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Maraviroc Switch Collaborative Study (MARCH)

18 gennaio 2016 aggiornato da: Kirby Institute

Randomised, Openlabel Study Evaluating Efficacy and Safety of Maraviroc as a Switch for Either NRTI or PI/r in HIV-1 Infected Individuals With Stable, Well-Controlled Plasma HIV-RNA While Taking Their First N(t)RTI + PI/r Regimen of cART

MARCH is an international, multicentre trial planning to enroll 380 HIV-1 infected patients who are currently on 2N(t)RTI + PI/r regimen and virologically suppressed. Participants will be randomized (1:2:2) to one of three treatment groups: to continue their current treatment regimen, maraviroc dose at 150 mg twice daily with PI/r, or maraviroc at 300 mg twice daily with 2N(t)RTI. As the participants population have HIV RNA <200 copies/mL, the phenotypic assessment of tropism cannot be used to determine tropism, instead we will employ the genotypic assessment of tropism by sequencing the V3 loop of the HIV envelope. The main aim of this study is to investigate whether switching to maraviroc, in combination with either RTI or PI/r, is as good at keeping the HIV viral load undetectable as the combination of RTI with PI/r. The other aim is to see if switching to these combinations with maraviroc will improve some of the side effects that can be seen when people take combination therapy including RTI and PI/r.

The study hypothesis is that in stable, virologically suppressed (plasma HIV-RNA <200 copies/mL) patients with no history of prior virological failure, a switch to either MVC dosed at 300mg twice daily (bid) combined with the same 2N(t)RTI backbone regimen or MVC dosed at 150mg twice daily (bid) with the current PI/r (or 300mg bid at the discretion of the investigator if the PI/r is fosamprenavir/r) provides similar (non-inferior) antiretroviral efficacy compared to continuation of the current 2N(t)RTI + PI/r regimen.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

399

Fase

  • Fase 4

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Buenos Aires, Argentina, C1405CKC
        • Fundacion IDEAA
      • Cordoba, Argentina
        • Hospital Privado- Centro Medico Cordoba
    • Ciudad de Buenos Aires
      • Buenos Aires, Ciudad de Buenos Aires, Argentina, 1425
        • FUNCEI
      • Buenos Aires, Ciudad de Buenos Aires, Argentina, C1181ACH
        • Hospital Italiano de Buenos Aires
      • Buenos Aires, Ciudad de Buenos Aires, Argentina, C1221ADC
        • Hospital G de Agudos JM Ramos Mejia
    • Provincia de Buenos Aires
      • El Palomar, Provincia de Buenos Aires, Argentina, 1684
        • Hospital Nacional Prof Alejandro Posadas
      • Isidro Casanova, Provincia de Buenos Aires, Argentina, 1765
        • Hospital Dr Diego Paroissien
    • Provincia de Santa Fe
      • Rosario, Provincia de Santa Fe, Argentina, S2000PBJ
        • CAICI
    • New South Wales
      • Sydney, New South Wales, Australia, 2010
        • Holdsworth House Medical Practice
      • Sydney, New South Wales, Australia, 2145
        • Westmead Hospital
      • Sydney, New South Wales, Australia, 2050
        • Royal Prince Alfred Hospital
      • Sydney, New South Wales, Australia, 2010
        • St. Vincent's Hospital
    • Queensland
      • Bisbane, Queensland, Australia, 4101
        • Gladstone Road Medical Centre
      • Brisbane, Queensland, Australia, 4000
        • Brisbane Sexual Health and HIV Service (formerly AMU)
      • Nambour, Queensland, Australia, 4560
        • Nambour General Hospital
    • South Australia
      • Adelaide, South Australia, Australia, 5000
        • O'Brien Street Practice
    • Victoria
      • Melbourne, Victoria, Australia, 3168
        • Monash Medical Centre
      • Melbourne, Victoria, Australia, 3004
        • Alfred Hospital
    • Alberta
      • Calgary, Alberta, Canada, T2R OX7
        • Southern Alberta Clinic
    • Ontario
      • Toronto, Ontario, Canada, M5G 2N2
        • University Health Network/Toronto General Hospital
      • Toronto, Ontario, Canada, ON M5G 1k2
        • Canadian Immunodeficiency Research Collaborative (CIRC) lnc (Maple Leaf Clinic)
    • Quebec
      • Montreal, Quebec, Canada, H3A 1T1
        • Clinic Opus/Lori
    • Santiago RM
      • Santiago, Santiago RM, Chile
        • Fundacion Arriaran
      • Orleans, Francia, 45100
        • Service Maladies infectieuses et Tropicales CHR ORLEANS La SOURCE
      • Berlin, Germania, 10777
        • Gemeinschaftspraxis Jessen Jessen Stein
      • Berlin, Germania, 13353
        • Dienstleistung centre ID (Baumgarten, MIB medical center for infectious diseases)
      • Bonn, Germania, 53127
        • University of Bonn, Med J. Immunologische Siudienzenirale
      • Cologne, Germania, 50937
        • Klinikum der Universität zu Köln
      • Düsseldorf, Germania, 40225
        • Universitätsklinikum Düsseldorf, Klinik für Gastroenterologie, Hepatologie und Infektiologie-MX- Amb
      • Hannover, Germania, 30625
        • Klinik für Immunologie und Rheumatologie, Medzinische Hochschule Hannover
    • Frankfurt am Main
      • Frankfurt, Frankfurt am Main, Germania, 60590
        • Johann Wolfgang Goethe-University Hospital, Medical HIVCENTER
      • Nagoya, Giappone, 460-0001
        • Nagoya Medical Center
      • Dublin, Irlanda, 7
        • Mater Misericordiae University Hospital
      • Leon, Messico, 37320
        • Hospital General de Leon
      • Mexico City, Messico
        • INCMNSZ
    • Jalisco
      • Guadalajara, Jalisco, Messico, 44280
        • Hospital Civil de Guadalajara
      • Warsaw, Polonia, 01-201
        • Wojewodzki Szpital Zakazny Centrum Diagnostyki i Terapii AIDS
      • London, Regno Unito, W2
        • St. Mary's Hospital, Imperial College
      • London, Regno Unito
        • St. Thomas's Hospital
    • Lothian
      • Edinburgh, Lothian, Regno Unito
        • Western General Hospital
    • Sussex
      • Brighton, Sussex, Regno Unito, BN21ES
        • Brighton & Sussex University NHS Trust
    • Warwickshire
      • Coventry, Warwickshire, Regno Unito, CV 1 4FS
        • Coventry and Warwickshire Partnership Trust
      • Madrid, Spagna, 28046
        • Hospital La Paz,
      • Madrid, Spagna, 28805
        • Hospital Príncipe de Asturias
      • Malaga, Spagna, 29010
        • Hospital Regional Carlos Haya De Malaga
      • Seville, Spagna, 41013
        • Virgen del Rocio University Hospital
      • Valencia, Spagna, 46026
        • Hospital Universitari i Politecnic La Fe
    • Catalonia
      • Badalona, Catalonia, Spagna, 08916
        • Hospital Germans Trias i Pujol
      • Barcelona, Catalonia, Spagna, 08036
        • Hospital Clínic de Barcelona
      • Barcelona, Catalonia, Spagna, 08041
        • Hospital De La Santa Creu I Sant Pau
      • Bangkok, Tailandia, 10330
        • Chulalongkorn University Hospital

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Documented HIV-1 infection by a licensed diagnostic test at any time prior to study entry
  • Age >18 years
  • HIV-1 RNA <200 copies/mL plasma for at least 24 weeks
  • Stable (>24 weeks) ART including two N(t)RTIs and a PI/r
  • No evidence of any primary HIV genotypic mutations in HIV reverse transcriptase or protease for all patients with available resistance testing results conducted prior to cART and/or during viral rebound/failure
  • Provision of written, informed consent.

Exclusion Criteria:

  • CXCR4 or CCR5/CXCR4 dual tropic HIV tropism or a non-reportable tropism result based on assessment using proviral DNA
  • Anticipated need to modify current cART regimen for toxicity management in the next 6 months
  • The following laboratory criteria,

    1. absolute neutrophil count (ANC) <750 cells/µL
    2. haemoglobin <8.0 g/dL
    3. platelet count <50,000 cells/µL
    4. serum AST, ALT >5 x upper limit of normal (ULN)
  • Active hepatitis B co-infection
  • Pregnant women or nursing mothers
  • Current use of any prohibited medications as described in product specific information.
  • Hypersensitivity to soy or peanuts
  • Acute therapy for serious infection or other serious medical illness (in the judgement of the site Principal Investigator) requiring systemic treatment and/or hospitalisation
  • Use of immunomodulators (e.g. systemic corticosteroids, recombinant interleukin-2, interferon) within 30 days prior to screening
  • Patients with current alcohol or illicit substance use that in the opinion of the site Principal Investigator would conflict with any aspect of the conduct of the study
  • Patients unlikely to be able to remain in follow-up for the protocol-defined period
  • Prisoners or subjects who are compulsorily detained (involuntary incarcerated).

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Nessun intervento: No change
continue their current cART regimen
Comparatore attivo: Replace N(t)RTI drugs with Maraviroc
Replace N(t)RTI drugs with MVC at a dose of 150mg bid (MVC 300mg bid can be used at the discretion of the Investigator if the PI/r is fosamprenavir/r) and continue the PI/r
Maraviroc is a marketed drug for the treatment of HIV-infection. Maraviroc will be supplied in two different oral dose forms, 150mg and 300mg given twice a day. The drug will be dosed according to the recommendations in the product label i.e. with PI/r the dose is 150mg bid except, Maraviroc 300mg bid can be used at the discretion of the investigator if the PI/r is fosamprenavir/r; those randomised to the 2N(t)RTI arm, will receive Maraviroc 300mg bid. Patients randomised to receive Maraviroc will be provided with bottles of Maraviroc which contain a 30-day supply.
Comparatore attivo: Replace PI/r drugs with Maraviroc
Replace PI/r drugs with MVC at a dose of 300mg bid and continue 2N(t)RTI.
Maraviroc is a marketed drug for the treatment of HIV-infection. Maraviroc will be supplied in two different oral dose forms, 150mg and 300mg given twice a day. The drug will be dosed according to the recommendations in the product label i.e. with PI/r the dose is 150mg bid except, Maraviroc 300mg bid can be used at the discretion of the investigator if the PI/r is fosamprenavir/r; those randomised to the 2N(t)RTI arm, will receive Maraviroc 300mg bid. Patients randomised to receive Maraviroc will be provided with bottles of Maraviroc which contain a 30-day supply.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
The comparison of the switch arms to control arm of proportions of participants with HIV RNA <200 copies/mL 48 weeks after randomisation.
Lasso di tempo: 48 weeks after randomization
48 weeks after randomization

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Virological endpoints: proportion of participants with plasma HIV-1 RNA<50 copies/ml
Lasso di tempo: 48 weeks from randomization

A number of secondary endpoints will be examined at or through to week 48 in this protocol. These will include, but not be limited to the following:

Virologic; Immunologic and biomarkers; Clinical; Metabolic and body composition; Safety; Adherence; Quality of Life and Resistance endpoints.

48 weeks from randomization

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: David A Cooper, AO, Kirby Institute, University of New South Wales

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 agosto 2011

Completamento primario (Effettivo)

1 dicembre 2015

Completamento dello studio (Effettivo)

1 dicembre 2015

Date di iscrizione allo studio

Primo inviato

28 giugno 2011

Primo inviato che soddisfa i criteri di controllo qualità

28 giugno 2011

Primo Inserito (Stima)

29 giugno 2011

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

20 gennaio 2016

Ultimo aggiornamento inviato che soddisfa i criteri QC

18 gennaio 2016

Ultimo verificato

1 gennaio 2016

Maggiori informazioni

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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