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A Study to Compare Tenofovir Versus Hepsera (Adefovir) for the Treatment of Hepatitis Be Antigen (HBeAg) Positive Chronic Hepatitis B
This study is ongoing, but not recruiting participants.
Sponsored by: Gilead Sciences
Information provided by: Gilead Sciences
ClinicalTrials.gov Identifier: NCT00116805
  Purpose

This study is designed to evaluate the safety and antiviral activity of tenofovir compared to Hepsera for the treatment of HBeAg positive chronic hepatitis B. Patients will either receive tenofovir or the approved hepatitis B therapy, Hepsera. After 48 weeks all patients will be switched to open label tenofovir.


Condition Intervention Phase
Chronic Hepatitis B
Drug: tenofovir disoproxil fumarate
Drug: adefovir dipivoxil
Phase III

MedlinePlus related topics: Hepatitis Hepatitis B
Drug Information available for: Hepatitis B Vaccines Adefovir dipivoxil Adefovir Tenofovir Tenofovir disoproxil Tenofovir Disoproxil Fumarate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Randomized, Double-Blind, Controlled Evaluation of Tenofovir DF Versus Adefovir Dipivoxil for the Treatment of HBeAg Positive Chronic Hepatitis B

Further study details as provided by Gilead Sciences:

Primary Outcome Measures:
  • HBV DNA <400 copies/mL and histological improvement (at least a 2 point reduction in the Knodell necroinflammatory score without worsening in fibrosis) [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • HBV DNA <400 copies/mL [ Time Frame: week 48 and then annually through week 384 ] [ Designated as safety issue: No ]
  • Histological improvement [ Time Frame: week 48 and week 240 ] [ Designated as safety issue: No ]
  • ALT normalization [ Time Frame: week 48 and then annually through week 384 ] [ Designated as safety issue: No ]
  • 0HBeAg and HBsAg loss/seroconversion [ Time Frame: week 48 and then annually through week 384 ] [ Designated as safety issue: No ]
  • Development of resistance mutations [ Time Frame: week 48 and then annually through week 384 ] [ Designated as safety issue: No ]
  • safety and tolerability [ Time Frame: week 48 and then annually through week 384 ] [ Designated as safety issue: Yes ]

Enrollment: 266
Study Start Date: May 2005
Estimated Study Completion Date: June 2014
Primary Completion Date: June 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
A: Experimental
Tenofovir Disoproxil Fumarate 300 mg once daily and then switch to open label tenofovir disoproxil fumarate 300 mg once daily for an additional 336 weeks
Drug: tenofovir disoproxil fumarate
300 mg once daily for 48 weeks and then open label tenofovir disoproxil fumarate 300 mg once daily for an additional 336 weeks
B: Active Comparator
Adefovir Dipivoxil10 mg once daily and then switch to open label tenofovir disoproxil fumarate 300 mg once daily for an additional 336 weeks
Drug: adefovir dipivoxil
10 mg once daily for 48 weeks and then open label tenofovir disoproxil fumarate 300 mg once daily for an additional 336 weeks

Detailed Description:

Efficacy of tenofovir versus Hepsera will be evaluated for histologic improvement, reductions in serum HBV DNA, changes in liver enzymes, and the generation of antibody to the virus. Safety will be assessed by evaluating adverse events, laboratory abnormalities and the development of drug-resistant mutations. After 48 weeks, all patients will receive tenofovir and the efficacy and safety of tenofovir will be monitored for an additional 336 weeks.

  Eligibility

Ages Eligible for Study:   18 Years to 69 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

A patient must meet all of the following inclusion criteria to be eligible for participation in this study.

  • Chronic HBV infection, defined as positive serum HBsAg for more than 6 months.
  • 18 through 69 years of age, inclusive.
  • Active HBeAg positive chronic HBV infection, with all of the following:

    • HBeAg positive at screening;
    • ALT levels > 2 × ULN and </= 10 × ULN;
    • Serum HBV DNA > 1 million copies/mL at screening;
    • creatinine clearance >/= 70 mL/min;
    • hemoglobin >/= 8 g/dL;
    • neutrophils >/= 1,000 /mL
  • Knodell necroinflammatory score >/= 3 and a Knodell fibrosis score < 4. However, up to 96 patients with cirrhosis, i.e., a Knodell fibrosis score equal to 4, will be eligible for enrollment.
  • Negative serum β-HCG
  • Nucleotide naïve, i.e., no prior nucleotide (tenofovir DF or adefovir dipivoxil) therapy for greater than 12 weeks.
  • Nucleoside naïve, i.e., no prior nucleoside (any nucleoside) therapy for greater than 12 weeks.
  • Willing and able to provide written informed consent.
  • Had a liver biopsy performed within 6 months of baseline and has readable biopsy slides or agrees to have a biopsy performed prior to baseline.

Exclusion Criteria:

A patient who meets any of the following exclusion criteria is not to be enrolled in this study.

  • Pregnant women, women who are breast feeding or who believe they may wish to become pregnant during the course of the study.
  • Males and females of reproductive potential who are unwilling to use an "effective" method of contraception during the study. For males, condoms should be used and for females, a barrier contraception method should be used.
  • Decompensated liver disease defined as conjugated bilirubin >1.5 x ULN, PT > 1.5 x ULN, platelets < 75,000/mL, serum albumin < 3.0 g/dL, or prior history of clinical hepatic decompensation (e.g., ascites, jaundice, encephalopathy, variceal hemorrhage).
  • Received any nucleoside, nucleotide (tenofovir DF or adefovir dipivoxil) or interferon (pegylated or not) therapy within 6 months prior to the pre-treatment biopsy.
  • Evidence of hepatocellular carcinoma (HCC), i.e., α-fetoprotein >50 ng/mL.
  • Coinfection with HCV, HIV, or HDV.
  • Significant renal, cardiovascular, pulmonary, or neurological disease.
  • Received solid organ or bone marrow transplantation.
  • Is currently receiving therapy with immunomodulators (e.g., corticosteroids, etc.), investigational agents, nephrotoxic agents, or agents susceptible of modifying renal excretion.
  • Has proximal tubulopathy.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00116805

  Show 114 Study Locations
Sponsors and Collaborators
Gilead Sciences
Investigators
Study Chair: Elsa Mondou, MD Gilead Sciences
  More Information

Related Info  This link exits the ClinicalTrials.gov site
Related Info  This link exits the ClinicalTrials.gov site
Related Info  This link exits the ClinicalTrials.gov site

Publications indexed to this study:
Responsible Party: Gilead Sciences ( Elsa Mondou, MD )
Study ID Numbers: GS-US-174-0103
Study First Received: June 30, 2005
Last Updated: August 27, 2008
ClinicalTrials.gov Identifier: NCT00116805  
Health Authority: United States: Food and Drug Administration

Keywords provided by Gilead Sciences:
tenofovir
adefovir
hepatitis B
HBeAg Positive

Study placed in the following topic categories:
Liver Diseases
Hepatitis, Chronic
Hepatitis, Viral, Human
Hepatitis
Virus Diseases
Digestive System Diseases
Hepatitis B, Chronic
Hepatitis B
Tenofovir
DNA Virus Infections
Adefovir dipivoxil
Adefovir
Tenofovir disoproxil

Additional relevant MeSH terms:
Anti-Infective Agents
Anti-HIV Agents
Anti-Retroviral Agents
Molecular Mechanisms of Pharmacological Action
Therapeutic Uses
Enzyme Inhibitors
Antiviral Agents
Hepadnaviridae Infections
Nucleic Acid Synthesis Inhibitors
Pharmacologic Actions
Reverse Transcriptase Inhibitors

ClinicalTrials.gov processed this record on January 16, 2009