A Study to Evaluate the Efficacy and Safety of Bepirovirsen in Participants Receiving Nucleos(t)ide Analogue Therapy for Chronic Hepatitis B Virus InfectionB -Definite
Trial overview
Proportion of Participants Achieving Functional Cure (FC)
Timeframe: Up to Week 72
Proportion of Participants Achieving Sustained Suppression of HBV DNA (<LLOQ) After Discontinuation of all Chronic HBV Treatment
Timeframe: Up to Week 72
Proportion of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
Timeframe: Up to Week 72
- Disease Under Study: Documented chronic Hepatitis B virus (HBV) infection for at least 6 months prior to the Screening visit.
- Stable Background NA Therapy: Currently receiving stable background NA therapy (not limited to, entecavir, tenofovir alafenamide, or tenofovir disoproxil fumarate) for at least 6 months prior to the Screening visit, with no planned changes to the NA regimen for at least 3 months before enrolment and during the study, except per protocol.
- Current or past Hepatitis C virus (HCV), Hepatitis D virus (HDV), Human immunodeficiency virus (HIV) co-infection.
- History of, or suspected, liver cirrhosis and/or evidence of cirrhosis, defined as:
- Disease Under Study: Documented chronic Hepatitis B virus (HBV) infection for at least 6 months prior to the Screening visit.
- Stable Background NA Therapy: Currently receiving stable background NA therapy (not limited to, entecavir, tenofovir alafenamide, or tenofovir disoproxil fumarate) for at least 6 months prior to the Screening visit, with no planned changes to the NA regimen for at least 3 months before enrolment and during the study, except per protocol.
- Quantitative serum HBsAg <= 100 IU/mL at the Screening visit.
- Serum HBV DNA <90 IU/mL at the Screening visit.
- Alanine aminotransferase (ALT) <= 2 x Upper Limit of Normal (ULN) at the Screening visit.
- Participants who are willing and able to cease their NA treatment in accordance with the protocol.
- For male participants: There are no contraceptive requirements.
- Is a woman of non-childbearing potential (WONCBP) OR
- Is a woman of childbearing potential (WOCBP) and using a contraceptive method that is highly effective (with a failure rate of <1 percent (%) per year) and preferably with low user dependency, for a period of 28 days prior to and during the Bepirovirsen Treatment Stage, and for at least 7 days after the last dose of bepirovirsen; and agrees not to donate eggs/ova/oocytes for the purpose of reproduction during the Bepirovirsen Treatment Stage. The Investigator should evaluate the potential for contraceptive method failure (e.g., non-compliance, recently initiated) in relationship to the first dose of bepirovirsen.
- If a urine pregnancy test cannot be confirmed as negative (it has an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
- The Investigator is responsible for reviewing a female participant’s medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
- Capable of giving signed informed consent (as described in the full protocol), which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in the full protocol.
For female participants: A female participant is eligible to participate if she is not pregnant or breastfeeding, and one of the following conditions applies:
A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 24 hours before the first dose of bepirovirsen.
- Current or past Hepatitis C virus (HCV), Hepatitis D virus (HDV), Human immunodeficiency virus (HIV) co-infection.
- Liver biopsy with a METAVIR score of F4.
- Liver stiffness measurement of greater than or equal to (>=)12 kilopascal (kPa) by ultrasound elastography or (>=) 5 kPa by magnetic resonance elastography.
- Diagnosed or suspected hepatocellular carcinoma, defined as: a. Alpha-fetoprotein concentration ≥ 200 nanogram per milliliters (ng/mL) at the Screening visit. b. If the alpha-fetoprotein concentration is ≥50 ng/mL to < 200 ng/mL at the Screening visit, then the absence of a liver mass must be documented by liver imaging performed within 6 months before Screening; if such liver imaging has not been performed, the participant must be excluded from this study.
- History of malignancy within 5 years before the Screening visit, except for specific cancers that are cured by surgical resection (e.g., skin cancer). Participants with a current malignancy or under evaluation for a possible malignancy must be excluded from the study.
- Current or past vasculitis, or the presence of symptoms and signs suggestive of vasculitis (vasculitic rash, skin ulceration, recurrent hematuria without an identified cause), and/or current or past autoimmune disease or other medical conditions that may be associated with vasculitis (e.g., systemic lupus erythematosus, rheumatoid arthritis, relapsing polychondritis, mononeuritis multiplex).
- This refers to illicit drug abuse or misuse of medications and substances with abuse potential. Medications used as directed, whether over the counter or prescribed, are acceptable and do not meet this exclusion criterion.
- Clinically significant medical comorbidities: Current or past medical conditions (including, but not limited to, cardiovascular, renal, or other diseases) that would make the participant unsuitable for this study, in the opinion of the Investigator.
- Currently taking or has taken within 3 months before Screening, any immunosuppressing drugs (e.g., prednisone), other than a short course of therapy (i.e., <= 2 weeks) or topical/inhaled steroid use.
- Participants who cannot receive immunosuppressive treatment (including therapeutic doses of steroids) should not be enrolled in this study.
- Currently taking or has taken within 12 months before Screening, any interferon containing therapy.
- Participants currently taking anti-coagulation therapies (, warfarin, Factor Xa inhibitors) or anti-platelet agents (e.g., aspirin or clopidogrel) are excluded from this study, unless these treatments can be safely discontinued throughout the duration of the Bepirovirsen Treatment Stage, in the opinion of the Investigator.
- Prior treatment with bepirovirsen.
- Prior treatment with any other oligonucleotide or siRNA within 12 months before the first dosing day. 15. The participant has received an investigational product from a clinical trial within the time period before the first dosing day defined as follows: 5 half-lives of the investigational product or twice the duration of its biological effect, whichever is longer; or 90 days, if either the half-life or duration of the biological effect of the investigational product is unknown.
- Fridericia’s QT correction formula (QTcF) > 480 milliseconds (msec) at the Screening visit (if the electrocardiogram [ECG] shows QTcF > 480 msec, then two additional ECGs need to be performed, and the mean QTcF from these triplicate measurements will be used to confirm that the participant meets this exclusion criterion).
- Serum albumin <= 3.5 grams per deciliter (g/dL)
- International normalized ratio (INR) >1.25
- Platelet count <100 x 10^9/L
- Total bilirubin >1.25 x ULN – Participants with Gilbert's syndrome can be included if direct bilirubin <= 1.25x ULN. – The Investigator needs to document this medical condition in the eCRF.
- Urine albumin to creatinine ratio (uACR) >0.3 milligrams per milligram (mg/mg) (>300 mg/gram [g]). In the event of an uACR above this threshold, eligibility may be determined by a repeat measurement. – If one or both components of the urine albumin to creatinine ratio are outside the reportable range, an accurate ratio cannot be reported. In such cases, the Investigator should review both components and interpret them in conjunction with other clinical characteristics (e.g., history of diabetes, hypertension).
- History of sensitivity to bepirovirsen, or components thereof, or other current or past drug allergy that would make the participant unsuitable for this study, in the opinion of the Investigator.
- Participants who do not wish to discontinue their background NA therapy.
History of, or suspected, liver cirrhosis and/or evidence of cirrhosis, defined as: a. Both Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) greater than (>) 2 and FibroSure/FibroTest score > 0.7 at the Screening visit. b. In addition, regardless of the APRI or FibroSure/FibroTest score at the Screening visit, the participant must be excluded from this study if any prior medical record before the Screening visit shows at least one of the following:
Current or past extrahepatic disorders (e.g., nephrotic syndrome, any type of glomerulonephritis, polyarteritis nodosa, cryoglobulinemia, uncontrolled hypertension) that are considered possibly related to HBV, in the opinion of the Investigator. Current or past alcohol or drug abuse/dependence: a. Current alcohol use that would interfere with participant compliance, in the opinion of the Investigator. b. Current or past drug abuse/dependence that would interfere with participant compliance, in the opinion of the Investigator.
Laboratory results as follows:
Trial location(s)
No location data available.
Study documents
No study documents available.
Results overview
Study Results yet to be posted
Plain language summaries
Plain language summaries of clinical trial results for Phase 2-4 clinical trials that were initiated on or after January 2022 will be posted by GSK within one year following study completion.