E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
HBV inmunization in patients with cirrhosis candidates for liver transplantation. |
Inmunización frente a VHB en pacientes con cirrosis hepática candidatos a trasplante de hígado. |
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E.1.1.1 | Medical condition in easily understood language |
Efficacy of vaccination against hepatitis B virus (HBV) in patients with chronic liver disease candidates for organ trasplantation. |
Eficacia de la vacunación frente al virus de la hepatitis B en pacientes con enfermedad crónica del higado candidatos a trasplante. |
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E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10054130 |
E.1.2 | Term | Hepatitis B immunisation |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061890 |
E.1.2 | Term | Organ transplant |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10019641 |
E.1.2 | Term | Hepatic cirrhosis |
E.1.2 | System Organ Class | 10019805 - Hepatobiliary disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the response rate obtained with two different vaccionation schemes against HBV in cirrhotic patients potential candidates for liver transplantation, who have failed seroconversion (anti-HBs < 10 UI/ml) after three intramuscular doses of 40 ?g at 0, 1 and 2 months. |
Comparar la tasa de respuesta obtenida con dos pautas de vacunación diferentes frente al VHB en pacientes cirróticos candidatos potenciales a trasplante de hígado, que no han obtenido seroconversión (anti-HBs < 10 UI/ml) tras tres dosis de 40 ?g intramusculares (IM) a los 0,1, y 2 meses. |
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E.2.2 | Secondary objectives of the trial |
To evaluate the association of immunogenicity of two vaccination procedures with clinical variables: age, sex, tobacco, diabetes, weight, body mass index / obesity, presence of anti-HBc positive, etiological factors and severity (Child Pugh stage, index MELD) in cirrhosis. |
Valorar la asociación de la inmunogenicidad de ambas pautas vacunales con variables clínicas: edad, sexo, tabaco, diabetes, peso, índice de masa corporal/obesidad, presencia de anti-HBc positivo, factores etiológicos y severidad (estadio de Child Pugh, índice de MELD) de la cirrosis. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Cirrhotic patients over 18 years old, potential candidates for liver transplantation with an estimated wait time of more than 6 months, with indication to HBV vaccionation (HBsAg negative and anti-HBs negative), who do not show a response after the first cycle of vaccination of three intramuscular doses of 40 ?g at 0, 1 and 2 months, and who have given their consent to participate in the study. |
Pacientes cirróticos mayores de 18 años potenciales candidatos a trasplante de hígado con un tiempo estimado de espera de más de 6 meses, con indicación de vacunación frente al VHB (HBsAg negativo y anti-HBs negativo), que no obtengan respuesta tras un primer ciclo de vacunación de tres dosis de 40 ?g IM a los 0, 1 y 2 meses, y que hayan prestado su conformidad para participar en el estudio. |
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E.4 | Principal exclusion criteria |
Absolute contraindication to HBV vaccine. Medical history of allergy to any component of the vaccine. Chronic renal failure on hemodialysis. Presence of antibodies against Human Immunodeficiency Virus. Patients with seroconversion (anti-HBs ? 10 IU /ml) after the first three doses of vaccine. Lack of consent to participate in the study. |
Contraindicación absoluta a la vacuna VHB. Antecedente de alergia a algún componente de la vacuna. Insuficiencia renal crónica en hemodiálisis. Presencia de anticuerpos frente al virus de la inmunodeficiencia humana. Pacientes con seroconversión (anti-HBs ? 10 UI/ml) tras las tres primeras dosis de vacuna. Ausencia de consentimiento para participar en el estudio. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Post-vaccination serological response measured by the titre of anti-HBs and the response rate (? 10 IU / ml). |
Respuesta serológica post-vacunal que se medirá mediante el título de anti-HBs y la tasa de respuesta (?10 UI/ml). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
At 35 ± 5 days after administration of the first cycle of vaccination (0, 1 and 2 months). In order to identify non-responders. At 35 ± 5 days after administration of the 4th dose at month 6 (Standard scheme). At 35 ± 5 days after administration of the second cycle of vaccination (0, 1 and 2 months) (Experimental scheme).
Serum extraction will coincide as much as possible with other blood determinations to control patient's disease. |
A los 35 ± 5 días de haber administrado el primer ciclo de vacunación (0, 1 y 2 meses). Servirá para identificar a los pacientes no respondedores. A los 35 ± 5 días tras la administración de la 4ª dosis a los 6 meses (pauta estándar). A los 35 ± 5 días tras haber administrado el segundo ciclo de vacunación (0, 1 y 2 meses) (pauta experimental).
La extracción de suero se hará coincidir en lo posible con otras determinaciones sanguíneas de control de la enfermedad. |
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E.5.2 | Secondary end point(s) |
Association of serological response to HBV vaccionation to other clinical variables: age, sex, etiology and severity of cirrhosis (according to Child Pugh score, MELD index),diabetes, tobacco, weight, index of body mass/obesity, presence of anti-HBc positive, local and general adverse effects of the vaccine. |
Asociación de la respuesta serológica a la vacuna VHB a otras variables clínicas: edad, sexo, etiología y severidad de la cirrosis (Estadío Child Pugh, indice MELD), diabetes, tabaco, peso, indice de masa corporal/obesidad, presencia de anti-HBc positivo, efectos adversos locales y generales de la vacuna. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Clinical variables (age, weight, etiology and severity of cirrhosis, diabetes, snuff, weight, body mass index, obesity, presence of anti-HBc positive) will be collected at baseline visit.
Local and general adverse effects of the vaccine will be recorded during the patients follow-up visits. |
Las variables clínicas (edad, peso, etiología y severidad de la cirrosis, diabetes, tabaco, peso, indice de masa corporal, obesidad, presencia de anti-HBc positivo) serán recogidas al inicio del estudio.
Los efectos adversos locales y generales de la vacuna se registrarán durante las visitas de seguimiento del paciente. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Mismo IMP usado como control, esquema de vacunación estándar |
Same IMP as control, standard vaccination scheme |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLS |
UVUP (ultima visita, último paciente incluido) |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |