The Efficacy and Safety of Tenofovir Amibufenamide to Treat Low-level Viraemia After Entecavir Treatment
- Conditions
- Chronic Hepatitis B
- Interventions
- Drug: TMF
- Registration Number
- NCT05755776
- Brief Summary
The goal of this observational study is to explore the efficacy and safety of Tenofovir Amibufenamide (TMF) in Entecavir (ETV) treated chronic hepatitis B patients with low-level viraemia. The main question it aims to answer is:
* The efficacy and safety of TMF in chronic hepatitis B patients with low-level viraemia.
* What is the appropriate treatment for ETV treated chronic hepatitis B patients with low-level viraemia.
Participants will choose to maintain their original regimen (ETV) or switch to TMF After being fully informed of the benefits and risks of treatment.
Researchers will compare ETV and TMF to see if there is a difference in the efficacy of the two drugs in chronic hepatitis B patients with low-level viraemia.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 204
- Must be able to understand and sign a written informed consent, which must be obtained prior to screening.
- Male and non-pregnant, non-lactating female subjects who have reached the age of 18-65 years (based on the date of signed informed consent). Female subjects of childbearing age with a negative serum pregnancy test.
- Documented signs of chronic HBV infection (e.g., HBsAg positive for more than 6 months.
- Subjects treated with ETV over 1 year will be able to be enrolled in the study.
- Subjects with 20 ≤ HBV-DNA < 2000 IU/mL at screening (including intermittent and continuous low-level viraeima).
- Must be willing and able to comply with all study requirements.
- Female patients who are pregnant or breastfeeding or who plan to become pregnant during the study period.
- Men and women of childbearing potential who are unwilling to use an "effective" method of contraception as defined in the protocol during the study period.
- Co-infection with HAV HCV, HIV, HDV or HEV; or co-infection with autologous liver, metabolism-related fatty liver, or drug-induced liver injury.
- Diagnosis of hepatocellular carcinoma by imaging (with evidence of hepatocellular carcinoma)
- Patients who have received a solid organ or bone marrow transplant
- History of malignancy within 5 years prior to screening, except for specific tumors cured by surgical resection (basal cell dermal skin cancer, etc.); patients evaluated for probable malignancy were ineligible.
- Currently receiving treatment with immunomodulators (e.g., corticosteroids), investigational drugs, nephrotoxic drugs, or drugs capable of regulating renal excretion. Drugs that modulate renal excretion.
- Renal, cardiovascular, pulmonary, or neurological disease that is considered severe by the investigator.
- Severe bone disease (e.g., osteochondrosis, chronic osteomyelitis, osteogenesis imperfecta, chondromalacia) or multiple fractures.
- Subjects receiving a contraindicated combination drug (subjects receiving a contraindicated drug require a minimum 30-day washout period) and known hypersensitivity reactions to study drugs, metabolites or formulation excipients.
- Current alcohol or drug abuse that, in the investigator's judgment, may interfere with the subject's compliance with study requirements.
- Any other clinical condition that, in the opinion of the investigator, would render the subject unsuitable for the study or unable to comply with the dosing requirements medical condition or prior treatment.
- Prior or existing clinical liver failure (Child-Pugh score ≥ grade B).
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description TMF group TMF Participants in this group will switch to TMF 25 mg, daily until the end of the study.
- Primary Outcome Measures
Name Time Method The proportions of undetectable HBV DNA in patients treated with ETV and TMF at week 48. 48 weeks Undetectable HBV DNA is defined as below 20 IU/mL.
- Secondary Outcome Measures
Name Time Method The proportions of undetectable pgRNA in patients treated with ETV and TMF at week 24 and 48. 24 weeks and 48 weeks Undetectable pgRNA is defined as below 100 pg/mL.
The proportions of undetectable HBV DNA in patients treated with ETV and TMF at week 24. 24 weeks Undetectable HBV DNA is defined as below 20 IU/mL.
The proportions of ALT normalization in patients treated with ETV and TMF at week 24 and 48. 24 weeks and 48 weeks There are two criteria for ALT normalization. Criteria1: below 40 U/L. Criteria2: Males: ALT\<30U/L, female: ALT\<19U/L.
Comparing pgRNA levels from baseline at week 24 and 48. 24 weeks and 48 weeks Comparing HBcrAg levels from baseline at week 24 and 48. 24 weeks and 48 weeks Comparing degree of liver fibrosis from baseline at week 24 and 48. 24 weeks and 48 weeks Evaluation of liver fibrosis including Fibroscan, APRI and FIB-4.
The proportions of undetectable HBcrAg in patients treated with ETV and TMF at week 24 and 48. 24 weeks and 48 weeks Comparing the change of creatinine clearance rate from baseline at week 24 and 48. 24 weeks and 48 weeks The types, incidence and severity of adverse events and serious adverse events during treatment were evaluated in both groups Week 48
Trial Locations
- Locations (13)
Chongqing University Three Gorges Central Hospital
🇨🇳Chongqing, China
Shuguang Hospital, Shanghai, China.
🇨🇳Shanghai, China
The Sixth People's Hospital of Shenyang
🇨🇳Shenyang, China
Shanghai East Hospital
🇨🇳Shanghai, China
Hepatobiliary disease of Jilin Province
🇨🇳Jilin, China
The Fourth People's Hospital of Zibo
🇨🇳Zibo, China
The Second Affiliated Hospital of Chongqing Medical University
🇨🇳Chongqing, Chongqing, China
Affiliated Hospital of Guangxi Medical University
🇨🇳Guangxi, China
The First People's Hospital of Yunnan Province
🇨🇳Kunming, China
Nanjing Second Hospital
🇨🇳Nanjing, China
the Second People's Hospital of Yunnan Province
🇨🇳Kunming, China
The First People's Hospital of Taicang
🇨🇳Taicang, China
The Second Hospital of Ningbo
🇨🇳Ningbo, China