A Phase 2a, Randomized, Partially-blind, Placebo-controlled Study to Assess the Efficacy, Safety, and Pharmacokinetics of Treatment With Multiple Doses of JNJ-56136379 as Monotherapy and in Combination With a Nucleos(t)Ide Analog in Subjects With Chronic Hepatitis B Virus Infection
Overview
- Phase
- Phase 2
- Intervention
- JNJ-56136379
- Conditions
- Hepatitis B
- Sponsor
- Janssen Sciences Ireland UC
- Enrollment
- 232
- Locations
- 76
- Primary Endpoint
- Change From Baseline in Hepatitis B Surface Antigen (HBsAg) Levels in Currently Not Treated Population at Week 24
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The main purpose of this study is to evaluate efficacy of 24 weeks of study treatment, in terms of changes in hepatitis B surface antigen (HBsAg) levels.
Detailed Description
The main study consists of 2-parts and each part will consist of 2 types of Chronic Hepatitis B-infected participant populations. Each part of the study will consist of screening phase (up to 8 weeks), treatment phase (24 weeks or 48 weeks, depending on treatment response), and post-treatment follow-up phase (24 weeks or 48 weeks, depending on treatment response). The duration of individual participation will be up to approximately 56 weeks (participants not eligible to continue treatment in extension phase), up to 80 weeks (participants continuing treatment in extension phase but not meeting treatment completion criteria), or up to 104 weeks (participants meeting treatment completion criteria). The safety and efficacy will be monitored throughout the study. In a separate substudy, at selected clinical sites, percutaneous core liver biopsy will be performed to evaluate changes of intrahepatic viral parameters.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Participants must have a body mass index (weight in kilogram (kg) divided by the square of height in meters) of 18.0 to 35.0 kilogram / square meter (kg/m\^2), extremes included
- •Participants must have chronic hepatitis B virus infection (CHB) infection documented by: Serum hepatitis B surface antigen (HBsAg)-positive at screening and serum HBsAg- or hepatitis B virus (HBV) deoxyribonucleic acid (DNA)-positive at least 6 months prior to screening; Serum immunoglobulin M (IgM) anti- hepatitis B core-related (HBc) antibody negative at screening
- •In participants currently not being treated (Treatment Arms 1-2-3 and 6-7-8): Participants must not be receiving any CHB treatment at screening, that is, Have never received treatment with HBV antiviral medicines, including NAs or interferon (IFN) products, OR Have not been on treatment with HBV antiviral medicines, including nucleos(t)ide analog (NA)s or IFN products within 6 months prior to baseline (first intake of study drugs), and participants must be HBeAg-positive and have HBV DNA greater than or equal to (\>=) 20,000 International Units Per Milliliter (IU/mL), OR be hepatitis B e antigen (HBeAg)-negative and have HBV DNA \>=2,000 IU /mL at screening, and participants must have HBsAg greater than (\>) 250 IU/mL at screening, and participants must have alanine aminotransferase (ALT) \> upper limit of normal (ULN) and less than or equal to (\<=) 5 \* ULN at screening, determined in the central laboratory
- •In virologically suppressed participants (Treatment Arms 4-5 and 9-10): Participants must be virologically suppressed by current NA treatment (entecavir (ETV) or tenofovir disoproxil fumarate (TDF)) as defined by HBV DNA less than (\<) 60 IU/mL at screening and at least 6 months prior to screening, and participants must be on the same NA treatment (ETV or TDF) and the same dose for \>=12 months prior to screening, and participants must have HBsAg \> 250 IU/mL at screening, and participants must have ALT \<=2\*ULN at screening
- •Participants must have: A liver biopsy result classified as Metavir F0-F2 within 1 year prior to screening or at the time of screening, OR FibroScan liver stiffness measurement \<8.0 kilopascal (kPa) within 6 months prior to screening or at the time of screening
Exclusion Criteria
- •Main Study:
- •Participants who test positive for anti-hepatitis B surface (HBs) antibodies
- •Participants with current hepatitis A virus infection (confirmed by hepatitis A antibody immunoglobulin M \[IgM\]), hepatitis D virus (HDV) infection (confirmed by HDV antibody), hepatitis E virus infection (confirmed by hepatitis E antibody IgM), or human immunodeficiency virus (HIV)-1 or HIV-2 infection (confirmed by antibodies) at screening; participants with a history of or current HCV infection (confirmed by HCV antibody). Evidence of other active infection (bacterial, viral, fungal, including acute tuberculosis) deemed clinically relevant by the investigator that would interfere with study conduct or its interpretation will also lead to exclusion
- •Participants with any evidence of hepatic decompensation at any time point prior to or at the time of screening: Direct bilirubin \>1.2\* ULN, or International normalized ratio (INR) \>1.5\* ULN, or Serum albumin \< lower limit of normal (LLN), or documented history or current evidence of variceal bleeding, ascites, or hepatic encephalopathy
- •Participants with a history of cardiac arrhythmia (example, extrasystoli, tachycardia at rest), history of risk factors for Torsades de Pointes syndrome (example, hypokalemia, family history of long QT syndrome) or history or other clinical evidence of significant or unstable cardiac disease (example, angina, congestive heart failure, myocardial infarction, diastolic dysfunction, significant arrhythmia, coronary heart disease, and/or clinically significant 12 lead electrocardiograms (ECGs) abnormalities), moderate to severe valvular disease, or uncontrolled hypertension at screening
- •Participants with contraindications to the use of ETV or TDF per local prescribing information
- •Presence of coagulopathy or hemoglobinopathy (including sickle cell disease, thalassemia)
- •Use of any anti-coagulant, anti-platelet, or non-steroidal anti-inflammatory drug medications from 10 days before until 5 days after each liver biopsy
- •Presence of ascites, focal liver lesions, and other findings that would be contraindications for liver biopsies
Arms & Interventions
Part A: Arm 1 (JNJ-56136379 or NA) (open label)
Participants with hepatitis B virus (HBV) currently not being treated and receiving JNJ-56136379 tablet (at a lower dose) orally for 24 weeks, will stop further dosing with JNJ-56136379 and start treatment with nucleos(t)ide analog (NA) (entecavir \[ETV\] or tenofovir disoproxil fumarate \[TDF\]), and enter the 24 week post treatment follow-up phase.
Intervention: JNJ-56136379
Part A: Arm 1 (JNJ-56136379 or NA) (open label)
Participants with hepatitis B virus (HBV) currently not being treated and receiving JNJ-56136379 tablet (at a lower dose) orally for 24 weeks, will stop further dosing with JNJ-56136379 and start treatment with nucleos(t)ide analog (NA) (entecavir \[ETV\] or tenofovir disoproxil fumarate \[TDF\]), and enter the 24 week post treatment follow-up phase.
Intervention: NA (ETV or TDF)
Part A: Arm 2 (Placebo+NA [ETV] or [TDF])
Participants with HBV currently not being treated will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: Placebo
Part A: Arm 2 (Placebo+NA [ETV] or [TDF])
Participants with HBV currently not being treated will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part A: Arm 3 (JNJ-56136379 + NA [ETV or TDF])
Participants with HBV currently not being treated will receive JNJ-56136379 along with NA (ETV or TDF) tablet orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: JNJ-56136379
Part A: Arm 3 (JNJ-56136379 + NA [ETV or TDF])
Participants with HBV currently not being treated will receive JNJ-56136379 along with NA (ETV or TDF) tablet orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part A: Arm 4 (Placebo + NA [ETV or TDF])
Virologically suppressed participants will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: Placebo
Part A: Arm 4 (Placebo + NA [ETV or TDF])
Virologically suppressed participants will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part A: Arm 5 (JNJ-56136379 + NA [ETV or TDF])
Virologically suppressed participants will receive JNJ-56136379 along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: JNJ-56136379
Part B: Arm 6 (JNJ-56136379 + NA [ETV or TDF]) (open label)
Participants with HBV currently not being treated will receive JNJ-56136379 tablet at a high dose, orally for 24 weeks. The eligible participants may enter the extension phase and will receive JNJ-56136379 along with NA (ETV or TDF) from Week 24 to Week 48.
Intervention: NA (ETV or TDF)
Part A: Arm 5 (JNJ-56136379 + NA [ETV or TDF])
Virologically suppressed participants will receive JNJ-56136379 along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part B: Arm 6 (JNJ-56136379 + NA [ETV or TDF]) (open label)
Participants with HBV currently not being treated will receive JNJ-56136379 tablet at a high dose, orally for 24 weeks. The eligible participants may enter the extension phase and will receive JNJ-56136379 along with NA (ETV or TDF) from Week 24 to Week 48.
Intervention: JNJ-56136379
Part B: Arm 7 (placebo + NA [ETV or TDF])
Participants with HBV currently not being treated will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: Placebo
Part B: Arm 7 (placebo + NA [ETV or TDF])
Participants with HBV currently not being treated will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part B: Arm 8 (JNJ-56136379 + NA [ETV or TDF])
Participants with HBV currently not being treated will receive JNJ-56136379 tablet at a high dose along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: JNJ-56136379
Part B: Arm 8 (JNJ-56136379 + NA [ETV or TDF])
Participants with HBV currently not being treated will receive JNJ-56136379 tablet at a high dose along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part B: Arm 9 (placebo + NA [ETV or TDF])
Virologically suppressed participants will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: Placebo
Part B: Arm 9 (placebo + NA [ETV or TDF])
Virologically suppressed participants will receive matching placebo along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Part B: Arm 10 (JNJ-56136379 + NA [ETV or TDF])
Virologically suppressed participants will receive JNJ-56136379 tablet at a high dose along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: JNJ-56136379
Part B: Arm 10 (JNJ-56136379 + NA [ETV or TDF])
Virologically suppressed participants will receive JNJ-56136379 tablet at a high dose along with NA (ETV or TDF) tablets orally for 24 weeks. The eligible participants may enter the extension phase and will continue study drugs up to 48 weeks.
Intervention: NA (ETV or TDF)
Outcomes
Primary Outcomes
Change From Baseline in Hepatitis B Surface Antigen (HBsAg) Levels in Currently Not Treated Population at Week 24
Time Frame: Baseline and Week 24
Change from baseline in HBsAg levels in currently not treated population at Week 24 based on Hepatitis B e Antigen (HBeAg) status was reported. Currently not treated population defined as participants who didn't receive any hepatitis B virus (HBV) treatment 6 months prior to baseline.
Change From Baseline in HBsAg Levels in Virologically Suppressed Population at Week 24
Time Frame: Baseline and Week 24
Change from baseline in HBsAg levels in virologically suppressed population at Week 24 based on HBeAg status was reported. Virologically suppressed population defined as participants who were on entecavir (ETV) or tenofovir disoproxil fumarate (TDF) for at least 12 months prior to screening and had HBV deoxyribonucleic acid (DNA) \<60 IU/mL. This outcome measure was planned to be analyzed for specified arms only.
Secondary Outcomes
- Percentage of Participants With HBsAg Seroclearance in Virologically Suppressed Population(Weeks 24 and 48)
- Change From Baseline in HBsAg Levels in Virologically Suppressed Population Over Time(Weeks 24, 48 and Follow-up Week 24)
- Change From Baseline in HBV DNA Levels in Virologically Suppressed Population(Baseline up to Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With Undetectable HBV DNA Levels in Currently Not Treated Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With HBsAg Seroclearance in Currently Not Treated Population(Weeks 24 and 48)
- Percentage of Participants With Normalized Alanine Aminotransferase (ALT) Levels in Currently Not Treated Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With Normalized ALT Levels in Virologically Suppressed Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With Virological Breakthrough in Virologically Suppressed Population(Weeks 24 and 48)
- Number of Participants With Serious Adverse Events (SAEs)(Up to Week 80)
- Percentage of Participants With >0.5 log10 IU/mL or >1 log10 IU/mL Reduction in HBsAg From Baseline in Virologically Suppressed Population(Weeks 24, 48 and Follow-up Week 24)
- Change From Baseline in HBeAg Levels in Virologically Suppressed Population(Baseline up to Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With >0.5 log10 IU/mL and >1 log10 IU/mL Reduction in HBeAg From Baseline in Virologically Suppressed Population(Weeks 24, 48 and Follow-up Week 24)
- Plasma Concentrations of ETV in Virologically Suppressed Population(Day 1: 0 hours, 2 hours; Weeks 1, 2, 4, 8, 12, 20, 24, 28, 32, 36, 44, 48: 0 hours; Follow-up: Weeks 2 and 4)
- Plasma Concentrations of JNJ-56136379 in Currently Not Treated Population(Day 1: 0 hours, 2 hours; Weeks 1, 2, 4, 8, 12, 20, 24, 28, 32, 36, 44, 48: 0 hours; Follow-up: Weeks 2 and 4)
- Number of Participants With Treatment- Emergent Adverse Events (AEs)(Up to Week 48)
- Percentage of Participants With HBsAg Levels <1,000 or <100 IU/mL in Virologically Suppressed Population(Weeks 24, 48 and Follow-up Week 24)
- Change From Baseline in Hepatitis B Virus (HBV) Deoxyribonucleic Acid (DNA) Levels in Currently Not Treated Population(Baseline up to Weeks 24, 48 and Follow-up Week 24)
- Change From Baseline in HBeAg Levels in Currently Not Treated Population(Baseline up to Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With HBsAg Seroconversion in Currently Not Treated Population(Weeks 24 and 48)
- Percentage of Participants With HBsAg Seroconversion in Virologically Suppressed Population(Weeks 24 and 48)
- Plasma Concentrations of TDF in Virologically Suppressed Population(Day 1: 0 hours, 2 hours; Weeks 1, 2, 4, 8, 12, 20, 24, 28, 32, 36, 44, 48: 0 hours; Follow-up: Weeks 2 and 4)
- Number of Participants With Clinically Significant Changes in Vital Signs, Physical Examinations, Electrocardiogram (ECG), and Clinical Laboratory Tests(Up to Week 80)
- Change From Baseline in HBsAg Levels in Currently Not Treated Population Over Time(Weeks 24, 48 and Follow-up Week 24)
- Plasma Concentrations of JNJ-56136379 in Virologically Suppressed Population(Day 1: 0 hours, 2 hours; Weeks 1, 2, 4, 8, 12, 20, 24, 28, 32, 36, 44, 48: 0 hours; Follow-up: Weeks 2 and 4)
- Number of Participants With Treatment-Associated Mutations(From Week 0 to Week 24, From Week 25 to Week 48, Up to Follow-up Week 24)
- Percentage of Participants With HBsAg Levels Less Than (<) 1,000 or <100 International Units Per Milliliter (IU/mL) in Currently Not Treated Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With Greater Than (>) 0.5 log10 IU/mL or >1 log10 IU/mL Reduction in HBsAg From Baseline in Currently Not Treated Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With Undetectable HBV DNA Levels in Virologically Suppressed Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With >0.5 log10 IU/mL and >1 log10 IU/mL Reduction in HBeAg From Baseline in Currently Not Treated Population(Weeks 24, 48 and Follow-up Week 24)
- Percentage of Participants With Virological Breakthrough in Currently Not Treated Population(Weeks 24 and 48)
- Plasma Concentrations of Entecavir [ETV] in Currently Not Treated Population(Day 1: 0 hours, 2 hours; Weeks 1, 2, 4, 8, 12, 20, 24, 28, 32, 36, 44, 48: 0 hours; Follow-up: Weeks 2 and 4)
- Plasma Concentrations of Tenofovir Disoproxil Fumarate (TDF) in Currently Not Treated Population(Day 1: 0 hours, 2 hours; Weeks 1, 2, 4, 8, 12, 20, 24, 28, 32, 36, 44, 48: 0 hours; Follow-up: Weeks 2 and 4)