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    Summary
    EudraCT Number:2019-000622-22
    Sponsor's Protocol Code Number:73763989HPB2001
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2019-07-04
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2019-000622-22
    A.3Full title of the trial
    A Phase 2b, Multicenter, Double-blind, Active-controlled, Randomized Study to Investigate the Efficacy and Safety of Different Combination Regimens Including JNJ-73763989 and/or JNJ-56136379 for the Treatment of Chronic Hepatitis B Virus Infection (The REEF-1 Study)
    Estudio en fase 2b, multicéntrico, doble ciego, activocontrolado y aleatorizado para investigar la eficacia y la seguridad de diferentes combinaciones incluyendo JNJ 73763989 y/o JNJ 56136379 para el tratamiento de la infección crónica por el virus de la hepatitis B. (Estudio REEF-1)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Clinical Study to Investigate the Efficacy and Safety of Different Combination Regimens Including JNJ-73763989 and/or JNJ-56136379 for the Treatment of Chronic Hepatitis B Virus Infection
    Estudio clínico para investigar la eficacia y seguridad de diferentes combinaciones, incluyendo JNJ-73763989 y/o JNJ-5613637379 para el tratamiento de la infección crónica por el virus de la hepatitis B.
    A.4.1Sponsor's protocol code number73763989HPB2001
    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 SponsorJanssen Sciences Ireland UC
    B.1.3.4CountryBelgium
    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 supportJanssen Sciences Ireland UC
    B.4.2CountryIreland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJANSSEN CILAG, S.A.
    B.5.2Functional name of contact pointGlobal Clinical Operations Spain
    B.5.3 Address:
    B.5.3.1Street AddressPaseo de las Doce Estrellas, 5-7
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28042
    B.5.3.4CountrySpain
    B.5.4Telephone number+34917228100
    B.5.5Fax number+34917228628
    B.5.6E-mailbpiney1@its.jnj.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 No
    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.3.1Product nameJNJ-73763989
    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 INNNot yet assigned
    D.3.9.3Other descriptive nameJNJ-73763989-AAM
    D.3.9.4EV Substance CodeSUB197801
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 2
    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 No
    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.3.1Product nameJNJ-56136379
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNot yet assigned
    D.3.9.3Other descriptive nameJNJ-56136379-AAA
    D.3.9.4EV Substance CodeSUB180015
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 3
    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 No
    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.3.1Product nameJNJ-56136379
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNot yet assigned
    D.3.9.1CAS number 1638266-40-6
    D.3.9.3Other descriptive nameJNJ-56136379-AAA
    D.3.9.4EV Substance CodeSUB180015
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 4
    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 Baraclude
    D.2.1.1.2Name of the Marketing Authorisation holderBristol-Myers Squibb Pharma EEIG
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEntecavir
    D.3.9.3Other descriptive nameENTECAVIR MONOHYDRATE
    D.3.9.4EV Substance CodeSUB25434
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 5
    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 Viread
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences Ireland UC
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTenofovir disoproxil
    D.3.9.3Other descriptive nameTENOFOVIR DISOPROXIL
    D.3.9.4EV Substance CodeSUB20643
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number245
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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.IMP: 6
    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 Vemlidy
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences Ireland UC
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTENOFOVIR ALAFENAMIDE
    D.3.9.1CAS number 379270-37-8
    D.3.9.4EV Substance CodeSUB121761
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboInjection
    D.8.4Route of administration of the placeboSubcutaneous use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 3
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Chronic Hepatitis B Virus Infection
    Infección crónica por el virus de la hepatitis B
    E.1.1.1Medical condition in easily understood language
    Chronic Hepatitis B Virus Infection
    Infección crónica por el virus de la hepatitis B
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level PT
    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
    To establish the dose-response relationship for antiviral activity of 3 doses of JNJ-3989+NA and to evaluate the efficacy of combination regimens of JNJ-3989+NA (with and without JNJ-6379) and of JNJ-6379+NA.
    Establecer la relación dosis-respuesta de la actividad antivírica de 3 dosis de JNJ-3989+AN y evaluar la eficacia de las combinaciones de JNJ 3989+AN (con y sin JNJ-6379) y de JNJ-6379+AN
    E.2.2Secondary objectives of the trial
    1. To evaluate the safety and tolerability of the study intervention throughout the study.
    2. To evaluate the efficacy of the study intervention during follow-up phase.
    3. To evaluate efficacy as measured by blood markers (such as HBsAg, HBeAg, HBV DNA, and ALT) during study intervention and follow-up.
    4. To evaluate the frequency of virologic breakthrough.
    5. To evaluate the efficacy of NA re-treatment in participants who meet the criteria for NA re-treatment.
    6. To evaluate the PK of JNJ-3989, JNJ-6379, and NA, as applicable.
    1. Evaluar la seguridad y tolerabilidad del tratamiento del estudio a lo largo de este.
    2. Evaluar la eficacia del tratamiento del estudio durante la fase de seguimiento.
    3. Evaluar la eficacia medida a través de marcadores sanguíneos (como el HBsAg, el HBeAg**, el ADN del VHB y la alanina aminotransferasa [ALT]) durante el tratamiento del estudio y el seguimiento.
    4. Evaluar la frecuencia de recaída virológica.
    5. Evaluar la eficacia de volver a tratar con AN a los participantes que cumplan los criterios para ello.
    6. Evaluar la farmacocinética (FC) de JNJ 3989, JNJ-6379 y AN, si procede.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Adult male or female participants ≥18 (or the legal age of consent in the jurisdiction in which the study is taking place) to 65 years of age, inclusive.
    2. Participants must be medically stable, with the exception of HBV disease, on the basis of physical examination, medical history, vital signs, and 12-lead ECG performed at screening. If there are abnormalities, they must be consistent with the underlying illness in the study population. This determination must be recorded in the participant’s source documents and initialed by the investigator.
    3. Participants must have chronic HBV infection documented by serum HBsAg positivity at screening. In addition, chronicity must be documented by serum HBsAg positivity at least 6 months prior to screening or alternative markers of chronicity (HBeAg positivity or HBV DNA positivity at least 6 months prior to screening, ALT elevation above ULN at least 6 months prior to screening without another cause than HBV infection, liver biopsy, or documented transmission event at least 6 months prior to screening).
    Note: if documentation of chronicity (as mentioned above) at least 6 months prior to screening is not available, participants may be included if HBsAg positive and negative for immunoglobulin M (IgM) antibodies to HBV core antigen at screening.
    4. Participants who are not currently treated (defined as not having been on treatment with HBV antiviral medicines, including NAs and IFN products within 6 months prior to screening), including treatment-naïve participants (defined as never having received treatment with HBV antiviral medicines, including NAs and IFN products) should have:
    a. Serum HBV DNA at screening ≥2,000 IU /mL for HBeAg-negative
    participants and ≥20,000 IU/mL for HBeAg-positive participants, AND
    b. ALT levels at screening <10x ULN AND >ULN on two sequential
    measurements at least 3 months apart (one of which is at screening).
    5. Virologically suppressed participants should:
    a. be on stable HBV treatment, defined as currently receiving NA treatment (ETV, TDF, or TAF) for at least 6 months prior to screening and having been on the same NA treatment regimen (at the same dose) as used in this study (see Protocol Section 6.1) for at least 3 months at the time of screening, AND b. have serum HBV DNA <60 IU/mL on two sequential measurements at least 6 months apart (one of which is at screening), AND
    c. have ALT values ≤2x ULN on two sequential measurements at least 6 months apart (one of which is at screening).
    6. Participants must have HBsAg >100 IU/mL at screening.
    7. Participants must have a BMI (weight in kg divided by the square of height in meters) between 18.0 and 35 kg/m2, extremes included.
    8. Participants must have:
    a. Fibroscan liver stiffness measurement ≤9.0 kPa within 6 months prior to screening or at the time of screening, OR
    b. If a fibroscan result is not available: a liver biopsy result classified as Metavir F0-F2 within 1 year prior to screening or at the time of screening.
    Note: Other radiologic liver staging modalities (eg, acoustic radiation force impulse) might be used if standard practice at the site or if otherwise validated and agreed with the sponsor. Results should be equivalent to Metavir F0-F2.
    Note: Conventional imaging procedures (eg, conventional liver ultrasound, computed tomography [CT] or magnetic resonance imaging [MRI]) and serum marker panels are not allowed to rule out severe fibrosis or cirrhosis.
    9. Participants must sign an ICF indicating that they understand the purpose of, and procedures required for, the study and is willing to participate in the study.
    10. Participants must sign a separate ICF if they agree to provide an optional DNA sample for research (where local regulations permit). Refusal to give consent for the optional DNA research sample does not exclude a participant from participation in the study.
    11. Female participants of childbearing potential must have a negative highly sensitive serum pregnancy test (b-human chorionic gonadotropin) at screening and a negative urine pregnancy test on Day 1 before the first dose of study intervention.

    Please refer to the protocol for a complete list of the inclusion criteria
    1. Adultos de ambos sexos ≥18 (o la edad legal de consentimiento en la jurisdicción en la que se realiza el estudio) hasta los 65 años de edad, inclusive.
    2. Los pacientes deben estar médicamente estables, con la excepción de la enfermedad del VHB, en la base a la exploración física, la historia clínica, los signos vitales y el ECG de 12 derivaciones realizado en el momento de la selección. Si hay anormalidades, deben ser consistentes con la enfermedad subyacente en la población del estudio. Esta determinación debe ser registrada en los documentos fuente del participante y firmada por el investigador.
    3. Los pacientes deben tener infección crónica de Hepatitis B documentada por la positividad del HBsAg en suero en el momento de selección. Además, la cronicidad debe documentarse mediante la positividad del HBsAg en suero al menos 6 meses antes de selección o mediante marcadores alternativos de cronicidad (positividad del HBeAg o del ADN del VHB al menos 6 meses antes de la selección, elevación de la ALT por encima del LSN al menos 6 meses antes de la selección sin otra causa que no sea la infección por el VHB, la biopsia del hígado o el evento de transmisión documentado al menos 6 meses antes de la selección). Nota: si no se dispone de documentación de cronicidad (como se ha mencionado anteriormente) al menos 6 meses antes de la selección, los pacientes podrán ser incluidos si el HBsAg es positivo y negativo para los anticuerpos de la clase inmunoglobulina M contra el antígeno del núcleo del VHB en la selección.
    4. Los pacientes que actualmente no reciben tto. (definido como no haber recibido tto. con medicamentos antivirales contra el VHB, incluidos los productos NA e IFN dentro de los 6 meses anteriores al selección), incluidos los pacientes que no han recibido tto. (definido como no haber recibido tto. con medicamentos antivirales contra el VHB, incluidos los productos NA e IFN) deben tener:
    a. ADN sérico para el VHB ≥2,000 IU /mL en el momento de la selección para pacientes HBeAg-negativo y ≥20,000 IU/mL para pacientes HBeAg positivos, Y
    b. Niveles de ALT en selección <10x LSN Y >LSN en dos secuenciales mediciones con un intervalo de al menos 3 meses (una de las cuales es en el momento de selección).
    5. Los pacientes que han sido suprimidos virológicamente deberían:
    a. estar en tto estable contra el VHB, definido como recibiendo actualmente tto contra el VHB (ETV, TDF o TAF) durante al menos 6 meses antes de la selección y haber seguido el mismo régimen de tto de NA (a la misma dosis) que el utilizado en este estudio (véase la Sección 6.1 del Protocolo) durante al menos 3 meses en el momento de selección, Y b. tener ADN sérico del VHB <60 UI/mL en dos mediciones secuenciales con un intervalo de al menos 6 meses entre cada una de ellas (una de las cuales se encuentra en la selección), Y
    c. tener valores ALT ≤2x LSN en dos mediciones secuenciales con un intervalo de al menos 6 meses (una de las cuales se encuentra en el momento de la selección).
    6. Los pacientes deben tener HBsAg >100 IU/mL en la selección
    7. Los pacientes deben tener un IMC (peso en kg dividido por el cuadrado de altura en metros) entre 18,0 y 35 kg/m2, extremos incluidos.
    8. Los pacientes deben tener:
    a. Medición de la rigidez hepática con Fibroscan ≤9.0 kPa dentro de los 6 meses anteriores a la selección o en el momento de la prueba, O
    b. Si no se dispone de un resultado de fibroscan: un resultado de una biopsia hepática clasificado como Metavir F0-F2 en el plazo de un año antes de la selección o en el momento de selección.
    Nota: Otras modalidades de estadificación hepática radiológica (p. ej., impulso de fuerza de radiación acústica) podrían utilizarse si es la práctica estándar del centro o si se valida y acuerda con el sponsor. Los resultados deben ser equivalentes a Metavir F0-F2.
    Nota: Los procedimientos convencionales de diagnóstico por imágenes (p. ej., ultrasonido hepático convencional, tomografía computarizada[TC] o resonancia magnética[RM]) y paneles de marcadores séricos no están permitidos para descartar fibrosis o cirrosis grave.
    9. Los pacientes deben firmar un ICF indicando que entienden el propósito y los procedimientos requeridos para el estudio y que están dispuestos a participar en el estudio.
    10. Los pacientes deben firmar una ICF por separado si están de acuerdo en proporcionar una muestra de ADN opcional para la investigación (donde lo permitan las regulaciones locales). La negativa a dar consentimiento para la muestra opcional de investigación del ADN no excluye a un participante de participar en el estudio.
    11. Las pacientes femeninas en edad fértil deben tener una prueba de embarazo en suero altamente sensible (gonadotropina coriónica b-humana) negativa en el momento de selección y una prueba de embarazo en orina negativa el día 1 antes de la primera dosis de la intervención del estudio.

    CONSULTAR EL PROTOCOLO PARA OBTENER UNA LISTA COMPLETA DE LOS CRITERIOS DE INCLUSIÓN.
    E.4Principal exclusion criteria
    1. Participants with evidence of hepatitis A virus infection (hepatitis A antibody IgM), HCV infection (HCV antibody [participants with undetectable HCV RNA and documentation of sustained virological response at least 24 weeks after completion of HCV treatment might be enrolled after discussion with the sponsor]), HDV infection (HDV antibody), or hepatitis E virus infection (hepatitis E antibody IgM), or HIV-1 or HIV-2 infection (confirmed by antibodies) at screening.
    2. Participants with any of the following laboratory abnormalities within 12 months prior to screening:
    a. Total bilirubin >1.5x ULN,
    b. Direct bilirubin >1.2x ULN,
    c. Prothrombin time >1.3x ULN,
    d. Serum albumin <3.2 g/dL.
    3. History or evidence of clinical signs/symptoms of hepatic decompensation including but not limited to: portal hypertension, ascites, hepatic encephalopathy, esophageal varices.
    4. Participants with evidence of liver disease of non-HBV etiology. This includes but is not limited to hepatitis virus infections mentioned in exclusion criterion 1, drug- or alcohol-related liver disease, autoimmune hepatitis, hemochromatosis, Wilson’s disease, α-1 antitrypsin deficiency, primary biliary cholangitis, primary sclerosing cholangitis, Gilbert’s syndrome (mild cases are allowed, see exclusion criterion 2a), or any other non-HBV liver disease considered clinically significant by the investigator.
    5. Participants with signs of HCC on an abdominal ultrasound performed within 6 months prior to screening or at the time of screening. In case of suspicious findings on conventional ultrasound the participant may still be eligible if HCC has been ruled out by a more specific imaging procedure (contrast enhanced ultrasound, CT or MRI).
    6. Participants with one or more of the following laboratory abnormalities at screening as defined by the Division of Acquired Immunodeficiency Syndrome (DAIDS) Toxicity Grading Scale (see Protocol Section 10.8, Appendix 8, DAIDS Table):
    a. Estimated creatinine clearance <60 mL/min at screening, calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula,
    b. Pancreatic amylase ≥grade 3,
    c. Lipase elevation ≥grade 3,
    d. Hemoglobin ≤10.9 g/dL (males), ≤10.4 g/dL (females),
    e. Platelet count ≤lower limit of normal (LLN),
    f. Alpha-fetoprotein (AFP) >100 ng/mL,
    g. Any other laboratory abnormality considered to be clinically significant by the investigator.
    7. Participants with hemoglobin A1c >8% at screening.
    8. Participants with a history of malignancy within 5 years before screening (exceptions are squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix, or malignancy, which is considered cured with minimal risk of recurrence).
    9. Participants with abnormal sinus rhythm (heart rate <45 or >100 beats per minute [bpm]); QT interval corrected for heart rate according to Fridericia (QTcF) >450 ms for male participants and >470 ms for female participants; QRS ≥120 ms; PR interval >220 ms; abnormal conduction; or any other clinically significant abnormalities on a 12-lead ECG at screening.
    10. Participants with a history of or current cardiac arrhythmias (eg, tachycardia at rest), history of risk factors for Torsade de Pointes syndrome (eg, hypokalemia, family history of long QT Syndrome) or history or other clinical evidence of significant or unstable cardiac disease (eg, angina, congestive heart failure, myocardial infarction, diastolic
    dysfunction, significant arrhythmia, coronary heart disease), moderate to severe valvular disease, or uncontrolled hypertension at screening. Any evidence of atrioventricular block or bundle branch block is also exclusionary.
    11. Participants with any current or previous illness for which, in the opinion of the investigator and/or sponsor, participation would not be in the best interest of the participant (eg, compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments. This may include but is not limited to significant vascular, pulmonary (eg, chronic obstructive pulmonary disease), gastrointestinal (eg, significant diarrhea, gastric stasis, or constipation that in the investigator’s opinion could influence drug absorption or bioavailability), endocrine (eg, thyroid disease), neurologic, hematologic, rheumatologic, psychiatric, neoplastic, or metabolic disturbances. Any condition possibly affecting drug absorption (eg, gastrectomy or other significant gastrointestinal tract surgery, such as gastroenterostomy, small bowel resection, or active enterostomy) will also lead to exclusion.
    12. Participants with any history of or current clinically significant skin disease requiring regular or periodic treatment.
    13. Participants with history of clinically relevant drug rash.

    Please refer to the protocol for a full list of the exclusion criteria
    1. Los pacientes con evidencia de infección por el virus de la hepatitis A (anticuerpo de la hepatitis A IgM), infección por el VHC (anticuerpo del VHC[participantes con ARN del VHC indetectable y documentación de respuesta virológica sostenida al menos 24 semanas después de la finalización del tratamiento contra el VHC podrían incluirse después de discutirlo con el promotor]), infección por el VHD (anticuerpo del VHD), o infección por el virus de la hepatitis E (anticuerpo de la hepatitis E IgM), o infección por el VIH-1 o el VIH-2 (confirmada por anticuerpos) en el momento de la selección.
    2. Pacientes con cualquiera de las siguientes anomalías de laboratorio dentro de los 12 meses anteriores al examen:
    a. Bilirrubina total >1.5x LSN,
    b. Bilirrubina directa >1.2x LSN,
    c. Tiempo de protrombina >1.3x LSN,
    d. Albúmina sérica <3.2 g/dL.
    3. Antecedentes o evidencia de signos/síntomas clínicos de descompensación hepática incluyendo pero no limitado a: hipertensión portal, ascitis, encefalopatía hepática, várices esofágicas.
    4. Pacientes con evidencia de enfermedad hepática de etiología no relacionada con el VHB. Esto incluye pero no se limita a las infecciones por el virus de la hepatitis mencionadas en el criterio de exclusión 1, las enfermedades hepáticas relacionadas con el alcohol o las drogas, la hepatitis autoinmune, la hemocromatosis, la enfermedad de Wilson, la deficiencia de antitripsina α-1, la colangitis biliar primaria, la colangitis esclerosante primaria, el síndrome de Gilbert (se permiten los casos leves, véase el criterio de exclusión 2a) o cualquier otra enfermedad hepática no relacionada con el VHB considerada clínicamente significativa por el investigador.
    5. Pacientes con signos de CHC en una ecografía abdominal realizada dentro de los 6 meses anteriores a la evaluación o en el momento de la selección. En caso de hallazgos sospechosos en una ecografía convencional, el participante puede ser elegible si el CHC ha sido descartado por un procedimiento de imagenología más específico (ultrasonido de contraste mejorado, TC o RMN).
    6. Pacientes con una o más de las siguientes anomalías de laboratorio en la selección, según la definición de la escala de clasificación de toxicidad de la División del Síndrome de Inmunodeficiencia Adquirida (DAIDS, por sus siglas en inglés) (véase la Sección 10.8 del Protocolo, Apéndice 8, Tabla DAIDS):
    a. Aclaramiento de creatinina estimada ≥grado 3 (<60 mL/min) en el momento de la selección, calculada mediante la fórmula de Colaboración para la Epidemiología de la Insuficiencia Renal Crónica (CKD-EPI),
    b. Amilasa pancreática ≥grado 3,
    c. Elevación de la lipasa ≥ grado 3
    d. Hemoglobina ≤10.9 g/dL (hombres), ≤10.4 g/dL (mujeres),
    e. Contaje de plaquetas ≤ al límite inferior de normalidad (LIN),
    f. Alfa-fetoproteína (AFP) >100 ng/mL,
    g. Cualquier otra anormalidad de laboratorio que el investigador considere clínicamente significativa.
    7. Pacientes con hemoglobina A1c >8% en la selección.
    8. Pacientes con antecedentes de malignidad dentro de los 5 años anteriores a la selección (las excepciones son los carcinomas escamosos y de células basales de la piel y el carcinoma in situ del cuello uterino, o malignidad, que se considera curada con un riesgo mínimo de recurrencia).
    9. Pacientes con ritmo sinusal anormal (frecuencia cardíaca <45 o >100 latidos por minuto[lpm]); intervalo QT corregido según Fridericia (QTcF) >450 ms para los pacientes masculinos y >470 ms para las pacientes femeninas; QRS ≥120 ms; intervalo PR >220 ms; conducción anormal; o cualquier otra anormalidad clínicamente significativa en un ECG de 12 derivaciones en la selección.
    10. Pacientes con antecedentes o arritmias cardíacas actuales (p. ej., taquicardia en reposo), antecedentes de factores de riesgo para el síndrome de Torsade de Pointes (p. ej., hipocaliemia, antecedentes familiares de síndrome de QT largo) o antecedentes u otra evidencia clínica de enfermedad cardíaca significativa o inestable (p. ej., angina de pecho, insuficiencia cardíaca congestiva, infarto de miocardio, diabetes, etc.).
    disfunción, arritmia significativa, cardiopatía coronaria), enfermedad valvular de moderada a grave o hipertensión no controlada en el momento de la selección. Cualquier evidencia de bloqueo auriculoventricular o bloqueo de la rama del haz también es excluyente.
    NOTA: CONSULTAR EL PROTOCOLO PARA VER LISTA DE CRITERIOS DE EXCLUSIÓN COMPLETA.
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of participants meeting the NA treatment completion criteria at Week 48.
    Proporción de pacientes que cumplen los criterios de finalización del tratamiento de NA en la semana 48.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 48
    Semana 48
    E.5.2Secondary end point(s)
    1. Proportion of participants with (S)AEs and abnormalities in clinical laboratory tests (including hematology, blood biochemistry, blood coagulation, and urinalysis, urine chemistry, and renal biomarkers), 12-lead ECGs, and vital signs.
    2a. Proportion of participants with HBsAg seroclearance 24 weeks after
    completion of all study intervention at Week 48.
    2b. Proportion of participants with HBsAg seroclearance 48 weeks after completion of all study intervention at Week 48.
    2c. Proportion of participants with HBsAg seroclearance 24 weeks and 48 weeks after completion of all study intervention at any time during follow-up.
    2d. Proportion of participants with HBV DNA <LLOQ 24 and 48 weeks after completion of all study intervention.
    2e. Proportion of participants meeting the NA treatment completion criteria during follow-up.
    2f. Frequency of relapse.
    2g. Proportion of participants not requiring NA re-treatment during follow-up.

    3a. Proportion of participants with (sustained) reduction, suppression, and/or seroclearance considering single and multiple markers (such as HBsAg, HBeAg,* HBV DNA and ALT).
    3b. Proportion of participants with HBsAg and HBeAg* seroconversion.
    3c. Change from baseline over time in HBsAg, HBeAg,* and HBV DNA.
    3d. Time to achieve HBsAg and HBeAg* seroclearance.
    3e. Proportion of participants with HBsAg levels and/or changes from baseline below/above different cut-offs (eg, HBsAg <100 IU/mL or >1 log10 IU/mL reduction in HBsAg from baseline).
    3f. Proportion of HBeAg-positive participants with HBeAg* levels and/or changes from baseline below/above different cut-offs.
    3g. Proportion of participants with HBV DNA levels and/or changes from baseline below/above different cut-offs (eg, <LLOQ of the assay).
    3h. Proportion of participants with ALT decrease and normalization.
    3i. Proportion of participants meeting the NA treatment completion criteria during follow-up.

    4. Proportion of participants with virologic breakthrough.

    5. Proportion of participants who reach HBV DNA undetectability after re-start of NA treatment during follow-up.

    6. PK parameters of JNJ-3989, JNJ-6379, and NA, as applicable.
    1. Proporción de pacientes con (S)AE y anormalidades en pruebas de laboratorio clínico (incluyendo hematología, bioquímica sanguínea, coagulación sanguínea y análisis de orina, química urinaria y biomarcadores renales), ECG de 12 derivaciones y signos vitales.
    2a. Proporción de pacientes con seroconversión del HBsAg 24 semanas después de la cirugía
    finalización de todas las intervenciones del estudio en la semana 48.
    2b. Proporción de pacientes con serotolerancia al HBsAg 48 semanas después de la finalización de toda la intervención del estudio en la semana 48.
    2c. Proporción de pacientes con serotolerancia al HBsAg 24 semanas y 48 semanas después de la finalización de todas las intervenciones del estudio en cualquier momento durante el seguimiento.
    2d. Proporción de pacientes con ADN del VHB <LLOQ 24 y 48 semanas después de la finalización de todas las intervenciones del estudio.
    2e. Proporción de pacientes que cumplen los criterios de finalización del tratamiento de NA durante el seguimiento.
    2f. Frecuencia de las recaídas.
    2g. Proporción de pacientes que no requirieron nuevo tratamiento de NA durante el seguimiento.
    3a. Proporción de pacientes con reducción, supresión y/o serotolerancia (sostenida) que consideran marcadores únicos y múltiples (como el HBsAg, el HBeAg,* el ADN del VHB y la ALT).
    3b. Proporción de pacientes con seroconversión de HBsAg y HBeAg*.
    3c. Cambio desde la línea de base a lo largo del tiempo en el ADN de HBsAg, HBeAg,* y HBV.
    3d. Momento en el que se consigue la seroconversión de HBsAg y HBeAg*.
    3e. Proporción de pacientes con niveles de HBsAg y/o cambios desde la línea de base por debajo o por encima de los diferentes límites (p.e., HBsAg <100 IU/mL o >1 log10 IU/mL de reducción en HBsAg desde la línea de base).
    3f. Proporción de pacientes positivos para el HBeAg* con niveles de HBeAg* y/o cambios con respecto a la línea de base por debajo o por encima de los diferentes valores límite.
    3g. Proporción de pacientes con niveles de ADN del VHB y/o cambios con respecto a la línea de base por debajo o por encima de los diferentes valores límite (por ejemplo, <LLOQ del ensayo).
    3h. Proporción de pacientes con disminución y normalización de la ALT.
    3i. Proporción de pacientes que cumplen los criterios de finalización del tratamiento de NA durante el seguimiento.
    4. Proporción de pacientes con rebrote virológico.
    5. Proporción de pacientes que alcanzan la indetectabilidad del ADN del VHB tras la reanudación del tratamiento de NA durante el seguimiento.
    6. Parámetros PK de JNJ-3989, JNJ-6379 y NA, según corresponda.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Throughout the duration of the study
    A lo largo de la duración del estudio
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    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 Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial6
    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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA46
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Belgium
    Brazil
    Canada
    China
    Czech Republic
    France
    Germany
    Hong Kong
    Italy
    Japan
    Korea, Republic of
    Malaysia
    Poland
    Russian Federation
    Spain
    Thailand
    Turkey
    United Kingdom
    United States
    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
    The EOS is considered as the last visit ([Extended] Follow-up Week 48 or early discontinuation) for the last participant in the study.
    El fin de estudio se considera como la última visita ([Extendida] Semana de Seguimiento 48 o descontinuación temprana) para el último paciente en el estudio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months3
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days17
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    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: 450
    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 state62
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 163
    F.4.2.2In the whole clinical trial 450
    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)
    Participants will be instructed that study intervention will not be made available to them after they have completed/discontinued study intervention and that they should return to their primary physician to determine standard of care
    Se les indicará a los pacientes que la intervención del estudio no estará disponible para ellos después de que hayan discontinuado su participación en el estudio y que deben regresar a su médico de cabecera para determinar el tratamiento a seguir.
    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 Decision2019-11-21
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-09-02
    P. End of Trial
    P.End of Trial StatusCompleted
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