Pegylated Interferon Alfa-2b in Reducing Relapse Rates After Nucleos(t)ide Analogue Withdrawal in HBeAg-negative CHB Patients with Low Level HBsAg

NCT06900166 | Not Yet Recruiting Phase 4

• 1 other identifier: CEASE2.0
• Study Type: interventional
• Target: 360
• Locations: 1 country
• Sites: 1

Brief Summary

All enrolled patients must meet the European Guidelines for the Prevention and Treatment of Chronic Hepatitis B (EASL, 2017) recommended discontinuation criteria, that is, HBeAg-negative chronic hepatitis B patients without fibrosis or cirrhosis who have undetectable HBV DNA for more than 3 years after receiving NUC treatment can attempt to discontinue the drug. At the same time, the patient's HBsAg level will not be higher than 1000 IU/mL. The study will set up three groups, group A directly stopped nucleoside analogues, follow-up to 96 weeks; Group B received PegIFNα-2b monotherapy for 48 weeks, group C received PegIFNα-2b combined with NUC treatment for 48 weeks, group B and group C stopped all antiviral drugs after completing 48 weeks of treatment, and then followed up for 96 weeks, a total of 144 weeks of follow-up. This study aims to further optimize the design on the basis of previous clinical studies to observe whether sequential interferon or combined with NUC therapy can reduce the virological relapse rate of HBeAg-negative chronic hepatitis B patients with low HBsAg level after 96 weeks of discontinuation, and to observe the impact on the functional cure rate.

Conditions

Chronic Hepatitis B

Outcome Measures

Primary Outcomes (1)

• Number of participants who relapse

  the cumulative virological relapse rate (HBV DNA\>2000 IU/ml on 2 separate occasions 1 months apart) during the research period.

  96 weeks after stopping NAs

Secondary Outcomes (4)

• Number of participants who relapse

  72 weeks after stopping all antivirals

• Number of participants who relapse Clinically

  72 weeks and 96 weeks after stopping all antivirals

• Number of participants who achieve HBsAg clearance and HBsAg seroconversion

  96 weeks after stopping all antivirals

• Number of participants who restart treatment

  96 weeks after stopping all antivirals

Study Arms (3)

Controlled Group

NO INTERVENTION

Directly stopped NUC, follow-up to 96 weeks

PegIFN alfa-2b 48 weeks

ACTIVE COMPARATOR

Discontinue the NUC treatment ,PegIFN alfa-2b for 48 weeks and follow up for 96 weeks

Drug: PegIFN alfa-2b

PegIFN alfa-2b and NUC 48 weeks

EXPERIMENTAL

Discontinue the NUC treatment ,PegIFN alfa-2b and NUC for 48 weeks, then follow up for 96 weeks

Drug: PegIFN alfa-2b and NUC

Interventions

PegIFN alfa-2b DRUG

180 μg/ 0.5 ml ,hypodermic injection once a week

PegIFN alfa-2b 48 weeks

PegIFN alfa-2b and NUC DRUG

180 μg/ 0.5 ml ,hypodermic injection once a week, NUC drugs should be used according to the instructions of each drug

PegIFN alfa-2b and NUC 48 weeks

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged between 18 and 65 (inclusive), regardless of gender;
• Fibroscan ≤ 7.4kpa;
• HBeAg-negative CHB patients: HBsAg positive, HBeAg negative, HBsAb negative and HBeAb positive before receiving NUC treatment and during screening in this study;
• HBeAg-negative chronic hepatitis B patients without liver cirrhosis who have been viral-negative for more than 3 years after receiving NUC treatment, and they meet the 2017 EASL guideline discontinuation standard (HBV DNA is lower than the lower limit of detection, that is, \<20 IU/ml);
• HBsAg≤1000 IU/ml;
• Have the intention to stop taking the drug, and sign a written informed consent.

You may not qualify if:

• HBsAb positive during screening;
• Patients with hepatitis B cirrhosis in the compensatory and decompensated stage: patients with a clear history of cirrhosis (imaging or histological evidence) or Child-Pugh score ≥5 before NUC treatment, or complications of cirrhosis in the decompensated stage such as ascites, hepatic encephalopathy, esophageal variceal hemorrhage, etc.;
• Patients who are allergic to alpha interferon and its drug ingredients, and the researchers judge that alpha interferon is not suitable for patients;
• Received immunomodulators (including interferon, etc.) within 1 year before screening;
• Combined with HAV, HCV, HDV, HEV, HIV infection, alcoholic liver disease, genetic metabolic liver disease, drug liver disease, non-alcoholic fatty liver disease and other chronic liver diseases;
• Combined with autoimmune diseases, including autoimmune liver disease, psoriasis, etc.
• Patients with primary liver cancer or screening with AFP greater than 100 ng/ml and imaging findings indicating the possibility of malignant liver occupation; Or AFP greater than 100 ng/ml for 3 months;
• Neutrophil count \< 1.5 x 109 cells /L or platelet count \< 90 x 109 cells /L;
• Creatinine is 1.5 times higher than the upper limit of normal;
• Patients with other malignant tumors (excluding cured patients);
• Patients with serious diseases of heart, lung, kidney, brain, blood and other important organs;
• Patients with severe neurological and psychiatric disorders (such as epilepsy, depression, mania, seizures, schizophrenia, etc.);
• Control unstable diabetes, hypertension, thyroid disease, etc.;
• Pregnant and lactating women or patients who had pregnancy plans during the study period and did not want to use contraception;
• Participate in other clinical investigators;

Sponsors & Collaborators

• Huashan Hospital: lead

Study Sites (1)

Huashan Hospital, Fudan University

Shanghai, Shanghai Municipality, 200040, China

Location

Related Publications (6)

• Papatheodoridi M, Papachristou E, Moschidis Z, Hadziyannis E, Rigopoulou E, Zachou K, Villeret F, Magiorkinis G, Lyberopoulou A, Gatselis N, Vlachogiannakos I, Manolakopoulos S, Dalekos GN, Zoulim F, Paraskevis D, Papatheodoridis GV. Significance of serum HBV RNA in non-cirrhotic HBeAg-negative chronic hepatitis B patients who discontinue effective antiviral therapy. J Viral Hepat. 2022 Nov;29(11):948-957. doi: 10.1111/jvh.13729. Epub 2022 Aug 30.

  PMID: 35789515 BACKGROUND

• Hirode G, Choi HSJ, Chen CH, Su TH, Seto WK, Van Hees S, Papatheodoridi M, Lens S, Wong G, Brakenhoff SM, Chien RN, Feld J, Sonneveld MJ, Chan HLY, Forns X, Papatheodoridis GV, Vanwolleghem T, Yuen MF, Hsu YC, Kao JH, Cornberg M, Hansen BE, Jeng WJ, Janssen HLA; RETRACT-B Study Group. Off-Therapy Response After Nucleos(t)ide Analogue Withdrawal in Patients With Chronic Hepatitis B: An International, Multicenter, Multiethnic Cohort (RETRACT-B Study). Gastroenterology. 2022 Mar;162(3):757-771.e4. doi: 10.1053/j.gastro.2021.11.002. Epub 2021 Nov 9.

  PMID: 34762906 BACKGROUND

• Hall SAL, Burns GS, Anagnostou D, Vogrin S, Sundararajan V, Ratnam D, Levy MT, Lubel JS, Nicoll AJ, Strasser SI, Sievert W, Desmond PV, Ngu MC, Angus P, Sinclair M, Meredith C, Matthews G, Revill PA, Jackson K, Littlejohn M, Bowden DS, Locarnini SA, Visvanathan K, Thompson AJ. Stopping nucleot(s)ide analogues in non-cirrhotic HBeAg-negative chronic hepatitis B patients: HBsAg loss at 96 weeks is associated with low baseline HBsAg levels. Aliment Pharmacol Ther. 2022 Jul;56(2):310-320. doi: 10.1111/apt.16968. Epub 2022 May 6.

  PMID: 35521992 BACKGROUND

• Liaw YF, Kao JH, Piratvisuth T, Chan HL, Chien RN, Liu CJ, Gane E, Locarnini S, Lim SG, Han KH, Amarapurkar D, Cooksley G, Jafri W, Mohamed R, Hou JL, Chuang WL, Lesmana LA, Sollano JD, Suh DJ, Omata M. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int. 2012 Jun;6(3):531-61. doi: 10.1007/s12072-012-9365-4. Epub 2012 May 17.

  PMID: 26201469 BACKGROUND

• European Association For The Study Of The Liver. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol. 2012 Jul;57(1):167-85. doi: 10.1016/j.jhep.2012.02.010. Epub 2012 Mar 20. No abstract available.

  PMID: 22436845 BACKGROUND

• Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009 Sep;50(3):661-2. doi: 10.1002/hep.23190. No abstract available.

  PMID: 19714720 BACKGROUND

MeSH Terms

Conditions

Hepatitis B, Chronic

Interventions

Nucleobindins

Condition Hierarchy (Ancestors)

Hepatitis B; Blood-Borne Infections; Communicable Diseases; Infections; Hepadnaviridae Infections; DNA Virus Infections; Virus Diseases; Hepatitis, Viral, Human; Hepatitis, Chronic; Hepatitis; Liver Diseases; Digestive System Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Calcium-Binding Proteins; Carrier Proteins; Proteins; Amino Acids, Peptides, and Proteins; DNA-Binding Proteins

Study Officials

• Principal Investigator Jiming Zhang, M.D.

  Huashan Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jiming Zhang, M.D.

CONTACT

jmzhang2006@gmail.com

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: chief physician,professor

Study Record Dates

• First Submitted: March 21, 2025
• First Posted: March 28, 2025
• Study Start: April 1, 2025
• Primary Completion (Estimated): April 1, 2029
• Study Completion (Estimated): April 1, 2029
• Last Updated: March 28, 2025

Record last verified: 2025-03

Locations

CN (1)