Myrcludex B in Combination With Peginterferon Alfa-2a Versus Peginterferon Alfa-2a Alone in Patients With Chronic Viral Hepatitis B With Delta-agent

NCT ID: NCT02888106

Last Updated: 2021-04-30

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-04-30

Study Completion Date

2020-10-30

Brief Summary

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Randomised, Comparative, Parallel-Arm Study to Assess Efficacy and Safety of Myrcludex B in Combination with Peginterferon Alfa-2a Versus Peginterferon Alfa-2a Alone in Patients with Chronic Viral Hepatitis B with Delta-agent

Detailed Description

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This is a multicenter, open-label, randomised, comparative, active-controlled parallel-arm phase II study.

The study will be conducted in Russia. The aim of this study is to explore the safety and efficacy of treatment with Myrcludex B used as a monotherapy and in combination with PEG-IFNα and Tenofovir compared to monotherapy with PEG-IFNα in patients with chronic viral hepatitis B with delta-agent, based on the achievement of undetectable viral load at the end of the follow-up period 6 months (24 weeks) after the end of treatment. The study is also aimed at investigating immunogenicity of Myrcludex B and the drug pharmacokinetics when used in combination with PEG IFN alfa-2a and with Tenofovir.

It is planned to screen 110 patients, and 90 patients will be randomised in equal numbers into six treatment arms.

* Arm A (n=15): PEG IFN alfa-2a 180 µg for 48 weeks
* Arm B (n=15): Myrcludex B 2 mg + PEG IFN alfa-2a 180 µg for 48 weeks
* Arm C (n=15): Myrcludex B 5 mg + PEG IFN alfa-2a 180 µg for 48 weeks
* Arm D (n=15): Myrcludex B 2 mg for 48 weeks
* Arm E (n=15): Myrcludex B 10 mg (10 mg once a day)+ PEG IFN alfa-2a 180 µg for 48 weeks
* Arm F (n=15): Myrcludex B 10 mg (5 mg twice a day)+ Tenofovir for 48 weeks

Conditions

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Chronic Viral Hepatitis B With Delta-agent

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Multicenter, Open-label, Randomized, Comparative, parallel-arm phase II study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A

PEG IFN alfa-2a 180 µg for 48 weeks

Group Type ACTIVE_COMPARATOR

PEG IFN alfa-2a

Intervention Type DRUG

solution for subcutaneous injection, once per week

Arm B

Myrcludex B 2 mg + PEG IFN alfa-2a 180 µg for 48 weeks

Group Type EXPERIMENTAL

Myrcludex B

Intervention Type DRUG

Lyophilised powder for solution for subcutaneous injection

PEG IFN alfa-2a

Intervention Type DRUG

solution for subcutaneous injection, once per week

Arm C

Myrcludex B 5 mg + PEG IFN alfa-2a 180 µg for 48 weeks

Group Type EXPERIMENTAL

Myrcludex B

Intervention Type DRUG

Lyophilised powder for solution for subcutaneous injection

PEG IFN alfa-2a

Intervention Type DRUG

solution for subcutaneous injection, once per week

Arm D

Myrcludex B 2 mg for 48 weeks

Group Type EXPERIMENTAL

Myrcludex B

Intervention Type DRUG

Lyophilised powder for solution for subcutaneous injection

Arm E

Myrcludex B 10 mg (10 mg once a day) + PEG-IFN alfa-2a 180 μg during 48 weeks

Group Type EXPERIMENTAL

Myrcludex B

Intervention Type DRUG

Lyophilised powder for solution for subcutaneous injection

PEG IFN alfa-2a

Intervention Type DRUG

solution for subcutaneous injection, once per week

Arm F

Myrcludex B 10 mg (5 mg twice a day) + Tenofovir during 48 weeks

Group Type EXPERIMENTAL

Myrcludex B

Intervention Type DRUG

Lyophilised powder for solution for subcutaneous injection

Tenofovir

Intervention Type DRUG

Film-coated tablets, 300 mg, per os, once daily

Interventions

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Myrcludex B

Lyophilised powder for solution for subcutaneous injection

Intervention Type DRUG

PEG IFN alfa-2a

solution for subcutaneous injection, once per week

Intervention Type DRUG

Tenofovir

Film-coated tablets, 300 mg, per os, once daily

Intervention Type DRUG

Other Intervention Names

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Bulevirtide Pegasys Viread

Eligibility Criteria

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Inclusion Criteria

1. Signed Informed Consent form.
2. Males and females 18 to 65 years of age (inclusively).
3. Patients with chronic hepatitis B (HBeAg-positive or negative) and HBsAg-positive for at least 6 months prior to Screening.
4. Positive for anti-HDV antibodies for at least 6 months prior to Screening.
5. HDV RNA-positive at Screening.
6. ALT ≥ 1 x ULN and \< 10 x ULN.
7. The patient agreed to use adequate method of contraception during the study, starting from the time of Informed Consent signing and until completion of the Follow-up Period.

Exclusion Criteria

1. Intolerance or hypersensitivity to the active ingredient or other components of the study drug Myrcludex B.
2. Intolerance or hypersensitivity to interferons alfa, genetically engineered E.coli medications, polyethylene glycol or other components of peginterferon alfa-2a.
3. Previous treatment with Myrcludex B (patients with previous exposure to interferon are eligible).
4. Therapy with antiviral drugs for chronic viral hepatitis B with delta-agent over the previous 6 months.
5. Therapy with anti-tumour agents (including radiotherapy) or immunomodulatory medications (including systemic glucocorticoids) over the previous 6 months.
6. The following laboratory test results at Screening:

1. Hemoglobin \< 100 g/L
2. Leucocytes \< 3000/µL
3. Neutrophils \< 1500/µL
4. Platelets \< 90000/µL
5. Serum creatinine \>1.5 x ULN.
7. Total bilirubin \> 34.2 µM/L. Patients with higher total bilirubin may be enrolled upon consultation with the study Medical Monitor, if there is clear evidence that the elevated bilirubin is caused by Gilbert's syndrome.
8. Current or previous decompensated liver disease, including coagulopathy, hyperbilirubinemia, hepatic encephalopathy, hypoalbuminaemia, ascites, and oesophageal varices haemorrhage; Child-Pugh score of B/C or ≥6 points.
9. HCV or HIV coinfection (patients with anti-HCV antibodies and no HCV RNA at Screening are eligible).
10. Hepatocellular carcinoma.
11. Signs of drug- or alcohol-induced liver disease or any other medical conditions associated with chronic liver disease (e.g. autoimmune hepatitis, hemochromatosis, thalassaemia, alcoholic hepatitis, toxic liver disease).
12. Contraindications for liver biopsy.
13. Concurrent malignancy (current diagnosed or suspected malignancy; risk of a previous malignancy recurrence).
14. Severe decompensated cardiovascular diseases, including unstable and poorly controlled conditions, over 6 months before Screening.
15. History of poorly controlled thyroid conditions or clinically significant signs of thyroid dysfunction at Screening.
16. Previous or current severe renal failure or significant renal dysfunction at Screening.
17. Previous or current chronic pulmonary disease with respiratory distortion at Screening.
18. Previous or current severe retinopathy, significant ophthalmology disorders associated with diabetes mellitus or hypertension.
19. Previous or current severe psychiatric disorders at Screening (e.g. severe depressions, suicidal attempts, severe neuroses or cognitive disorders).
20. Previous or current endocrine disorders (hypoglycaemia, hyperglycaemia, diabetes mellitus) that are not adequately controlled at Screening.
21. History of visceral organ transplantation.
22. Signs of drug and/or alcohol dependence (80 g of alcohol/day for men and 40 g of alcohol/day for women) within 1 year before Screening.
23. History of immune disorders (e.g. idiopathic thrombocytopenic purpura, lupus erythematosus, sclerodermia, severe psoriasis, rheumatoid arthritis).
24. Need for concomitant use of glucocorticoids or myelotoxic agents.
25. Participation in another clinical study within 30 days prior to enrollment into this study.
26. Pregnant or breast-feeding females.
27. Any other condition that, in the opinion of Investigator, precludes the patient from taking part in this study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hepatera Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pavel Bogomolov, PhD

Role: PRINCIPAL_INVESTIGATOR

Moscow Regional Research and Clinical Institute (MONIKI)

Locations

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State Budgetary educational institution of higher professional education "South Ural State Medical University" Ministry of healthcare

Chelyabinsk, , Russia

Site Status

State Budgetary Institution of healthcare "Specialized Clinical Infectious Diseases Hospital" Ministry of Health

Krasnodar, , Russia

Site Status

Moscow Regional Research and Clinical Institute

Moscow, , Russia

Site Status

Federal Budget Institution of Science "Central Research Institute of Epidemiology" of The Federal Service on Customers' Rights Protection and Human Well-being Surveillance

Moscow, , Russia

Site Status

LLC "Clinic of Modern Medicine"

Moscow, , Russia

Site Status

Medical Company "Gepatolog" LLC

Samara, , Russia

Site Status

State Budgetary Institution of healthcare 'Stavropol regional clinical hospital'

Stavropol, , Russia

Site Status

Countries

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Russia

References

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Lampertico P, Bogomolov PO, Chulanov V, Stepanova T, Morozov V, Allweiss L, Dandri M, Burhenne J, Blank A, Ciesek S, Elsner C, Dittmer U, An Q, Manuilov D, Da BL, Flaherty JF, Urban S, Wedemeyer H. Phase 2 Randomised Study of Bulevirtide as Monotherapy or Combined With Peg-IFNalpha-2a as Treatment for Chronic Hepatitis Delta. Liver Int. 2025 Feb;45(2):e70008. doi: 10.1111/liv.70008.

Reference Type DERIVED
PMID: 39853842 (View on PubMed)

Asselah T, Lampertico P, Aleman S, Bourliere M, Streinu-Cercel A, Bogomolov P, Morozov V, Stepanova T, Lazar S, Manuilov D, Mercier RC, Tseng S, Ye L, Flaherty JF, Osinusi A, Da BL, Chee GM, Lau AH, Brunetto MR, Wedemeyer H. Bulevirtide Monotherapy Is Safe and Well Tolerated in Chronic Hepatitis Delta: An Integrated Safety Analysis of Bulevirtide Clinical Trials at Week 48. Liver Int. 2025 Apr;45(4):e16174. doi: 10.1111/liv.16174. Epub 2024 Dec 8.

Reference Type DERIVED
PMID: 39648559 (View on PubMed)

Allweiss L, Volmari A, Suri V, Wallin JJ, Flaherty JF, Manuilov D, Downie B, Lutgehetmann M, Bockmann JH, Urban S, Wedemeyer H, Dandri M. Blocking viral entry with bulevirtide reduces the number of HDV-infected hepatocytes in human liver biopsies. J Hepatol. 2024 Jun;80(6):882-891. doi: 10.1016/j.jhep.2024.01.035. Epub 2024 Feb 8.

Reference Type DERIVED
PMID: 38340811 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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MYR 203

Identifier Type: -

Identifier Source: org_study_id

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