- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 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
연구 개요
상세 설명
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.
연구 유형
등록 (실제)
단계
- 2 단계
연락처 및 위치
연구 장소
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Gauteng
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Johannesburg, Gauteng, 남아프리카
- Wits HIV CRS
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California
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Los Angeles, California, 미국, 90033-1079
- USC CRS
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Sacramento, California, 미국
- Univ. of California Davis Med. Ctr., ACTU
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San Diego, California, 미국, 92103
- Ucsd, Avrc Crs
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Colorado
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Aurora, Colorado, 미국, 80262
- University of Colorado Hospital CRS
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Florida
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Miami, Florida, 미국, 33136
- Univ. of Miami AIDS CRS
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Hawaii
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Honolulu, Hawaii, 미국, 96816-2396
- Univ. of Hawaii at Manoa, Leahi Hosp.
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Indiana
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Indianapolis, Indiana, 미국, 46202-5250
- Indiana Univ. School of Medicine, Infectious Disease Research Clinic
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Maryland
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Baltimore, Maryland, 미국, 21287
- Johns Hopkins Adult AIDS CRS
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Baltimore, Maryland, 미국, 21201
- IHV Baltimore Treatment CRS
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Massachusetts
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Fall River, Massachusetts, 미국
- SSTAR, Family Healthcare Ctr.
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Minnesota
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Minneapolis, Minnesota, 미국, 55455-0392
- University of Minnesota, ACTU
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New York
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New York, New York, 미국, 10003
- Beth Israel Med. Ctr., ACTU
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New York, New York, 미국, 10016
- NY Univ. HIV/AIDS CRS
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Rochester, New York, 미국, 14215
- Univ. of Rochester ACTG CRS
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Rochester, New York, 미국, 14642-0001
- AIDS Care CRS
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Rochester, New York, 미국, 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, 미국, 27514
- Unc Aids Crs
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Greensboro, North Carolina, 미국, 27401-1004
- Regional Center for Infectious Disease, Wendover Medical Center CRS
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Raleigh, North Carolina, 미국
- Wake County Health and Human Services CRS
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Ohio
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Cincinnati, Ohio, 미국, 45267-0405
- Univ. of Cincinnati CRS
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Cleveland, Ohio, 미국, 44109-1998
- MetroHealth CRS
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Columbus, Ohio, 미국
- The Ohio State Univ. AIDS CRS
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Pennsylvania
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Philadelphia, Pennsylvania, 미국, 19104
- Hosp. of the Univ. of Pennsylvania CRS
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Pittsburgh, Pennsylvania, 미국, 15213-2582
- Pitt CRS
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Rhode Island
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Providence, Rhode Island, 미국, 02906
- The Miriam Hosp. ACTG CRS
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Tennessee
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Nashville, Tennessee, 미국, 37203
- Vanderbilt Therapeutics CRS
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Washington
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Seattle, Washington, 미국, 98104
- University of Washington AIDS CRS
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San Juan, 푸에르토 리코, 00936-5067
- Puerto Rico-AIDS CRS
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
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
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
공동 작업자 및 조사자
수사관
- 연구 의자: Donna Mildvan, MD, Beth Israel Medical Center
- 연구 의자: Charles Flexner, MD, Johns Hopkins University Hospital
간행물 및 유용한 링크
일반 간행물
- 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.
연구 기록 날짜
연구 주요 날짜
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- A5073
- 10073 (레지스트리 식별자: DAIDS ES)
- ACTG A5073
- AACTG A5073
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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