Effects of Telbivudine and Tenofovir Disoproxil Fumarate Treatment on the Hepatitis B Virus DNA Kinetics in CHB

Novartis

Status and phase: Completed; Phase 3

Conditions: Hepatitis B Virus

Treatments: Drug: Telbivudine plus tenofovir; Drug: Telbivudine; Drug: Tenofovir

Study type: Interventional

Funder types: Industry

Identifiers

NCT00805675

CLDT600AHK01

Details and patient eligibility

About

The purpose of this study is to compare the safety, tolerability and effectiveness of 12 weeks of treatment with telbivudine 600 mg daily plus tenofovir DF 300 mg one daily (OD) taken together vs. tenofovir DF 300 mg once daily (QD) or vs telbivudine 600 mg monotherapy daily (QD). This is an open labeled, active controlled, viral kinetics study which means the subjects and study doctor will know what study drug subjects have been assigned. This study is open to male and female subjects, <40 years of age, who have been infected with HBV for at least 6 months and have not received oral treatment for HBV.

Enrollment: 83 patients

Sex: All

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chronic HBV infection, defined as positive serum HBsAg for at least 6 months, or HBsAg positive > 3 months and negative for IgM anti-HBc and positive for IgG anti-HBc
• Age < 40 years old
• HBeAg positive
• HBV DNA > or = to 10^7 copies/mL by Abbott real-time PCR
• ALT < or = to 1 ULN
• Willing and able to provide written informed consent
• No prior oral HBV therapy (e.g., nucleotide and/or nucleoside therapy or other investigational agents for HBV infection)
• Is willing and able to comply with the study drug regimen and all other study procedures and requirements
• Is willing and able to provide written informed consent before any study assessment is perform

Exclusion criteria

• Decompensated liver disease defined as direct (conjugated) bilirubin > 1.2 × ULN, PT > 1.2 × ULN, platelets < 150,000/mm3, serum albumin < 3.5 g/dL, or prior history of clinical hepatic decompensation (e.g. ascites, jaundice, encephalopathy, variceal hemorrhage).
• Received interferon (pegylated or not) therapy within 6 months of the screening visit
• α-fetoprotein > 50 ng/mL
• Evidence of hepatocellular carcinoma (HCC)
• Co-infection with HCV (by serology), or HIV,
• 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.
• Use of other investigational drugs at the time of enrollment, or within 30 days
• History of hypersensitivity to any of the study drugs or to drugs of similar chemical classes
• Is pregnant or breastfeeding.
• Is a women of child-bearing potential (WOCBP)unless post-menopausal or using one or more acceptable method of contraception.
• Patient has any other concurrent medical or social condition likely to preclude compliance with the schedule of evaluations in the protocol, or likely to confound the efficacy or safety observations of the study.
• Patient is currently abusing alcohol or illicit drugs, or has a history of alcohol abuse or illicit substance abuse within the preceding two years.
• Patient has a medical condition that requires prolonged or frequent use of systemic acyclovir or famciclovir.

Other protocol-defined inclusion/exclusion criteria may apply

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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83 participants in 3 patient groups

Telbivudine 600 mg monotherapy

Experimental group

Description:

All patients in this arm were randomized to receive Telbivudine (LDT) 600 mg QD. Patients were randomized prior to the first dose of study medication, which was defined as the study Baseline (Day 1) Visit. Subsequently, patients returned to the clinic at Days 2, 4, 6, 8, 11, 15 (Wk 2), 22 (Wk 3), 29 (Wk 4), 43 (Wk 6), 57 (Wk 8), and 85 (Wk 12) during the 12 weeks treatment phase.

Treatment:

Drug: Telbivudine

Tenofovir disproxil fumarate 300 mg monotherapy

Active Comparator group

Description:

All patients in this arm were randomized to receive Tenofovir disoproxil fumarate 300 mg(equivalent to tenofovir disoproxil 245 mg)QD. Patients were randomized prior to the first dose of study medication, which was defined as the study Baseline (Day 1) Visit. Subsequently, patients returned to the clinic at Days 2, 4, 6, 8, 11, 15 (Wk 2), 22 (Wk 3), 29 (Wk 4), 43 (Wk 6), 57 (Wk 8), and 85 (Wk 12) during the 12 weeks treatment phase.

Treatment:

Drug: Tenofovir

Telbivudine 600 mg and Tenofovir 300 mg

Active Comparator group

Description:

All patients in this arm were randomized to receive Telbivudine (LDT) 600 mg QD and Tenofovir (TDF) 300 mg (equivalent to Tenofovir disoproxil 245 mg)QD. Patients were randomized prior to the first dose of study medication, which was defined as the study Baseline (Day 1) Visit. Subsequently, patients returned to the clinic at Days 2, 4, 6, 8, 11, 15 (Wk 2), 22 (Wk 3), 29 (Wk 4), 43 (Wk 6), 57 (Wk 8), and 85 (Wk 12) during the 12 weeks treatment phase.

Treatment:

Drug: Telbivudine plus tenofovir