Clinical trial • Phase II • Infectious Disease|Rare Disease

TOBEVIBART for Chronic Hepatitis D (HDV) infection

Phase II trial of TOBEVIBART for Chronic Hepatitis D (HDV) infection. Randomised, open-label. 119 participants.

Overview

Trial Therapeutic Area
Infectious Disease|Rare Disease
Trial Disease
Chronic Hepatitis D (HDV) infection
Trial Stage
Phase II
Drug Modality
Monoclonal antibody|Oligonucleotide

Key dates

Initial CTIS Submission Date
30-08-2024
First CTIS Authorization Date
16-09-2024

Trial design

Randomised, open-label Phase II trial in Netherlands, France, Germany and others.

Randomised
Yes
Open Label
Yes
Target Sample Size
119
Trial Duration For Participant
1344

Eligibility

Recruits 119 Vulnerable population flag is selected. The protocol requires participants to be capable of giving signed informed consent. Only adults (Age ≥ 18) are eligible. Specific informed consent forms (ICFs) are provided, including adult ICFs and separate ICFs for pregnant participants/partners and optional substudies; ICFs are available in multiple country/language versions (e.g. Dutch, French, German, Italian, Romanian, Bulgarian, English) as listed in the public documents..

Pregnancy Exclusion
Female participants must have a negative pregnancy test or confirmation of postmenopausal status. Postmenopausal status is defined as 12 months with no menses without an alternative medical cause (see Section 10.7 for additional details). Women of childbearing potential (WOCBP) must have a negative blood pregnancy test at screening and a negative urine pregnancy test on Day 1, cannot be breast feeding, and must be willing to use highly effective methods of contraception (Section 10.7) 14 days before study intervention administration through 48 weeks after the last dose of VIR-2218 or VIR-3434. Female participants must also agree to refrain from egg donation and in vitro fertilization from the time of study intervention administration through 24 weeks after the last dose of VIR-2218 or VIR-3434.
Vulnerable Population
Vulnerable population flag is selected. The protocol requires participants to be capable of giving signed informed consent. Only adults (Age ≥ 18) are eligible. Specific informed consent forms (ICFs) are provided, including adult ICFs and separate ICFs for pregnant participants/partners and optional substudies; ICFs are available in multiple country/language versions (e.g. Dutch, French, German, Italian, Romanian, Bulgarian, English) as listed in the public documents.

Inclusion criteria

  • {"criterion_text":"- 1. Age ≥ 18 (or age of legal consent, whichever is older) to < 70 years at the time of screening Type of Participant and Disease Characteristics\n- 2. Chronic HBV infection defined as a positive serum HBsAg, HBV DNA, or HBeAg on 2 occasions at least 6 months apart based on previous (within the past 12 months) or current laboratory documentation (any combination of these tests performed 6 months apart is acceptable)\n- 3. On locally approved NRTI therapy for at least 12 weeks prior to Day 1\n- 4. HBsAg > 0.05 IU/mL at screening\n- 5. Positive HDV antibody for at least 6 months prior to screening and HDV RNA ≥ 500 IU/mL at screening\n- 6. Serum alanine aminotransferase (ALT) > ULN and < 5 x ULN Weight\n- 7. Body Mass Index (BMI) ≥ 18 kg/m2 to ≤ 40 kg/m2 Sex and Contraceptive/Barrier Requirements\n- 8. Female participants must have a negative pregnancy test or confirmation of postmenopausal status. Postmenopausal status is defined as 12 months with no menses without an alternative medical cause (see Section 10.7 for additional details). Women of childbearing potential (WOCBP) must have a negative blood pregnancy test at screening and a negative urine pregnancy test on Day 1, cannot be breast feeding, and must be willing to use highly effective methods of contraception (Section 10.7) 14 days before study intervention administration through 48 weeks after the last dose of VIR-2218 or VIR-3434. Female participants must also agree to refrain from egg donation and in vitro fertilization from the time of study intervention administration through 24 weeks after the last dose of VIR-2218 or VIR-3434.\n- 9. Male participants with female partners of childbearing potential must agree to meet 1 of the following contraception requirements from the time of study intervention administration through 24 weeks after the last dose of VIR-2218 or VIR-3434: documentation of vasectomy or azoospermia, or male condom use plus partner use of 1 of the contraceptive options listed for contraception for WOCBP (Section 10.7). Male participants must also agree to not donate sperm from the time of first study intervention administration through 24 weeks after the last dose of VIR-2218 or VIR-3434. Informed Consent\n- 10. Capable of giving signed informed consent as described in Section 10.1.3, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol\n- For the rest of the inclusion criteria, please refer to the study protocol."}

Exclusion criteria

  • {"criterion_text":"- 1. History of clinically significant liver disease from non-HBV and non- HDV etiology as determined by the investigator\n- 2. History of clinically significant immune complex disease as determined by the investigator\n- 3. History of clinically significant autoimmune disorder as determined by the investigator\n- 4. History of HBV-related extrahepatic disease, including but not limited to HBV-related rash, arthritis, or glomerulonephritis\n- 5. History of allergic reactions, hypersensitivity, or intolerance to study intervention, its metabolites or excipients\n- 6. Anti-HBs >10 mIU/L at screening\n- 7. Corrected QT interval (QTc) > 450 milliseconds\n- 8. ALT or AST ≥ 5 x ULN\n- 9. Total bilirubin > 2.0 mg/dL\n- 10. Serum albumin < 30 g/L\n- 11. Absolute neutrophil count < 1,000/mm3 (/μL)\n- 12. International normalized ratio (INR) > 1.5\n- 13. Hemoglobin < 8 g/dL\n- 14. History of anaphylaxis\n- 15. History of malignancy diagnosed or treated within 5 years (localized treatment of squamous or noninvasive basal cell skin cancers is permitted; cervical carcinoma in situ is allowed if appropriately treated prior to screening); participants under evaluation for malignancy are not eligible\n- 16. History of or listed for bone marrow or solid organ transplant\n- 17. Known active infection other than chronic HBV and HDV infection or any clinically significant acute condition such as fever (> 38° C) or acute respiratory illness within 7 days prior to Day 1\n- 18. Coinfection with human immunodeficiency virus (HIV), hepatitis A virus (HAV), hepatitis C virus (HCV) or hepatitis E virus (HEV). Participants who are HCV antibody positive and HCV RNA negative are eligible. Participants who are HAV or HEV immunoglobulin M antibody (IgM) positive can be enrolled if asymptomatic and HAV or HEV immunoglobulin G antibody (IgG) positive.\n- 19. Any clinically significant medical or psychiatric condition that may interfere with study intervention, assessment, or compliance with the protocol or otherwise makes the participant unsuitable for participation in the study, as determined by the investigator. Participants with controlled Diabetes Mellitus are eligible.\n- 20. Acute or worsening chronic hepatitis, fluctuating or rapidly deteriorating hepatic function or use of any therapy known to exacerbate hepatic dysfunction in the opinion of the investigator. For the rest of the exclusion criteria, please refer to the study protocol."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Proportion of participants with undetectable HDV RNA (< LOD) or ≥ 2 log10 decrease in HDV RNA from baseline and alanine aminotransferase (ALT) normalization (ALT < upper limit of normal [ULN]) at Week 24.","definition_or_measurement_approach":"HDV RNA measured against limit of detection (LOD); endpoint counts participants with undetectable HDV RNA (< LOD) or ≥ 2 log10 decrease from baseline AND who have ALT normalization defined as ALT < ULN at Week 24."}
  • {"endpoint_text":"- Treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs)","definition_or_measurement_approach":"Safety assessed by recording incidence, severity and relatedness of TEAEs and SAEs during the study period per standard pharmacovigilance reporting."}

Secondary endpoints

  • {"endpoint_text":"- Proportion of participants with undetectable HDV RNA (< LOD) or ≥ 2 log10 decrease in HDV RNA from baseline and ALT normalization at Week 12, Week 48, Week 72, Week 96, Week 144 and Week 192.","definition_or_measurement_approach":"Same virologic and ALT normalization criteria assessed at specified weeks."}
  • {"endpoint_text":"- Proportion of participants with undetectable HDV RNA (< LOD) or ≥ 2 log10 decrease in HDV RNA from baseline at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144 and Week 192.","definition_or_measurement_approach":"HDV RNA undetectable (< LOD) or ≥2 log10 decrease from baseline at specified weeks."}
  • {"endpoint_text":"- Proportion of participants with undetectable HDV RNA (< LOD) at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144 and Week 192.","definition_or_measurement_approach":"Proportion with HDV RNA below LOD at specified weeks."}
  • {"endpoint_text":"- Proportion of participants with HDV RNA < lower limit of quantitation (LLOQ) at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144 and Week 192.","definition_or_measurement_approach":"HDV RNA < LLOQ measured at specified weeks."}
  • {"endpoint_text":"- Change from baseline in HDV RNA at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144 and Week 192.","definition_or_measurement_approach":"Change in quantitative HDV RNA from baseline to each specified week."}
  • {"endpoint_text":"- Proportion of participants with ALT normalization at Week 12, Week 24, Week 48, Week 72, Week 96, Week 144 and Week 192.","definition_or_measurement_approach":"ALT normalization defined as ALT < ULN at specified weeks."}
  • {"endpoint_text":"- Incidence of ADA and titers of ADA to VIR-3434 at specified study visits up to Week 192 (for cohorts with VIR-3434).","definition_or_measurement_approach":"Assessment of anti-drug antibodies (ADA) incidence and titers at specified visits up to Week 192 for VIR-3434-treated cohorts."}
  • {"endpoint_text":"- Change from baseline in liver fibrosis at Week 48, Week 96, Week 144, and Week 192.","definition_or_measurement_approach":"Liver fibrosis assessed versus baseline at specified weeks (methodology per protocol)."}
  • {"endpoint_text":"- Change from baseline in Model for End Stage Liver Disease (MELD) score at Week 12, Week 24, Week 36, Week 48, Week 60, Week 72, Week 84, Week 96, Week 144, and Week 192.","definition_or_measurement_approach":"Change in MELD score from baseline at listed timepoints."}
  • {"endpoint_text":"- Change from baseline CPT score at Week 24, Week 48, Week 72, Week 96, Week 144, and Week 192.","definition_or_measurement_approach":"Change in Child-Pugh-Turcotte (CPT) score from baseline at listed timepoints."}

Recruitment

Planned Sample Size
119
Recruitment Window Months
75
Consent Approach
Participants must be capable of giving signed informed consent. ICFs and subject information sheets are provided, including adult ICFs and separate ICFs for pregnant participants/partners and optional substudies. ICFs are available in multiple country/language versions (examples in the public documents: Dutch, French, German, Italian, Romanian, Bulgarian, English). No assent process for minors is applicable since only adults (≥18) are eligible.

Geography

Total Number Of Sites
12
Total Number Of Participants
119

Netherlands

Earliest CTIS Part Ii Submission Date
19-08-2024
Latest Decision Or Authorization Date
16-10-2025
Processing Time Days
423
Number Of Sites
1
Number Of Participants
4

Sites

Site Name
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Department Name
MDL
Principal Investigator Name
Milan Sonneveld
Principal Investigator Email
m.j.sonneveld@erasmusmc.nl
Contact Person Name
Milan Sonneveld
Contact Person Email
m.j.sonneveld@erasmusmc.nl

France

Earliest CTIS Part Ii Submission Date
19-08-2024
Latest Decision Or Authorization Date
17-10-2025
Processing Time Days
424
Number Of Sites
3
Number Of Participants
35

Sites

Site Name
Centre Hospitalier Universitaire De Rennes
Department Name
Hépatologie
Principal Investigator Name
Caroline Jezequel
Principal Investigator Email
caroline.jezequel@chu-rennes.fr
Contact Person Name
Caroline Jezequel
Site Name
Centre Hospitalier Universitaire De Toulouse
Department Name
Hepatologie
Principal Investigator Name
Sophie Metivier
Principal Investigator Email
metivier.s@chu-toulouse.fr
Contact Person Name
Sophie Metivier
Contact Person Email
metivier.s@chu-toulouse.fr
Site Name
Hopital Beaujon
Department Name
Hepatologie
Principal Investigator Name
Tarik Asselah
Principal Investigator Email
tarik.asselah@aphp.fr
Contact Person Name
Tarik Asselah
Contact Person Email
tarik.asselah@aphp.fr

Germany

Earliest CTIS Part Ii Submission Date
19-08-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
423
Number Of Sites
1
Number Of Participants
15

Sites

Site Name
Medizinische Hochschule Hannover
Department Name
Klinik für Gastroenterologie, Hepatologie, Infektiologie und Endokrinologie
Principal Investigator Name
Katja Deterding
Principal Investigator Email
deterding.katja@mh-hannover.de
Contact Person Name
Katja Deterding
Contact Person Email
deterding.katja@mh-hannover.de

Italy

Earliest CTIS Part Ii Submission Date
15-08-2024
Latest Decision Or Authorization Date
14-10-2025
Processing Time Days
426
Number Of Sites
2
Number Of Participants
10

Sites

Site Name
Azienda Ospedaliero Universitaria Pisana
Department Name
Unità Operativa di Epatologia
Principal Investigator Name
Maurizia Rossana Brunetto
Principal Investigator Email
maurizia.brunetto@unipi.it
Contact Person Name
Maurizia Rossana Brunetto
Contact Person Email
maurizia.brunetto@unipi.it
Site Name
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
Department Name
UOC Gastroenterologia ed Epatologia
Principal Investigator Name
Pietro Lampertico
Principal Investigator Email
pietro.lampertico@unimi.it
Contact Person Name
Pietro Lampertico
Contact Person Email
pietro.lampertico@unimi.it

Romania

Earliest CTIS Part Ii Submission Date
19-08-2024
Latest Decision Or Authorization Date
20-10-2025
Processing Time Days
423
Number Of Sites
1
Number Of Participants
30

Sites

Site Name
Institutul National De Boli Infectioase Prof.Dr.Matei Bals
Department Name
Infectious Diseases
Principal Investigator Name
Anca Streinu-Cercel
Principal Investigator Email
anca.streinucercel@gmail.com
Contact Person Name
Anca Streinu-Cercel
Contact Person Email
anca.streinucercel@gmail.com

Bulgaria

Earliest CTIS Part Ii Submission Date
19-08-2024
Latest Decision Or Authorization Date
15-10-2025
Processing Time Days
423
Number Of Sites
4
Number Of Participants
25

Sites

Site Name
Acibadem City Clinic Tokuda University Hospital EAD
Department Name
Department of Gastroenterology to Clinic of Gastroenterology
Principal Investigator Name
Rozalina Balabanska
Principal Investigator Email
rozabalabanska@abv.bg
Contact Person Name
Rozalina Balabanska
Contact Person Email
rozabalabanska@abv.bg
Site Name
Umbal - Prof. D-R Stoyan Kirkovich AD
Department Name
Department of Gastroenterology
Principal Investigator Name
Mariana Radicheva
Principal Investigator Email
dr.mradicheva@gmail.com
Contact Person Name
Mariana Radicheva
Contact Person Email
dr.mradicheva@gmail.com
Site Name
Diagnostic-Consultative Center Alexandrovska EOOD
Principal Investigator Name
Diana Petrova
Principal Investigator Email
prof.petrova@mail.bg
Contact Person Name
Diana Petrova
Contact Person Email
prof.petrova@mail.bg
Site Name
University Multiprofile Hospital For Active Treatment St. Ivan Rilski EAD
Department Name
Clinic of Gastroenterology
Principal Investigator Name
Krassimir Antonov
Principal Investigator Email
krasi_antonov@abv.bg
Contact Person Name
Krassimir Antonov
Contact Person Email
krasi_antonov@abv.bg

Sponsor

Primary sponsor

Full Name
Vir Biotechnology Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
PPD Development LP
Responsibilities
sponsorDuties codes: [1,12,2,5]
Name
Pharmaceutical Product Development LLC
Responsibilities
sponsorDuties code: [4]
Name
QPS LLC
Responsibilities
PK Analysis (sponsorDuties code 15)
Name
Syneos Health Inc.
Responsibilities
Sites Payment (sponsorDuties code 15)

Third parties

  • {"country":"Romania","full_name":"Arensia Exploratory Medicine S.R.L.","duties_or_roles":"sponsorDuties codes: [12,2,5]","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Mayo Collaborative Services LLC","duties_or_roles":"Exploratory analysis (sponsorDuties code 15; value: 'Exploratory analysis')","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Q Squared Solutions LLC","duties_or_roles":"Immunology/Virology Analysis (sponsorDuties code 15)","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Germany","full_name":"Fisher Clinical Services GmbH","duties_or_roles":"sponsorDuties codes: [14,15] (value for 15: 'IMP EU Returns for the EU sites')","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Frontage Laboratories Inc.","duties_or_roles":"PK/ADA Analysis (sponsorDuties code 15)","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"PPD Development LP","duties_or_roles":"sponsorDuties codes: [1,12,2,5]","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Pharmaceutical Product Development LLC","duties_or_roles":"sponsorDuties code: [4]","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"QPS LLC","duties_or_roles":"PK Analysis (sponsorDuties code 15)","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"Fisher Clinical Services GmbH (Rheinfelden address)","duties_or_roles":"sponsorDuties codes: [14,15] (value for 15: 'IMP EU Distribution for the EU sites')","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Myriad RBM Inc.","duties_or_roles":"Immunology Analysis (sponsorDuties code 15)","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"Netherlands","full_name":"DDL Diagnostic Laboratory B.V.","duties_or_roles":"Virology Analysis (sponsorDuties code 15)","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"4g Clinical LLC","duties_or_roles":"sponsorDuties code: [3]","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"Germany","full_name":"ARENSIA Exploratory Medicine GmbH","duties_or_roles":"sponsorDuties codes: [12,15,5] (value for 15: 'Feasibility and Contract negotiation with PI for Romania')","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Syneos Health Inc.","duties_or_roles":"Sites Payment (sponsorDuties code 15)","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"sponsorDuties code: [7]","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Precision For Medicine Inc.","duties_or_roles":"CyTOF Analysis (sponsorDuties code 15)","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Biomontr Labs","duties_or_roles":"HBV RNA analysis (sponsorDuties code 15)","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"United Biosource LLC","duties_or_roles":"Pharmacovigilance Services (sponsorDuties code 15)","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Bioagilytix Labs LLC","duties_or_roles":"ADA Analysis (sponsorDuties code 15)","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Bioagilytix Labs LLC (alternate entry)","duties_or_roles":"sponsorDuties code: [15]","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
VIR-3434
Active Substance
TOBEVIBART
Modality
Monoclonal antibody
Routes Of Administration
SUBCUTANEOUS USE
Route
SUBCUTANEOUS
Authorisation Status
Authorised (prodAuthStatus=1)
Maximum Dose
300 mg (maxDailyDoseAmount)
Investigational Product Name
VIR-2218
Active Substance
ELEBSIRAN
Modality
Oligonucleotide
Routes Of Administration
SUBCUTANEOUS USE
Route
SUBCUTANEOUS
Authorisation Status
Authorised (prodAuthStatus=1)
Maximum Dose
200 mg (maxDailyDoseAmount)

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