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
About this trial
This is an interventional treatment trial for HBV-related Liver Cirrhosis focused on measuring Telbivudine, renoprotective efficacy, liver cirrhosis
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
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
NCT ID
NCT01799486
First Posted
February 19, 2013
Last Updated
February 23, 2013
Sponsor
Lin Bingliang
Collaborators
Novartis
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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