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Treatment of Patients With Chronic Hepatitis B With Hepatitis B Immunoglobulins (HBIG)

Primary Purpose

Chronic Hepatitis B

Status
Recruiting
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Human hepatitis B Immunoglobulin (Hepatect®CP/Zutectra®)
Sponsored by
Hannover Medical School
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Hepatitis B focused on measuring Human hepatitis B Immunoglobulin

Eligibility Criteria

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

Inclusion Criteria:

Subjects must meet all of the following inclusion criteria to be eligible for participation in this study:

  1. Willing and able to provide written informed consent
  2. Male or female, age ≥ 18 years
  3. Confirmation of chronic HBV infection documented by:

    positive HBsAg at least 12 months before screening

  4. Cohort A: NA treatment for at least 12 months before screening. HBV-DNA should be below the lower limit of detection at screening. HBsAg positive and <100 IU/ml. HBeAg negative.
  5. Cohort B: Untreated with NAs for at least 12 months before screening. HBV-DNA < 2000 IU/ml. HBsAg positive and < 100 IU/ml. HBeAg-negative.
  6. Subject has not been treated with any investigational drug or device within 42 days before the screening visit or within 5 half-lives for investigational drugs, whichever is longer.
  7. Transient Elastography (FibroScan) < 7.5 kPa at screening.
  8. ALT levels < 1.5 times of upper the limit of normal at screening for both cohorts
  9. Body mass idex (BMI) > 18kg/m²
  10. A negative serum pregnancy test is required for female subjects (unless surgically sterile or women > 54 years of age with cessation for > 24 months of previously occurring menses). Complete abstinence from intercourse. Periodic abstinence (e.g., calendar, ovulation, symptothermal, postovulation methods) is not permitted. Or Consistent and correct use of 1 of the following methods of birth control listed below, in addition to a male partner who correctly uses a condom, from the date of Screening until the end of FU:

    • intrauterine device (IUD) with a failure rate of < 1% per year
    • bilateral tubal sterilization
    • vasectomy in male partner
    • hormone-containing contraceptive:

      • combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation:

        • oral
        • intravaginal
        • transdermal
      • progestogen-only hormonal contraception associated with inhibition of ovulation:

        • oral
        • injectable
        • implantable
  11. Subject must be able to comply with the dosing instructions for study drug administration and be able to complete the study schedule of assessments

Exclusion Criteria:

Subjects who meet any of the following exclusion criteria are not to be enrolled in this study:

  1. Clinically significant illness (other than hepatitis B) or any other major medical disorder that, in the opinion of the investigator, may interfere with subject treatment, assessment or compliance with the protocol. Subjects currently under evaluation for a potentially clinically significant illness (other than hepatitis B) are also excluded.
  2. Co-infection with hepatitis C virus (defined as HCV RNA positive. HCV RNA negative/anti-HCV-positive patients can be included) or co-infection with HIV.
  3. Clinical hepatic decompensation (i.e. clinical ascites, encephalopathy or variceal hemorrhage).
  4. Psychiatric hospitalization, suicide attempt, and/or a period of disability as a result of their psychiatric illness within the last 2 years. Subjects with psychiatric illness that is well-controlled on a stable treatment regimen for at least 12 months prior to screening or has not required medication in the last 12 months may be included.
  5. Significant drug allergy (such as anaphylaxis or hepatotoxicity).
  6. Pregnant or nursing female or male with pregnant female partner
  7. Clinically relevant drug or alcohol abuse within 12 months of screening including any uncontrolled drug use within 6 months of screening. A positive drug screen will exclude subjects unless it can be explained by a prescribed medication. The investigator must approve medication, the diagnosis and prescription. Uncontrolled users of intravenous drugs will not be permitted to enroll in the study.
  8. live-attenuated virus vaccinations such as: measles, mumps, rubella and varicella 4 weeks before and up to three months after administration of hepatitis B immunoglobulins. If not required by an emergency situation, passive or active immunizations or administration of plasma preparations or of other immunoglobulins is not allowed during the study
  9. A recent SARS-COV2 infection in the last 4 weeks prior to screening

Sites / Locations

  • Hannover Medical School, Department for Gastroenterology, Hepatology and EndocrinologyRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Hepatitis B immunoglobulins

Arm Description

20 patients treated in two cohorts for 12 weeks with hepatitis B Immunoglobulins (HBIG, Hepatect®CP/ Zutectra®). Cohort A: 10 HBsAg positive, HBeAg-negative patients being treated with anti-HBV nucleotide or nucleoside analogous (NAs) for at least 12 months before screening. HBV-DNA should be below the lower limit of detection at screening. HBsAg should be positive and below 100 IU/ml. Cohort B: 10 HBsAg positive, HBeAg-negative patients untreated with NAs for at least 12 months before screening. Patients with HBV-DNA levels below 2000 IU/ml and ALT < 1.5 times upper the limit of normal. HBsAg should be positive and below 100 IU/ml. Trial duration: A recruiting period of approximately 6 months is planned. The total time per patient to complete all study visits is approximately 40 weeks including: an 28 day screening period an 12 week treatment period an 24 week follow-up period

Outcomes

Primary Outcome Measures

To evaluate the efficacy of 12-weeks treatment with hepatitis B immunoglobulins in two different cohorts of patients with chronic hepatitis B defined by the proportion of subjects being HBsAg negative at treatment week 12
Primary efficiency endpoint: HBsAg negativity at week 12 of antiviral therapy

Secondary Outcome Measures

To analyze the change/decline of HBsAg during treatment
Secondary endpoint: HBsAg change/decline at weeks 1, 2, 4, 8 and 12 of treatment
To evaluate the post-treatment HBsAg kinetics/response
Secondary endpoint: Post-treatment HBsAg negativity up to FU week 24
To determine HBV-DNA levels during and after treatment with hepatitis B immunoglobulins
Secondary endpoint: HBV DNA levels during and after hepatitis B immunoglobulin treatment will be reported for each cohort.
To evaluate the biochemical disease activity (normalization of serum ALT levels)
Secondary endpoint: biochemical response (proportion of subjects who reached ALT normalization (ALT ≤ ULN) at week 12 of treatment)
To determine the quality of life by SF-36 questionnaire
Secondary endpoint: quality of life during treatment and follow-up (SF-36)
Assessment of safety by collection of adverse events (AEs) as frequencies (absolute/relative).
Adverse events (AEs) will be collected throughout the study (upon first administration of the IMPs up to 24 weeks after discontinuation of therapy, FU24) and will be reported with absolute and relative frequencies along with the corresponding 95% confidence intervals

Full Information

First Posted
March 29, 2022
Last Updated
October 9, 2023
Sponsor
Hannover Medical School
Collaborators
Biotest
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1. Study Identification

Unique Protocol Identification Number
NCT05345990
Brief Title
Treatment of Patients With Chronic Hepatitis B With Hepatitis B Immunoglobulins
Acronym
HBIG
Official Title
Hepatitis B Immunoglobulins to Induce HBsAg Clearance in Patients With Chronic Hepatitis B (HBIG for Cure)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 15, 2022 (Actual)
Primary Completion Date
November 2024 (Anticipated)
Study Completion Date
May 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hannover Medical School
Collaborators
Biotest

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is an open-label, single arm (two cohorts), single-center, phase II pilot-study to provide preliminary evidence whether hepatitis B immunoglobulins (HBIG) are efficacious and can be safely used in patients with chronic Hepatitis B Virus (HBV) infection. A total of 20 patients (male or female adults aged ≥ 18 years) will be enrolled in the study and receive hepatitis B immunoglobulins Hepatect®CP and Zutectra®.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis B
Keywords
Human hepatitis B Immunoglobulin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Patients treated in two cohorts for 12 weeks with hepatitis B immunoglobulins
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Hepatitis B immunoglobulins
Arm Type
Experimental
Arm Description
20 patients treated in two cohorts for 12 weeks with hepatitis B Immunoglobulins (HBIG, Hepatect®CP/ Zutectra®). Cohort A: 10 HBsAg positive, HBeAg-negative patients being treated with anti-HBV nucleotide or nucleoside analogous (NAs) for at least 12 months before screening. HBV-DNA should be below the lower limit of detection at screening. HBsAg should be positive and below 100 IU/ml. Cohort B: 10 HBsAg positive, HBeAg-negative patients untreated with NAs for at least 12 months before screening. Patients with HBV-DNA levels below 2000 IU/ml and ALT < 1.5 times upper the limit of normal. HBsAg should be positive and below 100 IU/ml. Trial duration: A recruiting period of approximately 6 months is planned. The total time per patient to complete all study visits is approximately 40 weeks including: an 28 day screening period an 12 week treatment period an 24 week follow-up period
Intervention Type
Drug
Intervention Name(s)
Human hepatitis B Immunoglobulin (Hepatect®CP/Zutectra®)
Intervention Description
Hepatect® is a solution to be administered Intravenously. Zutectra® is a solution to be administered subcutaneously. Treatment for 12 weeks with hepatitis B immunoglobulins with following administration scheme: D0: 10.000 IU Hepatect® i.v. D1-6: 500 IU Zutectra® s.c. D7: 10.000 IU Hepatect® i.v. D9- D84: 500 IU Zutectra® s.c. every 2nd day
Primary Outcome Measure Information:
Title
To evaluate the efficacy of 12-weeks treatment with hepatitis B immunoglobulins in two different cohorts of patients with chronic hepatitis B defined by the proportion of subjects being HBsAg negative at treatment week 12
Description
Primary efficiency endpoint: HBsAg negativity at week 12 of antiviral therapy
Time Frame
week 12 of antiviral therapy
Secondary Outcome Measure Information:
Title
To analyze the change/decline of HBsAg during treatment
Description
Secondary endpoint: HBsAg change/decline at weeks 1, 2, 4, 8 and 12 of treatment
Time Frame
week 1, 2, 4, 8 and 12 of treatment
Title
To evaluate the post-treatment HBsAg kinetics/response
Description
Secondary endpoint: Post-treatment HBsAg negativity up to FU week 24
Time Frame
Follow-up (FU) week 2, FU week 4, FU week 12 and FU week 24
Title
To determine HBV-DNA levels during and after treatment with hepatitis B immunoglobulins
Description
Secondary endpoint: HBV DNA levels during and after hepatitis B immunoglobulin treatment will be reported for each cohort.
Time Frame
screening, day 0, day 1, day 3, day 7, day 28, day 42, day 84, FU week 12 and FU week 24
Title
To evaluate the biochemical disease activity (normalization of serum ALT levels)
Description
Secondary endpoint: biochemical response (proportion of subjects who reached ALT normalization (ALT ≤ ULN) at week 12 of treatment)
Time Frame
week 12 of treatment
Title
To determine the quality of life by SF-36 questionnaire
Description
Secondary endpoint: quality of life during treatment and follow-up (SF-36)
Time Frame
day 0, day 84, FU week 12, FU week 24
Title
Assessment of safety by collection of adverse events (AEs) as frequencies (absolute/relative).
Description
Adverse events (AEs) will be collected throughout the study (upon first administration of the IMPs up to 24 weeks after discontinuation of therapy, FU24) and will be reported with absolute and relative frequencies along with the corresponding 95% confidence intervals
Time Frame
day 0, day 1, day 3, day 7, day 14, day 21, day 28, day 42, day 56, day 84, FU week 2, FU week 4, FU week 12, FU week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must meet all of the following inclusion criteria to be eligible for participation in this study: Willing and able to provide written informed consent Male or female, age ≥ 18 years Confirmation of chronic HBV infection documented by: positive HBsAg at least 12 months before screening Cohort A: NA treatment for at least 12 months before screening. HBV-DNA should be below the lower limit of detection at screening. HBsAg positive and <100 IU/ml. HBeAg negative. Cohort B: Untreated with NAs for at least 12 months before screening. HBV-DNA < 2000 IU/ml. HBsAg positive and < 100 IU/ml. HBeAg-negative. Subject has not been treated with any investigational drug or device within 42 days before the screening visit or within 5 half-lives for investigational drugs, whichever is longer. Transient Elastography (FibroScan) < 7.5 kPa at screening. ALT levels < 1.5 times of upper the limit of normal at screening for both cohorts Body mass idex (BMI) > 18kg/m² A negative serum pregnancy test is required for female subjects (unless surgically sterile or women > 54 years of age with cessation for > 24 months of previously occurring menses). Complete abstinence from intercourse. Periodic abstinence (e.g., calendar, ovulation, symptothermal, postovulation methods) is not permitted. Or Consistent and correct use of 1 of the following methods of birth control listed below, in addition to a male partner who correctly uses a condom, from the date of Screening until the end of FU: intrauterine device (IUD) with a failure rate of < 1% per year bilateral tubal sterilization vasectomy in male partner hormone-containing contraceptive: combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral intravaginal transdermal progestogen-only hormonal contraception associated with inhibition of ovulation: oral injectable implantable Subject must be able to comply with the dosing instructions for study drug administration and be able to complete the study schedule of assessments Exclusion Criteria: Subjects who meet any of the following exclusion criteria are not to be enrolled in this study: Clinically significant illness (other than hepatitis B) or any other major medical disorder that, in the opinion of the investigator, may interfere with subject treatment, assessment or compliance with the protocol. Subjects currently under evaluation for a potentially clinically significant illness (other than hepatitis B) are also excluded. Co-infection with hepatitis C virus (defined as HCV RNA positive. HCV RNA negative/anti-HCV-positive patients can be included) or co-infection with HIV. Clinical hepatic decompensation (i.e. clinical ascites, encephalopathy or variceal hemorrhage). Psychiatric hospitalization, suicide attempt, and/or a period of disability as a result of their psychiatric illness within the last 2 years. Subjects with psychiatric illness that is well-controlled on a stable treatment regimen for at least 12 months prior to screening or has not required medication in the last 12 months may be included. Significant drug allergy (such as anaphylaxis or hepatotoxicity). Pregnant or nursing female or male with pregnant female partner Clinically relevant drug or alcohol abuse within 12 months of screening including any uncontrolled drug use within 6 months of screening. A positive drug screen will exclude subjects unless it can be explained by a prescribed medication. The investigator must approve medication, the diagnosis and prescription. Uncontrolled users of intravenous drugs will not be permitted to enroll in the study. live-attenuated virus vaccinations such as: measles, mumps, rubella and varicella 4 weeks before and up to three months after administration of hepatitis B immunoglobulins. If not required by an emergency situation, passive or active immunizations or administration of plasma preparations or of other immunoglobulins is not allowed during the study A recent SARS-COV2 infection in the last 4 weeks prior to screening
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Katja Deterding, Dr.
Phone
+49 511 532
Ext
6817
Email
Deterding.Katja@mh-hannover.de
First Name & Middle Initial & Last Name or Official Title & Degree
Julia Kahlhöfer, Dr.
Phone
+49 511 532
Ext
6817
Email
studien.mhh.gas@mh-hannover.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heiner Wedemeyer, Prof.
Organizational Affiliation
Hannover Medical School, Department of Gastroenterology, Hepatology and Endocrinology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hannover Medical School, Department for Gastroenterology, Hepatology and Endocrinology
City
Hannover
State/Province
Lower Saxony
ZIP/Postal Code
30625
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heiner Wedemeyer, Prof.
Phone
0049511532
Ext
3305
Email
wedemeyer.heiner@mh-hannover.de
First Name & Middle Initial & Last Name & Degree
Heiner Wedemeyer, Prof.

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Treatment of Patients With Chronic Hepatitis B With Hepatitis B Immunoglobulins

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