Hepatitis B Virus (HBV) Viral Suppression by Entecavir in Adefovir Partial Responders - Full Text View

Sponsors and Collaborators:	Pacific Health Foundation Bristol-Myers Squibb
Information provided by:	Pacific Health Foundation
ClinicalTrials.gov Identifier:	NCT00704106

Purpose

We propose a largely retrospective study with short-term prospective follow-up in a subgroup of patients who have not yet been treated with 48 weeks of entecavir following partial response to adefovir. The aim of the study is to describe sequential virologic response to adefovir and entecavir.

Condition	Intervention
Hepatitis B	Drug: Entecavir

Study Type:	Observational
Study Design:	Cohort
Official Title:	HBV Viral Suppression by Entecavir in Adefovir Partial Responders

Resource links provided by NLM:

MedlinePlus related topics: Hepatitis Hepatitis B

Drug Information available for: Adefovir Entecavir

U.S. FDA Resources

Further study details as provided by Pacific Health Foundation:

Primary Outcome Measures:

Our goal is to study patients with chronic hepatitis B, who have been switched to entecavir due to suboptimal treatment response with adefovir for a minimum of 12 weeks with < 2 log drop IU/mL or with persistent viremia after 48 weeks. [ Time Frame: 48 weeks or after ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Compare rate of complete response (CR) as measured by complete virologic and biochemical response at 24 and 48 weeks in patients who had been treated with adefovir for 24 and 48 weeks prior to switching. [ Time Frame: 48 weeks or after ] [ Designated as safety issue: No ]
Compare rates of biochemical response (BR) as measured by ALT normalization on the 2 different treatments at corresponding treatment milestones as above. [ Time Frame: 48 weeks or after ] [ Designated as safety issue: No ]

Biospecimen Retention: None Retained

Biospecimen Description:

Estimated Enrollment:	80
Study Start Date:	May 2008
Estimated Study Completion Date:	January 2009

Groups/Cohorts	Assigned Interventions
Group 1 Persistent viremia after 48 weeks or longer.	Drug: Entecavir 0.5 or 1 mg dose qd Drug: Entecavir 0.5 mg or 1.0 mg dose qd
Group 2 <2 log IU/mL drop from initial HBVDNA after 12 weeks of adefovir	Drug: Entecavir 0.5 or 1 mg dose qd Drug: Entecavir 0.5 mg or 1.0 mg dose qd

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

Age 18 years or older
All genders and ethnicity
Positive HBsAg
HBeAg positive and negative
Pretreatment HBV DNA of 10,000 copies/mL or higher (for purposes of this study, both copies and equivalent IU measurements will be recorded and analyzed)
Patients who are switched to entecavir after treatment with adefovir for at least 12 weeks by the providing physician.
Less than a 2 log drop in HBV DNA from baseline at week 12.
Patient already on adefovir for 24 weeks and still have > or equal to 1000 copies/mL of HBV DNA.
Patients who still have positive HBV DNA PCR after 48 weeks or longer of adefovir.

Criteria

Inclusion Criteria:

Age 18 years or older
All genders and ethnicity
Positive HBsAg
HBeAg positive and negative
Pretreatment HBV DNA of 10,000 copies/mL or higher (for purposes of this study, both copies and equivalent IU measurements will be recorded and analyzed)
Patients who are switched to entecavir after treatment with adefovir for at least 12 weeks by the providing physician.
Less than a 2 log drop in HBV DNA from baseline at week 12.
Patient already on adefovir for 24 weeks and still have > or equal to 1000 copies/mL of HBV DNA.
Patients who still have positive HBV DNA PCR after 48 weeks or longer of adefovir.

Exclusion Criteria:

Patients who refused to consent to the study
Patients younger than 18
Vulnerable subjects such as pregnant women, prisoners, employees, patients with significant cognitive deficits.
Patients with prior exposure to another nucleoside for more than 2 weeks.
HIV co-infection
HCV co-infection
HDV co-infection
Recipients of solid organ transplantation
Patients who receive high-dose steroid (60 mg/d or higher and for longer than 10 days)

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00704106

Contacts

Contact: Long H Nguyen, B.A.	408-995-0333	longnguyen07@gmail.com
Contact: Nghi B Ha, B.S.	408-995-0333	nbha202@gmail.com

Locations

United States, California
San Jose Gastroenterology	Recruiting
San Jose, California, United States, 95116
Contact: Long H Nguyen, B.A. 408-995-0333 longnguyen07@gmail.com
Principal Investigator: Huy N Trinh, M.D.
San Jose Gastroenterology	Recruiting
San Jose, California, United States, 95128
Contact: Long H Nguyen, B.A. 408-995-0333 longnguyen07@gmail.com
Principal Investigator: Huy N Trinh, M.D.
United States, Texas
Digestive Health Associates of Texas	Recruiting
Plano, Texas, United States, 75093
Contact: Son Do, M.D. 972-398-0393 dotuongson@yahoo.com
Principal Investigator: Son Do, M.D.
Houston Gastroenterology Clinic	Recruiting
Houston, Texas, United States, 77072
Contact: Thuan Nguyen, M.D. 281-983-0938 giassoc@ev1.net
Principal Investigator: Thuan Nguyen, M.D.

Sponsors and Collaborators

Pacific Health Foundation

Bristol-Myers Squibb

Investigators

Principal Investigator:	Huy N Trinh, M.D.	Pacific Health Foundation
Principal Investigator:	Mindie H Nguyen, M.D., M.A.S.	Pacific Health Foundation

More Information

Publications:

McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis. 2005;25 Suppl 1:3-8. Review.

Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, Huang GT, Iloeje UH; REVEAL-HBV Study Group. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006 Jan 4;295(1):65-73.

Iloeje UH, Yang HI, Su J, Jen CL, You SL, Chen CJ; Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-In HBV (the REVEAL-HBV) Study Group. Predicting cirrhosis risk based on the level of circulating hepatitis B viral load. Gastroenterology. 2006 Mar;130(3):678-86.

Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, Tanwandee T, Tao QM, Shue K, Keene ON, Dixon JS, Gray DF, Sabbat J; Cirrhosis Asian Lamivudine Multicentre Study Group. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004 Oct 7;351(15):1521-31.

Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology. 2007 Feb;45(2):507-39. No abstract available. Erratum in: Hepatology. 2007 Jun;45(6):1347.

Keeffe EB, Dieterich DT, Han SH, Jacobson IM, Martin P, Schiff ER, Tobias H, Wright TL. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: an update. Clin Gastroenterol Hepatol. 2006 Aug;4(8):936-62. Epub 2006 Jul 14. Review.

Shaw T, Locarnini S. Entecavir for the treatment of chronic hepatitis B. Expert Rev Anti Infect Ther. 2004 Dec;2(6):853-71. Review.

Chan HL, Heathcote EJ, Marcellin P, Lai CL, Cho M, Moon YM, Chao YC, Myers RP, Minuk GY, Jeffers L, Sievert W, Bzowej N, Harb G, Kaiser R, Qiao XJ, Brown NA; 018 Study Group. Treatment of hepatitis B e antigen positive chronic hepatitis with telbivudine or adefovir: a randomized trial. Ann Intern Med. 2007 Dec 4;147(11):745-54. Epub 2007 Oct 1.

Keeffe EB, Zeuzem S, Koff RS, Dieterich DT, Esteban-Mur R, Gane EJ, Jacobson IM, Lim SG, Naoumov N, Marcellin P, Piratvisuth T, Zoulim F. Report of an international workshop: Roadmap for management of patients receiving oral therapy for chronic hepatitis B. Clin Gastroenterol Hepatol. 2007 Aug;5(8):890-7. Epub 2007 Jul 13. Review.

Responsible Party:	Pacific Health Foundation ( Huy N. Trinh/Mindie H. Nguyen )
Study ID Numbers:	PHF008
Study First Received:	June 20, 2008
Last Updated:	June 23, 2008
ClinicalTrials.gov Identifier:	NCT00704106 History of Changes
Health Authority:	United States: Institutional Review Board

Keywords provided by Pacific Health Foundation:

Hepatitis B
HBV
Treatment

Study placed in the following topic categories:

Virus Diseases
Hepatitis
Liver Diseases
Entecavir
Digestive System Diseases
Hepatitis B

Hepatitis, Viral, Human
Adefovir dipivoxil
DNA Virus Infections
Antiviral Agents
Adefovir

Additional relevant MeSH terms:

Anti-Infective Agents
Liver Diseases
Hepatitis, Viral, Human
Hepadnaviridae Infections
Antiviral Agents
Pharmacologic Actions
Hepatitis

Virus Diseases
Digestive System Diseases
Entecavir
Therapeutic Uses
Hepatitis B
DNA Virus Infections

ClinicalTrials.gov processed this record on July 02, 2009