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    Summary
    EudraCT Number:2021-003567-10
    Sponsor's Protocol Code Number:217023
    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:2021-10-19
    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 number2021-003567-10
    A.3Full title of the trial
    A phase 2, single-blinded, randomised, controlled multi-country study to evaluate the safety, reactogenicity, efficacy and immune response following sequential treatment with an anti-sense oligonucleotide (ASO) against chronic Hepatitis B (CHB) followed by chronic Hepatitis B targeted immunotherapy (CHB-TI) in CHB patients receiving nucleos(t)ide analogue (NA) therapy.
    Studio di fase 2, in singolo cieco, randomizzato, controllato, internazionale per valutare la sicurezza, la reattogenicità, l'efficacia e la risposta immunitaria dopo il trattamento sequenziale con un oligonucleotide anti-senso (ASO) contro l'epatite B cronica (CHB) seguito da immunoterapia mirata contro l'epatite B cronica (CHB-TI) in pazienti affetti da CHB sottoposti a terapia con analoghi nucleos(t)idici (NA).
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study on the safety, efficacy and immune response following sequential treatment with an anti-sense oligonucleotide against chronic Hepatitis B (CHB) and chronic Hepatitis B targeted immunotherapy (CHB-TI) in CHB patients receiving nucleos(t)ide analogue (NA) therapy.
    Studio sulla sicurezza, l'efficacia e la risposta immunitaria dopo il trattamento sequenziale con un oligonucleotide antisenso contro l'epatite B cronica (CHB) seguito da immunoterapia mirata contro l'epatite B cronica (CHB-TI) in pazienti affetti da CHB che ricevono una terapia con analoghi nucleos(t)idici (NA).
    A.3.2Name or abbreviated title of the trial where available
    TH HBV ASO-001
    TH HBV ASO-001
    A.4.1Sponsor's protocol code number217023
    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 SponsorGLAXOSMITHKLINE BIOLOGICALS
    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 supportGlaxoSmithKline Biologicals
    B.4.2CountryBelgium
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline Biologicals
    B.5.2Functional name of contact pointClinical Disclosure Advisor
    B.5.3 Address:
    B.5.3.1Street AddressRue de l’Institut, 89
    B.5.3.2Town/ cityRixensart
    B.5.3.3Post code1330
    B.5.3.4CountryBelgium
    B.5.4Telephone number00442089904466
    B.5.5Fax number00442089904466
    B.5.6E-mailGSKClinicalSupportHD@gsk.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 nameGSK3228836
    D.3.2Product code [GSK3228836]
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBepirovirsen
    D.3.9.1CAS number 1403787-62-1
    D.3.9.2Current sponsor codeGSK3228836A
    D.3.9.4EV Substance CodeSUB208554
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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 nameTH HBV adjuvanted recombinant proteins vaccine (80-80)
    D.3.2Product code [HBc-HBs/AS01B-4 80-80 vaccine component]
    D.3.4Pharmaceutical form Powder and suspension for suspension for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeHBc
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeHBs
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    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 nameTH HBV MVA-HBV 2x10e8 pfu vaccine component
    D.3.2Product code [MVA-HBV 2x10e8 pfu]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeMVA-HBV
    D.3.10 Strength
    D.3.10.1Concentration unit PFU plaque forming unit
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200000000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms Yes
    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 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 nameTH HBV ChAd155-hli-HBV 5x10e10 vp vaccine component
    D.3.2Product code [ChAd155-hli-HBV 5x10e10 vp ]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeChAd155-hIi-HBV
    D.3.10 Strength
    D.3.10.1Concentration unit Other
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500000000
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms Yes
    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/infusion
    D.8.4Route of administration of the placeboIntramuscular use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Hepatitis B virus (HBV) infection
    Infezione da virus Epatite B (HBV)
    E.1.1.1Medical condition in easily understood language
    HBV infection, especially chronic infection, is a significant worldwide medical problem that affects the liver.
    L'infezione da HBV, specialmente l'infezione cronica, è un importante problema medico mondiale che colpisce il fegato.
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10019731
    E.1.2Term 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
    Safety
    • To assess the safety of sequential treatment with GSK3228836 and GSK3528869A in participants with CHB infection stable on NA therapy.
    Efficacy
    • To assess the efficacy of sequential treatment with GSK3228836 and GSK3528869A.
    • To assess the efficacy of sequential treatment with GSK3228836 and GSK3528869A in comparison with GSK3228836 treatment.
    Sicurezza
    • Valutare la sicurezza del trattamento sequenziale con GSK3228836 e GSK3528869A nei partecipanti con infezione stabile da CHB in terapia con NA.
    Efficacia
    • Valutare l’efficacia del trattamento sequenziale con GSK3228836 e GSK3528869A.
    • Valutare l’efficacia del trattamento sequenziale con GSK3228836 e GSK3528869A in confronto al solo GSK3228836.
    E.2.2Secondary objectives of the trial
    Safety
    • To assess the safety of sequential treatment with GSK3228836 and GSK3528869A in participants with CHB infection stable on NA therapy.
    Efficacy
    • To assess the efficacy of sequential treatment with GSK3228836 and GSK3528869A in comparison with baseline in participants with CHB infection who are virally suppressed on NA therapy.
    • To describe durability of Sustained Virologic Response (SVR)
    Immunogenicity
    • To assess the humoral and cellular immune responses specific to HBs and HBc antigens of sequential treatment with GSK3228836 and GSK3528869A in participants with CHB infection who are virally suppressed on NA therapy.
    Sicurezza
    • Valutare la sicurezza del trattamento sequenziale con GSK3228836 e GSK3528869A in pazienti con infezione stabile CHB in terapia NA.
    Efficacia
    • Valutare l’efficacia del trattamento sequenziale con GSK3228836 e GSK3528869A in confronto al basale in partecipanti con infezione CHB in cui viene soppressa la replicazione virale con terapia NA.
    • Descrivere la durata di SVR (risposta virologica sostenuta).
    Immunogenicità
    • Valutare le risposte immunologiche umorali e cellulari specifiche verso gli antigeni HBs and HBc del trattamento sequenziale con GSK3228836 e GSK3528869A in partecipanti con infezione CHB in cui viene soppressa la replicazione virale con terapia NA.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    • Participants, who, in the opinion of the investigator, can and will comply with the requirements of the protocol.
    • Written or witnessed/thumb printed informed consent obtained from the participant prior to performance of any study-specific procedure.
    • A male or female between, and including, 18 and 65 years of age at the time of signing of the informed consent.
    • Participants who are Hepatitis B envelop antigen (HBeAg) positive or negative.
    • Participants who have documented chronic HBV infection =6 months prior to screening and currently receiving stable NA therapy population defined as no changes to their nucleos(t)ide regimen from at least 6 months prior to screening and with no planned changes to the stable regimen over the duration of the study.
    • CHB patient, under and adherent to treatment with a NA with high barrier to resistance (e.g. entecavir, tenofovir disoproxil fumarate and tenofovir alafenamide).
    • Participants with ALT = 2x upper limit of normal (ULN) documented in last 6 months.
    • Participants with plasma or serum HBsAg concentration >100 IU/mL.
    • Participants must be adequately suppressed, defined as plasma or serum HBV DNA <90 IU/mL.
    • A male participant is eligible to participate if they agree to the following during the intervention period and for at least 90 days after the last dose of study intervention
    - Refrain from donating sperm
    - AND be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agree to remain abstinent OR Must agree to use contraception/barrier as detailed below
    o Agree to use a male condom [and should also be advised of the benefit for a female partner to use a highly effective method of contraception as a condom may break or leak] when having sexual intercourse with a woman of childbearing potential (WOCBP) who is not currently pregnant
    • A female participant is eligible to participate:
    - If she is not pregnant or breastfeeding
    - AND at least one of the following conditions applies:
    o Is not a WOCBP
    o Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), preferably with low user dependency during the intervention period and for at least 90 days after the last dose of study treatment.
    • A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 24 hours before the first dose of study intervention.
    - If a urine test cannot be confirmed as negative, a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
    Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
    The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
    Un soggetto sarà eleggibile per questo studio soltanto se TUTTI i seguenti criteri di inclusione saranno soddisfatti:
    - Partecipanti, che, a giudizio dello sperimentatore, possono e rispetteranno i requisiti del protocollo (es. compilazione delle schede diario, ritorno per visite di controllo).
    - Consenso informato scritto o con testimone imparziale ottenuto dal partecipante prima dell'esecuzione di qualsiasi procedura specifica dello studio.
    - Uomo o donna di età compresa tra 18 e 65 anni compiuti al momento della firma del consenso informato.
    - Pazienti HBeAg positivi o negativi.
    - Pazienti con documentata infezione cronica da HBV =6 mesi prima dello screening e che attualmente ricevono una terapia stabile con NA, definita come nessuna modifica della posologia del nucleos(t)ide da almeno 6 mesi prima dello screening e senza modifiche pianificate al regime posologico per tutta la durata dello studio.
    - Paziente con CHB, in terapia e aderente al trattamento con NA con elevata soglia alla resistenza (es. entecavir, tenofovir disoproxil fumarato e tenofovir alafenamide).
    - Partecipanti con alanina transaminasi (ALT) = 2 volte il limite superiore della norma (ULN) documentato negli ultimi 6 mesi.
    - Partecipanti con concentrazione di HBsAg plasmatica o sierica >100 UI/mL.
    - I partecipanti devono avere adeguata soppressione della replicazione virale, definiti come HBV DNA plasmatico o sierico <90 UI/ml.
    - Un partecipante di sesso maschile è idoneo a partecipare se accetta durante il periodo di trattamento e per almeno 90 giorni dopo l'ultima dose del trattamento di studio quanto segue:
    - Astenersi dal donare sperma
    - E astenersi dai rapporti eterosessuali come stile di vita preferito e abituale (astinenza a lungo termine e persistente) e accettare di rimanere astinenti OPPURE deve accettare di utilizzare la contraccezione di barriera come descritto di seguito:
    o Accettare di usare un preservativo maschile [e anche la partner femminile dovrebbe essere informata del vantaggio di utilizzare un metodo contraccettivo altamente efficace poiché un preservativo può rompersi o perdere] quando si hanno rapporti sessuali con una donna in età fertile che non è attualmente incinta.
    - Una donna partecipante può partecipare:
    - Se non è incinta o non sta allattando
    - E si applica almeno una delle seguenti condizioni: o Non è un una donna in età fertile come definito nella Sezione 10.4 “Contraccezione e indicazioni sulle barriere del protocollo”
    o È una donna in età fertile e utilizza un metodo contraccettivo altamente efficace (con un tasso di fallimento <1% all'anno), preferibilmente con una bassa dipendenza dall'utente durante il periodo di trattamento e per almeno 90 giorni dopo l'ultima dose del trattamento in studio.
    - La donna in età fertile deve avere un test di gravidanza altamente sensibile negativo (urina o siero come richiesto dalle normative locali) entro 24 ore prima della prima dose dell'intervento in studio – vedere la Sezione 10.4. del protocollo.
    - Se un test su urine non può essere confermato come negativo (ad es. un risultato ambiguo), è necessario un test di gravidanza sul siero. In tali casi, il partecipante deve essere escluso dalla partecipazione se il risultato del test di gravidanza su siero è positivo.
    Ulteriori requisiti per i test di gravidanza si trovano nella Sezione 10.4. del protocollo.
    L'uso di contraccettivi da parte di uomini o donne deve essere coerente con le normative locali relative ai metodi contraccettivi per coloro che partecipano a studi clinici. Lo sperimentatore è responsabile di una revisione dell'anamnesi, della storia mestruale e dell'attività sessuale recente per ridurre il rischio di inclusione di una donna con una gravidanza precoce non rilevata.
    E.4Principal exclusion criteria
    •Clinically significant abnormalities, aside from chronic HBV infection in medical history or physical examination
    •Co-infection with: Current or past history of HCV, HIV, HDV
    •History of or suspected liver cirrhosis and/or evidence of cirrhosis
    •FibroScan TE score >9.6 kPa and FibroTest score >0.59 at Screening
    •Diagnosed or suspected HCC
    •History of malignancy within the past 5 years with the exception of specific cancers that are cured by surgical resection
    •History of vasculitis or presence of symptoms and signs of potential vasculitis
    •History of extrahepatic disorders possibly related to HBV immune conditions
    •Positive (or borderline positive) ANCA at screening
    •Low C3/C4 at screening AND evidence of past history or current manifestations of vasculitic/inflammatory/autoimmune conditions
    •History of alcohol or drug abuse/dependence
    •QTcF =450 msec
    •Laboratory results as follows:
    -Serum albumin<3.5 g/dL
    -GFR<60 mL/min/1.73m^2
    -INR>1.25
    -PLT count<140x10^9/L
    -HGB<10 g/dl
    -T Bil>1.25xULN unless it is considered as clinically not significant by the Investigator
    -ACR=0.03 mg/mg
    •Medical history of hepatic decompensation
    •Planned for liver transplantation or previous liver transplantation
    •Documented evidence of other currently active cause of hepatitis
    •Any other clinical condition that might pose additional risk to the participant due to participation in the study
    •Major congenital defects
    •Recurrent history or uncontrolled neurological disorders or seizures
    •History of any reaction or hypersensitivity likely to be exacerbated by any component of the study intervention(s)
    •Use of any investigational or non-registered product other than the study interventions during the period beginning 30 days before the first dose of study interventions, or their planned use during the study
    •Use of systemic cytotoxic agents, chronic antiviral agents or Chinese herbal medicines which may have activity against HBV within the previous 6 months (M) prior the study
    •Currently taking, or took within 12 M of screening, any interferon-containing therapy
    •Administration of adenovirus/adenovector-based or MVA-based vaccine within the last 12 M, except for adenovirus/adenovector-based COVID-19 vaccines that could be administered up to 30 days prior to the first study vaccine dose
    •Planned administration/administration of a vaccine not foreseen by the study protocol in the period starting 14 days before the first dose and ending 30 days after the last dose of study intervention administration
    •Administration of long-acting immune-modifying drugs at any time during the study
    •Administration of immunoglobulins and/or any blood products or plasma derivatives during the period starting 3 M before the first dose of study interventions or planned administration during the study
    •Chronic administration of immunosuppressants or other immune-modifying drugs during the period starting 3 M prior to the first study intervention. Inhaled and topical steroids are allowed
    •Participants for whom immunosuppressive treatment is not advised
    •Treatment with nephrotoxic drugs or competitors of renal excretion within 2 M prior to Screening or planned during the study
    •Participants requiring anti-coagulation therapies
    •Concurrently participating in another clinical study
    •Previous participation in clinical trials with administration of either GSK3228836 or GSK3528869A
    •Previous participation in a clinical study in which he/she has received an investigational product
    •Prior treatment with any other oligonucleotide or siRNA within 12 M prior to the first dosing day
    •Pregnant or lactating female
    •Female planning to become pregnant or planning to discontinue contraceptive precautions
    •Any study personnel or their immediate dependents, family, or household members
    •History of/sensitivity to GSK3228836, or components thereof, or a history of drug or other allergy that contraindicates their participation
    • Anomalie clin significative, ad eccez dell'infezione cronica da HBV nell'anamnesi
    • Co-infezione con storia attuale o passata da HCV, HIV, HDV
    • Storia di o sospetta cirrosi epatica e/o evidenza di cirrosi
    • Punteggio FibroScan TE >9,6 kPa e punteggio FibroTest >0,59 allo screening.
    • HCC diagnosticato o sospetto
    • Anamnesi di tumore negli ultimi 5 anni, ad eccez di tumori curabili mediante resez chirurgica
    • Storia di vasculite o presenza di sintomi e segni di potenziale vasculite
    • Storia di disturbi extraepatici potenzialmente correlati a condizioni immunitarie da HBV
    • ANCA positivo (o borderline positivo) allo screening
    • Basso C3/C4 allo screening E evidenza di anamnesi passata o manifestazioni attuali di condizioni vasculitiche/infiammatorie/autoimmuni
    • Storia di abuso/dipendenza da alcol o droghe
    • QTcF =450 msec
    • Risultati di lab come segue:
    -Albumina serica <3,5 g/dL
    -GFR<60 mL/min/1.73m^2
    -INR>1.25
    -PLT count<140x10^9/L
    -HGB<10 g/dl
    -Bil T>1.25xULN salvo che non considerato clinicamente non significativo dallo Sper
    -ACR =0.03 mg/mg
    • Anamnesi di scompenso epatico
    • Trapianto di fegato pianificato o precedente trapianto di fegato.
    • Evidenza documentata di altre cause di epatite attualmente attive.
    • Qualsiasi altra condizione clinica che potrebbe comportare un rischio aggiuntivo per il partecipante a causa della partecipazione allo studio.
    • Difetti congeniti maggiori.
    • Anamnesi positiva per episodi ricorrenti o disturbi neurologici o convulsioni non controllati.
    • Storia di qualsiasi reazione o ipersensibilità che potrebbe essere esacerbata da qualsiasi componente dei trattamenti in studio.
    • Uso di prodotto sperimentale o non registrato diverso da quelli di studio entro 30 giorni dalla prima dose sperimentale o il loro uso pianificato durante lo studio.
    • Uso di agenti citotossici sistemici, antivirali cronici o medicinali erboristici cinesi che possono avere attività contro HBV, nei 6 mesi precedenti la randomizzazione.
    • Attualmente sta assumendo, o ha preso entro 12 mesi dallo screening, terapia con interferone.
    • Somministrazione di vaccini a base di adenovirus/adenovettori o a base di MVA negli ultimi 12 mesi, ad eccezione dei vaccini COVID-19 che possono essere somministrati fino a 30 giorni prima della prima dose di studio.
    • Somministrazione/somministrazione pianificata di un vaccino/prodotto non previsto dal protocollo nei 14 giorni prima della prima dose e termina 30 giorni dopo l'ultima dose di studio.
    • Somministrazione di farmaci immunomodulanti a lunga durata d'azione durante lo studio.
    • Somministrazione di immunoglobuline e/o di qualsiasi emoderivato o plasmaderivato entro 3 mesi prima dalla prima dose di studio o pianificata durante lo studio.
    • Somministrazione cronica di immunosoppressori o altri immunomodulanti nei 3 mesi precedenti la prima dose di studio. Sono consentiti steroidi per via inalatoria e topici.
    • Partecipanti per i quali non è consigliato il trattamento immunosoppressivo.
    • Trattamento con farmaci nefrotossici o concorrenti dell'escrezione renale entro 2 mesi prima dello Screening o previsione di uso durante lo studio.
    • Partecipanti che necessitano di terapie anticoagulanti.
    • Partecipazione contemporanea a un altro studio clinico.
    • Partecipazione precedente a studi clinici con somministrazione di GSK3228836 o GSK3528869A.
    • Partecipazione precedente a uno studio clinico in cui si è ricevuto un prodotto sperimentale.
    • Precedente trattamento con qualsiasi altro oligonucleotide o RNA interferente breve (siRNA) entro 12 mesi prima della prima dose di studio.
    • Donne in gravidanza o in allattamento.
    • Donna che sta pianificando una gravidanza o sta pianificando di interrompere le precauzioni contraccettive.
    • Qualsiasi staff del centro o loro familiari a carico, familiari o membri della famiglia.
    • Storia di/sensibilità a GSK3228836, o suoi componenti, o storia di allergia a farmaci o altre allergie che controindica la loro partecipazione.
    E.5 End points
    E.5.1Primary end point(s)
    1. Percentage of participants reporting any grade 3 adverse event (AE) from first dose of GSK3228836 up to study end
    2. Percentage of participants reporting any serious adverse event (SAE) from first dose of GSK3228836 up to study end
    3. Percentage of participants reporting any grade 3 adverse events of special interest (AESIs) from first dose of GSK3228836 up to study end
    4. Percentage of participants who achieve sustained virologic response (SVR) for 24 weeks after end of active treatment in the absence of rescue medication, and difference between treatment arms (corresponding to GSK3228836 regimens)
    • Percentuale di partecipanti che hanno riportato qualsiasi evento avverso di grado 3 dalla prima dose di GSK3228836 fino alla fine dello studio.
    • Percentuale di partecipanti che hanno segnalato qualsiasi SAE dalla prima dose di GSK3228836 fino alla fine dello studio.
    • Percentuale di partecipanti che hanno segnalato qualsiasi AESI di grado 3 dalla prima dose di GSK3228836 fino alla fine dello studio.
    Efficacia
    • Percentuale di partecipanti che raggiungono SVR (HBsAg < LLOQ e HBV DNA < LLOQ) per 24 settimane dopo la fine del trattamento attivo1 in assenza di farmaci di salvataggio2.
    • Differenza tra i bracci di trattamento (corrispondenti ai regimi GSK3228836) nella percentuale di partecipanti che raggiungono SVR (HBsAg < LLOQ e HBV DNA < LLOQ) per 24 settimane dopo la fine del trattamento attivo1 in assenza di farmaci di salvataggio2.
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. From first dose of GSK3228836 (Treatment 1 [T1]-Day[D]1) up to study end (Treatment 2 [T2]-D841)
    2, 3. From first dose of GSK3228836 (T1-D1) up to study end (T2-D841)
    4. For up to 24 weeks after end of active treatment (end of active treatment = T1-D78 for ASO12 group, T1-D162 for ASO24 group and T2-D169 for ASO12-TI and ASO24-TI groups)
    1. Dalla prima dose di GSK3228836 (Trattamento 1 [T1]-Giorno[D]1) fino alla fine dello studio (Trattamento 2 [T2]-D841)
    2, 3. Dalla prima dose di GSK3228836 (T1-D1) fino alla fine dello studio (T2-D841)
    4. Fino a 24 settimane dopo la fine del trattamento attivo (fine del trattamento attivo = T1-D78 per il gruppo ASO12, T1-D162 per il gruppo ASO24 e T2-D169 per i gruppi ASO12-TI e ASO24-TI)
    E.5.2Secondary end point(s)
    1 Percentage (%) of participants reporting each solicited administration site event post-GSK3528869A study intervention administration
    2 % of participants reporting each solicited systemic event post-GSK3528869A study intervention administration
    3 % of participants reporting any unsolicited AE post-GSK3528869A study intervention administration
    4 % of participants reporting any AE from first dose of GSK3228836 up to study end
    5 % of participants reporting any AESIs from first dose of GSK3228836 up to study end
    6 % of participants reporting any pIMDs from first dose of GSK3528869A up to study end
    7 % of participants reporting hematological, biochemical or urinalysis laboratory abnormalities at pre-defined time points during T1 period
    8 % of participants reporting hematological, biochemical or urinalysis laboratory abnormalities at pre-defined time points during T2 period
    9 % of participants reporting hematological, biochemical or urinalysis laboratory abnormalities at pre-defined time points during follow-up period
    10 % of participants who achieve quantitative Hepatitis B surface antigen assessment (qHBsAg) decrease & HBsAg loss at pre-defined time points from GSK3228836 baseline (T1-D1) up to end of treatment period
    11 % of participants who achieve qHBsAg decrease & HBsAg loss at pre-defined time points from GSK3228836 baseline (T1-D1) up to end of T1 period
    12 % of participants who achieve qHBsAg decrease & HBsAg loss at pre-defined time points from GSK3528869A/control baseline (T2-D1) up to end of T2 period
    13 Changes in qHBsAg at pre-defined time points from GSK3228836 baseline (T1-D1) up to end of treatment period
    14 Changes in qHBsAg at pre-defined time points from GSK3228836 baseline (T1-D1) up to end of T1 period
    15 Changes in qHBsAg at pre-defined time points from GSK3528869A/control baseline (T2-D1) up to end of T2 period
    16 % of participants in ASO24-TI & ASO24 groups with HBsAg loss & anti-HBs seroconversion
    17 % of participants in ASO12-TI & ASO12 groups with HBsAg loss & anti-HBs seroconversion
    18 Geometric mean concentrations (GMCs) of qHBsAg for participants in ASO24-TI & ASO24 groups
    19 Geometric mean concentrations (GMCs) of qHBsAg for participants in ASO12-TI & ASO12 groups
    20 Duration of SVR in terms of time to the first occurrence of HBsAg reversion and/or HBV DNA reversion
    21 % of participants in ASO24-TI & ASO24 groups who experienced HBV DNA virologic breakthrough
    22 % of participants in ASO12-TI & ASO12 groups who experienced HBV DNA virologic breakthrough
    23 % of participants with anti-HBc antibody response
    24 Anti-HBc antibody concentrations
    25 % of participants who achieved HBsAg seroconversion
    26 % of participants with anti-HBs antibody response
    27 Anti-HBs antibody concentrations
    28 % of participants with anti-HBs antibody concentrations =10 mIU/mL
    29 % of participants with anti-HBs antibody concentrations =100 mIU/mL
    30 Frequency of HBc-specific CD4+ T-cells
    31 Frequency of HBs-specific CD4+ T-cells
    32 Frequency of HBc-specific CD8+ T-cells
    33 Frequency of HBs-specific CD8+ T-cells
    34 Number of HBc- & HBs-specific CD4+ T cells responders
    35 Number of HBc- & HBs-specific CD8+ T cells responders
    •Percentuale di partecipanti che hanno segnalato ognuno degli eventi avversi attesi al sito di iniezione (arrossamento, dolore e gonfiore nel sito di iniezione) entro 7 giorni (Giorno 1 – Giorno 7) dopo la somministrazione di ciascuna dose del trattamento in studio.
    • Percentuale di partecipanti che hanno segnalato ognuno degli eventi avversi sistemici attesi entro 7 giorni (Giorno 1 – Giorno 7) dopo la somministrazione di ciascuna dose del trattamento in studio.
    • Percentuale di partecipanti che hanno segnalato qualsiasi evento avverso non atteso entro 30 giorni (Giorno 1 – Giorno 30) dopo la somministrazione di ciascuna dose di GSK3528869A.
    • Percentuale di partecipanti che hanno segnalato qualsiasi evento avverso dalla prima dose di GSK3228836 fino alla fine dello studio
    • Percentuale di partecipanti che hanno segnalato qualsiasi AESI dalla prima dose di GSK3228836 fino alla fine dello studio
    • Percentuale di partecipanti che hanno segnalato qualsiasi pIMDs in qualsiasi momento dalla prima dose GSK3528869A fino alla fine dello studio.
    • Percentuale di partecipanti che hanno segnalato qualsiasi alterazione ematologica, biochimica o all’esame delle urine dalla prima dose di GSK3228836 fino alla fine dello studio.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Due to the character limitation, timeframes for secondary endpoints are available in section 9.3.2. of the protocol.
    A causa della limitazione dei caratteri, i tempi per gli endpoint secondari sono disponibili alla sezione 9.3.2 del protocollo
    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 Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity
    Immunogenicità
    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 Yes
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Sequenziale
    Sequential
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial4
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA33
    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
    Hong Kong
    Korea, Republic of
    Philippines
    Russian Federation
    Singapore
    Taiwan
    Thailand
    Turkey
    Belgium
    Bulgaria
    France
    Germany
    Italy
    Poland
    Romania
    Spain
    United Kingdom
    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
    End of Study (EoS): Date of the last testing/reading released of the Human Biological Samples or imaging data, related to primary and secondary endpoints. EoS must be achieved no later than 8 months after Last Subject Last Visit (LSLV).
    Fine dello studio (EoS): Data dell'ultimo test/lettura rilasciata dei campioni biologici umani o dei dati di imaging, relativi agli endpoint primari e secondari. L'EoS deve essere raggiunto non più tardi di 8 mesi dopo l'ultima visita del soggetto (LSLV).
    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 months4
    E.8.9.1In the Member State concerned days1
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months4
    E.8.9.2In all countries concerned by the trial days1
    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: 180
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 4
    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 state18
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 123
    F.4.2.2In the whole clinical trial 245
    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)
    After the participant has ended the participation in this trial they will continue with standard care.
    Dopo che il partecipante ha terminato la partecipazione a questo studio, continuerà con le cure standard.
    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 Decision2021-12-23
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-11-24
    P. End of Trial
    P.End of Trial StatusOngoing
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