Efficacy and Safety of Tenofovir Alafenamide (TAF) Versus Tenofovir Disoproxil Fumarate (TDF)-Containing Regimens in Participants With Chronic Hepatitis B Virus (HBV) Infection and Stage 2 or Greater Chronic Kidney Disease Who Have Received a Liver Transplant
Primary Purpose
Chronic Hepatitis B
Status
Completed
Phase
Phase 2
Locations
New Zealand
Study Type
Interventional
Intervention
TAF
TDF
Other approved antivirals
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Hepatitis B
Eligibility Criteria
Key Inclusion Criteria:
- Must have the ability to understand and sign a written informed consent form; consent must be obtained prior to initiation of study procedures
- Documented evidence of chronic HBV infection prior to transplantation
- Primary or secondary (re-transplant), liver alone or liver and kidney transplant recipient from deceased or living donor
- Liver Transplant ≥ 12 weeks prior to screening
- Maintained on TDF alone or in combination with other approved antivirals for HBV prophylaxis or treatment
- Have been on approved HBV oral antiviral (OAV) treatment for at least 12 weeks post-transplant prior to screening, with HBV DNA < lower limit of quantification (LLOQ) at screening
- Screening estimated glomerular filtration rate using the chronic kidney disease epidemiology collaboration (eGFR_CKD-EPI) < 90 ml/min/1.73m^2
- Male participants and female participants of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception
- Women considered of child bearing potential must have a negative serum pregnancy test at Screening and a negative urine test at Baseline before dosing
- Must be willing and able to comply with all study requirements
Key Exclusion Criteria:
- Multi-organ transplant that includes heart or lung recipient (participants who have their liver transplant as part of a liver-kidney dual transplant are eligible to enroll)
- Participants with history of de novo or recurrent hepatocellular carcinoma (HCC) post-transplant and at screening
- Histological evidence of unresolved transplant rejection
- Current, uncontrolled ascites, variceal hemorrhage, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, or other signs of decompensated cirrhosis
Participants meeting any of the following laboratory parameters at screening:
- Alanine aminotransferase (ALT) > 10 × the upper limit of normal (ULN)
- International normalized ratio (INR) > 1.5 × ULN unless the participant is stable on anticoagulant regimen affecting INR
- Albumin < 3.0 g/dL
- Direct bilirubin ≥ 4 × ULN
- Platelet count < 50,000/mL
- Co-infection with HIV or hepatitis C virus (HCV)
- Recent (within 4 weeks of Screening) episode or infection requiring systemic antibiotics
- Use of any prohibited medications listed within 28 days of the Baseline/Day 1 visit
- Malignancy within 5 years prior to screening, with the exception of specific cancers that are cured by surgical resection (e.g., basal cell skin cancer, etc.) or hepatocellular carcinoma. Participants under evaluation for possible malignancy are not eligible
- Significant cardiovascular, pulmonary, or neurological disease
- Use of investigational agents within 3 months of screening, unless allowed by the Sponsor
- Use of any prohibited medications
- Current alcohol or substance abuse judged by the investigator to potentially interfere with participant compliance
- Known hypersensitivity to study drugs, metabolites or formulation excipients
- Lactating females or those who may wish to become pregnant during the course of the study
NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.
Sites / Locations
- Auckland City Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Active Comparator
Experimental
Arm Label
TAF
TDF-Containing Regimens
Optional Treatment Extension Phase
Arm Description
TAF 25 mg once daily for 48 weeks
TDF alone or in combination with other approved antivirals per local practice for 48 weeks
After Week 48, participants will be eligible to receive TAF 25 mg once daily for an additional 144 weeks.
Outcomes
Primary Outcome Measures
Change From Baseline in Serum Estimated Glomerular Filtration Rate (eGFR) at Week 24 Using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine Equation
Percentage of Participants With HBV DNA < 20 IU/mL at Week 24
Secondary Outcome Measures
Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 24
Percent Change From Baseline in Hip BMD at Week 48
Percent Change From Baseline in Spine BMD at Week 24
Percent Change From Baseline in Spine BMD at Week 48
Change From Baseline in Serum Creatinine at Week 24
Change From Baseline in Serum Creatinine at Week 48
Change From Baseline in Serum eGFR_CKD-EPI at Week 48
Percentage of Participants With HBV DNA < 20 IU/mL at Week 48
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02862548
Brief Title
Efficacy and Safety of Tenofovir Alafenamide (TAF) Versus Tenofovir Disoproxil Fumarate (TDF)-Containing Regimens in Participants With Chronic Hepatitis B Virus (HBV) Infection and Stage 2 or Greater Chronic Kidney Disease Who Have Received a Liver Transplant
Official Title
A Phase 2, Randomized, Open Label Study to Evaluate the Efficacy and Safety of Tenofovir Alafenamide (TAF) Versus Tenofovir Disoproxil Fumarate (TDF)-Containing Regimens in Subjects With Chronic HBV Infection and Stage 2 or Greater Chronic Kidney Disease Who Have Received a Liver Transplant
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Completed
Study Start Date
September 16, 2016 (Actual)
Primary Completion Date
February 8, 2018 (Actual)
Study Completion Date
May 5, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The primary objectives of this study are to evaluate the safety, tolerability, and efficacy of tenofovir alafenamide (TAF) versus tenofovir disoproxil fumarate (TDF)-containing regimens at Week 24 in participants with chronic hepatitis B virus (HBV) infection and Stage 2 or greater chronic kidney disease who have received a liver transplant.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis B
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
51 (Actual)
8. Arms, Groups, and Interventions
Arm Title
TAF
Arm Type
Experimental
Arm Description
TAF 25 mg once daily for 48 weeks
Arm Title
TDF-Containing Regimens
Arm Type
Active Comparator
Arm Description
TDF alone or in combination with other approved antivirals per local practice for 48 weeks
Arm Title
Optional Treatment Extension Phase
Arm Type
Experimental
Arm Description
After Week 48, participants will be eligible to receive TAF 25 mg once daily for an additional 144 weeks.
Intervention Type
Drug
Intervention Name(s)
TAF
Other Intervention Name(s)
Vemlidy®
Intervention Description
Tablet administered orally
Intervention Type
Drug
Intervention Name(s)
TDF
Intervention Description
Tablet administered orally
Intervention Type
Drug
Intervention Name(s)
Other approved antivirals
Intervention Description
Other approved antivirals (such as lamivudine, entecavir, or immunoglobulin antihepatitis B) administered per local practice
Primary Outcome Measure Information:
Title
Change From Baseline in Serum Estimated Glomerular Filtration Rate (eGFR) at Week 24 Using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine Equation
Time Frame
Baseline, Week 24
Title
Percentage of Participants With HBV DNA < 20 IU/mL at Week 24
Time Frame
Week 24
Secondary Outcome Measure Information:
Title
Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 24
Time Frame
Baseline, Week 24
Title
Percent Change From Baseline in Hip BMD at Week 48
Time Frame
Baseline, Week 48
Title
Percent Change From Baseline in Spine BMD at Week 24
Time Frame
Baseline, Week 24
Title
Percent Change From Baseline in Spine BMD at Week 48
Time Frame
Baseline, Week 48
Title
Change From Baseline in Serum Creatinine at Week 24
Time Frame
Baseline, Week 24
Title
Change From Baseline in Serum Creatinine at Week 48
Time Frame
Baseline, Week 48
Title
Change From Baseline in Serum eGFR_CKD-EPI at Week 48
Time Frame
Baseline, Week 48
Title
Percentage of Participants With HBV DNA < 20 IU/mL at Week 48
Time Frame
Week 48
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria:
Must have the ability to understand and sign a written informed consent form; consent must be obtained prior to initiation of study procedures
Documented evidence of chronic HBV infection prior to transplantation
Primary or secondary (re-transplant), liver alone or liver and kidney transplant recipient from deceased or living donor
Liver Transplant ≥ 12 weeks prior to screening
Maintained on TDF alone or in combination with other approved antivirals for HBV prophylaxis or treatment
Have been on approved HBV oral antiviral (OAV) treatment for at least 12 weeks post-transplant prior to screening, with HBV DNA < lower limit of quantification (LLOQ) at screening
Screening estimated glomerular filtration rate using the chronic kidney disease epidemiology collaboration (eGFR_CKD-EPI) < 90 ml/min/1.73m^2
Male participants and female participants of childbearing potential who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception
Women considered of child bearing potential must have a negative serum pregnancy test at Screening and a negative urine test at Baseline before dosing
Must be willing and able to comply with all study requirements
Key Exclusion Criteria:
Multi-organ transplant that includes heart or lung recipient (participants who have their liver transplant as part of a liver-kidney dual transplant are eligible to enroll)
Participants with history of de novo or recurrent hepatocellular carcinoma (HCC) post-transplant and at screening
Histological evidence of unresolved transplant rejection
Current, uncontrolled ascites, variceal hemorrhage, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, or other signs of decompensated cirrhosis
Participants meeting any of the following laboratory parameters at screening:
Alanine aminotransferase (ALT) > 10 × the upper limit of normal (ULN)
International normalized ratio (INR) > 1.5 × ULN unless the participant is stable on anticoagulant regimen affecting INR
Albumin < 3.0 g/dL
Direct bilirubin ≥ 4 × ULN
Platelet count < 50,000/mL
Co-infection with HIV or hepatitis C virus (HCV)
Recent (within 4 weeks of Screening) episode or infection requiring systemic antibiotics
Use of any prohibited medications listed within 28 days of the Baseline/Day 1 visit
Malignancy within 5 years prior to screening, with the exception of specific cancers that are cured by surgical resection (e.g., basal cell skin cancer, etc.) or hepatocellular carcinoma. Participants under evaluation for possible malignancy are not eligible
Significant cardiovascular, pulmonary, or neurological disease
Use of investigational agents within 3 months of screening, unless allowed by the Sponsor
Use of any prohibited medications
Current alcohol or substance abuse judged by the investigator to potentially interfere with participant compliance
Known hypersensitivity to study drugs, metabolites or formulation excipients
Lactating females or those who may wish to become pregnant during the course of the study
NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilead Study Director
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Auckland City Hospital
City
Auckland
Country
New Zealand
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified external researchers may request IPD for this study after study completion. For more information, please visit our website at https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy.
IPD Sharing Time Frame
18 months after study completion
IPD Sharing Access Criteria
A secured external environment with username, password, and RSA code.
IPD Sharing URL
https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy
Learn more about this trial
Efficacy and Safety of Tenofovir Alafenamide (TAF) Versus Tenofovir Disoproxil Fumarate (TDF)-Containing Regimens in Participants With Chronic Hepatitis B Virus (HBV) Infection and Stage 2 or Greater Chronic Kidney Disease Who Have Received a Liver Transplant
We'll reach out to this number within 24 hrs