The objective of this clinical study was to observe the changes of HBsAg levels after a sequential 48 weeks-treatment of TAF in ETV experienced CHB patients and to monitor the levels of cytokines such as IFN-λ3, IP-10, IL-12, IL-10, and IL-21.
The first-line NAs include entecavir (ETV), tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF). All the NAs mentioned above could achieve complete virologic response. NAs mentioned above are sufficient in inhibiting viral replication. However, there may exist difference in long-term prognosis such as HBsAg level decline, resistance development and HCC development. A prospective study performed by our team previously showed that TDF was better than ETV in HBsAg decline. A Korean research showed that TDF therapy was associated with a significantly lower risk of HCC than ETV therapy; the TDF group showed a distinct reduction in HBsAg level after one-year treatment. Also, a Japanese RCT study indicated that the reduction in HBsAg level was significantly greater in the TDF arm than the ETV arm at week 24. The mechanism of HBsAg decline induced by TDF has not been fully elucidated. Patients treated with nucleotide analogues (adefovir, tenofovir) had higher serum IFN-λ3 levels than those treated with nucleoside analogues (lamivudine, entecavir), according to results recently published in Gut. A team from Japan has found that nucleotide analogues inhibit LPS-mediated IL-10 production and induce IL-12p70 and TNF-α production. We speculated that, compared with entecavir, tenofovir could up-regulate IFN-λ3 and reduce the level of HBsAg more significantly. As known as the second generation of TDF, TAF has a significantly longer half-life than TDF. A phase 3 study displayed that TAF 25 mg was non-inferior to TDF 300 mg in suppressing HBV replication, with a better performance in renal and bone safety. However, there is lack of study evaluating TAF in reducing HBsAg and induces IFN-λ3.The aim of this study was to investigate whether the TAF can achieve a better antiviral therapeutic endpoint, i.e. a greater reduction in HBsAg levels, or even meet the therapeutic expectation of stopping NAS in a larger number of treated patients. The objective of this clinical study was to observe the changes of HBsAg levels after a sequential 48 weeks-treatment of TAF in ETV experienced CHB patients and to monitor the levels of cytokines such as IFN-λ3, IP-10, IL-12, IL-10, and IL-21.
Study Type
OBSERVATIONAL
Enrollment
150
TAF is administered as a 25mg/tablet, taken orally with food once daily, for 48 weeks.
Huashan Hospital Affiliated to Fudan University
Shanghai, China
Ruijin Hospital Affiliate to Shanghai Jiao Tong University School of Medicine
Shanghai, China
Shanghai Public Health Clinical Center
Shanghai, China
Change of serum HBsAg at week 48 from baseline.
evaluate the changes of serum HBsAg level after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of serum HBeAg level from baseline.
evaluate the of changes serum HBeAg level from baseline after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of serum HBcAb level from baseline.
evaluate the of changes serum HBcAb level from baseline after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
propotion of patients who maintened HBV DNA suppression.
evaluate the propotion of patients who maintened HBV DNA suppression after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
propotion of patients who maintened ALT normalization.
evaluate the propotion of patients who maintened ALT normalization after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of renal markers - eGFR from baseline.
evaluate the change of renal markers -eGFR after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of renal markers - serum phosphate from baseline.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
evaluate the change of renal markers -serum phosphate after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of renal markers - UPCR from baseline.
evaluate the change of renal markers - UPCR after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of renal markers- UACR from baseline.
evaluate the change of renal markers - UACR after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of renal markers - RBP:Cr from baseline.
evaluate the change of renal markers -RBP:Cr after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of renal markers - β2MG:Cr from baseline.
evaluate the change of renal markers - β2MG:Cr after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of IFN-λ3 from baseline.
evaluate the change of IFN-λ3 after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of IP-10 from baseline.
evaluate the change of IP-10 after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of IL-12 from baseline.
evaluate the change of IL-12 after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of IL-10 from baseline.
evaluate the change of IL-10 after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment
Change of IL-21from baseline.
evaluate the change of IL-21 after 48 week-treatment of TAF in TN and ETV experienced CHB patients.
Time frame: from baseline to week 48 after TAF treatment