A Study to Determine the Best Dose of Antivirals in Patients With Both TB and HIV (OPTI-NNRTI)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
-
-
Bahia
-
Salvador, Bahia, Brasilien, 40110-160
- Hospital Universitario Prof. Edgard Santos/Universidade Federal da Bahia
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- ARV naïve subjects
- Documented HIV infection
- Documented TB infection
- Platelet count 40,000/mm3
- Hemoglobin ≥8.0 g/dL
- Absolute neutrophil count (ANC) >500/mm3
- AST (SGOT), ALT (SGPT), and alkaline phosphatase <3 X ULN
- Total bilirubin <2.5 x ULN
- Calculated creatinine clearance ≥60 mL/min
- For women of reproductive potential, negative urine pregnancy test
Exclusion Criteria:
- Unable to provide informed consent.
- History drug abuse that the investigators suspect will interfere with compliance to study medications and visits.
- Patients on hemodialysis.
- Tuberculosis meningitis.
- Women with CD4 > 250 and men with CD4 > 400 due to higher risk of hepatotoxicity related to use of NVP.
- Positive serology for hepatitis C.
- Evidence for active hepatitis B including positive serologies for HBsAg, HBeAg, or HBV-DNA. Note: If anti-HBs is positive, patient is eligible for study if liver enzymes are within the parameters indicated in the inclusion criteria
- Women who are breast-feeding
- Known allergy/sensitivity to study drug(s) or their formulations
- Patients with other OIs or intercurrent illness that could affect their ability to take study drugs
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: 1
Standard dose nevirapine (200 mg 2x daily) in combination with 2 nucleoside analogs
|
Patients co-infected with HIV and TB will receive either "standard" doses of nevirapine (200 mg 2x daily) or efavirenz (600 mg daily) or "high" doses of nevirapine (400 mg and 200 mg daily) or efavirenz (800 mg daily) that are chosen to compensate for the change in pharmacokinetics shown to occur when co-infected patients are treated with the antituberculous drug, rifampin.
Andre navne:
|
|
Eksperimentel: 2
High dose nevirapine (400 mg in the morning, 200 mg in the evening) in combination with 2 nucleoside analogs
|
Patients co-infected with HIV and TB will receive either "standard" doses of nevirapine (200 mg 2x daily) or efavirenz (600 mg daily) or "high" doses of nevirapine (400 mg and 200 mg daily) or efavirenz (800 mg daily) that are chosen to compensate for the change in pharmacokinetics shown to occur when co-infected patients are treated with the antituberculous drug, rifampin.
Andre navne:
|
|
Aktiv komparator: 3
Standard dose efavirenz (600 mg at bedtime) in combination with 2 nucleoside analogs
|
Patients co-infected with HIV and TB will receive either "standard" doses of nevirapine (200 mg 2x daily) or efavirenz (600 mg daily) or "high" doses of nevirapine (400 mg and 200 mg daily) or efavirenz (800 mg daily) that are chosen to compensate for the change in pharmacokinetics shown to occur when co-infected patients are treated with the antituberculous drug, rifampin.
Andre navne:
|
|
Eksperimentel: 4
High dose efavirenz (800 mg at bedtime) in combination with 2 nucleoside analogs
|
Patients co-infected with HIV and TB will receive either "standard" doses of nevirapine (200 mg 2x daily) or efavirenz (600 mg daily) or "high" doses of nevirapine (400 mg and 200 mg daily) or efavirenz (800 mg daily) that are chosen to compensate for the change in pharmacokinetics shown to occur when co-infected patients are treated with the antituberculous drug, rifampin.
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Decline in HIV RNA in plasma Rise in CD4 cell count
Tidsramme: Baseline, and Weeks 8, 20 and 32
|
These laboratory measures would be used to determine if there was a difference in the ARV failure rate between patients receiving standard dose vs high dose treatment with NNRTIs
|
Baseline, and Weeks 8, 20 and 32
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Terrence F Blaschke, M.D., Stanford University
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Infektioner
- Bakterielle infektioner
- Bakterielle infektioner og mykoser
- Gram-positive bakterielle infektioner
- Actinomycetales infektioner
- Mycobacterium infektioner
- Tuberkulose
- Molekylære mekanismer for farmakologisk virkning
- Anti-infektionsmidler
- Antivirale midler
- Reverse transkriptasehæmmere
- Nukleinsyresyntesehæmmere
- Enzymhæmmere
- Anti-HIV-midler
- Anti-retrovirale midler
- Cytokrom P-450 enzymhæmmere
- Cytokrom P-450 enzyminducere
- Cytokrom P-450 CYP3A inducere
- Cytokrom P-450 CYP2B6 inducere
- Cytokrom P-450 CYP2C9-hæmmere
- Cytokrom P-450 CYP2C19-hæmmere
- Nevirapin
- Efavirenz
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- Stanford Protocol ID: 95564
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