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Telbivudine Renoprotective Effect in Patients With the HBV-related Liver Cirrhosis: a Randomized Controlled Trial

Primary Purpose

HBV-related Liver Cirrhosis

Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Telbivudine
Enecavir
Adefovir
Sponsored by
Lin Bingliang
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HBV-related Liver Cirrhosis focused on measuring Telbivudine, renoprotective efficacy, liver cirrhosis

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:Subjects eligible for enrolment in the study must meet all of the following criteria:

  • eGFR in baseline less than 90 ml.min-1.1.73m2
  • Aged between 18-75 years (inclusive).
  • Male or female.
  • Subjects with positive HBsAg for more than 6 months and anti-HBs negative regardless of HBeAg status. If eAg+, HBV DNA ≥2×104 IU/ml and <2×108 IU/ml; If eAg-, HBV DNA ≥2×103 IU/ml and <2×106 IU/ml.
  • Subjects with HBV-related liver cirrhosis, including compensated cirrhosis and decompensated, but only Child-Pugh A or B. Cirrhosis was diagnosed by the evidence of a small, nodular liver, as shown by ultrasound, computerized omography (CT), and magnetic resonance (MR), with the exclusion of primary biliary cirrhosis and cirrhosis caused by schistosome.
  • The ablility to understand and sign a written informed consent prior to any study related procedure and comply with the requirements of the study.

Exclusion Criteria:

Subjects meeting any of the following criteria must not be enrolled in the study

  • History of hypersensitivity to any of the study drugs or to drugs with similar chemical structures
  • Patient is pregnant or breastfeeding.
  • Subjects with non-HBV cirrhosis
  • Co-infection with HAV/HCV/HDV/ HIV
  • Patients who have previously been involved in a trial with telbivudine.
  • Patient has received nucleoside or nucleotide drugs whether approved or investigational at any time.
  • Patient has received IFN or other immunomodulatory treatment in the 6 months before Screening for this study.
  • Patient has a history of malignancy of any organ system, treated or untreated, within the past 5 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin. Patients with previous findings suggestive of possible hepatocellular carcinoma (HCC), should have the disease ruled out prior to entrance into the study.
  • Patient has one or more additional known primary or secondary causes of liver disease other than CHB, including steatohepatitis,autoimmune hepatitis and so on. Gilbert's syndrome and Dubin-Johnson syndrome are not considered exclusion criteria for this study.
  • History of any other acute or chronic medical condition that in the opinion of the investigator would make the patient unsuitable for inclusion into the study.
  • Patient is currently abusing alcohol or illicit drugs, or has a history of alcohol abuse or illicit substance abuse within the preceding two years.
  • Patient has a medical condition that requires frequent or prolonged use of systemic corticosteroids, although inhaled corticosteroids are allowed.
  • Patient has a history of clinical and laboratory evidence of chronic renal insufficiency.
  • Patient has a medical condition requiring the chronic or prolonged use of potentially hepatotoxic drugs or nephrotoxic drugs.
  • Patient has any other concurrent medical or social condition likely to preclude compliance with the schedule of evaluations in the protocol, or likely to confound the efficacy or safety observations of the study.
  • Use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer.
  • Patient has a history of myopathy, myositis, or persistent muscle weakness.
  • Kidney impairment due to non-HBV factors
  • Inability to comply with study requirements as determined by the study investigator
  • Patients with eGFR≤15 ml.min-1.1.73m2, who may need dialysis or renal transplantation

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Telbivudine

    Adefovir

    Enecavir

    Arm Description

    Telbivudine,600mg/d,oral,100patients,2 years.

    Adefovir,10mg/d,oral,100 patients,2years.

    Enecavir,0.5mg/d,oral,100 patients,2 year

    Outcomes

    Primary Outcome Measures

    Change of estimate of glomerular filtration rate (eGFR)* and Serum creatinine in week 4,12,18,24,48,72,96 in each Group.
    NO.

    Secondary Outcome Measures

    Liver function change (ALB/GLB, ALT/AST, TB) in each Group

    Full Information

    First Posted
    February 19, 2013
    Last Updated
    February 23, 2013
    Sponsor
    Lin Bingliang
    Collaborators
    Novartis
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01799486
    Brief Title
    Telbivudine Renoprotective Effect in Patients With the HBV-related Liver Cirrhosis: a Randomized Controlled Trial
    Official Title
    Telbivudine Renoprotective Effect in Patients With the HBV-related Liver Cirrhosis: a Randomized Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2013
    Overall Recruitment Status
    Unknown status
    Study Start Date
    February 2013 (undefined)
    Primary Completion Date
    February 2013 (Actual)
    Study Completion Date
    March 2015 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor-Investigator
    Name of the Sponsor
    Lin Bingliang
    Collaborators
    Novartis

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Chronic hepatitis B virus (HBV) infection is a serious clinical problem because of its worldwide distribution and potential adverse outcome, including cirrhosis, which is a major cause of HBV related death. Studies show the use of nucleot(s)ide analogs treatment can alleviate, even reverse the progress of HBV-related cirrhosis. In cirrhosis stage, some potential factors, including endocrine disorder, renin, aldosterone, vasopressin increasing, hepatitis B virus related nephritis, hepatorenal syndrome, may cause renal damage. With the exposure of NAs, adverse reports of rhabdomyolysis, renal dysfunction, and lactic acidosis are increasing. So when choosing NAs, the potential renal function impairment should be considered. Recently, Gane, Xiaoxi Li have separately reported that Telbivudine can improve estimate of glomerular filtration rate (eGFR) of patients with chronic hepatitis B, while eGFR of patients with Lamivudine, adefovir and entecavir have a trend of decrease, which suggested Telbivudine may have renal protective effects. This effect on patients with HBV-related liver cirrhosis has not been studied, which is not clear now. This study is a randomized controlled study to prospectively observe Telbivudine's effect on renal function, which aims to provide evidence in antiviral treatment for the patients with cirrhosis.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    HBV-related Liver Cirrhosis
    Keywords
    Telbivudine, renoprotective efficacy, liver cirrhosis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    300 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Telbivudine
    Arm Type
    Experimental
    Arm Description
    Telbivudine,600mg/d,oral,100patients,2 years.
    Arm Title
    Adefovir
    Arm Type
    Experimental
    Arm Description
    Adefovir,10mg/d,oral,100 patients,2years.
    Arm Title
    Enecavir
    Arm Type
    Experimental
    Arm Description
    Enecavir,0.5mg/d,oral,100 patients,2 year
    Intervention Type
    Drug
    Intervention Name(s)
    Telbivudine
    Other Intervention Name(s)
    No.
    Intervention Description
    600 mg monotherapy supplied in film-coated tablets.
    Intervention Type
    Drug
    Intervention Name(s)
    Enecavir
    Other Intervention Name(s)
    No.
    Intervention Description
    0.5 mg monotherapy supplied in tablets.
    Intervention Type
    Drug
    Intervention Name(s)
    Adefovir
    Other Intervention Name(s)
    No.
    Intervention Description
    10 mg monotherapy supplied in tablets.
    Primary Outcome Measure Information:
    Title
    Change of estimate of glomerular filtration rate (eGFR)* and Serum creatinine in week 4,12,18,24,48,72,96 in each Group.
    Description
    NO.
    Time Frame
    up to 2years
    Secondary Outcome Measure Information:
    Title
    Liver function change (ALB/GLB, ALT/AST, TB) in each Group
    Time Frame
    up to 2 years
    Other Pre-specified Outcome Measures:
    Title
    Percentage of subjects with ALT normalization rate at year 1and year 2 in each Group.
    Time Frame
    up to 2 years
    Title
    The rate of complications (ascites, hepatorenal syndrome and so on)
    Time Frame
    up to 2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria:Subjects eligible for enrolment in the study must meet all of the following criteria: eGFR in baseline less than 90 ml.min-1.1.73m2 Aged between 18-75 years (inclusive). Male or female. Subjects with positive HBsAg for more than 6 months and anti-HBs negative regardless of HBeAg status. If eAg+, HBV DNA ≥2×104 IU/ml and <2×108 IU/ml; If eAg-, HBV DNA ≥2×103 IU/ml and <2×106 IU/ml. Subjects with HBV-related liver cirrhosis, including compensated cirrhosis and decompensated, but only Child-Pugh A or B. Cirrhosis was diagnosed by the evidence of a small, nodular liver, as shown by ultrasound, computerized omography (CT), and magnetic resonance (MR), with the exclusion of primary biliary cirrhosis and cirrhosis caused by schistosome. The ablility to understand and sign a written informed consent prior to any study related procedure and comply with the requirements of the study. Exclusion Criteria: Subjects meeting any of the following criteria must not be enrolled in the study History of hypersensitivity to any of the study drugs or to drugs with similar chemical structures Patient is pregnant or breastfeeding. Subjects with non-HBV cirrhosis Co-infection with HAV/HCV/HDV/ HIV Patients who have previously been involved in a trial with telbivudine. Patient has received nucleoside or nucleotide drugs whether approved or investigational at any time. Patient has received IFN or other immunomodulatory treatment in the 6 months before Screening for this study. Patient has a history of malignancy of any organ system, treated or untreated, within the past 5 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin. Patients with previous findings suggestive of possible hepatocellular carcinoma (HCC), should have the disease ruled out prior to entrance into the study. Patient has one or more additional known primary or secondary causes of liver disease other than CHB, including steatohepatitis,autoimmune hepatitis and so on. Gilbert's syndrome and Dubin-Johnson syndrome are not considered exclusion criteria for this study. History of any other acute or chronic medical condition that in the opinion of the investigator would make the patient unsuitable for inclusion into the study. Patient is currently abusing alcohol or illicit drugs, or has a history of alcohol abuse or illicit substance abuse within the preceding two years. Patient has a medical condition that requires frequent or prolonged use of systemic corticosteroids, although inhaled corticosteroids are allowed. Patient has a history of clinical and laboratory evidence of chronic renal insufficiency. Patient has a medical condition requiring the chronic or prolonged use of potentially hepatotoxic drugs or nephrotoxic drugs. Patient has any other concurrent medical or social condition likely to preclude compliance with the schedule of evaluations in the protocol, or likely to confound the efficacy or safety observations of the study. Use of other investigational drugs at the time of enrollment, or within 30 days or 5 half-lives of enrollment, whichever is longer. Patient has a history of myopathy, myositis, or persistent muscle weakness. Kidney impairment due to non-HBV factors Inability to comply with study requirements as determined by the study investigator Patients with eGFR≤15 ml.min-1.1.73m2, who may need dialysis or renal transplantation
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Lin Bingliang, PhD
    Organizational Affiliation
    Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Learn more about this trial

    Telbivudine Renoprotective Effect in Patients With the HBV-related Liver Cirrhosis: a Randomized Controlled Trial

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