Simvastatin for the Treatment of Chronic Hepatitis B
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Purpose
The investigators have shown robust in vitro anti-hepatitis B activity of simvastatin alone and synergistic activity with all four FDA-approved anti-hepatitis B oral drugs tested. The investigators propose phase 1 studies in 48 chronic hepatitis B human carriers who have never been treated before. Doses of drugs will remain at or below FDA-approved dosage levels for cholesterol lowering (simvastatin) or hepatitis B (tenofovir or entecavir). Arm 1 will have simvastatin monotherapy only. Arm 2 will combine simvastatin with tenofovir. Arm 3 will combine simvastatin with entecavir. For maximum safety, the 3 arms and the dose groups in each arm will be filled consecutively and not concurrently. The definition of efficacy for simvastatin alone will be a 1 log drop of hepatitis B virus in 14 days. Efficacy for combination of drugs will require a 2 log drop of hepatitis B virus in 14 days. Numerous safety tests and stop rules are noted in the protocol.
| Condition | Intervention | Phase |
|---|---|---|
|
Hepatitis B |
Drug: Simvastatin Drug: Tenofovir Drug: Entecavir |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Pilot Trial of Simvastatin Alone and Added to Tenofovir or Entecavir for the Treatment of Chronic Hepatitis B |
- Reduction of HBV DNA by one log. [ Time Frame: 14 days ] [ Designated as safety issue: No ]Simvastatin will be given in doses of 5,10,20,and 40mg per day
- Alanine aminotransferase (ALT) reduction [ Time Frame: 14 days ] [ Designated as safety issue: Yes ]ALT changes will be noted
| Enrollment: | 32 |
| Study Start Date: | December 2009 |
| Study Completion Date: | December 2011 |
| Primary Completion Date: | October 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Simvastatin
Simvastatin orally
|
Drug: Simvastatin
daily doses for 14 days
Other Name: Zocor
|
|
Experimental: Simvastatin and tenofovir
Simvastatin combined with tenofovir
|
Drug: Simvastatin
daily doses for 14 days
Other Name: Zocor
Drug: Tenofovir
|
|
Experimental: Simvastatin and entecavir
Simvastatin combined with entecavir
|
Drug: Simvastatin
daily doses for 14 days
Other Name: Zocor
Drug: Entecavir
Entecavir
|
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Hepatitis B positive by HBV DNA within 180 days.
- Ages 18-70.
- Men and non-pregnant women eligible.
- Veteran's eligibility or appropriate health insurance.
Exclusion Criteria:
- Use of any anti-HBV medicine within 30 days.
- Decompensated cirrhosis as evidenced by esophageal varices, ascites, or encephalopathy. (grade 1 varices without history of bleeding will be allowed, if patient meets Child's-Pugh functional classification grade A).
- A positive urine test for marijuana or alcohol within 2 months of screening.(Allowed to repeat tests on different days, if positive first time in order to become eligible for study.
- Severe cardiovascular disease (ejection fraction <20%)* or uncontrolled angina.
- Severe pulmonary disease (FEV1 < 1.0).
- Chronic renal insufficiency (creatinine clearance <50 ml/min.
- HIV positive patients.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Ted Bader, MD, Director of Liver Diseases, OUHSC/VAMC, Bader, Ted, M.D. |
| ClinicalTrials.gov Identifier: | NCT00994773 History of Changes |
| Other Study ID Numbers: | HBV 14934, Simvastatin against HepB |
| Study First Received: | October 10, 2009 |
| Last Updated: | August 15, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Bader, Ted, M.D.:
|
Hepatitis B simvastatin HBV DNA |
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 Simvastatin |
Tenofovir Tenofovir disoproxil Entecavir Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Lipid Regulating Agents Therapeutic Uses Hydroxymethylglutaryl-CoA Reductase Inhibitors Anticholesteremic Agents Enzyme Inhibitors Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Anti-Retroviral Agents |
ClinicalTrials.gov processed this record on June 18, 2013