1
|
Gao Y, Kong F, Song X, Shang J, Yao L, Xia J, Peng Y, Liu W, Gong H, Mu M, Cui H, Han T, Chen W, Wu X, Yang Y, Yan X, Jin Z, Wang P, Zhu Q, Chen L, Zhao C, Zhang D, Jin W, Wang D, Wen X, Liu C, Jia J, Mao Q, Ding Y, Jin X, Zhang Z, Mao Q, Li G, Niu J. Pradefovir Treatment in Patients With Chronic Hepatitis B: Week 24 Results From a Multicenter, Double-Blind, Randomized, Noninferiority, Phase 2 Trial. Clin Infect Dis 2022; 74:1925-1932. [PMID: 34487151 PMCID: PMC9187326 DOI: 10.1093/cid/ciab763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pradefovir is a liver-targeted prodrug of adefovir, a nucleoside/nucleotide analogue with antiviral activity against hepatitis B virus (HBV) DNA polymerase. This phase 2 study compared the efficacy and safety of oral pradefovir (30, 45, 60, or 75 mg) versus tenofovir disoproxil fumarate (TDF; 300 mg) and aimed to identify the most appropriate dose of pradefovir for the forthcoming phase 3 study. METHODS Treatment-naive and experienced (not on treatment >6 months) patients with chronic hepatitis B were eligible. RESULTS A total of 240 participants were randomized and treated in the study (48 per group). Approximately 80% were hepatitis B e antigen (HBeAg) positive, and 10% had liver cirrhosis. The reductions from baseline in HBV DNA levels achieved at week 24 were 5.40, 5.34, 5.33, and 5.40 log10 IU/mL, with pradefovir doses of 30-, 45-, 60-, and 75-mg, respectively, compared with 5.12 log10 IU/mL with TDF. However, HBeAg loss was attained by more participants who received 45-, 60-, or 75-mg pradefovir than by those receiving TDF (12%, 6%, and 9% vs 3%). The TDF group exhibited a more significant increase in serum creatinine than the pradefovir 30- and 45-mg groups, and serum phosphate levels were comparable among all groups. Most adverse events (AEs) were mild (grade 1). No treatment-related severe AEs were reported. Overall, AEs and laboratory abnormalities were comparable to those in the TDF group. CONCLUSIONS Pradefovir and TDF exhibited comparable reductions in HBV DNA levels. All treatments were safe and well tolerated. CLINICAL TRIALS REGISTRATION NCT00230503 and China Drug Trials CTR2018042.
Collapse
Affiliation(s)
| | | | - Xinwen Song
- Department of Infectious Diseases, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Jia Shang
- Department of Infectious Diseases, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Lvfeng Yao
- Department of Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jinyu Xia
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Yanzhong Peng
- Department of Infectious Diseases, Peking University Shenzhen Hospital, Shenzhen, China
| | - Weidong Liu
- Department of Hepatology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Huanyu Gong
- Department of Infectious Diseases, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mao Mu
- Department of Infectious Diseases, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Hesong Cui
- Department of Infectious Diseases, Yanbian University Affiliated Hospital, Yanji, Jilin, China
| | - Tao Han
- Department of Hepatology, Tianjin Third Central Hospital, Tianjin, China
| | - Wen Chen
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaolu Wu
- Department of Infectious Diseases, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Yongfeng Yang
- Department of Hepatology, The Second Hospital of Nanjing, Nanjing, Jiangsu, China
| | - Xuebing Yan
- Department of Infectious Disease, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhenjing Jin
- Department of Hepatology, The Second Hospital of Jilin University, Changchun, China
| | - Peng Wang
- Department of Infectious Diseases, Shunde Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Qingjing Zhu
- Department of Hepatology, Wuhan Hospital for Infectious Diseases, Wuhan, Hubei, China
| | - Liang Chen
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
| | - Caiyan Zhao
- Department of Infectious Diseases, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Dengke Zhang
- Xi’an Xintong Pharmaceutical Research, Xi’an, Shanxi, China
| | - Weili Jin
- Xi’an Xintong Pharmaceutical Research, Xi’an, Shanxi, China
| | - Daidi Wang
- Xi’an Xintong Pharmaceutical Research, Xi’an, Shanxi, China
| | - Xiuhong Wen
- Xi’an Xintong Pharmaceutical Research, Xi’an, Shanxi, China
| | - Chunmei Liu
- Xi’an Xintong Pharmaceutical Research, Xi’an, Shanxi, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qing Mao
- Institute of Infectious Diseases, First Affiliated Hospital of People’s Liberation Army Medical University, Chongqing, China
| | - Yanhua Ding
- Department of Phase I Clinical Trial, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xueyuan Jin
- Department of Quality Management, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | | | | | | | - Junqi Niu
- Correspondence: J. Niu, Department of Hepatology, The First Hospital of Jilin University, No. 1 Xinmin St, Changchun 130021 Jilin, China ()
| |
Collapse
|