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A Phase II Study to Determine the Safety and Efficacy of Interferon-gamma in Patients With Chronic Hepatitis B

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ClinicalTrials.gov Identifier: NCT00753467
Recruitment Status : Unknown
Verified September 2008 by Huntington Medical Research Institutes.
Recruitment status was:  Not yet recruiting
First Posted : September 16, 2008
Last Update Posted : October 21, 2010
Sponsor:
Collaborator:
InterMune
Information provided by:
Huntington Medical Research Institutes

Brief Summary:
Open-label, prospective, two part study evaluating IFN-γ 1b at a dose of 200μg by subcutaneous injection every day either alone or in combination with Adefovir dipivoxil or Adefovir dipivoxil alone at a dose of 10mg QD in patients with chronic Hepatitis B.

Condition or disease Intervention/treatment Phase
Hepatitis B Drug: IFN-γ 1b (Actimmune) Drug: Adefovir dipivoxil Drug: IFN-γ 1b and Adefovir dipivoxil combination Phase 2

Detailed Description:

After signing the informed consent potential patients will undergo a screening medical history, physical examination, and laboratory tests.

The study will consist of two parts:

  • Part A: IFN-γ 1b monotherapy
  • Part B: IFN-γ 1b combination therapy with Adefovir dipivoxil or Adefovir dipivoxil monotherapy

Patients will be enrolled sequentially into to one of three treatment groups. In Part A, ten patients will be enrolled and will receive IFN-γ 1b 200μg, administered every day by subcutaneous injection for 4 weeks. If HBV DNA is reduced by ≥ 1 log10 copies/ mL in ≥ 30% of patients the protocol will proceed to Part B.

In Part B, twenty patients will be enrolled into two cohorts (total of 10 for each cohort) and treated for four weeks. The two cohorts will be administered:

  • IFN-γ 1b 200μg, administered every day combination therapy with Adefovir dipivoxil (10mg QD) or
  • Adefovir dipivoxil (10mg QD) alone

On the initial study visit, patients will be given instruction on self injection of IFN-γ 1b (if applicable). Patients will be monitored for safety, tolerability, HBV DNA, clinical chemistries including a standard panel of liver tests and hematologies throughout the study and for the two week post-treatment observation period.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Protocol Title: A Phase II Open-labeled Study to Determine the Safety and Preliminary Efficacy of Interferon-gamma 1b (IFN-γ 1b) in Patients With Chronic Hepatitis B Who Are HBV DNA Positive
Study Start Date : September 2008
Estimated Primary Completion Date : August 2009
Estimated Study Completion Date : August 2009

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: 1
IFN-γ 1b monotherapy: 200 micro-grams daily for 30 days
Drug: IFN-γ 1b (Actimmune)
IFN-γ 1b: 200μg given SC ED = 2 vials of active drug (0.5 mL from each vial) will be mixed for a total volume of 1.0 mL per dose
Other Names:
  • Interferon gamma
  • Actimmune
  • Immune Interferon
  • IFN-gamma

Experimental: 2
IFN-γ 1b 200 micro-grams daily) combination therapy with Adefovir dipivoxil (10 mg daily) for 30 days
Drug: IFN-γ 1b and Adefovir dipivoxil combination
IFN-γ 1b: 200μg given SC ED = 2 vials of active drug (0.5 mL from each vial) will be mixed for a total volume of 1.0 mL per dose Adefovir dipivoxil: 1 tablet of 10mg given orally QD
Other Names:
  • Actimmune
  • Interferon gamma
  • IFN gamma
  • Immune Interferon
  • Hepsera

Active Comparator: 3
Adefovir dipivoxil monotherapy (10 mg QD) 30 days
Drug: Adefovir dipivoxil
Adefovir dipivoxil: 1 tablet of 10mg given orally QD
Other Name: Hepsera




Primary Outcome Measures :
  1. The primary objective is to evaluate the safety and tolerability of IFN-γ 1b either alone or in combination with Adefovir dipivoxil in patients with chronic Hepatitis B. [ Time Frame: 30 days ]

Secondary Outcome Measures :
  1. Evaluate the changes in serum HBV DNA concentrations following administration of Adefovir dipivoxil alone, IFN-γ 1b either alone or in combination with Adefovir dipivoxil in patients with chronic Hepatitis B. [ Time Frame: 30 days ]
  2. Evaluate the changes in liver tests and hematology following administration of Adefovir dipivoxil alone, IFN-γ 1b either alone or in combination with Adefovir dipivoxil in patients with chronic Hepatitis B. [ Time Frame: 30 days ]


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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Patients must fulfill all of the following criteria to be eligible for enrollment into the study:

  1. Men or women age 18 to 75 years
  2. Chronic hepatitis B infection based on a history of positive anti-HBsAg and positive for HBV DNA and with or without elevations in liver tests (test to be repeated on screening)

Exclusion Criteria:

Patients with any of the following will be excluded from randomization:

  1. Presence of clinically evident cirrhosis including: ascites requiring active diuretic therapy, history of or therapy for hepatic encephalopathy, or history of GI variceal bleeding
  2. Platelet count < 50,000/mm3
  3. Serum ALT level > 10 times upper limit of normal
  4. Alpha-fetoprotein level ≥ 200 ng/mL or alpha-fetoprotein level between 50-200 ng/mL in association with liver ultrasound or other radiographic abnormality suspicious for hepatic neoplasm
  5. Serum creatinine level > 1.6 mg/dL
  6. Hematology outside of specified limits: neutrophil count <1000/mm3, hemoglobin <10 g/dL in males and <9 g/dL in females
  7. Unstable or uncontrolled thyroid disease
  8. Treatment with any interferon-α or nucleoside/tide analog within the previous 4 weeks
  9. Presence of clinically significant cryoglobulinemia (e.g., skin rash, arthritis, or renal insufficiency due to cryoglobuliemia)
  10. Presence or history of autoimmune hepatitis, alpha-1 anti-trypsin deficiency, hemochromatosis, Wilson's disease, drug- or toxin-induced liver disease, alcohol-related liver disease, primary biliary cirrhosis, or sclerosing cholangitis (mild-to-moderate steatosis is acceptable)
  11. Chronic hepatitis C infection
  12. Hepatits Delta infection (HDV)
  13. Known history of HIV infection or positive HIV antibody test by Western Blot (test performed within 60 days of screening can be used to determine eligibility)
  14. A disease known to cause significant alteration in immunologic function including hematological malignancy or autoimmune disorder (e.g. rheumatoid arthritis, systemic lupus erythematosis, autoimmune thyroid disease, leukemia, lymphoma, etc)
  15. Concurrent therapy with immunosuppressive drugs or cytotoxic agents such as oral prednisone, cyclosporine, azathioprine, or chemotherapeutic agent(s) (e.g., cyclophosphamide, methotrexate, or cancer chemotherapy) or radiation therapy
  16. Behavior that suggests a significant risk of poor compliance including, but not limited to:

    1. Illicit drug abuse within the past 3 years
    2. Current or history of alcohol abuse within the past 2 years
  17. Prior treatment with IFN-γ 1b
  18. History of unstable or deteriorating cardiac disease, including but not limited to:

    1. Myocardial infarction, coronary artery bypass surgery, or angioplasty within the past 6 months
    2. Congestive heart failure requiring hospitalization within the past 6 months
    3. Uncontrolled arrhythmias
    4. Transient ischemic attacks (TIAs)
    5. Any cardiac condition that, in the opinion of the site PI, might be significantly exacerbated by flu-like symptoms associated with the administration of IFN γ 1b
  19. Preexisting (within last two years) or active psychiatric condition including severe depression, major psychoses, suicidal ideation or suicidal attempts
  20. History of (within last two years) or current neurologic or psychiatric disorder that, in the opinion of the site PI, might be exacerbated by flu-like symptoms associated with the administration of IFN γ 1b. In addition, patients with the following conditions should be excluded:

    1. History of multiple sclerosis
    2. Seizures within the past 2 years
  21. Severe or poorly controlled diabetes
  22. Pregnancy or lactation. Females of childbearing potential are required to have a negative urine pregnancy test prior to treatment and must agree to practice abstinence or prevent pregnancy by at least a barrier method of birth control for the duration of the study
  23. Hemoglobinopthies (e.g. thalassemia, sickle cell disease)
  24. Any serious or chronic disease that, in the opinion of the Principal Investigator (PI), may affect the assessment of safety or efficacy parameters. This includes, but is not limited to, patients with malignancy who are receiving chemotherapy, chronic obstructive pulmonary disease or asthma requiring maintenance oral steroids, or active kidney disease
  25. Any condition which, in the opinion of the site PI, is likely to result in the death of the patient within the next year
  26. Patients who, in the opinion of the site PI, are not suitable candidates for enrollment or would not comply with the requirements of the study
  27. Patients who have had a liver transplant
  28. Patients who have Adefovir mutations on baseline tests

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00753467


Locations
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United States, California
Huntington Medical Research Institutes
Pasadena, California, United States, 91105
Contact: Lori Tong, RN    626-397-5827    ltong@hmri.org   
Principal Investigator: Myron J Tong, PhD, MD         
Sponsors and Collaborators
Huntington Medical Research Institutes
InterMune
Investigators
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Study Chair: Myron J Tong, Phd, MD HMRI
Additional Information:
Publications of Results:

Other Publications:
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Responsible Party: Myron Tong, PhD, MD, HMRI
ClinicalTrials.gov Identifier: NCT00753467    
Other Study ID Numbers: TONG-HBV-0801
First Posted: September 16, 2008    Key Record Dates
Last Update Posted: October 21, 2010
Last Verified: September 2008
Keywords provided by Huntington Medical Research Institutes:
HBV
Treatment
Interferon-gamma
combination
Hepsera
Actimmune
HBV DNA
Additional relevant MeSH terms:
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Hepatitis A
Hepatitis B
Hepatitis B, Chronic
Hepatitis
Liver Diseases
Digestive System Diseases
Hepatitis, Viral, Human
Virus Diseases
Infections
Enterovirus Infections
Picornaviridae Infections
RNA Virus Infections
Blood-Borne Infections
Communicable Diseases
Hepadnaviridae Infections
DNA Virus Infections
Hepatitis, Chronic
Interferons
Adefovir
Adefovir dipivoxil
Interferon-gamma
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Reverse Transcriptase Inhibitors
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action