This is a randomized, double-blinded, placebo-controlled, multi center, dose ranging study of safety and efficacy in both volunteers with chronic hepatitis B virus infection and in volunteers with hepatitis D virus coinfection. Volunteers will be administered multiple oral doses of ATI-2173 and assessed for safety and efficacy including blood tests to show how the body metabolizes and eliminates the investigational drug as well as how the drug effects the virus infection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
40
ATI-2173 is a liver-targeted phosphoramidate prodrug of clevudine designed to enhance anti-HBV activity while decreasing systemic exposure to clevudine. It will be dosed as a capsule by mouth. Viread is a nucleotide analogue reverse transcriptase inhibitor used for chronic hepatitis B virus.
Viread is a nucleotide analogue reverse transcriptase inhibitor used for chronic hepatitis B virus.
AB-729 is a potent, selective, subcutaneously administered, N-acetylgalactosamine (Ga1NAc)-conjugated small interfering ribonucleic acid (siRNA) inhibitor of HBV
Republican Clinical Hospital "Timofei Mosneaga" Arensia EM Unit
Chisinau, Republic of Moldova, Moldova
Medical Center of Limited Liability Company "Harmoniya krasy"
Kyiv, Ukraine
The percentage of subjects who experienced at least 1 treatment-emergent adverse event (TEAE)
Time frame: Through study completion, an average of 1 year
The percentage of subjects who experienced at least one treatment emergent serious AE (SAE).
Time frame: Through study completion, an average of 1 year
Percentage of subjects who experienced a treatment-emergent dose limiting toxicity (DLT)
Time frame: Through study completion, an average of 1 year
Percentage of subjects who experienced at least one treatment emergent Grade 1, 2, 3, 4 or 5 laboratory abnormality
Time frame: Through study completion, an average of 1 year
Percentage of subjects who discontinued study drug due to a TEAE
Time frame: Through study completion, an average of 1 year
Alanine aminotransferase and aspartate aminotransferase levels versus time
Time frame: Through study completion, an average of 1 year
Time to HBV viral load relapse in HBV-infected subjects
Time frame: Through study completion, an average of 1 year
The reduction of HDV RNA on-treatment for HBV/HDV coinfected subjects
Time frame: Through study completion, an average of 1 year
TE(max, HBV) up to Day 90 and through end of study with or without AB-729 or placebo + tenofovir
Time frame: Through study completion, an average of 1 year
AUEC(HBV) up to Day 90 and through end of study with or without AB-729 of placebo + tenofovir
Time frame: Through study completion, an average of 1 year
TE(max, HDV) up to Day 90 and through end of study
Time frame: Through study completion, an average of 1 year
AUEC(HDV) up to Day 90 and through end of study
Time frame: Through study completion, an average of 1 year
Baseline-adjusted maximal reduction in HBV DNA viral load (Emax,HBV) through 6 months after end of treatment following ATI-2173 + tenofovir (with or without AB-729) or placebo + tenofovir for 90 days in HBV-infected and HBV/HDV coinfected subjects
Time frame: Through study completion at 6 months follow up
Baseline-adjusted maximal reduction in HDV RNA viral load (Emax,HDV) through 6 months after end of treatment following ATI-2173 + tenofovir or placebo + tenofovir for 90 days in HBV/HDV coinfected subjects
Time frame: Through study completion at 6 months follow up
Cmax of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
Tmax of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
Ctrough of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
Ctau of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
AUC0-24 of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
T1/2 of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
RAC(Cmax) of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
RAC(AUC) of ATI-2173, clevudine, tenofovir and M1 in plasma
Time frame: Through Day 120
Correlation between individual Day 90 clevudine and tenofovir Cmin and Emax,HBV or Emax, HDV of viral load
Time frame: Through Day 90
Proportion of subjects with HBV SVR6 by treatment arm
Time frame: Through study completion, an average of 1 year
Proportion of subjects with HDV SVR6 by treatment arm (HBV/HDV coinfected subjects only)
Time frame: Through study completion, an average of 1 year
Proportion of subjects by treatment arm with HBV SVR12, SVR18, and SVR24
Time frame: Through study completion, an average of 1 year
Proportion of subjects by treatment arm with HDV SVR12, SVR18, and SVR24 (HBV/HDV coinfected subjects only)
Time frame: Through study completion, an average of 1 year
Proportion of subjects by treatment arm with on-treatment ALT flares
Time frame: Through Day 90
Proportion of subjects by treatment arm with off-treatment ALT flares, with no on-treatment ALT flares by treatment arm
Time frame: From Day 90 through end of study, an average of 1 year
HBV DNA slope off-treatment
Time frame: Through end of study, an average of 1 year
Effect on HBV pgRNA in subjects who reach SVR6 as measured by percentage of subjects by validated assay
Time frame: Through end of study, an average of 1 year
HBV pgRNA at end of treatment by treatment arm
Time frame: Through Day 90
Effect on HBsAg in subjects who reach HBV SVR6 as measured by percentage of subjects by validated assay
Time frame: Through end of study, an average of 1 year
T(Emax,HBV) through 6 months after end of treatment following ATI-2173 + tenofovir for 90 days in HBV-infected subjects and in HBV/HDV coinfected subjects
Time frame: Through end of study, an average of 1 year
AUEC(HBV) through 6 months after end of treatment following ATI-2173 + tenofovir for 90 days in HBV-infected subjects and in HBV/HDV coinfected subjects
Time frame: Through end of study, an average of 1 year
T(Emax,HBV) through 6 months after end of treatment following ATI-2173 + tenofovir for 90 days in HBV/HDV coinfected subjects
Time frame: Through end of study, an average of 1 year
AUEC(HDV) through 6 months after end of treatment following ATI-2173 + tenofovir for 90 days in HBV/HDV coinfected subjects
Time frame: Through end of study, an average of 1 year
Change from baseline in HBsAg, HBV pgRNA, and HBcrAg at end of treatment and SVR6 in HBV-infected and in HBV/HDV coinfected subjects by treatment arm
Time frame: Through end of study, an average of 1 year
Reduction from baseline in HBsAg, HBV pgRNA, and HBcrAg following ATI-2173 + tenofovir (with or without AB-729) or placebo + tenofovir for 90 days in HBV-infected and HBV/HDV coinfected subjects
Time frame: Through end of study, an average of 1 year
Correlation between individual time to viral load relapse and Day 90 clevudine and/or tenofovir Cmin and AUC
Time frame: Through Day 90
Correlation between SVR6 and Day 90 clevudine and/or tenofovir Cmin and AUC
Time frame: Through Day 90
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