Antiviral Pharmacology and Adherence in Drug Users
2022年3月4日 更新者:University of Colorado, Denver
Approximately one half of all Americans living with Hepatitis C virus (HCV) are drug users, yet they are the least likely to receive HCV treatment.
Drug users are presumed non-adherent and therefore denied potentially life-saving therapy.
This assumption can only be confirmed or dispelled through prospective pharmacologic and adherence studies in this population.
Such studies would be greatly enhanced by an objective, quantitative measure of adherence which does not currently exist in the HCV field.
Through the work proposed in this application, sixty HIV/HCV co-infected drug users will be treated with direct acting antiviral agents (DAA) and randomized to receive directly observed DAA therapy (DOT) vs. no directly observed therapy (no-DOT).
Patients randomized to no-DOT will have wirelessly observed therapy (WOT) which involves use of a portable medication dispenser that sends a signal to a server with the date and time when the dispenser is opened.
In Aim 1, DAA concentrations will be compared in those randomized to DOT vs. no-DOT.
DAA pharmacokinetics will also be defined accounting for clinical factors like degree of hepatic impairment and use of concomitant recreational and antiretroviral drugs.
The goal is to quantify adherence in this population and the effect of variable adherence on drug concentrations.
In Aim 2, DAA concentrations (plasma, cellular, hair) will be linked with adherence patterns identified using WOT and DOT.
The goal is to identify a drug concentration biomarker that predicts adherence in this population.
In Aim 3, the relationship between DAA adherence (as measured by WOT and DOT and drug concentrations) and rate of cure will be established.
The goal is to define the degree of adherence needed for HCV cure.
研究概览
研究类型
介入性
注册 (实际的)
73
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
-
-
Colorado
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Aurora、Colorado、美国、80045
- University of Colorado Anschutz Medical Campus
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参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 70年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Ability to give informed consent
- HIV-infected men and women
- Chronic HCV infection as documented by quantifiable HCV RNA
- HCV genotype 1, 4, 5, 6
- 18-70 years of age
- Willingness and ability to comply with study procedures, including DOT, WOT, and biweekly clinic visits
- Considered an active drug user by HCV provider and self-reported drug use within the past month
Exclusion Criteria:
- Glomerular filtration rate < 30 mL/min/1.73 m2
- Receipt of prior HCV treatment and radiographic, histologic, or clinical evidence of cirrhosis
- Decompensated liver disease (i.e., ascites, history of esophageal variceal bleeding, hepatic encephalopathy)
- Medications not recommended per the SOF/LDV prescribing information (e.g., tipranavir and other P-gp inducers, tenofovir disoproxil fumarate plus cobicistat, rosuvastatin, amiodarone)
- Any medical condition that in the opinion of the investigators will make it challenging to adhere to the study protocol, such as unstable heart disease or cancer
- Chronic Hepatitis B virus Infection
- For females, active pregnancy or any intent to become pregnant
- For both sexes, an unwillingness to use contraception during the study period
- On parole or impending sentencing
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:其他
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
其他:Sofosbuvir/Ledipasvir with Directly Observed Therapy (DOT)
Participants randomized to vDOT will be provided a smart phone with cellular service and will be pre-programmed with the mobile phone-based video application and contact information for study personnel.
|
其他名称:
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其他:Sofosbuvir/Ledipasvir with Wirelessly Observed Therapy (WOT)
Participants on WOT will be provided the Wisepill portable medication dispenser.
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其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
Compare each individual's modeled estimate of ledipasvir and metabolites of sofosbuvir (GS-331007 and GS-331007-TP) steady state concentrations (Css) from non-linear mixed effects modeling to Css in subjects receiving DOT vs. WOT.
大体时间:12 weeks
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12 weeks
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Quantify GS-331007-TP concentrations in dried blood spots as a function of adherence (doses taken/doses prescribed).
大体时间:12 weeks
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12 weeks
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Estimate the probability of HCV cure as a function of adherence using logistic regression.
大体时间:24 weeks
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24 weeks
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2015年11月1日
初级完成 (实际的)
2020年3月1日
研究完成 (实际的)
2021年6月1日
研究注册日期
首次提交
2015年6月3日
首先提交符合 QC 标准的
2015年10月7日
首次发布 (估计)
2015年10月9日
研究记录更新
最后更新发布 (实际的)
2022年3月8日
上次提交的符合 QC 标准的更新
2022年3月4日
最后验证
2022年3月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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