Chronic Hepatitis b Patients Switch to tAf After Discontinuation of Nucleoside Analogue

NCT ID: NCT04496882

Last Updated: 2021-08-05

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

Clinical Phase

PHASE4

Total Enrollment

260 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-09

Study Completion Date

2023-12-31

Brief Summary

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We will conduct a phase 4, multicenter, open-label trial at 7 academic centers in Taiwan.

Chronic hepatitis B patients receiving oral antiviral therapy (entecavir \[ETV\], tenofovir disoproxil fumarate \[TDF\]) for at least 2 years, and fulfil the following nucleos(t)ide analogs discontinuation criteria. After nucleos(t)ide analogs discontinuation, patients had a clinical relapse and retreatment regimen switches to TAF.

The protocol will be approved by Institutional Review Board (IRB) or Research ethic committee (REC) of each site and will be conducted in accordance with the principles of Declaration of Helsinki and the International Conference on Harmonization for Good Clinical Practice. Each patient provides written informed consent before enrollment.

Detailed Description

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Tenofovir alafenamide (TAF) is a new generation of oral antiviral drugs with similar antiviral activities to tenofovir disoproxil fumarate (TDF) and reduces the adverse effects of nephrotoxicity and bone mineral density reduction. This drug has already been reimbursed by National Health Insurance, and can be used for the treatment of patients with chronic hepatitis B.

This is a single-arm prospective clinical trial to enroll patients who discontinued entecavir (ETV) and tenofovir disoproxil fumarate (TDF) and experienced a clinical hepatitis flare up. They can be retreated with TAF for 48 weeks without postponing a 3-month observation period for alanine aminotransferase (ALT) level. The virological control, ALT level recovery, and changes in liver fibrosis, hepatitis B surface antigen, hepatitis B core-associated antigen, and renal function will be observed during retreatment. In addition, a group of patients with the same characteristics who received retreatment with entecavir or TDF will be collected as a control group for comparison. We believe this study can help us understand the clinical benefits of switching to TAF for retreatment after hepatitis flare in patients to discontinue oral antiviral agents.

Conditions

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Chronic Hepatitis b Hepatitis B Reactivation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Switching therapy cohort

single arm, open label Patients will receive Vemlidy (tenofovir alafenamide, TAF) 25mg, daily for 48 weeks

Group Type EXPERIMENTAL

Vemlidy

Intervention Type DRUG

25mg Tenofovir Alafenamide

Historical continuing therapy cohort

By retrospectively review medical records, The patients continued the original regimen (ETV, TDF) for retreatment (within 3 months of clinical relapse)

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Vemlidy

25mg Tenofovir Alafenamide

Intervention Type DRUG

Other Intervention Names

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Tenofovir Alafenamide (TAF)

Eligibility Criteria

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Inclusion Criteria

1. Chronic hepatitis B patients receiving oral antiviral therapy (ETV, TDF) for at least 2 years, and fulfil the following NUCs discontinuation criteria (1)HBeAg-positive patients achieving HBeAg seroclearance, and received at least 1-year consolidation therapy (2) HBeAg-negative patients achieving undetectable HBV DNA for more than 1 year (on 3 occasions, 6 months apart)
2. After NUC discontinuation, patients had a clinical relapse (HBV DNA \> 2000 IU/mL, and ALT \> 2x ULN)
3. The retreatment regimen switches to TAF (within 3 months of clinical relapse)

B. Historical continuing therapy cohort

1. Chronic hepatitis B patients receiving oral antiviral therapy (ETV, TDF) for at least 2 years, and fulfil the following NUCs discontinuation criteria (1) HBeAg-positive patients achieving HBeAg seroclearance, and received at least 1-year consolidation therapy (2) HBeAg-negative patients achieving undetectable HBV DNA for more than 1 year(on 3 occasions, 6 months apart)
2. After NUC discontinuation, patients had a clinical relapse (HBV DNA \> 2000 IU/mL, and ALT \> 2x ULN)
3. The patients continued the original regimen (ETV, TDF) for retreatment (within 3 months of clinical relapse)

Exclusion Criteria

1. Patients who do not fulfill the discontinuation criteria
2. Patients who have HCV, HDV or HIV co-infection
3. Patients who discontinue lamivudine, adefovir, or telbivudine therapy
4. Patients with liver cirrhosis by ultrasonography and clinical diagnosis
Minimum Eligible Age

20 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital, Yun-Lin Branch

OTHER

Sponsor Role collaborator

Taipei City Hospital

OTHER_GOV

Sponsor Role collaborator

Chiayi Christian Hospital

OTHER

Sponsor Role collaborator

Dalin Tzu Chi General Hospital

OTHER

Sponsor Role collaborator

E-DA Hospital

OTHER

Sponsor Role collaborator

Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

OTHER

Sponsor Role collaborator

National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tung-Hung Su, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

National Taiwan University Hospital

Locations

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Buddhist Tzu Chi General Hospital, Da-Lin Branch

Chiayi City, , Taiwan

Site Status RECRUITING

Chia-Yi Christian Hospital

Chiayi City, , Taiwan

Site Status RECRUITING

National Taiwan University Hospital, Yun-Lin branch

Douliu, , Taiwan

Site Status RECRUITING

E-da hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

National Taiwan University Hospital

Taipei, , Taiwan

Site Status RECRUITING

Buddhist Tzu-Chi General Hospital Taipei Branch

Taipei, , Taiwan

Site Status NOT_YET_RECRUITING

Taipei City Hospital, Renai Branch

Taipei, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Tung-Hung Su, MD, PhD

Role: CONTACT

886972651694

Pei-Ying Yang, MS

Role: CONTACT

886965277228

Facility Contacts

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Kuo-Chih Tseng, MD

Role: primary

88652648000 ext. 3240

Chi-Yi Chen, MD

Role: primary

88652765041 ext. 5264

Yu-Jen Fang, MD

Role: primary

886972655715

Yao-Chun Hsu, MD, PhD

Role: primary

886975209520

Tung-Hung Su, MD, PhD

Role: primary

886972651694

Chia-Chi Wang, MD

Role: primary

886266289779 ext. 2317

Chih-Lin Lin, MD

Role: primary

886227099558

Other Identifiers

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201911095MIPD

Identifier Type: -

Identifier Source: org_study_id

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