A Study in Chronic Hepatitis B e-Antigen Negative Participants After Discontinuation of Nucleos(t)Ide Analog (NA) Treatment (SALMONS)
Primary Purpose
Hepatitis B, Chronic
Status
Withdrawn
Phase
Early Phase 1
Locations
International
Study Type
Interventional
Intervention
Entecavir (ETV)
Tenofovir Disoproxil Fumarate (TDF)
Tenofovir Alafenamide (TAF)
Sponsored by
About this trial
This is an interventional other trial for Hepatitis B, Chronic
Eligibility Criteria
Inclusion Criteria:
- Medically stable on the basis of physical examination, medical history, vital signs, and clinical laboratory tests performed at screening and during the pre-biopsy assessments. If the results of the serum chemistry panel including liver enzymes, blood coagulation, other specific tests, or hematology are outside the normal reference ranges, the participant may be included only if the investigator judges the abnormalities or deviations from normal to be not clinically significant or to be appropriate and reasonable for the population under study (in consultation with sponsor)
- Hepatitis B surface antigen (HBsAg) less than or equal to (<=) 500 International units per milliliters (IU/mL) (and greater than [>] 5 IU/mL) at screening
- Hepatitis B e antigen (HBeAg) less than (<) lower limit of quantification and hepatitis B e antibody (HBeAb) positive at screening
- Normal liver ultrasound (at screening or within 3 months before screening [documented evidence])
- Participants must have a body mass index between 18.0 and 35.0 Kilograms per meter square (kg/m^2), extremes included
Exclusion Criteria:
- History of or signs of cirrhosis or portal hypertension (absence of nodules, no smooth liver contour, no normal portal vein, spleen size greater than or equal to [>=] 12 centimeters [cm]) or signs of hepatocellular carcinoma (HCC) or clinically relevant renal abnormalities on an abdominal ultrasound performed within 3 months prior to screening (based on documented evidence, if available) or at the time of screening. In case of suspicious findings on conventional ultrasound the participant may still be eligible if HCC or clinically relevant renal abnormalities have been ruled out by a more specific imaging procedure (contrast enhanced ultrasound, computed tomography [CT] or magnetic resonance imaging [MRI])
- Participant's refusal to accept blood transfusions
- Participants with clinically relevant drug or alcohol abuse within 12 months before screening
- Received an investigational intervention or used an invasive investigational medical device within 3 months before the planned enrollment or is currently enrolled in an investigational study
- Participants of Asian descent
Sites / Locations
- Sygehus Lillebælt - Kolding Sygehus
- Odense Universitets Hospital
- Sjællands University hospital
- Hôpital Avicenne
- CHU Grenoble
- Hopital de La Croix Rousse
- Hopital Pontchaillou
- Universitatsklinikum Frankfurt
- Medizinische Hochschule Hannover
- Universitatsklinikum Leipzig
- Klinikum Sankt Georg Neurologie
- Eberhard Karls Universität Tübingen
- G.H. of Athens Evangelismos
- Laiko General Hospital of Athens
- General Hospital of Thessaloniki Ippokrateio
- ASST Spedali Civili di Brescia
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Foggia
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Azienda Ospedaliero-Universitaria di Modena, Ospedale di Baggiovara
- Azienda Ospedaliero Universitaria Pisana
- Casa Sollievo della Sofferenza
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino
- Hosp. Sra. Da Oliveira - Guimaraes
- Centro Hospitalar e Universitario de Coimbra
- Centro Hospitalar de Lisboa Norte - Hospital Santa Maria
- Centro Hospitalar de Trás os Montes e Alto Douro- Vila Real
- Hosp. Del Mar
- Hosp. Clinic I Provincial de Barcelona
- Hosp. Univ. Marques de Valdecilla
- Hosp. Clinico Univ. de Valencia
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Discontinuation of Nucleos(t)ide (NA) Treatment
Arm Description
Participants will receive standard of care NA treatment (Entecavir [ETV], Tenofovir Disoproxil Fumarate [TDF], Tenofovir Alafenamide [TAF]) in screening phase (up to 6 weeks) and in baseline visit (Day -1). NA treatment will be discontinued on Day 1 up to 96 weeks (Post-NA discontinuation off-treatment phase). Off-treatment refers to the phase after baseline, in which NA treatment will be discontinued.
Outcomes
Primary Outcome Measures
Percentage of Participants with Hepatitis B Surface Antigen (HBsAg) Seroclearance After Discontinuation of Nucleos(t)ide Analog (NA) Treatment
Percentage of participants with HBsAg seroclearance after discontinuation of NA treatment will be reported.
Percentage of Participants with HBsAg Seroclearance After Discontinuation of NA Treatment
Percentage of participants with HBsAg seroclearance after discontinuation of NA treatment will be reported.
Percentage of Participants with HBsAg Seroclearance After Discontinuation of NA Treatment
Percentage of participants with HBsAg seroclearance after discontinuation of NA treatment will be reported.
Secondary Outcome Measures
Percentage of Participants with Flares
Percentage of participants with flares (virologic, biochemical, and clinical) measured by blood markers (such as HBsAg, hepatitis B virus deoxyribonucleic acid [HBV DNA], and alanine aminotransferase [ALT]) will be reported.
Change from Baseline Over Time in HBsAg Level
Change from baseline over time in HBsAg level will be reported.
Change from Baseline Over Time in HBV DNA level
Change from baseline over time in HBV DNA level will be reported.
Time to Achieve First HBsAg Seroclearance
Time to achieve first HBsAg seroclearance will be reported.
Percentage of Sustained Clinical Responders
Percentage of sustained clinical responders (those with HBsAg seroclearance) will be reported.
Percentage of Participants with HBsAg Seroconversion
Percentage of participants with HBsAg seroconversion will be reported.
Percentage of Participants with Serious Adverse Events (SAEs)
SAE is any untoward medical occurrence that results in any of the following conditions that is death, life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization or results in persistent or significant disability/incapacity.
Percentage of Participants with Abnormalities in Clinical Laboratory Parameters
Percentage of participants with abnormalities in clinical laboratory parameters will be reported.
Percentage of Participants Who Meet the NA Re-Treatment Criteria
Percentage of participants who meet the NA re-treatment criteria will be reported.
Full Information
NCT ID
NCT05550519
First Posted
September 20, 2022
Last Updated
October 27, 2022
Sponsor
Janssen Pharmaceutica N.V., Belgium
1. Study Identification
Unique Protocol Identification Number
NCT05550519
Brief Title
A Study in Chronic Hepatitis B e-Antigen Negative Participants After Discontinuation of Nucleos(t)Ide Analog (NA) Treatment
Acronym
SALMONS
Official Title
A Prospective Study to Investigate the Relationship Between Hepatitis B Surface Antigen (HBsAg) Loss and the Dynamics in Host and Viral Markers After Discontinuation of Nucleos(t)Ide Analog (NA) Treatment in Chronic Hepatitis B E-antigen Negative Patients With Low On-treatment HBsAg Level
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Sponsor decision after reevaluation of strategy in the context of recruitment timelines projection
Study Start Date
October 31, 2022 (Anticipated)
Primary Completion Date
August 25, 2025 (Anticipated)
Study Completion Date
August 28, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Pharmaceutica N.V., Belgium
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
The purpose of this study is to assess the incidence of participants who reach hepatitis B surface antigen (HBsAg) seroclearance after discontinuing nucleos(t)ide analog (NA) therapy in participants with HBsAg less than or equal to (<=) 100 international units per milliliter (IU/mL) and participants with HBsAg greater than (>) 100 IU/mL to <= 500 IU/mL at baseline.
Detailed Description
Hepatitis B virus (HBV) virus infects the human liver. It consists of a nucleocapsid with hepatitis B core (HBc) protein and a membranous envelope containing hepatitis B surface antigen (HBsAg). Chronic hepatitis B (CHB) virus infection may lead to liver cirrhosis and hepatocellular carcinoma (HCC). Recent guidelines (European Association for the Study of the Liver [EASL] guidelines, Asian Pacific Association for the Study of the Liver [APASL] guidelines) suggest that discontinuation of treatment with nucleos(t)ide analog (NA) (Entecavir [ETV], tenofovir disoproxil fumarate [TDF] or tenofovir alafenamide [TAF]) in non-cirrhotic Hepatitis B e antigen (HBeAg) negative patients after a minimum of three years of viral suppression can trigger changes in virological and immune composition resulting in achieving HBsAg seroclearance (up to 25 percent [%]). The study will be conducted in 3 phases: screening phase (up to 6 weeks), baseline visit (1 day), and post-NA discontinuation phase (up to 96 weeks) which refers to the phase after baseline, in which treatment will be discontinued (off treatment). Discontinuation of NA treatment is considered as study intervention in this study. Collection of core liver biopsy, fine needle aspiration (FNA), and blood samples are considered study investigations/procedures. The participants will be followed for up to 2 years post-NA treatment discontinuation. The total duration of an individual participation will be up to 102 weeks (including up to 6 weeks for screening and baseline).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis B, Chronic
7. Study Design
Primary Purpose
Other
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Discontinuation of Nucleos(t)ide (NA) Treatment
Arm Type
Experimental
Arm Description
Participants will receive standard of care NA treatment (Entecavir [ETV], Tenofovir Disoproxil Fumarate [TDF], Tenofovir Alafenamide [TAF]) in screening phase (up to 6 weeks) and in baseline visit (Day -1). NA treatment will be discontinued on Day 1 up to 96 weeks (Post-NA discontinuation off-treatment phase). Off-treatment refers to the phase after baseline, in which NA treatment will be discontinued.
Intervention Type
Other
Intervention Name(s)
Entecavir (ETV)
Intervention Description
ETV will continue throughout screening and will be stopped at baseline.
Intervention Type
Other
Intervention Name(s)
Tenofovir Disoproxil Fumarate (TDF)
Intervention Description
TDF will continue throughout screening and will be stopped at baseline.
Intervention Type
Other
Intervention Name(s)
Tenofovir Alafenamide (TAF)
Intervention Description
TAF will continue throughout screening and will be stopped at baseline.
Primary Outcome Measure Information:
Title
Percentage of Participants with Hepatitis B Surface Antigen (HBsAg) Seroclearance After Discontinuation of Nucleos(t)ide Analog (NA) Treatment
Description
Percentage of participants with HBsAg seroclearance after discontinuation of NA treatment will be reported.
Time Frame
At Week 24
Title
Percentage of Participants with HBsAg Seroclearance After Discontinuation of NA Treatment
Description
Percentage of participants with HBsAg seroclearance after discontinuation of NA treatment will be reported.
Time Frame
At Week 48
Title
Percentage of Participants with HBsAg Seroclearance After Discontinuation of NA Treatment
Description
Percentage of participants with HBsAg seroclearance after discontinuation of NA treatment will be reported.
Time Frame
At Week 96
Secondary Outcome Measure Information:
Title
Percentage of Participants with Flares
Description
Percentage of participants with flares (virologic, biochemical, and clinical) measured by blood markers (such as HBsAg, hepatitis B virus deoxyribonucleic acid [HBV DNA], and alanine aminotransferase [ALT]) will be reported.
Time Frame
At Week 24, Week 48, and Week 96
Title
Change from Baseline Over Time in HBsAg Level
Description
Change from baseline over time in HBsAg level will be reported.
Time Frame
Baseline up to 96 weeks
Title
Change from Baseline Over Time in HBV DNA level
Description
Change from baseline over time in HBV DNA level will be reported.
Time Frame
Baseline up to 96 weeks
Title
Time to Achieve First HBsAg Seroclearance
Description
Time to achieve first HBsAg seroclearance will be reported.
Time Frame
Up to 96 weeks
Title
Percentage of Sustained Clinical Responders
Description
Percentage of sustained clinical responders (those with HBsAg seroclearance) will be reported.
Time Frame
At Week 24, Week 48, and Week 96
Title
Percentage of Participants with HBsAg Seroconversion
Description
Percentage of participants with HBsAg seroconversion will be reported.
Time Frame
At Week 24, Week 48, and Week 96
Title
Percentage of Participants with Serious Adverse Events (SAEs)
Description
SAE is any untoward medical occurrence that results in any of the following conditions that is death, life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization or results in persistent or significant disability/incapacity.
Time Frame
Up to 96 weeks
Title
Percentage of Participants with Abnormalities in Clinical Laboratory Parameters
Description
Percentage of participants with abnormalities in clinical laboratory parameters will be reported.
Time Frame
Up to 96 weeks
Title
Percentage of Participants Who Meet the NA Re-Treatment Criteria
Description
Percentage of participants who meet the NA re-treatment criteria will be reported.
Time Frame
Up to 96 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Medically stable on the basis of physical examination, medical history, vital signs, and clinical laboratory tests performed at screening and during the pre-biopsy assessments. If the results of the serum chemistry panel including liver enzymes, blood coagulation, other specific tests, or hematology are outside the normal reference ranges, the participant may be included only if the investigator judges the abnormalities or deviations from normal to be not clinically significant or to be appropriate and reasonable for the population under study (in consultation with sponsor)
Hepatitis B surface antigen (HBsAg) less than or equal to (<=) 500 International units per milliliters (IU/mL) (and greater than [>] 5 IU/mL) at screening
Hepatitis B e antigen (HBeAg) less than (<) lower limit of quantification and hepatitis B e antibody (HBeAb) positive at screening
Normal liver ultrasound (at screening or within 3 months before screening [documented evidence])
Participants must have a body mass index between 18.0 and 35.0 Kilograms per meter square (kg/m^2), extremes included
Exclusion Criteria:
History of or signs of cirrhosis or portal hypertension (absence of nodules, no smooth liver contour, no normal portal vein, spleen size greater than or equal to [>=] 12 centimeters [cm]) or signs of hepatocellular carcinoma (HCC) or clinically relevant renal abnormalities on an abdominal ultrasound performed within 3 months prior to screening (based on documented evidence, if available) or at the time of screening. In case of suspicious findings on conventional ultrasound the participant may still be eligible if HCC or clinically relevant renal abnormalities have been ruled out by a more specific imaging procedure (contrast enhanced ultrasound, computed tomography [CT] or magnetic resonance imaging [MRI])
Participant's refusal to accept blood transfusions
Participants with clinically relevant drug or alcohol abuse within 12 months before screening
Received an investigational intervention or used an invasive investigational medical device within 3 months before the planned enrollment or is currently enrolled in an investigational study
Participants of Asian descent
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Pharmaceutica N.V., Belgium Clinical Trial
Organizational Affiliation
Janssen Pharmaceutica N.V., Belgium
Official's Role
Study Director
Facility Information:
Facility Name
Sygehus Lillebælt - Kolding Sygehus
City
Kolding
ZIP/Postal Code
6000
Country
Denmark
Facility Name
Odense Universitets Hospital
City
Odense
ZIP/Postal Code
5000
Country
Denmark
Facility Name
Sjællands University hospital
City
Roskilde
ZIP/Postal Code
4000
Country
Denmark
Facility Name
Hôpital Avicenne
City
Bobigny
ZIP/Postal Code
93000
Country
France
Facility Name
CHU Grenoble
City
La Tronche
ZIP/Postal Code
38700
Country
France
Facility Name
Hopital de La Croix Rousse
City
Lyon
ZIP/Postal Code
69317
Country
France
Facility Name
Hopital Pontchaillou
City
Rennes cedex 9
ZIP/Postal Code
35033
Country
France
Facility Name
Universitatsklinikum Frankfurt
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
Facility Name
Medizinische Hochschule Hannover
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Universitatsklinikum Leipzig
City
Leipzig
ZIP/Postal Code
04109
Country
Germany
Facility Name
Klinikum Sankt Georg Neurologie
City
Leipzig
ZIP/Postal Code
04129
Country
Germany
Facility Name
Eberhard Karls Universität Tübingen
City
Tübingen
ZIP/Postal Code
72074
Country
Germany
Facility Name
G.H. of Athens Evangelismos
City
Athens
ZIP/Postal Code
10676
Country
Greece
Facility Name
Laiko General Hospital of Athens
City
Athens
ZIP/Postal Code
11527
Country
Greece
Facility Name
General Hospital of Thessaloniki Ippokrateio
City
Thessaloniki
ZIP/Postal Code
546 42
Country
Greece
Facility Name
ASST Spedali Civili di Brescia
City
Brescia
ZIP/Postal Code
25123
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria Ospedali Riuniti di Foggia
City
Foggia
ZIP/Postal Code
71100
Country
Italy
Facility Name
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
City
Milano
ZIP/Postal Code
20122
Country
Italy
Facility Name
Azienda Ospedaliero-Universitaria di Modena, Ospedale di Baggiovara
City
Modena
ZIP/Postal Code
41124
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria Pisana
City
Pisa
ZIP/Postal Code
56126
Country
Italy
Facility Name
Casa Sollievo della Sofferenza
City
San Giovanni Rotondo
ZIP/Postal Code
71013
Country
Italy
Facility Name
Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Hosp. Sra. Da Oliveira - Guimaraes
City
Braga
ZIP/Postal Code
4835-044
Country
Portugal
Facility Name
Centro Hospitalar e Universitario de Coimbra
City
Coimbra
ZIP/Postal Code
3000075
Country
Portugal
Facility Name
Centro Hospitalar de Lisboa Norte - Hospital Santa Maria
City
Lisboa
ZIP/Postal Code
1649-035
Country
Portugal
Facility Name
Centro Hospitalar de Trás os Montes e Alto Douro- Vila Real
City
Vila Real
ZIP/Postal Code
5000-508
Country
Portugal
Facility Name
Hosp. Del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Hosp. Clinic I Provincial de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hosp. Univ. Marques de Valdecilla
City
Santander
ZIP/Postal Code
39008
Country
Spain
Facility Name
Hosp. Clinico Univ. de Valencia
City
València
ZIP/Postal Code
46014
Country
Spain
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
The data sharing policy of the Janssen Pharmaceutical Companies of Johnson & Johnson is available at www.janssen.com/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale Open Data Access (YODA) Project site at yoda.yale.edu
IPD Sharing URL
https://www.janssen.com/clinical-trials/transparency
Learn more about this trial
A Study in Chronic Hepatitis B e-Antigen Negative Participants After Discontinuation of Nucleos(t)Ide Analog (NA) Treatment
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