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Entecavir Plus Adefovir Combination Therapy Versus Entecavir Monotherapy vs Therapy With Adefovir Plus Lamivudine for Chronic Hepatitis B Infected Subjects With Lamivudine-resistant Virus (DEFINE)
This study is currently recruiting participants.
Verified by Bristol-Myers Squibb, November 2009
First Received: December 11, 2006   Last Updated: November 16, 2009   History of Changes
Sponsor: Bristol-Myers Squibb
Information provided by: Bristol-Myers Squibb
ClinicalTrials.gov Identifier: NCT00410202
  Purpose

The purpose of this study is to evaluate the effectiveness of entecavir plus adefovir combination therapy versus entecavir monotherapy or therapy with adefovir plus lamivudine


Condition Intervention Phase
Hepatitis B, Chronic
Drug: Entecavir
Drug: Tenofovir
Drug: Adefovir
Drug: Lamivudine
Phase III

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Comparative Study of Entecavir vs. Adefovir Plus Lamivudine vs Combination Entecavir Plus Adefovir in Lamivudine-resistant Chronic Hepatitis B Subjects: The DEFINE Study

Resource links provided by NLM:


Further study details as provided by Bristol-Myers Squibb:

Primary Outcome Measures:
  • Compare the proportion of subjects in the combination therapy group to the proportion of subjects in each of the comparator therapy groups who achieve HBV DNA <50 IU/mL (approximately 300 copies/mL) [ Time Frame: at week 48 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Proportion of subjects who achieve HBV DNA < the lower limit of quantitation (LLD LOQ) for the Roche COBAS® TaqMan -(LOQ = 29 IU/mL [approximately 169 copies/mL] [ Time Frame: HPS assay at Weeks 48 and 96 ] [ Designated as safety issue: No ]
  • Proportion of subjects who achieve HBV DNA < the lower limit of detection (LOD) for the Roche COBAS® Taqman - (LOD = 10 IU/mL [approximately 58 copies/mL]) [ Time Frame: HPS assay at Weeks 48 and 96 ] [ Designated as safety issue: No ]
  • Proportions of subjects with HBV DNA in clinically relevant categories (eg HBV DNA values categorized in ranges that differ by 10 log increments) [ Time Frame: at 48 weeks ] [ Designated as safety issue: No ]
  • Proportion of subjects with ALT > 1 x upper limit of normal (ULN) at baseline who achieve ALT normalization (<= 1 x ULN) [ Time Frame: at Weeks 48 and 96 ] [ Designated as safety issue: No ]
  • Descriptive rates of resistance in each treatment arm [ Time Frame: through Weeks 48 and 96 ] [ Designated as safety issue: No ]

Estimated Enrollment: 420
Study Start Date: March 2008
Estimated Study Completion Date: May 2012
Estimated Primary Completion Date: November 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Entecavir: Active Comparator
With the option of adding Tenofovir at week 48. (This does not apply to Korea)
Drug: Entecavir
Tablets, Oral, 1mg, once daily, 100 weeks
Drug: Tenofovir
Tablets, Oral, 300 mg, once daily
Adefovir + Lamivudine: Active Comparator Drug: Adefovir
Tablets, Oral, 10mg, once daily, 100 weeks
Drug: Lamivudine
Tablets, Oral, 100mg, once daily, 100 weeks
Entecavir + Adefovir: Active Comparator Drug: Entecavir
Tablets, Oral, 1mg, once daily, 100 weeks
Drug: Adefovir
Tablets, Oral, 10mg, once daily, 100 weeks

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Evidence of lamivudine resistance
  • Subjects must have a history of previous lamivudine treatment at screening, and must have evidence of at least 1 LVD resistance substitution (valine, isoleucine, or serine) at reverse transcriptase codon 204 (M204V/I/S)
  • Nucleoside- and nucleotide-naive, except for lamivudine
  • Males or females ≥16 years of age (or minimum age of consent in a given country)
  • Compensated liver function
  • HBV DNA > 1.72 x 10*4* (approximately 10*5* copies/mL)
  • Documentation of HBeAg-positive and HBeAb-negative status at screening
  • Males and females >=16 years of age (or minimum age of consent in a given country)
  • Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study (and for up to 6 weeks after the last dose of investigational product) in such a manner that the risk of pregnancy is minimized
  • WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal. Post menopausal is defined as:
  • Amenorrhea >= 12 consecutive months without another cause
  • For women with irregular menstrual periods and on hormone replacement therapy (HRT), a documented serum follicle stimulating hormone (FSH) level > 35 mIU/mL
  • Women who are using oral contraceptives, other hormonal contraceptives (vaginal products, skin patches, or implanted or injectable products), or mechanical products such as an intrauterine device or barrier methods (diaphragm, condoms, spermicides) to prevent pregnancy, or are practicing abstinence or where partner is sterile (e.g., vasectomy), should be considered to be of child bearing potential
  • WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72 hours prior to the start of investigational product

Exclusion Criteria:

  • Evidence of decompensated cirrhosis
  • Coinfection with HIV, HCV, or HDV
  • Laboratory values out of protocol-specified range
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00410202

Contacts
Contact: For participation information at a USA site use a phone number below. For site information outside the USA please email: Clinical.Trials@bms.com
Contact: First line of email MUST contain NCT# & Site#. Only trial sites that are recruiting have contact information at this time.

  Hide Study Locations
Locations
United States, Connecticut
University Of Connecticut Health Center Terminated
Farmington, Connecticut, United States, 06030
Argentina, Santa Fe
Local Institution Recruiting
Rosario, Santa Fe, Argentina, S2000KDS
Contact: Site 122            
Australia, New South Wales
Local Institution Recruiting
Concord, New South Wales, Australia, 2139
Contact: Site 064            
Canada, Alberta
Local Institution Recruiting
Calgary, Alberta, Canada, T2N 4N1
Contact: Site 108            
Canada, British Columbia
Local Institution Recruiting
Vancouver, British Columbia, Canada, V5Z 1H2
Contact: Site 107            
Greece
Local Institution Active, not recruiting
Athens, Greece, 11527
Hong Kong
Local Institution Recruiting
Shatin, Hong Kong, 30-32
Contact: Site 075            
Local Institution Not yet recruiting
Kowloon, Hong Kong, -
Contact: Site 098            
Local Institution Not yet recruiting
Tai Po, Hong Kong, .
Contact: Site 119            
Local Institution Recruiting
Hong Kong, Hong Kong, *
Contact: Site 134            
India
Local Institution Recruiting
Lucknow, India, 226014
Contact: Site 001            
Local Institution Recruiting
New Delhi, India, 110002
Contact: Site 002            
Local Institution Recruiting
Vellore, India, 632004
Contact: Site 060            
Local Institution Terminated
Ludhiana, India, 141001
Local Institution Recruiting
Ahmedabad, India, 380006
Contact: Site 121            
Local Institution Recruiting
Chandigarh, India, 160012
Contact: Site 126            
Local Institution Recruiting
Indore, India, 452014
Contact: Site 140            
Local Institution Not yet recruiting
New Delhi, India, 110062
Contact: Site 141            
Local Institution Not yet recruiting
Mumbai, India, 400 008
Contact: Site 142            
Indonesia
Local Institution Recruiting
Jakarta, Indonesia, 10350
Contact: Site 097            
Italy
Local Institution Recruiting
Brescia, Italy, 25123
Contact: Site 037            
Local Institution Recruiting
Antella Firenze, Italy, 50012
Contact: Site 038            
Local Institution Not yet recruiting
Roma, Italy, 00149
Contact: Site 068            
Korea, Republic of
Local Institution Recruiting
Seoul, Korea, Republic of, 110-744
Contact: Site 080            
Local Institution Recruiting
Seoul, Korea, Republic of, 152-703
Contact: Site 081            
Local Institution Recruiting
Seoul, Korea, Republic of, 135-710
Contact: Site 090            
Local Institution Recruiting
Seoul, Korea, Republic of, 138-736
Contact: Site 095            
Local Institution Recruiting
Daegu, Korea, Republic of, 700-712
Contact: Site 092            
Local Institution Recruiting
Pusan, Korea, Republic of, 602-739
Contact: Site 093            
Local Institution Recruiting
Suwon, Korea, Republic of, 443-721
Contact: Site 094            
Local Institution Recruiting
Seoul, Korea, Republic of, 120-752
Contact: Site 091            
Local Institution Recruiting
Seoul, Korea, Republic of, 135-720
Contact: Site 117            
Local Institution Recruiting
Seoul, Korea, Republic of, 136-705
Contact: Site 123            
Local Institution Recruiting
Seoul, Korea, Republic of, 143-729
Contact: Site 124            
Local Institution Recruiting
Seoul, Korea, Republic of, 156-755
Contact: Site 125            
Local Institution Recruiting
Seoul, Korea, Republic of, 137-040
Contact: Site 130            
Local Institution Recruiting
Pusan, Korea, Republic of, 626770
Contact: Site 137            
Local Institution Recruiting
Bucheon, Korea, Republic of, 420767
Contact: Site 139            
Local Institution Recruiting
Sungnam, Korea, Republic of, 463-712
Contact: Site 143            
Korea, Republic of, Amdong-Gu
Local Institution Recruiting
Incheon, Amdong-Gu, Korea, Republic of, 405-760
Contact: Site 146            
Korea, Republic of, Dongdaemun-Gu
Local Institution Recruiting
Seoul, Dongdaemun-Gu, Korea, Republic of, 130-702
Contact: Site 133            
Korea, Republic of, Donggu
Local Institution Recruiting
Ulsan, Donggu, Korea, Republic of, 682-714
Contact: Site 144            
Korea, Republic of, Gangwon-Do
Local Institution Recruiting
Chuncheon-Si, Gangwon-Do, Korea, Republic of, 200-704
Contact: Site 132            
Local Institution Not yet recruiting
Wonju, Gangwon-Do, Korea, Republic of, 220-701
Contact: Site 145            
Local Institution Recruiting
Gangneung-Si, Gangwon-Do, Korea, Republic of, 210-711
Contact: Site 148            
Korea, Republic of, Gyeonggi-Do
Local Institution Recruiting
Ansan-Si, Gyeonggi-Do, Korea, Republic of, 425-707
Contact: Site 129            
Local Institution Recruiting
Suwon-Si, Gyeonggi-Do, Korea, Republic of, 442-723
Contact: Site 131            
Local Institution Recruiting
Anyang-Si, Gyeonggi-Do, Korea, Republic of, 431-070
Contact: Site 147            
Korea, Republic of, Ilsanseo-Gu
Local Institution Recruiting
Goyang, Ilsanseo-Gu, Korea, Republic of, 414-410
Contact: Site 138            
Korea, Republic of, Jung-Gu
Local Institution Recruiting
Incheon, Jung-Gu, Korea, Republic of, 400-711
Contact: Site 136            
Korea, Republic of, Nowon-Gu
Local Institution Recruiting
Seoul, Nowon-Gu, Korea, Republic of, 139872
Contact: Site 135            
Malaysia
Local Institution Recruiting
Kuala Lumpur, Malaysia, 50603
Contact: Site 076            
Malaysia, Sabah
Local Institution Recruiting
Kota Kinabalu, Sabah, Malaysia, 88586
Contact: Site 110            
Philippines
Local Institution Recruiting
Cebu City, Philippines, 6000
Contact: Site 099            
Local Institution Recruiting
Manila, Philippines, 1502
Contact: Site 120            
Poland
Local Institution Recruiting
Lodzi, Poland, 91-347
Contact: Site 007            
Local Institution Recruiting
Kielce, Poland, 25-317
Contact: Site 008            
Local Institution Recruiting
Chorzow, Poland, 41-500
Contact: Site 031            
Local Institution Not yet recruiting
Bialystok, Poland, 15-540
Contact: Site 013            
Local Institution Recruiting
Krakow, Poland, 31-531
Contact: Site 016            
Local Institution Recruiting
Lublin, Poland, 20-081
Contact: Site 017            
Local Institution Recruiting
Warszawa, Poland, 01-201
Contact: Site 010            
Russian Federation
Local Institution Not yet recruiting
St. Petersburg, Russian Federation, 191163
Contact: Site 042            
Local Institution Recruiting
Moscow, Russian Federation, 115446
Contact: Site 043            
Local Institution Not yet recruiting
Moscow, Russian Federation, 117593
Contact: Site 044            
Local Institution Recruiting
St. Petersburg, Russian Federation, 191167
Contact: Site 046            
Local Institution Not yet recruiting
St. Petersburg, Russian Federation, 194044
Contact: Site 047            
Local Institution Recruiting
St. Petersburg, Russian Federation, 190103
Contact: Site 048            
Local Institution Recruiting
Moscow, Russian Federation, 129110
Contact: Site 049            
Local Institution Recruiting
Moscow, Russian Federation, 105275
Contact: Site 050            
Local Institution Recruiting
Moscow, Russian Federation, 105275
Contact: Site 056            
Local Institution Recruiting
St. Petersburg, Russian Federation, 191167
Contact: Site 127            
Singapore
Local Institution Recruiting
Singapore, Singapore, 119074
Contact: Site 083            
Taiwan
Local Institution Recruiting
Taipei, Taiwan, 100
Contact: Site 086            
Local Institution Recruiting
Tainan R.o.c., Taiwan, 70403
Contact: Site 087            
Local Institution Recruiting
Kaohsiung, Taiwan, 80756
Contact: Site 088            
Local Institution Recruiting
Taoyuan, Taiwan, 333
Contact: Site 118            
Thailand
Local Institution Recruiting
Chiang Mai, Thailand, 50200
Contact: Site 082            
Local Institution Recruiting
Bangkok, Thailand, 10160
Contact: Site 084            
Turkey
Local Institution Recruiting
Bornova Izmir, Turkey, 35100
Contact: Site 034            
Local Institution Not yet recruiting
Besevler Ankara, Turkey, 06620
Contact: Site 079            
Local Institution Recruiting
Trabzon, Turkey, 61080
Contact: Site 089            
Local Institution Not yet recruiting
Kayseri, Turkey, 38039
Contact: Site 104            
Sponsors and Collaborators
Bristol-Myers Squibb
Investigators
Study Director: Bristol-Myers Squibb Bristol-Myers Squibb
  More Information

Additional Information:
No publications provided

Responsible Party: Bristol-Myers Squibb ( Study Director )
Study ID Numbers: AI463-111
Study First Received: December 11, 2006
Last Updated: November 16, 2009
ClinicalTrials.gov Identifier: NCT00410202     History of Changes
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Anti-Infective Agents
Liver Diseases
Hepatitis, Chronic
Molecular Mechanisms of Pharmacological Action
Lamivudine
Hepatitis, Viral, Human
Hepadnaviridae Infections
Reverse Transcriptase Inhibitors
Entecavir
Anti-Retroviral Agents
Hepatitis B, Chronic
Therapeutic Uses
Hepatitis B
Tenofovir
Nucleic Acid Synthesis Inhibitors
Anti-HIV Agents
Enzyme Inhibitors
Antiviral Agents
Pharmacologic Actions
Virus Diseases
Hepatitis
Digestive System Diseases
Adefovir dipivoxil
DNA Virus Infections
Adefovir

ClinicalTrials.gov processed this record on November 27, 2009