A Phase 3 interventional study of GSK548470 300 mg tablet in Hepatitis B, Chronic, sponsored by GlaxoSmithKline. Completed at 11 sites in Japan. Open to participants aged 16 Years to 69 Years. Per ClinicalTrials.gov, last updated 2015-06-22.
Sponsored by GlaxoSmithKline · Phase 3, Interventional, and Treatment
The purpose of this study is to evaluate the efficacy and safety of once-daily treatment with GSK548470 300 mg in Japanese patients with compensated chronic hepatitis B with poor response to other drugs.
This is a multicenter, open-label study in Japanese patients with compensated chronic hepatitis B with poor response to other drugs in order to evaluate the efficacy and safety of GSK548470 administered at a dose of 300 mg once daily. The target sample size is set at 32 subjects. The primary objective is to evaluate the efficacy and safety of once-daily treatment with GSK548470 300 mg in subjects with compensated chronic hepatitis B with poor response to other drugs. The secondary objective is to evaluate the long-term efficacy and safety of once-daily treatment with GSK548470 300 mg.To evaluate the efficacy and safety of GSK548470 in the study, subjects receiving a combination of lamivudine (LAM) and adefovir pivoxil (ADV) will be switched to a combination of LAM and GSK548470, while subjects on entecavir hydrate (ETV) with or without ADV will be switched to a combination of ETV and GSK548470.
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Exclusion Criteria:
GSK548470 300 mg tablet is administered orally once daily
Drug: GSK548470 300 mg tablet
Blue tablets containing 300 mg of tenofovir disoproxil fumarate
Also known as: GSK548470
Number of Participants With HBV DNA Level < 2.1 log10 Copies/mL at Week 24
The number of participants with serum hepatitis B virus deoxyribonucleic acid (HBV DNA) level \< the lower limit of quantitation (2.1 log10 copies/millilitres\[copies/mL\]) (i.e., the rate of suppression) at Week 24 was summarized. Statistical analysis was not provided for the number of participants achieving HBV DNA \<2.1 log10 copies/mL (at Week 24). Missing values observed during the treatment period was imputed by the last observation carried forward (LOCF) method.
Time frame: Week 24
Mean Change From Baseline in Serum HBV DNA Level at Week 24, Week 48 and Week 96
The mean change from Baseline in the hepatitis B virus deoxyribonucleic acid (HBV DNA) level at Week 24, Week 48 and Week 96 were assessed (HBV DNA values below the lower limit of quantitation \[i.e. 2.1 log10 copies/mL\] for the assay were set to the lower limit minus 0.1 \[i.e. 2.0 log10 copies/mL\]). Change from Baseline was calculated as the post-Baseline value minus the Baseline value. The Last Observation Carried Forward (LOCF) method was applied for missing values.
Time frame: Baseline and Week 24, Week 48 and Week 96
Number of Participants With Serum HBV DNA < 2.1 log10 Copies/mL at Week 48 and Week 96
The number of participants with serum HBV DNA level \< the lower limit of quantitation (2.1 log10 copies/mL) (i.e., the rate of suppression) at Week 48 and Week 96 were summarized. The LOCF method was applied for missing values.
Time frame: Week 48 and Week 96
Number of Participants With Alanine Aminotransferase (ALT) Normalization at Week 24, Week 48 and Week 96
The number of participants with alanine aminotransferase (ALT) normalization at Week 24, Week 48 and Week 96 were summarized. ALT normalization is defined as when an ALT value exceeds the upper limit of normal range (ULN) at Baseline and within the normal range at the end of treatment. The LOCF method was applied for missing values.
Time frame: Week 24, Week 48 and Week 96
Number of Participants With HBeAg Loss at Week 24, Week 48 and Week 96
The number of participants achieving hepatitis Be antigen (HBeAg) loss at Week 24, Week 48 and Week 96 in positive HBeAg participants at Baseline were summarized. Loss of HBeAg is defined as the change of detectable HBeAg from positive to negative. The LOCF method was applied for missing values.
Time frame: Week 24, Week 48 and Week 96
Number of Participants With HBeAg/HBeAb Seroconversion at Week 24, Week 48 and Week 96
The number of participants achieving hepatitis Be antigen (HBeAg)/hepatitis B e antibody (HBeAb) seroconversion at Week 24, Week 48 and Week 96 in positive HBeAg and negative HBeAb participants at Baseline were summarized. Seroconversion to HBeAg is defined as change of detectable antibody to HBeAg from negative to positive. The LOCF method was applied for missing values.
Time frame: Week 24, Week 48 and Week 96
Number of Participants Achieving HBsAg Loss at Week 24, Week 48 and Week 96
The number of participants with hepatitis B surface antigen (HBsAg) loss at Week 24, Week 48 and Week 96 in positive HBsAg participants at Baseline were summarized. Loss of HBsAg is defined as change of detectable HBsAg from positive to negative. The LOCF method was applied for missing values.
Time frame: Week 24, Week 48 and Week 96
Number of Participants Achieving HBsAg/HBsAb Seroconversion at Week 24, Week 48 and Week 96
The number of participants with hepatitis B surface antigen (HBsAg)/hepatitis B surface antibody (HBsAb) seroconversion at Week 24, Week 48 and Week 96 in positive HBsAg and negative HBsAb participants at Baseline were summarized. HBsAg seroconversion was defined as change of detectable antibody to HBsAg from negative to positive. The LOCF method was applied for missing values.
Time frame: Week 24, Week 48 and Week 96
Number of Participants With Virological Breakthrough and Resistance-related Mutations
The number of participants who harbored resistance-related mutations and developed virological breakthrough was summarized. Virological breakthrough defined as HBV DNA level increase \>=1 log10 copies/mL above the treatment nadir were analyzed through end of treatment. Subjects who achieved the HBV-DNA values below lower limit of quantification (LLQ) (\< 2.1 log10 copies/mL) in quantitative analysis at Week 96 were also considered "negative" in drug-resistance without implementation of genotypic analysis. Lamivudine (LAM), adefovir pivoxil (ADV), and entecavir hydrate (ETV) resistance-related mutations were analyzed at Screening (i.e. Baseline), Week 24, Week 48 and Week 96 in participants with HBV DNA level above the lower limit of detection. Virologic breakthrough was defined as 1.0 log10 or greater increases in serum HBV DNA levels from on-treatment nadir. The LOCF method was applied for missing values.
Time frame: Screening, Week 24, Week 48, Week 96 and Virological Breakthrough
Number of Participants Achieving Each Indicated HBsAg Category at Baseline, Week 24, Week 48 and Week 96
The number of participants achieving each indicated hepatitis B surface antigen (HBsAg) category (HBsAg \<80, 80 to 800, 800 to 8000, 8000 to 80000, \>=80000) (kilo international unit per liter \[KIU/L\]) by study visit was summarized.
Time frame: Baseline, Week 24, Week 48 and Week 96
Number of Participants Achieving Each Indicated HBcrAg Category at Baseline,Week 24, Week 48 and Week 96
The number of participants achieving each indicated hepatitis B core-related antigen (HBcrAg) category (HBcrAg \<3.0 log10, 3.0 to 4.0 log10, 4.0 to 5.0 log10, 5.0 to 6.0 log10, \>=6.0 log10) (kilo units per liter \[KU/L\]) by study visit was summarized. The LOCF method was applied for missing values.
Time frame: Baseline, Week 24, Week 48 and Week 96
| Milestone | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Started | 13 | 21 |
| Completed | 12 | 21 |
| Not completed | 1 | 0 |
| Withdrew: Protocol defined stopping criteria | 1 | 0 |
The number of participants with serum hepatitis B virus deoxyribonucleic acid (HBV DNA) level \< the lower limit of quantitation (2.1 log10 copies/millilitres\[copies/mL\]) (i.e., the rate of suppression) at Week 24 was summarized. Statistical analysis was not provided for the number of participants achieving HBV DNA \<2.1 log10 copies/mL (at Week 24). Missing values observed during the treatment period was imputed by the last observation carried forward (LOCF) method.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Number of Participants With HBV DNA Level < 2.1 log10 Copies/mL at Week 24 | 8 | 12 |
The mean change from Baseline in the hepatitis B virus deoxyribonucleic acid (HBV DNA) level at Week 24, Week 48 and Week 96 were assessed (HBV DNA values below the lower limit of quantitation \[i.e. 2.1 log10 copies/mL\] for the assay were set to the lower limit minus 0.1 \[i.e. 2.0 log10 copies/mL\]). Change from Baseline was calculated as the post-Baseline value minus the Baseline value. The Last Observation Carried Forward (LOCF) method was applied for missing values.
| log10 copies/mL | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 24 | -2.72 (-3.50 to -1.93) | -3.33 (-4.01 to -2.65) |
| Week 48 | -2.88 (-3.70 to -2.06) | -3.50 (-4.28 to -2.73) |
| Week 96 | -3.02 (-3.84 to -2.21) | -3.50 (-4.35 to -2.66) |
The number of participants with serum HBV DNA level \< the lower limit of quantitation (2.1 log10 copies/mL) (i.e., the rate of suppression) at Week 48 and Week 96 were summarized. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 48 | 9 | 12 |
| Week 96 | 10 | 14 |
The number of participants with alanine aminotransferase (ALT) normalization at Week 24, Week 48 and Week 96 were summarized. ALT normalization is defined as when an ALT value exceeds the upper limit of normal range (ULN) at Baseline and within the normal range at the end of treatment. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 24 | 3 | 6 |
| Week 48 | 3 | 5 |
| Week 96 | 3 | 6 |
The number of participants achieving hepatitis Be antigen (HBeAg) loss at Week 24, Week 48 and Week 96 in positive HBeAg participants at Baseline were summarized. Loss of HBeAg is defined as the change of detectable HBeAg from positive to negative. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 24 | 0 | 0 |
| Week 48 | 1 | 0 |
| Week 96 | 1 | 0 |
The number of participants achieving hepatitis Be antigen (HBeAg)/hepatitis B e antibody (HBeAb) seroconversion at Week 24, Week 48 and Week 96 in positive HBeAg and negative HBeAb participants at Baseline were summarized. Seroconversion to HBeAg is defined as change of detectable antibody to HBeAg from negative to positive. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 24 | 0 | 0 |
| Week 48 | 0 | 0 |
| Week 96 | 0 | 0 |
The number of participants with hepatitis B surface antigen (HBsAg) loss at Week 24, Week 48 and Week 96 in positive HBsAg participants at Baseline were summarized. Loss of HBsAg is defined as change of detectable HBsAg from positive to negative. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 24 | 0 | 0 |
| Week 48 | 0 | 0 |
| Week 96 | 0 | 0 |
The number of participants with hepatitis B surface antigen (HBsAg)/hepatitis B surface antibody (HBsAb) seroconversion at Week 24, Week 48 and Week 96 in positive HBsAg and negative HBsAb participants at Baseline were summarized. HBsAg seroconversion was defined as change of detectable antibody to HBsAg from negative to positive. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Week 24 | 0 | 0 |
| Week 48 | 0 | 0 |
| Week 96 | 0 | 0 |
The number of participants who harbored resistance-related mutations and developed virological breakthrough was summarized. Virological breakthrough defined as HBV DNA level increase \>=1 log10 copies/mL above the treatment nadir were analyzed through end of treatment. Subjects who achieved the HBV-DNA values below lower limit of quantification (LLQ) (\< 2.1 log10 copies/mL) in quantitative analysis at Week 96 were also considered "negative" in drug-resistance without implementation of genotypic analysis. Lamivudine (LAM), adefovir pivoxil (ADV), and entecavir hydrate (ETV) resistance-related mutations were analyzed at Screening (i.e. Baseline), Week 24, Week 48 and Week 96 in participants with HBV DNA level above the lower limit of detection. Virologic breakthrough was defined as 1.0 log10 or greater increases in serum HBV DNA levels from on-treatment nadir. The LOCF method was applied for missing values.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Virological breakthrough, through end of study n=0 | 0 | 1 |
| LAM resistance-related mutations,Screening,n=13,21 | 11 | 17 |
| ADV resistance-related mutations,Screening,n=13,21 | 4 | 0 |
| ETV resistance-related mutations,Screening,n=13,21 | 6 | 16 |
| LAM resistance-related mutations, Week 24, n=5, 9 | 4 | 8 |
| ADV resistance-related mutations, Week 24, n=5, 9 | 2 | 0 |
| ETV resistance-related mutations, Week 24, n=5, 9 | 1 | 8 |
| LAM resistance-related mutations, Week 48, n= 3, 9 | 2 | 7 |
| ADV resistance-related mutations, Week 48, n= 3, 9 | 1 | 0 |
| ETV resistance-related mutations, Week 48, n= 3, 9 | 1 | 7 |
| LAM resistance-related mutations, Week 96, n= 2, 7 | 2 | 6 |
| ADV resistance-related mutations, Week 96, n= 2, 7 | 1 | 0 |
| ETV resistance-related mutations, Week 96, n= 2, 7 | 2 | 6 |
| LAM resistance-related mutations, VB, n=0,1 | 0 | 1 |
| ADV resistance-related mutations, VB, n=0,1 | 0 | 0 |
| ETV resistance-related mutations, VB, n=0,1 | 0 | 1 |
The number of participants achieving each indicated hepatitis B surface antigen (HBsAg) category (HBsAg \<80, 80 to 800, 800 to 8000, 8000 to 80000, \>=80000) (kilo international unit per liter \[KIU/L\]) by study visit was summarized.
| participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| HBsAg <80 KIU/L, Baseline | 0 | 0 |
| HBsAg 80-800 KIU/L, Baseline | 1 | 0 |
| HBsAg 800-8000 KIU/L, Baseline | 6 | 12 |
| HBsAg 8000-80,000 KIU/L, Baseline | 6 | 8 |
| HBsAg >=80,000 KIU/L, Baseline | 0 | 1 |
| HBsAg <80 KIU/L, Week 24 | 0 | 0 |
| HBsAg 80-800 KIU/L, Week 24 | 3 | 0 |
| HBsAg 800-8000 KIU/L, Week 24 | 5 | 15 |
| HBsAg 8000-80,000 KIU/L, Week 24 | 5 | 6 |
| HBsAg >=80,000 KIU/L, Week 24 | 0 | 0 |
| HBsAg <80 KIU/L, Week 48 | 0 | 0 |
| HBsAg 80-800 KIU/L, Week 48 | 3 | 1 |
| HBsAg 800-8000 KIU/L, Week 48 | 5 | 14 |
| HBsAg 8000-80,000 KIU/L, Week 48 | 5 | 6 |
| HBsAg >=80,000 KIU/L, Week 48 | 0 | 0 |
| HBsAg <80 KIU/L, Week 96 | 0 | 0 |
| HBsAg 80-800 KIU/L, Week 96 | 4 | 3 |
| HBsAg 800-8000 KIU/L, Week 96 | 6 | 13 |
| HBsAg 8000-80,000 KIU/L, Week 96 | 3 | 5 |
| HBsAg >=80,000 KIU/L, Week 96 | 0 | 0 |
The number of participants achieving each indicated hepatitis B core-related antigen (HBcrAg) category (HBcrAg \<3.0 log10, 3.0 to 4.0 log10, 4.0 to 5.0 log10, 5.0 to 6.0 log10, \>=6.0 log10) (kilo units per liter \[KU/L\]) by study visit was summarized. The LOCF method was applied for missing values.
| Participants | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| HBcrAg <3.0 Log KU/L, Baseline | 0 | 0 |
| HBcrAg 3.0-4.0 Log KU/L, Baseline | 0 | 1 |
| HBcrAg 4.0-5.0 Log KU/L, Baseline | 0 | 1 |
| HBcrAg 5.0-6.0 Log KU/L, Baseline | 1 | 0 |
| HBcrAg >=6.0 Log KU/L, Baseline | 12 | 19 |
| HBcrAg <3.0 Log KU/L, Week 24 | 0 | 0 |
| HBcrAg 3.0-4.0 Log KU/L, Week 24 | 0 | 1 |
| HBcrAg 4.0-5.0 Log KU/L, Week 24 | 1 | 1 |
| HBcrAg 5.0-6.0 Log KU/L, Week 24 | 1 | 1 |
| HBcrAg >=6.0 Log KU/L, Week 24 | 11 | 18 |
| HBcrAg <3.0 Log KU/L, Week 48 | 0 | 0 |
| HBcrAg 3.0-4.0 Log KU/L, Week 48 | 1 | 1 |
| HBcrAg 4.0-5.0 Log KU/L, Week 48 | 0 | 1 |
| HBcrAg 5.0-6.0 Log KU/L, Week 48 | 2 | 1 |
| HBcrAg >=6.0 Log KU/L, Week 48 | 10 | 18 |
| HBcrAg <3.0 Log KU/L, Week 96 | 0 | 0 |
| HBcrAg 3.0-4.0 Log KU/L, Week 96 | 1 | 1 |
| HBcrAg 4.0-5.0 Log KU/L, Week 96 | 0 | 1 |
| HBcrAg 5.0-6.0 Log KU/L, Week 96 | 3 | 2 |
| HBcrAg >=6.0 Log KU/L, Week 96 | 9 | 17 |
Collected over Serious adverse events (SAEs) and non-serious AEs were collected from the start of study medication to the end of the treatment period (up to average of 96 weeks).. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| LAM 100 mg/TDF 300 mg | — | 1/13 (7.7%) | 12/13 (92.3%) |
| ETV 0.5 mg/TDF 300 mg | — | 2/21 (9.5%) | 17/21 (81%) |
| Event | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| Lumbar spinal stenosisMusculoskeletal and connective tissue disorders | 1/13 | 0/21 |
| Calculus uretericRenal and urinary disorders | 0/13 | 1/21 |
| AppendicitisInfections and infestations | 0/13 | 1/21 |
| Event | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg |
|---|---|---|
| NasopharyngitisInfections and infestations | 7/13 | 11/21 |
| HeadacheNervous system disorders | 2/13 | 2/21 |
| Gallbladder polypHepatobiliary disorders | 2/13 | 0/21 |
| DiarrhoeaGastrointestinal disorders | 0/13 | 3/21 |
| RashSkin and subcutaneous tissue disorders | 1/13 | 3/21 |
| Alanine aminotransferase increasedInvestigations | 1/13 | 3/21 |
| Hepatic steatosisHepatobiliary disorders | 1/13 | 3/21 |
| DyspepsiaGastrointestinal disorders | 1/13 | 2/21 |
| Abdominal discomfortGastrointestinal disorders | 0/13 | 2/21 |
| Abdominal painGastrointestinal disorders | 0/13 | 2/21 |
| Age, Continuous(Years) | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg | Total |
|---|---|---|---|
| Mean | 52.1 ± 7.57 | 50.3 ± 9.18 | 51.0 ± 8.52 |
| Sex: Female, Male(Participants) | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg | Total |
|---|---|---|---|
| Female | 5 | 4 | 9 |
| Male | 8 | 17 | 25 |
| Race/Ethnicity, Customized(Participants) | LAM 100 mg/TDF 300 mg | ETV 0.5 mg/TDF 300 mg | Total |
|---|---|---|---|
| Asian-Japanese Heritage | 13 | 21 | 34 |
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Studies of the drug tested here: Tenofovir