
Time Frame
week 96
Title
HBV DNA and alanine aminotransferase (ALT) level
Description
Percentage of subjects with HBV DNA > 2,000 IU/ml and ALT > 2x ULN at week 96
Time Frame
week 96
Title
Sustained suppression of HBV DNA
Description
Sustained suppression of HBV DNA less than the lower limit of qualification at week 96.
Time Frame
week 96
Title
HBeAg level
Description
To compare the proportion of HBeAg seroreversion and seroconversion at weeks 72 and 96 across treatment arms.
Time Frame
weeks 72 and 96

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: Adults with age 20-75 years old; Subjects who are over 70 years of age must be in generally good health; Confirmed diagnosis of chronic hepatitis B (CHB) virus infection: with positive HBsAg ≧ 6 months prior to the study entry; Quantitative HBsAg level < 1,500 IU/ml at screening; Confirmed HBeAg (-) at screening; Stable disease: ALT < 3 x upper limit of normal (ULN), total bilirubin < 1.5 × ULN (except in Gilbert syndrome) and direct bilirubin < ULN at screening, serum HBV DNA < 50 IU/mL for ≧ 1 year prior to study entry; Stable treatment with nucleos(t)ide regimen (adefovir, entecavir, tenofovir or one of the following combinations: entecavir/adefovir or entecavir/tenofovir) for at least 2 years prior to study entry; Interferon treatment naïve; Normal fundoscopic examination by ophthalmologist at screening; defined as no significant or major fundoscopic findings including but not limited to retinal exudates, hemorrhage, detachment, neovascularization, papilloedema, optic atrophy, microaneurysms and macular changes; Be able to attend all scheduled visits and to comply with all study procedures; Be able to provide written informed consent. Exclusion Criteria: HBeAg-positive chronic hepatitis B; Documented history of drug resistance to any nucleoside/ nucleotide analogue; History of treatment with lamivudine or telbivudine prior to the study entry; Clinically significant abnormalities, other than HBV infection, based upon the results of a medical history, physical examination, vital signs, and a 12-lead electrocardiogram (ECG) at screening as determined by the investigator; Other form of significant chronic liver disease apart from chronic hepatitis B infection; Severe steatohepatitis by ultrasound or other examinations at the discretion of investigators; Liver cirrhosis; Known positive for anti-HIV; Positive for anti-hepatitis C virus(HCV), Subject could be enrolled if no HCV RNA detected within 1 year; Co-infection with hepatitis D; One of clinically significant abnormal laboratory test result at screening: white blood cell (WBC) < 3,000/mm^3, absolute neutrophil count (ANC) < 1500/mm^3, Hgb < 10g/dL, platelet < 90,000/mm^3, estimated Glomerular filtration rate < 60 mL/min; History of significant alcohol or illicit drug abuse within six months prior to the screening visit (alcohol consumption of more than fourteen units of alcohol per week [1 Unit = 150 mL of wine, 360 mL of beer, or 45 mL of 40% alcohol]) or refusal to abstain from illicit drugs and minimize alcohol consumption throughout the study; History of severe allergic or hypersensitivity reactions (e.g bronchospasm, angioedema), asthma, or anaphylaxis Therapy with any systemic anti-viral treatment (except for treatment for HBV), anti-neoplastic, immunomodulatory treatment (including supraphysiologic doses of steroids and radiation) and immunosuppressants within 1 month (3 months for those with long elimination half-lives) prior to the first dose of study drug; Use of an investigational drug within the last 4 weeks; Any history or presence of poorly controlled or clinically significant medical conditions that are not suitable to receive interferon-based treatment, at the discretion of the investigator: major psychiatric (including but not limited to those with severe depression, severe bipolar disorder, schizophrenia, suicidal ideation or history of suicidal attempt),neurological, cardiovascular (e.g. uncontrolled hypertension), pulmonary (including but not limited to chronic obstructive lung disease), hematological, immunologic, endocrine, metabolic (e.g. diabetes mellitus with HbA1C > 8.0%), autoimmune disease, thyroid or other uncontrolled systemic disease, coagulation disorders or blood dyscrasias; A depot injection or an implant of any drug within 3 months prior to administration of study medication, other than contraception or hyaluronic acid injections in joints for osteoarthritis; History of solid organ transplantation; History of malignancy diagnosed or treated within 5 years prior to screening (except for recent localized treatment of squamous or noninvasive basal cell skin cancers; cervical carcinoma in situ), cancer survivors not on maintenance therapy within the past 5 years; History of opportunistic infection (e.g., invasive candidiasis or pneumocystis pneumonia) Serious localized infection (e.g., cellulitis, abscess) or systemic and life-threatening infection (e.g., septicemia) within the 3 months prior to screening; Pregnant subjects. Female subjects or the spouse of male subjects, with child-bearing potential who are unwilling or unable to practice adequate contraception, defined as vasectomy in men, tubal ligation in women, or use of condoms and spermicides, or birth control pills, or intrauterine devices from 4 weeks prior to Day 1 until 90 days after the last dose of study drug.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Chun-Jen Liu
Phone
886-2-23123456
Ext
67503
Email
cjliu@ntu.edu.tw
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chun-Jen Liu
Organizational Affiliation
National Taiwan University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kaohsiung Medical University Chung-Ho Memorial Hospital
City
Kaohsiung
Country
Taiwan
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chia-Yen Dai
First Name & Middle Initial & Last Name & Degree
Chia-Yen Dai
Facility Name
China Medical University Hospital
City
Taichung
Country
Taiwan
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cheng-Yuan Peng
Facility Name
National Taiwan University Hospital
City
Taipei
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chun-Jen Liu
First Name & Middle Initial & Last Name & Degree
Chun-Jen Liu
Facility Name
Taipei Medical University Hospital
City
Taipei
Country
Taiwan
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yi-Wen Huang
Facility Name
Taipei Veterans General Hospital
City
Taipei
Country
Taiwan
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yi-Hsiang Huang
First Name & Middle Initial & Last Name & Degree
Yi-Hsiang Huang

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Comparing P1101 to Entecavir in Patients With HBeAg(-) Hepatitis B Under Long-term Nucleos(t)Ide Analogue Therapy

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