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- Ensayo clínico NCT00001085
A Study of 141W94 Used Alone or in Combination With Zidovudine Plus 3TC in HIV-Infected Patients
A Randomized, Double-Blind, Phase II Study of 141W94 (VX-478) Monotherapy vs. 141W94 (VX-478) Plus ZDV Plus 3TC in HIV Infected Individuals
To determine the proportion of patients whose plasma HIV-1 RNA level remains below a detectable level (less than 500/ml) after 24 weeks of study therapy with either 141W94 monotherapy or 141W94 plus zidovudine (ZDV) and lamivudine (3TC). To determine the safety and tolerability of 141W94 monotherapy and the combination of 141W94 plus 3TC in patients with HIV infection.
Although dramatic inhibition of HIV-1 replication is achieved with ritonavir or indinavir monotherapy, in both cases maximum suppression required combination treatment together with nucleoside analog RT inhibitors. This study tests the hypothesis that monotherapy with 141W94 doses that result in Cmin levels far in excess of the IC90 corrected for plasma protein binding for HIV-1 can achieve the same virologic and immunologic effects in terms of magnitude and durability, as has been observed with combinations of other protease inhibitors plus nucleoside analogs.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Although dramatic inhibition of HIV-1 replication is achieved with ritonavir or indinavir monotherapy, in both cases maximum suppression required combination treatment together with nucleoside analog RT inhibitors. This study tests the hypothesis that monotherapy with 141W94 doses that result in Cmin levels far in excess of the IC90 corrected for plasma protein binding for HIV-1 can achieve the same virologic and immunologic effects in terms of magnitude and durability, as has been observed with combinations of other protease inhibitors plus nucleoside analogs.
In this randomized, double-blind study, patients' HIV RNA is screened 30 days prior to entry. Patients satisfying enrollment criteria must have been on a stable antiretroviral regimen for 30 days prior to study screening and remain on the same regimen until entry. Patients are stratified based on the screening HIV-1 RNA copy number obtained within 30 days of entry: 5,000 - 50,000 copies/ml versus greater than 50,000 copies/ml. In addition, patients are stratified based on previous antiretroviral use: naive versus experienced. Patients are randomized to one of 2 treatment arms: Arm A - 141W94, plus Zidovudine (ZDV) and Lamivudine (3TC) or Arm B - 141W94, plus ZDV placebo and 3TC placebo.
[AS PER AMENDMENT 8/25/97: Patients assigned to the monotherapy arm are advised to discontinue their study medication immediately and initiate antiretroviral therapy with indinavir, nevirapine, stavudine and 3TC, as outlined in ACTG 347 roll-over protocol, ACTG 373. Patients in the three-drug arm continue on study therapy.] [AS PER AMENDMENT 12/19/97: Patients receive study treatment for 56 weeks and are followed through week 68.]
Tipo de estudio
Inscripción
Fase
- Fase 2
Contactos y Ubicaciones
Ubicaciones de estudio
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Alabama
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Birmingham, Alabama, Estados Unidos, 35294
- Alabama Therapeutics CRS
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California
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Los Angeles, California, Estados Unidos, 900331079
- USC CRS
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Colorado
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Aurora, Colorado, Estados Unidos, 80262
- University of Colorado Hospital CRS
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Florida
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Miami, Florida, Estados Unidos, 331361013
- Univ. of Miami AIDS CRS
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Georgia
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Atlanta, Georgia, Estados Unidos, 30308
- The Ponce de Leon Ctr. CRS
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Illinois
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Chicago, Illinois, Estados Unidos, 60612
- Cook County Hosp. CORE Ctr.
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Chicago, Illinois, Estados Unidos, 60611
- Northwestern University CRS
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Chicago, Illinois, Estados Unidos, 60612
- Rush Univ. Med. Ctr. ACTG CRS
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Massachusetts
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Boston, Massachusetts, Estados Unidos, 02118
- Bmc Actg Crs
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Boston, Massachusetts, Estados Unidos, 02215
- Beth Israel Deaconess Med. Ctr., ACTG CRS
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Missouri
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Saint Louis, Missouri, Estados Unidos
- Washington U CRS
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Saint Louis, Missouri, Estados Unidos, 63112
- St. Louis ConnectCare, Infectious Diseases Clinic
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New York
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New York, New York, Estados Unidos, 10016
- NY Univ. HIV/AIDS CRS
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North Carolina
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Chapel Hill, North Carolina, Estados Unidos, 275997215
- Unc Aids Crs
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Pennsylvania
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Philadelphia, Pennsylvania, Estados Unidos, 19104
- Hosp. of the Univ. of Pennsylvania CRS
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria
Concurrent Medication:
Allowed:
- Chemoprophylaxis for Pneumocystis carinii pneumonia is required for all patients who have a CD4 cell count <= 200 cells/mm3.
- Topical and/or oral antifungal agents, except for those listed in excluded medications.
- Treatment, maintenance or chemoprophylaxis with approved agents for opportunistic infections as clinically indicated, unless listed in excluded medications.
- All antibiotics as clinically indicated.
- Systemic corticosteroid use for <= 21 days for acute problems is permitted as medically indicated; chronic systemic corticosteroid use is not permitted.
- Recombinant erythropoietin and granulocyte colony-stimulating factor as medically indicated.
Regularly prescribed medications such as:
- antipyretics, analgesics, allergy medications, antidepressants, sleep medications, oral contraceptives (a barrier method is also required for this study), megestrol acetate, testosterone or any other medications, as medically indicated.
- Alternative therapies such as vitamins, acupuncture and visualization techniques are permitted (excluding herbal medications).
NOTE:
- Patients should report the use of these therapies; alternative therapies will be recorded.
Patients must have:
- HIV-1 infection as documented by ELISA and confirmed.
- >= 5,000 HIV-1 RNA copies/ml (within 30 days prior to study entry).
- CD4 cell count >= 50 cells/mm3 within 60 days prior to study entry.
- Signed, informed consent for patients < 18 years of age.
Prior Medication: Required:
- Patients must be on a stable antiretroviral regimen for 30 days prior to study screening and remain on the same regimen until entry.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
- Any active infection requiring acute treatment within 14 days prior to entry.
- A malignancy that requires systemic therapy other than minimal Kaposi's sarcoma.
NOTE:
- Patients with minimal Kaposi's sarcoma, defined as <= 5 cutaneous lesions and no visceral disease or tumor-associated edema, will be allowed to enroll as long as they do not require systemic therapy for Kaposi's sarcoma.
Patients with the following prior symptoms and conditions are excluded:
- Inability to tolerate ZDV 500-600 mg daily if ZDV was administered previously. Intolerance to ZDV is defined as any grade toxicity that resulted in a dose reduction or termination of ZDV.
Prior Medication:
Excluded:
- Any 3TC therapy prior to entry.
- Any HIV-1 protease inhibitor therapy prior to study entry (e.g., saquinavir, ritonavir, indinavir, nelfinavir, 141W94).
- Any immunomodulator therapy within 30 days prior to entry.
- Active immunization within 30 days prior to entry.
Any antiretroviral therapy change within 30 days prior to study screening.
1. Concurrent use of non-protocol specified antiretroviral agents; either investigational or licensed.
- Immunomodulators that affect immunologic or virologic indices such as systemic corticosteroids, thalidomide, or cytokines.
- Concomitant use of rifabutin and/or rifampin.
- Investigational drugs other than 141W94/VX-478.
- Systemic cytotoxic chemotherapy.
- Oral astemizole (Hismanal), carbamazepine (Tegretol), dexamethasone (Decadron), ketoconazole (Nizoral), itraconazole (Sporanox), phenobarbital, phenytoin (Dilantin), terfenadine (Seldane), cisapride (Propulsid), triazolam (Halcion) and midazolam (Versed).
- Herbal medications.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
Colaboradores e Investigadores
Investigadores
- Silla de estudio: Gulick R
Publicaciones y enlaces útiles
Publicaciones Generales
- Murphy RL, Gulick RM, DeGruttola V, D'Aquila RT, Eron JJ, Sommadossi JP, Currier JS, Smeaton L, Frank I, Caliendo AM, Gerber JG, Tung R, Kuritzkes DR. Treatment with amprenavir alone or amprenavir with zidovudine and lamivudine in adults with human immunodeficiency virus infection. AIDS Clinical Trials Group 347 Study Team. J Infect Dis. 1999 Apr;179(4):808-16. doi: 10.1086/314668.
- Murphy R, Degruttola V, Gulick R, D'Aquila R, Eron J, Sommadossi JP, Smeaton L, Currier J, Tung R, Kuritzkes D. 141W94 with or without zidovudine/3TC in patients with no prior protease inhibitor or 3TC therapy-ACTG 347. Conf Retroviruses Opportunistic Infect. 1998 Feb 1-5;5th:175 (abstract no 512)
- Eron JJ Jr, Smeaton LM, Fiscus SA, Gulick RM, Currier JS, Lennox JL, D'Aquila RT, Rogers MD, Tung R, Murphy RL. The effects of protease inhibitor therapy on human immunodeficiency virus type 1 levels in semen (AIDS clinical trials group protocol 850). J Infect Dis. 2000 May;181(5):1622-8. doi: 10.1086/315447. Epub 2000 Apr 26.
- Eron J, Smeaton L, Degruttola V, Schock J, Fiscus S, Tung R, Gulick R, Murphy R. The effects of amprenavir (APV) alone or in combination with ZDV/3TC, on HIV-1 levels in semen: a substudy of ACTG 347. Conf Retroviruses Opportunistic Infect. 1999 Jan 31-Feb 4;6th:109 (abstract no 222)
Fechas de registro del estudio
Fechas importantes del estudio
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Infecciones por virus de ARN
- Enfermedades virales
- Infecciones
- Infecciones transmitidas por la sangre
- Enfermedades contagiosas
- Enfermedades De Transmisión Sexual Virales
- Enfermedades de transmisión sexual
- Infecciones por lentivirus
- Infecciones por retroviridae
- Síndromes de deficiencia inmunológica
- Enfermedades del sistema inmunológico
- Infecciones por VIH
- Mecanismos moleculares de acción farmacológica
- Agentes antiinfecciosos
- Agentes Antivirales
- Inhibidores de la transcriptasa inversa
- Inhibidores de la síntesis de ácidos nucleicos
- Inhibidores de enzimas
- Agentes Anti-VIH
- Agentes antirretrovirales
- Antimetabolitos
- Inhibidores de la proteasa
- Agentes antibacterianos
- Inhibidores de la proteasa del VIH
- Inhibidores de la proteasa viral
- Agentes antituberculosos
- Antibióticos, Antituberculosos
- Lamivudina
- Zidovudina
- Amprenavir
Otros números de identificación del estudio
- ACTG 347
- 11317 (Identificador de registro: DAIDS ES)
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
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