Study of Tenofovir Alafenamide in HBV-Infected Pregnant Women

Chronic Hepatitis b Clinical Trial

Official title:

Study to Evaluate the Pharmacokinetic, Safety, and Efficacy of TAF in HBV-Infected Pregnant Women

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05853718
• Other study ID #: IIT-20210825-0020-01
• Status: Recruiting
• Phase: Phase 4
• Start date: May 6, 2021
• Est. completion date: December 30, 2024

Study information

• Verified date: March 2023
• Source: First People's Hospital of Hangzhou
• Contact: Jie Jin, MD
• Phone: 13372517879
• Email: jinjie0429[@]163.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the pharmacokinetics, efficacy and safety of TAF in HBV-infected pregnant women.

Description:

Pregnant women with high viral load (HBV DNA>2 × 10^5 IU/mL ) are recommended to be given Tenofovir Disoproxil Fumarate(TDF) for mother-to-child blocking of Chronic hepatitis B(CHB) by guidelines. Tenofovir alafenamide (TAF) is a new targeted pro-drug of Tenofovir (TFV) and was approved for use in China in December 2018. Compared with TDF, the therapeutic dose of TAF is small. 25mg TAF can obtain the antiviral effect similar to 300mg TDF, thus reducing the concentration of TFV in the blood.

This is a prospective clinical study, aiming to evaluate the pharmacokinetics, efficacy and safety of TAF in HBV-infected pregnant women when used for prevention of mother-to-child transmission of hepatitis B virus. 50 HBeAg-positive and HBV DNA levels ≥ 2 × 10^5 IU/mL pregnant women will be enrolled to receive Tenofovir alafenamide (TAF) from week 28-32 of gestation until delivery. According to the mother's wishes, intensive blood samples will be collected to determine the concentration of TAF and TFV in plasma of pregnant women before and after taking TAF, calculate the pharmacokinetic parameters. And the mother's milk is collected every day for 5 days for TAF concentration determination. The primary endpoint was the pharmacokinetic parameters of TAF and TFV, rate of mother-to-child transmission, the congenital malformation rate of infants. The secondary endpoint was the decrease of HBV DNA level at delivery, the clearance and seroconversion rate of HBeAg, postpartum ALT flare, concentration of TAF and TFV in milk,and other adverse events of mothers and infants.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: December 30, 2024
• Est. primary completion date: July 30, 2024
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 20 Years to 40 Years

Eligibility

Inclusion Criteria:

• Age of 20-40 years; Positive for hepatitis B surface antigen (HBsAg) and hepatitis B virus e antigen (HBeAg); HBV DNA level >200 000 IU/mL during the 24th-32nd week of pregnancy; Willing to take TAF for mother-to-child blockade; Both husband and wife are willingly sign an informed consent.

Exclusion Criteria:

• Co-infected with hepatitis C or HIV, or other chronic diseases; History of spontaneous abortion or congenital malformation; Decompensated cirrhosis and liver cancer; History of kidney injury, CCr <50ml/min and urine protein test positive (>300mg/L); Fetal malformations detected by B-ultrasound during pregnancy; ALT > 2×upper limit of normal (ULN); TBIL = 1×ULN; Albumin (ALB) < 25 g/L.

Related Conditions & MeSH terms

• Chronic Hepatitis b
• Hepatitis B
• Hepatitis B, Chronic
• Tenofovir Alafenamide Fumarate

Intervention

Drug:
• Tenofovir Alafenamide Tablets
Take 25mg TAF daily from week 28-32 of gestation until delivery

Locations

Country	Name	City	State
China	Hangzhou First People's Hospital	Hangzhou	Zhejiang

Sponsors (1)

Lead Sponsor	Collaborator
First People's Hospital of Hangzhou

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Assessment on the pharmacokinetics of TAF and TFV in plasma of pregnant women	When taking the last TAF before delivery , 2ml of drug-containing blood was collected from the upper extremity veins at 0, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24h after taking TAF. Blood drug concentration at each time point was calculated according to standard curve.	The day before delivery
Primary	Rate of mother-to-child transmission of HBV	Testing for HBsAg in the infants between 7 and 12 months of age.	During 7-12 months after birth
Primary	Rate of birth defect of infants	The proportion of infants with the aforementioned abnormalities discovered during the study period	From the date of birth to age of 28 weeks
Secondary	Reduction of HBV DNA levels at delivery	Reduction of HBV DNA levels (IU/mL) at delivery when compared to the baseline before initiating TAF	At delivery
Secondary	Drug concentration of TAF and TFV in breast milk after drug withdrawal	Postpartum breast milk was collected to measure TAF and TFV concentrations after drug withdrawal	Immediately after breast milk is available and last for 5 days
Secondary	Concentrations of TAF and TFV in infant urine and plantar blood	Collect infant urine and plantar blood within 72 hours of birth	Within 72 hours of birth