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Combination Therapy With Interferon Plus Interleukin 2 and Hepatitis B Vaccine in Chronic Hepatitis B Patients

Primary Purpose

Hepatitis B, Chronic

Status
Completed
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Entecavir
Interferon alfa-2b
Interleukin 2
Hepatitis B Vaccine
Sponsored by
Tongji Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis B, Chronic

Eligibility Criteria

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

Inclusion Criteria:

  1. Male and female patients from 18 to 65 years of age;
  2. Undergoing treatment with entecavir for at least 1 year ;
  3. HBsAg(+), HBeAg(+), HBV DNA≥ 100000 copies/ml,ALT≥2 ULN and ≤10 ULN before receiving entecavir treatment;
  4. HBV DNA ≤1000 copies/mL;
  5. HBeAg (-);
  6. HBsAg (+);
  7. Negative urine or serum pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of test drug;
  8. Liver biopsy confirmed without cirrhosis (optional);
  9. Agree to participate in the study and sign the patient informed consent.

Exclusion Criteria:

  1. Patients who had NAs resistance;
  2. Other antiviral, anti-neoplastic or immunomodulatory treatment (including supra physiologic doses of steroids and radiation) 6 months prior to the first dose of randomized treatment (except for 7 days of acyclovir for herpetic lesions more than 1 month prior to first administration of randomized treatment). Patients who are expected to need systemic antiviral therapy other than that provided by the study at any time during their participation are also excluded;
  3. Women with ongoing pregnancy or breast-feeding;
  4. Co-infection with active hepatitis A, hepatitis C, hepatitis D(Those hospitals which have the ability to do the test will do) and/or human immunodeficiency virus (HIV);
  5. ALT >10 ULN;
  6. Evidence of decompensated liver disease (Child-Pugh score > 5 ). Child-Pugh > 5 means, if one of the following 6 conditions are met, the patient has to be excluded: a. Serum albumin < 3.5 g/L; b. Prothrombin time > 3 seconds prolonged; c. Serum bilirubin > 34 μ mol/L; d. History of encephalopathy; e. History of variceal bleeding; f. Ascites;
  7. History or other evidence of a medical condition associated with chronic liver disease other than viral hepatitis (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures, thalassemia);
  8. Signs or symptoms of hepatocellular carcinoma, patients with a value of alpha-fetoprotein > 100 ng/mL are excluded, unless stability (less than 10% increase) has been documented over at least the previous 3 months. Patients with values < 20 ng/mL but > 100 ng/mL may be enrolled, if hepatic neoplasia has been excluded by liver imaging;
  9. Neutrophil count < 1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening;
  10. Hemoglobin < 11.5 g/dL for females and <12.5 g/dL for men;
  11. Serum creatinine level > 1.5 ULN in screening period.
  12. Phosphorus < 0.65 mmol/L;
  13. ANA > 1:100;
  14. History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at herapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease;
  15. History of a severe seizure disorder or current anticonvulsant use;
  16. History of immunologically mediated disease, (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, rheumatoid arthritis etc.);
  17. History of chronic pulmonary disease associated with functional limitation;
  18. Diseases that IFN and Nucleotides or nucleosides are not suitable.

Sites / Locations

  • Anhui Provincial Hospital
  • BeiJing YouAn Hospital, Capital Medical University
  • First Hospital, Beijing University
  • People'S Hospital Under Beijing University
  • The First Affiliated Hospital of Fujian Medical University
  • Department of infectious disease, Nanfang Hospital of Southern Medical University
  • Tongji Hospital
  • Departmen of infectious disease, Xiangya Hospital, Central-south Universit
  • ShengJing Hospital of China Medical University
  • Shanghai Ruijin Hospital, Jiao Tong University School of Medicine
  • The First Affiliated Hospital of College of Medicine, Zhejiang University
  • The first affiliated hospital of Wenzhou medical universtiy

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

1, conventional control group

2, combination and sequential group

3, multitarget group

Arm Description

Entecavir 0.5 mg po daily for 72 weeks

Interferon alfa-2b 600wIU qod iH for 48 weeks plus Entecavir 0.5mg qd po for 8 weeks

Interferon alfa-2b 600wIU qod iH for 48 weeks plus Entecavir 0.5mg qd po for 8 weeks plus interleukin 2 25 wIU qod iH for 12 weeks plus Hepatitis B Vaccine 60ug qm im for 48 weeks

Outcomes

Primary Outcome Measures

Percentage of HBsAg loss at week 48
Change from baseline in Percentage of HBsAg loss at week 48

Secondary Outcome Measures

decline from baseline in HBsAg quantification at week 48
HBsAg quantification are measured.
Change from baseline in HBsAg seroconversion at week 48
HBsAg seroconversion from baseline is measured.

Full Information

First Posted
February 2, 2015
Last Updated
May 8, 2018
Sponsor
Tongji Hospital
Collaborators
Beijing Kawin Technology Share-Holding Co., Ltd., Fujian Cosunter Pharmaceutical Co. Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT02360592
Brief Title
Combination Therapy With Interferon Plus Interleukin 2 and Hepatitis B Vaccine in Chronic Hepatitis B Patients
Official Title
Combination Therapy of Interferon Alfa-2b Plus Interleukin 2 and Hepatitis B Vaccine in Entecavir-experienced Chronic Hepatitis B Patients With HBeAg Seroclearance: a Prospective, Randomized Open-label Trial (Endeavor Study, a Pilot Study)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
June 2013 (Actual)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
April 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Tongji Hospital
Collaborators
Beijing Kawin Technology Share-Holding Co., Ltd., Fujian Cosunter Pharmaceutical Co. Ltd

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is a multi-center, randomized, prospective, open-label Phase IV Clinical trial to evaluate efficacy and safety of interferon alfa-2b therapy combinated with interleukin 2 and hepatitis B therapeutic vaccine versus interferon alfa-2b alone in chronic hepatitis B patients with entecavir achieving HBeAg seroclearance. Patients were randomized to one of 3 groups to receive different antiviral treatment.
Detailed Description
Patients who have been pretreated with entecavir for at least one year, with HBV (Hepatitis B Virus) DNA less than 1000 copies/ml and HBeAg seroclearance were randomized to one of 3 groups, to receive Entecavir 0.5 mg po daily for 72 weeks, or Interferon alfa-2b 600wIU qod iH for 48 weeks plus Entecavir 0.5mg qd po for 8 weeks, or Interferon alfa-2b 600wIU qod iH for 48 weeks plus Entecavir 0.5mg qd po for 8 weeks plus interleukin 2 25 wIU qod iH for 12 weeks plus Hepatitis B Vaccine 60ug qm im for 48 weeks.

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
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
94 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1, conventional control group
Arm Type
Active Comparator
Arm Description
Entecavir 0.5 mg po daily for 72 weeks
Arm Title
2, combination and sequential group
Arm Type
Experimental
Arm Description
Interferon alfa-2b 600wIU qod iH for 48 weeks plus Entecavir 0.5mg qd po for 8 weeks
Arm Title
3, multitarget group
Arm Type
Experimental
Arm Description
Interferon alfa-2b 600wIU qod iH for 48 weeks plus Entecavir 0.5mg qd po for 8 weeks plus interleukin 2 25 wIU qod iH for 12 weeks plus Hepatitis B Vaccine 60ug qm im for 48 weeks
Intervention Type
Drug
Intervention Name(s)
Entecavir
Other Intervention Name(s)
ETV
Intervention Description
In arm 1, Entecavir is used for 48 weeks and the follow up 24 weeks as conventional control, In arm 2 and 3, Entecavir is used for 8 weeks.
Intervention Type
Drug
Intervention Name(s)
Interferon alfa-2b
Other Intervention Name(s)
IFN a-2b
Intervention Description
In arm 2 and 3, interferon alfa-2b is used for 48 weeks
Intervention Type
Drug
Intervention Name(s)
Interleukin 2
Other Intervention Name(s)
IL-2
Intervention Description
In arm 3, Interleukin 2 is used for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Hepatitis B Vaccine
Intervention Description
In arm 3, Hepatitis B Vaccine is used for 48 weeks
Primary Outcome Measure Information:
Title
Percentage of HBsAg loss at week 48
Description
Change from baseline in Percentage of HBsAg loss at week 48
Time Frame
week 48
Secondary Outcome Measure Information:
Title
decline from baseline in HBsAg quantification at week 48
Description
HBsAg quantification are measured.
Time Frame
week 48
Title
Change from baseline in HBsAg seroconversion at week 48
Description
HBsAg seroconversion from baseline is measured.
Time Frame
week 48
Other Pre-specified Outcome Measures:
Title
Percentage of HBeAg seroconversion at week 48
Description
Percentage of HBeAg seroconversion are measured at week 48
Time Frame
week 48
Title
Percentage of HBV DNA normalization
Description
Percentage of HBV DNA normalization is measured.
Time Frame
week 48
Title
Percentage of sustained virology response at week 72
Description
Sustained virology response is measure at follow up week 24
Time Frame
week 72
Title
Percentage of ALT normalization at week 48
Description
Percentage of ALT normalization at week 48 is measured.
Time Frame
week 48

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 patients from 18 to 65 years of age; Undergoing treatment with entecavir for at least 1 year ; HBsAg(+), HBeAg(+), HBV DNA≥ 100000 copies/ml,ALT≥2 ULN and ≤10 ULN before receiving entecavir treatment; HBV DNA ≤1000 copies/mL; HBeAg (-); HBsAg (+); Negative urine or serum pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of test drug; Liver biopsy confirmed without cirrhosis (optional); Agree to participate in the study and sign the patient informed consent. Exclusion Criteria: Patients who had NAs resistance; Other antiviral, anti-neoplastic or immunomodulatory treatment (including supra physiologic doses of steroids and radiation) 6 months prior to the first dose of randomized treatment (except for 7 days of acyclovir for herpetic lesions more than 1 month prior to first administration of randomized treatment). Patients who are expected to need systemic antiviral therapy other than that provided by the study at any time during their participation are also excluded; Women with ongoing pregnancy or breast-feeding; Co-infection with active hepatitis A, hepatitis C, hepatitis D(Those hospitals which have the ability to do the test will do) and/or human immunodeficiency virus (HIV); ALT >10 ULN; Evidence of decompensated liver disease (Child-Pugh score > 5 ). Child-Pugh > 5 means, if one of the following 6 conditions are met, the patient has to be excluded: a. Serum albumin < 3.5 g/L; b. Prothrombin time > 3 seconds prolonged; c. Serum bilirubin > 34 μ mol/L; d. History of encephalopathy; e. History of variceal bleeding; f. Ascites; History or other evidence of a medical condition associated with chronic liver disease other than viral hepatitis (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures, thalassemia); Signs or symptoms of hepatocellular carcinoma, patients with a value of alpha-fetoprotein > 100 ng/mL are excluded, unless stability (less than 10% increase) has been documented over at least the previous 3 months. Patients with values < 20 ng/mL but > 100 ng/mL may be enrolled, if hepatic neoplasia has been excluded by liver imaging; Neutrophil count < 1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening; Hemoglobin < 11.5 g/dL for females and <12.5 g/dL for men; Serum creatinine level > 1.5 ULN in screening period. Phosphorus < 0.65 mmol/L; ANA > 1:100; History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at herapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease; History of a severe seizure disorder or current anticonvulsant use; History of immunologically mediated disease, (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, rheumatoid arthritis etc.); History of chronic pulmonary disease associated with functional limitation; Diseases that IFN and Nucleotides or nucleosides are not suitable.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qin Ning, Ph.D. M.D.
Organizational Affiliation
Department of Infectious Diseases, Tongji Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Anhui Provincial Hospital
City
Hefei
State/Province
Anhui
Country
China
Facility Name
BeiJing YouAn Hospital, Capital Medical University
City
Beijing
State/Province
Beijing
Country
China
Facility Name
First Hospital, Beijing University
City
Beijing
State/Province
Beijing
Country
China
Facility Name
People'S Hospital Under Beijing University
City
Beijing
State/Province
Beijing
Country
China
Facility Name
The First Affiliated Hospital of Fujian Medical University
City
Fuzhou
State/Province
Fujian
Country
China
Facility Name
Department of infectious disease, Nanfang Hospital of Southern Medical University
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Tongji Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430030
Country
China
Facility Name
Departmen of infectious disease, Xiangya Hospital, Central-south Universit
City
Changsha
State/Province
Hunan
Country
China
Facility Name
ShengJing Hospital of China Medical University
City
Shenyang
State/Province
Liaoning
Country
China
Facility Name
Shanghai Ruijin Hospital, Jiao Tong University School of Medicine
City
Shanghai
State/Province
Shanghai
Country
China
Facility Name
The First Affiliated Hospital of College of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
Country
China
Facility Name
The first affiliated hospital of Wenzhou medical universtiy
City
Wenzhou
State/Province
Zhejiang
Country
China

12. IPD Sharing Statement

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Combination Therapy With Interferon Plus Interleukin 2 and Hepatitis B Vaccine in Chronic Hepatitis B Patients

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