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A Trial To Evaluate The Efficacy And Safety Of Multiple Combination Therapies In Participants With Chronic Hepatitis B

Phase 2
Completed
Conditions
Hepatitis B, Chronic
Interventions
Drug: Nucleos(t)ide (NUC)
Drug: CpAM (RO7049389)
Drug: TLR7 (RO7020531)
Drug: siRNA (RO7445482)
Drug: PD-L1 LNA (RO7191863)
Drug: PEG-IFN
Registration Number
NCT04225715
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This is a study designed to evaluate the safety, tolerability and efficacy of New Molecular Entity (NME) combination therapies in Chronic Hepatitis B (CHB) participants with preserved liver function and without significant fibrosis/cirrhosis. The platform design allows comparison of multiple NME combination therapies against a common control, and introduction of additional treatment arms at later study time points. Each arm will consist of a screening phase (up to 8 weeks), treatment phase (up to 48 weeks) and post-treatment follow-up phase (48 weeks). The safety and efficacy will be monitored throughout the study.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
281
Inclusion Criteria
  • Body mass index between 18 and 32 kg/m2 inclusive.
  • Participants with Chronic Hepatitis B (CHB) infection (HBsAg positive for >=6 months) who are on established NUC (entecavir or tenofovir alafenamide/disoproxil fumarate) monotherapy for >=12 months, having received the same NUC therapy for >=3 months prior to screening.
  • HBV DNA below the lower LLOQ or < 20 IU/mL for > 6 months prior to screening and confirmed at screening.
  • Alanine transaminase (ALT) <=1.5 x upper limit of normal (ULN) for > 6 months prior to screening and confirmed at screening.
  • Female Participants: Eligible to participate if she is not pregnant, not breastfeeding and agrees to remain abstinent (refrain from heterosexual intercourse) or use highly effective contraceptive methods.
  • Male Participants: During the treatment period and for at least 6 months after the final dose of study treatment, agrees to remain abstinent (refrain from heterosexual intercourse), use contraceptive measures and refrain from donating sperm.
Exclusion Criteria
  • Pregnant or lactating women.
  • Co-infection with other pathogens such as Hepatitis A, C, D and E or Human Immunodeficiency Virus (HIV).
  • History of cirrhosis or current evidence of significant liver fibrosis or cirrhosis or decompensated liver disease.
  • History of or suspicion of Hepatocellular Carcinoma (HCC).
  • Thyroid disease poorly controlled on prescribed medications or clinically relevant abnormal thyroid function tests.
  • Clinically significant disease other than CHB that, in the opinion of the Investigator, makes the participant unsuitable for the study.
  • Pre-existing cardiac disease that in the opinion of the investigator would increase the risk for the participant to take part in the study.
  • History of alcohol abuse and/or drug abuse within one year of randomization.
  • History of having received (in the last 6 months) or currently receiving any systemic antineoplastic (including radiation) or immunosuppressive (including biologic immunosuppressors) or immune modulating treatment.
  • Currently taking, or have received within 3 months of Day 1, systemic corticosteroids.
  • Electrocardiogram (ECG) with clinically significant abnormalities.
  • Previous treatment with an investigational agent for Hepatitis B (HBV) within 6 months prior to screening.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Core Protein Allosteric Modulator (CpAM; RO7049389) + Toll-like Receptor 7 (TLR7;RO7020531) + NUCTLR7 (RO7020531)Participants will receive RO7049389 (600 mg once daily \[QD\]) in addition to their background NUC therapy for the 48-week treatment period. RO7020531 (150 mg once every other day \[QOD\]) will be administered during Weeks 1-12 and Weeks 25-36. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
Nucleos(t)ide (NUC) Control ArmNucleos(t)ide (NUC)Participants will continue their background NUC therapy for the 48-week treatment period. At the end of the treatment period, in line with current CHB treatment guidelines, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + TLR7 (RO7020531) + NUCNucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. RO7020531 (150 mg QOD) will be administered during Weeks 13-24 and Weeks 37-48 (i.e., 2 treatment cycles of 12 weeks' duration each and 42 doses of RO7020531 for each cycle). At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + TLR7 (RO7020531) + NUCTLR7 (RO7020531)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. RO7020531 (150 mg QOD) will be administered during Weeks 13-24 and Weeks 37-48 (i.e., 2 treatment cycles of 12 weeks' duration each and 42 doses of RO7020531 for each cycle). At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + TLR7 (RO7020531) + NUCsiRNA (RO7445482)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. RO7020531 (150 mg QOD) will be administered during Weeks 13-24 and Weeks 37-48 (i.e., 2 treatment cycles of 12 weeks' duration each and 42 doses of RO7020531 for each cycle). At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
Short Interfering Ribonucleic acid (siRNA; RO7445482) (Dose1) + NUCNucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 1) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
Core Protein Allosteric Modulator (CpAM; RO7049389) + Toll-like Receptor 7 (TLR7;RO7020531) + NUCCpAM (RO7049389)Participants will receive RO7049389 (600 mg once daily \[QD\]) in addition to their background NUC therapy for the 48-week treatment period. RO7020531 (150 mg once every other day \[QOD\]) will be administered during Weeks 1-12 and Weeks 25-36. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA(RO7445482)+ Programmed Death Ligand-1 Locked Nucleic Acid (PD-L1 LNA; RO7191863) + NUC [1]PD-L1 LNA (RO7191863)Participants will receive RO7445482 (Dose 2) during Weeks 1-24 and RO7191863 (Dose 1) will be administered during Weeks 13-24, in addition to their background NUC therapy for the 24-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + PD-L1 LNA (RO7191863) + NUC [2]siRNA (RO7445482)Participants will receive RO7445482 (Dose 2) during Weeks 1-24 and RO7191863 (Dose 1) will be administered during Weeks 25-36, in addition to their background NUC therapy for the 36-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
Core Protein Allosteric Modulator (CpAM; RO7049389) + Toll-like Receptor 7 (TLR7;RO7020531) + NUCNucleos(t)ide (NUC)Participants will receive RO7049389 (600 mg once daily \[QD\]) in addition to their background NUC therapy for the 48-week treatment period. RO7020531 (150 mg once every other day \[QOD\]) will be administered during Weeks 1-12 and Weeks 25-36. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) (Dose 2) + NUCNucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) (Dose 2) + NUCsiRNA (RO7445482)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + Pegylated Interferon (PEG-IFN) + NUCNucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. PEG-IFN will be administered at a dose of 180 μg once weekly (QW) for 48 weeks. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
Short Interfering Ribonucleic acid (siRNA; RO7445482) (Dose1) + NUCsiRNA (RO7445482)Participants will receive RO7445482 (Dose 1) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + Pegylated Interferon (PEG-IFN) + NUCPEG-IFNParticipants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. PEG-IFN will be administered at a dose of 180 μg once weekly (QW) for 48 weeks. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + PD-L1 LNA (RO7191863) + NUC [2]Nucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 2) during Weeks 1-24 and RO7191863 (Dose 1) will be administered during Weeks 25-36, in addition to their background NUC therapy for the 36-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + PD-L1 LNA (RO7191863) + NUC [2]PD-L1 LNA (RO7191863)Participants will receive RO7445482 (Dose 2) during Weeks 1-24 and RO7191863 (Dose 1) will be administered during Weeks 25-36, in addition to their background NUC therapy for the 36-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + Pegylated Interferon (PEG-IFN) + NUCsiRNA (RO7445482)Participants will receive RO7445482 (Dose 2) in addition to their background NUC therapy for the 48-week treatment period. PEG-IFN will be administered at a dose of 180 μg once weekly (QW) for 48 weeks. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + CpAM (RO7049389) + NUCsiRNA (RO7445482)Participants will receive RO7445482 (Dose 2) and RO7049389 (600 mg QD) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + CpAM (RO7049389) + NUCNucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 2) and RO7049389 (600 mg QD) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA (RO7445482) + CpAM (RO7049389) + NUCCpAM (RO7049389)Participants will receive RO7445482 (Dose 2) and RO7049389 (600 mg QD) in addition to their background NUC therapy for the 48-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA(RO7445482)+ Programmed Death Ligand-1 Locked Nucleic Acid (PD-L1 LNA; RO7191863) + NUC [1]Nucleos(t)ide (NUC)Participants will receive RO7445482 (Dose 2) during Weeks 1-24 and RO7191863 (Dose 1) will be administered during Weeks 13-24, in addition to their background NUC therapy for the 24-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
siRNA(RO7445482)+ Programmed Death Ligand-1 Locked Nucleic Acid (PD-L1 LNA; RO7191863) + NUC [1]siRNA (RO7445482)Participants will receive RO7445482 (Dose 2) during Weeks 1-24 and RO7191863 (Dose 1) will be administered during Weeks 13-24, in addition to their background NUC therapy for the 24-week treatment period. At the end of the treatment period, participants will continue NUC treatment during the follow-up unless the NUC discontinuation criteria have been met.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants with Hepatitis B Surface Antigen (HBsAg) loss at 24 weeks post-EOT (End Of Treatment)Up to 72 weeks
Secondary Outcome Measures
NameTimeMethod
Percentage of Participants with HBsAg lossUp to 96 weeks
Percentage of Participants with HBsAg seroconversionUp to 96 weeks
Plasma PK (CpAM) (IU/mL)Up to 48 weeks
Plasma PK PD-L1 LNAUp to 37 weeks
Change from baseline in quantitative HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, HBcrAg, HBV RNA, and HBV DNA levels over time (IU/mL)Up to 96 weeks
Percentage of Participants with Anti PD-L1 LNA AntibodiesUp to 85 weeks
Plasma Pharmacokinetics (PK) (TLR7) (IU/mL)Up to 48 weeks
Plasma PK (NUC) (IU/mL)Up to 48 weeks
Percentage of Participants with Adverse Events (AEs)Up to 96 weeks
Percentage of Participants with Hepatitis B Early Antigen (HBeAg) loss (baseline HBeAg-positive participants).Up to 96 weeks
Percentage of Participants with HBeAg seroconversion (baseline HBeAgpositive participants)Up to 96 weeks
Percentage of Participants with HBV DNA < lower limit of quantification (LLOQ), <200 IU/mL and <2,000 IU/mLUp to 96 weeks
Plasma PK (siRNA) (IU/mL)Up to 48 weeks
Percentage of Participants with Anti-siRNA AntibodiesUp to 96 weeks
Percentage of Participants with Anti-PEG-IFN AntibodiesUp to 96 weeks
Serum PK (PEG-IFN) (IU/mL)Up to 48 weeks

Trial Locations

Locations (51)

Ruijin Hospital Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai City, China

Inland Empire Liver Foundation

🇺🇸

Rialto, California, United States

Quest Clinical Research

🇺🇸

San Francisco, California, United States

Uni of Alberta Hospital

🇨🇦

Edmonton, Alberta, Canada

Toronto Liver Centre

🇨🇦

Toronto, Ontario, Canada

Ottawa Hospital

🇨🇦

Ottawa, Ontario, Canada

Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

The First Hospital of Jilin University

🇨🇳

Changchun City, China

Peking University People's Hospital

🇨🇳

Beijing, China

Beijing Friendship Hospital

🇨🇳

Beijing, China

West China Hospital, Sichuan University

🇨🇳

Chengdu, China

Nanfang Hospital, Southern Medical University

🇨🇳

Guangzhou, China

Capital Medical University (CMU) - Beijing Ditan Hospital; Liver Center (Center for Liver Diseases)

🇨🇳

Hangzhou City, China

Huashan Hospital, Fudan University

🇨🇳

Shanghai City, China

Hopital Beaujon; Chir 2

🇫🇷

Clichy, France

Hopital de la Croix-Rousse ? Groupement Hospitalier Nord; Pharmacie / Secteur Essais Cliniques

🇫🇷

Lyon, France

Hopital Brabois Adultes; Service Médecine Interne Hématologie

🇫🇷

Vandoeuvre-les-nancy, France

Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

Pusan National University Hospital

🇰🇷

Busan, Korea, Republic of

Chuncheon Sacred Heart Hospital

🇰🇷

Gangwon-Do, Korea, Republic of

Inje University Busan Paik Hospital; Clinical Trial Center

🇰🇷

Busan, Korea, Republic of

Yonsei Uni College of Medicine, Severance Hospital; Internal Medicine Dept.

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center / Clinical Trial Center

🇰🇷

Seoul, Korea, Republic of

SMG-SNU Boramae Medical Center

🇰🇷

Seoul, Korea, Republic of

Seoul National University College of Medicine, Liver Research Institute

🇰🇷

Seoul, Korea, Republic of

Middlemore Clinical Trials

🇳🇿

Auckland, New Zealand

Spitalul Clinic Judetean de Urgenta Cluj Napoca

🇷🇴

Cluj-Napoca, Romania

Auckland Clinical Studies Limited

🇳🇿

Auckland, New Zealand

Hospital Universitario Puerta de Hierro

🇪🇸

Majadahonda, Madrid, Spain

Kaohsiung Medical University Chung-Ho Memorial Hospital; Pharmacy

🇨🇳

Kaohsiung City, Taiwan

Vall d?Hebron Institute of Oncology (VHIO), Barcelona

🇪🇸

Barcelona, Spain

Hospital Montecelo

🇪🇸

Pontevedra, Spain

China Medical University Hospital; Internal Medicine

🇨🇳

Taichung, Taiwan

Hivnat; Thai Red Cross Center

🇹🇭

Bangkok, Thailand

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

National Cheng Kung Univ Hosp

🇨🇳

Tainan, Taiwan

King College Hospital NHS Foundation Trust

🇬🇧

London, United Kingdom

St George's Hospital

🇬🇧

London, United Kingdom

Prince of Wales Hospital

🇭🇰

Shatin, New Territories, Hong Kong

Hospital Alvaro Cunqueiro; Servicio de Farmacia. Planta -1

🇪🇸

Vigo, Pontevedra, Spain

Tokuda Hospital Sofia; Hematology department

🇧🇬

Sofia, Bulgaria

University Multiprofile Hospital For Active Treatment "Sveti Ivan Rilski" EAD; clinical hematology

🇧🇬

Sofia, Bulgaria

Hospital San Juan de Dios La Serena

🇨🇱

La Serena, Chile

King Chulalongkorn Memorial Hospital

🇹🇭

Bangkok, Thailand

Medical Center "Nov Rehabilitatsionen Tsentar", EOOD

🇧🇬

Stara Zagora, Bulgaria

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Siriraj Hospital

🇹🇭

Bangkok, Thailand

University of Calgary; HSC- Faculty of Medicine

🇨🇦

Calgary, Alberta, Canada

Changhua Christian Hospital

🇨🇳

Chang Hua, Taiwan

Maharaj Nakorn Chiang Mai Hospital

🇹🇭

Chiang Mai, Thailand

Royal Liverpool University Hospital

🇬🇧

Liverpool, United Kingdom

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