Viral Kinetics Study of Telbivudine and Entecavir in Adults With Chronic Hepatitis B
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Purpose
This exploratory study is designed to determine the early viral kinetic profile during treatment with telbivudine or entecavir at multiple time points over 12 weeks.
| Condition | Intervention | Phase |
|---|---|---|
|
Hepatitis B Chronic Hepatitis B |
Drug: Entecavir Drug: Telbivudine |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized, Open-label, Controlled, Multicenter, Exploratory Trial to Characterize the Results of Daily Oral Administration of Telbivudine (LDT600) 600 mg or Entecavir (ETV) 0.5 mg Given Over 12 Weeks on the Kinetics of Hepatitis B Virus (HBV) DNA in Adults With HBeAg-positive, Compensated Chronic Hepatitis B (CHB) |
- Change in Mean Hepatitis B Virus (HBV) DNA Levels [ Time Frame: Baseline (day 1) to Week 12 (day 85) ] [ Designated as safety issue: No ]Baseline HBV DNA is defined as the last pre-dose assessment of HBV DNA.
- Change in Mean HBV DNA Level [ Time Frame: Baseline (day 1) to Weeks 2, 4, 8 ] [ Designated as safety issue: No ]Baseline HBV DNA is defined as the last pre-dose assessment of HBV DNA.HBV DNA reductions, considered as the repeated measures, from baseline to Weeks 2, 4, 8.
- The Area Under the Curve (AUC) of HBV DNA Change. [ Time Frame: From Baseline to Week 12 ] [ Designated as safety issue: No ]In AUC efficacy analyses, all the visits from baseline to Week 12 visit (including the planned and the repeated) with a non-missing HBV DNA level were included.
- Change in Alanine Aminotransferase (ALT) Levels [ Time Frame: From Baseline to Week 12 ] [ Designated as safety issue: No ]
- Characterization of Very Early Viral Kinetics: Estimation of Viral Clearance [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
Viral kinetic parameters were estimated with a bi-phasic mathematical model:
V(t) = (1-ε)pI(t) - cV(t)
I(t) = (1- η)TV(t) - δI(t)
V serum viral load, I productively infected cells, ε efficiency factor of blocking virus production, p viral production rate, c viral clearance rate, η efficiency factor of blocking de novo infection, β de novo infection rate, T uninfected target cells, δ rate of infected cell loss. Maximum-likelihood estimation for the viral kinetic parameters entailed fitting a nonlinear differential equation system via the least-squares approach from serum HBV DNA data.
- Characterization of Very Early Viral Kinetics: Estimation of the Rate of Infected Cell Loss [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]
Viral kinetic parameters were estimated with a bi-phasic mathematical model:
V(t) = (1-ε)pI(t) - cV(t)
I(t) = (1- η)TV(t) - δI(t)
V serum viral load, I productively infected cells, ε efficiency factor of blocking virus production, p viral production rate, c viral clearance rate, η efficiency factor of blocking de novo infection, β de novo infection rate, T uninfected target cells, δ rate of infected cell loss. Maximum-likelihood estimation for the viral kinetic parameters entailed fitting a nonlinear differential equation system via the least-squares approach from serum HBV DNA data.
- Characterization of Very Early Viral Kinetics: Estimation of the Efficiency Factor of Blocking Virus Production [ Time Frame: Baseline to 12 weeks ] [ Designated as safety issue: No ]Viral kinetic parameters were estimated with a bi-phasic mathematical model of HBV DNA by using compartments of free virus, infected cells, and uninfected target cells. The model parameter of interest was the effectiveness of the drug in blocking virus production from infected cells (efficacy, ε). Blocking efficiency was within the range between 0 and 1.
- Number of Patients Who Are Polymerase Chain Reaction (PCR) Negative [ Time Frame: At Week 12 ] [ Designated as safety issue: No ]PCR negative was considered <300 copies/mL. PCR positive was considered =>300 copies/mL.
| Enrollment: | 44 |
| Study Start Date: | December 2006 |
| Primary Completion Date: | February 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Telbivudine |
Drug: Telbivudine
Telbivudine 600 mg once daily for 12 weeks.
|
| Active Comparator: Entecavir |
Drug: Entecavir
Entecavir 0.5 mg once daily for 12 weeks.
|
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female, 18-70 years of age with documented compensated hepatitis B "e" antigen (HBeAg)-positive chronic hepatitis B
- Able to comply with study regimen and provide written informed consent
Exclusion Criteria:
- Pregnant or breastfeeding
- Unwilling to use double barrier method of contraception
- Co-infected with hepatitis C virus (HCV), hepatitis D virus (HDV) or human immunodeficiency virus (HIV)
- Received Hepatitis B therapy in the past
- Use of immunomodulatory therapy in past 12 months
- History of or symptoms of hepatic decompensation or pancreatitis
- Frequent or prolonged use of potentially hepatotoxic or nephrotoxic drugs
- Concurrent medication likely to preclude compliance with schedule of evaluations
- Use of other investigational drugs within 30 days of enrollment
- Abnormal laboratory values during screening
Other protocol-defined inclusion/exclusion criteria may apply
Contacts and Locations| Korea, Republic of | |
| Holy Family Hospital_Bucheon | |
| Bucheon,Kyunggi, Korea, Republic of | |
| Inje University Busan Paik Hospital | |
| Busan, Korea, Republic of | |
| Yeungnam University Medical Center | |
| Daegu, Korea, Republic of | |
| Gachon Univ. Gil Medical Center Hospital | |
| Incheon, Korea, Republic of | |
| Kangnam Sacred Heart Hospital | |
| Seoul, Korea, Republic of | |
| The Catholic University of Korea | |
| Seoul, Korea, Republic of | |
| Korea University Medical Center_Anam | |
| Seoul, Korea, Republic of | |
| Asan Medical Center | |
| Seoul, Korea, Republic of | |
| Study Director: | Novartis Pharmaceuticals | Novartis Pharmaceuticals |
More Information
Additional Information:
Publications:
| Responsible Party: | External Affairs, Novartis Pharmaceuticals |
| ClinicalTrials.gov Identifier: | NCT00412529 History of Changes |
| Other Study ID Numbers: | CLDT600A2407 |
| Study First Received: | December 15, 2006 |
| Results First Received: | December 2, 2010 |
| Last Updated: | July 18, 2011 |
| Health Authority: | Korea: Food and Drug Administration United States: Food and Drug Administration |
Keywords provided by Novartis:
|
HBeAg-positive, chronic hepatitis B telbivudine entecavir viral kinetics |
Additional relevant MeSH terms:
|
Hepatitis Hepatitis A Hepatitis B Hepatitis, Chronic Hepatitis B, Chronic Liver Diseases Digestive System Diseases Hepatitis, Viral, Human Virus Diseases Enterovirus Infections |
Picornaviridae Infections RNA Virus Infections Hepadnaviridae Infections DNA Virus Infections Entecavir Antiviral Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 21, 2013