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A randomized, Open label, Single center, Prospective study to compare efficacy and safety of Therapeutic Vaccination with Intensified schedule plus Pegylated Interferon dual Therapy on Seroclearance of Hepatitis B virus Surface Antigen in Patients with Complete Virological Response Induced by Entecavir
A randomized, Open label, Single center, Prospective study to compare efficacy and safety of Therapeutic Vaccination with Intensified schedule plus Pegylated Interferon dual Therapy on Seroclearance of Hepatitis B virus Surface Antigen in Patients with Complete Virological Response Induced by Entecavir (E + VIP)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Concomitant:Pegasys, Euvax B, Baracrude | Experimental |
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| Sequential:Pegasys, Euvax B, Baracrude | Experimental |
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| Control Group | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peginterferon alfa-2a | Biological | once weekly 180 μg subcutaneous injection for 48 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| The rate of HBsAg-seroclearance | The rate of HBsAg-seroclearance at the time point of at weeks 100 in the sequential treatment group (24 weeks after termination of treatment) versus control group(ETV monotherapy) at weeks 100. | The rate of HBsAg-seroclearance at the time point of at weeks 100 |
| Measure | Description | Time Frame |
|---|---|---|
| The rate of HBsAg-seroconversion | The rate of HBsAg-seroconversion at weeks 100 in the sequential treatment group versus control group(ETV monotherapy) at weeks 100. | The rate of HBsAg-seroconversion at weeks 100 |
| The change of HBsAg level from baseline |
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Inclusion Criteria:
Exclusion Criteria:
Patients with decompensated liver cirrhosis, any one of the following ① Serum bilirubin > 3 mg/dL
② Prothrombin time > 6 seconds prolonged or INR >2.3
③ Serum albumin < 2.8 g/dL
④ History of ascites, variceal hemorrhage, or hepatic encephalopathy
⑤ Child-Pugh score ≥7 (Child-Pugh class B or C)
Patients who have evidence of renal insufficiency defined as serum creatinine>1.5 mg/dL
Patients with psychological problem including depression
Patients who have previous/current significant co-morbidities including congestive heart failure, chronic kidney disease, hematologic disease and malignancy including hepatocellular carcinoma(patients with malignancy cured 5 years before screening can be enrolled)
Patients with seropositivity for anti-HCV, anti-HDV or anti-HIV
Patients who have excessive alcohol consumption (> 30 g/day)
Patients who have evidence of autoimmune hepatitis, hemochromatosis or Wilson's disease
Pregnant or breast feeding females or plan for pregnancy or no contraception
Patients with disease may deteriorate with interferon therapy(eg, autoimmune thyroiditis)
Patients who have an psoriasis
Patients who have history of antiviral-resistant HBV after previous treatment with oral antiviral agents
Previous diagnosis with immunodeficiency or concomitant treatment of immune suppressive agent or previous organ transplantation Recipients
Patients who have a history of hypersensitivity to study drug
Uncontrollable seizure, convulsion and/or central nervous system disorders
Patients with severe bone marrow disorder or with history of hypersensitivity to biologic agent such as vaccine.
Neutrophil count < 1,500/mm3 or platelet count < 75,000/mm3 or hemoglobin < 10 g/dl
Patients with Pulmonary disease (in case of history of pulmonary disease with complete recovery, enrollment is on investigator's discretion)
Patients who have a fever ≥ 38 °C at the baseline
Patients who have a risk of febrile response or systemic reaction
Patients who the investigator deems inappropriate to participate in this study
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| Name | Affiliation | Role |
|---|---|---|
| Yoon Jun Kim, MD, PhD | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University | Seoul | ASI|KR|KS013 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32556157 | Derived | Lee JH, Lee YB, Cho EJ, Yu SJ, Yoon JH, Kim YJ. Entecavir Plus Pegylated Interferon and Sequential Hepatitis B Virus Vaccination Increases Hepatitis B Surface Antigen Seroclearance: A Randomized Controlled Proof-of-Concept Study. Clin Infect Dis. 2021 Nov 2;73(9):e3308-e3316. doi: 10.1093/cid/ciaa807. |
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| ID | Term |
|---|---|
| D019694 | Hepatitis B, Chronic |
| ID | Term |
|---|---|
| D006509 | Hepatitis B |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| C100416 | peginterferon alfa-2a |
| C413685 | entecavir |
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| HBV vaccination | Biological | 1.0 mL (20 μg) intramuscular injection at 4, 8, 12 and 28 weeks |
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| Entecavir | Drug | Continue Entecavir(0.5mg) for 100 weeks |
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The change of HBsAg level from baseline at weeks 100 in the sequential treatment group versus control group(ETV monotherapy) at weeks 100. |
| The change of HBsAg level from baseline at weeks 100 |
| The change of HBsAg-seroclearance | The change of HBsAg-seroclearance in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment. | The change of HBsAg-seroclearance at weeks 4, weeks 12, weeks 24, weeks 36, weeks 48, weeks 60, weeks 72, weeks 96, weeks 100, weeks 148 |
| The change of HBsAg-seroconversion | The change of HBsAg-seroconversion in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment. | The change of HBsAg-seroconversion at weeks 4, weeks 12, weeks 24, weeks 36, weeks 48, weeks 60, weeks 72, weeks 96, weeks 100, weeks 148 |
| The change of HBsAg level | The change of HBsAg level in the concomitant treatment group versus control group(ETV monotherapy) for exploratory assessment. | The change of HBsAg level at weeks 4, weeks 12, weeks 24, weeks 36, weeks 48, weeks 60, weeks 72, weeks 96, weeks 100, weeks 148 |
| D018347 |
| Hepadnaviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D006525 | Hepatitis, Viral, Human |
| D006521 | Hepatitis, Chronic |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |