TrialReader


Study to Evaluate the Safety and Efficacy of Switching to Tenofovir Alafenamide (TAF) From Tenofovir Disoproxil Fumarate (TDF) and/or Other Oral Antiviral Treatment (OAV)

NCT03180619 — Phase 2, Completed, 124 participants, Gilead Sciences

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  

A Phase 2, Open-label Study to Evaluate the Safety and Efficacy of Switching to Tenofovir Alafenamide (TAF) From Tenofovir Disoproxil Fumarate (TDF) and/or Other Oral Antiviral Treatment (OAV) in Virologically Suppressed Chronic Hepatitis B Subjects With Renal and/or Hepatic Impairment

RegistryNCT03180619
StatusCompleted
PhasePhase 2
Study typeInterventional; non randomized, parallel, masking: none, treatment
Enrollment124 (Actual)
SponsorGilead Sciences (Industry)
ConditionsChronic Hepatitis B
InterventionsTAF (Drug)
Datesstart 2017-06-29, primary completion 2019-03-27, completion 2020-09-04, first posted 2017-06-08, last updated 2021-09-27
Locations30 sites in United States, Canada, Hong Kong, Italy, New Zealand, South Korea, Taiwan, United Kingdom

Related Papers Related Patents Related Grants Related Experts
AI Assistant Save
All trials for Chronic Hepatitis B All trials of TAF

-Summary

The primary objective of this study is to evaluate the safety and tolerability and virologic response of tenofovir alafenamide (TAF) in virologically suppressed chronic hepatitis B participants with renal and/or hepatic impairment.

Expand all sections  ·  Collapse all

+Arms and interventions

ArmTypeInterventionsDescription
Part A (Renal Impairment): Moderate or Severe Renal ImpairmentExperimentalDrug: TAFParticipants with chronic hepatitis B (CHB) and moderate or severe renal impairment who were virologically suppressed and taking tenofovir disoproxil fumarate (TDF), a TDF-containing anti-hepatitis B virus (HBV) regimen, or other oral antivirals (OAVs), will switch to tenofovir alafenamide (TAF) and receive TAF 25 milligram (mg) tablet once daily orally for 96 weeks.
Part A (Renal Impairment): End Stage Renal DiseaseExperimentalDrug: TAFParticipants with CHB and end stage renal disease who were virologically suppressed and taking TDF, a TDF-containing anti-HBV regimen, or OAVs, will switch to TAF and receive TAF 25 mg tablet once daily orally for 96 weeks.
Part B: Hepatic ImpairmentExperimentalDrug: TAFParticipants with CHB and moderate or severe hepatic impairment who were virologically suppressed and taking TDF, a TDF-containing anti-HBV regimen, or OAVs, will switch to TAF and receive TAF 25 mg tablet once daily orally for 96 weeks.
  • TAF (Drug), also known as Vemlidy®: Tablet administered orally once daily

+Outcome measures

Primary outcomes

  • Percentage of Participants Achieving Virologic Response (Plasma Hepatitis B Virus [HBV] Deoxyribonucleic Acid [DNA] < 20 IU/mL) at Week 24 [Week 24]: The percentage of participants with HBV DNA < 20 IU/mL at Week 24 was determined by the Missing = Failure (M = F) approach.
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Adverse Events (AEs) at Week 24 [Week 24]: Treatment-emergent AEs were defined as: * Any AEs with an onset date on or after the study drug start date and no later than the study drug stop date + 3 days after permanent discontinuation of study drug; * Any AEs with onset date on or after the study drug start date for those who have not permanently discontinued study drug; * Any AEs leading to premature discontinuation of study drug. The most severe graded AE from all tests was counted for each participant.
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Laboratory Abnormalities at Week 24 [Week 24]: Graded treatment-emergent laboratory abnormalities were defined as values that increased at least 1 toxicity grade from baseline at any postbaseline visit, up to and including the date of last dose of study drug + 3 days for participants who permanently discontinued study drug or the last available date in the database snapshot for participants who were on treatment at the time of the analysis. The most severe graded abnormality from all tests was counted for each participant.

Secondary outcomes

  • Percentage of Participants Who Experienced Graded Treatment-Emergent AEs at Week 48 [Week 48]: Treatment-emergent AEs were defined as: Any AEs with an onset date on or after the study drug start date and no later than the study drug stop date + 3 days after permanent discontinuation of study drug; Any AEs with onset date on or after the study drug start date for those who have not permanently discontinued study drug; Any AEs leading to premature discontinuation of study drug. The most severe graded AE from all tests was counted for each participant.
  • Percentage of Participants Who Experienced Graded Treatment-Emergent AEs at Week 96 [Week 96]: Treatment-emergent AEs were defined as: Any AEs with an onset date on or after the study drug start date and no later than the study drug stop date + 3 days after permanent discontinuation of study drug; Any AEs with onset date on or after the study drug start date for those who have not permanently discontinued study drug; Any AEs leading to premature discontinuation of study drug. The most severe graded AE from all tests was counted for each participant.
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Laboratory Abnormalities at Week 48 [Week 48]: Graded treatment-emergent laboratory abnormalities were defined as values that increased at least 1 toxicity grade from baseline at any postbaseline visit, up to and including the date of last dose of study drug + 3 days for participants who permanently discontinued study drug or the last available date in the database snapshot for participants who were on treatment at the time of the analysis. The most severe graded abnormality from all tests was counted for each participant.
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Laboratory Abnormalities at Week 96 [Week 96]: Graded treatment-emergent laboratory abnormalities were defined as values that increased at least 1 toxicity grade from baseline at any post-baseline visit, up to and including the date of last dose of study drug + 3 days for participants who permanently discontinued study drug or the last available date in the database snapshot for participants who were on treatment at the time of the analysis. The most severe graded abnormality from all tests was counted for each participant.
  • Change From Baseline in Estimated Glomerular Filtration Rate by the Cockcroft-Gault Formula (eGFRcg) in Participants With Moderate or Severe Renal Impairment and Hepatically Impaired Participants at Week 24 [Baseline, Week 24]: GFR is a measure of the rate at which blood is filtered by the kidney. Cockcroft-Gault is an equation (calculation) used to estimate GFR based on serum creatinine, weight, and gender. eGFRcg = (140 - age in years) x (body weight in kg) x (0.85 if female) divided by 72 x serum creatinine in mg/dL. Moderate renal impairment= 30 mL/min ≤ eGFRCG ≤ 59 mL/min Severe renal impairment= 15 mL/min ≤ eGFRCG < 30 mL/min Change from baseline was calculated as the value at Week 24 minus the value at Baseline.
  • Change From Baseline in eGFRcg in Participants With Moderate or Severe Renal Impairment and Hepatically Impaired Participants at Week 48 [Baseline, Week 48]: GFR is a measure of the rate at which blood is filtered by the kidney. Cockcroft-Gault is an equation (calculation) used to estimate GFR based on serum creatinine, weight, and gender. eGFRcg = (140 - age in years) x (body weight in kg) x (0.85 if female) divided by 72 x serum creatinine in mg/dL. Moderate renal impairment= 30 mL/min ≤ eGFRCG ≤ 59 mL/min Severe renal impairment= 15 mL/min ≤ eGFRCG < 30 mL/min Change from baseline was calculated as the value at Week 48 minus the value at Baseline.
  • Change From Baseline in eGFRcg in Participants With Moderate or Severe Renal Impairment and Hepatically Impaired Participants at Week 96 [Baseline, Week 96]: GFR is a measure of the rate at which blood is filtered by the kidney. Cockcroft-Gault is an equation (calculation) used to estimate GFR based on serum creatinine, weight, and gender. eGFRcg = (140 - age in years) x (body weight in kg) x (0.85 if female) divided by 72 x serum creatinine in mg/dL. Moderate renal impairment= 30 mL/min ≤ eGFRCG ≤ 59 mL/min Severe renal impairment= 15 mL/min ≤ eGFRCG < 30 mL/min Change from baseline was calculated as the value at Week 96 minus the value at Baseline.
  • Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 24 [Baseline, Week 24]: Percent change = Change from baseline at a postbaseline visit/baseline * 100%.
  • Percent Change From Baseline in Hip BMD at Week 48 [Baseline, Week 48]: Percent change = Change from baseline at a postbaseline visit/baseline * 100%.
  • Percent Change From Baseline in Hip BMD at Week 96 [Baseline, Week 96]: Percent change = Change from baseline at a postbaseline visit/baseline * 100%.
  • Percent Change From Baseline in Spine BMD at Week 24 [Baseline, Week 24]: Percent change = Change from baseline at a postbaseline visit/baseline * 100%.
  • Percent Change From Baseline in Spine BMD at Week 48 [Baseline, Week 48]: Percent change = Change from baseline at a postbaseline visit/baseline * 100%.
  • Percent Change From Baseline in Spine BMD at Week 96 [Baseline, Week 96]: Percent change = Change from baseline at a postbaseline visit/baseline * 100%.
  • Percentage of Participants Achieving Virologic Response (Plasma HBV DNA < 20 IU/mL) at Week 48 [Weeks 48]: The percentage of participants with HBV DNA < 20 IU/mL at Week 48 was determined by the Missing = Failure (M = F) approach.
  • Percentage of Participants Achieving Virologic Response (Plasma HBV DNA < 20 IU/mL) at Week 96 [Weeks 96]: The percentage of participants with HBV DNA < 20 IU/mL at Week 48 was determined by the Missing = Failure (M = F) approach.
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Detected (≥ Lower Limit of Detection [LLOD]) at Week 24 [Week 24]: The percentage of participants with HBV DNA < 20 IU/mL and target detected (≥ LLOD; i.e. 10 IU/mL) at Week 24 was determined by the M = F approach.
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Detected (≥ LLOD) at Week 48 [Week 48]: The percentage of participants with HBV DNA < 20 IU/mL and target detected (≥ LLOD; i.e. 10 IU/mL) at Week 48 was determined by the M = F approach.
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Detected (≥ LLOD) at Week 96 [Week 96]: The percentage of participants with HBV DNA < 20 IU/mL and target detected (≥ LLOD; i.e. 10 IU/mL) at Week 96 was determined by the M = F approach.
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Not Detected (< LLOD) at Week 24 [Week 24]: The percentage of participants with HBV DNA < 20 IU/mL and target not detected (< LLOD; i.e. 10 IU/mL) at Week 24 was determined by the M = F approach.
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Not Detected (< LLOD) at Week 48 [Weeks 48]: The percentage of participants with HBV DNA < 20 IU/mL and target not detected (< LLOD; i.e. 10 IU/mL) at Week 48 was determined by the M = F approach.
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Not Detected (< LLOD) at Week 96 [Weeks 96]: The percentage of participants with HBV DNA < 20 IU/mL and target not detected (< LLOD; i.e. 10 IU/mL) at Week 96 was determined by the M = F approach.
  • Percentage of Participants With Serological Response: Loss of Hepatitis B s-Antigen (HBsAg) at Week 24 [Week 24]: HBsAg loss was defined as HBsAg changing from positive at baseline to negative at a postbaseline. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Loss of HBsAg at Week 48 [Week 48]: HBsAg loss was defined as HBsAg changing from positive at baseline to negative at a postbaseline. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Loss of HBsAg at Week 96 [Week 96]: HBsAg loss was defined as HBsAg changing from positive at baseline to negative at a postbaseline. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Seroconversion to Anti-HBs at Week 24 [Week 24]: HBsAg seroconversion was defined as HBsAg loss and HBsAb test changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Seroconversion to Anti-HBs at Week 48 [Week 48]: HBsAg seroconversion was defined as HBsAg loss and HBsAb test changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Seroconversion to Anti-HBs at Week 96 [Week 96]: HBsAg seroconversion was defined as HBsAg loss and HBsAb test changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Loss of HBeAg in HBeAg-Positive Participants at Week 24 [Week 24]: HBeAg loss was defined as HBeAg changing from positive at baseline to negative at a postbaseline. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Loss of HBeAg in HBeAg-Positive Participants at Week 48 [Week 48]: HBeAg loss was defined as HBeAg changing from positive at baseline to negative at a postbaseline. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Loss of HBeAg in HBeAg-Positive Participants at Week 96 [Week 96]: HBeAg loss was defined as HBeAg changing from positive at baseline to negative at a postbaseline. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Seroconversion to Anti-HBe in HBeAg-Positive Participants at Week 24 [Week 24]: HBeAg seroconversion was defined as HBeAg loss and HBeAb test changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Seroconversion to Anti-HBe in HBeAg-Positive Participants at Week 48 [Week 48]: HBeAg seroconversion was defined as HBeAg loss and HBeAb test changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
  • Percentage of Participants With Serological Response: Seroconversion to Anti-HBe in HBeAg-Positive Participants at Week 96 [Week 96]: HBeAg seroconversion was defined as HBeAg loss and HBeAb test changing from negative/missing at baseline to positive at a postbaseline visit. The M = F approach was used for this analysis.
  • Percentage of Participants With Normal Alanine Aminotransferase (ALT) at Week 24 by Central Laboratory and the American Association for the Study of Liver Diseases (AASLD) Criteria [Week 24]: Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. The M = F approach was used for this analysis.
  • Percentage of Participants With Normal ALT at Week 48 by Central Laboratory and the AASLD Criteria [Week 48]: Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. The M = F approach was used for this analysis.
  • Percentage of Participants With Normal ALT at Week 96 by Central Laboratory and the AASLD Criteria [Week 96]: Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. The M = F approach was used for this analysis.
  • Percentage of Participants With Normalized ALT at Week 24 by Central Laboratory and the AASLD Criteria [Week 24]: ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit. Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. The M = F approach was used for this analysis.
  • Percentage of Participants With Normalized ALT at Week 48 by Central Laboratory and the AASLD Criteria [Week 48]: ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit. Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. The M = F approach was used for this analysis.
  • Percentage of Participants With Normalized ALT at Week 96 by Central Laboratory and the AASLD Criteria [Week 96]: ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit. Central laboratory ULN for ALT were as follows: ≤ 43 U/L for males aged 18 to < 69 years and ≤ 35 U/L for males aged ≥ 69 years; ≤ 34 U/L for females aged 18 to < 69 years and ≤ 32 U/L for females aged ≥ 69 years. The ULN for ALT using the 2018 AASLD normal range was 25 U/L for females and 35 U/L for males. The M = F approach was used for this analysis.
  • Change From Baseline in FibroTest® Score at Week 24 [Baseline, Week 24]: The FibroTest® score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis. Change from baseline was calculated as the value at Week 24 minus the value at Baseline.
  • Change From Baseline in FibroTest® Score at Week 48 [Baseline, Week 48]: The FibroTest® score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis. Change from baseline was calculated as the value at Week 48 minus the value at Baseline.
  • Change From Baseline in FibroTest® Score at Week 96 [Week 96]: The FibroTest® score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis. Change from baseline was calculated as the value at Week 96 minus the value at Baseline.
  • Change From Baseline in Child-Pugh-Turcotte (CPT) Score in Hepatically Impaired Participants at Week 24 [Baseline, Week 24]: CPT scores grade the severity of cirrhosis and are used to determine the need for liver transplantation. Scores can range from 5 to 15, with higher scores indicating a greater severity of disease.
  • Change From Baseline in CPT Score in Hepatically Impaired Participants at Week 48 [Baseline, Week 48]: CPT scores grade the severity of cirrhosis and are used to determine the need for liver transplantation. Scores can range from 5 to 15, with higher scores indicating a greater severity of disease.
  • Change From Baseline in CPT Score in Hepatically Impaired Participants at Week 96 [Baseline, Week 96]: CPT scores grade the severity of cirrhosis and are used to determine the need for liver transplantation. Scores can range from 5 to 15, with higher scores indicating a greater severity of disease.
  • Change From Baseline in Model for End-Stage Liver Disease (MELD) Score in Hepatically Impaired Participants at Week 24 [Baseline, Week 24]: MELD scores are used to assess prognosis and suitability for liver transplantation. Scores can range from 6 to 40, with higher scores indicating greater disease severity.
  • Change From Baseline in MELD Score in Hepatically Impaired Participants at Week 48 [Baseline, Week 48]: MELD scores are used to assess prognosis and suitability for liver transplantation. Scores can range from 6 to 40, with higher scores indicating greater disease severity.
  • Change From Baseline in MELD Score in Hepatically Impaired Participants at Week 96 [Baseline, Week 96]: MELD scores are used to assess prognosis and suitability for liver transplantation. Scores can range from 6 to 40, with higher scores indicating greater disease severity.

+Eligibility

Sex: All, ages: 18 Years to any

Key Inclusion Criteria:

All Participants (Parts A and B):

* Adult male or non-pregnant female individuals
* Documented evidence of chronic HBV infection
* Alanine aminotransferase (ALT) ≤ 10 × upper limit of normal (ULN)

Part A Only (renal impairment):

* Maintained on TDF and/or other OAV treatment(s) for CHB for at least 48 weeks and with viral suppression (HBV deoxyribonucleic acid \[DNA\] < lower limit of quantitation \[LLOQ\]) for ≥ 6 months prior to screening

  * All individuals must have HBV DNA < 20 International units per milliliter (IU/mL) at screening by central laboratory
  * Both Hepatitis B e-Antigen (HBeAg) positive and negative individuals are eligible to participate
* Moderate renal impairment (30 milliliters per minute \[mL/min\] ≤ estimated glomerular filtration rate by the cockcroft-gault formula \[eGFRcg\] ≤ 59 mL/min), severe renal impairment (15 mL/min ≤ eGFRcg < 30 mL/min) or end stage renal disease (ESRD) (eGFR < 15 mL/min) maintained on hemodialysis (HD)
* Stable renal function (for participants with moderate or severe impairment): serum creatinine measured at least once within three months prior to screening. The measurement difference between the value measured within three months prior to screening versus the screening value must be ≤ 25% of the screening value

Part B Only (hepatic impairment):

* Maintained on TDF and/or other OAV(s) for CHB for at least 48 weeks and with viral suppression (HBV DNA < LLOQ) for ≥ 6 months prior to screening

  * All individuals must have HBV DNA < 20 IU/mL at screening by central laboratory
  * Both HBeAg positive and negative individuals are eligible to participate
* Child-pugh-turcotte (CPT) score of 7-12 (inclusive) OR a past history of CPT score ≥ 7 and any CPT score ≤ 12 at screening
* eGFRCG ≥ 30 mL/min using the Cockcroft-Gault equation

Key Exclusion Criteria:

All Individuals (Parts A \& B):

* Women who are breastfeeding or who believe they may wish to become pregnant during the course of the study
* Males and females of reproductive potential who are unwilling to use an "effective", protocol-specified method(s) of contraception during the study
* Co-infection with hepatitis C virus (HCV), human immunodeficiency virus (HIV), or hepatitis D virus (HDV)
* Prior Interferon (IFN) use within 6 months of screening
* Evidence of hepatocellular carcinoma
* Received solid organ or bone marrow transplant
* Significant cardiovascular, pulmonary, or neurological disease
* Malignancy within 5 years prior to screening, with the exception of specific cancers that are cured by surgical resection (basal cell skin cancer, etc.). Individuals under evaluation for possible malignancy are not eligible
* Currently receiving therapy with immunomodulators (e.g. corticosteroids), nephrotoxic agents, or agents capable of modifying renal excretion
* Known hypersensitivity to study drugs, metabolites, or formulation excipients
* Current alcohol or substance abuse judged by the investigator to potentially interfere with individual's compliance
* Any other clinical condition or prior therapy that, in the opinion of the Investigator, would make the individual unsuitable for the study or unable to comply with dosing requirements.

Part A Only (Renal Impairment):

* Current or historical evidence of clinical hepatic decompensation (e.g., ascites, encephalopathy or variceal hemorrhage)
* Abnormal hematological and biochemical parameters, including:

  * Hemoglobin < 9 grams per deciliter (g/dL)
  * Absolute neutrophil count < 750/cubic millimeter (mm\^3)
  * Platelets ≤ 50,000/mm\^3
  * Aspartate aminotransferase (AST) > 10 × ULN
  * Albumin < 3.0 g/dL
  * Total bilirubin > 2.5 × ULN
  * International normalized ratio of prothrombin time (INR) > 1.5 × ULN (unless stable on anticoagulant regimen)
* Individuals with ESRD (i.e. eGFRcg < 15 mL/min) not on HD, or those on other forms of renal replacement therapy (i.e. peritoneal dialysis)

Part B Only (Hepatic Impairment):

* Active variceal bleeding within 6 months or prior placement of a portosystemic shunt (such as transjugular intrahepatic portosystemic shunt \[TIPS\])
* History of hepatorenal syndrome, hepatopulmonary syndrome, Grade 3 or Grade 4 hepatic encephalopathy, or spontaneous bacterial peritonitis within 6 months of screening
* Grade 2 hepatic encephalopathy at screening
* Model for end-stage liver disease (MELD) score ≥ 30
* Abnormal hematological and biochemical parameters, including

  * Absolute neutrophil count < 750/mm\^3
  * Platelets < 30,000/mm\^3
  * Hemoglobin < 8.0 g/dL

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

+Posted results

Participant flow

MilestonePart A (Renal Impairment): Moderate or Severe Renal ImpairmentPart A (Renal Impairment): End Stage Renal DiseasePart B: Hepatic Impairment
Started781531
Completed671425
Not completed1116

Outcome results

  • Percentage of Participants Achieving Virologic Response (Plasma Hepatitis B Virus [HBV] Deoxyribonucleic Acid [DNA] < 20 IU/mL) at Week 24 (Primary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 97.4; Part A (Renal Impairment): End Stage Renal Disease 100.0; Part B: Hepatic Impairment 100.0
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Adverse Events (AEs) at Week 24 (Primary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 53.8; Part A (Renal Impairment): End Stage Renal Disease 73.3; Part B: Hepatic Impairment 54.8
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Laboratory Abnormalities at Week 24 (Primary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 96.2; Part A (Renal Impairment): End Stage Renal Disease 100.0; Part B: Hepatic Impairment 90.3
  • Percentage of Participants Who Experienced Graded Treatment-Emergent AEs at Week 48 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 71.8; Part A (Renal Impairment): End Stage Renal Disease 86.7; Part B: Hepatic Impairment 71.0
  • Percentage of Participants Who Experienced Graded Treatment-Emergent AEs at Week 96 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 74.4; Part A (Renal Impairment): End Stage Renal Disease 100.0; Part B: Hepatic Impairment 77.4
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Laboratory Abnormalities at Week 48 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 96.2; Part A (Renal Impairment): End Stage Renal Disease 100.0; Part B: Hepatic Impairment 90.3
  • Percentage of Participants Who Experienced Graded Treatment-Emergent Laboratory Abnormalities at Week 96 (Secondary), Number, percentage of particpants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 96.2; Part A (Renal Impairment): End Stage Renal Disease 100.0; Part B: Hepatic Impairment 100.0
  • Change From Baseline in Estimated Glomerular Filtration Rate by the Cockcroft-Gault Formula (eGFRcg) in Participants With Moderate or Severe Renal Impairment and Hepatically Impaired Participants at Week 24 (Secondary), Median, mL/min: Part A (Renal Impairment): Moderate or Severe Renal Impairment -0.4 (-3.9 to 4.5); Part B: Hepatic Impairment 1.9 (-5.6 to 12.2)
  • Change From Baseline in eGFRcg in Participants With Moderate or Severe Renal Impairment and Hepatically Impaired Participants at Week 48 (Secondary), Median, mL/min: Part A (Renal Impairment): Moderate or Severe Renal Impairment -0.5 (-4.1 to 3.0); Part B: Hepatic Impairment 1.2 (-13.5 to 6.5)
  • Change From Baseline in eGFRcg in Participants With Moderate or Severe Renal Impairment and Hepatically Impaired Participants at Week 96 (Secondary), Median, mL/min: Part A (Renal Impairment): Moderate or Severe Renal Impairment 1.0 (-2.8 to 4.5); Part B: Hepatic Impairment -2.4 (-11.4 to 10.7)
  • Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 24 (Secondary), Mean, percent change: Part A (Renal Impairment): Moderate or Severe Renal Impairment 0.135 +/- 1.8348; Part A (Renal Impairment): End Stage Renal Disease 0.322 +/- 2.1835; Part B: Hepatic Impairment 0.322 +/- 2.5105
  • Percent Change From Baseline in Hip BMD at Week 48 (Secondary), Mean, percent change: Part A (Renal Impairment): Moderate or Severe Renal Impairment 0.565 +/- 2.6160; Part A (Renal Impairment): End Stage Renal Disease -1.075 +/- 3.6355; Part B: Hepatic Impairment -0.221 +/- 3.0158
  • Percent Change From Baseline in Hip BMD at Week 96 (Secondary), Mean, percent change: Part A (Renal Impairment): Moderate or Severe Renal Impairment 0.425 +/- 2.8381; Part A (Renal Impairment): End Stage Renal Disease -0.834 +/- 4.7171; Part B: Hepatic Impairment 0.277 +/- 3.2549
  • Percent Change From Baseline in Spine BMD at Week 24 (Secondary), Mean, percent change: Part A (Renal Impairment): Moderate or Severe Renal Impairment 1.229 +/- 3.4252; Part A (Renal Impairment): End Stage Renal Disease 0.683 +/- 3.1370; Part B: Hepatic Impairment 1.258 +/- 2.3416
  • Percent Change From Baseline in Spine BMD at Week 48 (Secondary), Mean, percent change: Part A (Renal Impairment): Moderate or Severe Renal Impairment 1.516 +/- 3.7486; Part A (Renal Impairment): End Stage Renal Disease 0.016 +/- 4.1636; Part B: Hepatic Impairment 0.535 +/- 3.4386
  • Percent Change From Baseline in Spine BMD at Week 96 (Secondary), Mean, percent change: Part A (Renal Impairment): Moderate or Severe Renal Impairment 1.293 +/- 4.4136; Part A (Renal Impairment): End Stage Renal Disease -0.283 +/- 4.5327; Part B: Hepatic Impairment -0.249 +/- 3.9127
  • Percentage of Participants Achieving Virologic Response (Plasma HBV DNA < 20 IU/mL) at Week 48 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 92.3; Part A (Renal Impairment): End Stage Renal Disease 93.3; Part B: Hepatic Impairment 100.0
  • Percentage of Participants Achieving Virologic Response (Plasma HBV DNA < 20 IU/mL) at Week 96 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 83.3; Part A (Renal Impairment): End Stage Renal Disease 86.7; Part B: Hepatic Impairment 77.4
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Detected (≥ Lower Limit of Detection [LLOD]) at Week 24 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 21.8; Part A (Renal Impairment): End Stage Renal Disease 40.0; Part B: Hepatic Impairment 22.6
  • Percentage of Participants With Plasma HBV DNA < 20 IU/mL and Target Detected (≥ LLOD) at Week 48 (Secondary), Number, percentage of participants: Part A (Renal Impairment): Moderate or Severe Renal Impairment 26.9; Part A (Renal Impairment): End Stage Renal Disease 26.7; Part B: Hepatic Impairment 25.8
  • 31 more outcome measures not shown.

Adverse events

Time frame: Adverse Events: From the first dose date up to last dose date (maximum: 108.1 weeks) plus 3 days; All-Cause Mortality: Enrollment up to last dose date (maximum: 166.2 weeks) plus 3 days

ArmDeathsSerious adverse eventsOther adverse events
Part A (Renal Impairment): Moderate or Severe Renal Impairment2/78 (2.6%)12/78 (15.4%)34/78 (43.6%)
Part A (Renal Impairment): End Stage Renal Disease (Cohort 2)1/15 (6.7%)8/15 (53.3%)15/15 (100.0%)
Part B (Hepatic Impairment): Moderate or Severe Hepatic Impair2/31 (6.5%)10/31 (32.3%)23/31 (74.2%)

Serious adverse events by term

TermOrgan systemPart A (Renal Impairment): Moderate or Severe Renal ImpairmentPart A (Renal Impairment): End Stage Renal Disease (Cohort 2)Part B (Hepatic Impairment): Moderate or Severe Hepatic Impair
AnaemiaBlood and lymphatic system disorders0/781/150/31
ThrombocytopeniaBlood and lymphatic system disorders0/781/150/31
Atrial flutterCardiac disorders0/780/151/31
Atrioventricular block completeCardiac disorders1/780/150/31
Deafness neurosensoryEar and labyrinth disorders0/781/150/31
Adrenal massEndocrine disorders0/780/151/31
CataractEye disorders2/780/150/31
Abdominal painGastrointestinal disorders0/781/150/31
AscitesGastrointestinal disorders0/780/151/31
ColitisGastrointestinal disorders0/781/150/31
Duodenal ulcer haemorrhageGastrointestinal disorders0/780/151/31
Gingival bleedingGastrointestinal disorders0/780/151/31
Intestinal obstructionGastrointestinal disorders0/781/150/31
Upper gastrointestinal haemorrhageGastrointestinal disorders0/780/151/31
Catheter site dischargeGeneral disorders0/781/150/31
Bile duct stoneHepatobiliary disorders0/780/151/31
Hepatic failureHepatobiliary disorders0/780/151/31
Hepatorenal syndromeHepatobiliary disorders0/780/151/31
BacteraemiaInfections and infestations0/781/150/31
Fungal cystitisInfections and infestations0/780/151/31
Lower respiratory tract infectionInfections and infestations0/781/150/31
Lower respiratory tract infection viralInfections and infestations0/781/150/31
Peritonitis bacterialInfections and infestations0/780/151/31
PneumoniaInfections and infestations2/781/150/31
SepsisInfections and infestations0/781/151/31
Urinary tract infectionInfections and infestations0/780/151/31
Arteriovenous fistula site complicationInjury, poisoning and procedural complications0/781/150/31
Arteriovenous fistula thrombosisInjury, poisoning and procedural complications0/781/150/31
Drain site complicationInjury, poisoning and procedural complications0/780/151/31
Head injuryInjury, poisoning and procedural complications1/780/150/31
Shunt occlusionInjury, poisoning and procedural complications0/781/150/31
Subdural haematomaInjury, poisoning and procedural complications0/780/151/31
Carcinoembryonic antigen increasedInvestigations1/780/150/31
Model for end stage liver disease score increasedInvestigations0/780/151/31
HyperkalaemiaMetabolism and nutrition disorders1/780/150/31
Back painMusculoskeletal and connective tissue disorders1/780/150/31
Focal myositisMusculoskeletal and connective tissue disorders0/781/150/31
Bladder cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/780/150/31
Hepatocellular carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/781/151/31
Lung neoplasm malignantNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/780/150/31
Ovarian cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/781/150/31
Rectal cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/780/150/31
EncephalopathyNervous system disorders0/780/151/31
Hepatic encephalopathyNervous system disorders0/780/152/31
Ischaemic strokeNervous system disorders2/780/151/31
Subarachnoid haemorrhageNervous system disorders1/780/151/31
BronchospasmRespiratory, thoracic and mediastinal disorders0/781/150/31
DyspnoeaRespiratory, thoracic and mediastinal disorders0/781/150/31
HaemothoraxRespiratory, thoracic and mediastinal disorders0/781/150/31
Pleural effusionRespiratory, thoracic and mediastinal disorders0/782/150/31
Pneumonia aspirationRespiratory, thoracic and mediastinal disorders1/780/151/31
Respiratory failureRespiratory, thoracic and mediastinal disorders1/780/150/31

Other adverse events by term

TermOrgan systemPart A (Renal Impairment): Moderate or Severe Renal ImpairmentPart A (Renal Impairment): End Stage Renal Disease (Cohort 2)Part B (Hepatic Impairment): Moderate or Severe Hepatic Impair
AnaemiaBlood and lymphatic system disorders2/783/151/31
Blood loss anaemiaBlood and lymphatic system disorders0/781/150/31
CoagulopathyBlood and lymphatic system disorders0/781/150/31
ThrombocytopeniaBlood and lymphatic system disorders0/781/151/31
Thrombotic thrombocytopenic purpuraBlood and lymphatic system disorders0/781/150/31
Deafness neurosensoryEar and labyrinth disorders0/781/150/31
Ear haemorrhageEar and labyrinth disorders0/781/150/31
Ear painEar and labyrinth disorders0/781/150/31
VertigoEar and labyrinth disorders1/781/150/31
CataractEye disorders1/781/151/31
Cataract nuclearEye disorders0/781/150/31
Conjunctival haemorrhageEye disorders0/781/151/31
IridocyclitisEye disorders0/781/150/31
Abdominal painGastrointestinal disorders2/781/152/31
Abdominal pain lowerGastrointestinal disorders1/781/150/31
AscitesGastrointestinal disorders0/782/154/31
ConstipationGastrointestinal disorders2/784/153/31
Dental cariesGastrointestinal disorders0/781/152/31
DiarrhoeaGastrointestinal disorders3/783/156/31
FlatulenceGastrointestinal disorders0/780/152/31
HaemorrhoidsGastrointestinal disorders2/781/150/31
Mouth ulcerationGastrointestinal disorders0/781/150/31
NauseaGastrointestinal disorders1/781/151/31
Peptic ulcerGastrointestinal disorders0/781/150/31
Portal hypertensive gastropathyGastrointestinal disorders0/780/152/31
StomatitisGastrointestinal disorders0/781/150/31
ToothacheGastrointestinal disorders3/781/150/31
VomitingGastrointestinal disorders0/781/152/31
Chest discomfortGeneral disorders0/781/150/31
FatigueGeneral disorders0/780/152/31
Oedema peripheralGeneral disorders1/781/152/31
PainGeneral disorders0/781/150/31
PyrexiaGeneral disorders0/783/155/31
JaundiceHepatobiliary disorders0/781/150/31
CellulitisInfections and infestations0/781/150/31
ConjunctivitisInfections and infestations0/781/152/31
EndophthalmitisInfections and infestations0/781/150/31
HordeolumInfections and infestations0/781/150/31
NasopharyngitisInfections and infestations6/780/150/31
PneumoniaInfections and infestations2/781/151/31
Skin infectionInfections and infestations0/781/150/31
Upper respiratory tract infectionInfections and infestations11/783/156/31
Urinary tract infectionInfections and infestations3/781/150/31
Arteriovenous fistula site complicationInjury, poisoning and procedural complications0/781/150/31
Incision site painInjury, poisoning and procedural complications0/781/150/31
Ligament sprainInjury, poisoning and procedural complications1/781/150/31
Limb injuryInjury, poisoning and procedural complications0/781/150/31
Procedural painInjury, poisoning and procedural complications0/781/150/31
Shunt occlusionInjury, poisoning and procedural complications0/781/150/31
Vascular pseudoaneurysmInjury, poisoning and procedural complications0/781/150/31
Blood bilirubin increasedInvestigations0/780/152/31
Blood creatinine increasedInvestigations1/780/152/31
Bone density decreasedInvestigations1/780/155/31
HyperkalaemiaMetabolism and nutrition disorders1/782/150/31
HyperlipidaemiaMetabolism and nutrition disorders1/780/152/31
HypokalaemiaMetabolism and nutrition disorders0/781/151/31
Metabolic acidosisMetabolism and nutrition disorders0/781/150/31
Vitamin B12 deficiencyMetabolism and nutrition disorders0/781/150/31
ArthralgiaMusculoskeletal and connective tissue disorders0/782/153/31
Back painMusculoskeletal and connective tissue disorders2/781/150/31

37 more terms not shown.

+Locations (30)

FacilityCityCountryStatus
Coalition of Inclusive MedicineLos Angeles, CaliforniaUnited States
Silicon Valley Research Institute, IncSan Jose, CaliforniaUnited States
Henry Ford Health SystemDetroit, MichiganUnited States
Harborview Medical CenterSeattle, WashingtonUnited States
University of Calgary Liver UnitCalgaryCanada
Centre de Recherche du Centre Hospitalier de l'Universite de MontrealMontrealCanada
University Health Network,Toronto general Hospital,Toronto centre for liver diseaseTorontoCanada
Toronto Liver CentreTorontoCanada
(G.I.R.I.) GI Research InstituteVancouverCanada
Prince of Wales HospitalShatin, NTHong Kong
Princess Margaret HospitalKowloonHong Kong
Alice Ho Miu Ling Nethersole HospitalTai PoHong Kong
U.O. Medicina Generale Epatologia IRCCS Humanitas Centro di Ricerca Traslazionale in EpatologiaRozzano, MilanItaly
Dipartimento di Scienze Mediche e Chirurgiche (DIMEC) AOU Policlinico S.Orsola-Malpighi di BolognaBolognaItaly
UOC Gastroenterol-Epatol.-Fondazione IRCCS Ca GrandaMilanItaly
Auckland Clinical StudiesGrafton, AucklandNew Zealand
Dong-A University HospitalBusanSouth Korea
Pusan National University HospitalBusanSouth Korea
Asan Medical CenterSeoulSouth Korea
Yonsei University Health System, Severance HospitalSeoulSouth Korea
Changhua Christian HospitalChanghuaTaiwan
Ditmanson Medical Foundation Chia-Yi Christian HospitalChiayi CityTaiwan
Kaohsiung Medical University Chung-Ho Memorial HospitalKaohsiung CityTaiwan
Kaohsiung Chang Gung Memorial HospitalKaohsiung CityTaiwan
Taichung Veterans Genl HospTaichungTaiwan
National Taiwan University HospitalTaipeiTaiwan
Veterans General Hospital-TaipeiTaipeiTaiwan
Chang Gung Medical Foundation, Linkou Chang Gung Memorial HospitalTaoyuan CityTaiwan
Nottingham University HospitalLondonUnited Kingdom
King's College Hospital NHS Foundation TrustLondonUnited Kingdom

+Publications

  • Results publication: Lim YS, Lin CY, Heo J, Bae H, Chuang WL, Hui AJ, et al. Safety and Efficacy of Switching to Tenofovir Alafenamide in Virally Suppressed Chronic Hepatitis B Patients With Hepatic Impairment: Week-48 Results From a Phase 2 Open-label Study [Poster SAT442]. The Digital International Liver Congress (ILC); 2020 27-29 August.
  • Results publication: Janssen HLA, Lampertico P, Chen CY, Heo J, Fournier C, Ahn SH, et al. Safety and Efficacy of Switching to Tenofovir Alafenamide in Virally Suppressed Chronic Hepatitis B Patients With Renal Impairment: Week-48 Results From a Phase 2 Open-label Study [Poster SAT429]. The Digital International Liver Congress (ILC); 2020 27-29 August.
  • Results publication: Lim YS, Lampertico P, Bae H, Chuang WL, Heo J, Huang YH, et al. Switching From Tenofovir Disoproxil Fumarate or Other Oral Antiviral Therapy to Tenofovir Alafenamide in Virally Suppressed Chronic Hepatitis B Patients With Hepatic Impairment: Week 24 Efficacy and Safety Results From a Phase 2 Open-label Study [Poster 501]. AASLD: The Liver Meeting; 2019 08-12 November; Boston, MA.
  • Results publication: Janssen HLA, Lim YS, Gane EJ, Fournier C, Ahn SH, Tsang O, et al. Efficacy and Safety of Switching to Tenofovir Alafenamide in Virally Suppressed Chronic Hepatitis B Patients With Renal Impairment: Week 24 Results From a Phase 2 Open-label Study [Poster 483]. AASLD: The Liver Meeting; 2019 08-12 November; Boston, MA.
  • Results publication: Liu CJ, Lim YS, Chen CY, Chen CH, Huang YH, Lin CY, Lin CC, Yu ML, Abramov F, Yee LJ, Duan R, Flaherty JF, Su WW, Yang SS, Janssen HLA, Chuang WL. Switching to tenofovir alafenamide in virally-suppressed chronic hepatitis B patients with renal/hepatic impairment: Phase 2 study sub-analysis from Taiwan. J Formos Med Assoc. 2025 Jul 30:S0929-6646(25)00390-0. doi: 10.1016/j.jfma.2025.07.023. Online ahead of print. PMID 40744841
  • Results publication: Janssen HLA, Lim YS, Lampertico P, Heo J, Chen CY, Fournier C, Tsang TYO, Bae H, Chen CH, Coffin CS, Ahn SH, Trinh H, Flaherty JF, Abramov F, Zhao Y, Liu Y, Lau A, German P, Chuang WL, Agarwal K, Gane E. Switching to tenofovir alafenamide in patients with virologically suppressed chronic hepatitis B and renal or hepatic impairment: final week 96 results from an open-label, multicentre, phase 2 study. Lancet Gastroenterol Hepatol. 2024 Aug;9(8):718-733. doi: 10.1016/S2468-1253(24)00096-7. Epub 2024 Jun 17. PMID 38901444

+Study documents

+Investigators

  • Gilead Study Director, Study director, Gilead Sciences

+Funding

NIH grants: 2016

My Notes