A Phase 3, Randomized, Double-Blind Study to Evaluate the Safety and Efficacy of Tenofovir Alafenamide (TAF) 25 mg QD Versus Tenofovir Disoproxil Fumarate (TDF) 300 mg QD for the Treatment of HBeAg-Negative, Chronic Hepatitis B
Overview
- Phase
- Phase 3
- Intervention
- TAF
- Conditions
- HBeAg-negative Chronic Hepatitis B
- Sponsor
- Gilead Sciences
- Enrollment
- 426
- Locations
- 105
- Primary Endpoint
- Percentage of Participants With Hepatitis B Virus (HBV) DNA < 29 IU/mL
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The primary objective of this study is to compare the efficacy, safety, and tolerability of tenofovir alafenamide (TAF) versus tenofovir disoproxil fumarate (TDF) in treatment-naive and treatment-experienced adults with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection.
Detailed Description
Study GS-US-320-0108 is a multi-center clinical trial, planned to enroll participants in multiple countries, including China. However, due to the review timeline difference in China, full enrollment was reached in the main study before China was able to participate. Therefore, details for the China cohort was registered separately (NCT02836236) on ClinicalTrials.gov as the China cohort will not be part of the main study analysis.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Ability to understand and sign a written informed consent form, which must be obtained prior to initiation of study procedures.
- •Adult males and non-pregnant, non-lactating females.
- •Documented evidence of chronic HBV infection.
- •Hepatitis e antigen (HBeAg)-negative, chronic hepatitis B with all of the following:
- •HBeAg-negative and hepatitis B e antibody (HBeAb) positive at screening.
- •Screening HBV DNA ≥ 2 x 10\^4 IU/mL.
- •Screening serum alanine aminotransferase (ALT) level \> 60 U/L (males) or \> 38 U/L (females) and ≤ 10 x the upper limit of the normal range (ULN).
- •Treatment-naive participants (defined as \< 12 weeks of oral antiviral treatment with any nucleoside or nucleotide analogue), OR treatment-experienced participants (defined as participants meeting all entry criteria \[including HBV DNA and serum ALT criteria\] and with ≥ 12 weeks of previous treatment with any nucleoside or nucleotide analogue).
- •Previous treatment with interferon (pegylated or non pegylated) must have ended at least 6 months prior to Baseline.
- •Adequate renal function.
Exclusion Criteria
- •Females who are breastfeeding.
- •Males and females of reproductive potential who are unwilling to use an "effective", protocol-specified method(s) of contraception during the study.
- •Co-infection with hepatitis C virus, human immunodeficiency virus (HIV), or hepatitis D virus.
- •Evidence of hepatocellular carcinoma.
- •Any history of, or current evidence of, clinical hepatic decompensation.
- •Abnormal hematological and biochemical parameters, including aspartate aminotransferase (AST) \> 10 x ULN
- •Received solid organ or bone marrow transplant.
- •History of malignancy within the past 5 years, with the exception of specific cancers that are cured by surgical resection; individuals under evaluation for possible malignancy are not eligible.
- •Currently receiving therapy with immunomodulators (eg, corticosteroids), investigational agents, nephrotoxic agents, or agents capable of modifying renal excretion.
- •Individuals receiving ongoing therapy with drugs not to be used with tenofovir alafenamide or tenofovir disoproxil fumarate or individuals with a known hypersensitivity to study drugs, metabolites, or formulation excipients.
Arms & Interventions
TAF 25 mg
TAF + TDF placebo for 96 weeks (per amendment 1 \& 2) or 144 weeks (per amendment 3).
Intervention: TAF
TAF 25 mg
TAF + TDF placebo for 96 weeks (per amendment 1 \& 2) or 144 weeks (per amendment 3).
Intervention: TDF Placebo
TDF 300 mg
TDF + TAF placebo for 96 weeks (per amendment 1 \& 2) or 144 weeks (per amendment 3).
Intervention: TDF
TDF 300 mg
TDF + TAF placebo for 96 weeks (per amendment 1 \& 2) or 144 weeks (per amendment 3).
Intervention: TAF Placebo
Open-label TAF
All participants who complete the double-blind period (96 weeks or 144 weeks) will be eligible to receive open-label TAF until Week 384 of the study. After the end of study treatment, participants can either switch to commercially available anti-HBV treatments in their country or will be followed every 4 weeks, for up to 24 weeks off treatment (treatment-free follow-up (TFFU)) for safety assessment.
Intervention: TAF
Outcomes
Primary Outcomes
Percentage of Participants With Hepatitis B Virus (HBV) DNA < 29 IU/mL
Time Frame: Week 48
The primary efficacy endpoint was determined by the achievement of HBV DNA \< 29 IU/mL at Week 48.
Secondary Outcomes
- Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 48(Baseline, Week 48)
- Change From Baseline in Serum Creatinine at Week 48(Baseline, Week 48)
- Percent Change From Baseline in Spine BMD at Week 48(Baseline, Week 48)