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A Study of Switch From Nucleotide to Peginterferon Alfa-2a in CHB Patients Achieving HBeAg Loss and HBV DNA <200IU/ml (New Switch)

Primary Purpose

Chronic Hepatitis B

Status
Unknown status
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Peginterferon alfa 2a
Sponsored by
The Second Affiliated Hospital of Chongqing Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Hepatitis B focused on measuring nucleoside, peginterferon alfa-2a

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients on-treatment with NAs (ADV, ETV or LAM) for 1-3 years, having achieved HBeAg loss at screening, and HBV DNA <200IU/ml for at least 48 weeks
  • Male and female patients ≥ 18 to 65 years of age
  • Chronic hepatitis B (positive HBsAg for at least 6 months prior to NA therapy start)
  • Compensated liver disease (Child-Pugh <6)
  • Absence of hepatocellular carcinoma on liver imaging and/or alfa fetoprotein < 50 ng/ml
  • Negative urine or blood pregnancy test for women of childbearing potential within 24 hours of first PEG IFN study medication administration
  • Able and willing to provide informed consent and abide by the requirements of the study

Exclusion Criteria:

  • Neutrophil count <1.5 x 109cells/L or platelet count <90 x 109cells/L
  • Co-infections with HIV, HAV, HCV, HDV or HEV
  • Women with ongoing pregnancy or breast feeding, or wishing to become pregnant during the study period
  • Prolonged and excessive alcohol intake (> 40g/day for men and > 30g/day for women)
  • Active intravenous drug abuse
  • History or current treatment with telbivudine
  • Treatment with immunomodulators (e.g. Interferon) for less than one year before study enrollment
  • Treatment with immunosuppressors (including systemic corticosteroids) or anti-neoplastic treatment (including radiation therapy) <=6 months prior to the first dose of study drug or the expectation that such treatment will be needed at any time during the study
  • Serum concentrations of ceruloplasmin or alfa-antitrypsin consistent with an increased risk of metabolic disease
  • History or other evidence of chronic pulmonary disease associated with functional limitation
  • History of severe cardiac disease
  • History of the severe seizure disorder or current anticonvulsivant use
  • History of thyroid disease poorly controlled on prescribed medications. Patients with elevated thyroid stimulating hormone concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease
  • History or other evidence of severe retinopathy
  • History of autoimmune disease or presence of a significant level of auto-antibodies
  • Renal insufficiency (creatinine clearance of < 50 ml/min according to the Cockroft and Gault equation), kidney transplant, hemodialysis
  • History of depression or uncontrolled psychiatric disorders
  • Subjects protected by law or not in a position to give consent
  • Patients with reproductive potential not willing to use an effective method of contraception.
  • Evidence of an active or suspected cancer or a history of malignancy (other than basocellular carcinoma or in-situ cervical carcinoma)

Sites / Locations

  • The 2nd affiliated Hospital of Chongqing Medical University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

48-week standard treatment

96-week prolonged treatment

Arm Description

48-week standard treatment by Peginterferon alfa 2a 180µg/week

96-week prolonged treatment by Peginterferon alfa 2a 180µg/week

Outcomes

Primary Outcome Measures

determine the response rate (HBsAg clearance at Week 48 and 96)
To determine the response rate (HBsAg clearance at Week 48 and 96) in subjects who are being treated by NAs and achieved a combined response which consists of both HBeAg loss and HBV DNA <1000 copies/ml

Secondary Outcome Measures

HBsAg/HBeAg/HBV DNA changes/ALT normalization /HBsAg seroconversion at EOT and EOF
HBsAg loss at EOF Quantitative HBe/sAg reduction at every check point. HBeAg seroconversion at EOT and EOF HBV DNA changes over 48 or 96 weeks at every check points ALT normalization at EOT and EOF HBsAg seroconversion at EOT and EOF

Full Information

First Posted
October 19, 2011
Last Updated
November 1, 2011
Sponsor
The Second Affiliated Hospital of Chongqing Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT01464281
Brief Title
A Study of Switch From Nucleotide to Peginterferon Alfa-2a in CHB Patients Achieving HBeAg Loss and HBV DNA <200IU/ml
Acronym
New Switch
Official Title
A Randomized, Multicenter Study Evaluating HBsAg Clearance in CHB Patients Achieving HBeAg Loss and HBV DNA <200copies/ml on Treatment With Nucleotide Analogues and Switched to Peginterferon Alfa-2a
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Unknown status
Study Start Date
October 2011 (undefined)
Primary Completion Date
June 2016 (Anticipated)
Study Completion Date
December 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Second Affiliated Hospital of Chongqing Medical University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A Randomized, open-label, multicenter study. The patients after 1-3 years NAs treatment and having achieved HBeAg loss and HBV DNA <200IU/ml will be switched to Pegasys for 48 or 96 weeks (with a 12 weeks period of overlap with the NA for safety reasons). The subjects will be randomized into 2 groups: Group 1 : 48-week standard treatment by Peginterferon alfa 2a 180µg/week Group 2 : 96-week prolonged treatment by Peginterferon alfa 2a 180µg/week. All the patients will be followed up for 48 weeks after discontinuation of the study medication. Note: NAs will be stratified LAM, ETV and ADV, with the ratio 1:1:1.
Detailed Description
eligibility criteria: Men and women old of 18 to 65 years with chronic hepatitis B HBeAg positive treated with nucleoside and/or nucleotide analogues for 1-2 years and with partial response (HBeAg loss and HBV DNA <1000copies/ml).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis B
Keywords
nucleoside, peginterferon alfa-2a

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
48-week standard treatment
Arm Type
Experimental
Arm Description
48-week standard treatment by Peginterferon alfa 2a 180µg/week
Arm Title
96-week prolonged treatment
Arm Type
Active Comparator
Arm Description
96-week prolonged treatment by Peginterferon alfa 2a 180µg/week
Intervention Type
Drug
Intervention Name(s)
Peginterferon alfa 2a
Intervention Description
Group 1 : 48-week standard treatment by Peginterferon alfa 2a 180µg/week Group 2 : 96-week prolonged treatment by Peginterferon alfa 2a 180µg/week.
Primary Outcome Measure Information:
Title
determine the response rate (HBsAg clearance at Week 48 and 96)
Description
To determine the response rate (HBsAg clearance at Week 48 and 96) in subjects who are being treated by NAs and achieved a combined response which consists of both HBeAg loss and HBV DNA <1000 copies/ml
Time Frame
1 year
Secondary Outcome Measure Information:
Title
HBsAg/HBeAg/HBV DNA changes/ALT normalization /HBsAg seroconversion at EOT and EOF
Description
HBsAg loss at EOF Quantitative HBe/sAg reduction at every check point. HBeAg seroconversion at EOT and EOF HBV DNA changes over 48 or 96 weeks at every check points ALT normalization at EOT and EOF HBsAg seroconversion at EOT and EOF
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients on-treatment with NAs (ADV, ETV or LAM) for 1-3 years, having achieved HBeAg loss at screening, and HBV DNA <200IU/ml for at least 48 weeks Male and female patients ≥ 18 to 65 years of age Chronic hepatitis B (positive HBsAg for at least 6 months prior to NA therapy start) Compensated liver disease (Child-Pugh <6) Absence of hepatocellular carcinoma on liver imaging and/or alfa fetoprotein < 50 ng/ml Negative urine or blood pregnancy test for women of childbearing potential within 24 hours of first PEG IFN study medication administration Able and willing to provide informed consent and abide by the requirements of the study Exclusion Criteria: Neutrophil count <1.5 x 109cells/L or platelet count <90 x 109cells/L Co-infections with HIV, HAV, HCV, HDV or HEV Women with ongoing pregnancy or breast feeding, or wishing to become pregnant during the study period Prolonged and excessive alcohol intake (> 40g/day for men and > 30g/day for women) Active intravenous drug abuse History or current treatment with telbivudine Treatment with immunomodulators (e.g. Interferon) for less than one year before study enrollment Treatment with immunosuppressors (including systemic corticosteroids) or anti-neoplastic treatment (including radiation therapy) <=6 months prior to the first dose of study drug or the expectation that such treatment will be needed at any time during the study Serum concentrations of ceruloplasmin or alfa-antitrypsin consistent with an increased risk of metabolic disease History or other evidence of chronic pulmonary disease associated with functional limitation History of severe cardiac disease History of the severe seizure disorder or current anticonvulsivant use History of thyroid disease poorly controlled on prescribed medications. Patients with elevated thyroid stimulating hormone concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease History or other evidence of severe retinopathy History of autoimmune disease or presence of a significant level of auto-antibodies Renal insufficiency (creatinine clearance of < 50 ml/min according to the Cockroft and Gault equation), kidney transplant, hemodialysis History of depression or uncontrolled psychiatric disorders Subjects protected by law or not in a position to give consent Patients with reproductive potential not willing to use an effective method of contraception. Evidence of an active or suspected cancer or a history of malignancy (other than basocellular carcinoma or in-situ cervical carcinoma)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hong Ren
Organizational Affiliation
The 2nd affiliated Hospital of Chongqing Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The 2nd affiliated Hospital of Chongqing Medical University
City
Chongqing
State/Province
Chongqing
ZIP/Postal Code
400010
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
30481882
Citation
Hu P, Shang J, Zhang WH, Gong GZ, Li YG, Chen XY, Jiang JN, Xie Q, Dou XG, Sun YT, Li YF, Liu YX, Liu GZ, Ma DW, Chi XL, Tang H, Li XO, Xie Y, Chen XP, Jiang JJ, Zha P, Hou JL, Gao ZL, Fan HM, Ding JG, Zhang DZ, Ren H. [HBsAg loss with Pegylated-interferon alfa-2a in hepatitis B patients with partial response to nucleos(t)-ide analog: new switch study]. Zhonghua Gan Zang Bing Za Zhi. 2018 Oct 20;26(10):756-764. doi: 10.3760/cma.j.issn.1007-3418.2018.10.005. Chinese.
Results Reference
derived
PubMed Identifier
29577029
Citation
Hu P, Shang J, Zhang W, Gong G, Li Y, Chen X, Jiang J, Xie Q, Dou X, Sun Y, Li Y, Liu Y, Liu G, Mao D, Chi X, Tang H, Li X, Xie Y, Chen X, Jiang J, Zhao P, Hou J, Gao Z, Fan H, Ding J, Zhang D, Ren H. HBsAg Loss with Peg-interferon Alfa-2a in Hepatitis B Patients with Partial Response to Nucleos(t)ide Analog: New Switch Study. J Clin Transl Hepatol. 2018 Mar 28;6(1):25-34. doi: 10.14218/JCTH.2017.00072. Epub 2018 Mar 17.
Results Reference
derived

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A Study of Switch From Nucleotide to Peginterferon Alfa-2a in CHB Patients Achieving HBeAg Loss and HBV DNA <200IU/ml

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