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Hepatitis B Virus Associated Nephrotic SyndromePhase 4TOHBVGNNCT03062813

Tacrolimus Combined With Entecavir on HBV Associated Glomerulonephritis(HBV-GN)

A Phase 4 study testing Tacrolimus &entecavir in people with Hepatitis B Virus Associated Nephrotic Syndrome, run by Guangdong Provincial People's Hospital at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study was to evaluate the efficacy and safety of Tacrolimus combined with entecavir antiviral therapy for HBV-associated glomerulonephritis in china. Tacrolimus combined with entecavir rapidly and effectively induced remission of HBV-GN in Chinese adults. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
Tacrolimus &entecavir
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
112 participants
Where
1 siteChina
Study dates
1 Feb 2017to 31 Mar 2020
Phase
Phase 4
Are there results?
None posted in the registry

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 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and female patients aged between 18 and 65 years with HBV-GN;
  • All HBV-GN cases with biopsy-proven;
  • Evidence of chronic HBV infection based on the presence of HBsAg, HBeAg or HBV DNA in the serum;(HBsAg, HBeAg was positive, HBV DNA ≥10*3 IU/ml). Chronic HBV infection lasted for six months, and all patients did not receive the antiviral therapy in the past six months;
  • Proteinuria more than 3.0g/24h, UPCR>3000mg/g.cr, the result will be proofed by at least two tests;
  • No glucocorticoid and immunosuppressive treatment within the previous 2 weeks.

Who cannot join

  • The diagnosis of idiopathic membranous nephropathy(MN), systemic lupus erythematosus, malignancy, diabetes mellitus, severe infections or any other systemic disease known to be associated with secondary MN;
  • eGFR<30ml/min.1.73m*2;
  • Renal pathology showed that Tubular atrophy or Interstitial fibrosis was more than 50%;
  • The participant is allergy to tacrolimus, entecavir;
  • History of diabetes mellitus;
  • History of severe heart disease or cerebrovascular diseases;
  • Other active infection such as cytomegalovirus (CMV),Tuberculosis,Hepatitis A virus (HAV),Hepatitis C virus (HCV),Hepatitis D virus (HDV); Innate or acquired immunodeficiency; liver cirrhosis, liver malignment tumor;
  • Pregnant, trying to become pregnant or breast feeding;

Trial locations and contacts

1 site in 1 country.

Zhiming Ye, PHD contact

86-13826161678

13826161678@139.com

Lifen Wang, PHD contact

86-18022392896

15010942109@139.com

China1 site, 1 recruiting
  • Guangdong General Hospital, Guangdong Academy of Medical Sciences

    Guangzhou, Guangdong, 510080

    Liming Yao, bachelor, 86-83827812-20894

    Recruiting

Other trials in China

About this study

Official title: The Therapy of Tacrolimus Combined With Entecavir on HBV Associated Glomerulonephritis : A Multicenter, Prospective, Randomized, Controlled, Single-blind Trial.

This study was to evaluate the efficacy and safety of Tacrolimus combined with entecavir antiviral therapy for HBV-associated glomerulonephritis in china. Tacrolimus combined with entecavir rapidly and effectively induced remission of HBV-GN in Chinese adults. Meanwhile, Tacrolimus may have a synergistic antiviral effect with entecavir. The study protocol was reviewed and approved by Guangdong General Hospital's Ethic Committee, and all participants provided written informed consents. The study will be a prospective, randomized,controlled,single-blind, multi-centre, withdrawal study conducted by Guangdong general hospital, Guangdong Academy of Medical Sciences.there will be two phases, phase 1, Screening and enrolling 112 HBV-GN patients about one year,and phase 2, ongoing follow-up for 24 weeks.The data of all patients will be recorded in the HBV-GN electronic database.Before the randomisation, All patients will receive entecavir routine antiviral therapy for two weeks.And then they will be randomized to two different group,the treatment group: Tacrolimus combined with entecavir antiviral therapy,the control group: The Tacrolimus placebo and entecavir antiviral therapy. The Tacrolimus target trough concentration was 5-10 ng/mL during the therapy. The primary outcome variables were the number of patients who reached complete or partial remission (CR or PR) after the 25 week-treatment. CR was defined as <0.3 g/24 h proteinuria (UPCR<300mg/g.cr) or lower plus stable renal function (eGFR>50 ml/min/1.73 m2) and PR as proteinuria 0.3-3.0 g/24 h (UPCR 300-3000mg/g.cr) and 50% lower than baseline proteinuria plus stable renal function. Secondary outcome variables: 1) The number of patients who reached complete or partial remission (CR or PR) after the 13 week-treatment. 2) Serum creatinine (SCr) increased 2 times the baseline levels or 50% lower than the baseline eGFR(according to chronic kidney disease-EPI (CKD-EPI) )after the 25 week-treatment. 3)Serum HBV DNA was undetectable(HBV DNA<500copies/ml) at the end of 25 week-treatment. 4) The number of patients who present acute kidney injury at the end of 25 week-treatment.

Being tested
Tacrolimus &entecavir, placebo & entecavir
Keywords
Hepatitis B virus, tacrolimus,membranous nephropathy
Medical subject headings
Hepatitis B, Glomerulonephritis, Membranous

What participants receive

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

  • Tacrolimus &entecavirDrug

    Also called FK506,Prograf, baraclude

    HBV-GN patients with nephrotic syndrome were randomly givenTacrolimus (0.05-0.1 mg/kg/day) combined with entecavir. Tacrolimus was divided into two daily doses at 12-hour intervals. Subsequent doses were adjusted to achieve a whole blood 12-hour trough level between 5 and 10 ng/ml.All patients will receive entecavir antiviral therapy(0.5mg/d), entecavir was taken once a day. All of HBV-GN patients were followed up to 25week.

  • placebo & entecavirDrug

    Also called baraclude

    HBV-GN patients with nephrotic syndrome were randomly givenTacrolimus placebo (0.05-0.1 mg/kg/day) combined with entecavir.Tacrolimus placebo was divided into two daily doses at 12-hour intervals. All patients will receive entecavir antiviral therapy(0.5mg/d), entecavir was taken once a day. All of HBV-GN patients were followed up to 25week.

Study groups in NCT03062813
Study groupRoleWhat they receive
Tacrolimus & entecavirExperimentalTacrolimus capsule, 0.5mg/capsule,1.0mg/capsule, 0.05-0.1mg/kg.d by mouth , every 12 hours for a day.Entecavir 0.5mg tablet by mouth every night.
Receives: Drug: Tacrolimus &entecavir
placebo & entecavirActive comparatorTacrolimus capsule, 0.5mg/capsule,1.0mg/capsule, 0.05-0.1mg/kg.d by mouth , every 12 hours for a day.Entecavir 0.5mg tablet by mouth every night.
Receives: Drug: placebo & entecavir

What is being measured

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

  1. Remission rate of proteinuria

    the number of patients who reached complete or partial remission (CR or PR) after the 25 week-treatment. CR was defined as <0.3 g/24 h proteinuria (UPCR<300mg/g.cr) or lower plus stable renal function (eGFR>50 ml/min/1.73 m2) and PR as proteinuria 0.3-3.0 g/24 h (UPCR 300-3000mg/g.cr) and 50% lower than baseline proteinuria plus stable renal function.

    Measured: 25 weeks

Secondary outcomes (4)
  1. Remission rate of proteinuria

    The number of patients who reached complete or partial remission (CR or PR) after the 13 week-treatment.

    Measured: 13 weeks

  2. The change of Scr

    SCr increased 2 times the baseline levels or 50% lower than the baseline eGFR(according to CKD-EPI)

    Measured: 25 weeks

  3. Serum HBV DNA

    Serum HBV DNA was undetectable(HBV DNA<500copies/ml) at the end of 25 week-treatment.

    Measured: 25 weeks

  4. The rate of acute kidney injury

    The number of patients who present acute kidney injury at the end of 25 week-treatment.

    Measured: 25 weeks

Timeline

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

  1. First posted23 Feb 2017
  2. Study start1 Feb 2017
  3. Primary completion1 Feb 2020 (estimated)
  4. Study completion31 Mar 2020 (estimated)

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
112 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03062813
Sponsor's protocol ID
ZMYe
Acronym
TOHBVGN
Status last verified
Feb 2017
First submitted
20 Feb 2017
Last updated
24 Feb 2017
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Lai KN, Li PK, Lui SF, Au TC, Tam JS, Tong KL, Lai FM. Membranous nephropathy related to hepatitis B virus in adults. N Engl J Med. 1991 May 23;324(21):1457-63. doi: 10.1056/NEJM199105233242103.

    PubMed 2023605
  • Venkataseshan VS, Lieberman K, Kim DU, Thung SN, Dikman S, D'Agati V, Susin M, Valderrama E, Gauthier B, Prakash A, et al. Hepatitis-B-associated glomerulonephritis: pathology, pathogenesis, and clinical course. Medicine (Baltimore). 1990 Jul;69(4):200-16.

    PubMed 2142748
  • Elewa U, Sandri AM, Kim WR, Fervenza FC. Treatment of hepatitis B virus-associated nephropathy. Nephron Clin Pract. 2011;119(1):c41-9; discussion c49. doi: 10.1159/000324652. Epub 2011 Jun 15.

    PubMed 21677438
  • Tang S, Lai FM, Lui YH, Tang CS, Kung NN, Ho YW, Chan KW, Leung JC, Lai KN. Lamivudine in hepatitis B-associated membranous nephropathy. Kidney Int. 2005 Oct;68(4):1750-8. doi: 10.1111/j.1523-1755.2005.00591.x.

    PubMed 16164651
  • Igarashi T, Shimizu A, Igarashi T, Hanaoka K, Yoshizaki K, Shigemori T, Shimizu S, Komeichi H, Itoh Y. Seroconversion of hepatitis B envelope antigen by entecavir in a child with hepatitis B virus-related membranous nephropathy. J Nippon Med Sch. 2013;80(5):387-95. doi: 10.1272/jnms.80.387.

    PubMed 24189358
  • Zheng XY, Wei RB, Tang L, Li P, Zheng XD. Meta-analysis of combined therapy for adult hepatitis B virus-associated glomerulonephritis. World J Gastroenterol. 2012 Feb 28;18(8):821-32. doi: 10.3748/wjg.v18.i8.821.

    PubMed 22371643
  • Yan H, Zhong G, Xu G, He W, Jing Z, Gao Z, Huang Y, Qi Y, Peng B, Wang H, Fu L, Song M, Chen P, Gao W, Ren B, Sun Y, Cai T, Feng X, Sui J, Li W. Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus. Elife. 2012 Nov 13;1:e00049. doi: 10.7554/eLife.00049.

    PubMed 23150796
  • Watashi K, Sluder A, Daito T, Matsunaga S, Ryo A, Nagamori S, Iwamoto M, Nakajima S, Tsukuda S, Borroto-Esoda K, Sugiyama M, Tanaka Y, Kanai Y, Kusuhara H, Mizokami M, Wakita T. Cyclosporin A and its analogs inhibit hepatitis B virus entry into cultured hepatocytes through targeting a membrane transporter, sodium taurocholate cotransporting polypeptide (NTCP). Hepatology. 2014 May;59(5):1726-37. doi: 10.1002/hep.26982. Epub 2014 Apr 1.

    PubMed 24375637
  • Chen M, Li H, Li XY, Lu FM, Ni ZH, Xu FF, Li XW, Chen JH, Wang HY; Chinese Nephropathy Membranous Study Group. Tacrolimus combined with corticosteroids in treatment of nephrotic idiopathic membranous nephropathy: a multicenter randomized controlled trial. Am J Med Sci. 2010 Mar;339(3):233-8. doi: 10.1097/MAJ.0b013e3181ca3a7d.

    PubMed 20220333
  • Chen Y, Schieppati A, Cai G, Chen X, Zamora J, Giuliano GA, Braun N, Perna A. Immunosuppression for membranous nephropathy: a systematic review and meta-analysis of 36 clinical trials. Clin J Am Soc Nephrol. 2013 May;8(5):787-96. doi: 10.2215/CJN.07570712. Epub 2013 Feb 28.

    PubMed 23449768
  • Xu J, Zhang W, Xu Y, Shen P, Ren H, Wang W, Li X, Pan X, Chen N. Tacrolimus combined with corticosteroids in idiopathic membranous nephropathy: a randomized, prospective, controlled trial. Contrib Nephrol. 2013;181:152-62. doi: 10.1159/000348475. Epub 2013 May 8.

    PubMed 23689577
  • Praga M, Barrio V, Juarez GF, Luno J; Grupo Espanol de Estudio de la Nefropatia Membranosa. Tacrolimus monotherapy in membranous nephropathy: a randomized controlled trial. Kidney Int. 2007 May;71(9):924-30. doi: 10.1038/sj.ki.5002215. Epub 2007 Mar 21.

    PubMed 17377504
  • Xie XF, Xie BY, Zhang WH, Hou JH, Liu DL, Zhang L, Xu LX, Li ZL, Li RZ, Ye ZM. The efficacy and safety of tacrolimus and entecavir combination therapy in the treatment of hepatitis B virus-associated glomerulonephritis: a multi-center, placebo controlled, and single-blind randomized trial. Ann Palliat Med. 2022 May;11(5):1762-1773. doi: 10.21037/apm-22-328.

    PubMed 35672893

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Tacrolimus &entecavir in people with Hepatitis B Virus Associated Nephrotic Syndrome, run by Guangdong Provincial People's Hospital at 1 site in China.

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 5 inclusion and 8 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: status not confirmed, as of the sponsor's last update on 24 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

Results are not available in the source record.

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

Contact Zhiming Ye, PHD (86-13826161678, 13826161678@139.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Remission rate of proteinuria (time frame: 25 weeks). 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 NCT03062813, which also lists 13 linked publications.

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 Feb 2017.

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