Dolutegravir Antiretroviral Strategy to Promote Improvement and Reduce Drug Exposure (ASPIRE)
Dolutegravir Antiretroviral Strategy to Promote Improvement and Reduce Drug Exposure (ASPIRE) Study
調査の概要
詳細な説明
DESIGN HIV-1 infected subjects with CD4 nadir > 200 cells/mm3, no history of virologic failure and plasma HIV RNA <50 copies/mL for at least 48 weeks while on any United States Department of Health and Human Services (DHHS) recommended or alternative three-drug antiretroviral regimen will be randomized to dolutegravir (DTG) plus lamivudine (Arm 1) or continuation of their current regimen (Arm 2) for 48 weeks. The primary endpoint is virologic failure defined as confirmed plasma HIV-1 RNA > 50 copies/mL before or at Week 24
All subjects will undergo routine monitoring including plasma HIV-1 RNA, CD4/CD8 count, hematology, chemistry and fasting lipids. Resistance testing will be done in all patients who experience virologic failure. Single-copy HIV-1 assay will be done to quantify residual viremia.
DURATION 48 weeks
SAMPLE SIZE 90 subjects
POPULATION HIV-1-infected men and women, 18 years and older, with CD4 nadir > 200 cells/mm3, no baseline resistance, no history of virologic failure, and HIV RNA <50 copies/mL for at least 48 weeks prior to study entry while on any DHHS recommended or alternative three-drug regimen
REGIMEN Subjects will be randomized (1:1) to:
Arm 1: dolutegravir 50 mg plus lamivudine 300 mg once daily OR Arm 2: Continue current DHHS recommended or alternative three-drug antiretroviral regimen
研究の種類
入学 (実際)
段階
- フェーズ 3
連絡先と場所
研究場所
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California
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San Diego、California、アメリカ
- University of California San Diego
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Georgia
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Atlanta、Georgia、アメリカ
- Emory University
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Illinois
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Chicago、Illinois、アメリカ、60611
- Northwestern University
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Massachusetts
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Boston、Massachusetts、アメリカ
- Brigham and Women's Hospital
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New York
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New York、New York、アメリカ
- Cornell University
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Ohio
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Cincinnati、Ohio、アメリカ
- University of Cincinnati
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Columbus、Ohio、アメリカ
- The Ohio State University
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- HIV-1 Infection
- HIV-1 RNA <50 copies/mL on all measurements within 48 weeks prior to study entry while on any DHHS recommended or alternative three-drug antiretroviral regimen. (A history of switching for simplification and/or tolerability is allowed. At least two measurements within the previous 48 weeks are required prior to study screening.)
- No history of virologic failure, defined as consecutive HIV RNA > 50 copies/mL after 12 months of initiating ART. An isolated (non-consecutive) HIV RNA > 50 copies/mL (but less than 400 copies/mL) is permitted after 12 months of initiating ART but not in the 48-week window prior to study entry.
- Screening plasma HIV RNA < 20 copies/mL using the COBAS AmpliPrep/COBAS TaqMan HIV-1 Test V2.0, obtained within 45 days prior to study entry
- Nadir CD4 count >200 cells/mm
- Pretreatment genotype documenting no mutations in the protease or reverse transcriptase genes
- No known resistance to integrase inhibitors
- Laboratory values obtained within 45 days prior to study entry:
ANC >750 Hemoglobin >10 g/dL Platelets >50,000 Calculated creatinine clearance (CrCl) >50 mL/min
- Negative serum or urine pregnancy test
- Men and women age greater or equal to 18 years.
- Ability to continue current regimen (i.e, have uninterrupted access)
- No evidence of chronic hepatitis B
Exclusion Criteria:
- Serious illness or AIDS-related complication within 21 days of screening requiring systemic treatment and/or hospitalization
- Treatment within 30 days prior to study entry with immune modulators
- Vaccination within 7 days
- Active HCV treatment or anticipated need for treatment within study period. (HCV infection alone is not exclusionary)
- Unstable liver disease or severe hepatic impairment
- Known allergy or hypersensitivity to DTG or lamivudine.
- Active drug or alcohol use or dependence that could interfere with adherence to study requirements
- ALT (alanine aminotransferase) >5 x ULN (upper limit of normal) OR ALT >3 x ULN and total bilirubin >1.5 x ULN (with 35% direct bilirubin)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:dolutegravir plus lamivudine
dolutegravir 50 mg plus lamivudine 300 mg once daily
|
50 mg tablet by mouth once daily for 48 weeks
他の名前:
300 mg tablet by mouth once daily for 48 weeks
他の名前:
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アクティブコンパレータ:Continue current ART regimen
Continue current DHHS recommended or alternative three-drug antiretroviral regimen
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Continue current DHHS recommended or alternative three-drug antiretroviral regimen
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Proportion of Participants With Treatment Failure
時間枠:24 weeks
|
Proportion of participants with treatment failure (defined as virologic failure (HIV RNA >50 copies/mL), loss to follow-up, or treatment discontinuation) between those who switch to DTG + lamivudine and those who continue their current ART regimen
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24 weeks
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Proportion of Participants With Virologic Success
時間枠:48 weeks
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Proportion of participants with virologic success (<50 copies/mL) based on FDA snapshot definition
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48 weeks
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Change in CD4 Count From Baseline to Week 48
時間枠:Baseline and 48 weeks
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Change in CD4 count between arms will be presented in the attached statistical analysis table
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Baseline and 48 weeks
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Change in Total Cholesterol From Baseline to Week 48
時間枠:Baseline and 48 weeks
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Change in Total Cholesterol between arms will be presented in the attached statistical analysis table
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Baseline and 48 weeks
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Change in LDL Cholesterol From Baseline to Week 48
時間枠:Baseline and Week 48
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Change in Low-density lipoprotein (LDL) cholesterol between arms will be presented in the attached statistical analysis table
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Baseline and Week 48
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Change in Creatinine Clearance From Baseline to Week 48
時間枠:Baseline and Week 48
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Change in Creatinine Clearance between arms will be presented in the attached statistical analysis table
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Baseline and Week 48
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Drug Resistance Associated Mutations
時間枠:48 weeks
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Drug resistance mutations measured by HIV genotyping in patients with confirmed virologic failure
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48 weeks
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Residual Viremia by HIV-1 Single-copy Assay
時間枠:48 weeks
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Difference in HIV-1 detection by the HIV-1 single copy assay between arms will be presented in statistical analysis
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48 weeks
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- ASPIRE
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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