A Clinical Study of Ixazomib to Reactivate HIV and Reduce HIV Reservoir Size
A Phase 2, Double-Blinded, Randomized, Placebo-Controlled Trial of Ixazomib to Reactivate HIV and Reduce HIV Reservoir Size
This study tests whether a medicine called ixazomib is safe for people living with HIV, and whether it can wake up HIV that is hiding in the body so the immune system and treatment can reach it.
HIV can stay hidden inside cells even when antiretroviral therapy (ART) keeps the virus under control. These hidden cells are called the HIV reservoir, and they are the reason HIV is not cured by ART alone. Laboratory research suggests ixazomib may reactivate hidden HIV and also help kill the cells that carry it. Ixazomib is already approved to treat a cancer called multiple myeloma and has been given to a smaller group of people with HIV in an earlier study.
About 45 adults with HIV that is well controlled on ART will take part. Participants are assigned by chance to take either ixazomib or a placebo - a capsule with no active medicine - one capsule by mouth once a week for a total of 25 doses. Two out of every three participants receive ixazomib and one out of three receives placebo. Neither participants nor the study staff know which one a participant is taking.
Everyone continues their own HIV treatment throughout the study.
Participation lasts about 7 months: 24 weeks of weekly capsules and 4 more weeks of follow-up after the last dose. Participants come to the clinic for about 14 visits, and take their capsule 24 to 36 hours before each visit so blood samples can show the effect of the dose.
The main purposes of the study are to evaluate whether ixazomib is safe and tolerable, and to measure whether it increases the very small amounts of HIV in the blood compared with placebo. The study also measures the size of the HIV reservoir and how the immune system responds.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
A5420 is a phase 2, double-blinded, randomized, placebo-controlled trial of ixazomib in adults with HIV-1 who are virologically suppressed on antiretroviral therapy. Forty-five participants will be randomized 2:1 to ixazomib 4 mg or matching placebo, taken orally once weekly for a total of 25 doses over 24 weeks, while continuing their own suppressive ART. Randomization is stratified by sex (male/female) using permuted blocks to balance enrollment across arms. Participants are evaluated at screening, entry (week 0), and weeks 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24, with a post-treatment evaluation at week 28 following a 4-week washout, for approximately 14 visits over roughly 7 months.
Study treatment is administered as a single 4 mg capsule taken with water on an empty stomach, at least 1 hour before or 2 hours after food, on the same day and at approximately the same time each week. Capsules are not broken, chewed, or opened. Doses preceding a clinic visit are taken 24 to 36 hours before that visit so that plasma and cell-associated virologic measurements capture the post-dose interval.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
Contatti e Sedi
Luoghi di studio
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Alabama
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Birmingham, Alabama, Stati Uniti, 35222
- Alabama CRS (Site #31788)
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Contatto:
- Sonya Heath
- Numero di telefono: 205-996-2371
- Email: heaths@uab.edu
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California
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Los Angeles, California, Stati Uniti, 90035
- University of California, Los Angeles CARE Center CRS (Site #601)
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Contatto:
- Kara Chew
- Numero di telefono: 310-825-0796
- Email: kchew@mednet.ucla.edu
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San Diego, California, Stati Uniti, 92103
- UCSD Antiviral Research Center CRS (Site #701)
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Contatto:
- Steven Hendrickx
- Numero di telefono: 619-543-6968
- Email: smhendrickx@health.ucsd.edu
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San Francisco, California, Stati Uniti, 94110
- University of California, San Francisco HIV/AIDS CRS (Site #801)
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Contatto:
- Annie Luetkemeyer
- Numero di telefono: 415-502-5753
- Email: Annie.luetkemeyer@ucsf.edu
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Colorado
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Aurora, Colorado, Stati Uniti, 80045
- University of Colorado Hospital CRS (Site #6101)
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Contatto:
- Nicola Haakonsen
- Numero di telefono: 303-724-0708
- Email: Nicola.haakonsen@cuanschutz.edu
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District of Columbia
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Washington D.C., District of Columbia, Stati Uniti, 20009
- Whitman-Walker Institute, Inc. CRS (Site #31791)
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Contatto:
- Sarah Henn
- Numero di telefono: 202-745-6174
- Email: shenn@whitman-walker.org
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Georgia
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Atlanta, Georgia, Stati Uniti, 30308-2012
- The Ponce de Leon Center CRS (Site #5802)
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Contatto:
- Vincent Marconi
- Numero di telefono: 404-321-6111
- Email: vcmarco@emory.edu
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Illinois
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Chicago, Illinois, Stati Uniti, 60611
- Northwestern University CRS (Site #2701)
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Contatto:
- Amesika Nyaku
- Numero di telefono: 312-694-6856
- Email: Amesika.nyaku@northwestern.edu
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Massachusetts
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Boston, Massachusetts, Stati Uniti, 02114
- Massachusetts General Hospital CRS (MGH CRS) (Site #101)
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Contatto:
- Rajesh Gandhi
- Numero di telefono: 617-726-3811
- Email: rgandhi@mgh.harvard.edu
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New York
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New York, New York, Stati Uniti, 10032
- Columbia Physicians & Surgeons (P&S) CRS (Site #30329)
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Contatto:
- Michael Yin
- Numero di telefono: 212-305-7185
- Email: mty4@cumc.columbia.edu
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Rochester, New York, Stati Uniti, 14642
- University of Rochester Adult HIV Therapeutic Strategies Network CRS (Site #31787)
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Contatto:
- Sonal Munsiff
- Numero di telefono: 585-276-7199
- Email: Sonal_Munsiff@URMC.Rochester.edu
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North Carolina
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Chapel Hill, North Carolina, Stati Uniti, 27599-7215
- Chapel Hill CRS (Site #3201)
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Contatto:
- David Wohl
- Numero di telefono: 919-843-2723
- Email: wohl@med.unc.edu
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Ohio
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Cincinnati, Ohio, Stati Uniti, 45267-0405
- Cincinnati Clinical Research Site (Site #2401)
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Contatto:
- Carl Fichtenbaum
- Numero di telefono: 513-584-6361
- Email: carl.fichtenbaum@uc.edu
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Cleveland, Ohio, Stati Uniti, 44106
- Case Clinical Research Site (Site #2501)
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Contatto:
- George Yendewa
- Numero di telefono: 216-844-2298
- Email: gay7@case.edu
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Columbus, Ohio, Stati Uniti, 43210-1282
- Ohio State University CRS (Site #2301)
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Contatto:
- Susan Koletar
- Numero di telefono: 614-293-5494
- Email: susan.koletar@osumc.edu
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Pennsylvania
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Philadelphia, Pennsylvania, Stati Uniti, 19104
- Penn Therapeutics CRS (Site #6201)
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Contatto:
- William Short
- Numero di telefono: 215-662-8693
- Email: william.short@pennmedicine.upenn.edu
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Pittsburgh, Pennsylvania, Stati Uniti, 15213
- University of Pittsburgh CRS (Site #1001)
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Contatto:
- Yijia Li
- Numero di telefono: 412-647-7228
- Email: liy33@upmc.edu
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Tennessee
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Nashville, Tennessee, Stati Uniti, 37204
- Vanderbilt Therapeutics (VT) CRS (Site #3652)
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Contatto:
- David Haas
- Numero di telefono: 615-936-8594
- Email: david.haas@vumc.org
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Texas
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Houston, Texas, Stati Uniti, 77030
- Houston Advancing Research Team CRS (Site #31473)
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Contatto:
- Roberto Arduino
- Numero di telefono: 713-500-6731
- Email: roberto.c.arduino@uth.tmc.edu
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Washington
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Seattle, Washington, Stati Uniti, 98104
- University of Washington Positive Research CRS (Site #1401)
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Contatto:
- Rachel Bender Ignacio
- Numero di telefono: 206-744-4876
- Email: rbi13@uw.edu
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Documented HIV-1 infection.
- Plasma HIV-1 RNA of 50 copies/mL or lower, for at least 48 weeks prior to study entry while on antiretroviral therapy. One blip above 50 but below 200 copies/mL in the preceding 48 weeks is permitted provided at least two other measurements in that period were 50 copies/mL or lower.
- Plasma HIV-1 RNA below the lower limit of quantification within 30 days prior to study entry.
- Receiving antiretroviral therapy for less than 10 years.
- On antiretroviral therapy for at least 48 weeks prior to study entry, with no interruption of more than 7 consecutive days in the 90 days prior to entry, and no change in regimen within 90 days prior to entry.
- CD4+ T cell count of at least 500 cells/mm^3 within 30 days prior to study entry.
- Laboratory values within 30 days prior to study entry: absolute neutrophil count at least 1,000/mm^3; hemoglobin at least 10 g/dL (female participants) or at least 11 g/dL (male participants); platelet count at least 75,000/mm^3; estimated glomerular filtration rate at least 30 mL/min/1.73m^2; bilirubin no more than 1.5 times the upper limit of normal, or no more than 3 times the upper limit of normal if the isolated elevation is attributable to a participant medication or Gilbert syndrome, or direct bilirubin within the normal range.
- For participants who can become pregnant, a negative serum or urine pregnancy test within 24 hours prior to study entry.
- For participants who can become pregnant, agreement to use two methods of contraception from 10 days prior to study entry through 90 days after the last dose of study treatment. Egg donation is prohibited over the same period.
- For participants whose sexual activity could result in a partner becoming pregnant, agreement to use condoms from 10 days prior to study entry through 90 days after the last dose of study treatment. Sperm donation is prohibited over the same period.
- Negative hepatitis B surface antigen within 30 days prior to study entry.
- Negative hepatitis C antibody, or if positive, a negative HCV RNA PCR, within 30 days prior to study entry.
Exclusion Criteria:
- Untreated, active AIDS-defining illness.
- Receiving an HIV protease inhibitor or efavirenz as part of the antiretroviral regimen.
- Current pregnancy or breastfeeding.
- Receipt of an investigational HIV vaccine or HIV-specific monoclonal antibody, or participation in a trial of any investigational product, within 180 days prior to study entry, or expected participation in such a study during this study.
- Any current clinically significant acute or chronic medical condition other than HIV infection that in the investigator's opinion would preclude participation.
- Any history of peripheral neuropathy, or peripheral neuropathy detected during screening.
- History of an HIV-associated malignancy, including Kaposi sarcoma or lymphoma of any type, treated with systemic chemotherapy or immunotherapy.
- Active or recent non-HIV-associated malignancy requiring systemic chemotherapy or surgery within 36 months prior to study entry, or for whom such therapy is expected within the following 12 months. Surgical removal of minor localized skin cancers is not exclusionary.
- Use of prohibited medications within 30 days prior to study entry or planned use during study participation.
- Known allergy, sensitivity, or hypersensitivity to ixazomib or its formulation.
- Active drug or alcohol use or dependence that, in the investigator's opinion, would interfere with adherence to study requirements.
- Acute or serious illness requiring systemic treatment or hospitalization within 30 days prior to study entry.
- Anticipated change in antiretroviral regimen during the 24 weeks following study entry.
- Current uncontrolled cardiovascular symptoms, including uncontrolled hypertension (systolic blood pressure above 140 mmHg or diastolic blood pressure above 90 mmHg), uncontrolled cardiac arrhythmia, symptomatic congestive heart failure, unstable angina, or myocardial infarction within 24 weeks prior to study entry.
- Any serious medical or psychiatric illness that in the investigator's opinion could interfere with completion of protocol treatment.
- Known gastrointestinal disease or procedure that could interfere with oral absorption or tolerance of ixazomib, including difficulty swallowing.
- Previous treatment with ixazomib.
- Known resistance to two or more classes of antiretrovirals.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Quadruplicare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Ixazomib
Ixazomib 4 mg orally once weekly for a total of 25 doses over 24 weeks. |
One Ixazomib 4 mg capsule should be taken by mouth with a full glass of water on an empty stomach at least 1 hour before or 2 hours after food once a week on the same day and approximately the same time each week
Altri nomi:
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Comparatore placebo: Placebo
Placebo for Ixazomib orally once weekly for a total of 25 doses over 24 weeks. |
One Placebo for Ixazomib capsule should be taken by mouth with a full glass of water on an empty stomach at least 1 hour before or 2 hours after food once a week on the same day and approximately the same time each week |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Lasso di tempo |
|---|---|
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Proportion of Ixazomib-Treated Participants With at Least One Grade 3 or Higher Adverse Event Related to Study Treatment.
Lasso di tempo: Entry (Week 0) to Week 28
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Entry (Week 0) to Week 28
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Frequency of Ixazomib-Treated Participants Who Prematurely Discontinue Study Treatment for Reasons That Are Deemed Related to Study Treatment.
Lasso di tempo: Entry (Week 0) to Week 24
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Entry (Week 0) to Week 24
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Post-Dose Plasma HIV-1 RNA Levels Measured by Multireplicate Single-Copy Assay (SCA)
Lasso di tempo: Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
|
Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Lasso di tempo |
|---|---|
|
Intact Proviral DNA Levels Measured by the Intact Proviral DNA Assay (IPDA)
Lasso di tempo: Screening, Entry (Week 0), and Weeks 4, 24, and 28
|
Screening, Entry (Week 0), and Weeks 4, 24, and 28
|
|
Plasma HIV-1 RNA Levels Measured by Multireplicate Single-Copy Assay (SCA)
Lasso di tempo: Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
|
Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
|
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Cell-Associated HIV RNA Levels
Lasso di tempo: Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
|
Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
|
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Cell-Associated HIV RNA/DNA Ratio
Lasso di tempo: Screening, Entry (Week 0), and Weeks 4, 24, and 28
|
Screening, Entry (Week 0), and Weeks 4, 24, and 28
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Infezioni a trasmissione ematica
- Malattie urogenitali
- Malattie genitali
- Malattie del sistema immunitario
- Infezioni
- Infezioni da virus a RNA
- Malattie virali
- Malattie trasmissibili
- Malattie sessualmente trasmissibili, virali
- Malattie trasmesse sessualmente
- Infezioni da lentivirus
- Infezioni da retroviridae
- Sindromi da deficit immunologico
- Malattie da virus lenti
- Infezioni da HIV
- Sindrome da immunodeficienza acquisita
- ixazomib
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- A5420
- 39030 (Altro identificatore: DAIDS Document ID)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
Individual participant data that underlie results in the publication, after deidentification.
Periodo di condivisione IPD
Beginning 3 months following publication and available throughout period of funding of the Advancing Clinical Therapeutics Globally (ACTG) by NIH
Criteri di accesso alla condivisione IPD
With whom? Researchers who provide a methodologically sound proposal for use of the data that is approved by the ACTG.
For what types of analyses? To achieve aims in the proposal approved by the ACTG.
By what mechanism will data be made available? Researchers may submit a request for access to data using the ACTG "Data Request" form at: https://actgnetwork.org/submit-a-proposal/. Researchers of approved proposals will need to sign an ACTG Data Use Agreement before receiving the data.
Tipo di informazioni di supporto alla condivisione IPD
- STUDIO_PROTOCOLLO
- LINFA
Informazioni su farmaci e dispositivi, documenti di studio
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