244 Participants Needed

VIR-2218 + VIR-3434 + PEG-IFNα for Chronic Hepatitis B

(MARCH Trial)

Recruiting at 32 trial locations
SI
Overseen ByStudy Inquiry
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Vir Biotechnology, Inc.
Must be taking: NRTI therapy
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial involves testing three treatments (VIR-2218, VIR-3434, and PEG-IFNα) on patients with chronic hepatitis B. The goal is to see if these treatments are safe, can be tolerated by patients, and are effective in reducing the virus. The treatments work by either lowering the virus levels or boosting the immune system to fight the virus. Peginterferon alpha (PEG-IFNα) has been used to treat chronic hepatitis B by modulating the immune system, often in combination with other medications for enhanced efficacy.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it requires that you have been on NRTI therapy (a type of medication for hepatitis B) for at least 2 months before joining.

What is known about the safety of PEG-IFNα in humans?

PEG-IFNα (pegylated interferon) has been used in treating chronic hepatitis B and is known to have considerable side effects, though specific details on these side effects are not provided in the available research.12345

How is the drug VIR-2218 + VIR-3434 + PEG-IFNα different from other treatments for chronic hepatitis B?

This drug combination is unique because it combines VIR-2218 and VIR-3434 with PEG-IFNα, potentially offering a novel approach by targeting the virus with multiple mechanisms, whereas traditional treatments often rely on PEG-IFNα alone or in combination with other drugs like lamivudine.46789

What data supports the effectiveness of the drug PEG-IFNα in treating chronic hepatitis B?

Research shows that PEG-IFNα can lead to significant improvements in patients with chronic hepatitis B, including seroconversion (a change from a negative to a positive blood test result) in up to 36% of patients. This suggests that PEG-IFNα is effective in treating chronic hepatitis B, especially in combination with other treatments.46101112

Are You a Good Fit for This Trial?

This trial is for men and women aged 18 to 65 with chronic hepatitis B infection lasting at least 6 months, who have been on NRTI therapy for over two months. It's not suitable for those with significant liver damage, history of severe allergic reactions to monoclonal antibodies or interferons, other chronic liver diseases, substance abuse issues, or certain medical conditions.

Inclusion Criteria

You have been diagnosed with Chronic Hepatitis B
Have you been diagnosed with chronic hepatitis B virus infection for at least 6 months?
Have been on stable nucleoside/nucleotide analogue (NA) treatment (for example, tenofovir or entecavir) for the last 6 months?

Exclusion Criteria

Have you had major surgery within the past 3 months?
Have you taken any interferon-containing therapy (for example, Pegasys or Peg-Intron) within the past 12 months?
You have been diagnosed with Liver Disease
See 7 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive multiple doses of VIR-2218, VIR-3434, and/or PEG-IFNα

4-48 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

24 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • PEG-IFNα
  • VIR-2218
  • VIR-3434
Trial Overview The study tests the safety and effectiveness of VIR-2218, VIR-3434, and/or PEG-IFNα in treating chronic hepatitis B. Participants will receive one or more of these treatments as part of a phase 2 clinical trial designed to evaluate how well they work and how safe they are.
How Is the Trial Designed?
13Treatment groups
Experimental Treatment
Group I: Cohort 8a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 for 20 weeks
Group II: Cohort 7a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 for 44 weeks
Group III: Cohort 6a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 for 11 weeks
Group IV: Cohort 5a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 for 11 weeks
Group V: Cohort 4a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 for 4 weeks
Group VI: Cohort 3a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 for 4 weeks
Group VII: Cohort 2c (VIR-2218 + VIR-3434 + PEG-IFNα)Experimental Treatment3 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 + PEG-IFNα for 48 weeks
Group VIII: Cohort 2b (VIR-3434)Experimental Treatment1 Intervention
Participants will receive multiple doses of VIR-3434 for 20 weeks
Group IX: Cohort 2a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple lead-in doses of VIR-2218, then combination therapy with VIR-2218 + VIR-3434 for 20 weeks total
Group X: Cohort 1d (VIR-3434 + PEG-IFNα)Experimental Treatment2 Interventions
Participants will receive multiple doses of VIR-3434 + PEG-IFNα for 48 weeks
Group XI: Cohort 1c (VIR-2218 + VIR-3434 + PEG-IFNα)Experimental Treatment3 Interventions
Participants will receive multiple doses of VIR-2218 + VIR-3434 + PEG-IFNα for 24 weeks
Group XII: Cohort 1b (VIR-3434)Experimental Treatment1 Intervention
Participants will receive multiple doses of VIR-3434 for 44 weeks
Group XIII: Cohort 1a (VIR-2218 + VIR-3434)Experimental Treatment2 Interventions
Participants will receive multiple lead-in doses of VIR-2218, then combination therapy with VIR-2218 + VIR-3434 for 20 weeks total

Find a Clinic Near You

Who Is Running the Clinical Trial?

Vir Biotechnology, Inc.

Lead Sponsor

Trials
30
Recruited
13,300+

Published Research Related to This Trial

In a study of 160 HBeAg-negative chronic hepatitis B patients treated with pegylated interferons, 25% achieved a sustained virologic response (SVR), indicating the treatment's efficacy.
Key predictors for achieving SVR included a decline of 1 log10 IU/mL in viral load after the first month and a serum HBV DNA level below 2,000 IU/mL by the third month of treatment.
Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B.Guclu, E., Tuna, N., Karabay, O., et al.[2018]
In a study of 16 HBeAg-positive hepatitis B patients with lamivudine resistance, pegylated interferon-alpha treatment resulted in a 12.5% seroconversion rate, indicating limited efficacy in this resistant population.
Despite a significant reduction in viral load during treatment, levels rebounded after cessation, suggesting that pegylated interferon-alpha may only be beneficial for patients with low levels of mutant virus.
The effect of pegylated interferon-alpha on the treatment of lamivudine resistant chronic HBeAg positive hepatitis B virus infection.Leemans, WF., Flink, HJ., Janssen, HL., et al.[2018]
In a study of 218 treatment-naive Chinese patients with HBeAg-positive chronic hepatitis B, the combination of pegylated interferon alfa-2a and entecavir did not show superior efficacy compared to peg-IFN monotherapy, with similar rates of HBeAg seroconversion across all treatment groups.
All treatment groups achieved significant reductions in HBeAg levels, but while the ETV add-on showed greater reductions in hepatitis B virus DNA during treatment, these effects were not sustained after treatment ended, indicating that the optimal treatment strategy remains unclear.
A randomized, open-label clinical study of combined pegylated interferon Alfa-2a (40KD) and entecavir treatment for hepatitis B "e" antigen-positive chronic hepatitis B.Xie, Q., Zhou, H., Bai, X., et al.[2022]

Citations

Predictors of response to pegylated interferon treatment in HBeAg-negative patients with chronic hepatitis B. [2018]
The effect of pegylated interferon-alpha on the treatment of lamivudine resistant chronic HBeAg positive hepatitis B virus infection. [2018]
A randomized, open-label clinical study of combined pegylated interferon Alfa-2a (40KD) and entecavir treatment for hepatitis B "e" antigen-positive chronic hepatitis B. [2022]
Long-term follow up of peginterferon-α-2a treatment of hepatitis B e-antigen (HBeAg) positive and HBeAg negative chronic hepatitis B patients in phase II and III studies. [2020]
[Study on the relationship between hepatitis B virus genotypes and the effect of polyethylene glycol-interferon-alpha therapy on HBeAg-positive chronic hepatitis B]. [2018]
Extended treatment with peginterferon α-2a in combination with lamivudine or adefovir for 96 weeks yields high rates of HBeAg and HBsAg seroconversion. [2018]
[Observation on effect of peg interferon lphaa-2a treating lamivudine resistant chronic hepatitis B]. [2018]
Factors that predict response of patients with hepatitis B e antigen-positive chronic hepatitis B to peginterferon-alfa. [2018]
[Pegylated interferon alpha 2a in treating chronic hepatitis B patients]. [2018]
10.United Statespubmed.ncbi.nlm.nih.gov
Sustained HBeAg and HBsAg loss after long-term follow-up of HBeAg-positive patients treated with peginterferon alpha-2b. [2022]
Peginterferon α in the treatment of chronic hepatitis B. [2023]
Modelling of early viral kinetics and pegylated interferon-alpha2b pharmacokinetics in patients with HBeag-positive chronic hepatitis B. [2018]
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