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This study is intended to confirm the efficacy, safety, pharmacokinetic (PK) profile, and the durability of hepatitis B virus surface antigen (HBsAg) suppression observed with bepirovirsen for 24 weeks (with loading doses) as compared to the placebo arm.

Phase 3
Conditions
Health Condition 1: D50-D89- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Registration Number
CTRI/2023/02/050043
Lead Sponsor
GSK Research & Development Limited
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Open to Recruitment
Sex
Not specified
Target Recruitment
0
Inclusion Criteria

Age: At least 18 years of age at the time of signing the informed consent.

Type of Participant and Disease Characteristics:

Participants must be HBeAg-negative at screening.

Participants who have documented chronic HBV infection more than equal to 6 months prior to Screening AND Currently receiving stable NA therapy defined as no changes to their NA regimen from at least 6 months prior to Screening and with no planned changes to the stable regimen over the duration of the study.

Plasma or serum HBsAg concentration >100 IU/mL, but no greater than 3000 IU/mL

Plasma or serum HBV DNA concentration must be adequately suppressed, defined as plasma or serum HBV DNA <90 IU/mL

Alanine aminotransferase (ALT) =2 x ULN

Participants who are willing and able to cease their NA treatment in accordance with the protocol.

Sex and Contraceptive/Barrier Requirements

A female participant is eligible to participate if she is not pregnant or breastfeeding, and 1 of the following conditions applies:

1 Is a woman of non-childbearing potential (WONCBP) as defined in Section 10.4 OR Is a WOCBP and using a contraceptive method (for a period of 28 days prior to enrollment [first dose of study drug]) that is highly effective (with a failure rate of <1% per year), preferably with low user dependency during the study intervention period and for at least 7 days after the last dose of study intervention and agrees not to donate eggs (ova, oocytes) for the purpose of reproduction during this period. The investigator should evaluate the potential for contraceptive method failure (e.g., noncompliance, recently initiated) in relationship to the first dose of study intervention.

A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 24 hours before the first dose of study intervention

If a urine test cannot be confirmed as negative (e.g., an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.

The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.

Informed Consent:

Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in this protocol.

Exclusion Criteria

Medical Conditions

1 Clinically significant abnormalities, aside from chronic HBV infection in medical

history (e.g., moderate-severe liver disease other than chronic HBV, acute coronary

syndrome within 6 months of screening, major surgery within 3 months of screening,

significant/unstable cardiac disease, uncontrolled diabetes, bleeding diathesis or

coagulopathy) or physical examination

Co-infection with:

a. Current history of Hepatitis C infection or participants that have been cured for

<12 months at the time of screening

b. Human immunodeficiency virus (HIV)

c. Hepatitis D virus

3 History of or suspected liver cirrhosis and/or evidence of cirrhosis as determined by

a. Both APRI >2 and FibroSure/FibroTest result >0.7

• If only 1 parameter (APRI or FibroSure/FibroTest) result is positive, a

discussion with the Medical Monitor is required before inclusion in study is permitted

b Regardless of APRI of Fibrosure/FibroTest score, if the participant meets 1 of the

following criteria documented from their medical history, they will be excluded

from the study

Liver biopsy (i.e., Metavir Score F4)

• Liver stiffness >12 kPa

4 Diagnosed or suspected hepatocellular carcinoma as evidenced by the following

a. Alpha-fetoprotein concentration =200 ng/mL

b. If the screening alpha fetoprotein concentration is =50 ng/mL and <200 ng/mL,

the absence of liver mass must be documented by imaging within 6 months before randomization

5. History of malignancy within the past 5 years with the exception of specific cancers

that are cured by surgical resection (e.g., skin cancer). Participants under evaluation

for possible malignancy are not eligible.

6. History of vasculitis or presence of symptoms and signs of potential vasculitis

(e.g., vasculitic rash, skin ulceration, repeated blood detected in urine without

identified cause) or history/presence of other diseases that may be associated with

vasculitis condition (e.g., systemic lupus erythematosus, rheumatoid arthritis,

relapsing polychondritis, mononeuritis multiplex)

7. History of extrahepatic disorders possibly related to HBV immune conditions

(e.g., nephrotic syndrome, any type of glomerulonephritis, polyarteritis nodosa,

cryoglobulinemia, uncontrolled hypertension)

8. History of alcohol or drug abuse/dependence

a. Current alcohol use as judged by investigator to potentially interfere with

participant compliance

b. History of or current drug abuse/dependence as judged by the investigator to

potentially interfere with participant compliance

i. Refers to illicit drugs and substances with abuse potential. Medications

that are used by the participant as directed, whether over-the-counter or through prescription, are acceptable and would not meet the exclusion criteria

Prior/Concomitant Therapy:

9 Currently taking, or took within 3 months of screening, any immunosuppressing

drugs (e.g., prednisone), other than a short course of therapy (=2 weeks) or topical/inhaled steroid use.

10. Participants to whom immunosuppressive treatment, including therapeutic doses of

steroids is contraindicated, should not be considered for enrolment in the study.

11. Currently taki

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The number of participants who achieved FC after discontinuation of all chronic HBV treatment (bepirovirsen/placebo and NA) in the absence of rescue medication will be reported. The FC for HBV is defined as Sustained suppression (24 weeks or longer) of HBV DNA (LLOQ) off all HBV treatment with HBsAg loss (0.05 IU/mL) with or without HBsAb after a finite duration of therapy.Timepoint: Upto 72 Weeks
Secondary Outcome Measures
NameTimeMethod
umber of participants achieving FC with baseline HBsAg =3000 IU/mL. <br/ ><br> <br/ ><br>Timepoint: Upto 72 weeks;Number of participants achieving sustained suppression of HBV DNA (LLOQ) with baseline HBsAg =1000 IU/mLTimepoint: Upto 72 weeks
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