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Hepatitis BPhase 3NCT00065507

Comparison of Entecavir to Adefovir in Chronic Hepatitis B Virus (HBV) Patients With Hepatic Decompensation

A Phase 3 study testing Entecavir (ETV) and Adefovir (ADV) in people with Hepatitis B, run by Bristol-Myers Squibb at 61 sites in 17 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a phase IIIb comparative study of entecavir 1.0 mg once daily (QD) vs. adefovir 10 mg QD in patients who have chronic hepatitis B infection and hepatic decompensation. The patients are treated for 96 weeks after the last subject is randomized. Read more about this study

Who is it for?
Ages 16 years and older
Conditions the study is for
Hepatitis B
What is being tested?
Entecavir (ETV) and Adefovir (ADV)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
195 participants
Where
61 sitesin 17 countries
Study dates
Aug 2003to May 2013
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Child-Pugh (CP) score >= 7
  • Hepatitis B virus (HBV) viremia

Who cannot join

  • Alanine aminotransferase (ALT) > 15 x upper limit of normal (ULN)
  • Human immunodeficiency virus (HIV)/hepatitis C virus (HCV)/hepatitis D virus (HDV) coinfection

Trial locations and contacts

61 sites in 17 countries.

61 sites in 17 countries

United States16 sites
  • Pediatric Gasteroenterology

    Atlanta, Georgia, 30342

  • Johns Hopkins University

    Baltimore, Maryland, 21205

  • Baylor University Medical Center

    Dallas, Texas, 75246

  • Ut Southwestern Medical Center

    Dallas, Texas, 75390-9151

  • Henry Ford Health System Irb

    Detroit, Michigan, 48202

  • Hawaii Medical Center East

    Honolulu, Hawaii, 96817

  • Indiana University Med Center

    Indianapolis, Indiana, 46202-5121

  • The Cht Liver Research Center

    Louisville, Kentucky, 40292

  • University Of Miami School Of Medicine

    Miami, Florida, 33136

  • Yale University School Of Medicine

    New Haven, Connecticut, 06520

  • Mount Sinai Medical Center

    New York, New York, 10029

  • Columbia Presbyterian Medical Center (Cpmc)

    New York, New York, 10032

  • Integris Baptist Medical Center

    Oklahoma City, Oklahoma, 73112

  • Mcguire Dvamc

    Richmond, Virginia, 23249

  • Research And Education, Inc.

    San Diego, California, 92115

  • California Pacific Medical Center

    San Francisco, California, 94115

Other trials in United States

Greece5 sites
  • Local institution

    Athens, 11522

  • Local Institution

    Athens, 11527

  • Local Institution

    Athens, 15127

  • Local Instituition

    Thessaloniki, 54006

  • Local Institution

    Thessaloniki, 570 10

Other trials in Greece

Taiwan5 sites
  • Local Institution

    Changhua, 500

  • Local Institution

    Taichung, 404

  • Local Institution

    Taipei, 100

  • Local Institution

    Taoyuan, 333

  • Local Institution

    Tianan, 704

Other trials in Taiwan

Brazil4 sites
  • Local Institution

    Porto Alegre - Rs, Rio Grande do Sul, 90035-003

  • Local institution

    São Paulo, São Paulo, 01246-000

  • Local Institution

    São Paulo, São Paulo, 01246-903

  • Local Institution

    Sao Paulo - Sp, São Paulo, 05403-900

Other trials in Brazil

India4 sites
  • Local Institution

    Hyderabad, Andhra Pradesh, 500082

  • Local Institution

    Kolkata, 700020

  • Local Institution

    Lucknow, 226014

  • Local Institution

    New Delhi, 110002

Other trials in India

Poland4 sites
  • Local Institution

    Bydgoszcz, 85-030

  • Local Institution

    Chorzów, 41-500

  • Local Institution

    Krakow, 31-202

  • Local Institution

    Lodz, 91-347

Other trials in Poland

Singapore4 sites
  • Local Institution

    Singapore, 119228

  • Local Institution

    Singapore, 169608

  • Local Institution

    Singapore, 308433

  • Local Institution

    Singapore, 529889

Other trials in Singapore

Russia3 sites
  • Local Institution

    Moscow, 115446

  • Local Institution

    Moscow, 117333

  • Local Institution

    Smolensk, 214018

Other trials in Russia

Thailand3 sites
  • Local Institution

    Bangkok, 10400

  • Local Institution

    Bangkok, 10700

  • Local Institution

    Hat Yai, 90110

Other trials in Thailand

Canada2 sites
  • Local Institution

    Calgary, Alberta, T2N 4N1

  • Local Institution

    Vancouver, British Columbia, V5Z 1H2

Other trials in Canada

France2 sites
  • Local Institution

    Clichy, 92118

  • Local Institution

    Strasbourg, 67100

Other trials in France

Philippines2 sites
  • Local Institution

    Cebu, 6000

  • Local Institution

    Manila, 1008

Other trials in Philippines

South Africa2 sites
  • Local Institution

    Observatory, Western Cape, 7925

  • Local Institution

    Paarl, Western Cape, 7620

Other trials in South Africa

Turkey (Türkiye)2 sites
  • Local Institution

    Adana, 01330

  • Local Institution

    Izmir, 35100

Other trials in Turkey (Türkiye)

Hong Kong1 site
  • Local Institution

    Tai Po

Other trials in Hong Kong

Indonesia1 site
  • Local Institution

    Jakarta, 10430

Other trials in Indonesia

United Kingdom1 site
  • Local Institution

    London, Greater London, NW3 2QG

Other trials in United Kingdom

About this study

Official title: Comparison of the Efficacy and Safety of Entecavir Versus Adefovir in Subjects Chronically Infected With Hepatitis B Virus and Evidence of Hepatic Decompensation

This is a phase IIIb comparative study of entecavir 1.0 mg once daily (QD) vs. adefovir 10 mg QD in patients who have chronic hepatitis B infection and hepatic decompensation. The patients are treated for 96 weeks after the last subject is randomized.

Conditions
Hepatitis B
Being tested
Entecavir (ETV), Adefovir (ADV)
Keywords
hepatic decompensation
Medical subject headings
Hepatitis B

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Entecavir (ETV)Drug

    Also called Baraclude, BMS-200475

    Tablets, Oral, 1 mg once daily, 96 weeks from the time the last patient is randomized

  • Adefovir (ADV)Drug

    Tablets, Oral, 10 mg, once daily, 96 weeks from the time the last patient is randomized

Study groups in NCT00065507
Study groupRoleWhat they receive
A1ExperimentalNot described
Receives: Drug: Entecavir (ETV)
A2Active comparatorNot described
Receives: Drug: Adefovir (ADV)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in Hepatitis B Virus (HBV) DNA by Polymerase Chain Reaction (PCR) at Week 24

    Mean reduction in serum HBV DNA determined by PCR assay (log10 copies/mL) at Week 24 adjusted for baseline HBV DNA and lamivudine resistance (LVDr) status, based on linear regression analysis.

    Measured: Baseline, Week 24

Secondary outcomes (27)
  1. Change From Baseline in HBV DNA by PCR at Week 48

    Mean change from baseline in HBV DNA by PCR at Week 48, adjusted for baseline HBV DNA and LVDr Status.

    Measured: Baseline, Week 48

  2. Number of Participants With HBV DNA < 300 Copies/mL by PCR At Week 24

    Measured: Week 24

  3. Number of Participants With HBV DNA < 300 Copies/mL by PCR At Week 48

    Measured: Week 48

  4. Number of Participants Achieving Alanine Transaminase (ALT) Normalization (≤1.0 x Upper Limit of Normal [ULN]) at Weeks 24 and 48

    Number of participants in each group who achieved ALT normalization (≤1.0 x upper limit of normal [ULN]) among those with baseline ALT >1.0 x ULN at Weeks 24 and 48

    Measured: Week 24, Week 48

  5. Number of Subjects Achieving Composite Endpoint (HBV DNA < 10*4 Copies/mL by PCR Assay and Normal ALT [≤ 1.0 x ULN]) Through Week 48

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 48

  6. >=2-Point Reduction From Baseline in Child-Pugh Score Through Week 48

    Child-Pugh classification assesses the prognosis of chronic liver disease by 5 clinical measures, scored 1-3 each (most severe derangement=3). Score range: 5 (best prognosis) to 15 (worst prognosis).

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  7. Number of Participants With Improvement or No Worsening in Child-Pugh Score From Baseline to Week 48

    Number of participants in each group with improvement or no worsening in Child-Pugh score from baseline to Week 48 as measured by improvement or no worsening in Child-Pugh score. Child-Pugh classification assesses the prognosis of chronic liver disease by 5 clinical measures, scored 1-3 each (most severe derangement=3). Score range: 5 (best prognosis) to 15 (worst prognosis).

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 48

  8. Change From Baseline in Child-Pugh Score Through Week 48

    Mean change from baseline in Child-Pugh score through week 48. Child-Pugh classification assesses the prognosis of chronic liver disease by 5 clinical measures, scored 1-3 each (most severe derangement=3). Score range: 5 (best prognosis) to 15 (worst prognosis).

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  9. Number of Participants With Improvement in Child-Pugh Class at Week 24 and Week 48

    Number of Participants in each group with improvement in Child-Pugh score from baseline to Week 48 as measured by improvement in Child-Pugh class. Improvement in Child-Pugh Class is defined as change from B to A or C to A. Evaluable subjects are subjects with Child-Pugh Class B or C at Baseline. Child-Pugh classification assesses the prognosis of chronic liver disease by 5 clinical measures, scored 1-3 each (most severe derangement=3). Score range: 5 (best prognosis) to 15 (worst prognosis). Child-Pugh class A to C employs the added score from above: 5-6=Class A; 7-9=Class B; 10-15=Class C.

    Measured: Week 24, Week 48

  10. Mean Change From Baseline in Model for End-Stage Liver Disease (MELD) Scores From Baseline Through Week 48

    Adjusted mean change from baseline in MELD score through Week 48 (adjusted for baseline value). The Model for End-Stage Liver Disease (MELD), is a scoring system for assessing the severity of chronic liver disease. MELD uses the patient's values for serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. In interpreting the MELD Score in hospitalized patients, the 3 month mortality is: 40 or more=100% mortality; 30-39=83% mortality; 20-29=76% mortality; 10-19=27% mortality; <10=4% mortality.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  11. Improvement or No Worsening in MELD Score Through Week 48

    Participants with improvement or no worsening (any decrease or no change from baseline in score) in MELD score through Week 48. The Model for End-Stage Liver Disease (MELD), is a scoring system for assessing the severity of chronic liver disease. MELD uses the patient's values for serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. In interpreting the MELD Score in hospitalized patients, the 3 month mortality is: 40 or more=100% mortality; 30-39=83% mortality; 20-29=76% mortality; 10-19=27% mortality; <10=4% mortality.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 48

  12. Mean Changes From Baseline in Quality of Life as Measured by the Short Form 36 (SF-36)

    Scoring for the SF-36 will be done using the algorithm developed by the Research ANd Development(RAND) Corporation (a scale of 0-100). Higher scores represent better quality of life. Coding for items with 2-category responses=0 and 100; 3-category=0/50/100; 5-category=0/25/50/75/100; 6-category=0/20/40/60/80/100. Scores of items in the same scale are combined to create the 8 scale scores (physical functioning, role-physical, bodily-pain, general health, vitality, social functioning, role-emotional, mental health). Physical and mental health composite scores will be computed for the group.

    Measured: Baseline, Week 24, Week 48

  13. Mean Changes From Baseline in Quality of Life, as Measured by EuroQol-5D (EQ-5D) at Weeks 24 and 48

    The EQ-5D has 5 attributes (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression), each with 3 levels (no problem, some problems, and major problems). This algorithm gives valuation (weights) to each of the 15 responses on the form. Each valuation is a negative number, subtracted from the maximum score of 1 (perfect well being). The overall health index score ranges from 0 (dead) to 1 (perfect health) value scale, and the visual analog scale ranges from 0 to 100. Item weights will be obtained from the EuroQol group.

    Measured: Baseline, Week 24, Week 48

  14. Change From Baseline in Albumin Through Week 48

    Mean albumin levels, and mean change from baseline in albumin, a measure of synthetic liver function. Normal range for albumin = 3.5 - 5.3 g/dL.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  15. Mean Change From Baseline in Prothrombin Time Through Week 48

    Mean prothrombin time, and mean change from baseline in prothrombin time, a measure of synthetic liver function. Prothrombin time is the time it takes (in seconds) for a sample of blood to clot. Normal range for prothrombin time (PT) = 10-13 seconds.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  16. Mean Change From Baseline in Total Bilirubin Through Week 48

    Mean total bilirubin levels, and mean change from baseline in total bilirubin, a measure of liver secretory function.Normal range for total bilirubin = 0.2 - 1.2 mg/dL.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  17. Change From Baseline in Platelet Count Through Week 48

    Mean baseline platelet count and mean change from baseline in platelet count at specific timepoints. Platelets are the smallest particles found in the blood, which play a major role in forming blood clots. Normal range for platelets = 140 - 450 X 10*9 c/L.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  18. Participants Achieving Albumin Normalization Through Week 48

    Number of participants who achieved normalization of albumin (>= 1 x lower limit of normal [LLN]), a measure of liver function, at specific timepoints.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  19. Participants Achieving Prothrombin Time Normalization Through Week 48

    Number of participants who achieved normalization of prothrombin time (<= 1 x ULN), a measure of liver function, at specific timepoints.

    Measured: Baseline, Week4, Week 8, Week 12, Week 24, Week 36, Week 48

  20. Participants Achieving Total Bilirubin Normalization Through Week 48

    Number of participants who achieved normalization of total bilirubin (<= 1 x ULN), a measure of liver function, at specific timepoints.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  21. Participants Achieving Platelet Count Normalization Through Week 48

    Number of participants who achieved normalization of platelet count (>= 1 x lower limit of normal [LLN]), a measure of liver function, at specific timepoints.

    Measured: Baseline, Week 4, Week 8, Week 12, Week 24, Week 36, Week 48

  22. Number of Hepatocellular Carcinoma (HCC) Events at Different Time Points Through Week 48

    HCC-free survival was analyzed using life tables. Measured values show the number of HCC events among treated participants at given time points.

    Measured: Week 48

  23. Cumulative Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs), Deaths, HCC, Discontinuations Due to AEs, and Confirmed Creatinine Increase >=0.5 mg/dL

    AE=any new untoward medical occurrence/worsening of a pre-existing medical condition regardless of causal relationship. SAE=any untoward medical occurrence at any dose that: results in death; is life-threatening; requires/prolongs inpatient hospitalization; results in persistent/significant disability; is cancer; is congenital anomaly/birth defect; results in drug dependency/abuse; is an important medical event. Grades:1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening/disabling, 5=Death. Confirmed increase in serum creatinine=values ≥0.5 mg/dL compared with baseline on 2 sequential measures.

    Measured: on-treatment events obtained after the start of therapy and no more than 5 days after the last dose of study therapy.

  24. Number of Participants With Treatment-Emergent Grade 3/4 Laboratory Abnormalities - Week 48 and Cumulative Data

    Grade 3/4 laboratory abnormalities (hematology, electrolyte, lipase, liver function, metabolic, renal function, urinalysis). The Week 48 data set was used to evaluate the Week-48 on-treatment safety. The cumulative data set was used to evaluate the safety while on treatment. Common Terminology Criteria for Adverse Events v3.0 (CTCAE) Grades:1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening/disabling, 5=Death.

    Measured: Week 48=all on-treatment laboratory measurements up to Week 48. Cumulative data = on-treatment laboratory measurements obtained after the start of therapy and no more than 5 days after the last dose of study therapy.

  25. Number of Participants With Alanine Aminotransferase (ALT) Flares - On Treatment

    ALT flare=ALT > 2 x baseline and > 10 x upper limit of normal (ULN) by clinical laboratory evaluation. Table includes number of participants with selected clinical events and/or laboratory abnormalities during ALT flares. Selected clinical events during ALT flares=ascites, hepatic encephalopathy, jaundice, bacterial peritonitis. Selected Laboratory abnormalities during ALT flares=international normalized ratio > 1.5 or prothrombin time >= 1.2 x ULN and total bilirubin >2.5 mg/dL and > 1 mg/dL increase from baseline.

    Measured: On-treatment=up to Week 48 (Day 336); if discontinued early, all data up to 5 days after discontinuation date.

  26. Number of Participants With Malignant Neoplasms - On Treatment or During 24-Week Follow-up Period

    Data includes type of malignant neoplasm.

    Measured: On-treatment=up to Week 48 (Day 336); if discontinued early, all data up to 5 days after discontinuation date. 24-week follow-up=limited to end-of-dosing values and those from 6 days after last dose of study therapy to end of follow-up.

  27. Number of Participants Undergoing Liver Transplant - On-Treatment or 24-Week Follow-Up

    Measured: On-treatment=up to Week 48 (Day 336); if discontinued early, all data up to 5 days after discontinuation date. 24-week follow-up=limited to end-of-dosing values and those from 6 days after last dose of study therapy to end of follow-up.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jul 2003 (estimated)
  2. Study startAug 2003
  3. Primary completionOct 2008
  4. Study completionMay 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
195 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00065507
Sponsor's protocol ID
AI463-048
Status last verified
Jun 2013
First submitted
28 Jul 2003
Last updated
24 Jun 2013
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Entecavir (ETV) and Adefovir (ADV) in people with Hepatitis B, run by Bristol-Myers Squibb at 61 sites in 17 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Jun 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 61 sites in United States, Greece, Taiwan, Brazil, India and 12 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Jul 2010). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Hepatitis B Virus (HBV) DNA by Polymerase Chain Reaction (PCR) at Week 24 (time frame: Baseline, Week 24). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jun 2013.

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