- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico 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
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
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.
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 2
Contactos y Ubicaciones
Ubicaciones de estudio
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California
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Los Angeles, California, Estados Unidos, 90033-1079
- USC CRS
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Sacramento, California, Estados Unidos
- Univ. of California Davis Med. Ctr., ACTU
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San Diego, California, Estados Unidos, 92103
- Ucsd, Avrc 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, 33136
- Univ. of Miami AIDS CRS
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Hawaii
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Honolulu, Hawaii, Estados Unidos, 96816-2396
- Univ. of Hawaii at Manoa, Leahi Hosp.
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Indiana
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Indianapolis, Indiana, Estados Unidos, 46202-5250
- Indiana Univ. School of Medicine, Infectious Disease Research Clinic
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Maryland
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Baltimore, Maryland, Estados Unidos, 21287
- Johns Hopkins Adult AIDS CRS
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Baltimore, Maryland, Estados Unidos, 21201
- IHV Baltimore Treatment CRS
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Massachusetts
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Fall River, Massachusetts, Estados Unidos
- SSTAR, Family Healthcare Ctr.
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Minnesota
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Minneapolis, Minnesota, Estados Unidos, 55455-0392
- University of Minnesota, ACTU
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New York
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New York, New York, Estados Unidos, 10003
- Beth Israel Med. Ctr., ACTU
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New York, New York, Estados Unidos, 10016
- NY Univ. HIV/AIDS CRS
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Rochester, New York, Estados Unidos, 14215
- Univ. of Rochester ACTG CRS
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Rochester, New York, Estados Unidos, 14642-0001
- AIDS Care CRS
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Rochester, New York, Estados Unidos, 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, Estados Unidos, 27514
- Unc Aids Crs
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Greensboro, North Carolina, Estados Unidos, 27401-1004
- Regional Center for Infectious Disease, Wendover Medical Center CRS
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Raleigh, North Carolina, Estados Unidos
- Wake County Health and Human Services CRS
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Ohio
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Cincinnati, Ohio, Estados Unidos, 45267-0405
- Univ. of Cincinnati CRS
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Cleveland, Ohio, Estados Unidos, 44109-1998
- MetroHealth CRS
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Columbus, Ohio, Estados Unidos
- The Ohio State Univ. 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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Pittsburgh, Pennsylvania, Estados Unidos, 15213-2582
- Pitt CRS
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Rhode Island
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Providence, Rhode Island, Estados Unidos, 02906
- The Miriam Hosp. ACTG CRS
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Tennessee
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Nashville, Tennessee, Estados Unidos, 37203
- Vanderbilt Therapeutics CRS
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Washington
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Seattle, Washington, Estados Unidos, 98104
- University of Washington AIDS CRS
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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, Sudáfrica
- Wits HIV 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
- 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
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Colaboradores e Investigadores
Investigadores
- Silla de estudio: Donna Mildvan, MD, Beth Israel Medical Center
- Silla de estudio: Charles Flexner, MD, Johns Hopkins University Hospital
Publicaciones y enlaces útiles
Publicaciones Generales
- 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.
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
- Inhibidores del citocromo P-450 CYP3A
- Inhibidores de enzimas del citocromo P-450
- Inhibidores de la proteasa del VIH
- Inhibidores de la proteasa viral
- Tenofovir
- Emtricitabina
- Ritonavir
- Lopinavir
- Estavudina
Otros números de identificación del estudio
- A5073
- 10073 (Identificador de registro: DAIDS ES)
- ACTG A5073
- AACTG A5073
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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