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- Essai clinique NCT01766726
Effects of Newly-Initiated QUAD Therapy on Aortic/Coronary Inflammation in ART-Naïve Infected Patients (Quad)
15 mars 2017 mis à jour par: Steven K. Grinspoon, MD, Massachusetts General Hospital
The main aims of this study are to determine whether: a) ART-naïve HIV+ subjects have increased artherosclerotic plaque inflammation/vulnerability, b) newly-initiated QUAD/Stribild therapy will decrease plaque inflammation/vulnerability in these subjects, and c) QUAD/Stribild therapy will improve indices of immune dysregulation and lipid dysfunction as a mechanism of improved plaque inflammation/vulnerability.
Parameters of lipid and immune function will also be assessed in healthy control subjects, for comparison.
Aperçu de l'étude
Statut
Complété
Les conditions
Description détaillée
Patients with HIV are at higher risk of morbidity and mortality from cardiovascular disease than healthy subjects.
Antiretroviral therapy (ART) has greatly increased the lifespan of HIV+ patients, but their risk of CVD remains higher than normal.
Previously, it has been shown that compared to healthy control subjects, ART-treated HIV+ patients have more atherosclerotic plaque inflammation in the aorta.
This study is intended to determine whether atherosclerotic plaque inflammation/vulnerability is increased in ART-naïve HIV+ patients and whether these parameters can be improved through 6 months of newly-initiated QUAD/Stribild therapy.
Additionally, the study will determine whether indices of immune dysregulation and lipid dysfunction are increased in ART-naive HIV+ patients and whether these parameters can also be improved through 6 months of newly initiated QUAD/Stribild therapy.
Type d'étude
Observationnel
Inscription (Réel)
33
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Massachusetts
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Boston, Massachusetts, États-Unis, 02114
- Massachusetts General Hospital
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
Méthode d'échantillonnage
Échantillon non probabiliste
Population étudiée
Subjects with HIV infection being cared for in the Eastern Massachusetts area may be appprised of the study by their treating infectious disease doctors.
Additionally, subjects with HIV infection from the community will be recruited via posters, advertisements, e-postings.
Healthy control subjects from the community will be recruited via posters, advertisements, and e-postings.
La description
HIV-infected Subjects:
Inclusion Criteria:
- men and women, ages 18+, with documented HIV-infection who are ART-naive and ready to be started on ART with QUAD/Stribild by their treating infectious disease doctors
Exclusion Criteria:
- history of prior, sustained ART use
- CD4 <50 or AIDS-defining illness
- known current opportunistic infection or acute infections (not including Hepatitis B/C)
- pregnancy or breastfeeding
- history of acute coronary syndrome or coronary artery stenting or surgery, diabetes mellitus, or significant autoimmune/inflammatory disease
- plans for sustained use during 6 month study interval of a confounding immune suppressant medication including intravenous or oral corticosteroid
- hemoglobin < 12.5 g/dl for men or < 12 g/dl for women
- eGFR < 70 ml/min/1.73 m2 calculated by CDK-EPI
- contrast dye allergy
- contraindication to beta blockers or nitroglycerin administered during MDCT coronary angiography (coronary CTA) protocol
- body weight > 320 lbs (PET scanner limitation)
- significant radiation exposure (>2 myocardial perfusion scans or CT angiograms) received within the past year
- reported active illicit drug use
Healthy control subjects:
Inclusion Criteria:
-men and women, ages 18+, without HIV infection
Exclusion Criteria:
- known current opportunistic infection or acute infections (not including Hepatitis B/C)
- pregnancy or breastfeeding
- history of acute coronary syndrome or coronary artery stenting or surgery, diabetes mellitus, or significant autoimmune/inflammatory disease
- sustained use of a confounding immune suppressant medication including intravenous or oral corticosteroid
- hemoglobin < 12.5 g/dl for men or < 12 g/dl for women
- reported active illicit drug use
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: Cohorte
- Perspectives temporelles: Éventuel
Cohortes et interventions
Groupe / Cohorte |
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Healthy control subjects
Historical healthy control subjects matched to HIV+ patients on traditional cardiovascular risk factors will be studied at baseline with respect to arterial inflammation and coronary atherosclerotic plaque.
Prospectively recruited healthy control subjects matched to HIV+ patients on traditional cardiovascular risk factors will be studied at baseline with respect to lipid and immune function.
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ART-naïve HIV+ patients starting QUAD/Stribild
ART-naïve HIV+ patients who are about to be started QUAD/Stribild by their treating clinicians will be studied at baseline and 6 months after initiating QUAD/Stribild therapy.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Aortic/coronary target to background ratio (TBR) on cardiac FDG-PET
Délai: Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Degree of aortic/coronary atherosclerotic plaque inflammation assessed via cardiac FDG-PET as target to background ratio (TBR) of the standardized uptake value (SUV).
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Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Aortic/coronary atherosclerotic plaque on coronary computed tomography angiography (coronary CTA)
Délai: Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Aortic/coronary atherosclerotic plaque assessed via coronary CTA.
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Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Lipid and lipoprotein levels
Délai: Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Levels of lipids and lipoproteins including but not limited to levels of total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and levels select apolipoprotein levels.
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Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Indices of pro-atherogenic lipid dysfunction
Délai: Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Including HDL oxidative potential and other assessments of HDL function and structure.
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Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Inflammatory biomarker levels
Délai: Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Levels of inflammatory biomarkers including but not limited to soluble CD163.
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Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Percentage of circulating activated leukocyte subsets
Délai: Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Percentage of circulating activated leukocyte subsets including but not limited to percentage of circulating CD14+CD16+ monocytes assessed via flow cytometry.
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Baseline and change from baseline to 6 months in HIV cohort starting QUAD/Stribild
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Steven K Grinspoon, MD, Massachusetts General Hospital
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Toribio M, Burdo TH, Fulda ES, Cetlin M, Chu SM, Feldpausch MN, Robbins GK, Neilan TG, Melbourne K, Grinspoon SK, Zanni MV. Effects of Integrase Inhibitor-Based ART on the NLRP3 Inflammasome Among ART-Naive People With HIV. Open Forum Infect Dis. 2020 Sep 29;7(10):ofaa459. doi: 10.1093/ofid/ofaa459. eCollection 2020 Oct.
- Toribio M, Park MH, Zanni MV, Robbins GK, Burdo TH, Williams KC, Feldpausch MN, Stone L, Melbourne K, Grinspoon SK, Fitzgerald ML. HDL Cholesterol Efflux Capacity in Newly Diagnosed HIV and Effects of Antiretroviral Therapy. J Clin Endocrinol Metab. 2017 Nov 1;102(11):4250-4259. doi: 10.1210/jc.2017-01334.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 décembre 2012
Achèvement primaire (Réel)
1 janvier 2016
Achèvement de l'étude (Réel)
1 janvier 2016
Dates d'inscription aux études
Première soumission
9 janvier 2013
Première soumission répondant aux critères de contrôle qualité
9 janvier 2013
Première publication (Estimation)
11 janvier 2013
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
17 mars 2017
Dernière mise à jour soumise répondant aux critères de contrôle qualité
15 mars 2017
Dernière vérification
1 mars 2017
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 2012P001138
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
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