Addition of PegIFN Alfa-2a to CHB Patients Treated With Nucleot(s)Ides
Primary Purpose
Hepatitis B
Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
PegIFN alfa-2a
Sponsored by
About this trial
This is an interventional treatment trial for Hepatitis B focused on measuring HBsAg clearance
Eligibility Criteria
Inclusion Criteria:
- Male and female subjects,18-65 years
- positive for hepatitis B surface antigen (HBsAg) and negative for antibodies to HBsAg (anti-HBs antibodies) for at least 6 months before NAs treated
- nucleot(s)ides monotherapy (including lamivudine, adefovir, entecavir, tenofovir) and achieved HBV DNA<1000 copies/mL with HBsAg <3000 IU/mL, positive or negative for HBeAg, and negative for anti-HBs antibodies
- Subjects with no contra-indications to Peginterferon alfa therapy as detailed in the label (Hypersensitivity to the active substance, to alpha interferon, or to any of the excipients; Autoimmune hepatitis; Severe hepatic dysfunction or decompensated cirrhosis of the liver; A history of severe pre-existing cardiac disease, including unstable or uncontrolled cardiac disease in the previous six months)
- Subjects who are not co-infected with Hepatitis A Virus, Hepatitis C Virus or HIV
- Female subjects not pregnant or breast feeding when Peginterferon alfa treatment commenced, and aware of the requirement to use an effective method of contraception during therapy
- Written informed consent signed.
Exclusion Criteria:
- positive for Hepatitis A Virus Ab, HCV-RNA or positive for Hepatitis C Virus Ab, HDV Ab, HEV Ab or positive for HIV Ab in screening period
- Hepatocellular carcinoma(HCC) or alpha feto protein(AFP) levels more than 100 ng/ml and Hepatic malignant potential of Imaging examination or AFP levels more than 100 ng/ml for 3 months
- Compensated or Decompensated liver cirrhosis: with history of cirrhosis before nucleot(s)ides treatment or Child-Pugh score ≥ 5 or Complications of liver cirrhosis such as ascites, hepatic encephalopathy, esophageal gastric varices bleeding
- Autoimmune disease including Autoimmune hepatitis and Psoriasis and so on
- Pregnant women and lactating women or patients with pregnancy plans and not willing to use contraception during the study period
- A history of immunoregulation drug therapy within one year before entry including IFN and so on
- Have a history of alcohol abuse
- With severe psychiatric condition or nervous disease such as epilepsy, depression, mania, epilepsy, schizophrenia and so on
- A neutrophil count of less than 1500 per cubic millimeter or a platelet count of less than 90,000 per cubic millimeter
- Severe organ dysfunction
- With other malignant tumors(exclude the cured ones)
- Uncontrolled diabetes, hypertension or thyroid disease
- A serum creatinine level that was more than 1.5 times the upper limit of the normal range
- Hypersensitivity to interferon(IFN) or its active substance, and ineligible to IFN
- Participate in other clinical studies at the same time
- Patients unsuitable for the research -
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Active Comparator
Arm Label
nucleot(s)ides treated
PegIFN alfa-2a + nucleot(s)ides treated
Arm Description
patients who treated with nucleot(s)ides (including lamivudine, adefovir, entecavir, tenofovir) are still using the original treatment for 72 weeks
patients who treated with nucleot(s)ides (including lamivudine, adefovir, entecavir, tenofovir), then will add PegIFN alfa-2a to the original nucleot(s)ides for 48 weeks, then follow up for 24 weeks
Outcomes
Primary Outcome Measures
Number of participants who achieve HBsAg clearance
To investigate whether Peg-IFN alfa-2a add on treatment can improve the HBsAg clearance in CHB patients at the end of the treatment (48 week).
Secondary Outcome Measures
Number of participants who achieve HBsAg seroconversion
To investigate whether Peg-IFN alfa-2a add on treatment can improve the HBsAg seroconversion in CHB patients at the end of the treatment (48 week).
Number of participants who achieve HBeAg clearance and seroconversion
To investigate whether Peg-IFN alfa-2a add on treatment can improve HBeAg clearance and seroconversion at the end of the treatment (48 week).
HBsAg changes from Baseline
Pegasys 24 weeks Group:12,24 weeks and Pegasys 48 weeks Group:12,24,48 weeks
Number of participants who achieve HBV DNA<1000 copies/ml
To investigate whether Peg-IFN alfa-2a add on treatment can improve HBV DNA<1000 copies/ml
Full Information
NCT ID
NCT02644538
First Posted
December 28, 2015
Last Updated
December 30, 2015
Sponsor
The Second Affiliated Hospital of Chongqing Medical University
Collaborators
People's Hospital of Anshun City of Guizhou Province, The First Affiliated Hospital of Nanchang University, First Affiliated Hospital of Xinjiang Medical University
1. Study Identification
Unique Protocol Identification Number
NCT02644538
Brief Title
Addition of PegIFN Alfa-2a to CHB Patients Treated With Nucleot(s)Ides
Official Title
A Randomized, Controlled, Open-label, Multicenter Clinical Trial to Evaluate the Addition of PegIFN Alfa-2a to CHB Patients Treated With Nucleot(s)Ides
Study Type
Interventional
2. Study Status
Record Verification Date
December 2015
Overall Recruitment Status
Unknown status
Study Start Date
December 2015 (undefined)
Primary Completion Date
December 2017 (Anticipated)
Study Completion Date
December 2018 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Second Affiliated Hospital of Chongqing Medical University
Collaborators
People's Hospital of Anshun City of Guizhou Province, The First Affiliated Hospital of Nanchang University, First Affiliated Hospital of Xinjiang Medical University
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study evaluates whether PegIFN alfa-2a add on can improve CHB patients HBsAg clearance at the end of 48 weeks treatment. The CHB patients who received nucleot(s)ides anti-virus treatment and reached HBV DNA<1000 copies/ml and HBsAg<3000 IU/ml, were randomly assigned into two groups: One group continue the nucleot(s)ides treatment for 72 weeks, the other add on PegIFN alfa-2a on the basis of the original treatment for 48 weeks, and follow up for 24 weeks.
Detailed Description
nucleot(s)ides is a potent inhibitor of hepatitis B viral(HBV) replication, but long-term therapy may be required, and it is difficult for CHB patients to achieve HBsAg clearance by using nucleot(s)ides. Therefore, it is need take long-term therapy if chronic hepatitis B (CHB) choose to use nucleot(s)ides, and in another way, nucleot(s)ides resistance is an important clinical risk. More and more young patients want to stop treating, and discontinuation of nucleot(s)ides is a feasible strategy to reduce resistance. However, it is really easy to relapse if patients did not arrive HBsAg clearance. PegIFN alfa-2a can clear HBV by direct anti-viral and immune regulation mechanisms including enhancing natural killer cell response, increased cluster of differentiation 8(CD8 +) T lymphocytes and other mechanisms to restore and enhance the immune response in patients with CHB; and what's more, patients are safety after discontinuing.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis B
Keywords
HBsAg clearance
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
196 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
nucleot(s)ides treated
Arm Type
No Intervention
Arm Description
patients who treated with nucleot(s)ides (including lamivudine, adefovir, entecavir, tenofovir) are still using the original treatment for 72 weeks
Arm Title
PegIFN alfa-2a + nucleot(s)ides treated
Arm Type
Active Comparator
Arm Description
patients who treated with nucleot(s)ides (including lamivudine, adefovir, entecavir, tenofovir), then will add PegIFN alfa-2a to the original nucleot(s)ides for 48 weeks, then follow up for 24 weeks
Intervention Type
Drug
Intervention Name(s)
PegIFN alfa-2a
Other Intervention Name(s)
Pegasys
Intervention Description
chronic hepatitis B patients who treated with nucleot(s)ides (including lamivudine, adefovir, entecavir, tenofovir) arrived HBV DNA <1000copies/ml, and HBsAg<3000IU/ml, then change the treatment to original nucleot(s)ides add on PegIFN alfa-2a, the combined treatment is for 48 weeks, and follow up for 24 weeks
Primary Outcome Measure Information:
Title
Number of participants who achieve HBsAg clearance
Description
To investigate whether Peg-IFN alfa-2a add on treatment can improve the HBsAg clearance in CHB patients at the end of the treatment (48 week).
Time Frame
treat for 48 weeks
Secondary Outcome Measure Information:
Title
Number of participants who achieve HBsAg seroconversion
Description
To investigate whether Peg-IFN alfa-2a add on treatment can improve the HBsAg seroconversion in CHB patients at the end of the treatment (48 week).
Time Frame
48 weeks
Title
Number of participants who achieve HBeAg clearance and seroconversion
Description
To investigate whether Peg-IFN alfa-2a add on treatment can improve HBeAg clearance and seroconversion at the end of the treatment (48 week).
Time Frame
48 weeks
Title
HBsAg changes from Baseline
Description
Pegasys 24 weeks Group:12,24 weeks and Pegasys 48 weeks Group:12,24,48 weeks
Time Frame
12,24 and 48 weeks
Title
Number of participants who achieve HBV DNA<1000 copies/ml
Description
To investigate whether Peg-IFN alfa-2a add on treatment can improve HBV DNA<1000 copies/ml
Time Frame
12,24 and 48 weeks
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:
Male and female subjects,18-65 years
positive for hepatitis B surface antigen (HBsAg) and negative for antibodies to HBsAg (anti-HBs antibodies) for at least 6 months before NAs treated
nucleot(s)ides monotherapy (including lamivudine, adefovir, entecavir, tenofovir) and achieved HBV DNA<1000 copies/mL with HBsAg <3000 IU/mL, positive or negative for HBeAg, and negative for anti-HBs antibodies
Subjects with no contra-indications to Peginterferon alfa therapy as detailed in the label (Hypersensitivity to the active substance, to alpha interferon, or to any of the excipients; Autoimmune hepatitis; Severe hepatic dysfunction or decompensated cirrhosis of the liver; A history of severe pre-existing cardiac disease, including unstable or uncontrolled cardiac disease in the previous six months)
Subjects who are not co-infected with Hepatitis A Virus, Hepatitis C Virus or HIV
Female subjects not pregnant or breast feeding when Peginterferon alfa treatment commenced, and aware of the requirement to use an effective method of contraception during therapy
Written informed consent signed.
Exclusion Criteria:
positive for Hepatitis A Virus Ab, HCV-RNA or positive for Hepatitis C Virus Ab, HDV Ab, HEV Ab or positive for HIV Ab in screening period
Hepatocellular carcinoma(HCC) or alpha feto protein(AFP) levels more than 100 ng/ml and Hepatic malignant potential of Imaging examination or AFP levels more than 100 ng/ml for 3 months
Compensated or Decompensated liver cirrhosis: with history of cirrhosis before nucleot(s)ides treatment or Child-Pugh score ≥ 5 or Complications of liver cirrhosis such as ascites, hepatic encephalopathy, esophageal gastric varices bleeding
Autoimmune disease including Autoimmune hepatitis and Psoriasis and so on
Pregnant women and lactating women or patients with pregnancy plans and not willing to use contraception during the study period
A history of immunoregulation drug therapy within one year before entry including IFN and so on
Have a history of alcohol abuse
With severe psychiatric condition or nervous disease such as epilepsy, depression, mania, epilepsy, schizophrenia and so on
A neutrophil count of less than 1500 per cubic millimeter or a platelet count of less than 90,000 per cubic millimeter
Severe organ dysfunction
With other malignant tumors(exclude the cured ones)
Uncontrolled diabetes, hypertension or thyroid disease
A serum creatinine level that was more than 1.5 times the upper limit of the normal range
Hypersensitivity to interferon(IFN) or its active substance, and ineligible to IFN
Participate in other clinical studies at the same time
Patients unsuitable for the research -
12. IPD Sharing Statement
Plan to Share IPD
Undecided
IPD Sharing Plan Description
still undecided
Citations:
PubMed Identifier
15014185
Citation
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Citation
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Citation
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Marcellin P, Bonino F, Yurdaydin C, Hadziyannis S, Moucari R, Kapprell HP, Rothe V, Popescu M, Brunetto MR. Hepatitis B surface antigen levels: association with 5-year response to peginterferon alfa-2a in hepatitis B e-antigen-negative patients. Hepatol Int. 2013 Mar;7(1):88-97. doi: 10.1007/s12072-012-9343-x. Epub 2012 Mar 23.
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Piratvisuth T, Marcellin P, Popescu M, Kapprell HP, Rothe V, Lu ZM. Hepatitis B surface antigen: association with sustained response to peginterferon alfa-2a in hepatitis B e antigen-positive patients. Hepatol Int. 2013 Jun;7(2):429-36. doi: 10.1007/s12072-011-9280-0. Epub 2011 Jun 24.
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Citation
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Addition of PegIFN Alfa-2a to CHB Patients Treated With Nucleot(s)Ides
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