- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00916448
The Effects of Atazanavir-induced Hyperbilirubinemia During Human Endotoxemia
August 13, 2015 updated by: Radboud University Medical Center
The Effects of Atazanavir-induced Hyperbilirubinemia on the Innate Immune Response During Human Endotoxemia. A Parallel Double Blind Placebo Controlled Pilot Study.
Excessive inflammation, production of free radicals and vascular injury are considered the main contributors to the development of organ dysfunction in patients with severe infections and sepsis.
The endogenously produced unconjugated bilirubin is one of the most powerful anti-oxidants of the human body and the administration of bilirubin in animal experiments has been shown to protect from inflammation-induced death.
However, bilirubin for human administration is not yet available.
Therefore, we wish to exploit one of the side effects of atazanavir, a registered drug currently used as a protease inhibitor in HIV infected patients.
Atazanavir inhibits the enzyme UPD glucuronosyl transferase enzyme (UGT1A1) and therefore increases endogenously produced bilirubin levels moderately.
To study the effect of hyperbilirubinemia during inflammation we will apply the human endotoxemia model.
The human endotoxemia model permits elucidation of key players in the immune response to a gram negative stimulus in vivo, therefore serving as a useful tool to investigate potential novel therapeutic strategies in a standardized setting.
We hypothesize that atazanavir-induced hyperbilirubinemia has beneficial anti-inflammatory and vascular effects during human endotoxemia.
Study Overview
Status
Completed
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
30
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Gelderland
-
Nijmegen, Gelderland, Netherlands, 6500 HB
- Radboud University Nijmegen Medical Centre
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 35 years (Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
Male
Description
Inclusion Criteria:
- Healthy male volunteers
Exclusion Criteria:
- Use of any medication or anti-oxidant vitamin supplements.
- History of allergic reaction to atazanavir.
- Smoking.
- Previous spontaneous vagal collapse.
- History, signs or symptoms of cardiovascular disease.
- (Family) history of myocardial infarction or stroke under the age of 65 years.
- Cardiac conduction abnormalities on the ECG consisting of a 2nd degree atrioventricular block or a complex bundle branch block.
- Hypertension (defined as RR systolic > 160 or RR diastolic > 90).
- Hypotension (defined as RR systolic < 100 or RR diastolic < 50).
- Renal impairment (defined as plasma creatinin >120 μmol/l).
- Liver enzyme abnormalities or positive hepatitis serology.
- Subjects with a total bilirubin level above 15 μmol/L and a normal direct bilirubin level suggesting Gilbert Syndrome.
- Positive HIV serology or any other obvious disease associated with immune deficiency.
- Febrile illness in the week before the LPS challenge.
- Participation in a drug trial or donation of blood 3 months prior to the LPS challenge.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo
placebo medication: 2 capsules taken twice daily for 4 consecutive days and thereafter infusion of 2 ng/kg E.coli endotoxin intravenously
|
2 ng/kg E. coli reference endotoxin 11:H 10:K negative intravenously
|
Active Comparator: Atazanavir
Atazanavir 150 mg, 2 capsules taken twice daily for 4 consecutive days and thereafter infusion of 2 ng/kg E.coli endotoxin intravenously
|
2 ng/kg E. coli reference endotoxin 11:H 10:K negative intravenously
capsules of 150 mg, 2 capsules, twice daily on 4 consecutive days
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The effect of atazanavir-induced hyperbilirubinemia on systemic activation of the innate immune response by measurement of various cytokines induced by a lipopolysaccharide (LPS) challenge.
Time Frame: before and at several time points until 24 hrs after endotoxin administration
|
before and at several time points until 24 hrs after endotoxin administration
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
To determine if the attenuated vascular response to endothelium dependent vasodilators and vasoconstrictors during endotoxemia can be prevented by atazanavir-induced hyperbilirubinemia.
Time Frame: before and until 6 hours after endotoxin administration
|
before and until 6 hours after endotoxin administration
|
To detect the effects of human endotoxemia on gastric perfusion measured by tonometry in the presence or absence of atazanavir-induced hyperbilirubinemia.
Time Frame: Before and at several time points up to 9 hours after endotoxin administration
|
Before and at several time points up to 9 hours after endotoxin administration
|
To determine if atazanavir induced hyperbilirubinemia can attenuate subclinical renal damage (determined by several markers of acute kidney injury) known to occur during human endotoxemia.
Time Frame: Before and at several time points up to 24 hours after endotoxin administration
|
Before and at several time points up to 24 hours after endotoxin administration
|
To determine the effect of atazanavir induced hyperbilirubinemia on heme oxygenase induction and activity during human endotoxemia.
Time Frame: before and at several time points up to 24 hours after endotoxin administration
|
before and at several time points up to 24 hours after endotoxin administration
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Peter Pickkers, MD, PhD, Radboud University Nijmegen Medical Centre, The Netherlands
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
May 1, 2009
Primary Completion (Actual)
March 1, 2010
Study Completion (Actual)
July 1, 2015
Study Registration Dates
First Submitted
June 5, 2009
First Submitted That Met QC Criteria
June 8, 2009
First Posted (Estimate)
June 9, 2009
Study Record Updates
Last Update Posted (Estimate)
August 14, 2015
Last Update Submitted That Met QC Criteria
August 13, 2015
Last Verified
July 1, 2015
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Infections
- Systemic Inflammatory Response Syndrome
- Sepsis
- Bacteremia
- Toxemia
- Inflammation
- Endotoxemia
- Hyperbilirubinemia
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Enzyme Inhibitors
- Anti-HIV Agents
- Anti-Retroviral Agents
- Protease Inhibitors
- HIV Protease Inhibitors
- Viral Protease Inhibitors
- Atazanavir Sulfate
Other Study ID Numbers
- ATV LPS study
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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