A Study to Compare Tenofovir Disoproxil Fumarate Versus Adefovir Dipivoxil for the Treatment of HBeAg-Negative Chronic Hepatitis B

NCT ID: NCT00117676

Last Updated: 2017-03-07

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

382 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-02-28

Study Completion Date

2016-01-31

Brief Summary

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This primary objectives of this study are to compare the efficacy, safety, and tolerability of tenofovir disoproxil fumarate (TDF) versus adefovir dipivoxil (ADV) for the treatment of pre-core mutant chronic hepatitis B. Participants will receive TDF or ADV for 48 weeks (double-blind). After 48 weeks, eligible participants switched to open-label TDF for up to 480 weeks.

Detailed Description

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Conditions

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Chronic Hepatitis B

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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TDF-TDF

TDF plus ADV placebo (double-blind period), followed by TDF (open-label period). Participants may add FTC (as part of emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) FDC tablet) to their treatment regimen in the open-label period.

Group Type EXPERIMENTAL

TDF

Intervention Type DRUG

300 mg tablet administered orally once daily

ADV placebo

Intervention Type DRUG

Tablet administered orally once daily

FTC/TDF

Intervention Type DRUG

200/300 mg fixed-dose combination (FDC) tablet administered orally once daily

ADV-TDF

ADV plus TDF placebo (double-blind period), followed by TDF (open-label period). Participants may add FTC (as part of FTC/TDF FDC tablet) to their treatment regimen in the open-label period.

Group Type ACTIVE_COMPARATOR

TDF

Intervention Type DRUG

300 mg tablet administered orally once daily

ADV

Intervention Type DRUG

10 mg tablet administered orally once daily

TDF placebo

Intervention Type DRUG

Tablet administered orally once daily

FTC/TDF

Intervention Type DRUG

200/300 mg fixed-dose combination (FDC) tablet administered orally once daily

Interventions

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TDF

300 mg tablet administered orally once daily

Intervention Type DRUG

ADV

10 mg tablet administered orally once daily

Intervention Type DRUG

TDF placebo

Tablet administered orally once daily

Intervention Type DRUG

ADV placebo

Tablet administered orally once daily

Intervention Type DRUG

FTC/TDF

200/300 mg fixed-dose combination (FDC) tablet administered orally once daily

Intervention Type DRUG

Other Intervention Names

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Viread® Hepsera® Truvada®

Eligibility Criteria

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Inclusion Criteria

* Chronic hepatitis B virus (HBV) infection, defined as positive serum hepatitis B s-antigen (HBsAg) for at least 6 months.
* 18 through 69 years of age, inclusive.
* Active hepatitis B e-antigen (HBeAg) negative chronic HBV infection, with all of the following:

* HBeAg negative and HBeAb positive at screening
* Alanine aminotransferase (ALT) levels \> the upper limit of the normal range (ULN) and ≤ 10 x ULN
* Serum HBV DNA \> 100,000 copies/mL at screening
* Creatinine clearance ≥ 70 mL/min
* Hemoglobin ≥ 8 g/dL
* Neutrophils ≥ 1,000 /mL
* Knodell necroinflammatory score ≥ 3 and a Knodell fibrosis score \< 4; however, up to 120 patients with cirrhosis, ie, a Knodell fibrosis score equal to 4, will be eligible for enrollment
* Negative serum β-human chorionic gonadotropin (hCG)
* Nucleotide naive, ie, no prior nucleotide (TDF or ADV) therapy for greater than 12 weeks
* Nucleoside naive, ie, no prior nucleoside (any nucleoside) therapy for greater than 12 weeks. However, up to 120 patients with \> 12 weeks prior lamivudine experience will be eligible
* Willing and able to provide written informed consent
* Had a liver biopsy performed within 6 months of baseline and has readable biopsy slides or agrees to have a biopsy performed prior to baseline

Exclusion Criteria

* Pregnant women, women who are breast feeding, or women who believe they may wish to become pregnant during the course of the study
* Males and females of reproductive potential who are unwilling to use an effective method of contraception during the study.
* Decompensated liver disease defined as conjugated bilirubin \> 1.5 x ULN, prothrombin time (PT) \> 1.5 x ULN, platelets \< 75,000/mL, serum albumin \< 3.0 g/dL, or prior history of clinical hepatic decompensation (eg, ascites, jaundice, encephalopathy, variceal hemorrhage)
* Received any nucleoside, nucleotide (TDF or ADV) or interferon (pegylated or not) therapy within 6 months prior to the pre treatment biopsy
* Evidence of hepatocellular carcinoma (HCC)
* Coinfection with hepatitis C virus (HCV), human immunodeficiency virus (HIV), or hepatitis D virus (HDV)
* Significant renal, cardiovascular, pulmonary, or neurological disease
* Received solid organ or bone marrow transplantation
* Is currently receiving therapy with immunomodulators (eg, corticosteroids, etc.), investigational agents, nephrotoxic agents, or agents susceptible of modifying renal excretion
* Has proximal tubulopathy
Minimum Eligible Age

18 Years

Maximum Eligible Age

69 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gilead Sciences

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gilead Study Director

Role: STUDY_DIRECTOR

Gilead Sciences

Locations

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La Jolla, California, United States

Site Status

Pasadena, California, United States

Site Status

San Diego, California, United States

Site Status

San Diego, California, United States

Site Status

San Francisco, California, United States

Site Status

San Jose, California, United States

Site Status

Atlanta, Georgia, United States

Site Status

Honolulu, Hawaii, United States

Site Status

Boston, Massachusetts, United States

Site Status

Ann Arbor, Michigan, United States

Site Status

Detroit, Michigan, United States

Site Status

St Louis, Missouri, United States

Site Status

Flushing, New York, United States

Site Status

New York, New York, United States

Site Status

New York, New York, United States

Site Status

Falls Church, Virginia, United States

Site Status

Richmond, Virginia, United States

Site Status

Camperdown, New South Wales, Australia

Site Status

Concord, New South Wales, Australia

Site Status

Westmead, New South Wales, Australia

Site Status

Woolloongabba, Queensland, Australia

Site Status

Clayton, Victoria, Australia

Site Status

Fitzroy, Victoria, Australia

Site Status

Heidelberg, Victoria, Australia

Site Status

Prahan, Victoria, Australia

Site Status

Sofia, , Bulgaria

Site Status

Sofia, , Bulgaria

Site Status

Varna, , Bulgaria

Site Status

Calgary, Alberta, Canada

Site Status

Vancouver, British Columbia, Canada

Site Status

Winnipeg, Manitoba, Canada

Site Status

Toronto, Ontario, Canada

Site Status

Brno, , Czechia

Site Status

Hradec Králové, , Czechia

Site Status

Prague, , Czechia

Site Status

Praha 6 - Stresovice, , Czechia

Site Status

Clichy, , France

Site Status

Créteil, , France

Site Status

Lille, , France

Site Status

Lyon, , France

Site Status

Nancy, , France

Site Status

Paris, , France

Site Status

Strasbourg, , France

Site Status

Toulouse, , France

Site Status

Düsseldorf, , Germany

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Frankfurt, , Germany

Site Status

Hamburg, , Germany

Site Status

Hanover, , Germany

Site Status

Herne, , Germany

Site Status

Homburg/Saar, , Germany

Site Status

Mainz, , Germany

Site Status

München, , Germany

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Tübingen, , Germany

Site Status

Athens, , Greece

Site Status

Larissa, , Greece

Site Status

Leipzig, , Greece

Site Status

Thessaloniki, , Greece

Site Status

Thessaloniki, , Greece

Site Status

Thessaloniki, , Greece

Site Status

Bologna, , Italy

Site Status

Torino, , Italy

Site Status

Rotterdam, , Netherlands

Site Status

Auckland, , New Zealand

Site Status

Hamilton, , New Zealand

Site Status

Whakatane, , New Zealand

Site Status

Bialystok, , Poland

Site Status

Bydgoszcz, , Poland

Site Status

Chorzów, , Poland

Site Status

Krakow, , Poland

Site Status

Warsaw, , Poland

Site Status

Wroclaw, , Poland

Site Status

Majadahonda, Madrid, Spain

Site Status

Barcelona, , Spain

Site Status

Valencia, , Spain

Site Status

Bursa, , Turkey (Türkiye)

Site Status

Istanbul, , Turkey (Türkiye)

Site Status

Istanbul, , Turkey (Türkiye)

Site Status

Izmir, , Turkey (Türkiye)

Site Status

London, , United Kingdom

Site Status

London, , United Kingdom

Site Status

Countries

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United States Australia Bulgaria Canada Czechia France Germany Greece Italy Netherlands New Zealand Poland Spain Turkey (Türkiye) United Kingdom

References

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Kitrinos KM, Corsa A, Liu Y, Flaherty J, Snow-Lampart A, Marcellin P, Borroto-Esoda K, Miller MD. No detectable resistance to tenofovir disoproxil fumarate after 6 years of therapy in patients with chronic hepatitis B. Hepatology. 2014 Feb;59(2):434-42. doi: 10.1002/hep.26686.

Reference Type RESULT
PMID: 23939953 (View on PubMed)

Marcellin P, Gane E, Buti M, Afdhal N, Sievert W, Jacobson IM, Washington MK, Germanidis G, Flaherty JF, Aguilar Schall R, Bornstein JD, Kitrinos KM, Subramanian GM, McHutchison JG, Heathcote EJ. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet. 2013 Feb 9;381(9865):468-75. doi: 10.1016/S0140-6736(12)61425-1. Epub 2012 Dec 10.

Reference Type RESULT
PMID: 23234725 (View on PubMed)

Gordon SC, Krastev Z, Horban A, Petersen J, Sperl J, Dinh P, Martins EB, Yee LJ, Flaherty JF, Kitrinos KM, Rustgi VK, Marcellin P. Efficacy of tenofovir disoproxil fumarate at 240 weeks in patients with chronic hepatitis B with high baseline viral load. Hepatology. 2013 Aug;58(2):505-13. doi: 10.1002/hep.26277. Epub 2013 May 3.

Reference Type RESULT
PMID: 23364953 (View on PubMed)

Tsai NC, Marcellin P, Buti M, Washington MK, Lee SS, Chan S, Trinh H, Flaherty JF, Kitrinos KM, Dinh P, Charuworn P, Subramanian GM, Gane E. Viral suppression and cirrhosis regression with tenofovir disoproxil fumarate in Asians with chronic hepatitis B. Dig Dis Sci. 2015 Jan;60(1):260-8. doi: 10.1007/s10620-014-3336-7. Epub 2014 Sep 2.

Reference Type RESULT
PMID: 25179493 (View on PubMed)

Fung S, Gordon SC, Krastev Z, Horban A, Petersen J, Sperl J, Gane E, Jacobson IM, Yee LJ, Dinh P, Martins EB, Flaherty JF, Kitrinos KM, Dusheiko G, Trinh H, Flisiak R, Rustgi VK, Buti M, Marcellin P. Tenofovir disoproxil fumarate in Asian or Pacific Islander chronic hepatitis B patients with high viral load (>/= 9 log10 copies/ml). Liver Int. 2015 Feb;35(2):422-8. doi: 10.1111/liv.12694. Epub 2014 Oct 28.

Reference Type RESULT
PMID: 25277773 (View on PubMed)

Buti M, Fung S, Gane E, Afdhal NH, Flisiak R, Gurel S, Flaherty JF, Martins EB, Yee LJ, Dinh P, Bornstein JD, Mani Subramanian G, Janssen HL, George J, Marcellin P. Long-term clinical outcomes in cirrhotic chronic hepatitis B patients treated with tenofovir disoproxil fumarate for up to 5 years. Hepatol Int. 2015 Apr;9(2):243-50. doi: 10.1007/s12072-015-9614-4. Epub 2015 Mar 13.

Reference Type RESULT
PMID: 25788199 (View on PubMed)

Buti M, Tsai N, Petersen J, Flisiak R, Gurel S, Krastev Z, Aguilar Schall R, Flaherty JF, Martins EB, Charuworn P, Kitrinos KM, Subramanian GM, Gane E, Marcellin P. Seven-year efficacy and safety of treatment with tenofovir disoproxil fumarate for chronic hepatitis B virus infection. Dig Dis Sci. 2015 May;60(5):1457-64. doi: 10.1007/s10620-014-3486-7. Epub 2014 Dec 23.

Reference Type RESULT
PMID: 25532501 (View on PubMed)

Corsa A, Liu Y, Flaherty JF, Marcellin P, Miller M, Kitrinos KM. No Detectable Resistance to Tenofovir Disoproxil Fumarate (TDF) in HBeAg+ and HBeAg- Patients With Chronic Hepatitis B (CHB) After Eight Years of Treatment [Abstract 1707]. The 65th Annual Meeting of the American Association for the Study of Liver Diseases: The Liver Meeting (AASLD); 2014 08-10 November; Boston MA.

Reference Type RESULT

Marcellin P, Gane EJ, Flisiak R, Trinh HN, Petersen J, Gurel S, et al. Long Term Treatment with Tenofovir Disoproxil Fumarate for Chronic Hepatitis B Infection is Safe and Well Tolerated and Associated with Durable Virologic Response with no Detectable Resistance: 8 Year Results from Two Phase 3 Trials [Abstract]. 55th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD); 2014 November 7-11; Boston, MA.

Reference Type RESULT

Gane EJ, Marcellin P, Sievert W, Trinh HN, Shiffman ML, Washington MK, et al. Five years of Treatment with Tenofovir DF for Chronic Hepatitis B Infection in Asian Patients is Associated with Sustained Viral Suppression and Significant Regression of Histological Fibrosis and Cirrhosis [Poster Number 1429]. 62nd Annual Meeting of the American Association for the Study of Liver Diseases; 2011 November 4-8; San Francisco, California.

Reference Type RESULT

Liu Y, Corsa AC, Buti M, Cathcart AL, Flaherty JF, Miller MD, Kitrinos KM, Marcellin P, Gane EJ. No detectable resistance to tenofovir disoproxil fumarate in HBeAg+ and HBeAg- patients with chronic hepatitis B after 8 years of treatment. J Viral Hepat. 2017 Jan;24(1):68-74. doi: 10.1111/jvh.12613. Epub 2016 Sep 23.

Reference Type RESULT
PMID: 27658343 (View on PubMed)

Marcellin P, Wong DK, Sievert W, Buggisch P, Petersen J, Flisiak R, Manns M, Kaita K, Krastev Z, Lee SS, Cathcart AL, Crans G, Op den Brouw M, Jump B, Gaggar A, Flaherty J, Buti M. Ten-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B virus infection. Liver Int. 2019 Oct;39(10):1868-1875. doi: 10.1111/liv.14155. Epub 2019 Jul 10.

Reference Type DERIVED
PMID: 31136052 (View on PubMed)

Buti M, Wong DK, Gane E, Flisiak R, Manns M, Kaita K, Janssen HLA, Op den Brouw M, Jump B, Kitrinos K, Crans G, Flaherty J, Gaggar A, Marcellin P. Safety and efficacy of stopping tenofovir disoproxil fumarate in patients with chronic hepatitis B following at least 8 years of therapy: a prespecified follow-up analysis of two randomised trials. Lancet Gastroenterol Hepatol. 2019 Apr;4(4):296-304. doi: 10.1016/S2468-1253(19)30015-9. Epub 2019 Feb 20.

Reference Type DERIVED
PMID: 30795958 (View on PubMed)

Jacobson IM, Washington MK, Buti M, Thompson A, Afdhal N, Flisiak R, Akarca US, Tchernev KG, Flaherty JF, Aguilar Schall R, Myers RP, Subramanian GM, McHutchison JG, Younossi Z, Marcellin P, Patel K. Factors Associated With Persistent Increase in Level of Alanine Aminotransferase in Patients With Chronic Hepatitis B Receiving Oral Antiviral Therapy. Clin Gastroenterol Hepatol. 2017 Jul;15(7):1087-1094.e2. doi: 10.1016/j.cgh.2017.01.032. Epub 2017 Feb 12.

Reference Type DERIVED
PMID: 28215615 (View on PubMed)

Pan CQ, Chan S, Trinh H, Yao A, Bae H, Lou L. Similar efficacy and safety of tenofovir in Asians and non-Asians with chronic hepatitis B. World J Gastroenterol. 2015 May 14;21(18):5524-31. doi: 10.3748/wjg.v21.i18.5524.

Reference Type DERIVED
PMID: 25987775 (View on PubMed)

Heathcote EJ, Marcellin P, Buti M, Gane E, De Man RA, Krastev Z, Germanidis G, Lee SS, Flisiak R, Kaita K, Manns M, Kotzev I, Tchernev K, Buggisch P, Weilert F, Kurdas OO, Shiffman ML, Trinh H, Gurel S, Snow-Lampart A, Borroto-Esoda K, Mondou E, Anderson J, Sorbel J, Rousseau F. Three-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B. Gastroenterology. 2011 Jan;140(1):132-43. doi: 10.1053/j.gastro.2010.10.011. Epub 2010 Oct 16.

Reference Type DERIVED
PMID: 20955704 (View on PubMed)

Marcellin P, Heathcote EJ, Buti M, Gane E, de Man RA, Krastev Z, Germanidis G, Lee SS, Flisiak R, Kaita K, Manns M, Kotzev I, Tchernev K, Buggisch P, Weilert F, Kurdas OO, Shiffman ML, Trinh H, Washington MK, Sorbel J, Anderson J, Snow-Lampart A, Mondou E, Quinn J, Rousseau F. Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B. N Engl J Med. 2008 Dec 4;359(23):2442-55. doi: 10.1056/NEJMoa0802878.

Reference Type DERIVED
PMID: 19052126 (View on PubMed)

Other Identifiers

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2004-005119-27

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

GS-US-174-0102

Identifier Type: -

Identifier Source: org_study_id

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