- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01513122
Bone and Body Comp: A Sub Study of the SECOND-LINE Study
The use of anti HIV drugs (ART), and in particular a class of drugs known as nucleoside reverse transcriptase inhibitors (N(t)RTI), has been associated with changes in body fat and in particular loss of peripheral fat in the limbs. Low bone mineral density and osteoporosis are also common in HIV-infected patients. There appears to be some association between ART and bone loss, but this is poorly understood and requires further research. The SECOND-LINE study provides an opportunity to examine if a new anti-HIV drug (raltegravir) can result in greater increase in limb fat than a drug regimen containing N(t)RTI, which is currently standard of care. This study also provides an opportunity to examine if additional bone loss occurs with the second regimen of anti-HIV drugs and whether non-N(t)RTI regimens of ART used in second line therapy result in more or less bone loss than use of other classes of anti-HIV drugs such as protease inhibitors or N(t)RTI combinations.
It is hypothesized that subjects randomised into Raltegravir arm will demonstrate greater increases in limb fat and smaller reductions in bone density at the proximal femur over 48 weeks than those randomised into the control arm (LPV/r + 2-3N(t)RTIs).
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
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Buenos Aires, Argentina
- CEADI
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Chennai, Indien, 600113
- YRGCare Medical Centre
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Kuala Lumpur, Malaysia, 50603
- University of Malaya Medical Centre
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Bloemfontein, Sydafrika
- Josha Research
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Cape Town, Sydafrika, 7925
- Desmond Tutu HIV Foundation
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Soweto, Sydafrika
- Chris Hani Baragwanath Hospital
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Bangkok, Thailand, 10330
- HIV-NAT Program on AIDS - Thai Red Cross
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Second-Line main study identifier: NCT00931463
Inclusion Criteria:
- HIV-1 positive by licensed diagnostic test
- Aged 16 years or older (or minimum age as determined by local regulations or as legal requirements dictate)
- Have received first antiretroviral regimen consisting of an NNRTI plus 2N(t)RTIs for ≥ 24 weeks
- No change in antiretroviral therapy within 12 weeks prior to screening
- Failed first-line NNRTI + 2N(t)RTI combination therapy according to virological criteria defined by two consecutive (≥7 days apart) HIV RNA results of > 500 copies/mL
- No prior or current exposure to HIV protease inhibitors and/or HIV integrase inhibitors
- Able to provide written informed consent
Exclusion Criteria:
The following laboratory variables:
- absolute neutrophil count (ANC) < 500 cells/µL
- hemoglobin < 7.0 g/dL
- platelet count < 50,000 cells/µL
- ALT > 5 x ULN
- Pregnant or nursing mothers
- Participants with active viral hepatitis B infection defined by the presence in serum of hepatitis B surface antigen
- Use of immunomodulators within 30 days prior to screening
- Use of any prohibited medications (rifampicin, midazolam, triazolam, cisapride, pimozide, amiodarone, dihydroergotamine, ergotamine, ergonovine, methylergonovine, astemizole, terfenadine, vardenafil, and St. John's wort)
- Intercurrent illness requiring hospitalisation
- Active opportunistic disease not under adequate control in the opinion of the site Principal Investigator
- Participants with current alcohol or illicit substance abuse that in the opinion of the site Principal Investigator might adversely affect participation in the study
- Participants deemed by the site Principal Investigator unlikely to be able to remain in follow-up for the protocol-defined period
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Aktiv komparator: Arm 1. Lopinavir / ritonavir + 2-3N(t)RTI
LPV/r 200mg/50mg 4 tabs once daily or 2 tabs twice daily + 2-3N(t)RTI
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LPV/r 200mg/50mg 4 tabs once daily or 2 tabs twice daily
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Aktiv komparator: Arm 2. Lopinavir /ritonavir + raltegravir
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LPV/r 200mg/50mg 4 tabs once daily or 2 tabs twice daily
raltegravir 400mg 1 tablet twice daily.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
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Mean Bone Mineral Density Changes From Baseline to 48 Weeks as Measured by DXA Scan
Tidsramme: 48 weeks
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48 weeks
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Mean Limbs Fat Changes From Baseline to 48 Weeks as Measured by DXA Scan
Tidsramme: 48 weeks
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48 weeks
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Sekundære resultatmål
Resultatmål |
Tidsramme |
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Mean Total Body Fat Changes From Baseline to 48 Weeks as Measured by DXA Scan
Tidsramme: 48 weeks
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48 weeks
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Mean Triglycerides Changes From Baseline to 48 Weeks
Tidsramme: 48 weeks
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48 weeks
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Mean Total Cholesterol Changes From Baseline to 48 Weeks
Tidsramme: 48 weeks
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48 weeks
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Mean Glucose Changes From Baseline to 48 Weeks
Tidsramme: 48 weeks
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48 weeks
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Ledende efterforsker: Paddy Mallon, Mater Misericordiae University Hospital, Dublin
- Ledende efterforsker: Waldo Belloso, Hospital Italiano, Argentina
- Ledende efterforsker: Samuel Ferret, Hopital Saint-Louis, France
- Ledende efterforsker: Praphan Phanuphak, HIV-NAT Program on AIDS - Thai Red Cross, Bangkok
- Ledende efterforsker: Jennifer Hoy, The Alfred
Publikationer og nyttige links
Generelle publikationer
- Martin A, Moore C, Mallon PW, Hoy J, Emery S, Belloso W, Phanuphak P, Ferret S, Cooper DA, Boyd MA; Second Line study team. Bone mineral density in HIV participants randomized to raltegravir and lopinavir/ritonavir compared with standard second line therapy. AIDS. 2013 Sep 24;27(15):2403-11. doi: 10.1097/01.aids.0000432534.47217.b4.
- Martin A, Moore CL, Mallon PW, Hoy JF, Emery S, Belloso WH, Phanuphak P, Ferret S, Cooper DA, Boyd MA; Second-Line Study Team. HIV lipodystrophy in participants randomised to lopinavir/ritonavir (LPV/r) +2-3 nucleoside/nucleotide reverse transcriptase inhibitors (N(t)RTI) or LPV/r + raltegravir as second-line antiretroviral therapy. PLoS One. 2013 Oct 30;8(10):e77138. doi: 10.1371/journal.pone.0077138. eCollection 2013.
- Boyd MA, Amin J, Mallon PW, Kumarasamy N, Lombaard J, Wood R, Chetchotisakd P, Phanuphak P, Mohapi L, Azwa I, Belloso WH, Molina JM, Hoy J, Moore CL, Emery S, Cooper DA; SECOND-LINE Study Group. Body composition and metabolic outcomes after 96 weeks of treatment with ritonavir-boosted lopinavir plus either nucleoside or nucleotide reverse transcriptase inhibitors or raltegravir in patients with HIV with virological failure of a standard first-line antiretroviral therapy regimen: a substudy of the randomised, open-label, non-inferiority SECOND-LINE study. Lancet HIV. 2017 Jan;4(1):e13-e20. doi: 10.1016/S2352-3018(16)30189-8. Epub 2016 Nov 1.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Molekylære mekanismer for farmakologisk virkning
- Anti-infektionsmidler
- Antivirale midler
- Enzymhæmmere
- Anti-HIV-midler
- Anti-retrovirale midler
- Proteasehæmmere
- Cytokrom P-450 CYP3A-hæmmere
- Cytokrom P-450 enzymhæmmere
- HIV-integrasehæmmere
- Integrasehæmmere
- HIV-proteasehæmmere
- Virale proteasehæmmere
- Raltegravir kalium
- Ritonavir
- Lopinavir
Andre undersøgelses-id-numre
- 2L body comp sub-study
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
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