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Efficacy of NA Combined With PEG-IFN-α2b in the Continuous Versus Pulsed Treatment of Patients With Chronic Hepatitis B (EPCP)

Primary Purpose

Hepatitis B, Chronic

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
PEGylated recombinant human interferon alpha-2b injection
PEGylated recombinant human interferon alpha-2b injection
Sponsored by
Anhui Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis B, Chronic

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Age 18 to 60 years, both sexes (both 18 and 60 years) HBsAg positive for more than 6 months; NAs treated patients on continuous NA therapy for more than 6 months with HBsAg ≥ 1500 IU/ml and HBV-DNA < 500 IU/ml at enrolment; Primary treated patients with surface antigen >1500 IU, unlimited E antigen and unlimited HBV DNA at enrolment, meeting the treatment indications of the 2019 edition of the guidelines for the prevention and treatment of chronic hepatitis B. negative urine or serum pregnancy test within 24 hours prior to the first dose (for women of childbearing age) Exclusion Criteria: Combined active hepatitis A, C, D, E and/or HIV infection; Patients who are on future and intend to continue to use tibivudine methaemoglobin greater than 100ng/ml at screening; or methaemoglobin that has not remained stable for 3 months prior to the trial and/or liver imaging suggestive of liver tumours; decompensated liver disease (Child-Pugh score ≥ 7), meaning that patients will be excluded if one of the following is met: prolonged prothrombin time ≥ 3 seconds, serum bilirubin > 34umol/L, history of hepatic encephalopathy, history of oesophageal variceal bleeding, ascites; pregnant or lactating women or patients with planned pregnancy during the study period and unwilling to use contraception Neutrophil count < 1.5 x 10^9/L or platelet count < 90 x 10^9/L and creatinine > 1.5 ULN History of severe psychiatric illness, especially depression. Major psychosis defined as major depressive disorder or psychosis, suicide attempts, hospitalisation for psychosis or incapacity for a period of time due to psychosis; history of immune-mediated disease (e.g. inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune haemolytic anaemia, scleroderma, severe psoriasis, rheumatoid arthritis) or abnormally elevated levels of autoimmune antibodies Patients with severe combined diseases of the heart, lungs, kidneys, brain, blood and other vital organs, combined with other malignancies History of severe epilepsy or current treatment with anti-epileptic drugs. Unstable control of diabetes mellitus, hypertension, thyroid disease, etc. Patients with a history of severe retinopathy or as indicated by other evidence of retinopathy; History of any organ transplantation and existing functional grafts (except corneal or hair transplants); Patients who are allergic to interferon and its drug components and who, in the judgment of the investigator, are unsuitable for interferon application Patients who, in the opinion of the investigator, are not suitable for participation in this study.

Sites / Locations

  • The First Affiliated Hospital of Anhui Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Continuous Combination Therapy Cohort

Pulsed Combination Therapy Cohort

Arm Description

Patients with primary CHB with HBsAg ≥ 1500 IU/ml and HBV-DNA < 500 IU/ml and patients with CHB after treatment with NAs will be enrolled. After fully informed consent, pegylated interferon alpha-2b 180µg will be administered by subcutaneous injection once a week for up to 96 weeks.

Patients with primary CHB with HBsAg ≥ 1500 IU/ml and HBV-DNA < 500 IU/ml and patients with CHB after treatment with NAs will be enrolled. After fully informed consent, pegylated interferon alpha-2b 180µg will be administered by subcutaneous injection once weekly for 8 weeks of treatment and discontinued for 4 weeks up to 96 weeks.

Outcomes

Primary Outcome Measures

HBsAg negative conversion rate after 96 weeks of treatment
After 96 weeks of treatment, 5 ml of blood will be drawn from the patient, serum will be extracted, and HBsAg values will be quantified by chemiluminescence assay; samples less than 0.5 ng/ml will be judged as negative.
HBsAb conversion rate after 96 weeks of treatment
After 96 weeks of treatment, 5 ml of blood will be drawn from the patient, serum will be extracted, and HBsAb values will be quantified by chemiluminescence; samples greater than 10 miu/ml 0.5 will be judged as positive.

Secondary Outcome Measures

Full Information

First Posted
June 2, 2023
Last Updated
June 24, 2023
Sponsor
Anhui Medical University
Collaborators
The First Affiliated Hospital, University of Science and Technology of China, The Second Hospital of Anhui Medical University, Chaohu Hospital of Anhui Medical University, First Affiliated Hospital Bengbu Medical College
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1. Study Identification

Unique Protocol Identification Number
NCT05922306
Brief Title
Efficacy of NA Combined With PEG-IFN-α2b in the Continuous Versus Pulsed Treatment of Patients With Chronic Hepatitis B
Acronym
EPCP
Official Title
A Multicenter, Prospective Cohort Study: Efficacy of NA Combined With PEG-IFN-α2b Continuous Versus Pulsed Therapy for 96 Weeks in Patients With Chronic Hepatitis B.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 2023 (Anticipated)
Primary Completion Date
June 2027 (Anticipated)
Study Completion Date
December 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Anhui Medical University
Collaborators
The First Affiliated Hospital, University of Science and Technology of China, The Second Hospital of Anhui Medical University, Chaohu Hospital of Anhui Medical University, First Affiliated Hospital Bengbu Medical College

4. Oversight

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

5. Study Description

Brief Summary
Previous studies have shown that there are alterations in the number and affinity of interferon receptors during interferon therapy and that such alterations recover to varying degrees some time after the end of treatment. It can be conjectured that the rest period of pulsed therapy facilitates the recovery of type I interferon receptors and thus the next round of IFN therapy compared to a continuous regimen of interferon.
Detailed Description
A large-sample, multicenter, prospective, real-world study using NAs in combination with PEG-IFN-α-2b for the treatment of CHB patients with continuous or pulsed combination therapy over a course of up to 96 weeks is proposed to compare the differences in clinical cure rates and E antigen conversion rates between groups. Multiple novel markers of hepatitis B infection, including HBV pgRNA, HBcrAg and anti-HBcAb quantification, were dynamically measured at baseline, 12, 24, 48, 72 and 96 weeks to explore the appropriate strategy for achieving clinical cure rates in CHB patients treated with NAs in combination with PEG-IFN-α-2b.

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
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Masking Description
Participants and investigators will be informed of the treatment protocol. Participants will be grouped according to the random number method at initial entry and will be given the option to continue in the current cohort or withdraw from the cohort study at their own discretion after treatment assessment at each node.
Allocation
Randomized
Enrollment
1084 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Continuous Combination Therapy Cohort
Arm Type
Active Comparator
Arm Description
Patients with primary CHB with HBsAg ≥ 1500 IU/ml and HBV-DNA < 500 IU/ml and patients with CHB after treatment with NAs will be enrolled. After fully informed consent, pegylated interferon alpha-2b 180µg will be administered by subcutaneous injection once a week for up to 96 weeks.
Arm Title
Pulsed Combination Therapy Cohort
Arm Type
Experimental
Arm Description
Patients with primary CHB with HBsAg ≥ 1500 IU/ml and HBV-DNA < 500 IU/ml and patients with CHB after treatment with NAs will be enrolled. After fully informed consent, pegylated interferon alpha-2b 180µg will be administered by subcutaneous injection once weekly for 8 weeks of treatment and discontinued for 4 weeks up to 96 weeks.
Intervention Type
Drug
Intervention Name(s)
PEGylated recombinant human interferon alpha-2b injection
Other Intervention Name(s)
Nucleotide analogues
Intervention Description
Continuous combination therapy: pegylated interferon alpha-2b 180µg, subcutaneously once a week for 96 weeks, combined with NAs throughout the treatment period.
Intervention Type
Drug
Intervention Name(s)
PEGylated recombinant human interferon alpha-2b injection
Other Intervention Name(s)
Nucleotide analogues
Intervention Description
Pulsed combination therapy: pegylated interferon alpha-2b 180µg once weekly by subcutaneous injection for 8 weeks with 4 weeks off for a total treatment duration of 96 weeks, combined with NAs throughout the treatment period.
Primary Outcome Measure Information:
Title
HBsAg negative conversion rate after 96 weeks of treatment
Description
After 96 weeks of treatment, 5 ml of blood will be drawn from the patient, serum will be extracted, and HBsAg values will be quantified by chemiluminescence assay; samples less than 0.5 ng/ml will be judged as negative.
Time Frame
96 weeks
Title
HBsAb conversion rate after 96 weeks of treatment
Description
After 96 weeks of treatment, 5 ml of blood will be drawn from the patient, serum will be extracted, and HBsAb values will be quantified by chemiluminescence; samples greater than 10 miu/ml 0.5 will be judged as positive.
Time Frame
96 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 to 60 years, both sexes (both 18 and 60 years) HBsAg positive for more than 6 months; NAs treated patients on continuous NA therapy for more than 6 months with HBsAg ≥ 1500 IU/ml and HBV-DNA < 500 IU/ml at enrolment; Primary treated patients with surface antigen >1500 IU, unlimited E antigen and unlimited HBV DNA at enrolment, meeting the treatment indications of the 2019 edition of the guidelines for the prevention and treatment of chronic hepatitis B. negative urine or serum pregnancy test within 24 hours prior to the first dose (for women of childbearing age) Exclusion Criteria: Combined active hepatitis A, C, D, E and/or HIV infection; Patients who are on future and intend to continue to use tibivudine methaemoglobin greater than 100ng/ml at screening; or methaemoglobin that has not remained stable for 3 months prior to the trial and/or liver imaging suggestive of liver tumours; decompensated liver disease (Child-Pugh score ≥ 7), meaning that patients will be excluded if one of the following is met: prolonged prothrombin time ≥ 3 seconds, serum bilirubin > 34umol/L, history of hepatic encephalopathy, history of oesophageal variceal bleeding, ascites; pregnant or lactating women or patients with planned pregnancy during the study period and unwilling to use contraception Neutrophil count < 1.5 x 10^9/L or platelet count < 90 x 10^9/L and creatinine > 1.5 ULN History of severe psychiatric illness, especially depression. Major psychosis defined as major depressive disorder or psychosis, suicide attempts, hospitalisation for psychosis or incapacity for a period of time due to psychosis; history of immune-mediated disease (e.g. inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune haemolytic anaemia, scleroderma, severe psoriasis, rheumatoid arthritis) or abnormally elevated levels of autoimmune antibodies Patients with severe combined diseases of the heart, lungs, kidneys, brain, blood and other vital organs, combined with other malignancies History of severe epilepsy or current treatment with anti-epileptic drugs. Unstable control of diabetes mellitus, hypertension, thyroid disease, etc. Patients with a history of severe retinopathy or as indicated by other evidence of retinopathy; History of any organ transplantation and existing functional grafts (except corneal or hair transplants); Patients who are allergic to interferon and its drug components and who, in the judgment of the investigator, are unsuitable for interferon application Patients who, in the opinion of the investigator, are not suitable for participation in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yufeng Gao, MD
Phone
13956938032
Email
aygyf@anmu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jiabing Li, MD
Organizational Affiliation
The First Affiliated Hospital of Anhui Medical University
Official's Role
Study Chair
Facility Information:
Facility Name
The First Affiliated Hospital of Anhui Medical University
City
Hefei
State/Province
Anhui
ZIP/Postal Code
23000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yufeng Gao, MD
Phone
1395693032
Email
aygyf@ahmu.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Efficacy of NA Combined With PEG-IFN-α2b in the Continuous Versus Pulsed Treatment of Patients With Chronic Hepatitis B

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