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Hepatitis B Virus (HBV)Phase 3NCT00734162

Evaluation of Tenofovir Disoproxil Fumarate in Adolescents With Chronic Hepatitis B Infection

A Phase 3 study testing Tenofovir disoproxil fumarate (TDF) in people with Hepatitis B Virus (HBV), run by Gilead Sciences at 21 sites in 7 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

The primary purpose of the study is to evaluate the effectiveness, safety, and tolerability of tenofovir disoproxil fumarate (TDF) in adolescents (aged 12-17 years) with chronic hepatitis B virus (HBV) infection. The optimal treatment for adolescents with chronic HBV infection is currently unknown. Read more about this study

Who is it for?
Ages 12 to 17 years
Conditions the study is for
Hepatitis B Virus (HBV)
What is being tested?
Tenofovir disoproxil fumarate (TDF)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
106 participants
Where
21 sitesin 7 countries
Study dates
Dec 2008to Dec 2015
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 12 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Male or female, 12 through 17 years of age, inclusive (consent of parent/legal guardian required)
  • Documented chronic HBV infection
  • HBeAg positive or HBeAg negative
  • Weight > 35 kg
  • Able to swallow oral tablets
  • HBV DNA > 100,000 copies/mL (polymerase chain reaction (PCR) method)
Show all 12Show fewer
  • Alanine aminotransferase (ALT) > 2 × upper limit of normal (ULN) at screening, OR any history of ALT > 2 × ULN over the past 24 months
  • Willing and able to provide written informed consent/assent (child and parent/legal guardian)
  • Negative serum pregnancy test (for postmenarchal females only)
  • Estimated glomerular filtration rate (creatinine clearance [using the Schwartz formula]) > 80 mL/min/1.73m^2
  • Adequate hematologic function (absolute neutrophil count ≥ 1,500/mm^3; hemoglobin ≥ 10.0 g/dL)
  • No prior TDF therapy (participants may have received prior interferon or oral anti-HBV nucleoside/nucleotide therapy; participants must have discontinued interferon therapy ≥ 6 months prior to screening; participants experienced on anti-HBV nucleoside/nucleotide therapy must have discontinued therapy ≥ 16 weeks prior to screening to avoid flare if randomized to the placebo arm)

Who cannot join

  • Pregnant women, women who are breast feeding or who believe they may wish to become pregnant during the course of the study
  • Males and females of reproductive potential who are not willing to use an effective method of contraception during the study
  • Decompensated liver disease
  • Receipt of interferon (pegylated or not) therapy within 6 months of the Screening Visit
  • Receipt of anti-HBV nucleoside/nucleotide therapy within 16 weeks of the Screening Visit
  • Alpha fetoprotein > 50 ng/mL
Show all 16Show fewer
  • Evidence of hepatocellular carcinoma (HCC)
  • Coinfection with HIV, hepatitis C virus (HCV), or hepatitis D virus (HDV)
  • History of significant renal disease (eg, nephrotic syndrome, renal dysgenesis, polycystic kidney disease, congenital nephrosis, acute tubular necrosis, other renal disease)
  • History of significant bone disease (eg, osteomalacia, chronic osteomyelitis, osteogenesis imperfecta, osteochondroses, multiple bone fractures)
  • Significant cardiovascular, pulmonary, or neurological disease
  • Evidence of a gastrointestinal malabsorption syndrome that may interfere with absorption of orally administered medications
  • History of solid organ or bone marrow transplantation
  • Ongoing therapy with nephrotoxic agents, competitors of renal excretion, systemic chemotherapeutic agents, systemic corticosteroids, interleukin-2 (IL-2), or other immunomodulating or investigational agents
  • Known hypersensitivity to the study drugs, the metabolites or formulation excipients
  • Any other condition (including alcohol or substance abuse) or prior therapy that, in the opinion of the Investigator, would make the participants unsuitable for the study or unable to comply with dosing requirements

Trial locations and contacts

21 sites in 7 countries.

21 sites in 7 countries

Poland8 sites
  • Samodzielny Publiczny Dzieciecy Szpital Kliniczny Akademii Medycznej w Bialymstoku

    Bialystok, 15-274

  • Wojewodzki Specjalistyczny Szpital im Bieganskiego

    Bydgoszcz, 85-030

  • Wojewodzki Szpital Obserwacyjno-Zakazny im. T. Browicza

    Bydgoszcz, 85-030

  • Krakowski Szpital Specjalistyczny im. Jana Pawla II

    Krakow, 31-202

  • Samodzielny Publiczny Szpital Kliniczny im. Karola Johschera

    Poznan, 60-572

  • Specjalistyczny Zespol Opieki Zdrowotnej nad Matka i Dzieckiem

    Poznan, 61-734

  • Wojewodzki Szpital Zakazny

    Warsaw, 01-201

  • Samodzielny Publiczny Szpital Kliniczny Nr 1

    Wroclaw, 50-368

Other trials in Poland

United States3 sites
  • Riley Hospital for Children

    Indianapolis, Indiana, 46202

  • Children's Hospital & Research Center at Oakland

    Oakland, California, 94609

  • Children's Hospital & Regional Medical Center, d/b/a Seattle Children's Research Institute

    Seattle, Washington, 98105

Other trials in United States

Romania3 sites
  • Fundeni Clinical Institute

    Bucharest, 022328

  • Institute for Infectious Diseases

    Bucharest, 21105

  • Cluj Childrens Emergency Hospital

    Napaco, 400217

Other trials in Romania

Bulgaria2 sites
  • Multiprofile Hospital for Active Treatment Sveti Georgi

    Plovdiv, 4002

  • Clinic of Gastroenterology, Specialized Hospital for Active Treatment of Pediatric Diseases, Sofia

    Sofia, 1606

Other trials in Bulgaria

France2 sites
  • Hopital Femmes Meres Enfants

    Bron, 69677

  • Hôpital Claude Huriez

    Lille, 59037

Other trials in France

Spain2 sites
  • Hosp Univ y Politecnico La Fe de Valencia

    Madrid, 28046

  • Hospital Universitario De Getafe

    Madrid, 46009

Other trials in Spain

Turkey (Türkiye)1 site
  • Ege Universitesi Tip Fakultesi Hastanesi

    Izmir, 35100

Other trials in Turkey (Türkiye)

About this study

Official title: A Randomized, Double-Blind Evaluation of the Antiviral Efficacy, Safety, and Tolerability of Tenofovir Disoproxil Fumarate Versus Placebo in Adolescents With Chronic Hepatitis B Infection

The primary purpose of the study is to evaluate the effectiveness, safety, and tolerability of tenofovir disoproxil fumarate (TDF) in adolescents (aged 12-17 years) with chronic hepatitis B virus (HBV) infection.

The optimal treatment for adolescents with chronic HBV infection is currently unknown. Treatment with interferon alfa, lamivudine, and adefovir dipivoxil in pediatric populations has been shown to be less than optimal. Further, the safety and efficacy of entecavir and telbivudine have not been established in patients < 16 years of age. A study evaluating TDF in adolescents (ages 12-17) was needed to assess the safety and efficacy of this agent in the treatment of chronic hepatitis B in this patient population. In addition, the study will help to further elucidate the pharmacokinetic (PK) and resistance profiles of TDF. Through their participation, study participants will help generate critical new information to help guide the most optimal treatment of chronic HBV infection in adolescents.

This is a randomized, double-blind study to evaluate the antiviral efficacy, safety, and tolerability of TDF versus placebo in adolescents with chronic HBV infection. TDF treatment-naive participants were randomized in a 1:1 ratio to TDF or placebo. After 72 weeks of blinded treatment, participants were to switch to open-label TDF for an additional 2.5 years of treatment, provided that no safety concerns are identified by the Independent Data Monitoring Committee monitoring the study.

Being tested
Tenofovir disoproxil fumarate (TDF), Placebo
Keywords
tenofovir, adolescents, chronic hepatitis B
Medical subject headings
Hepatitis B, Hepatitis B, Chronic

What participants receive

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

  • Tenofovir disoproxil fumarate (TDF)Drug

    Also called Viread®

    TDF administered as a 300-mg tablet once daily

  • PlaceboDrug

    TDF placebo tablet once daily

Study groups in NCT00734162
Study groupRoleWhat they receive
Tenofovir disoproxil fumarate (TDF)ExperimentalNot described
Receives: Drug: Tenofovir disoproxil fumarate (TDF)
PlaceboPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

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

  1. Percentage of Participants With HBV DNA < 400 Copies/mL at Week 72

    The percentage of participants with HBV DNA < 400 copies/mL at Week 72 was summarized by treatment and age group (grouped by baseline age for analysis), using the missing = failure (M = F) analysis with the double-blind efficacy evaluation (DBEE) algorithm.

    In the M = F analysis method, all missing data were considered as failure to meet the outcome measure threshold. This method was combined with the DBEE algorithm, which included all available data for the double-blind period, and any data for the open-label period were not included; data generated during treatment-free follow-up from subjects who achieved HBsAg loss and entered treatment-free follow-up during double-blind treatment period were included.

    Measured: Week 72

  2. Percentage of Participants With at Least a 6% Decrease From Baseline in Bone Mineral Density (BMD) of the Spine at Week 72

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    In contrast with what was previously reported in the interim results posting, 1 participant met the primary safety endpoint of at least a 6% decrease from baseline in spine BMD at Week 72, based on the final BMD data analysis. The apparent discrepancy was due to the correction factor applied to the subject-specific BMD calculations performed at the time of the Interim Week 72 clinical study report that could not take into account the actual Week 72 phantom data (ie, calibration test used in longitudinal clinical trials to monitor and adjust for shifts in the dual-energy x-ray absorptiometry (DXA) scanner calibration over time), which were not provided by the site at that time. The correction factor applied to the final analysis has been properly based on all phantom data through the end of Week 72, as well as through the end of Week 192.

    Measured: Baseline to Week 72

Secondary outcomes (35)
  1. Percentage of Participants With HBV DNA < 400 Copies/mL at Weeks 48, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Weeks 48, 96, 144, and 192

  2. Percentage of Participants With Normal Alanine Aminotransferase (ALT) at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Weeks 48, 72, 96, 144, and 192

  3. Percentage of Participants With HBV DNA < 400 Copies/mL and Normal ALT at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Weeks 48, 72, 96, 144, and 192

  4. Percentage of Participants With HBV DNA < 169 Copies/mL at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Weeks 48, 72, 96, 144, and 192

  5. Percentage of Participants With Hepatitis B Surface Antigen (HBsAg) Loss at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis), using the M = F.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  6. Percentage of Participants With HBsAg Seroconversion at Weeks 48, 72, 96, 144, and 192

    HBsAg seroconversion was defined as change of detectable antibody to HBsAg from negative to positive. Data were summarized by treatment and age group (grouped by baseline age for analysis), using the M = F.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  7. Percentage of Participants With at Least a 6% Decrease From Baseline in Spine BMD at Weeks 48, 96, 144, and 192

    The percentage of participants reported is the cumulative incidence from baseline to the respective time point. Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Weeks 48, 96, 144, and 192

  8. Percentage of Participants With at Least a 6% Decrease From Baseline in Whole Body BMD at Weeks 48, 72, 96, 144, and 192

    The percentage of participants reported is the cumulative incidence from baseline to the respective time point. Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  9. Percent Change From Baseline in Spine Bone Mineral Density (BMD) at Week 48

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 48

  10. Percent Change From Baseline in Spine BMD at Week 72

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 72

  11. Percent Change From Baseline in Spine BMD at Week 96

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 96

  12. Percent Change From Baseline in Spine BMD at Week 144

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 144

  13. Percent Change From Baseline in Spine BMD at Week 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 192

  14. Percent Change From Baseline in Whole Body BMD at Week 48

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 48

  15. Percent Change From Baseline in Whole Body BMD at Week 72

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 72

  16. Percent Change From Baseline in Whole Body BMD at Week 96

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 96

  17. Percent Change From Baseline in Whole Body BMD at Week 144

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 144

  18. Percent Change From Baseline in Whole Body BMD at Week 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 192

  19. Change From Baseline in Z-score for Spine BMD at Week 48

    To assess any effect of treatment on growth, Z-scores were used to express the deviation from a reference population for lumbar spine BMD. A Z-score of 0 indicated that a subject was typical of the population for their age, ethnicity, and gender. A negative Z-score indicated that the subject's recorded value was lower than typical for their age, ethnicity, and gender. A positive Z-score indicates that the subject's recorded value was higher than typical for their age, ethnicity, and gender. Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 48

  20. Change From Baseline in Z-score for Spine BMD at Week 72

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 72

  21. Change From Baseline in Z-score for Spine BMD at Week 96

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 96

  22. Change From Baseline in Z-score for Spine BMD at Week 144

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 144

  23. Change From Baseline in Z-score for Spine BMD at Week 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 192

  24. Change From Baseline in Z-score for Whole Body BMD at Week 48

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 48

  25. Change From Baseline in Z-score for Whole Body BMD at Week 72

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 72

  26. Change From Baseline in Z-score for Whole Body BMD at Week 96

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 96

  27. Change From Baseline in Z-score for Whole Body BMD at Week 144

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 144

  28. Change From Baseline in Z-score for Whole Body BMD at Week 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis).

    Measured: Baseline; Week 192

  29. Number of Participants With Changes in Drug-Resistant Mutations During the Study

    The number of participants with changes in drug-resistant mutations during the study was summarized.

    Measured: Baseline through Week 192

  30. Percentage of Participants Who Were HBeAg-Positive at Baseline and Who Had HBeAg Loss at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  31. Percentage of Participants Who Were HBeAg-Positive at Baseline and Who Had HBeAg Seroconversion at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  32. Percentage of Participants Who Were HBeAg-Positive at Baseline Who Had HBV DNA < 400 Copies/mL, Normal ALT, and HBeAg Loss/Seroconversion at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  33. Percentage of Participants With Abnormal ALT at Baseline Who Had Normalized ALT at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  34. Percentage of Participants With Abnormal ALT at Baseline Who Had HBV DNA < 400 Copies/mL and Normalized ALT at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

  35. Percentage of Participants Who Were HBeAg-Positive With Abnormal ALT at Baseline Who Had HBV DNA < 400 Copies/mL, Normalized ALT, and HBeAg Loss/Seroconversion at Weeks 48, 72, 96, 144, and 192

    Data were summarized by treatment and age group (grouped by baseline age for analysis) using the missing = failure method.

    Measured: Baseline; Weeks 48, 72, 96, 144, and 192

Timeline

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

  1. First posted14 Aug 2008 (estimated)
  2. Study startDec 2008
  3. Primary completionMar 2011
  4. Study completionDec 2015

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
Double blind
Who is masked
Participant, Investigator
Enrolment
106 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00734162
Sponsor's protocol ID
GS-US-174-0115
Status last verified
Jul 2016
First submitted
13 Aug 2008
Last updated
1 Sep 2016
Data monitoring committee
Yes

Publications

  • Murray KF, Szenborn L, Wysocki J, Rossi S, Corsa AC, Dinh P, McHutchison J, Pang PS, Luminos LM, Pawlowska M, Mizerski J. Randomized, placebo-controlled trial of tenofovir disoproxil fumarate in adolescents with chronic hepatitis B. Hepatology. 2012 Dec;56(6):2018-26. doi: 10.1002/hep.25818. Epub 2012 Aug 27.

    PubMed 22544804

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tenofovir disoproxil fumarate (TDF) in people with Hepatitis B Virus (HBV), run by Gilead Sciences at 21 sites in 7 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 12 inclusion and 16 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 1 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in Poland, United States, Romania, Bulgaria, France and 2 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. Some participants in this study may receive a placebo. 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 7 Nov 2012). 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?

Percentage of Participants With HBV DNA < 400 Copies/mL at Week 72 (time frame: Week 72). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00734162, which also lists 1 linked publication.

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 1 Sep 2016.

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