Thymosin α1 treatment of chronic hepatitis B:: results of a phase III multicentre, randomized, double-blind and placebo-controlled study

Previous clinical trials have suggested that thymosin alpha(1) (T alpha(1)), an immunomodulatory peptide. may be effective in the treatment of chronic hepatitis B (CHB), The aim of this study was to determine the efficacy of T alpha(1) in a multicentre, placebo-controlled and double-blind study of 97 patients with serum hepatitis B virus (HBV) DNA- and hepatitis B e antigen (HBeAg)-positive CHB. Patients who had been hepatitis B surface antigen (HBsAg) positive for at least 12 months entered a 3-month screening period prior to randomization. Forty-nine patients received T alpha(1) (1.6 mg) and 48 patients received placebo, twice weekly for 6 months, and were followed-up for an additional 6 months. At inclusion, both groups were comparable for age, gender, histological grading, and aminotransferase and HBV DNA levels. A complete response to treatment. defined as a sustained serum HBV DNA-negative status (two negative results at least 3 months apart) during the 12-month study. with negative HBV DNA and HBeAg values at month 12, was seen in seven (14%) patients given T alpha(1) and in two (4%) patients treated with placebo (P = 0.084). Five (10%) patients given T alpha(1) and four (8%) patients given placebo exhibited a delayed response (defined as sustained serum HBV DNA negativity achieved after the 12-month study period with negative HBV DNA and HBeAg values at the last assessment). A total of 12 (25%) patients given T alpha(1) and six (13%) patients given placebo showed a sustained loss of HBV DNA with a negative HBeAg value during or following the 12-month study period (P < 0.11). These results do not confirm observations of treatment efficacy reported in other clinical studies.