MedPath

Regression of Liver Fibrosis by Tenofovir Alafenamide (TAF)

Phase 4
Active, not recruiting
Conditions
Chronic Hepatitis B
Interventions
Registration Number
NCT04939441
Lead Sponsor
Jidong Jia
Brief Summary

Tenofovir alafenamide (TAF) is a new prodrug of tenofovir developed to treat patients with chronic hepatitis B virus (HBV) infection. Whereas, the long-term effect of TAF to liver fibrosis is still unknown. Here, we enrolled treatment naive CHB patients with biopsy-proven significant fibrosis (METAVIR fibrosis stage ≥ F2). All enrolled subjects will be treated with TAF monotherapy for 96 weeks. After 96 weeks of therapy, the second liver biopsy will be performed to evaluate the rate of liver fibrosis regression. During this study, all subjects will be assessed for laboratory tests, imaging examination at baseline, first 12-week and every 24-week during follow-up.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • 18-69 years old (inclusive);
  • BMI (18-30 kg/m2);
  • Chronic hepatitis B virus (HBV) infection, defined as positive serum hepatitis B s-antigen (HBsAg) for more than 6 months; or chronic hepatitis B proven by live biopsy;
  • Not received nucleoside (acid) analogue and/or interferon therapy (treatment-naive);
  • Liver biopsy performed within 6 months before treatment and had readable biopsy slides or agrees to have a biopsy performed prior to baseline;
  • METAVIR fibrosis stage ≥ F2;
  • For patients without cirrhosis (F2/3), HBV DNA levels >2000 IU/mL before treatment; For patients with cirrhosis (F4), HBV DNA >20 IU/mL before treatment;
  • ALT≤10 ULN before treatment;
  • Creatinine clearance ≥ 50 mL/min;
  • Agreement not to undertake other HBV systemic antiviral or interferon (IFN) regimens during participation in this study;
  • Willing and able to provide written informed consent.
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Exclusion Criteria
  • Patients with Child-Turcotte-Pugh(CTP)score ≥ 7;
  • Patients with decompensated cirrhosis: including ascites, hepatic encephalopathy, esophageal varices bleeding or other complications of decompensated cirrhosis or liver transplantation;
  • Patients co-infection with hepatitis C virus (HCV), human immunodeficiency virus (HIV), or hepatitis delta virus (HDV), or alcoholic liver diseases, autoimmune liver disease, genetic liver disease, drug-induced liver injury, non-alcoholic fatty liver disease or other chronic liver diseases;
  • Patients with evidence of hepatocellular carcinoma (HCC) by imaging with or without AFP;
  • Patients with other uncured malignant tumors;
  • Patients with organ or bone marrow transplantation;
  • Patients currently receiving therapy with immunomodulators (eg, corticosteroids, etc.), investigational agents, nephrotoxic agents, or agents susceptible of modifying renal excretion;
  • Patients who are allergic to any component of TAF;
  • Patients who recently or newly started bisphosphate (within 1 month);
  • Patients with active alcohol or drug abuse or history of alcohol or drug abuse (hinder compliance with treatment, or participation in the study or interpretation of results considered by the Investigator);
  • Patients with significant renal, cardiovascular, pulmonary, or neurological disease
  • Males and females of reproductive potential who are unwilling to use an effective method of contraception during the study;
  • Pregnant women, women who are breast feeding or who believe they may wish to become pregnant during the course of the study;
  • Not suitable for this study identified by researchers.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
TAF groupTenofovir alafenamideTAF \[Vemlidy® 25mg QD\] monotherapy
Primary Outcome Measures
NameTimeMethod
Proportion of patients with fibrosis regressionWeek 96

Fibrosis stage decrease at least 1 point by Ishak score or "Predominantly Regressive" by "Beijing classification"

HBV DNA undetectable rateWeek 96

Serum HBV DNA \<20 IU/mL

Secondary Outcome Measures
NameTimeMethod
Percentage of liver stiffness decrease >= 30%Week 48 and Week 96

Proportion of patients with liver stiffness decrease \>= 30% from baseline to week 48 and 96

ALT normalization rateWeek 48 and Week 96

Proportion of patients with ALT \<= 1.0xULN

HBeAg and HBsAg loss and seroconversion rateWeek 48 and Week 96

Proportions of patients with HBsAg loss and seroconversion to anti-HBs, and proportions of patients with HBeAg loss and seroconversion to anti-HBe.

Changes in renal functionWeek 48 and Week 96

Changes of eGFR (estimated Glomerular Filtration rate) from baseline to week 48 and 96

HBV DNA undetectable rateWeek 24, Week 48 and Week 72

HBV DNA undetectable rate at week 24, 48, and 72

Incidence of liver-related endpoint eventsWeek 96

liver-related endpoint events: decompensation, HCC, liver transplantation, liver-related death

Changes of bone mineral densityWeek 48 and Week 96

Percentage changes in spine BMD and hip BMD from baseline to week 48 and 96

Trial Locations

Locations (7)

Ruijin Hospital

🇨🇳

Shanghai, Shanghai, China

Beijing Ditan Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Shuguang Hospital

🇨🇳

Shanghai, Shanghai, China

Shanghai East Hospital

🇨🇳

Shanghai, Shanghai, China

Huashan Hospital Fudan University

🇨🇳

Shanghai, Shanghai, China

Tianjin Third Central Hospital

🇨🇳

Tianjin, Tianjin, China

Tianjin Second People's Hospital

🇨🇳

Tianjin, Tianjin, China

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