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| Name | Class |
|---|---|
| Xiamen Amoytop Biotech Co., Ltd. | INDUSTRY |
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This study is a multi-center, randomized, prospective, open-label Phase III Clinical trial to assess the efficacy and safety of combination and sequential treatment with Y peginterferon Alfa-2b,entecavir and GMCSF in chronic hepatitis B patients nucleotides or nucleosides experienced. Patients were randomized to one of 3 groups to receive different antiviral treatment.
Patients who have been pretreated with and responded to one or two nucleotides or nucleosides for at least one year, with HBV (Hepatitis B Virus) DNA less than 1000 copies/ml and HBsAg less 3000 IU/ml were randomized to one of 3 groups, to receive Y peginterferon Alfa-2b 180mcg/week for 96 weeks, entecavir 0.5 mg po daily for 48 weeks plus GMCSF (Granulocyte-macrophage colony stimulating factor) for 48 weeks, or Y peginterferon Alfa-2b 180mcg/week for 96 weeks and entecavir 0.5 mg po daily for 48 weeks, or only ETV for 96 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1,conventional control group | Active Comparator | Drug: Entecavir and or adefovir dipivoxil are used for 96 weeks and the follow up 24 weeks. Entecavir 0.5mg po daily or plus ADV (adefovir dipivoxil)10mg po daily. |
|
| 2,combination and sequential group | Experimental | Drug: Y peginterferon Alfa-2b 180 micrograms sc/week for 96 weeks; Drug: Entecavir and or adefovir dipivoxil are used for 48 weeks. Entecavir 0.5mg po daily for 48 weeks or plus ADV 10mg po daily. |
|
| 3, multitarget group | Experimental | Drug: Y peginterferon Alfa-2b 180 micrograms sc/week for 96 weeks; Drug: Granulocyte-macrophage colony stimulating factor is used for 48 weeks; Drug: Entecavir and or adefovir dipivoxil are used for 48 weeks. Entecavir 0.5mg po daily for 48 weeks or plus ADV 10mg po daily. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Y peginterferon alfa-2b | Drug | In arm 2 and 3, Y peginterferon alfa-2b is used for 96 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of HBsAg loss at week 96 | Change from baseline in Percentage of HBsAg loss at week 96 | week 96 |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in HBsAg quantification and HBsAg decline at week 96 | HBsAg quantification and HBsAg decline from baseline are measured. | week 96 |
| Change from baseline in HBsAg seroconversion at week 96 |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of HBeAg loss or HBeAg seroconversion at week 96 for HBeAg positive patients | Percentage of HBeAg loss or HBeAg seroconversion are measured at week 96 for patients with HBeAg positive at baseline | week 96 |
| Percentage of HBV DNA normalization and ALT normalization at week 96 |
Inclusion Criteria:
Exclusion Criteria:
Patients who had NAs resistance and HBV DNA > 1000 copies/ml, or treatment of drugs with IFN longer than 6 months;
Other antiviral, anti-neoplastic or immunomodulatory treatment (including supra physiologic doses of steroids and radiation) 6 months prior to the first dose of randomized treatment (except for 7 days of acyclovir for herpetic lesions more than 1 month prior to first administration of randomized treatment). Patients who are expected to need systemic antiviral therapy other than that provided by the study at any time during their participation are also excluded;
Women with ongoing pregnancy or breast-feeding;
Co-infection with active hepatitis A, hepatitis C, hepatitis D(Those hospitals which have the ability to do the test will do) and/or human immunodeficiency virus (HIV);
ALT >10 ULN;
Evidence of decompensated liver disease (Child-Pugh score > 5 ). Child-Pugh > 5 means, if one of the following 5 conditions are met, the patient has to be excluded:
one of the following 5 conditions are met, the patient has to be excluded:
History or other evidence of a medical condition associated with chronic liver disease other than viral hepatitis (e.g., hemochromatosis, autoimmune hepatitis, metabolic liver disease, alcoholic liver disease, toxin exposures, thalassemia);
Signs or symptoms of hepatocellular carcinoma, patients with a value of alpha-fetoprotein > 100 ng/mL are excluded, unless stability (less than 10% increase) has been documented over at least the previous 3 months. Patients with values < 20 ng/mL but > 100 ng/mL may be enrolled, if hepatic neoplasia has been excluded by liver imaging;
Neutrophil count < 1500 cells/mm3 or platelet count <90,000 cells/mm3 at screening;
Hemoglobin < 11.5 g/dL for females and <12.5 g/dL for men;
Serum creatinine level > 1.5 ULN in screening period.
Phosphorus < 0.65 mmol/L;
ANA > 1:100;
History of severe psychiatric disease, especially depression. Severe psychiatric disease is defined as treatment with an antidepressant medication or a major tranquilizer at therapeutic doses for major depression or psychosis, respectively, for at least 3 months at any previous time or any history of the following: a suicidal attempt hospitalization for psychiatric disease, or a period of disability due to a psychiatric disease;
History of a severe seizure disorder or current anticonvulsant use;
History of immunologically mediated disease, (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, rheumatoid arthritis etc.);
History of chronic pulmonary disease associated with functional limitation;
Diseases that IFN and Nucleotides or nucleosides are not suitable.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Qin Ning | Contact | 86 27 83662391 | qning@vip.sina.com |
| Name | Affiliation | Role |
|---|---|---|
| Qin Ning, Doctor | Department of Infectious Diseases, Tongji Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Youan Hospital | Recruiting | Beijing | Beijing Municipality | 100069 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41366186 | Derived | Wu D, Huang D, Peng S, Chen Y, Yang F, Zhang X, Fu L, Xu L, Jiang J, Zheng Q, Chen X, Liu Y, Dou X, Ma K, Xi D, Wang P, Sun L, He R, Tian Y, Yin P, Yan W, Han M, Ning Q. Efficacy and safety of entecavir, peginterferon alfa-2b and GM-CSF combination therapy: the anchor randomized controlled trial. Hepatol Int. 2026 Feb;20(1):31-45. doi: 10.1007/s12072-025-10977-2. Epub 2025 Dec 9. | |
| 40665748 |
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| Granulocyte-macrophage colony stimulating factor | Drug | In arm 3, Granulocyte-macrophage colony stimulating factor is used for 48 weeks intermittently |
|
|
| Entecavir and or adefovir dipivoxil | Drug | In arm 1, Entecavir and or adefovir dipivoxil are used for 96 weeks and the follow up 24 weeks as conventional control, In arm 2 and 3, Entecavir and or adefovir dipivoxil are used for 48 weeks. |
|
|
HBsAg seroconversion from baseline is measured.
| week 96 |
Percentage of HBV DNA normalization and ALT normalization at week 96 are measured. |
| week 96 |
| Percentage of sustained virology response at week 120 | Sustained virology response is measure at follow up week 24 | week 120 |
| Tongji Hospital | Recruiting | Wuhan | Hubei | 430030 | China |
|
| Xiangya Hospital, Central South University | Recruiting | Changsha | Hunan | 410008 | China |
|
| The First Affiliated Hospital of Wenzhou Medical University | Recruiting | Wenzhou | Zhejiang | 325000 | China |
|
| Derived |
| Gu M, Wu W, You J, Wu Q, Huang F, Zhang Y, Wang P, Xi D, Yan W, Wang X, Chen T, Wu D, Ning Q, Han M. High-Throughput Viral Integration Detection Reveals Baseline Breakpoints Burden Associated With HBsAg Seroclearance. Aliment Pharmacol Ther. 2025 Nov;62(9):887-900. doi: 10.1111/apt.70270. Epub 2025 Jul 16. |
| 35149125 | Derived | Huang D, Wu D, Wang P, Wang Y, Yuan W, Hu D, Hu J, Wang Y, Tao R, Xiao F, Zhang X, Wang X, Han M, Luo X, Yan W, Ning Q. End-of-treatment HBcrAg and HBsAb levels identify durable functional cure after Peg-IFN-based therapy in patients with CHB. J Hepatol. 2022 Jul;77(1):42-54. doi: 10.1016/j.jhep.2022.01.021. Epub 2022 Feb 8. |
| ID | Term |
|---|---|
| D019694 | Hepatitis B, Chronic |
| ID | Term |
|---|---|
| D006509 | Hepatitis B |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| 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 |
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| ID | Term |
|---|---|
| C417083 | peginterferon alfa-2b |
| D003115 | Colony-Stimulating Factors |
| C413685 | entecavir |
| C106812 | adefovir dipivoxil |
| ID | Term |
|---|---|
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D016298 | Hematopoietic Cell Growth Factors |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
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