Effectiveness of the Early Addition of Abacavir to an Anti-HIV Drug Combination
A Pilot Study of Early Treatment Intensification of Antiretroviral Therapy
The purpose of this study is to see if adding 1 drug to an anti-HIV drug combination early in treatment against HIV can lower the viral load (amount of HIV in the blood) to a level so low that it cannot be measured (undetectable). The drug that will be added to a treatment is abacavir (ABC).
Many patients who take 3 anti-HIV drugs together are able to achieve very low viral loads, for example, viral loads below 50 copies/ml. However, some patients taking only 3 drugs are not able to achieve a viral load this low. Doctors hope that, by adding the drug ABC to a current treatment, a viral load below 50 copies/ml can be achieved. Doctors would like to find out if it is effective to start patients on 3 drugs and then add another drug (treatment intensification) if the treatment is not working as well as hoped.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
Combination antiretroviral therapy can offer patients potent suppression of HIV replication and improved immunologic functioning. However, despite aggressive antiretroviral regimens currently in use, only about 50 to 60 percent of patients attain plasma viral loads below 50 copies/ml after 24 weeks. Initiating treatment with a 4-drug regimen may increase this percentage, but this may also contribute to patient non-adherence, drug-related toxicities, potential cross-resistance to drugs used in future regimens, and high financial costs. Another strategy is early intensification (adding a single drug to an existing regimen) in patients who are at risk for attaining incomplete viral suppression after 24 weeks of therapy. ABC may produce a significant antiviral effect when used as an intensification agent in patients on a stable antiretroviral regimen. The results of this study will offer insight into the potential benefits of early treatment intensification.
Patients entering this study will have initiated potent antiretroviral therapy. Between 60 and 90 days [AS PER AMENDMENT 1/9/01: 60 and 104 days] after beginning their background regimen, patients are randomized to add either ABC (Arm A) or a matching placebo (Arm B) for 12 weeks. Patients completing 12 weeks of treatment continue on study for an additional 24 weeks to Week 36. Patients discontinue treatment if virologic failure occurs at any time. Patients still return to the clinic for HIV-1 RNA measurements at Weeks 12 and 36, depending on when discontinuation occurred. Patients who discontinue treatment at or after Week 12 due to virologic failure are offered open-label ABC for the remainder of the study (through Week 36). Blood samples are collected at Weeks 4, 8, 12, 20, 28, and 36. Plasma samples for population sequencing of HIV-1 PR and RT genes are collected on all patients at study entry and at the time of virologic failure. Baseline genotype (presence or absence of PR and RT resistance mutations and number of resistance mutations) is correlated to treatment outcome. Samples from the time of failure are analyzed for the accumulation of additional resistance mutations. [AS PER AMENDMENT 5/5/00: Patients and their primary care physicians will be unblinded to the patient's treatment after the study is completed at Week 36 or if virologic failure occurs at or after Week 12 [AS PER AMENDMENT 1/9/01: or if ABC hypersensitivity is suspected].]
Typ studie
Typ studie
Zápis
Zápis
Fáze
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
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San Juan, Portoriko, 009365067
- Univ of Puerto Rico
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California
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Los Angeles, California, Spojené státy, 90095
- UCLA CARE Ctr
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Menlo Park, California, Spojené státy, 94025
- Willow Clinic
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San Jose, California, Spojené státy, 951282699
- Santa Clara Valley Med Ctr / AIDS Community Rsch Consortium
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Stanford, California, Spojené státy, 943055107
- San Mateo AIDS Program / Stanford Univ
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Stanford, California, Spojené státy, 943055107
- Stanford Univ Med Ctr
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Torrance, California, Spojené státy, 90502
- Harbor UCLA Med Ctr
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Colorado
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Denver, Colorado, Spojené státy, 80262
- Univ of Colorado Health Sciences Ctr
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Florida
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Miami, Florida, Spojené státy, 331361013
- Univ of Miami School of Medicine
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Georgia
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Atlanta, Georgia, Spojené státy, 30308
- Emory Univ
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Illinois
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Chicago, Illinois, Spojené státy, 60611
- Northwestern Univ Med School
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Chicago, Illinois, Spojené státy, 60612
- Cook County Hosp
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Maryland
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Baltimore, Maryland, Spojené státy, 21287
- Johns Hopkins Hosp
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Baltimore, Maryland, Spojené státy, 212052196
- State of MD Div of Corrections / Johns Hopkins Univ Hosp
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Missouri
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St Louis, Missouri, Spojené státy, 63112
- St Louis Regional Hosp / St Louis Regional Med Ctr
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New York
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Buffalo, New York, Spojené státy, 14215
- SUNY / Erie County Med Ctr at Buffalo
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New York, New York, Spojené státy, 10003
- Beth Israel Med Ctr
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New York, New York, Spojené státy, 10016
- Bellevue Hosp / New York Univ Med Ctr
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New York, New York, Spojené státy, 10032
- Columbia Presbyterian Med Ctr
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New York, New York, Spojené státy, 10021
- Aaron Diamond AIDS Rsch Ctr / Rockefeller Univ
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Rochester, New York, Spojené státy, 14642
- Univ of Rochester Medical Center
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North Carolina
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Chapel Hill, North Carolina, Spojené státy, 275997215
- Univ of North Carolina
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Durham, North Carolina, Spojené státy, 27710
- Duke Univ Med Ctr
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Ohio
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Cincinnati, Ohio, Spojené státy, 452670405
- Univ of Cincinnati
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Pennsylvania
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Philadelphia, Pennsylvania, Spojené státy, 19104
- Univ of Pennsylvania at Philadelphia
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Philadelphia, Pennsylvania, Spojené státy, 19104
- Philadelphia Veterans Administration Med Ctr
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South Carolina
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West Columbia, South Carolina, Spojené státy, 29169
- Julio Arroyo
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Tennessee
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Nashville, Tennessee, Spojené státy, 37203
- Vanderbilt Univ Med Ctr
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Texas
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Dallas, Texas, Spojené státy, 75390
- Univ of Texas, Southwestern Med Ctr of Dallas
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Washington
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Seattle, Washington, Spojené státy, 98104
- Univ of Washington
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
Patients may be eligible for this study if they:
- Are HIV-positive.
- Have been taking anti-HIV therapy that includes at least 3 anti-HIV drugs and is an acceptable anti-HIV drug combination for 60 to 104 days before study treatment. Patients must not have changed any of the drugs in the 28 days before study entry. (This study has been changed by extending the number of days that anti-HIV therapy has been received.)
- Have a viral load greater than 500 but less than or equal to 10,000 copies/ml and have had a significant decrease in viral load between 49 and 84 days after starting this anti-HIV therapy. (This study has been changed by extending the length of time of viral load decrease.)
- Are at least 13 years old (consent of parent or guardian required if under 18).
- Agree to practice abstinence or use barrier method of birth control (such as condoms) during the study and for 3 months after.
Exclusion Criteria
Patients will not be eligible for this study if they:
- Have ever taken ABC.
- Have received anti-HIV therapy for more than 104 days in the past. (This study has been changed by extending the number of days that anti-HIV therapy has been received.)
- Have a fever for 7 days in the 30 days before study entry.
- Have cancer, including Kaposi's sarcoma, that requires chemotherapy.
- Have an active infection that requires treatment in the 21 days before study entry.
- Have any opportunistic (AIDS-related) infection or disease that requires a change in medication in the 14 days before study entry.
- Have any medical condition or history of an illness that the doctor feels would place them at risk or make them unable to complete the study.
- Are taking drugs that affect the immune system or any experimental anti-HIV drugs, except for their current drug combination.
- Are taking St. John's wort. (This study has been changed. Previously, patients taking St. John's wort were eligible.)
- Have received a vaccine in the 21 days before study entry.
- Are pregnant or breast-feeding.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Maskování: Dvojnásobek
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Vyšetřovatelé
Vyšetřovatelé
- Studijní židle: Pablo Tebas
- Studijní židle: John Bartlett
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Začátek studia
Dokončení studie
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- RNA virové infekce
- Virová onemocnění
- Infekce
- Infekce přenášené krví
- Přenosné nemoci
- Pohlavně přenosné choroby, virové
- Pohlavně přenosné nemoci
- Lentivirové infekce
- Retroviridae infekce
- Syndromy imunologické nedostatečnosti
- Onemocnění imunitního systému
- HIV infekce
- Molekulární mechanismy farmakologického působení
- Antiinfekční látky
- Antivirová činidla
- Inhibitory reverzní transkriptázy
- Inhibitory syntézy nukleových kyselin
- Inhibitory enzymů
- Anti-HIV činidla
- Antiretrovirová činidla
- Abacavir
Další identifikační čísla studie
Další identifikační čísla studie
- ACTG A5064
- AACTG A5064
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