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    Summary
    EudraCT Number:2012-000080-25
    Sponsor's Protocol Code Number:ML28262
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2012-10-09
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2012-000080-25
    A.3Full title of the trial
    A Phase IIb, Open Label, Single Arm, Multicenter Study to Evaluate the Effect of 48-weeks Peginterferon alfa-2a (PEG-IFN) Administration on Serum HBsAg in Chronic Hepatitis B, HBeAg-Negative, Genotype D Patients on Treatment with Nucleos(t)ide Analogues (NAs), Showing Stable HBV DNA Suppression.
    Studio multicentrico, di Fase IIb, in aperto, con un solo gruppo di trattamento per valutare l’effetto su HBsAg sierico della somministrazione di Peginterferone alfa-2a (PEG-IFN) per 48 settimane in pazienti con infezione da epatite B cronica, HBeAg negativa, di genotipo D, in trattamento con analoghi nucleos(t)idici (NA), che mostrano una soppressione stabile di HBV DNA.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Research study, conducted in patients with chronic hepatitis B, during treatment with nucleos(t)ide analogues (NA), with the aim to assess the effect of the administration of peginterferon alfa-2a (PEG-IFN) for 48 weeks, on the improvement of treatment responses.
    Studio di ricerca, condotto in pazienti affetti da epatite B cronica, in corso di trattamento con analoghi nucleos(t)idici (NA), volto a valutare l’effetto della somministrazione di Peginterferone alfa-2a (PEG-IFN) per 48 settimane sul miglioramento delle risposte al trattamento
    A.3.2Name or abbreviated title of the trial where available
    HERMES
    HERMES
    A.4.1Sponsor's protocol code numberML28262
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorROCHE
    B.1.3.4CountryItaly
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportRoche S.p.A.
    B.4.2CountryItaly
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationRoche S.p.A
    B.5.2Functional name of contact pointClinical Operations
    B.5.3 Address:
    B.5.3.1Street AddressViale G.B. Stucchi 110
    B.5.3.2Town/ cityMonza
    B.5.3.3Post code20900
    B.5.3.4CountryItaly
    B.5.4Telephone number039 247 5070
    B.5.5Fax number039 247 5084
    B.5.6E-mailsergio.scaccabarozzi@roche.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name PEGASYS
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPEGINTERFERON ALFA-2A
    D.3.9.1CAS number 198153-51-4
    D.3.9.2Current sponsor codeRO 25-8310
    D.3.9.4EV Substance CodeSUB16452MIG
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number180
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Chronic Hepatitis B
    Epatite B cronica
    E.1.1.1Medical condition in easily understood language
    Chronic Hepatitis B
    Epatite B cronica
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 15.0
    E.1.2Level LLT
    E.1.2Classification code 10008910
    E.1.2Term Chronic hepatitis B
    E.1.2System Organ Class 10021881 - Infections and infestations
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Serum HBsAg decline at the end of PEG-IFN plus NA combination treatment (Study Week 48).
    Riduzione di HBsAg sierico alla fine del trattamento in combinazione con PEG-IFN e NA (Settimana 48 dello studio).
    E.2.2Secondary objectives of the trial
    - Serum HBsAg decline after 24 weeks of PEG-IFN plus NA combination treatment (Study Week 24).
    - Serum HBsAg decline during follow-up, 24 weeks following the end of PEG-IFN plus NA combination treatment (Study Week 72).
    - Serum HBsAg decline at the end of follow-up, 48 weeks following the end of PEG-IFN plus NA combination treatment (Study Week 96).
    - Serum HBsAg loss (HBsAg ≤0.05 UI/ml) at Study Week 48.
    - Serum HBsAg loss at Study Week 72.
    - Serum HBsAg loss at Study Week 96.
    - Assess the predictive value of IL28B genotype on HBsAg decrease/HBsAg loss.
    - Investigate the relationship between serum levels of IP-10 and HBsAg decrease/HBsAg loss.
    - Safety of the addition of PEG-IFN to the standard treatment with NAs.
    - Riduzione di HBsAg sierico dopo 24 settimane di trattamento in combinazione con PEG-IFN e NA (Settimana 24 studio).
    - Riduzione di HBsAg sierico durante il periodo di follow-up, 24 settimane dopo la fine del trattamento in combinazione con PEG-IFN e NA (Settimana 72 dello studio).
    - Riduzione di HBsAg sierico alla fine del periodo di follow-up, 48 settimane dopo la fine del trattamento in combinazione con PEG-IFN e NA (Settimana 96 dello studio).
    - Assenza di HBsAg sierico (HBsAg ≤0.05 UI/ml) alla Settimana 48 dello studio.
    - Assenza di HBsAg sierico alla Settimana 72 dello studio.
    - Assenza di HBsAg sierico alla Settimana 96 dello studio.
    - Valutare il valore predittivo del genotipo IL28B sulla riduzione/assenza di HBsAg.
    - Studiare la relazione tra i livelli sierici di IP-10 e la riduzione/assenza di HBsAg.
    - Sicurezza dell’aggiunta di PEG-IFN al trattamento standard con NAs
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    • Adults (aged 18-65) with chronic hepatitis B.
    • Negative for HBeAg.
    • Infected with HBV genotype D.
    • In monotherapy with any NA but telbivudine at enrolment, and HBV DNA persistently below 20 IU/ml for at least 12 months.
    • HBsAg >100 IU/ml at the beginning of the Lead-In phase, confirmed before addition of PEG-IFN.
    • Showing a steady HBsAg kinetic (HBsAg decrease <0.5 log10 IU/ml from week -12 to start of the Add-On phase.
    • Negative pregnancy test (for women of childbearing potential) documented at baseline (prior to the first dose of PEG-IFN). Additionally, all fertile males with partners of childbearing age and females must be using reliable contraception during and for 3 months after the Add-On phase
    - Adulti (età 18-65 anni) con epatite cronica B.
    - Negativi per HBeAg.
    - Con infezione da HBV genotipo D.
    - In monoterapia con qualsiasi NA ad eccezione di telbivudina all’arruolamento e con HBV DNA in modo persistente al di sotto di 20 IU/ml da almeno 12 mesi.
    - HBsAg &gt;100 IU/ml all’inizio della fase Lead-In, confermato prima dell’aggiunta di PEG-IFN.
    - Pazienti che mostrano una cinetica stabile di HBsAg (diminuzione di HBsAg &lt;0.5 log10 IU/ml dalla settimana -12 all’inizio della fase Add-On).
    • Test di gravidanza sulle urine o sul siero negativo (per le donne potenzialmente fertili) documentato al basale (prima della prima somministrazione di PEG-IFN). Inoltre, tutti gli uomini fertili con partner potenzialmente in grado di avere figli e le donne dovranno utilizzare un metodo contraccettivo affidabile durante la fase di Add-On e per i tre mesi successivi a tale fase.
    E.4Principal exclusion criteria
    • Co-infection with HAV, HCV, HDV, HIV.
    • Evidence of decompensated liver disease (Child-Pugh ≥6).
    • History or other evidence of a medical condition associated with chronic liver disease (e.g., hemochromatosis, autoimmune hepatitis, alcoholic liver disease, toxin exposures).
    • Known hypersensitivity to PEG-IFN.
    • Women with ongoing pregnancy or who are breast feeding.
    • Neutrophil count <1500 cells/mmc, platelet count <100,000 cells/mmc or hemoglobin <11 g/dL for females and <12 g/dL for males.
    • Evidence of alcohol and/or drug abuse within one year of study entry.
    • 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 immunologically mediated disease (e.g., inflammatory bowel disease, idiopathic thrombocytopenic purpura, lupus erythematosus, autoimmune hemolytic anemia, scleroderma, severe psoriasis, rheumatoid arthritis).
    • History or other evidence of bleeding from esophageal varices or other conditions consistent with decompensated liver disease.
    • History or other evidence of chronic pulmonary disease associated with functional limitation.
    • History of severe cardiac disease (e.g., NYHA Functional Class III or IV, myocardial infarction within 6 months, ventricular tachyarrhythmias requiring ongoing treatment, unstable angina or other significant cardiovascular diseases).
    • History of a severe seizure disorder or current anticonvulsant use.
    • Evidence of an active or suspected cancer or a history of malignancy (other than basocellular carcinoma or in-situ cervical carcinoma) within a period of 5 years prior to study entry. Patients with a lesion suspicious of hepatic malignancy will be excluded.
    • History of having received any systemic anti-neoplastic (including radiation) or immunomodulatory treatment (including systemic corticosteroids) ≤ 6 months prior to the first dose of study drug or the expectation that such treatment will be needed at any time during the study.
    • History of major organ transplantation with an existing functional graft (other than corneal or hair transplantation).
    • History of thyroid disease poorly controlled on prescribed medications. Patients with elevated thyroid stimulating hormone concentrations with elevation of antibodies to thyroid peroxidase and any clinical manifestations of thyroid disease are excluded.
    • History or other evidence of severe retinopathy.
    • Inability or unwillingness to provide informed consent or abide by the requirements of the study.
    • History or other evidence of severe illness or any other conditions which would make the patient, in the opinion of the investigator, unsuitable for the study.
    • Serum alfa-fetoprotein > 50 mg/ml.
    • Co-infezione da HAV, HCV, HDV, HIV.
    • Evidenza di patologia epatica scompensata (Child-Pugh ≥6).
    • Storia o altra evidenza di una condizione medica associata a patologia epatica cronica (ad es. emocromatosi, epatite autoimmune, patologia epatica da alcool, esposizione a tossine).
    • Ipersensibilità nota a PEG-IFN.
    • Donne in gravidanza o allattamento.
    • Conta dei neutrofili &lt;1500 cellule/mmc, conta piastrinica &lt;100,000 cellule/mmc o emoglobina &lt;11 g/dL per le donne e &lt;12 g/dL per gli uomini.
    • Evidenza di abuso di alcool e/o di sostanze stupefacenti nell’anno precedente all’ingresso in studio.
    • Storia di patologia psichiatrica severa, specialmente depressione. La patologia psichiatrica severa è definita come il trattamento con qualsiasi farmaco antidepressivo o un tranquillante maggiore a dosi terapeutiche per depressione maggiore o psicosi, rispettivamente, per almeno tre mesi in qualsiasi momento precedente o storia di uno qualsiasi dei seguenti: tentativo di suicidio, ricovero per patologia psichiatrica o un periodo di disabilità dovuto a una patologia psichiatrica.
    • Storia di patologia immunologicamente mediata (ad esempio, patologia intestinale infiammatoria, porpora trombocitopenica idiopatica, lupus eritematoso, anemia emolitica autoimmune, sclerodermia, psoriasi severa, artrite reumatoide).
    • Storia o altra evidenza di sanguinamento da varici esofagee o altre condizioni coerenti con patologia epatica scompensata.
    • Storia o altra evidenza di patologia polmonare cronica associata a limitazione funzionale.
    • Storia di patologia cardiaca severa (ad esempio classe funzionale NYHA III o IV, infarto miocardico nei 6 mesi precedenti, tachiaritmie che richiedono un trattamento in corso, angina instabile o altra patologia cardiovascolare significativa).
    • Storia di una patologia convulsiva severa o attuale utilizzo di anticonvulsivanti.
    • Evidenza di cancro attivo o sospetto o storia di patologia maligna (ad eccezione del carcinoma basocellulare o del carcinoma cervicale in-situ) nei 5 anni precedenti l’ingresso in studio. I pazienti con una lesione sospetta di patologia epatica maligna saranno esclusi.
    • Storia di assunzione di qualsiasi trattamento antineoplastico sistemico (comprese radiazioni) o di trattamento immunomodulante (compresi corticosteroidi sistemici) ≤ 6 mesi precedenti la prima somministrazione di farmaco in studio o aspettativa che tale trattamento si renda necessario in qualsiasi momento durante lo studio.
    • Storia di trapianto d’organo maggiore con esistente trapianto funzionale (ad eccezione del trapianto di cornea o di capelli).
    • Storia di patologia tiroidea scarsamente controllata dai farmaci prescritti. I pazienti con alte concentrazioni di tireotropina, con aumenti degli anticorpi per perossidasi tiroidea e qualsiasi manifestazione di patologia tiroidea saranno esclusi.
    • Storia o altra evidenza di retinopatia severa.
    • Incapacità o indisponibilità a fornire il consenso informato o ad attenersi ai requisiti dello studio.
    • Storia o altra evidenza di patologia severa o di qualsiasi altra condizione che renderebbe il paziente non idoneo allo studio, a giudizio dello sperimentatore.
    • Alfa-fetoproteina sierica &gt; 50 mg/ml.
    E.5 End points
    E.5.1Primary end point(s)
    Serum HBsAg decline at the end of PEG-IFN plus NA combination treatment (Study Week 48).
    Riduzione di HBsAg sierico alla fine del trattamento in combinazione con PEG-IFN e NA (Settimana 48 dello studio).
    E.5.1.1Timepoint(s) of evaluation of this end point
    week 48
    alla settimana 48
    E.5.2Secondary end point(s)
    1)Serum HBsAg decline after 24 weeks of PEG-IFN plus NA combination treatment .
    2) Serum HBsAg decline during follow-up, 24 weeks following the end of PEG-IFN plus NA combination treatment
    3)Serum HBsAg decline at the end of follow-up, 48 weeks following the end of PEG-IFN plus NA combination treatment.
    4) Serum HBsAg loss (HBsAg ≤0.05 UI/ml) at Study Week 48.
    5)Serum HBsAg loss at Study Week 72.
    6)Serum HBsAg loss at Study Week 96.
    7)Assess the predictive value of IL28B genotype on HBsAg decrease/HBsAg loss.
    8)Investigate the relationship between serum levels of IP-10 and HBsAg decrease/HBsAg loss.
    1)Riduzione di HBsAg sierico dopo 24 settimane di trattamento in combinazione con PEG-IFN e NA.
    2)Riduzione di HBsAg sierico durante il periodo di follow-up, 24 settimane dopo la fine del trattamento in combinazione con PEG-IFN e NA.
    3)Riduzione di HBsAg sierico alla fine del periodo di follow-up, 48 settimane dopo la fine del trattamento in combinazione con PEG-IFN e NA.
    4)Assenza di HBsAg sierico (HBsAg ≤0.05 UI/ml) alla Settimana 48 dello studio.
    5)Assenza di HBsAg sierico alla Settimana 72 dello studio.
    6)Assenza di HBsAg sierico alla Settimana 96 dello studio.
    7)Valutare il valore predittivo del genotipo IL28B sulla riduzione/assenza di HBsAg.
    8) Studiare la relazione tra i livelli sierici di IP-10 e la riduzione/assenza di HBsAg.
    9) Sicurezza dell’aggiunta di PEG-IFN al trattamento standard con NAs
    E.5.2.1Timepoint(s) of evaluation of this end point
    1) Study Week 24
    2) Study Week 72
    3) Study Week 96
    4) study week 48
    5) study week 72
    6) study week 96
    7) and 8) end of the study
    1) settimana 24
    2) settimana 72
    3) settimana 96
    4) settimana 48
    5) settimana 72
    6) settimana 96
    7) e 8) fine dello studio
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised Information not present in EudraCT
    E.8.1.2Open Information not present in EudraCT
    E.8.1.3Single blind Information not present in EudraCT
    E.8.1.4Double blind Information not present in EudraCT
    E.8.1.5Parallel group Information not present in EudraCT
    E.8.1.6Cross over Information not present in EudraCT
    E.8.1.7Other Information not present in EudraCT
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Information not present in EudraCT
    E.8.2.2Placebo Information not present in EudraCT
    E.8.2.3Other Information not present in EudraCT
    E.8.2.4Number of treatment arms in the trial1
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned15
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial 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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months32
    E.8.9.1In the Member State concerned days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1Number of subjects for this age range: 0
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 81
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state81
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    please refers to study protocol
    si prega di fare riferimento al protocollo di studi
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2012-09-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2012-09-18
    P. End of Trial
    P.End of Trial StatusCompleted
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