A Study of Switch From Nucleotide to Peginterferon Alfa-2a in CHB Patients Achieving HBeAg Loss and HBV DNA <200IU/ml (New Switch)
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Purpose
A Randomized, open-label, multicenter study.
The patients after 1-3 years NAs treatment and having achieved HBeAg loss and HBV DNA <200IU/ml will be switched to Pegasys for 48 or 96 weeks (with a 12 weeks period of overlap with the NA for safety reasons). The subjects will be randomized into 2 groups:
Group 1 : 48-week standard treatment by Peginterferon alfa 2a 180µg/week Group 2 : 96-week prolonged treatment by Peginterferon alfa 2a 180µg/week.
All the patients will be followed up for 48 weeks after discontinuation of the study medication.
Note: NAs will be stratified LAM, ETV and ADV, with the ratio 1:1:1.
| Condition | Intervention |
|---|---|
|
Chronic Hepatitis B |
Drug: Peginterferon alfa 2a |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized, Multicenter Study Evaluating HBsAg Clearance in CHB Patients Achieving HBeAg Loss and HBV DNA <200copies/ml on Treatment With Nucleotide Analogues and Switched to Peginterferon Alfa-2a |
- determine the response rate (HBsAg clearance at Week 48 and 96) [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]To determine the response rate (HBsAg clearance at Week 48 and 96) in subjects who are being treated by NAs and achieved a combined response which consists of both HBeAg loss and HBV DNA <1000 copies/ml
- HBsAg/HBeAg/HBV DNA changes/ALT normalization /HBsAg seroconversion at EOT and EOF [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
- HBsAg loss at EOF
- Quantitative HBe/sAg reduction at every check point.
- HBeAg seroconversion at EOT and EOF
- HBV DNA changes over 48 or 96 weeks at every check points
- ALT normalization at EOT and EOF
- HBsAg seroconversion at EOT and EOF
| Estimated Enrollment: | 300 |
| Study Start Date: | October 2011 |
| Estimated Study Completion Date: | December 2016 |
| Estimated Primary Completion Date: | June 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 48-week standard treatment
48-week standard treatment by Peginterferon alfa 2a 180µg/week
|
Drug: Peginterferon alfa 2a
Group 1 : 48-week standard treatment by Peginterferon alfa 2a 180µg/week Group 2 : 96-week prolonged treatment by Peginterferon alfa 2a 180µg/week.
|
|
Active Comparator: 96-week prolonged treatment
96-week prolonged treatment by Peginterferon alfa 2a 180µg/week
|
Drug: Peginterferon alfa 2a
Group 1 : 48-week standard treatment by Peginterferon alfa 2a 180µg/week Group 2 : 96-week prolonged treatment by Peginterferon alfa 2a 180µg/week.
|
Detailed Description:
eligibility criteria: Men and women old of 18 to 65 years with chronic hepatitis B HBeAg positive treated with nucleoside and/or nucleotide analogues for 1-2 years and with partial response (HBeAg loss and HBV DNA <1000copies/ml).
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients on-treatment with NAs (ADV, ETV or LAM) for 1-3 years, having achieved HBeAg loss at screening, and HBV DNA <200IU/ml for at least 48 weeks
- Male and female patients ≥ 18 to 65 years of age
- Chronic hepatitis B (positive HBsAg for at least 6 months prior to NA therapy start)
- Compensated liver disease (Child-Pugh <6)
- Absence of hepatocellular carcinoma on liver imaging and/or alfa fetoprotein < 50 ng/ml
- Negative urine or blood pregnancy test for women of childbearing potential within 24 hours of first PEG IFN study medication administration
- Able and willing to provide informed consent and abide by the requirements of the study
Exclusion Criteria:
- Neutrophil count <1.5 x 109cells/L or platelet count <90 x 109cells/L
- Co-infections with HIV, HAV, HCV, HDV or HEV
- Women with ongoing pregnancy or breast feeding, or wishing to become pregnant during the study period
- Prolonged and excessive alcohol intake (> 40g/day for men and > 30g/day for women)
- Active intravenous drug abuse
- History or current treatment with telbivudine
- Treatment with immunomodulators (e.g. Interferon) for less than one year before study enrollment
- Treatment with immunosuppressors (including systemic corticosteroids) or anti-neoplastic treatment (including radiation therapy) <=6 months prior to the first dose of study drug or the expectation that such treatment will be needed at any time during the study
- Serum concentrations of ceruloplasmin or alfa-antitrypsin consistent with an increased risk of metabolic disease
- History or other evidence of chronic pulmonary disease associated with functional limitation
- History of severe cardiac disease
- History of the severe seizure disorder or current anticonvulsivant use
- History of thyroid disease poorly controlled on prescribed medications. Patients with elevated thyroid stimulating hormone concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease
- History or other evidence of severe retinopathy
- History of autoimmune disease or presence of a significant level of auto-antibodies
- Renal insufficiency (creatinine clearance of < 50 ml/min according to the Cockroft and Gault equation), kidney transplant, hemodialysis
- History of depression or uncontrolled psychiatric disorders
- Subjects protected by law or not in a position to give consent
- Patients with reproductive potential not willing to use an effective method of contraception.
- Evidence of an active or suspected cancer or a history of malignancy (other than basocellular carcinoma or in-situ cervical carcinoma)
Contacts and Locations| China, Chongqing | |
| The 2nd affiliated Hospital of Chongqing Medical University | |
| Chongqing, Chongqing, China, 400010 | |
| Principal Investigator: | Hong Ren | The 2nd affiliated Hospital of Chongqing Medical University |
More Information
No publications provided
| Responsible Party: | Hong Ren, Principal Investigator, The Second Affiliated Hospital of Chongqing Medical University |
| ClinicalTrials.gov Identifier: | NCT01464281 History of Changes |
| Other Study ID Numbers: | ML27928 |
| Study First Received: | October 19, 2011 |
| Last Updated: | November 1, 2011 |
| Health Authority: | China: Food and Drug Administration |
Keywords provided by The Second Affiliated Hospital of Chongqing Medical University:
|
nucleoside peginterferon alfa-2a |
Additional relevant MeSH terms:
|
Hepatitis Hepatitis A Hepatitis B Hepatitis, Chronic Hepatitis B, Chronic Liver Diseases Digestive System Diseases Hepatitis, Viral, Human Virus Diseases Enterovirus Infections Picornaviridae Infections |
RNA Virus Infections Hepadnaviridae Infections DNA Virus Infections Peginterferon alfa-2a Interferon-alpha Antiviral Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Immunologic Factors Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 21, 2013