Updated key points of chronic hepatitis B virus infection: developing drugs for treatment issued by the U.S. food and drug administration(clinical part)
10.3969/j.issn.1001-5256.2022.08.008
- VernacularTitle:美国食品药品监督管理局《慢性乙型肝炎病毒感染: 治疗药物的开发行业指南》的更新要点解读(临床部分)
- Author:
Di SHA
1
;
Yidi WU
1
;
Junqi NIU
2
;
Meixia WANG
3
Author Information
1. Clinical Research Center, Qilu Pharmaceutical Co., Ltd., Jinan 250100, China
2. Department of Hepatology, Center for Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun 130021, China
3. Clinical Trial Institution Management Office & Phase Ⅰ Clinical Trial Study Office, Beijing Jishuitan Hospital, Beijing 100031, China
- Publication Type:Guideline Interpretation
- Keywords:
Hepatitis B, Chronic;
Antiviral Agents;
Practice Guideline;
United States Food and Drug Administration
- From:
Journal of Clinical Hepatology
2022;38(8):1759-1762
- CountryChina
- Language:Chinese
-
Abstract:
In November 2018, the U.S. food and drug administration (FDA) issued guidance for the development of drugs for chronic hepatitis B virus infection (draft for comments) (hereinafter referred to as draft for comments), and in April 2022, the FDA issued Chronic Hepatitis B Virus Infection: Developing Drugs for Treatment, which has been updated with some details based on the Draft for Comments. This guidance further emphasizes the importance of HBsAg clearance in clinical trials, and classifies chronic suppressive therapy into two categories, namely noninferiority (NI) (or superiority) test with nucleos(t)ide analogues as control and add-on superiority trial with nucleos(t)ide analogues as control, and as for the latter, HBV DNA is no longer recommended as a primary endpoint of the trial, which poses a huge challenge to the development of innovative drugs targeting HBV DNA. The new finite duration therapy should aim to eliminate HBsAg and reduce virologic relapse and the risk of liver disease progression during treatment cessation. Reduction in HBsAg from baseline is not recommended as a primary endpoint for phase Ⅲ clinical trials, since the correlation between such reduction and clinical response remains unclear. In addition, this guidance also specifies the duration of treatment cessation and treatment consolidation period and the criteria for withdrawal of nucleos(t)ide analogues.
