TDF VS LAM + ADV in LAM + ADV Treated LAM-resistant CHB Patients With Undetectable Hepatitis B Virus DNA

NCT ID: NCT01732367

Last Updated: 2016-10-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

171 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-11-30

Study Completion Date

2016-04-30

Brief Summary

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This study will provide a rationale for switch from lamivudine plus adefovir to tenofovir monotherapy in Lamivudine plus Adefovir Treated Lamivudine-resistant chronic hepatitis B patients with Undetectable Hepatitis B Virus DNA

Detailed Description

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Recently, in Korea, long-term medication of antiviral agents and their resulting resistance expression have been the most serious cause of failure to treat chronic hepatitis B. Exp.

In particular, the annual resistance rate to lamivudine currently widely being used in Korea amounts to about 15 to 20 percents and the rate is expected to reach 70 to 80 percent in four to five years.

The guidelines by the American Association for the Study of Liver Disease (AASLD) and the European Association for the Study of the Liver (EASL) recommend a combination therapy with adefovir or tenofovir for patients with lamivudine resistant HBV .

In Korea, however, in case of combined prescription of lamivudine and adefovir, only one of them is covered by the health insurance and therefore many patients are difficult to continue treatment due to their economic conditions.

Tenofovir that has been developed most recently and will be placed on sale sooner or later in Korea has strong antiviral effects, causes little or no emergence of resistant viruses, and is known to have lower nephrotoxicity than adefovir.

In particular, several papers reported that tenofovir has effective and sustaining antiviral effects in patients who had other antiviral agents resistant HBV as well as those who received initial treatment. This shows that patients only with lamivudine resistant HBV can be treated only with tenofovir without a combination therapy and when they have low levels of HBV DNA, treatment is relatively effective despite their resistance to adefovir.

Therefore, it is considered that tenofovir switching therapy in patients with undetectable HBV DNA after lamivudine plus adefovir combination therapy to maintain their virus response.

The results of this study will provide a rationale for switch from lamivudine plus adefovir to tenofovir monotherapy in such patients.

Conditions

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Chronic Hepatitis B

Keywords

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Tenofovir Lamivudine Adefovir Chronic Hepatitis B

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Lamivudine plus adefovir

Continue lamivudine/adefovir add on treatment (standard treatment)

Group Type ACTIVE_COMPARATOR

Lamivudine plus adefovir

Intervention Type DRUG

Lamivudine 100mg QD for 96 weeks + Adefovir 10mg QD for 96 weeks

Tenofovir

Switch from lamivudine/adefovir add on treatment to tenofovir monotherapy

Group Type EXPERIMENTAL

Tenofovir

Intervention Type DRUG

Tenofovir 300mg QD for 96 weeks

Interventions

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Lamivudine plus adefovir

Lamivudine 100mg QD for 96 weeks + Adefovir 10mg QD for 96 weeks

Intervention Type DRUG

Tenofovir

Tenofovir 300mg QD for 96 weeks

Intervention Type DRUG

Other Intervention Names

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Zeffix Hepsera Viread

Eligibility Criteria

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Inclusion Criteria

* Male and female patients aged 18 or older
* The CHB patients (both HBeAg-positive and - negative) who have at least 6 months undetectable HBV DNA (serum HBV DNA ≤ 20 IU/mL) after lamivudine plus adefovir combination therapy.

Exclusion Criteria

* Patients with decompensated liver disease
* Patients with HCV, HDV or HIV
* Patients with HCC
* Serum ALT \> 2x ULN level
* Serum creatinine \> 2.0mg/dL
* Pregnant or lactating women
* Women who have a plan for pregnancy within the three coming years
* Patients who have uncontrolled severe concomitant diseases- severe cardiovascular diseases and other infection
* Those who have no capabilities to understand and sign an informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kyungpook National University Hospital

OTHER

Sponsor Role collaborator

Daegu Catholic University Medical Center

OTHER

Sponsor Role collaborator

DongGuk University

OTHER

Sponsor Role collaborator

Pusan National University Hospital

OTHER

Sponsor Role collaborator

Yeungnam University Hospital

OTHER

Sponsor Role collaborator

Keimyung University Dongsan Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Jang Byoung Kuk

Keimyung University Dongsan Medical Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Byoung Kuk Jang, M.D

Role: PRINCIPAL_INVESTIGATOR

Department of Internal Medicine, Keimyung University Dongsan Medical Center

Locations

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Department of Internal Medicine, Keimyung University Dongsan Medical Center

Daegu, , South Korea

Site Status

Countries

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South Korea

References

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Lee HJ, Kim SJ, Kweon YO, Park SY, Heo J, Woo HY, Hwang JS, Chung WJ, Lee CH, Kim BS, Suh JI, Tak WY, Jang BK. Evaluating the efficacy of switching from lamivudine plus adefovir to tenofovir disoproxil fumarate monotherapy in lamivudine-resistant stable hepatitis B patients. PLoS One. 2018 Jan 12;13(1):e0190581. doi: 10.1371/journal.pone.0190581. eCollection 2018.

Reference Type DERIVED
PMID: 29329305 (View on PubMed)

Other Identifiers

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TDF0001

Identifier Type: -

Identifier Source: org_study_id