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Trial registered on ANZCTR
Registration number
ACTRN12610001101077
Ethics application status
Approved
Date submitted
5/11/2010
Date registered
16/12/2010
Date last updated
14/03/2011
Type of registration
Prospectively registered
Titles & IDs
Public title
The Evaluation of efficacy and safety of Tenofovir in combination with peginterferon alpha-2a subcutaneous for 48 weeks in patients with chronic hepatitis B viral infections (HBV)
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Scientific title
A randomized, open-label, controlled, multi-centre pilot study evaluating the efficacy and safety of Tenofovir 300 mg PO in combination with peginterferon alpha-2a subcutaneous 180 micrograms for 48 weeks in patients with HBeAg-positive CHB
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Secondary ID [1]
252894
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Study No SAR020506
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Hepatitis B viral infection
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Condition category
Condition code
Infection
258591
258591
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0
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Other infectious diseases
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Oral and Gastrointestinal
258738
258738
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Inflammatory and Immune System
258739
258739
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0
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1 Oral antiviral Tenofovir 300mg (daily for 48weeks) plus Peginterferon 180micrograms (subcutaneous injection once weekly for 48 weeks)
Arm 2 Peginterferon 180micrograms (subcutaneous injection once weekly for 24weeks) followed by combination Oral antiviral Tenofovir 300mg (daily for 24weeks) plus Peginterferon 180micrograms (subcutaneous injection once weekly for 24 weeks)
Arm 3 Peginterferon monotherapy 180micrograms (subcutaneous injection once weekly for 48weeks)
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Intervention code [1]
257422
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Treatment: Drugs
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Comparator / control treatment
Peginterferon alpha-2a 180micrograms (subcutaneous injection once weekly for 48weeks)
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary objective of this study is to demonstrate the efficacy of the combination of peginterferon alpha-2a with Tenofovir in achieving sustained HBV suppression as measured by HBsAg loss in adult patients with HBeAg positive CHB by serum assay (blood test)
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Assessment method [1]
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Timepoint [1]
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24weeks post dosing of study medication.
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Secondary outcome [1]
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Evaluating the effect of the combination of peginterferon alpha-2a with Tenofovir on HBsAg clearance rates by a lead in phase of Peginterferon monotherapy for 24 weeks prior to combination therapy by serum assay (blood test)
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Assessment method [1]
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Timepoint [1]
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24weeks post dosing of study medication.
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Secondary outcome [2]
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Evaluating the effect of peginterferon and Tenofovir combination therapy on other parameters of viral suppression including; HBV DNA non-detectability, reduction from baseline, and sustained reduction in HBV DNA over the course of the study. HBeAg loss, HBeAb seroconversion and reduction in HBeAg titres from baseline HBsAg loss, HBsAb seroconversion and reduction in HBsAg titres from baseline and ALT normalization by serum assay (blood test)
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Assessment method [2]
265988
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Timepoint [2]
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24weeks post dosing of study medication.
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Eligibility
Key inclusion criteria
Documented Chronic Hepatitis B defined by all of the following:
1.Clinical history compatible with CHB
2.Detectable serum HBsAg at the Screening visit and at least 6 months prior
3.HBeAg-positive and HBeAb-negative at the Screening visit
4.History of evidence of chronic liver inflammation, documented by previous history of elevated serum ALT (at least two documented elevated ALT values spanning six months or more))
5.Elevated serum ALT level (1.1 – 10 x upper limit of normal (ULN)) at the Screening visit
6.Serum HBV DNA level = 3 log10 IU/mL at the screening visit
7.Chronic liver inflammation on a liver biopsy performed within the previous 5 years
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1.History of hypersensitivity to any of the study drugs or to drugs with similar chemical structures
2.Co-infection with hepatitis C virus (HCV), hepatitis D virus (HDV), or Human immunodeficiency virus (HIV).
3.Has had any of the following drug therapy:
*Received nucleoside or nucleotide therapy whether approved or investigational in the three months before screening for this study.
*Received conventional interferon alpha or other immunomodulatory therapies in the six months before screening for this study.
*Has previously received Pegylated Interferon alpha at any stage for the treatment of CHB
4.Has a medical condition that requires frequent or prolonged use of systemic corticosteroids although inhaled or intra-articular corticosteroids are allowed.
5.Has a medical condition requiring the chronic or prolonged use of potentially hepatotoxic drugs or nephrotoxic drugs.
6.Is currently abusing alcohol or illicit drugs or has a history of alcohol abuse or illicit substance abuse within the preceding 12 months.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The investigators will ensure that only patients who meet the inclusion and exclusion criteria will be considered eligible for the study.
This is an investigator initiated, randomized, open-label, national, multicenter, three-arm, pilot study evaluating the efficacy of peginterferon alpha-2a plus Tenofovir combination therapy and Peginterferon lead in therapy followed by combination therapy with Tenofovir in adult HBeAg-positive outpatients with CHB.
Only subjects who have provided written informed consent will be enrolled in the study.
allocation involved contacting the holder of the allocation schedule who was "off-site" or at central administration. Concealment is done by sealed envelopes. Central randomisation is done by fac from the offsite central administration. Randomisation has been developed by the statistician and concealed by sealed envelopes. Each randomisation will take the next sequential envelope allocated to the sites allocated concealed sealed envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using a randomization table created by a computer software (i.e., computerised sequence)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/01/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
75
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
258010
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Anouk Dev
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Address
Dept of Gastroenterology
Level 3, Main Building
Monash Medical Centre
246 Clayton Road
Clayton Victoria
3168
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
257203
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Dr. Sally Bell
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Address [1]
257203
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35 Victoria Parade
Fitzroy 3065 Victoria
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Country [1]
257203
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
260004
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Southern Health Human Research and Ethics Committee
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Ethics committee address [1]
260004
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Level 4, Main Building Monash Medical Centre 246 Clayton Road Clayton Victoria 3168
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Ethics committee country [1]
260004
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Australia
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Date submitted for ethics approval [1]
260004
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21/07/2010
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Approval date [1]
260004
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10/03/2011
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Ethics approval number [1]
260004
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HREC/10/SHA/17 - 10213A
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Summary
Brief summary
This is a randomized, openlabel, national, multicenter, three arm, pilot, investigator initiated study evaluating the efficacy and safety of Tenofovir 300 mg PO in combination with peginterferon alpha2a sc 180 µg in patients with HBeAg positive CHB. The patients will be randomized into three treatment arms at a ratio of 1:1:1 Arm 1: Full course combination therapy: 48 weeks of both peginterferon alpha2a plus Tenofovir disoproxil fumarate Arm 2: Peginterferon alpha2a lead-in therapy: 24 weeks of a ‘lead in’ course of peginterferon monotherapy, followed by 24 weeks of combination peginterferon Arm 3: Peginterferon alpha2a 180mcg weekly for 48 weeks The study consists of four periods: Screening (= 8 weeks prior to Baseline visit), Baseline Visit (Day 1), Treatment Phase (48 weeks) Posttreatment Followup (24 weeks) Study purpose: The primary purpose of this study is to evaluate whether the combination of Peginterferon and Tenofovir therapy may lead to improved antiviral outcomes compared to that typically seen with Peginterferon monotherapy. Objectives: The primary objective of this study is to demonstrate the efficacy of the combination of peginterferon alpha-2a with Tenofovir in achieving sustained HBV suppression as measured by HBsAg loss in adult patients with HBeAg positive CHB Secondary objectives include 1. Evaluating the effect of on HBsAg clearance rates by a lead in phase of Peginterferon monotherapy for 24 weeks prior to combination therapy 2. Evaluating the effect of peginterferon and Tenofovir combination therapy on other parameters of viral suppression including 3. HBV DNA non-detectability, reduction from baseline, and sustained reduction in HBV DNA over the course of the study. 4. HBeAg loss, Anti-HBe seroconversion and reduction in HBeAg titres from baseline 5. HBsAg loss, HBsAb seroconversion and reduction in HBsAg titres from baseline 6. ALT normalization 7. To determine which baseline and ‘on therapy’ markers may be used to predict clinical and virological outcomes including quantitative HBeAg and HBsAg titres, HBV viral load, ALT and HBV genotype In addition a sub Immunological Study will be conducted at 2 of the study sites (Monash Medical Centre and St Vincent’s Hospital Melbourne). Patients recruited at both sites will be invited to participate in smaller subcohort study evaluating innate immune during the treatment and follow up periods to determine whether innate immune function can be used as a predictive marker of treatment induced HBsAg and HBeAg seroconversion.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Dilip Ratnam
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Address
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Department of Gastroenterology
Level 3, Main Building
Monash Medical Centre
246 Clayton Road, Clayton Victoria
3168
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Country
15036
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Australia
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Phone
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613 9594 3177
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Fax
15036
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613 9594 6586
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Dilip Ratnam
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Address
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Department of Gastroenterology
Level 3, Main Building
Monash Medical Centre
246 Clayton Road, Clayton Victoria
3168
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Country
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Australia
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Phone
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613 9594 3177
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Fax
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613 9594 6586
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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