Deze pagina is automatisch vertaald en de nauwkeurigheid van de vertaling kan niet worden gegarandeerd. Raadpleeg de Engelse versie voor een brontekst.

Effectiveness of the Early Addition of Abacavir to an Anti-HIV Drug Combination

8 september 2008 bijgewerkt door: National Institute of Allergy and Infectious Diseases (NIAID)

A Pilot Study of Early Treatment Intensification of Antiretroviral Therapy

The purpose of this study is to see if adding 1 drug to an anti-HIV drug combination early in treatment against HIV can lower the viral load (amount of HIV in the blood) to a level so low that it cannot be measured (undetectable). The drug that will be added to a treatment is abacavir (ABC).

Many patients who take 3 anti-HIV drugs together are able to achieve very low viral loads, for example, viral loads below 50 copies/ml. However, some patients taking only 3 drugs are not able to achieve a viral load this low. Doctors hope that, by adding the drug ABC to a current treatment, a viral load below 50 copies/ml can be achieved. Doctors would like to find out if it is effective to start patients on 3 drugs and then add another drug (treatment intensification) if the treatment is not working as well as hoped.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Combination antiretroviral therapy can offer patients potent suppression of HIV replication and improved immunologic functioning. However, despite aggressive antiretroviral regimens currently in use, only about 50 to 60 percent of patients attain plasma viral loads below 50 copies/ml after 24 weeks. Initiating treatment with a 4-drug regimen may increase this percentage, but this may also contribute to patient non-adherence, drug-related toxicities, potential cross-resistance to drugs used in future regimens, and high financial costs. Another strategy is early intensification (adding a single drug to an existing regimen) in patients who are at risk for attaining incomplete viral suppression after 24 weeks of therapy. ABC may produce a significant antiviral effect when used as an intensification agent in patients on a stable antiretroviral regimen. The results of this study will offer insight into the potential benefits of early treatment intensification.

Patients entering this study will have initiated potent antiretroviral therapy. Between 60 and 90 days [AS PER AMENDMENT 1/9/01: 60 and 104 days] after beginning their background regimen, patients are randomized to add either ABC (Arm A) or a matching placebo (Arm B) for 12 weeks. Patients completing 12 weeks of treatment continue on study for an additional 24 weeks to Week 36. Patients discontinue treatment if virologic failure occurs at any time. Patients still return to the clinic for HIV-1 RNA measurements at Weeks 12 and 36, depending on when discontinuation occurred. Patients who discontinue treatment at or after Week 12 due to virologic failure are offered open-label ABC for the remainder of the study (through Week 36). Blood samples are collected at Weeks 4, 8, 12, 20, 28, and 36. Plasma samples for population sequencing of HIV-1 PR and RT genes are collected on all patients at study entry and at the time of virologic failure. Baseline genotype (presence or absence of PR and RT resistance mutations and number of resistance mutations) is correlated to treatment outcome. Samples from the time of failure are analyzed for the accumulation of additional resistance mutations. [AS PER AMENDMENT 5/5/00: Patients and their primary care physicians will be unblinded to the patient's treatment after the study is completed at Week 36 or if virologic failure occurs at or after Week 12 [AS PER AMENDMENT 1/9/01: or if ABC hypersensitivity is suspected].]

Studietype

Ingrijpend

Inschrijving

80

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Puerto Rico
      • San Juan, Puerto Rico, 009365067
        • Univ of Puerto Rico
  • Verenigde Staten
    • California
      • Los Angeles, California, Verenigde Staten, 90095
        • UCLA CARE Ctr
      • Menlo Park, California, Verenigde Staten, 94025
        • Willow Clinic
      • San Jose, California, Verenigde Staten, 951282699
        • Santa Clara Valley Med Ctr / AIDS Community Rsch Consortium
      • Stanford, California, Verenigde Staten, 943055107
        • San Mateo AIDS Program / Stanford Univ
      • Stanford, California, Verenigde Staten, 943055107
        • Stanford Univ Med Ctr
      • Torrance, California, Verenigde Staten, 90502
        • Harbor UCLA Med Ctr
    • Colorado
      • Denver, Colorado, Verenigde Staten, 80262
        • Univ of Colorado Health Sciences Ctr
    • Florida
      • Miami, Florida, Verenigde Staten, 331361013
        • Univ of Miami School of Medicine
    • Georgia
      • Atlanta, Georgia, Verenigde Staten, 30308
        • Emory Univ
    • Illinois
      • Chicago, Illinois, Verenigde Staten, 60611
        • Northwestern Univ Med School
      • Chicago, Illinois, Verenigde Staten, 60612
        • Cook County Hosp
    • Maryland
      • Baltimore, Maryland, Verenigde Staten, 21287
        • Johns Hopkins Hosp
      • Baltimore, Maryland, Verenigde Staten, 212052196
        • State of MD Div of Corrections / Johns Hopkins Univ Hosp
    • Missouri
      • St Louis, Missouri, Verenigde Staten, 63112
        • St Louis Regional Hosp / St Louis Regional Med Ctr
    • New York
      • Buffalo, New York, Verenigde Staten, 14215
        • SUNY / Erie County Med Ctr at Buffalo
      • New York, New York, Verenigde Staten, 10003
        • Beth Israel Med Ctr
      • New York, New York, Verenigde Staten, 10016
        • Bellevue Hosp / New York Univ Med Ctr
      • New York, New York, Verenigde Staten, 10032
        • Columbia Presbyterian Med Ctr
      • New York, New York, Verenigde Staten, 10021
        • Aaron Diamond AIDS Rsch Ctr / Rockefeller Univ
      • Rochester, New York, Verenigde Staten, 14642
        • Univ of Rochester Medical Center
    • North Carolina
      • Chapel Hill, North Carolina, Verenigde Staten, 275997215
        • Univ of North Carolina
      • Durham, North Carolina, Verenigde Staten, 27710
        • Duke Univ Med Ctr
    • Ohio
      • Cincinnati, Ohio, Verenigde Staten, 452670405
        • Univ of Cincinnati
    • Pennsylvania
      • Philadelphia, Pennsylvania, Verenigde Staten, 19104
        • Univ of Pennsylvania at Philadelphia
      • Philadelphia, Pennsylvania, Verenigde Staten, 19104
        • Philadelphia Veterans Administration Med Ctr
    • South Carolina
      • West Columbia, South Carolina, Verenigde Staten, 29169
        • Julio Arroyo
    • Tennessee
      • Nashville, Tennessee, Verenigde Staten, 37203
        • Vanderbilt Univ Med Ctr
    • Texas
      • Dallas, Texas, Verenigde Staten, 75390
        • Univ of Texas, Southwestern Med Ctr of Dallas
    • Washington
      • Seattle, Washington, Verenigde Staten, 98104
        • Univ of Washington

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

13 jaar en ouder (Kind, Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria

Patients may be eligible for this study if they:

  • Are HIV-positive.
  • Have been taking anti-HIV therapy that includes at least 3 anti-HIV drugs and is an acceptable anti-HIV drug combination for 60 to 104 days before study treatment. Patients must not have changed any of the drugs in the 28 days before study entry. (This study has been changed by extending the number of days that anti-HIV therapy has been received.)
  • Have a viral load greater than 500 but less than or equal to 10,000 copies/ml and have had a significant decrease in viral load between 49 and 84 days after starting this anti-HIV therapy. (This study has been changed by extending the length of time of viral load decrease.)
  • Are at least 13 years old (consent of parent or guardian required if under 18).
  • Agree to practice abstinence or use barrier method of birth control (such as condoms) during the study and for 3 months after.

Exclusion Criteria

Patients will not be eligible for this study if they:

  • Have ever taken ABC.
  • Have received anti-HIV therapy for more than 104 days in the past. (This study has been changed by extending the number of days that anti-HIV therapy has been received.)
  • Have a fever for 7 days in the 30 days before study entry.
  • Have cancer, including Kaposi's sarcoma, that requires chemotherapy.
  • Have an active infection that requires treatment in the 21 days before study entry.
  • Have any opportunistic (AIDS-related) infection or disease that requires a change in medication in the 14 days before study entry.
  • Have any medical condition or history of an illness that the doctor feels would place them at risk or make them unable to complete the study.
  • Are taking drugs that affect the immune system or any experimental anti-HIV drugs, except for their current drug combination.
  • Are taking St. John's wort. (This study has been changed. Previously, patients taking St. John's wort were eligible.)
  • Have received a vaccine in the 21 days before study entry.
  • Are pregnant or breast-feeding.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Masker: Dubbele

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)

Onderzoekers

  • Studie stoel: Pablo Tebas
  • Studie stoel: John Bartlett

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 november 1999

Studie voltooiing

1 april 2001

Studieregistratiedata

Eerst ingediend

17 januari 2000

Eerst ingediend dat voldeed aan de QC-criteria

30 augustus 2001

Eerst geplaatst (Schatting)

31 augustus 2001

Updates van studierecords

Laatste update geplaatst (Schatting)

9 september 2008

Laatste update ingediend die voldeed aan QC-criteria

8 september 2008

Laatst geverifieerd

1 juni 2003

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • ACTG A5064
  • AACTG A5064

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Abonneren