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    Summary
    EudraCT Number:2020-004376-18
    Sponsor's Protocol Code Number:ANRSHB07IPcureB
    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:2021-12-14
    Trial 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 number2020-004376-18
    A.3Full title of the trial
    ANRS HB07 IP-cure-B proof of concept (PoC) clinical trial. Educating the liver immune environment through TLR8 stimulation followed by NUC discontinuation
    ANRS HB07 IP-cure-B. Studio pilota per educare il profilo immunologico intraepatico mediante trattamento con agonista di TLR8 seguito da sospensione della terapia con analoghi
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Educating the liver immune environment through TLR8 stimulation followed by NUC discontinuation
    Educare il profilo immunologico intraepatico mediante trattamento con agonista di TLR8 seguito da sospensione della terapia con analoghi
    A.3.2Name or abbreviated title of the trial where available
    ANRS HB07 IP cure B
    ANRS HB07 IP cure B
    A.4.1Sponsor's protocol code numberANRSHB07IPcureB
    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 SponsorINSERM-ANRS
    B.1.3.4CountryFrance
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportEuropean Commission
    B.4.2CountryEuropean Union
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationANRS | MIE
    B.5.2Functional name of contact pointCarole Cagnot
    B.5.3 Address:
    B.5.3.1Street Address101 rue de Tolbiac
    B.5.3.2Town/ cityParis
    B.5.3.3Post code75013
    B.5.3.4CountryFrance
    B.5.4Telephone number+33153948060
    B.5.6E-mailcarole.cagnot@anrs.fr
    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 nameSelgantolimod
    D.3.2Product code [SLGN]
    D.3.4Pharmaceutical form Cachet
    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 2004677-13-6
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameGS-9688
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1500
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameEntecavir / NUC
    D.3.2Product code [NA]
    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.3.9.1CAS number 142217-69-4
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameNA
    D.3.9.4EV Substance CodeSUB21468
    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: 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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameTenofovir / NUC
    D.3.2Product code [NA]
    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.3.9.1CAS number 202138-50-9
    D.3.9.2Current sponsor codena
    D.3.9.4EV Substance CodeSUB12607MIG
    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: 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.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameTenofovir alafenamide / NUC
    D.3.2Product code [NA]
    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 codena
    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.IMP: 5
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameEntecavir/NUC
    D.3.2Product code [NA]
    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.3.9.1CAS number 142217-69-4
    D.3.9.2Current sponsor codena
    D.3.9.4EV Substance CodeSUB21468
    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: 6
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameTenofovir alafenamide/NUC
    D.3.2Product code [NA]
    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 codeNA
    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.IMP: 7
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameTenofivir/NUC
    D.3.2Product code [NA]
    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.3.9.1CAS number 202138-50-9
    D.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB12607MIG
    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.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Chronic Hepatitis B virus (HBV) infection
    Infezione cronica da virus dell'epatite B (HBV)
    E.1.1.1Medical condition in easily understood language
    Chronic Hepatitis B virus (HBV) infection
    Infezione cronica da virus dell'epatite B (HBV)
    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
    The primary objective is to study the virological efficacy of both stopping NUC and stopping NUC after SLGN treatment compared to a control arm (NUC taken continuously for 76 weeks) which is defined as the standard of care for CHB treatment in HBeAg negative patients
    L'obiettivo primario dello studio è studiare l'efficacia virologica definita come riduzione di HBsAg =1 log10 UI/ml a 76 settimane sia della sospensione del trattamento con NUC sia della sospensione del trattamento con NUC dopo somministrazione di SLGN rispetto a un braccio di controllo (NUC assunto continuativamente per 76 settimane) che è definito lo standard di cura per il trattamento della CHB in pazienti HBeAg-negativi
    E.2.2Secondary objectives of the trial
    In terms of efficacy :
    o To assess and compare virological responses at each time point (HBsAg decline, reduction in HBsAg levels, loss of HBsAg)
    o To evaluate changes in serum HBsAg, HBcrAg, HBV RNA and HBV DNA from baseline and at each timepoint.
    o To assess the time to HBsAg loss.
    o To assess rates and time to HBsAb seroconversion

    In terms of safety/tolerance:
    o To describe ALT flares at each time point.
    o To assess all grade AEs
    o To assess the re-treatment rate (NUC therapy)

    In terms of quality of life :
    o To assess and compare health-related quality of life, evaluated using the EuroQol five-dimensions questionnaire (EQ-5D-5L), at baseline, W28 and W76 (WP7, see appendices 5 & 6).

    Exploratory objectives, to evaluate:
    o The modulation of innate immune responses
    o The reconstitution of HBV-specific adaptive responses
    o The evolution of HBV intra-hepatic markers
    o Evolution of viral genome integration burden in selected patients by capture-sequencing.
    Efficacia:
    Valutare e confrontare le risposte virologiche a ciascun tempo di rilevazione in termini di i) riduzione di HBsAg di almeno 0,3, 0,5 e 1,0 log10 UI/ml ii) riduzione dei livelli di HBsAg sotto la soglia di 100 UI/ml e 10 UI/ml e iii) perdita di HBsAg.
    Livelli sierici di HBsAg, HBcrAg, RNA di HBV e DNA di HBV rispetto al basale durante il periodo dello studio
    Valutare il tempo alla perdita di HBsAg, i tassi e il tempo alla sieroconversione per HBsAb
    Sicurezza/tolleranza:
    Descrivere gli aumenti di ALT a ogni tempo di rilevazione e il tasso di ritrattamento (terapia con NUC)
    Qualità della vita sono
    Valutare e confrontare la qualità della vita correlata alla salute utilizzando il questionario EuroQol a 5 dimensioni (EQ-5D-5L)
    Obiettivi esplorativi
    La modulazione delle risposte immunitarie innate e la ricostituzione delle risposte adattative HBV-specifiche
    L'evoluzione dei marcatori intraepatici di HBV e del carico di integrazione del genoma virale in pazienti selezionati
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1) Patients with HBeAg negative CHB on documented NUC for = 3 years with HBV DNA LLOQ by local assay by polymerase chain reaction (PCR) documented at least annually over the last 3 years. NUC can include only tenofovir/TDF, tenofovir/TAF or entecavir,
    2) HBsAg > 100 IU/mL but < 1,000 IU/mL at screening,
    3) Male and female subjects aged 18 to 70 years (inclusive) at the day of screening,
    4) Ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) within 6 months of screening date with no evidence of hepatocellular carcinoma (HCC),
    5) No evidence of advanced fibrosis or cirrhosis at screening: Elastography (Fibroscan) value = 9 kPa and ultrasonography without any sign of cirrhosis and platelets = 150x109/L,
    6) No evidence of advanced fibrosis or cirrhosis before the onset of NUC therapy,
    7) HBV DNA < 20 IU/mL at screening,
    8) ALT levels within the normal range of the local lab (< ULN) at screening,
    9) Negative urine or serum pregnancy test (for women of childbearing potential) documented within the 24-hour period prior to the first dose of IMP. If the urine pregnancy test is positive, a follow-up serum test is
    required for confirmation,
    10) Women of childbearing potential must agree to use a highly effective method of contraception from screening throughout the study period and for 7 days after the last dose of study drug. Men with female partners who are of childbearing potential must agree that they or their partners will use a highly effective method of contraception from screening throughout the study period and for 7 days after the last dose of study drug.
    a) Women of childbearing potential are sexually mature women who have not undergone bilateral oophorectomy or hysterectomy; or who have not been postmenopausal (ie, who have not menstruated at all) for at least 1 year.
    b) Highly effective methods of contraception not using hormonal contraceptives will be intrauterine device, tubal sterilization, Essure microinsert system; male partner sterilization; or total abstinence from heterosexual intercourse, when this is the preferred and usual lifestyle of the subject. Note: The double-barrier method (eg, synthetic condoms, diaphragm, or cervical cap with spermicidal foam, cream, or gel), periodic abstinence (such as calendar, symptothermal, post-ovulation), withdrawal (coitus interruptus), lactational amenorrhea method, and spermicide only are not acceptable as highly effective methods of contraception.
    11) Screening Electrocardiogram (ECG) without clinically significant abnormalities and with QTcF interval (QT corrected using Fridericia's formula) = 450 msec for males and = 470 msec for females,
    12) Must be willing and able to comply with all study requirements,
    13) Must have the ability to understand and sign a written informed consent form (ICF),
    1) Pazienti con CHB HBeAg-negativo in trattamento documentato con NUC da =3 anni con un limite inferiore di quantificazione (Lower Limit Of Quantification, LLOQ) di DNA di HBV documentato in base alla reazione a catena della polimerasi (Polymerase Chain Reaction, PCR) eseguita a livello locale almeno annualmente negli ultimi 3 anni. I NUC possono includere solo tenofovir/TDF, tenofovir/TAF o entecavir.
    2) HBsAg >100 UI/ml ma <3.000 UI/ml allo screening.
    3) Soggetti maschi e femmine di età compresa tra 18 e 70 anni (inclusi) al giorno dello screening.
    4) Ecografia, tomografia computerizzata (TC) o risonanza magnetica (RM) nei 6 mesi che precedono la data dello screening senza evidenze di carcinoma epatocellulare (HCC).
    5) Nessuna evidenza di fibrosi avanzata o cirrosi allo screening: valore di elastografia (Fibroscan) =9 kPa, ultrasonografia senza segni di cirrosi e piastrine =150x109/l.
    6) Nessuna evidenza di fibrosi avanzata o cirrosi prima dell'inizio della terapia con NUC.
    7) DNA di HBV <20 UI/ml allo screening,
    8) Livelli di ALT nell'intervallo di normalità del laboratorio locale (<ULN) allo screening.
    9) Test di gravidanza su siero o urina negativo (per le donna in grado di procreare) documentato eseguito nelle 24 che precedono la prima dose del farmaco sperimentale (Investigational Medicinal Product, IMP). Se il test di gravidanza su urina è positivo, è necessario un test su siero di conferma.
    10) Le donne in grado di procreare devono accettare di utilizzare un metodo contraccettivo altamente efficace dallo screening per l'intera durata dello studio e per 7 giorni dopo l'ultima dose del farmaco in studio. Gli uomini con partner femminili in grado di procreare devono accettare di utilizzare o che le proprie partner utilizzino un metodo contraccettivo altamente efficace dallo screening per l'intera durata dello studio e per 7 giorni dopo l'ultima dose del farmaco in studio.
    a) Le donne in grado di procreare sono donne sessualmente mature che non sono state sottoposte a ooforectomia o isterectomia bilaterale; o che non sono in postmenopausa (cioè, che non hanno più cicli mestruali) da almeno 1 anno.
    b) Metodi contraccettivi altamente efficaci che non utilizzano contraccettivi ormonali sono dispositivo intrauterino, sterilizzazione tubarica, sistema di micro-inserti Essure; sterilizzazione del partner o totale astinenza da rapporti eterosessuali, qualora fosse lo stile di vita preferito e consueto del soggetto. Nota: il metodo a doppia barriera (per es., preservativo sintetico, diaframma o cappuccio cervicale con schiuma, cream o gel spermicida), l'astinenza periodica (quali, calendario, metodi sintotermico e post-ovulazione), il coito interrotto, il metodo dell'amenorrea lattazionale e lo spermicida da soli non sono accettabili come metodi di contraccezione altamente efficaci.
    11) Elettrocardiogramma (ECG) allo screening senza anomalie clinicamente significative e con intervallo QTcF (QT corretto con formula di Fridericia) =450 msec per gli uomini e =470 msec per le donne.
    12) Soggetti disponibili a e in grado di soddisfare tutti i requisiti dello studio.
    13) Soggetti in grado di comprendere e firmare il modulo di consenso informato (Informed Consent Form, ICF) scritto.
    E.4Principal exclusion criteria
    1) Any history of decompensation of liver disease including history of ascites, encephalopathy and gastrointestinal bleeding,
    2) Any sign of oesophageal and/or gastric varices,
    3) Laboratory parameters not within defined thresholds:
    a) White blood cells < 4,000 cells/µL (< 4.0×109/L);
    b) Hemoglobin < 11 g/dL (< 110 g/L) for females, < 13 g/dL (< 130 g/L) for males;
    c) Platelets < 130,000 per µL (< 130×109/L);
    d) Albumin < 3.5 g/dL (< 35 g/L);
    e) International normalized ratio (INR) > 1.5;
    f) Total bilirubin > 1.2 mg/dL (> 20.52 µmol/L).
    Note: subjects with an elevated indirect bilirubin and known Gilbert's disease can be included if direct bilirubin is within normal limits.
    g) Alpha-fetoprotein (AFP) > 20 ng/mL;
    h) Creatinine clearance (using the Cockcroft-Gault method) < 60 mL/min;
    4) Co-infection with hepatitis C virus (HCV) (antibodies anti-HCV positive), human immunodeficiency virus type 1 (HIV-1) (antibodies anti-HIV positive) or hepatitis D virus (HDV) (antibodies anti-HDV positive),
    5) Evidence or history or suspicion of HCC,
    6) Malignancy within 5 years prior to screening, with the exception of specific cancers that are cured by surgical resection (basal cell skin cancer, etc). Note: subjects under evaluation for possible malignancy are not eligible.
    7) Significant cardiovascular, pulmonary, or neurological disease,
    8) Received solid organ or bone marrow transplant,
    9) Received within 3 months of screening or expected to receive prolonged therapy with immunomodulators (eg, corticosteroids, anti-TNF) or biologics (eg, monoclonal antibody, IFN),
    10) Subjects currently taking medication(s) that are transported through organic anion transporting polypeptide 1 (OATP1) including, but not limited to: atazanavir, rifampin, cyclosporine, eltrombopag, gemfibrozil, lopinavir/ritonavir, and saquinavir,
    11) Concomitant treatment with the following medications (if taken within 21 days prior the baseline visit through the end of treatment plus 7 days)/diet:
    a) Hematologic stimulating agents (eg, erythropoiesis-stimulating agents; granulocyte colony stimulating factor [GCSF]; and thrombopoietin [TPO] mimetics),
    b) Potent CYP3A4 inhibitors or inducers, including but not limited to antifungals (fluconazole, ketoconazole…), antibiotics (telithromycin, rifabutin, rifampicin…), St. John's Wort, grapefruit juice, anticonvulsants (carbamazepine, phenobarbital, phenytoin…) etc,
    c) Immunosuppressant (except short term use of prednisone as a steroid burst [= 1 week of use]) and cytotoxic medications,
    12) Known hypersensitivity or resistance to study drugs or formulation excipients,
    13) Diagnosis of autoimmune disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, autoimmune hepatitis, sarcoidosis, psoriasis of greater than mild severity, autoimmune uveitis), poorly controlled diabetes mellitus, significant psychiatric illness, severe chronic obstructive pulmonary disease, hemoglobinopathy, retinal disease, or immunosuppressed patients,
    14) Use of another investigational agent within 6 months of screening and during the whole duration of the trial,
    15) Current alcohol or substance abuse judged by the Investigator to potentially interfere with compliance,
    16) Females who are breastfeeding, pregnant or may wish to become pregnant during the study,
    17) Female subjects unwilling to refrain from egg donation and in vitro fertilization during and until at least 7 days after the last study drug dose. Male subjects unwilling to refrain from sperm donation during and
    until at least 7 days after the last study drug,
    18) Any medical condition that, in the opinion of the investigator, could interfere with evaluation of the study objectives or safety of the subjects.
    -Qualsiasi storia di epatopatia in fase di decompensazione, inclusi storia di ascite, encefalopatia e sanguinamento gastrointestinale
    -presenza di varice esofagea e/o gastrica
    -Parametri di laboratorio al di fuori delle soglie:*globuli bianchi <4.000 cellule/µl,*emoglobina <11 g/dl per le donne, <13 g/dl per gli uomini,*piastrine <130.000 per µl ,*albumina <3,5 g/dl,*rapporto internazionale normalizzato (INR) >1,5
    *bilirubina totale >1,2 mg/dl (>20,52 µmol/l).
    *alfa-fetoproteina (AFP) >20 ng/ml
    *clearance della creatinina (utilizzando il metodo di Cockcroft-Gault) <60 ml/min
    -Infezione concomitante con virus dell'epatite C (HCV) (positività per gli anticorpi anti-HCV), virus dell'immunodeficienza umana di tipo 1 (HIV-1) (positività per gli anticorpi anti-HIV) o virus dell'epatite D (HDV) (positività per gli anticorpi anti-HDV)
    -Evidenza, storia o sospetto di carcinoma epatocellulare
    -Malignità nei 5 anni che precedono lo screening, con l'eccezione di tumori specifici curati con resezione chirurgica (carcinoma della pelle a cellule basali, ecc.). Nota: i soggetti in valutazione per un possibile tumore maligno non sono idonei
    -Patologia cardiovascolare, polmonare o neurologica significativa
    -Trapianto di organo solido o di midollo osseo
    -Trattamento con immunomodulatori nei 3 mesi che precedono lo screening o previsto trattamento prolungato con immunomodulatori (per es., corticosteroidi, anti-TNF) o agenti biologici (per es., anticorpo monoclonale, IFN)
    -Attuale assunzione di medicinali che sono trasportati mediante il polipeptide trasportatore di anioni organici 1 (Organic Anion Transporting Polypeptide 1, OATP1) che include a titolo esemplificativo, ma non esaustivo: atazanavir, rifampicina, ciclosporina, eltrombopag, gemfibrozil, lopinavir/ritonavir e saquinavir
    -Trattamento concomitante con i seguenti medicinali (se assunti nei 21 giorni prima della visita al basale fino alla fine del trattamento più 7 giorni)/dieta:
    *agenti stimolanti ematologici (per es., agenti stimolanti l'eritropoiesi, fattore stimolante le colonie di granulociti [Granulocyte Colony Stimulating Factor, GCSF], mimetici della trombopoeitina [TPO]).
    *Inibitori o induttori potenti di CYP3A4, inclusi a titolo esemplificativo, ma non esaustivo gli antifungini (fluconazolo, ketoconazolo, ecc.), antibiotici (telitromicina, rifabutina, rifampicina, ecc.), l'erba di S. Giovanni, succo di pompelmo,anticonvulsivanti (carbamazepina, fenobarbital, fenitoina, ecc.) ecc
    *Immunosoppressivi [eccetto l'uso a breve termine di prednisone come steroide con burst (=1 settimana di utilizzo)] e medicinali citotossici.
    -Nota ipersensibilità o resistenza ai farmaci in studio o agli eccipienti della formulazione.
    -Diagnosi di malattia autoimmune (per es., lupus eritematoso sistemico, artrite reumatoide, malattia infiammatoria intestinale, epatite autoimmune, sarcoidosi, psoriasi di gravità superiore a lieve, uveite autoimmune), diabete mellito scarsamente controllato, disturbo psichiatrico significativo, malattia polmonare ostruttiva cronica grave, emoglobinopatia, retinopatia o pazienti immunosoppressi
    -Uso di un altro agente sperimentale nei 6 mesi che precedono lo screening e per l'intera durata dello studio.
    -Abuso di alcool o sostanze che, secondo il parere dello sperimentatore, potrebbe interferire potenzialmente con la compliance.
    -Donne che allattano al seno, in gravidanza o che desiderano iniziare una gravidanza durante lo studio
    -Donne che non intendono astenersi dal donare gli ovuli e rinunciare alla fertilizzazione in vitro durante lo studio e per almeno 7 giorni dopo l'ultima dose del farmaco in studio. Uomini che non intendono astenersi dal donare lo sperma durante lo studio e per almeno 7 giorni dopo l'ultima dose del farmaco in studio
    -Qualsiasi condizione medica che, secondo il parere dello sperimentatore, potrebbe interferire con la valutazione degli obiettivi dello studio o la sicurezza dei soggetti
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint for efficacy is the percentage of subjects with = 1.0 log10 IU/mL decline of HBsAg
    L'endpoint primario di efficacia è la percentuale di soggetti con riduzione di HBsAg =1,0 log10 UI/ml alla settimana 76 rispetto al basale
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 76 compared to baseline
    Settimana 76 rispetto al basale
    E.5.2Secondary end point(s)
    Secondary endpoints in terms of efficacy are:
    o Percentage of subjects with HBsAg = 0.3 log10 IU/mL decline at weeks 12, 24, 28, 36, 48, 76 compared to baseline
    o Percentage of subjects with HBsAg = 0.5 log10 IU/mL decline at weeks 12, 24, 28, 36, 48, 76 compared to baseline
    o Percentage of subjects with HBsAg = 1.0 log10 IU/mL decline at weeks 12, 24, 28, 36, 48 compared to baseline
    o Percentage of subjects with HBsAg < 100 IU/mL at weeks 12, 24, 28, 36, 48, 76
    o Percentage of subjects with HBsAg < 10 IU/mL at weeks 12, 24, 28, 36, 48, 76
    o Percentage of subjects with HBsAg loss at weeks 12, 24, 28, 36, 48, 76 and time to HBsAg loss since baseline
    o Percentage of subjects with HBsAb seroconversion at weeks 12, 24, 28, 36, 48, 76 and time to HBsAb seroconversion
    o Changes in serum HBsAg, HBcrAg, HBV RNA and HBV DNA levels in log10 IU/mL from baseline to weeks 12, 24, 28, 36, 48, 76.; Secondary endpoints in terms of safety/tolerance are:
    o Percentage of subjects reporting a grade 3 or 4 AE
    o Percentage of all grade AEs
    o Percentage of subjects with ALT flares at each time point (ALT flares defined as = 10 x ULN)
    o Percentage of subjects in whom NUC treatment has been re-initiated.; Secondary endpoints in terms of quality of life are:
    o To assess and compare health-related quality of life, measured using EQ-5D-5L utility score (collected with a self-completed questionnaire, see appendix 5) at baseline, weeks 28 and 76 (WP7, see appendix 6 of the protocol).; Exploratory endpoints
    o Evolution of serum cytokine/chemokine profiling and in phenotypic expression of innate cell surface markers between W0 and W76
    o Evolution of gene expression profiling of innate immune genes between W0 and W76
    o Evolution of memory- and exhaustion-related phenotypic parameters on intrahepatic and peripheral CD8 and CD4 T cells between W0 and W76
    o Evolution of CD8- and CD4-mediated anti-viral activity expressed as cytokine production, cytotoxicity and capacity of expansion between W0 and W76
    o Evolution of HBV-specific T cell metabolism, mitochondrial, proteasomal, DNA repair functions and epigenetic regulation between W0 and W76
    o Evolution of deregulated transcriptional profiles of HBV-specific T cells between W0 and W76
    o Evolution of intrahepatic levels of cccDNA and pgRNA by droplet digital PCR (ddPCR) between W20 and W32
    o Description of cccDNA epigenenetic status by micro-ChIP and, in selected cases by cccDNA ChIP-Seq and/or cccDNA ATAC-Seq at W20 and W32
    o Evolution of viral genome sequences obtained by NGS between W20 and W32.
    o Frequency of viral genome integration in selected patients by capture-sequencing between W20 and W32.
    Endpoint secondari in termini di efficacia sono:
    o Percentuale di soggetti con diminuzione di HBsAg = 0,3 log10 UI/mL alle settimane 12, 24, 28, 36, 48, 76 rispetto al basale
    o Percentuale di soggetti con diminuzione di HBsAg = 0,5 log10 UI/mL alle settimane 12, 24, 28, 36, 48, 76 rispetto al basale
    o Percentuale di soggetti con diminuzione di HBsAg = 1,0 log10 UI/mL alle settimane 12, 24, 28, 36, 48 rispetto al basale
    o Percentuale di soggetti con HBsAg < 100 UI/mL alle settimane 12, 24, 28, 36, 48, 76
    o Percentuale di soggetti con HBsAg < 10 UI/mL alle settimane 12, 24, 28, 36, 48, 76
    o Percentuale di soggetti con perdita di HBsAg alle settimane 12, 24, 28, 36, 48, 76 e tempo alla perdita di HBsAg dal basale
    o Percentuale di soggetti con sieroconversione HBsAb alle settimane 12, 24, 28, 36, 48, 76 e tempo alla sieroconversione HBsAb
    o Variazioni dei livelli sierici di HBsAg, HBcrAg, HBV RNA e HBV DNA in log10 IU/mL dal basale alle settimane 12, 24, 28, 36, 48, 76.; Endpoint secondari in termini di sicurezza/tolleranza sono:
    o Percentuale di soggetti che riportano un AE di grado 3 o 4
    o Percentuale di tutti gli eventi avversi di grado
    o Percentuale di soggetti con ALT flare in ogni momento (ALT flare definito come = 10 x ULN)
    o Percentuale di soggetti in cui è stato ripreso il trattamento NUC.; Gli endpoint secondari in termini di qualità della vita sono:
    o Per valutare e confrontare la qualità della vita correlata alla salute, misurata utilizzando il punteggio di utilità EQ-5D-5L (raccolto con un questionario autocompilato, vedere appendice 5) al basale, settimane 28 e 76 (WP7, vedere appendice 6 del protocollo).; Endpoint esplorativi
    o Evoluzione del profilo sierico di citochine/chemochine e nell'espressione fenotipica di marcatori di superficie cellulare innata tra W0 e W76
    o Evoluzione del profilo di espressione genica dei geni immunitari innati tra W0 e W76
    o Evoluzione dei parametri fenotipici correlati alla memoria e all'esaurimento sulle cellule T CD8 e CD4 intraepatiche e periferiche tra W0 e W76
    o Evoluzione dell'attività antivirale mediata da CD8 e CD4 espressa come produzione di citochine, citotossicità e capacità di espansione tra W0 e W76
    o Evoluzione del metabolismo delle cellule T specifiche dell'HBV, mitocondriale, proteasomiale, funzioni di riparazione del DNA e regolazione epigenetica tra W0 e W76
    o Evoluzione dei profili trascrizionali deregolati delle cellule T HBV-specifiche tra W0 e W76
    o Evoluzione dei livelli intraepatici di cccDNA e pgRNA mediante droplet digital PCR (ddPCR) tra W20 e W32
    o Descrizione dello stato epigenetico del cccDNA mediante micro-ChIP e, in casi selezionati mediante cccDNA ChIP-Seq e/o cccDNA ATAC-Seq a W20 e W32
    o Evoluzione delle sequenze del genoma virale ottenute da NGS tra W20 e W32.
    o Frequenza di integrazione del genoma virale in pazienti selezionati mediante cattura-sequenziamento tra W20 e W32.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Weeks 12, 24, 28, 36, 48, 76 compared to baseline; End of the trial; at baseline, weeks 28 and 76; between W0 and W76 or between W20 and W32.
    Settimane 12, 24, 28, 36, 48, 76 rispetto al basale; Fine dello studio clinico; al basale, settimane 28 e 76; tra W0 e W76 o tra W20 e W32.
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    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) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA6
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.7Trial has a data monitoring committee Yes
    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
    12 months after the W76 visit of the last participant, in order to do analysis planned after the last patient last visit
    12 mesi dopo la visita W76 dell'ultimo partecipante, per fare analisi pianificate dopo l'ultima visita dell'ultimo paziente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months33
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months33
    E.8.9.2In all countries concerned by the trial days0
    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: 85
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 15
    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 state34
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 100
    F.4.2.2In the whole clinical trial 100
    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)
    Normal treatment of that condition, if required
    Trattamento previsto dalla pratica clinica, se richiesto
    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 Decision2022-02-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-12-14
    P. End of Trial
    P.End of Trial StatusOngoing
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