A Study of Treatment With RO6864018 in Virologically Suppressed Participants With Chronic Hepatitis B Virus (HBV) Infection

Study Overview
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Brief Summary
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This randomized, multicenter, partially double-blind, placebo-controlled study is designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and antiviral effects of treatment with RO6864018 in virologically suppressed participants with chronic HBV infection.

Official Title
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A Multiple-Center, Randomized, Partially Double-Blind, Placebo-Controlled Study to Investigate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Antiviral Effects of 12-Week Treatment With RO6864018 in Virologically Suppressed Patients With Chronic Hepatitis B Virus Infection

Conditions
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Hepatitis B, Chronic

Intervention / Treatment
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* Drug: Entecavir
* Drug: Placebo
* Drug: RO6864018
* Drug: Tenofovir


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Chronic hepatitis B infection Positive test for HBsAg for more than 6 months prior to randomization HBsAg titer greater than or equal to (>/=) 250 international units per milliliter (IU/mL) at Screening Treatment with any nucleoside/nucleotide analogue for >/= 1 year with ongoing entecavir and/or tenofovir treatment at randomization and for at least 3 months prior to randomization HBV DNA less than (<) 90 IU/mL for at least the preceding 6 months HBeAg positive at randomization and for at least 6 months prior to randomization Exclusion Criteria: Pregnant or lactating women Documented history of HBV genotype D History or other evidence of bleeding from esophageal varices History of decompensated liver disease, chronic liver disease other than HBV infection, or any evidence of metabolic liver disease Positive test for hepatitis A, hepatitis C, or human immunodeficiency virus (HIV) Documented history of hepatitis D infection History of or suspicion of hepatocellular carcinoma History of immunologically mediated disease History of organ transplantation History of thyroid disease Significant acute infection

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Placebo, Every Other Day (QOD)<br>Placebo orally (PO) QOD for 12 weeks + noninvestigational entecavir or tenofovir as prescribed by participant's physician | Drug: Entecavir<br>* Entecavir will be administered as per local labeling.<br>Drug: Placebo<br>* Participants will be administered PO placebo capsules matched to RO6864018, either QOD or QWk for 12 weeks of treatment.<br>Drug: Tenofovir<br>* Tenofovir will be administered as per local labeling.<br>|
| Placebo Comparator: Placebo, Once a Week (QWk)<br>Placebo PO QWk for 12 weeks + noninvestigational entecavir or tenofovir as prescribed by participant's physician | Drug: Entecavir<br>* Entecavir will be administered as per local labeling.<br>Drug: Placebo<br>* Participants will be administered PO placebo capsules matched to RO6864018, either QOD or QWk for 12 weeks of treatment.<br>Drug: Tenofovir<br>* Tenofovir will be administered as per local labeling.<br>|
| Experimental: RO6864018, 1200 milligrams (mg) QOD<br>RO6864018 1200 mg PO QOD for 12 weeks + noninvestigational entecavir or tenofovir as prescribed by participant's physician | Drug: Entecavir<br>* Entecavir will be administered as per local labeling.<br>Drug: RO6864018<br>* Participants will be administered RO6864018 as 200-mg PO capsules at a dose of 800 mg or 1200 mg, either QOD or QWk for 12 weeks of treatment.<br>Drug: Tenofovir<br>* Tenofovir will be administered as per local labeling.<br>|
| Experimental: RO6864018, 1200 mg QWk<br>RO6864018 1200 mg PO QWk for 12 weeks + noninvestigational entecavir or tenofovir as prescribed by participant's physician | Drug: Entecavir<br>* Entecavir will be administered as per local labeling.<br>Drug: RO6864018<br>* Participants will be administered RO6864018 as 200-mg PO capsules at a dose of 800 mg or 1200 mg, either QOD or QWk for 12 weeks of treatment.<br>Drug: Tenofovir<br>* Tenofovir will be administered as per local labeling.<br>|
| Experimental: RO6864018, 800 mg QOD<br>RO6864018 800 mg PO QOD for 12 weeks + noninvestigational entecavir or tenofovir as prescribed by participant's physician | Drug: Entecavir<br>* Entecavir will be administered as per local labeling.<br>Drug: RO6864018<br>* Participants will be administered RO6864018 as 200-mg PO capsules at a dose of 800 mg or 1200 mg, either QOD or QWk for 12 weeks of treatment.<br>Drug: Tenofovir<br>* Tenofovir will be administered as per local labeling.<br>|
| Experimental: RO6864018, 800 mg QWk<br>RO6864018 800 mg PO QWk for 12 weeks + noninvestigational entecavir or tenofovir as prescribed by participant's physician | Drug: Entecavir<br>* Entecavir will be administered as per local labeling.<br>Drug: RO6864018<br>* Participants will be administered RO6864018 as 200-mg PO capsules at a dose of 800 mg or 1200 mg, either QOD or QWk for 12 weeks of treatment.<br>Drug: Tenofovir<br>* Tenofovir will be administered as per local labeling.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Safety: Percentage of Participants with Adverse Events |  | Baseline up to approximately 36 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pharmacodynamics: Peripheral Blood Levels of Interferon (IFN)-Alpha in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IFN-Alpha in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IFN-Gamma-Induced Protein (IP)-10 in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IP-10 in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Quantitative HBV Deoxyribonucleic Acid (DNA) Level in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Weeks 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up; and at any point that breakthrough occurs (up to 36 weeks) | 
| Efficacy: Quantitative HBV DNA Level in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up; and at any point that breakthrough occurs (up to 36 weeks) | 
| Efficacy: Quantitative Hepatitis B Surface Antigen (HBsAg) Level in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Weeks 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Quantitative HBsAg Level in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with Loss of HBsAg in QOD Dosing Cohorts |  | Baseline; on Day 7 of Week 12; then at Week 36 during follow-up | 
| Efficacy: Percentage of Participants with Loss of HBsAg in QWk Dosing Cohorts |  | Baseline; on Day 7 of Week 12; then at Week 36 during follow-up | 
| Efficacy: Percentage of Participants with Loss of Hepatitis B Envelope Antigen (HBeAg) in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Weeks 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with Loss of HBeAg in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with HBsAg Seroconversion in QOD Dosing Cohorts | HBsAg Seroconversion = antibody to HBsAg (Anti-HBs) Positive Status and Loss of HBsAg | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Week 5; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with HBsAg Seroconversion in QWk Dosing Cohorts | HBsAg Seroconversion = anti-HBs Positive Status and Loss of HBsAg | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 5; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with HBeAg Seroconversion in QOD Dosing Cohorts | HBeAg Seroconversion = antibody to HBeAg (anti-HBe) Positive Status and Loss of HBeAg | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Week 5; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with HBeAg Seroconversion in QWk Dosing Cohorts | HBeAg Seroconversion = anti-HBe Positive Status and Loss of HBeAg | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 5; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacokinetics: Maximum Observed Plasma Concentration (Cmax) of RO6864018 Metabolite in QOD Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Days 1, 7 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 3, 5, 7, 12 and Day 6 of Week 12 | 
| Pharmacokinetics: Cmax of RO6864018 Metabolite in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 | 
| Pharmacokinetics: Time to Maximum Observed Plasma Concentration (Tmax) of RO6864018 Metabolite in QOD Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Days 1, 7 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 3, 5, 7, 12 and Day 6 of Week 12 | 
| Pharmacokinetics: Tmax of RO6864018 Metabolite in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 | 
| Pharmacokinetics: Area Under the Plasma Concentration-Time Curve Extrapolated to Infinity (AUCinf) of RO6864018 Metabolite in QOD Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Days 1, 7 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 3, 5, 7, 12 and Day 6 of Week 12 | 
| Pharmacokinetics: AUCinf of RO6864018 Metabolite in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 | 
| Pharmacokinetics: Area Under the Plasma Concentration-Time Curve up to the Last Measurable Concentration (AUClast) of RO6864018 Metabolite in QOD Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Days 1, 7 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 3, 5, 7, 12 and Day 6 of Week 12 | 
| Pharmacokinetics: AUClast of RO6864018 Metabolite in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 | 
| Pharmacokinetics: Half-life (t1/2) of RO6864018 Metabolite in QOD Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Days 1, 7 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 3, 5, 7, 12 and Day 6 of Week 12 | 
| Pharmacokinetics: T1/2 of RO6864018 Metabolite in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 | 
| Pharmacodynamics: Peripheral Blood Levels of Neopterin in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of Neopterin in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of Tumor Necrosis Factor (TNF)-Alpha in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of TNF-alpha in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of Interleukin (IL)-6 in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IL-6 in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IL-10 in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IL-10 in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IL-12p40 in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Days 1, 3, 7 of Week 1; on Day 1 of Weeks 3, 5, 7; and Day 6 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Peripheral Blood Levels of IL-12p40 in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) and post-dose (6, 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with Development of Anti-HBe in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Weeks 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with Development of Anti-HBe in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with Development of Anti-HBs in QOD Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 7 of Week 1 and Day 1 of Weeks 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Efficacy: Percentage of Participants with Development of Anti-HBs in QWk Dosing Cohorts |  | Baseline; pre-dose (0 hours) on Day 1 of Weeks 2, 3, 5, 7; on Day 7 of Week 12; then at Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Transcriptional Responses as Measured by messenger ribonucleic acid (mRNA) Levels for QWk Cohorts |  | QWk: Baseline; pre-dose (0 hours) and post-dose (6 and 24 hours) on Day 1 of Weeks 1, 2, 3, 5, 7, 12, and Day 7 of Week 12; then Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Transcriptional Responses as Measured by messenger ribonucleic acid (mRNA) Levels for QOD Cohorts |  | Baseline; pre-dose; post-dose (6 and 24 hours) on Days 1, 3, and 7 for Week 1, Day 1 of Weeks 3, 5, 7, Day 6 of Week 12; then Weeks 16, 20, 24, 28, 32, 36 during follow-up | 
| Pharmacodynamics: Percentage of T Cells, B Cells, and NK Cells (TBNK) |  | For QOD and QWk Cohorts: Baseline; pre-dose (0 hours) on Day 1 of Weeks 1, 2, 5; then Weeks 20, 28, 36 during follow-up | 
| Pharmacodynamics: Percentage of Myeloid Cells |  | For QOD and QWk Cohorts: Baseline; pre-dose (0 hours) on Day 1 of Weeks 1, 2, 5; then Weeks 20, 28, 36 during follow-up | 
| Pharmacodynamics: Percentage of Plasmacytoid Dendritic Cells |  | For QOD and QWk Cohorts: Baseline; pre-dose (0 hours) on Day 1 of Weeks 1, 2, 5; then Weeks 20, 28, 36 during follow-up | 
| Pharmacokinetics: Cmax of Entecavir in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 | 
| Pharmacokinetics: AUCinf of Entecavir in QWk Dosing Cohorts |  | Pre-dose (0 hours) and post-dose (0.25, 1, 2, 4, 6, 8, 12, 24 hours) on Day 1 of Week 1; pre-dose (0 hours) and post-dose (1, 2-4 hours) on Day 1 of Weeks 2, 3, 5, 7, 12 |