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The purpose of this study is to evaluate antiviral activity and efficacy of entecavir (ETV) compared to adefovir in adults with chronic hepatitis B who have not been treated yet with an antiviral medicine.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A1 | Active Comparator |
| |
| A2 | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| entecavir | Drug | Tablets, Oral, ETV 0.5 mg, once daily, up to 96 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Hepatitis B Virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) Assay at Week 12 | Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 12, adjusted for baseline (Week 12 - baseline). A negative value = improvement. | Baseline, Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in HBV DNA by PCR Assay at Week 48 | Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 48, adjusted for baseline (Week 48 - Baseline). A negative value = improvement. | Baseline, Week 48 |
| Viral Load Undetectable (HBV DNA <300 Copies/mL) |
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Inclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Bristol-Myers Squibb | Bristol-Myers Squibb | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Local Institution | San Diego | California | United States | |||
| Local Institution |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19065670 | Background | Leung N, Peng CY, Hann HW, Sollano J, Lao-Tan J, Hsu CW, Lesmana L, Yuen MF, Jeffers L, Sherman M, Min A, Mencarini K, Diva U, Cross A, Wilber R, Lopez-Talavera J. Early hepatitis B virus DNA reduction in hepatitis B e antigen-positive patients with chronic hepatitis B: A randomized international study of entecavir versus adefovir. Hepatology. 2009 Jan;49(1):72-9. doi: 10.1002/hep.22658. |
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132 enrolled; 63 not randomized (59 did not meet study criteria, 3 withdrew consent, 1 lost to follow-up). 1 randomized to adefovir (ADV) received entecavir (ETV) throughout treatment, & is counted in the ADV group for primary efficacy analysis, not included in the secondary efficacy analyses, & counted in the ETV group in safety analyses.
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| ID | Title | Description |
|---|---|---|
| FG000 | Entecavir | ETV 0.5 mg once daily (QD) |
| FG001 | Adefovir | ADV 10 mg QD |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| adefovir | Drug | Tablets, Oral, ADV 10 mg, once daily, up to 96 weeks |
|
Number of Subjects with HBV DNA <300 copies/mL by Roche COBAS® Amplicor (limit of quantitation 300 copies/mL) |
| Week 48 |
| Alanine Aminotransferase (ALT) Normalization | Number of participants with ALT ≤ 1 x upper limit of normal (ULN) | Week 48 |
| HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo Infections | The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the effectiveness of the drug in blocking virus production from infected cells (efficacy, ε) and effectiveness of the study treatment in blocking de novo infection of susceptible cells (η). The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group. | Week 12 |
| HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death Rate | The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the clearance rate of the free virus (c), the death rate of productively infected cells (δ), The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group. | Week 12 |
| HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Half-Life of Free Virus | The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. An important derived parameter is the half-life of free virus (ie, the average amount of time for HBV particles in plasma to be reduced to half the initial level), calculated as 24*ln(2)/c. The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group. | Week 12 |
| HBV DNA Viral Kinetics - Spline Model | This analysis uses a 3-parameter piece-wise linear model and describes the biphasic decline in HBV DNA (measured by PCR assay) through Week 12. The 3 parameters are the values for the 2 slopes, describing the first and second phase declines, respectively, and the estimated HBV DNA at the knot (at day 10; the time point where the 2 phases join). The biphasic viral decay kinetics for each treatment were obtained using a spline fitting procedure to estimate the 3 parameters for each subject; these estimates were then averaged within each treatment group. | Week 12 |
| Summary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and Deaths | AE=new untoward medical occurrence or worsening of pre-existing medical condition regardless of causal relationship to treatment. SAE=untoward medical occurrence that is life-threatening, a congenital anomaly/birth defect, or an important medical event, or results in death, inpatient hospitalization/prolongation of hospitalization, or persistent/significant disability. AE grades: mild (1), moderate (2), severe (3), life-threatening (4), death (5). ALT flare= >2x baseline & >10x ULN up to end of therapy + 5 days. Hepatic SAE=SAEs consistent with worsening of hepatitis or hepatic decompensation. | cumulative through the end of on-treatment observation as available at the time of the Week 48 dataset |
| Summary of Safety - Laboratory Abnormalities Reported as Clinical AEs | Laboratory abnormalities reported as clinical AEs | Week 48 |
| San Francisco |
| California |
| United States |
| Local Institution | Torrance | California | United States |
| Local Institution | Miami | Florida | United States |
| Local Institution | North Miami Beach | Florida | United States |
| Local Institution | Baltimore | Maryland | United States |
| Local Insitution | New York | New York | United States |
| Local Institution | New York | New York | United States |
| Local Institution | Philadelphia | Pennsylvania | United States |
| Local Institution | Dallas | Texas | United States |
| Local Institution | Galveston | Texas | United States |
| Local Institution | Edmonton | Alberta | Canada |
| Local Institution | Vancouver | British Columbia | Canada |
| Local Institution | Toronto | Ontario | Canada |
| Local Institution | Chai Wan | Hong Kong |
| Local Institution | Pokfulham | Hong Kong |
| Local Institution | Tai Po | Hong Kong |
| Local Institution | Jakarta | Indonesia |
| Local Institution | Cebu | Philippines |
| Local Institution | Manila | Philippines |
| Local Institution | Singapore | Singapore |
| Local Institution | Taichung | Taiwan |
| Local Institution | Taoyan | Taiwan |
| Local Institution | Bangkok | Thailand |
| As-Randomized Population |
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| As-Treated Population |
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| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Entecavir | ETV 0.5 mg once daily (QD) |
| BG001 | Adefovir | ADV 10 mg QD |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean | Standard Deviation | years |
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| Age Continuous | Median | Full Range | participants |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Number | Participants |
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| Region of Enrollment | Number | participants |
| ||||||||||||||||
| Prior interferon (IFN) | Number | Participants |
| ||||||||||||||||
| Alanine Aminotransferease (ALT) | Mean | Standard Deviation | U/L |
| |||||||||||||||
| Hepatitis B virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) | Mean | Standard Deviation | log10 copies/mL |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in Hepatitis B Virus DNA (HBV DNA) by Polymerase Chain Reaction (PCR) Assay at Week 12 | Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 12, adjusted for baseline (Week 12 - baseline). A negative value = improvement. | As-randomized participants who completed 12 weeks of treatment | Posted | Mean | Standard Error | log10 copies/mL | Baseline, Week 12 |
|
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| ||||||||||||||||||||||||||||
| Secondary | Change From Baseline in HBV DNA by PCR Assay at Week 48 | Antiviral efficacy, as measured by the mean reduction in serum HBV DNA levels by PCR (log10 copies/mL) at Week 48, adjusted for baseline (Week 48 - Baseline). A negative value = improvement. | Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Mean | Standard Error | log10 c/mL | Baseline, Week 48 |
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| Secondary | Viral Load Undetectable (HBV DNA <300 Copies/mL) | Number of Subjects with HBV DNA <300 copies/mL by Roche COBAS® Amplicor (limit of quantitation 300 copies/mL) | Treated participants who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Number | Participants | Week 48 |
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| ||||||||||||||||||||||||||||||
| Secondary | Alanine Aminotransferase (ALT) Normalization | Number of participants with ALT ≤ 1 x upper limit of normal (ULN) | treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Number | participants | Week 48 |
|
| ||||||||||||||||||||||||||||||
| Secondary | HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Efficacy in Blocking Virus Production and de Novo Infections | The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the effectiveness of the drug in blocking virus production from infected cells (efficacy, ε) and effectiveness of the study treatment in blocking de novo infection of susceptible cells (η). The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group. | Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Number | percent effective | Week 12 |
|
| ||||||||||||||||||||||||||||||
| Secondary | HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Viral Clearance Rate and Infected Cell Death Rate | The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. The model parameters of interest are the clearance rate of the free virus (c), the death rate of productively infected cells (δ), The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group. | Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Number | per day | Week 12 |
|
| ||||||||||||||||||||||||||||||
| Secondary | HBV DNA Viral Kinetics Estimates of Exponential Decay Model - Half-Life of Free Virus | The biphasic decline of HBV DNA is characterized via a 4-parameter exponential decay model previously published for HBV compounds. An important derived parameter is the half-life of free virus (ie, the average amount of time for HBV particles in plasma to be reduced to half the initial level), calculated as 24*ln(2)/c. The model parameters reflect the biphasic pattern that is typically observed after initiation of antiviral therapy. Parameters were estimated for each subject separately and then averaged within each treatment group. | Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Number | hours | Week 12 |
|
| ||||||||||||||||||||||||||||||
| Secondary | HBV DNA Viral Kinetics - Spline Model | This analysis uses a 3-parameter piece-wise linear model and describes the biphasic decline in HBV DNA (measured by PCR assay) through Week 12. The 3 parameters are the values for the 2 slopes, describing the first and second phase declines, respectively, and the estimated HBV DNA at the knot (at day 10; the time point where the 2 phases join). The biphasic viral decay kinetics for each treatment were obtained using a spline fitting procedure to estimate the 3 parameters for each subject; these estimates were then averaged within each treatment group. | Treated subjects who had both baseline and Week 12 HBV DNA measurements and who received the randomized treatment. 1 participant randomized to ADV actually received ETV and is not counted in secondary efficacy analyses. | Posted | Number | log10 copies/mL | Week 12 |
|
| ||||||||||||||||||||||||||||||
| Secondary | Summary of Safety - Most Frequent (> 10%) Adverse Events (AEs), Serious Adverse Events (SAEs), Discontinuations Due to AEs, and Deaths | AE=new untoward medical occurrence or worsening of pre-existing medical condition regardless of causal relationship to treatment. SAE=untoward medical occurrence that is life-threatening, a congenital anomaly/birth defect, or an important medical event, or results in death, inpatient hospitalization/prolongation of hospitalization, or persistent/significant disability. AE grades: mild (1), moderate (2), severe (3), life-threatening (4), death (5). ALT flare= >2x baseline & >10x ULN up to end of therapy + 5 days. Hepatic SAE=SAEs consistent with worsening of hepatitis or hepatic decompensation. | As-treated population. 1 participant was randomized to ADV, but treated with ETV was counted in the ETV group. | Posted | Number | Participants | cumulative through the end of on-treatment observation as available at the time of the Week 48 dataset |
|
| ||||||||||||||||||||||||||||||
| Secondary | Summary of Safety - Laboratory Abnormalities Reported as Clinical AEs | Laboratory abnormalities reported as clinical AEs | As-treated population. 1 participant who was randomized to ADV, but treated with ETV was counted in the ETV group. | Posted | Number | Participants | Week 48 |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | ADV 10 mg | 2 | 33 | 16 | 33 | |||
| EG001 | ETV 0.5 mg | 1 | 36 | 17 | 36 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ALANINE AMINOTRANSFERASE INCREASED | Investigations | MedDRA 8.1 | Systematic Assessment |
| |
| RIB FRACTURE | Injury, poisoning and procedural complications | MedDRA 8.1 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| LIPASE INCREASED | Investigations | MedDRA 8.1 | Systematic Assessment |
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| HEADACHE | Nervous system disorders | MedDRA 8.1 | Systematic Assessment |
| |
| DIZZINESS | Nervous system disorders | MedDRA 8.1 | Systematic Assessment |
| |
| ABDOMINAL PAIN | Gastrointestinal disorders | MedDRA 8.1 | Systematic Assessment |
| |
| INFLUENZA | Infections and infestations | MedDRA 8.1 | Systematic Assessment |
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| NASOPHARYNGITIS | Infections and infestations | MedDRA 8.1 | Systematic Assessment |
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| UPPER RESPIRATORY TRACT INFECTION | Infections and infestations | MedDRA 8.1 | Systematic Assessment |
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| BACK PAIN | Musculoskeletal and connective tissue disorders | MedDRA 8.1 | Systematic Assessment |
| |
| COUGH | Respiratory, thoracic and mediastinal disorders | MedDRA 8.1 | Systematic Assessment |
| |
| RHINORRHOEA | Respiratory, thoracic and mediastinal disorders | MedDRA 8.1 | Systematic Assessment |
| |
| MALAISE | General disorders | MedDRA 8.1 | Systematic Assessment |
|
Bristol-Myers Squibb Co. agreements with investigators vary; constant is our right to embargo communications regarding trial results prior to public release for a period ≤60 days from submittal for review. We will not prohibit investigators from publishing, but will prohibit the disclosure of previously undisclosed confidential information other than study results, and request postponement of single-center publications until after disclosure of the clinical trial's primary publication.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| BMS Study Director | Bristol-Myers Squibb | Clinical.Trials@bms.com |
| ID | Term |
|---|---|
| D006509 | Hepatitis B |
| D002908 | Chronic Disease |
| D019694 | Hepatitis B, Chronic |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D018347 | Hepadnaviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D006525 | Hepatitis, Viral, Human |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006521 | Hepatitis, Chronic |
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| ID | Term |
|---|---|
| C413685 | entecavir |
| C053001 | adefovir |
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| Male |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
|
| East Asia |
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| No prior IFN |
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