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Kaletra and Viread in Antiretroviral Naïve Patients

2 grudnia 2020 zaktualizowane przez: Johnny Stephens, Oklahoma State University Center for Health Sciences

A Phase IV Open Label Investigation of the Efficacy and Durability of Once Daily Antiretroviral Therapy With Kaletra and Viread in Antiretroviral Naïve Patients.

Once daily antiretroviral therapy with Viread (tenofovir DF, 300mg) plus Kaletra (LPV/r, 800mg/200mg) will be effective in suppressing and maintaining suppression of HIV RNA to <50 copies/ml in antiretroviral naïve patients through 48 weeks of therapy.

Przegląd badań

Status

Zakończony

Interwencja / Leczenie

Szczegółowy opis

This study is a phase IV prospective, open-label, controlled treatment protocol consisting of once daily Kaletra dosed at 800mg lopinavir with 200mg ritonavir in four combination tablets plus Viread dosed as 300 mg tenofovir DF. This will be a single site, multi-investigator, study for 48 weeks. Consecutive eligible patients will be enrolled into the study to reach the enrollment goal of 30 patients. Eligible patients will be identified and screened during routine initial or follow-up visits at the Internal Medicine Specialty Services Clinic. This clinic serves as the HIV/AIDS specialty care clinic and is a subdivision of the Department of Internal Medicine, Oklahoma State University Center for Health Sciences College of Osteopathic Medicine. The study site currently serves >700 persons living with HIV in northeast Oklahoma with four to five antiretroviral naïve patients seen each week.

Patients meeting all inclusion criteria will receive routine standard of care for our program as prescribed by the DHHS guidelines. Patients will have a Complete Blood Count (CBC), Complete Metabolic Profile (CMP), fasting lipid profile, CD4 count, HIV-1 RNA level, and other prescribed or indicated laboratory preformed at baseline and throughout the study as described in the Visits and Evaluations section of this protocol. All of the aforementioned laboratory tests will be performed at the Diagnostic Laboratories of Oklahoma, a division of Quest Diagnostics. Any antiretroviral resistance testing will be performed at Virologic Labs, Inc. Adherence will be assessed at discontinuation of the study and when indicated for evaluation of virologic failure by Memory Electronic Monitoring Systems caps and pharmacy refill data. Patients will be monitored at each study visit for tolerability and adverse events. Patients who develop a study related Grade 1 or 2 Adverse Events (Aes) may continue the study. Those who develop Grade 3 or 4 AEs will have study medications discontinued. Patients with asymptomatic elevations of triglyceride or Low Density Lipoprotein (LDL) cholesterol levels may be treated with appropriate lipid lowering therapy at the investigators discretion.

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

6

Faza

  • Faza 4

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Oklahoma
      • Tulsa, Oklahoma, Stany Zjednoczone, 74127
        • OSU Internal Medicine Specialty Clinic

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat do 70 lat (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  1. Male or female patients >18 years of age with documented HIV-1 infection
  2. Naïve to antiretroviral therapy
  3. Able and willing to provide written informed consent
  4. No CD4 restriction
  5. HIV-1 RNA levels >5000 c/mL
  6. Female patients must meet these additional criteria

    1. Non-childbearing potential
    2. Negative serum pregnancy test at screen
    3. Willingness to abstain from sexual intercourse or use double barrier contraception

Exclusion Criteria:

  1. Presence of any of the following:

    1. Aminotransferases >3xULN
    2. Hemoglobin concentration <8.0g/dl
    3. Absolute neutrophil count <800 cells/cubic mm
    4. Platelet count <50,000 cells/cubic mm
    5. Acute illness, or an acute illness ≤7 days
    6. Presence of Opportunistic Infection, or an OI within 30 days of screening
    7. Acute or chronic active Hepatitis B
    8. Hepatitis C
    9. Creatinine Clearance <50 mL/min
  2. Pregnant or breast-feeding women
  3. Presence of any illness, physical or behavioral conditions (i.e., substance abuse, excluding cannabis) that will impair the patient's ability participate
  4. Patient who, in the opinion of the investigator, will be unlikely to complete the study protocol and adhere to the study drug regimens
  5. Concurrent use of medications that may potentially interact with study medications including: astemizole, terfenadine, rifampin, dihydroergotamine, ergonovine, ergotamine, methylergonovine, cisapride, St. John's wort, lovastatin, simvastatin, pimozide, midazolam, triazolam, adefovir, cidofovir, acyclovir, ganciclovir, and valganciclovir.
  6. Patient suffers from a serious medical condition that may in the opinion of the investigator compromise his or her safety.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Nie dotyczy
  • Model interwencyjny: Zadanie dla jednej grupy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Once daily
Patients taking 4 (four) lopinavir/ritonavir (200mg/50mg tablets) and 1 (one) tenofovir (300mg tablet) every 24 (twenty four) hours.
Four tablets of lopinavir/ritonavir and one tablet of tenofovir given once daily
Inne nazwy:
  • Viread
  • Kaletra

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
To Assess the Efficacy of Once Daily Antiretroviral Therapy With Viread 300mg and Kaletra 800mg/200mg in Suppressing HIV RNA Levels to <50 Copies/ml in Antiretroviral naïve Patients.
Ramy czasowe: 4, 8, 12, 16, 24, 32, 40, and 48 weeks
To assess the efficacy of once daily antiretroviral therapy with Viread 300mg and Kaletra 800mg/200mg in suppressing HIV RNA levels to <50 copies/ml in antiretroviral naïve patients. This will be done by the proportion of patients with plasma HIV-1 RNA levels M 50 copies/ml at the end of 48 weeks of therapy.
4, 8, 12, 16, 24, 32, 40, and 48 weeks

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Proportion of Patients With <400copies/ml
Ramy czasowe: 4,8, and 12 weeks
Proportion of patients with <400copies/ml will be done by determining plasma HIV-1 RNA levels
4,8, and 12 weeks
Review Virologic Response to Assess Rate of Viral Decline.
Ramy czasowe: weeks 4, 8, 12, 16, and 24
Review virologic response to assess rate of viral decline through CD4 count at baseline and throughout the study.
weeks 4, 8, 12, 16, and 24
Proportion of Patients With <50 Copies/ml HIV-1 RNA
Ramy czasowe: at weeks 4, 8, 12, 16, 24, 32, 40, and 48
Proportion of patients with <50 copies/ml HIV-1 RNA through evaluation of patients Plasma HIV-1 RNA levels
at weeks 4, 8, 12, 16, 24, 32, 40, and 48
Change From Baseline CD4 Counts
Ramy czasowe: at weeks 4, 8, 12, 16, 24, 32, 40, and 48
CD4 count done at baseline and throughout the study.
at weeks 4, 8, 12, 16, 24, 32, 40, and 48
Time to Virologic Failure.
Ramy czasowe: Week 48
Virologic failure is defined by any of the following: 1) <1 log10 decline in HIV RNA by week 8 of therapy; 2) failure to achieve <50 c/mL by week 24; 3) HIV RNA> 500 c/ML on two consecutive occasions (less than 30 days apart), with no evidence of suppression after adherence counseling. When HIV RNA levels are obtained >500 copies/mL it will be repeated within 2 weeks. If after adherence counseling, HIV RNA demonstrates > 1 log 10 decline but remains >500, the patient will receive a final adherence counseling session and have his/her HIV RNA measure repeated at day 30: if a third consecutive HIV RNA remains 500 c/mL the patient will be removed from study, if <500c/mL the patient will remain on study
Week 48
Tolerability and Adverse Events.
Ramy czasowe: 48 weeks
Adverse events and safety parameters are monitored for ll subjects for the duration of the study. Toxicities and adverse events will be graded using the modified ACTG toxicity ratings scale. Study drugs may be interrupted for safety reasons and/or based on grade of toxicity/adverse event.
48 weeks
Change From Baseline Fasting Total Cholesterol and Fasting Triglyceride Levels.
Ramy czasowe: 48 weeks
Change from baseline fasting total cholesterol and fasting triglyceride levels will be measured by fasting lipid panels taken at baseline and at various timepoints.
48 weeks
Characterize Adherence Rates for This Therapeutic Regimen by the Use of Medication Electronic Monitoring Systems (MEMS) Caps.
Ramy czasowe: 48 weeks
The medication event monitoring system (MEMS) is a cap that fits on standard medicine bottles and records the time and date each time the bottle is opened and closed.
48 weeks
Characterize Adherence Rates for This Therapeutic Regimen by Use of Pharmacy Refill Records.
Ramy czasowe: 48 weeks
Characterize adherence rates for this therapeutic regimen by use of pharmacy refill records is assessed by an examination of pharmacy refill data for patients.
48 weeks
Assess Genotypic Changes in Patients With Virologic Failure.
Ramy czasowe: 48 weeks
At time of virologic failure genotypes will be performed on baseline and failure isolates; phenotypic testing will be performed on failure isolates to examine LPV susceptibility.
48 weeks
Assess Lopinavir Trough Levels in Patients Failing to Obtain Virologic Suppression.
Ramy czasowe: 48 weeks
Assess lopinavir trough levels in patients failing to obtain virologic suppression by measuring lopinavir trough level
48 weeks

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Współpracownicy

Śledczy

  • Główny śledczy: Damon Baker, D.O., Oklahoma State University Center for Health Sciences

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów

1 maja 2008

Zakończenie podstawowe (Rzeczywisty)

1 maja 2011

Ukończenie studiów (Rzeczywisty)

1 maja 2011

Daty rejestracji na studia

Pierwszy przesłany

15 maja 2008

Pierwszy przesłany, który spełnia kryteria kontroli jakości

16 maja 2008

Pierwszy wysłany (Oszacować)

19 maja 2008

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

4 grudnia 2020

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

2 grudnia 2020

Ostatnia weryfikacja

1 grudnia 2020

Więcej informacji

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

Badania kliniczne na Zakażenia wirusem HIV

Badania kliniczne na Once daily

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