ANRS HB 05 Multicenter Study Evaluating Efficacy and Safety of Clevudine Monotherapy Versus Tenofovir Monotherapy Versus Combination Therapy of Clevudine and Tenofovir for 96 Weeks in HBeAg Negative Patients With Chronic Hepatitis B, naïve to Anti-VHB Therapy

Sponsor

French National Agency for Research on AIDS and Viral Hepatitis (Other)

Overall Status

Terminated

CT.gov ID

NCT00823342

Collaborator

Gilead Sciences (Industry), Pharmasset (Industry)

150

Enrollment

Location

Arms

Duration (Months)

4.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

For chronic HBV infection, an optimal pharmacological agent to promote recovery from chronic HBV infection would be one that inhibits HBV DNA polymerase, combined with the clearence from the liver of cccDNA to block HBV reactivation after the circulating viral burden has been eliminated by therapy. The activity of clevudine on cccDNA in combination with its potent antiviral activity on HBV polymerase makes it the optimal agent in combination with tenofovir for this protocol.

Condition or Disease	Intervention/Treatment	Phase
HBe Negative Chronic Hepatitis B Hepatitis B Viral Infection	Drug: CLEVUDINE + TENOFOVIR PLACEBO Drug: CLEVUDINE IN ASSOCIATION TENOFOVIR Drug: TENOFOVIR + CLEVUDINE PLACEBO	Phase 3

Study Design

Study Type:

Interventional

Anticipated Enrollment :

150 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Triple (Participant, Care Provider, Investigator)

Primary Purpose:

Treatment

Official Title:

ANRS HB 05 : A Randomized, Double Blind, Multicenter Study Evaluating Efficacy and Safety of Clevudine Monotherapy Versus Tenofovir Monotherapy Versus Combination Therapy of Clevudine and Tenofovir for 96 Weeks in HBeAg Negative Patients With Chronic Hepatitis B, naïve to Anti-VHB Therapy

Study Start Date :

Dec 1, 2008

Anticipated Primary Completion Date :

Mar 1, 2011

Anticipated Study Completion Date :

Sep 1, 2011

Arms and Interventions

Arm	Intervention/Treatment
Placebo Comparator: Group A CLEVUDINE 30 mg qd + TENOFOVIR Placebo	Drug: CLEVUDINE + TENOFOVIR PLACEBO 30 MG
Active Comparator: Group B TENOFOVIR 300 mg qd in association with CLEVUDINE 30 mg qd	Drug: CLEVUDINE IN ASSOCIATION TENOFOVIR TENOFOVIR 300 mg qd in association with CLEVUDINE 30 mg qd
Placebo Comparator: Group C TENOFOVIR 300 mg qd + CLEVUDINE Placebo	Drug: TENOFOVIR + CLEVUDINE PLACEBO TENOFOVIR 300 mg qd + CLEVUDINE Placebo

Arm

Intervention/Treatment

Placebo Comparator: Group A

CLEVUDINE 30 mg qd + TENOFOVIR Placebo

Drug: CLEVUDINE + TENOFOVIR PLACEBO

30 MG

Active Comparator: Group B

TENOFOVIR 300 mg qd in association with CLEVUDINE 30 mg qd

Drug: CLEVUDINE IN ASSOCIATION TENOFOVIR

TENOFOVIR 300 mg qd in association with CLEVUDINE 30 mg qd

Placebo Comparator: Group C

TENOFOVIR 300 mg qd + CLEVUDINE Placebo

Drug: TENOFOVIR + CLEVUDINE PLACEBO

TENOFOVIR 300 mg qd + CLEVUDINE Placebo

Outcome Measures

Primary Outcome Measures

Compare the long term efficacy of new anti-HBV strategies of CLV monotherapy VS TDF monotherapy VS the combination of CLV + TDF for 96 weeks in HBeAg negative patients with CHB, naïve to anti-HBV-therapy, at 24 weeks post-treatment [At 120 week]

Secondary Outcome Measures

Compare the safety profile of CLV + TDF compared to that of CLV and TDF in HBeAg negative patients with CHB, naïve to anti-HBV-therapy. - To compare perceived toxicity as expressed by the nature and the number of self-reported side effects, percept [At 24 week, 48 week and 96 week]

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Male and female patients over 18 years of age
Chronic hepatitis B, HBs Ag-positive for over 6 months, anti HBs negative
Patients with HBeAg- negative chronic hepatitis B (CHB) and anti-HBe positive at screen
Patients naïve to anti-HBV nucleoside or nucleotide and any other experimental nucleoside/nucleotide analog for HBV
Serum HBV-DNA quantifiable over 2000 IU/mL at screening
ALT over 1.25 ULN and below 10 ULN
Liver biopsy (baseline or within prior 6 months) with evidence of chronic hepatic inflammatory injury (Metavir Activity score over 1 ; Knodell necroinflammatory score over 3, Ishak score over 1)

Exclusion Criteria:

Cirrhosis or bridging fibrosis on liver biopsy
Subjects who have received any form of alpha interferon in the past 6 months prior to the first administration of randomized treatment
Any systemic anti-viral, anti-neoplastic or immuno-modulatory treatment (including supraphysiologic doses of steroids and radiation) below 6 months prior to the first dose of randomized treatment and during the study (except for below 10 days of acyclovir for herpetic lesions, or prednisone below 10 mg/days for below 10 days more than 1 month)
Women with ongoing pregnancy or breast feeding
Positive test at screening for anti-HAV IgM Ab, anti-HIV Ab, anti-HCV Ab, HCV RNA, anti-HDV Ab
History or other evidence of a medical condition associated with chronic liver disease other than HBV (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease including Wilson's disease and alpha1-antitrypsin deficiency, alcoholic liver disease, toxin exposures, toxic thalassemia, NASH)
History or other evidence of bleeding from esophageal varices or other clinical conditions consistent with decompensated liver disease (defined by one of the following criteria being met: serum albumin below 3.5 g/L, prothrombin time over 4 seconds prolonged, serum bilirubin over 34 µmol/L, history of encephalopathy, history of ascites)
Neutrophil count below 1200 cells/mm3 or platelet count below 90,000 cells/mm3 at screening
Serum creatinine level over 130µmol/l or calculated creatinine clearance below 70 ml/min (Cockcroft-Gault)
Evidence or history of tubular nephropathy , Fanconi syndrom or hypophosphoremia.
Evidence of drug abuse (including excessive alcohol consumption) within one year of study entry
History of a severe seizure disorder or current anticonvulsant use
History of immunologically mediated disease (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, severe psoriasis, rheumatoid arthritis etc.)
History of major organ transplantation with an existing functional graft
History or other evidence of severe illness or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study
Evidence of an active or suspected cancer or a history of malignancy where the risk of recurrence is over 20 % within 2 years
Patients with a value of alpha-fetoprotein over 100 ng/mL are excluded, unless stability (less than 10 % increase) has been documented over at least the previous 3 months
Patients included in another trial within 8 weeks prior to screening
Inability or unwillingness to provide informed consent or abide by the requirements of the study Reassessments : If a patient fails to meet the above inclusion /exclusion criteria for a reason thought to be reversible, that patient may be reassessed for entry on two additional occasions at most. If the parameter out of range for inclusion was ALT over 10 x ULN, the patient should be reassessed over 4 weeks after the date corresponding to the value that was over 10 x ULN.