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    Summary
    EudraCT Number:2019-000622-22
    Sponsor's Protocol Code Number:73763989HPB2001
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-06-15
    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 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)
    Uno studio multicentrico di fase IIb in doppio cieco, con controllo attivo, randomizzato per valutare l’efficacia e la sicurezza di diversi regimi associati comprendenti JNJ-73763989 e/o JNJ-56136379 per il trattamento dell’infezione cronica da virus dell’epatite B (Studio 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
    Uno studio clinico per valutare l'efficacia e la sicurezza di diversi regimi associati comprendenti JNJ-73763989 e/o JNJ-56136379 per il trattamento dell’infezione cronica da virus dell’epatite B
    A.3.2Name or abbreviated title of the trial where available
    REEF-1
    REEF-1
    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 Unlimited Company
    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 Unlimited Company
    B.4.2CountryIreland
    B.4.1Name of organisation providing supportJanssen Cilag S.p.A.
    B.4.2CountryItaly
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International N.V.
    B.5.2Functional name of contact pointClinical Registry Group
    B.5.3 Address:
    B.5.3.1Street AddressArchimedesweg 29
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333
    B.5.3.4CountryNetherlands
    B.5.4Telephone number0031715242166
    B.5.5Fax number0031715242110
    B.5.6E-mailClinicalTrialsEU@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.3.2Product code [JNJ-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.3.9.2Current sponsor codeNap
    D.3.9.4EV Substance CodeSUB197801
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.3.2Product code [JNJ-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.3.9.2Current sponsor codeNap
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.3.2Product code [JNJ-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.3.9.1CAS number 1638266-40-6
    D.3.9.2Current sponsor codeNap
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.3.1Product nameNap
    D.3.2Product code [Nap]
    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.3.9.2Current sponsor codeNap
    D.3.9.4EV Substance CodeSUB25434
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.3.1Product nameNap
    D.3.2Product code [Nap]
    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 FUMARATO
    D.3.9.2Current sponsor codeNap
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.3.1Product nameNap
    D.3.2Product code [Nap]
    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.3.9.2Current sponsor codeNap
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 placeboSolution for injection
    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
    Infezione cronica da virus dell’epatite B
    E.1.1.1Medical condition in easily understood language
    Chronic Hepatitis B Virus Infection
    Infezione cronica da virus dell’epatite 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.
    Stabilire la relazione dose-risposta dell’attività antivirale di 3 dosi di JNJ-3989+AN e valutare l’efficacia dei regimi associati JNJ-3989+AN (con e senza JNJ-6379) e 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. Valutare la sicurezza e la tollerabilità dell’intervento dello studio nel corso dello studio.
    2. Valutare l’efficacia dell’intervento dello studio durante la fase di follow-up.
    3.Valutare l’efficacia misurata dai marcatori ematici (quali HBsAg, HBeAg**, DNA HBV e alanina aminotransferasi [ALT]) durante l’intervento dello studio e il follow-up.
    4. Valutare la frequenza del breakthrough virologico.
    5. Valutare l’efficacia del ritrattamento con l’AN nei partecipanti che soddisfano i criteri sul ritrattamento.
    6. Valutare la farmacocinetica (PK) di JNJ-3989, JNJ-6379 e AN, se pertinente.
    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 atscreening), 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.

    Please refer to the protocol for a complete list of the inclusion criteria
    1. Adulti di sesso maschile o femminile di età compresa tra 18 anni (o la maggiore età legale nella giurisdizione in cui si svolge lo studio) e 65 anni (inclusi).
    2. Partecipanti in condizioni mediche stabili, ad eccezione dell’infezione da HBV, come indicato dall’esame obiettivo, l’anamnesi medica, i segni vitali e l’ECG a 12 derivazioni eseguiti alla visita di screening. Eventuali anomalie devono essere coerenti con la malattia di base nella popolazione dello studio. Lo sperimentatore deve registrare questo dato nella documentazione originale del partecipante e apporvi le proprie iniziali.
    3. Partecipanti con infezione cronica da HBV documentata dalla positività a HBsAg nel siero allo screening. La cronicità deve essere inoltre documentata da una positività a HBsAg nel siero registrata almeno 6 mesi prima dello screening o da altri marcatori di cronicità (positività a HBeAg o positività a DNA HBV almeno 6 mesi prima dello screening, innalzamento di ALT oltre l’ULN almeno 6 mesi prima dello screening senza altra causa diversa dall’infezione da HBV, biopsia del fegato o evento di trasmissione documentato almeno 6 mesi prima dello screening).
    Nota: in assenza di una documentazione della cronicità (come sopra indicato) registrata almeno 6 mesi prima dello screening, i partecipanti potranno essere inseriti nello studio se risulteranno positivi a HBsAg e negativi agli anticorpi immunoglobuline M (IgM) per l’antigene HBc allo screening.
    4. I partecipanti attualmente non trattati (definiti come soggetti che non hanno assunto alcun trattamento per l’HBV, ovvero nessun AN o IFN, nei 6 mesi precedenti allo screening), compresi anche i partecipanti naïve al trattamento (definiti come soggetti che non hanno mai assunto un trattamento per l’HBV, ovvero nessun AN o IFN), devono presentare i seguenti valori:
    a. DNA HBV nel siero allo screening ¿2000 UI/mL per i partecipanti HBeAg-negativi e =20.000 UI/mL per i partecipanti HBeAg-positivi E
    b. livelli di ALT allo screening <10x ULN E >ULN in due misurazioni consecutive eseguite ad almeno 3 mesi di distanza (una misurazione deve avvenire allo screening).
    5. I partecipanti virologicamente soppressi devono:
    a. assumere un trattamento stabile per l’HBV (ovvero devono assumere un AN [ETV, TDF o TAF] da almeno 6 mesi prima dello screening) e devono assumere lo stesso AN (allo stesso dosaggio) utilizzato in questo studio (vedere la Sezione 6.1) da almeno 3 mesi al momento dello screening E
    b. presentare DNA HBV nel siero <60 UI/mL in due misurazioni consecutive eseguite ad almeno 6 mesi di distanza (una misurazione deve avvenire allo screening) E
    c. presentare valori di ALT <2x ULN in due misurazioni consecutive eseguite ad almeno 6 mesi di distanza (una misurazione deve avvenire allo screening).
    6. Partecipanti con HBsAg >100 UI/mL allo screening.
    7. Partecipanti con IMC (peso in kg diviso per il quadrato dell’altezza in metri) compreso tra 18,0 e 35,0 kg/2, estremi inclusi.
    8. Partecipanti con:
    a. una misurazione Fibroscan della rigidità del fegato =9,0 kPa entro i 6 mesi precedenti allo screening o al momento dello screening OPPURE
    b. se il risultato del Fibroscan non è disponibile, una biopsia del fegato classificata come Metavir F0-F2 entro l’anno precedente allo screening o al momento dello screening.
    Nota: è possibile utilizzare altre modalità radiologiche di stadiazione epatica (ad es., l’impulso di forza di radiazione acustica [ARFI]) se costituiscono la prassi standard presso il centro di sperimentazione o se sono validate in altro modo e concordate con lo sponsor. I risultati devono essere equivalenti a Metavir F0-F2.
    Nota: non è consentito l’uso di procedure di imaging tradizionali (ad es., ecografia, tomografia computerizzata [TC] o risonanza magnetica [RM] del fegato di tipo tradizionale) e analisi dei marcatori sierici per escludere la presenza di fibrosi o cirrosi grave.
    Per una panoramica completa dei criteri di inclusione fare riferimento alla Sinossi (pag. 27-30).
    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 or at the time of screening:
    a. Total bilirubin >1.5x ULN,
    b. Direct bilirubin >1.2x ULN,
    c. Prothrombin time >1.5x ULN,
    d. Serum albumin <3.0 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, a-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 or clinically relevant renal abnormalities 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 or clinically relevant renal abnormalities 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 glomerular filtration rate (eGFR) =grade 3 (i.e. <60ml/min/1.73 m2) 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).


    Please refer to the protocol for a full list of the exclusion criteria
    1. Partecipanti con evidenza di infezione da virus dell’epatite A (anticorpo IgM dell’epatite A), infezione da HCV (anticorpo per l’HCV), infezione da HDV (anticorpo per l’HDV) o infezione da virus dell’epatite E (anticorpo IgM dell’epatite E) o infezione da HIV-1 o HIV-2 (confermata dagli anticorpi) allo screening.
    Nota: i partecipanti con RNA HCV non rilevabile e documentazione di una risposta virologica duratura almeno 24 settimane dopo il completamento del trattamento per l’HCV possono essere arruolati previa consultazione dello sponsor.
    2. Partecipanti che hanno presentato una qualsiasi delle anomalie di laboratorio elencate di seguito entro i 12 mesi precedenti allo screening o al momento dello screening:
    a. Bilirubina totale >1,5x ULN
    b. Bilirubina diretta >1,2x ULN
    c. Tempo di protrombina >1,3x ULN
    d. Albumina sierica <3,2 g/dL
    3. Storia o evidenza di segni/sintomi clinici di scompenso epatico tra cui, a titolo esemplificativo, ipertensione portale, ascite, encefalopatia epatica, varici esofagee.
    4. Partecipanti con evidenza di malattia epatica di eziologia diversa dall’HBV tra cui, a titolo esemplificativo, infezioni da virus dell’epatite indicate nel criterio di esclusione 1, malattia epatica correlata al consumo di farmaci o alcol, epatite autoimmune, emocromatosi, malattia di Wilson, deficit di a1-antitripsina, colangite biliare primaria, colangite sclerosante primaria, sindrome di Gilbert (sono consentiti casi lievi, vedere il criterio di esclusione 2a) o altre malattie epatiche diverse dall’HBV considerate clinicamente significative dallo sperimentatore.
    5. Partecipanti con segni di HCC o con problemi renali clinicamente rilevanti all’ecografia addominale eseguita entro i 6 mesi precedenti allo screening o al momento dello screening. In caso di risultati sospetti dell’ecografia tradizionale, il partecipante sarà considerato idoneo se la presenza di HCC o problemi renali clinicamente rilevanti saranno esclusi da una procedura di imaging più specifica (ecografia, TC o RM con mezzo di contrasto).
    6. Partecipanti con una o più delle seguenti anomalie di laboratorio allo screening secondo la definizione della scala di classificazione delle tossicità DAIDS (Division of Acquired Immunodeficiency Syndrome) (vedere la Sezione 10.8, Appendice 8, Tabella DAIDS):
    a. eGFR > o = grado 3 (ovvero <60 mL/min/1.73 m2) allo screening, calcolato con la formula CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
    b. Amilasi pancreatica =grado 3
    c. Innalzamento della lipasi =grado 3
    d. Emoglobina =10,9 g/dL (maschi), =10,4 g/dL (femmine)
    e. Conta piastrinica =limite inferiore della norma (LLN)
    f. Alfa-fetoproteina (AFP) >100 ng/mL
    g. Qualsiasi altra anomalia di laboratorio considerata clinicamente significativa dallo sperimentatore
    Nota: i partecipanti con AFP >ULN (ma <100 ng/mL) possono essere considerati idonei se è possibile escludere la presenza di un HCC con un esame di imaging sensibile (ad es., TC con contrasto o RM) durante lo screening.
    Nota: la ripetizione di un esame di laboratorio che abbia fornito valori anomali e potrebbe determinare l’esclusione sarà consentita una sola volta senza previa autorizzazione dello sponsor. La ripetizione dell’esame avrà luogo durante una visita non programmata nella fase di screening. I partecipanti che presenteranno un valore normale all’esame ripetuto potranno essere inclusi.
    7. Partecipanti con emoglobina A1c >8% allo screening.
    8. Partecipanti con storia di neoplasia maligna entro i 5 anni precedenti allo screening (ad eccezione dei carcinomi squamosi e basocellulari della pelle, del carcinoma in situ della cervice o di una neoplasia maligna che, secondo lo sperimentatore, è considerata curata con un rischio minimo di recidiva).

    Per una panoramica completa dei criteri di esclusione fare riferimento alla Sinossi (pag. 30-34).
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of participants meeting the NA treatment completion criteria at Week 48.
    Percentuale di partecipanti che soddisfano i criteri sul completamento del trattamento con l’AN alla Settimana 48
    E.5.1.1Timepoint(s) of evaluation of this end point
    48 weeks
    48 settimane
    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. Percentuale di soggetti con eventi avversi (seri) ([S]AE) e anomalie degli esami clinici di laboratorio (compresi esami ematologici, esami ematochimici, test di coagulazione ematica, analisi delle urine, esami chimici delle urine e biomarcatori renali), degli elettrocardiogrammi (ECG) a 12 derivazioni e dei segni vitali.
    2a. Percentuale di soggetti con clearance sierica di HBsAg 24 settimane dopo il completamento di tutto l’intervento dello studio alla Settimana 48.
    2b. Percentuale di soggetti con clearance sierica di HBsAg 48 settimane dopo il completamento di tutto l’intervento dello studio alla Settimana 48.
    2c. Percentuale di soggetti con DNA HBV <limite inferiore di quantificazione (LLOQ) 24 e 48 settimane dopo il completamento di tutto l’intervento dello studio alla Settimana 48.
    2d. Percentuale di soggetti che soddisfano i criteri sul completamento del trattamento con l’AN durante il follow-up.
    2e. Percentuale di soggetti con clearance sierica di HBsAg 24 e 48 settimane dopo il completamento del trattamento con l’AN in qualsiasi momento durante il follow-up.
    2f. Frequenza delle recidive.
    2g. Percentuale di soggetti che richiedono il ritrattamento con l’AN durante il follow-up (vedere Criteri sul ritrattamento con l’AN durante il follow-up).
    3a. Percentuale di soggetti con riduzione, soppressione e/o clearance sierica (duratura) considerando singoli e molteplici marcatori (quali HBsAg, HBeAg**, DNA HBV e ALT).
    3b. Percentuale di soggetti con sieroconversione di HBsAg e HBeAg**.
    3c. Variazione nel tempo di HBsAg, HBeAg** e DNA HBV rispetto al basale.
    3d. Tempo necessario per ottenere la clearance sierica di HBsAg e HBeAg**.
    3e. Percentuale di soggetti con livelli di HBsAg e/o variazioni di HBsAg rispetto al basale inferiori o superiori a diversi cut-off (ad es., HBsAg <100 UI/mL o riduzione >1 log10 UI/mL di HBsAg rispetto al basale).
    3f. Percentuale di soggetti HBeAg-positivi con livelli di HBeAg** e/o variazioni di HBeAg** rispetto al basale inferiori o superiori a diversi cut-off.
    3g. Percentuale di soggetti con livelli di DNA HBV e/o variazioni di DNA HBV rispetto al basale inferiori o superiori a diversi cut-off (ad es., <LLOQ del test).
    3h. Percentuale di soggetti con diminuzione e normalizzazione di ALT.
    3i. Percentuale di soggetti che soddisfano i criteri di completamento del trattamento con l'AN durante il follow-up
    4. Percentuale di soggetti con breakthrough virologico.
    5. Percentuale di soggetti che raggiungono la non rilevabilità del DNA HBV dopo la ripresa del trattamento con l’AN durante il follow-up.
    6. Parametri della PK di JNJ-3989, JNJ-6379 e AN, se pertinente.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Throughout the duration of the study; Per tutta la durata 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 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 concerned5
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Brazil
    Canada
    China
    Hong Kong
    Japan
    Korea, Republic of
    Malaysia
    Russian Federation
    Thailand
    Turkey
    United States
    Belgium
    France
    Germany
    Italy
    Poland
    Spain
    United Kingdom
    Czechia
    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.
    Si considera come conclusione della sperimentazione l'ultima visita ([Extended] Follow-up alla settimana 48 o interruzione precoce) dell'ultimo soggetto nello Studio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days17
    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 state35
    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
    Dopo il completamento dello studio o il ritiro prematuro del soggetto dallo studio, lo sperimentatore spiegherà al soggetti che il farmaco in studio non sarà disponibile e che dovranno fare riferimento al loro medico per determinare trattamento da seguire secondo standard terapeutico.
    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 Decision2019-09-19
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-07-16
    P. End of Trial
    P.End of Trial StatusOngoing
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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