Overview
Sponsor-declared trial summary
Hepatitis B
•To assess the safety and tolerability of oral administration of GSK3965193 monotherapy (Part 3) and in combination with bepirovirsen (Part 4). • To evaluate pharmacodynamic (PD) effect of GSK3965193 monotherapy in PLWCHB (Part 3). • To evaluate efficacy of GSK3965193 in combination with bepirovirsen in PLWCHB (Part 4)
Key facts
- Sponsor
- Glaxosmithkline Research & Development Limited
- Participant type
- Patients
- Age range
- 18-64 years
- Gender
- Male and Female
- Therapeutic area
- Diseases [C] - Virus Diseases [C02]
- Trial duration
- 31 Oct 2024 → 8 Apr 2026
- Decision date (initial)
- 2024-08-26
- Transition trial
- No
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- No
External identifiers
- EU CT number
- 2023-509684-24-00
- ClinicalTrials.gov
- NCT05330455
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Pharmacokinetic, Safety, Efficacy, Pharmacodynamic
•To assess the safety and tolerability of oral administration of GSK3965193 monotherapy (Part 3) and in combination with bepirovirsen (Part 4). • To evaluate pharmacodynamic (PD) effect of GSK3965193 monotherapy in PLWCHB (Part 3). • To evaluate efficacy of GSK3965193 in combination with bepirovirsen in PLWCHB (Part 4)
Secondary objectives 3
- To evaluate the PK characteristics of repeat doses of GSK3965193 in PLWCHB (Part 3)
- To assess the safety and tolerability of bepirovirsen monotherapy in PLWCHB who have completed GSK3965193/placebo monotherapy (Part 3)
- To evaluate PD effect of GSK3965193 in combination with bepirovirsen in PLWCHB (Part 4)
Conditions and MedDRA coding
Hepatitis B
| Version | Level | Code | Term | System organ class |
|---|---|---|---|---|
| 20.1 | PT | 10008910 | Chronic hepatitis B | 100000004862 |
Study design 2 periods
| # | Title | Allocation | Blinding | Roles blinded | Arms |
|---|---|---|---|---|---|
| 1 | Part 3 – Monotherapy of GSK3965193 Followed by Optional Bepirovirsen in Participants with CHB Part 3 is a 28-day, repeat dose study with one dose level of GSK3965193 or placebo in Patients Living with Chronic Hepatitis B (PLWCHB) on stable NA therapy, with an option to receive subsequent treatment with 24 weeks of open label bepirovirsen (sequential therapy)
|
Randomised Controlled | Double | [{"id":160436,"code":2,"name":"Investigator"},{"id":160437,"code":3,"name":"Monitor"},{"id":160438,"code":1,"name":"Subject"}] | Part 3 – GSK3965193 Monotherapy: Participants will receive 28 days of GSK3965193 monotherapy followed by a two-week washout period Part 3 – Placebo-to-Match GSK3965193 Monotherapy: Participants will receive 28 days of Placebo-to-Match GSK3965193 monotherapy followed by a two-week washout period Part 3 - Optional Bepirovirsen treatment: Participants with a screening HBsAg <=3000 IU/ml who have completed either GSK3965193 or Placebo-to-Match GSK3965193 dosing and a two-week washout period will receive 24 weeks of open label Bepirovirsen treatment Part 3 – Placebo-to-Match GSK3965193 and Bepirovirsen: Participants will receive combination therapy with Placebo-to-Match GSK3965193 (blinded, 28 days) and open label Bepirovirsen treatment (24 weeks). Treatments will start concurrently. |
| 2 | Part 4 – Combination Therapy of GSK3965193 and Bepirovirsen in PLWCHB Part 4 is a 24-week, repeat dose study with one dose level of GSK3965193 or placebo in combination with bepirovirsen in 1 cohort of PLWCHB on stable NA therapy who have not participated in Part 3 of the study. This part will commence contingent on the clinical safety and efficacy data from Part 3.
|
Randomised Controlled | Double | [{"id":160442,"code":1,"name":"Subject"},{"id":160440,"code":3,"name":"Monitor"},{"id":160441,"code":2,"name":"Investigator"}] | Part 4 – GSK3965193 and Bepirovirsen: Participants will receive combination therapy with GSK3965193 (blinded, 28 days) and open label Bepirovirsen treatment (24 weeks). Treatments will start concurrently. |
Regulatory references
- Scientific advice from competent authorities
- Medicines And Healthcare Products Regulatory Agency, European Medicines Agency
- Plan to share IPD
- Yes
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 9
- Between 18 (or local legal age of consent) and 65 years of age inclusive, at the time of signing the informed consent
- Body weight >=50 kg and body mass index within the range 18-32 kg/m2 (inclusive)
- a. A male participant is eligible to participate if they agree to the following during the intervention period and for at least 7 days after the last dose of study treatment (GSK3965193) in Parts 1, 2 and 3 and at least 90 days after the last dose of bepirovirsen in Part 4 or the optional Part 3 extension: i. Refrain from donating sperm AND ii. Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent OR Must agree to use contraception/barrier as detailed below: Agree to use a male condom [and should also be advised of the benefit for a female partner to use a highly effective method of contraception as a condom may break or leak] when having sexual intercourse with a woman of childbearing potential who is not currently pregnant
- b. A female participant is eligible to participate in Parts 3 and 4 if she is not pregnant or breastfeeding AND at least 1 of the following conditions applies: 1. Is a WONCBP as defined in Section 10.4 (Appendix 4), OR 2. is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of < 1% per year) as described in Section 10.4.2, preferably with low user dependency during the intervention period and for at least 7 days after the last dose of study treatment in Part 3 and 90 days after the last dose of bepirovirsen in Part 4 or if the participant chooses to continue with the optional bepirovirsen extension in Part 3. The investigator should evaluate the potential for contraceptive method failure (e.g., noncompliance, recently initiated in relationship to the first dose of study intervention). ii. A WOCBP must have 1. A negative highly sensitive pregnancy test (serum) at screening and on Day -1, see Section 8.2.8 (Pregnancy Testing). iii. Additional requirements for pregnancy testing during and after study intervention are located in Section 8.2.8. iv. The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
- Participants who have documented chronic HBV infection ≥6 months prior to screening
- Participants currently receiving stable nucleos(t)ide analog (NA) therapy (e.g., tenofovir disoproxil, tenofovir alafenamide, entecavir). “Stable” is defined as no changes to the nucleos(t)ide regimen for at least 6 months prior to screening and with no planned changes to the regimen for the duration of the study
- Plasma or serum HBsAg concentration >100 IU/mL
- Plasma or serum HBV DNA concentration <90 IU/mL
- ALT <=2 x the upper limit of normal (ULN)
Exclusion criteria 23
- Clinically significant abnormalities affecting physical or mental health in medical history or on physical examination (e.g., moderate-severe liver disease other than chronic HBV, acute coronary syndrome within 6 months of screening, major surgery within 3 months of screening, significant/unstable cardiac disease (including pacemaker or AICD), uncontrolled diabetes, bleeding diathesis or coagulopathy), apart from chronic HBV infection.
- Co-infection with: a. Current or past history of HCV b. HIV c. Hepatitis D virus (HDV)
- History of or suspected liver cirrhosis and/or evidence of cirrhosis
- Diagnosed or suspected hepatocellular carcinoma
- History of malignancy within the past 5 years with the exception of specific cancers that are cured by surgical resection (e.g., skin cancer). Participants under evaluation for possible malignancy are not eligible
- History of vasculitis or presence of symptoms and signs of potential vasculitis [e.g., vasculitic rash, skin ulceration, repeated blood detected in urine without identified cause] or history/presence of other diseases that may be associated with vasculitis condition (e.g., systemic lupus erythematosus, rheumatoid arthritis, relapsing polychondritis, mononeuritis multiplex)
- History of extrahepatic disorders possibly related to HBV immune conditions (e.g., nephrotic syndrome, any type of glomerulonephritis, polyarteritis nodosa, cryoglobulinaemia, uncontrolled hypertension)
- History of alcohol or drug abuse/dependence judged by investigator to potentially interfere with participant compliance
- History of or other evidence of bleeding from esophageal varices
- Documented history or other evidence of metabolic liver disease within 1 year of randomization
- Documented history or other evidence of diabetes (regardless of insulin-dependence)
- Personal history or family history of peripheral neuropathy
- A score >4 on the Toronto Clinical Scoring System for Polyneuropathy
- History of having received or currently receiving any systemic anti-neoplastic (including radiation) or immune-modulatory treatment (including systemic oral corticosteroids) within the 3 months prior to randomization or the expectation that such treatment will be needed at any time during the study
- Abnormal and clinically significant 12-lead ECG finding
- Currently taking, or taken within 3 months prior to randomisation, any immunosuppressing drugs (e.g., prednisone), other than a short course of therapy (≤2 weeks) or topical/inhaled steroid use
- Participants for whom immunosuppressive treatment is not advised, including therapeutic doses of steroids, will be excluded
- Participants requiring anti-coagulation therapies
- Prior treatment with any oligonucleotide or small interfering RNA (siRNA) within 12 months prior to the first dosing day. Patients who have received a course of bepirovirsen, even if it has been more than 12 months, are excluded
- Positive test for COVID-19 infection
- Currently taking, or has taken within 12 months of randomization, any interferon-containing therapy.
- The participant has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 5 half-lives (if known) or twice the duration (if known) of the biological effect of the study treatment (whichever is longer) or 90 days (if half-life or duration is unknown)
- Laboratory results as follows: a. Serum albumin ≤3.5 g/dL b. Glomerular filtration rate (GFR) ≤60 mL/min /1.73m2 as calculated by the chronic kidney diseases epidemiology collaboration (2021 CKD-EPI) formula c. INR >1.25 d. Platelet count <140 X 109 /L e. Total bilirubin >1.25 x ULN f. Urine ACR ≥0.03 mg/mg (or ≥30 mg/g). In the event of an ACR above this threshold, eligibility may be confirmed by a second measurement.
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 4
- Incidence of AEs, SAEs, withdrawals due to AEs
- Incidence of clinically significant laboratory parameters (haematology, clinical chemistry, urinalysis), vital signs, cardiac parameters (electrocardiogram), and sensory nerve conduction
- In Part 3 - Maximum reduction of serum HBsAg levels from baseline over 6 weeks (4 weeks on treatment and 2 weeks post-treatment)
- In Part 4 - Achieving complete response (undetectable serum HBV DNA and HBsAg for 6 consecutive months after the planned end of treatment of bepirovirsen)
Secondary endpoints 4
- In Part 3 - AUC(0-tau), Cmax, Tmax, and apparent terminal half-life (T1/2) will be calculated as data permits
- In Part 3 - >=0.5x log IU/mL reduction of serum HBsAg levels from baseline anytime during the study (on-treatment and post-treatment)
- In Part 3 - Incidence of AEs, SAEs, withdrawals due to AEs and incidence of clinically significant laboratory parameters (haematology, clinical chemistry, urinalysis) and vital signs occurring in participants taking bepirovirsen monotherapy after completing GSK3965193/placebo monotherapy
- In Part 4 - HBsAg loss (defined by two consecutive measurements of HBsAg below the limit of quantification) anytime during the study (on-treatment and post-treatment)
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 2
PRD11146342 · Product
- Active substance
- GSK3965193B
- Pharmaceutical form
- TABLET
- Route of administration
- ORAL USE
- Authorisation status
- Not Authorised
- MA holder
- GLAXOSMITHKLINE RESEARCH & DEVELOPMENT LIMITED
- Paediatric formulation
- No
- Orphan designation
- No
PRD7999023 · Product
- Active substance
- Bepirovirsen
- Pharmaceutical form
- SOLUTION FOR INJECTION
- Route of administration
- SUBCUTANEOUS USE
- Authorisation status
- Not Authorised
- MA holder
- GLAXOSMITHKLINE
- Paediatric formulation
- No
- Orphan designation
- No
Placebo 1
Placebo to Match GSK3965193 Tablets
N/A · Product
- Other product name
- N/A
- Pharmaceutical form
- N/A
- ATC code
- N/A — N/A
- Marketing authorisation
- N/A
- MA holder
- N/A
- MA country
- Iceland
- Paediatric formulation
- No
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Glaxosmithkline Research & Development Limited
- Sponsor organisation
- Glaxosmithkline Research & Development Limited
- Address
- G S K House, 980 Great West Road 980 Great West Road
- City
- Brentford
- Postcode
- TW8 9GS
- Country
- United Kingdom
Scientific contact point
- Organisation
- Glaxosmithkline Research & Development Limited
- Contact name
- EU GSK Clinical Trials Call Center
Public contact point
- Organisation
- Glaxosmithkline Research & Development Limited
- Contact name
- EU GSK Clinical Trials Call Center
Third parties 14
| Organisation | City, country | Duties |
|---|---|---|
| Infinity Biologix LLC ORG-100040369
|
Piscataway, United States | Laboratory analysis |
| Labcorp Early Development Laboratories Limited ORG-100011365
|
Harrogate, United Kingdom | Laboratory analysis |
| Fisher Clinical Services UK Limited ORG-100012049
|
Horsham, United Kingdom | Other |
| Fm Richard Et Associes ORG-100042723
|
Paris, France | Other |
| WCG Clinical Inc. ORG-100040730
|
Princeton, United States | Other |
| Creapharm Clinical Supplies ORG-100020131
|
Le Haillan, France | Code 14 |
| PPD Global Central Labs (S) Pte Ltd ORG-100041754
|
Singapore, Singapore | Laboratory analysis |
| Corevitas LLC ORG-100042037
|
Waltham, United States | Other |
| Nordic Bioscience A/S ORG-100009315
|
Herlev, Denmark | Laboratory analysis |
| Arkansas Children's Research Institute ORG-100047434
|
Little Rock, United States | Laboratory analysis |
| Cerba Research ORG-100042694
|
Gent, Belgium | Laboratory analysis |
| Pharmaceutical Product Development LLC ORG-100016999
|
Highland Heights, United States | Laboratory analysis |
| PPD Global Central Labs ORG-100046496
|
Zaventem, Belgium | Laboratory analysis |
| Medable Inc. ORG-100043083
|
Palo Alto, United States | Other |
Locations
2 EU/EEA countries · 6 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| France | Ended | 18 | 4 |
| Italy | Ended | 6 | 2 |
| Rest of world
Hong Kong, Korea, Republic of, United Kingdom, Thailand, Canada, Taiwan
|
— | 109 | — |
Investigational sites
Country notifications
Trial-start, recruitment-start, end and early-termination notifications submitted per Member State
| Country | Trial start | Trial end | Recruitment start | Recruitment end | Early termination |
|---|---|---|---|---|---|
| France | 2024-10-31 | 2025-12-16 | 2024-11-12 | 2025-08-14 | |
| Italy | 2024-11-21 | 2025-08-14 | 2024-12-19 | 2025-08-14 |
Results and documents
Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial
Documents 17 files
Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.
| Type | Title | Version |
|---|---|---|
| Protocol (for publication) | D1_Protocol_Redacted_2023-509684-24-00 | 10 |
| Recruitment arrangements (for publication) | K1_Recruitment and Informed Consent Procedure_No CCI PI | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment and Informed Consent Procedure_No CCI PI | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_Genetic Research_No CCI PI | 1.0 |
| Subject information and informed consent form (for publication) | L1_ICF_Main_Redacted | 2.0 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional Bepi Treatment_Redacted | 2.0 |
| Subject information and informed consent form (for publication) | L1_ICF_Part 3 Optional Bepirovirsen Treatment_Redacted | 3.0 |
| Subject information and informed consent form (for publication) | L1_ICF_Pregnant Participant_Redacted | 2 |
| Subject information and informed consent form (for publication) | L1_ICF_Pregnant Participant_Redacted | 1.1 |
| Subject information and informed consent form (for publication) | L1_ICF_Pregnant Partner_Redacted | 2 |
| Subject information and informed consent form (for publication) | L1_ICF_Pregnant Partner_Redacted | 1.1 |
| Subject information and informed consent form (for publication) | L1_ICF_Restart_Redacted | 1.1 |
| Subject information and informed consent form (for publication) | L1_Part 3 Main study_Redacted | 4.0 |
| Subject information and informed consent form (for publication) | L1_Treatment Restart of Bepirovirsen_No CCI PI | 2 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis_FR_Redacted | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis_IT_Redacted | 3 |
| Synopsis of the protocol (for publication) | D1_Protocol synopsis_Redacted_EN | 7 |
Application history
5 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2024-04-29 | France | Acceptable 2024-08-19
|
2024-08-20 |
| 2 | SUBSTANTIAL MODIFICATION | SM-1 | 2024-09-11 | France | Acceptable | 2024-10-16 |
| 3 | NON SUBSTANTIAL MODIFICATION | NSM-1 | 2024-11-21 | Acceptable | 2024-11-21 | |
| 4 | SUBSTANTIAL MODIFICATION | SM-2 | 2025-04-01 | France | Acceptable 2025-05-28
|
2025-05-28 |
| 5 | NON SUBSTANTIAL MODIFICATION | NSM-2 | 2025-12-05 | Acceptable 2025-05-28
|
2025-12-05 |