[Systematic evaluation of clinical trial protocols of new drugs as a cure of chronic hepatitis B]

Zhonghua Gan Zang Bing Za Zhi. 2020 Aug 20;28(8):662-666. doi: 10.3760/cma.j.cn501113-20200609-00305.
[Article in Chinese]

Abstract

Objective: To describe the current status of registration and design characteristics of clinical trials of new drugs for curing hepatitis B through domestic and foreign websites, so as to provide references for the follow-up clinical trials of new hepatitis B drugs. Methods: A search was conducted on the US Clinical Trials Database and the Chinese Clinical Trial Registry Center. The search date was from the establishment of the database to May 26, 2020, and the registration trials of new drugs for curing hepatitis B at home and abroad were included. Two researchers independently searched and screened the literature and extracted the data. Results: A total of 106 registered clinical trials of new drugs for curing hepatitis B were included (94 English registration websites and 12 Chinese registration websites), and the number of registrations had increased year by year. Among them, the proportion of therapeutic vaccines and core protein inhibitors were the highest, accounting for 27.4% (n = 29) and 22.6% (n = 24), respectively. The vast majority of clinical trials (n = 96, 90.6%) were in the early stages (Phase I and II). The subjects in phase I clinical trial were mainly healthy people and treated CHB patients, while the subjects in phase II clinical trial were mainly CHB patients who had achieved viral suppression after initial or post-treatment. The main evaluation indicators of Phase I clinical trials were the safety and tolerability of new drugs. The main evaluation indicators in about half of Phase II clinical trials were HBsAg negative conversion/quantitative decline. Overall, the number of clinical trials with the new design was small, accounting for 3.8% (4 / 106). There were relatively few trials of new drugs for curing hepatitis B on domestic registration websites, and the information provided was incomplete. Conclusion: The number of clinical trials of new hepatitis B drugs at home and abroad is increasing year by year, but most of them are in phase I and II, with few adopting new designs. In addition, the information integrity of the domestic website registration center needs to be improved.

目的: 描述国内外网站治愈乙型肝炎新药临床试验的注册现状及试验设计特点,为后续乙型肝炎新药临床试验的开展提供参考。 方法: 检索美国临床试验数据库及中国临床试验注册中心,检索日期为建库至2020年5月26日,纳入国内外乙型肝炎治愈新药的注册试验。由两位研究者独立检索并筛选文献、提取资料。 结果: 共纳入106项乙型肝炎治愈新药注册临床试验(英文注册网站94项,中文注册网站12项),注册量呈逐年增长趋势。其中治疗性疫苗及核心蛋白抑制剂占比最高,分别为27.4%(n = 29)和22.6%(n = 24)。绝大部分临床试验(n = 96,90.6%)处于早期(I期及II期)阶段。I期临床试验的受试者主要为健康人及经治慢性乙型肝炎患者,II期临床试验的受试者主要为初治或经治后达到病毒抑制的慢性乙型肝炎患者。I期临床试验的主要评价指标为新药的安全性及耐受性,约半数II期临床试验采用HBsAg阴转/定量下降作为主要评价指标。总体上,采用新型设计的临床试验数量较少,仅占3.8%(4/106)。国内注册网站乙型肝炎治愈新药试验相对较少,填报信息欠完整。 结论: 国内外乙型肝炎新药临床试验注册量逐年增长,但多处于I期和II期,采用新型设计者较少。国内网站注册试验的信息完整性有待提高。.

Keywords: Clinical trials; Cure; Hepatitis B, chronic; Systematic review.

MeSH terms

  • Clinical Trials as Topic*
  • Hepatitis B, Chronic* / drug therapy
  • Humans
  • Research Design