Switch or Sequential Combination Therapy of Peginterferon in Hepatitis B Patients With Longterm Entecavir Therapy

NCT ID: NCT02589652

Last Updated: 2015-10-28

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

UNKNOWN

Total Enrollment

294 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-10-31

Study Completion Date

2017-10-31

Brief Summary

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This is a multicenter, prospective cohort study to evaluate the efficacy and safety of sequential combination or switch therapy of pegylated interferon alfa-2a in chronic hepatitis B patients with low HBsAg and HBeAg titers after long-term entecavir therapy, and compared to those who continued on ETV therapy.

Detailed Description

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Chronic hepatitis B (CHB) infection remains a global health treat. The ideal end point of therapy is HBsAg loss or HBsAg seroconversion, indicating a complete remission of CHB. In patients with HBeAg-positive CHB, sustained HBeAg seroconversion is also a desirable end point. Current therapies include pegylated interferon (PegIFN) finite and nucleos(t)ide analogues (NUCs) longterm therapy. However, only 30-40% of patients may achieve HBeAg seroconversion on PegIFN monotherapy, whereas 15-20% of patients on entecavir (ETV). Recently, accumulating evidence had shown that optimization of switching or combining PegIFN in patients on long-term ETV therapy may increase rate of HBeAg seroconversion and even lead to the complete eradication of HBV. However, these two regimens has not been tested adequately in patients with low HBsAg/HBeAg titers on long-term ETV therapy.

This is a multicenter, prospective cohort study to evaluate the efficacy and safety of sequential combination or switch therapy of pegylated interferon alfa-2a in chronic hepatitis B patients with low HBsAg and HBeAg titers after long-term entecavir therapy, and compared to those who continued on ETV therapy.

Conditions

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Chronic Hepatitis B

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Switch group

Patients who have been assigned to pegylated interferon alfa-2a.

Pegylated interferon alfa-2a

Intervention Type DRUG

ETV 0.5mg oral daily plus PegIFN alfa-2a 180ug subcutaneous injection weekly for 8 weeks and followed by PegIFN alfa-2a 180ug subcutaneous injection weekly for 40 weeks

Sequential combination group (S-C group)

Patients who have been assigned to pegylated interferon alfa-2a plus entecavir.

Pegylated interferon alfa-2a plus Entecavir

Intervention Type DRUG

ETV 0.5mg oral daily plus PegIFN alfa-2a 180ug subcutaneous injection weekly for 48 weeks

ETV group

Patients who have been assigned to entecavir monotherapy.

Entecavir

Intervention Type DRUG

ETV 0.5mg oral daily for 48 weeks

Interventions

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Pegylated interferon alfa-2a

ETV 0.5mg oral daily plus PegIFN alfa-2a 180ug subcutaneous injection weekly for 8 weeks and followed by PegIFN alfa-2a 180ug subcutaneous injection weekly for 40 weeks

Intervention Type DRUG

Pegylated interferon alfa-2a plus Entecavir

ETV 0.5mg oral daily plus PegIFN alfa-2a 180ug subcutaneous injection weekly for 48 weeks

Intervention Type DRUG

Entecavir

ETV 0.5mg oral daily for 48 weeks

Intervention Type DRUG

Other Intervention Names

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PegIFN alpha-2a PegIFN alpha-2a ETV ETV

Eligibility Criteria

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Inclusion Criteria

* Male and female patients \> 18 and ≤ 60 years of age;
* Positive HBsAg for more than 6 months;
* Patients receiving previous ETV therapy ≥2 years;
* Patients who have achieved undetectable HBV DNA, HBsAg \<1500IU/mL and HBeAg \<200S/CO prior to switch or S-C therapy;
* ALT\<=10\*ULN and TB\<2\*ULN;
* Patients who have been assigned to treatment with PegIFN (S-C or switch) or continuous ETV after previous ETV therapy

Exclusion Criteria

* Evidence of decompensated cirrhosis or hepatocellular carcinoma;
* Serological evidence of co-infection with HCV, HDV or HIV;
* Pregnant or breast-feeding women;
* Patients with diseases that might contraindicate to PegIFN therapy including severe psychiatric diseases, immunological diseases, severe retinopathy, thyroid dysfunction, leukocytopenia, thrombopenia, etc
* Patients receiving concomitant therapy with telbivudine;
* A history of drug or alcohol abuse;
* Other conditions that investigates consider not suitable for participate
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Huashan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Wen-hong Zhang

Director of Division of Infectious Diseases

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wenhong Zhang, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Huashan Hospital

Locations

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The First Affiliated Hospital, Anhui Medical University

Hefei, Anhui, China

Site Status

The Second Affiliated Hospital, Anhui Medical University

Hefei, Anhui, China

Site Status

Beijing Ditan Hospital

Beijing, Beijing Municipality, China

Site Status

Fuzhou Municipal Infectious Disease Hospital

Fuzhou, Fujian, China

Site Status

Zhongshan No.2 People's Hospital, Zhongshan, Guangdong

Guangzhou, Guangdong, China

Site Status

The third People's Hospital of Shenzhen

Shenzhen, Guangdong, China

Site Status

The Third Hospital of Hebei Medical University

Shijiazhuang, Hebei, China

Site Status

Fifth People's Hospital of Suzhou

Suzhou, Jiangsu, China

Site Status

The Affiliated Hospital of Xuzhou Medical College

Xuzhou, Jiangsu, China

Site Status

Shenyang Municipal Infectious Disease Hospital

Shenyang, Liaoning, China

Site Status

Shandong Provincial Hospital of Shandong University

Jinan, Shandong, China

Site Status

The First Affiliated Hospital Medical School of Xi'an Jiaotong University

Xi’an, Shanxi, China

Site Status

The Affiliated Hospital of Luzhou Medical College

Luzhou, Sichuan, China

Site Status

Sichuan Provincial People's Hospital

Sichuan, Sichuan, China

Site Status

The First Affiliated Hospital, College of Medicine, Zhejiang University

Hangzhou, Zhejiang, China

Site Status

The Second Hospital of Yinzhou of Ningbo

Ningbo, Zhejiang, China

Site Status

Rui'an People's Hospital

Rui’an, Zhejiang, China

Site Status

Countries

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China

Central Contacts

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Yiqi Yu, MD

Role: CONTACT

+86 21 52888123 ext. 8123

Wenhong Zhang, MD, PhD

Role: CONTACT

+86 21 52889999 ext. 8123

Facility Contacts

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Jiabin Li

Role: primary

Yufeng Gao

Role: primary

Yao Xie

Role: primary

Minghua Lin

Role: primary

Jing Yuan

Role: primary

Caiyan Zhao

Role: primary

Chuanwu Zhu

Role: primary

Xuebing Yan

Role: primary

Mingxiang Zhang

Role: primary

Wanhua Ren

Role: primary

Yingren Zhao

Role: primary

Gang Wu

Role: primary

0830-2292040

Xingxiang Yang

Role: primary

Xiaowei Xu

Role: primary

Guojun Li

Role: primary

Liang Hong

Role: primary

0577-65866555

Other Identifiers

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81271833

Identifier Type: -

Identifier Source: org_study_id

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