Study to Assess Efficacy and Safety of Bulevirtide in Patients With CHD

• Status: Active, not recruiting
• Trial end date: 2024-07-01
• Target enrollment: 0
• Participant gender: All

Summary

The primary objective of this study is to evaluate the efficacy of bulevirtide for treatment of chronic hepatitis delta (CHD) in comparison to delayed treatment.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Gilead Sciences; MYR GmbH
• Collaborator: Hepatera Ltd.

Criteria

Inclusion Criteria:

1. Provision of signed and dated informed consent form.

2. Positive serum anti-HDV antibody results or PCR results for serum/ plasma HDV RNA for at least 6 months before screening.

3. Positive PCR results for serum/ plasma HDV RNA at screening.

4. Alanine transaminase level > 1 x ULN, but less than 10 x ULN.

5. Serum albumin > 28 g/L.

6. Negative urine pregnancy test for females of childbearing potential.

7. Inclusion criteria for females:

• Postmenopausal for at least 2 years, or

• Surgically sterile (total hysterectomy or bilateral oophorectomy, bilateral tubal ligation, staples, or another type of sterilization), or

• Abstinence from heterosexual intercourse throughout the study, or

• Willingness to use highly effective contraception (double barrier method or barrier contraception in combination with hormonal or intrauterine contraceptive) throughout the study and for 3 months after the last dose of the study medication for patients discontinued during the treatment period.

8. Individuals must agree to use a highly effective contraception (double barrier method or barrier contraception in combination with hormonal or intrauterine contraceptive used by female partners) and not to donate sperm throughout the study and for 3 months after the last dose of the study medication for patients discontinued during the treatment period.

Exclusion Criteria:

1. Child-Pugh hepatic insufficiency score over 7 points. Uncomplicated oesophageal varices allowed; Individuals with current bleeding or ligation, or history of bleeding or ligation within the last 2 years are excluded.

2. HCV or uncontrolled HIV coinfection. Individuals with HCV antibodies can be enrolled, if screening HCV RNA test is negative. Individuals with HIV infection can be enrolled if CD4+ cell counts are >500/mL and HIV RNA is below limit of detection for at least 12 months.

3. Creatinine clearance < 60 mL/min as estimated using Cockcroft-Gault formula.

4. Total bilirubin ≥ 34.2 µmol/L. [Patients with higher total bilirubin values may be included after the consultation with the Study Medical Monitor, if such elevation can be clearly attributed to Gilbert's syndrome associated with low-grade hyperbilirubinemia.]

5. Evidence of an active or suspected malignancy or a history of malignancy, or an untreated pre-malignancy disorder within the last 5 years (with the exception of successfully treated carcinoma of the cervix in situ and successfully treated basal cell carcinoma and squamous cell carcinoma not less than 1 year prior to screening [and no more than 3 excised skin cancer within the last 5 years prior to screening]) or history of hepatic carcinoma.

6. Systemic connective tissue disorders.

7. NYHA (New York Heart Association) class III-IV congestive heart failure.

8. Patients with uncontrolled arterial hypertension: systolic blood pressure > 150 mm Hg and/ or diastolic blood pressure > 100 mm Hg at Screening.

9. Previous or unstable concurrent diseases or conditions that prevent individual's enrolment into the study.

10. Patients with mental disorders or social circumstances that preclude them from following protocol requirements.

11. Current or previous (within last 2 years) decompensated liver disease, including coagulopathy, hepatic encephalopathy and esophageal varices hemorrhage.

12. One or more additional known primary or secondary causes of liver disease, other than hepatitis B (e.g., alcoholism, autoimmune hepatitis, malignancy with hepatic involvement, hemochromatosis, alpha-1 antitrypsin deficiency, Wilson's Disease, other congenital or metabolic conditions affecting the liver, congestive heart failure or other severe cardiopulmonary disease, etc.). Gilbert's syndrome, a benign disorder associated with low-grade hyperbilirubinemia, will not exclude patients from participation in this trial. Autoimmune hepatitis stigmata attributed to HDV infection in the opinion of the investigator are allowed.

13. White blood cells (WBC) count < 3000 cells/mm3 (<1500 if African patients).

14. Neutrophil count < 1500 cells/mm3 (<1000 if African patients).

15. Platelet count < 60,000 cells/mm3.

16. Use of prohibited psychotropic agents at Screening.

17. Use of interferons within 6 months before Screening.

18. History of solid organ transplantation.

19. Current alcohol abuse or alcohol abuse within 6 months prior to enrolment in this study; past or current drug addict.

20. History of disease requiring regular use of systemic glucocorticosteroids (inhalative glucocorticosteroids are allowed) or other immunosuppressants.

21. Pregnant or breast-feeding females.

22. Participation in another clinical study with investigational drugs within 30 days prior to randomization.

23. Receipt of bulevirtide previously, e.g. in clinical trials.

24. Inability to follow protocol requirements and undergo all protocol procedures. NOTE:

Patients with medical contraindication for liver biopsy are allowed to participate in this study. Such patients will exempt from liver biopsy requirements in this study.

Individuals receiving prohibited treatment at Screening cannot be included into the study unless this treatment is withdrawn prior to randomization.