- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00036452
A Study to Compare Anti-HIV Drugs Given Twice a Day or Once a Day, With or Without Direct Observation
A Randomized, Phase II, Open Label Study to Compare Twice Daily and Once Daily Potent Antiretroviral Therapy and to Compare Self-Administered Therapy and Therapy Administered Under Direct Observation
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
While many factors contribute to the success or failure of antiretroviral therapy for HIV, among the most important are factors that influence adherence to a treatment regimen, such as duration of therapy, dosing frequency, pill burden, side effects, and patient behaviors. Inconsistent adherence or nonadherence to antiretroviral therapy can result in suboptimal drug exposure. Suboptimal drug exposure can, in turn, impact short- and long-term patient outcomes by increasing the likelihood of drug resistant HIV mutants and subsequent virologic and clinical failure. It is therefore essential to design treatment regimens that promote long-term adherence to potent antiretroviral therapy. This study will evaluate the relative contribution of reduced-frequency dosing and directly observed therapy on the magnitude and durability of virologic suppression in patients treated with potent antiretroviral therapy.
Patients will be randomly assigned to one of three study arms. Arms A, B, and C receive the same daily dosage of lopinavir/ritonavir (LPV/r), emtricitabine (FTC), and stavudine extended release (d4T XR) or tenofovir DF (TDF). In Arm A, drugs are self-administered for 48 weeks; LPV/r is taken twice daily and FTC and d4T XR or TDF once daily. In Arm B, all drugs are self-administered once daily for 48 weeks. In Arm C, drugs are taken once a day under directly observed therapy during Weeks 0-24, and then by self-administration during Weeks 25-48. Adherence to the regimen is measured using an electronic drug monitoring system. Viral load, CD4 and CD8 T cell responses, population pharmacokinetics, and quality of life indicators are measured throughout the study. The tolerability and safety of the treatment regimens are also monitored.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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San Juan, Puerto Rico, 00936-5067
- Puerto Rico-AIDS CRS
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Gauteng
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Johannesburg, Gauteng, Südafrika
- Wits HIV CRS
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California
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Los Angeles, California, Vereinigte Staaten, 90033-1079
- USC CRS
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Sacramento, California, Vereinigte Staaten
- Univ. of California Davis Med. Ctr., ACTU
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San Diego, California, Vereinigte Staaten, 92103
- Ucsd, Avrc Crs
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Colorado
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Aurora, Colorado, Vereinigte Staaten, 80262
- University of Colorado Hospital CRS
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Florida
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Miami, Florida, Vereinigte Staaten, 33136
- Univ. of Miami AIDS CRS
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Hawaii
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Honolulu, Hawaii, Vereinigte Staaten, 96816-2396
- Univ. of Hawaii at Manoa, Leahi Hosp.
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Indiana
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Indianapolis, Indiana, Vereinigte Staaten, 46202-5250
- Indiana Univ. School of Medicine, Infectious Disease Research Clinic
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Maryland
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Baltimore, Maryland, Vereinigte Staaten, 21287
- Johns Hopkins Adult AIDS CRS
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Baltimore, Maryland, Vereinigte Staaten, 21201
- IHV Baltimore Treatment CRS
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Massachusetts
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Fall River, Massachusetts, Vereinigte Staaten
- SSTAR, Family Healthcare Ctr.
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Minnesota
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Minneapolis, Minnesota, Vereinigte Staaten, 55455-0392
- University of Minnesota, ACTU
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New York
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New York, New York, Vereinigte Staaten, 10003
- Beth Israel Med. Ctr., ACTU
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New York, New York, Vereinigte Staaten, 10016
- NY Univ. HIV/AIDS CRS
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Rochester, New York, Vereinigte Staaten, 14215
- Univ. of Rochester ACTG CRS
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Rochester, New York, Vereinigte Staaten, 14642-0001
- AIDS Care CRS
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Rochester, New York, Vereinigte Staaten, 14642-0001
- McCree McCuller Wellness Ctr. at the Connection, Infectious Disease Unit
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North Carolina
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Chapel Hill, North Carolina, Vereinigte Staaten, 27514
- Unc Aids Crs
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Greensboro, North Carolina, Vereinigte Staaten, 27401-1004
- Regional Center for Infectious Disease, Wendover Medical Center CRS
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Raleigh, North Carolina, Vereinigte Staaten
- Wake County Health and Human Services CRS
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Ohio
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Cincinnati, Ohio, Vereinigte Staaten, 45267-0405
- Univ. of Cincinnati CRS
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Cleveland, Ohio, Vereinigte Staaten, 44109-1998
- MetroHealth CRS
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Columbus, Ohio, Vereinigte Staaten
- The Ohio State Univ. AIDS CRS
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Pennsylvania
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Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
- Hosp. of the Univ. of Pennsylvania CRS
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Pittsburgh, Pennsylvania, Vereinigte Staaten, 15213-2582
- Pitt CRS
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Rhode Island
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Providence, Rhode Island, Vereinigte Staaten, 02906
- The Miriam Hosp. ACTG CRS
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Tennessee
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Nashville, Tennessee, Vereinigte Staaten, 37203
- Vanderbilt Therapeutics CRS
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Washington
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Seattle, Washington, Vereinigte Staaten, 98104
- University of Washington AIDS CRS
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria
- HIV infection
- Age 13 years or older and have written consent of guardian if under 18
- Weigh at least 88 pounds
- Viral load of 2000 copies/ml or more within 90 days before study entry
- Have not taken anti-HIV drugs for more than 7 days
- Agree to use acceptable methods of contraception during the study and for 1 month after stopping the study drugs
Exclusion Criteria
- Pregnant or breastfeeding
- In jail
- Sensitive or allergic to any part of the study drugs
- Treated with acute systemic therapy for a serious infection or other serious medical illness within 7 days prior to study entry, unless the participant has completed 7 days of therapy and is clinically stable
- Recent serious illness, including pancreatitis or peripheral neuropathy
- Alcohol or illicit drug abuse
- Taken any of the following within 14 days before study entry: investigational drugs, anti-HIV vaccines, drugs that may cause pancreatitis or peripheral neuropathy, or drugs that are associated with CYP3A
- Treated for cancer (not including minimal Kaposi's sarcoma) within 30 days before study entry
- History of mental illness that might interfere with the study
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Mitarbeiter und Ermittler
Ermittler
- Studienstuhl: Donna Mildvan, MD, Beth Israel Medical Center
- Studienstuhl: Charles Flexner, MD, Johns Hopkins University Hospital
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, Wagener MM, Singh N. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000 Jul 4;133(1):21-30. doi: 10.7326/0003-4819-133-1-200007040-00004. Erratum In: Ann Intern Med 2002 Feb 5;136(3):253.
- Liu H, Golin CE, Miller LG, Hays RD, Beck CK, Sanandaji S, Christian J, Maldonado T, Duran D, Kaplan AH, Wenger NS. A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001 May 15;134(10):968-77. doi: 10.7326/0003-4819-134-10-200105150-00011. Erratum In: Ann Intern Med 2002 Jan 15;136(2):175.
- Volmink J, Matchaba P, Garner P. Directly observed therapy and treatment adherence. Lancet. 2000 Apr 15;355(9212):1345-50. doi: 10.1016/S0140-6736(00)02124-3. Erratum In: Lancet 2000 Jul 29;356(9227):434.
- Bangsberg DR, Mundy LM, Tulsky JP. Expanding directly observed therapy: tuberculosis to human immunodeficiency virus. Am J Med. 2001 Jun 1;110(8):664-6. doi: 10.1016/s0002-9343(01)00729-x. No abstract available.
- Kirkland LR, Fischl MA, Tashima KT, Paar D, Gensler T, Graham NM, Gao H, Rosenzweig JR, McClernon DR, Pittman G, Hessenthaler SM, Hernandez JE; NZTA4007 Study Team. Response to lamivudine-zidovudine plus abacavir twice daily in antiretroviral-naive, incarcerated patients with HIV infection taking directly observed treatment. Clin Infect Dis. 2002 Feb 15;34(4):511-8. doi: 10.1086/338400. Epub 2002 Jan 4.
- Gross R, Tierney C, Andrade A, Lalama C, Rosenkranz S, Eshleman SH, Flanigan T, Santana J, Salomon N, Reisler R, Wiggins I, Hogg E, Flexner C, Mildvan D; AIDS Clinical Trials Group A5073 Study Team. Modified directly observed antiretroviral therapy compared with self-administered therapy in treatment-naive HIV-1-infected patients: a randomized trial. Arch Intern Med. 2009 Jul 13;169(13):1224-32. doi: 10.1001/archinternmed.2009.172.
- Flexner C, Tierney C, Gross R, Andrade A, Lalama C, Eshleman SH, Aberg J, Sanne I, Parsons T, Kashuba A, Rosenkranz SL, Kmack A, Ferguson E, Dehlinger M, Mildvan D; ACTG A5073 Study Team. Comparison of once-daily versus twice-daily combination antiretroviral therapy in treatment-naive patients: results of AIDS clinical trials group (ACTG) A5073, a 48-week randomized controlled trial. Clin Infect Dis. 2010 Apr 1;50(7):1041-52. doi: 10.1086/651118.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- RNA-Virusinfektionen
- Viruserkrankungen
- Infektionen
- Durch Blut übertragene Infektionen
- Übertragbare Krankheiten
- Sexuell übertragbare Krankheiten, viral
- Sexuell übertragbare Krankheiten
- Lentivirus-Infektionen
- Retroviridae-Infektionen
- Immunologische Mangelsyndrome
- Erkrankungen des Immunsystems
- HIV-Infektionen
- Molekulare Mechanismen der pharmakologischen Wirkung
- Antiinfektiva
- Antivirale Mittel
- Reverse-Transkriptase-Inhibitoren
- Inhibitoren der Nukleinsäuresynthese
- Enzym-Inhibitoren
- Anti-HIV-Agenten
- Antiretrovirale Mittel
- Antimetaboliten
- Protease-Inhibitoren
- Cytochrom P-450 CYP3A-Inhibitoren
- Cytochrom-P-450-Enzym-Inhibitoren
- HIV-Protease-Inhibitoren
- Virale Protease-Inhibitoren
- Tenofovir
- Emtricitabin
- Ritonavir
- Lopinavir
- Stavudin
Andere Studien-ID-Nummern
- A5073
- 10073 (Registrierungskennung: DAIDS ES)
- ACTG A5073
- AACTG A5073
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .