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A Clinical Study of Ixazomib to Reactivate HIV and Reduce HIV Reservoir Size

2026年11月10日 更新者：National Institute of Allergy and Infectious Diseases (NIAID)

A Phase 2, Double-Blinded, Randomized, Placebo-Controlled Trial of Ixazomib to Reactivate HIV and Reduce HIV Reservoir Size

This study tests whether a medicine called ixazomib is safe for people living with HIV, and whether it can wake up HIV that is hiding in the body so the immune system and treatment can reach it.

HIV can stay hidden inside cells even when antiretroviral therapy (ART) keeps the virus under control. These hidden cells are called the HIV reservoir, and they are the reason HIV is not cured by ART alone. Laboratory research suggests ixazomib may reactivate hidden HIV and also help kill the cells that carry it. Ixazomib is already approved to treat a cancer called multiple myeloma and has been given to a smaller group of people with HIV in an earlier study.

About 45 adults with HIV that is well controlled on ART will take part. Participants are assigned by chance to take either ixazomib or a placebo - a capsule with no active medicine - one capsule by mouth once a week for a total of 25 doses. Two out of every three participants receive ixazomib and one out of three receives placebo. Neither participants nor the study staff know which one a participant is taking.

Everyone continues their own HIV treatment throughout the study.

Participation lasts about 7 months: 24 weeks of weekly capsules and 4 more weeks of follow-up after the last dose. Participants come to the clinic for about 14 visits, and take their capsule 24 to 36 hours before each visit so blood samples can show the effect of the dose.

The main purposes of the study are to evaluate whether ixazomib is safe and tolerable, and to measure whether it increases the very small amounts of HIV in the blood compared with placebo. The study also measures the size of the HIV reservoir and how the immune system responds.

研究概览

地位

尚未招聘

条件

干预/治疗

详细说明

A5420 is a phase 2, double-blinded, randomized, placebo-controlled trial of ixazomib in adults with HIV-1 who are virologically suppressed on antiretroviral therapy. Forty-five participants will be randomized 2:1 to ixazomib 4 mg or matching placebo, taken orally once weekly for a total of 25 doses over 24 weeks, while continuing their own suppressive ART. Randomization is stratified by sex (male/female) using permuted blocks to balance enrollment across arms. Participants are evaluated at screening, entry (week 0), and weeks 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24, with a post-treatment evaluation at week 28 following a 4-week washout, for approximately 14 visits over roughly 7 months.

Study treatment is administered as a single 4 mg capsule taken with water on an empty stomach, at least 1 hour before or 2 hours after food, on the same day and at approximately the same time each week. Capsules are not broken, chewed, or opened. Doses preceding a clinic visit are taken 24 to 36 hours before that visit so that plasma and cell-associated virologic measurements capture the post-dose interval.

研究类型

介入性

注册 (估计的)

45

阶段

  • 阶段2

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

  • 美国
    • Alabama
      • Birmingham、Alabama、美国、35222
        • Alabama CRS (Site #31788)
        • 接触：
    • California
      • Los Angeles、California、美国、90035
        • University of California, Los Angeles CARE Center CRS (Site #601)
        • 接触：
      • San Diego、California、美国、92103
        • UCSD Antiviral Research Center CRS (Site #701)
        • 接触：
      • San Francisco、California、美国、94110
        • University of California, San Francisco HIV/AIDS CRS (Site #801)
        • 接触：
    • Colorado
      • Aurora、Colorado、美国、80045
    • District of Columbia
      • Washington D.C.、District of Columbia、美国、20009
        • Whitman-Walker Institute, Inc. CRS (Site #31791)
        • 接触：
    • Georgia
      • Atlanta、Georgia、美国、30308-2012
        • The Ponce de Leon Center CRS (Site #5802)
        • 接触：
    • Illinois
      • Chicago、Illinois、美国、60611
    • Massachusetts
      • Boston、Massachusetts、美国、02114
        • Massachusetts General Hospital CRS (MGH CRS) (Site #101)
        • 接触：
    • New York
      • New York、New York、美国、10032
        • Columbia Physicians & Surgeons (P&S) CRS (Site #30329)
        • 接触：
      • Rochester、New York、美国、14642
        • University of Rochester Adult HIV Therapeutic Strategies Network CRS (Site #31787)
        • 接触：
    • North Carolina
      • Chapel Hill、North Carolina、美国、27599-7215
        • Chapel Hill CRS (Site #3201)
        • 接触：
    • Ohio
      • Cincinnati、Ohio、美国、45267-0405
        • Cincinnati Clinical Research Site (Site #2401)
        • 接触：
      • Cleveland、Ohio、美国、44106
        • Case Clinical Research Site (Site #2501)
        • 接触：
          • George Yendewa
          • 电话号码：216-844-2298
          • 邮箱：gay7@case.edu
      • Columbus、Ohio、美国、43210-1282
        • Ohio State University CRS (Site #2301)
        • 接触：
    • Pennsylvania
      • Philadelphia、Pennsylvania、美国、19104
      • Pittsburgh、Pennsylvania、美国、15213
        • University of Pittsburgh CRS (Site #1001)
        • 接触：
    • Tennessee
      • Nashville、Tennessee、美国、37204
        • Vanderbilt Therapeutics (VT) CRS (Site #3652)
        • 接触：
    • Texas
      • Houston、Texas、美国、77030
    • Washington
      • Seattle、Washington、美国、98104
        • University of Washington Positive Research CRS (Site #1401)
        • 接触：
          • Rachel Bender Ignacio
          • 电话号码：206-744-4876
          • 邮箱：rbi13@uw.edu

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:

  1. Documented HIV-1 infection.
  2. Plasma HIV-1 RNA of 50 copies/mL or lower, for at least 48 weeks prior to study entry while on antiretroviral therapy. One blip above 50 but below 200 copies/mL in the preceding 48 weeks is permitted provided at least two other measurements in that period were 50 copies/mL or lower.
  3. Plasma HIV-1 RNA below the lower limit of quantification within 30 days prior to study entry.
  4. Receiving antiretroviral therapy for less than 10 years.
  5. On antiretroviral therapy for at least 48 weeks prior to study entry, with no interruption of more than 7 consecutive days in the 90 days prior to entry, and no change in regimen within 90 days prior to entry.
  6. CD4+ T cell count of at least 500 cells/mm^3 within 30 days prior to study entry.
  7. Laboratory values within 30 days prior to study entry: absolute neutrophil count at least 1,000/mm^3; hemoglobin at least 10 g/dL (female participants) or at least 11 g/dL (male participants); platelet count at least 75,000/mm^3; estimated glomerular filtration rate at least 30 mL/min/1.73m^2; bilirubin no more than 1.5 times the upper limit of normal, or no more than 3 times the upper limit of normal if the isolated elevation is attributable to a participant medication or Gilbert syndrome, or direct bilirubin within the normal range.
  8. For participants who can become pregnant, a negative serum or urine pregnancy test within 24 hours prior to study entry.
  9. For participants who can become pregnant, agreement to use two methods of contraception from 10 days prior to study entry through 90 days after the last dose of study treatment. Egg donation is prohibited over the same period.
  10. For participants whose sexual activity could result in a partner becoming pregnant, agreement to use condoms from 10 days prior to study entry through 90 days after the last dose of study treatment. Sperm donation is prohibited over the same period.
  11. Negative hepatitis B surface antigen within 30 days prior to study entry.
  12. Negative hepatitis C antibody, or if positive, a negative HCV RNA PCR, within 30 days prior to study entry.

Exclusion Criteria:

  1. Untreated, active AIDS-defining illness.
  2. Receiving an HIV protease inhibitor or efavirenz as part of the antiretroviral regimen.
  3. Current pregnancy or breastfeeding.
  4. Receipt of an investigational HIV vaccine or HIV-specific monoclonal antibody, or participation in a trial of any investigational product, within 180 days prior to study entry, or expected participation in such a study during this study.
  5. Any current clinically significant acute or chronic medical condition other than HIV infection that in the investigator's opinion would preclude participation.
  6. Any history of peripheral neuropathy, or peripheral neuropathy detected during screening.
  7. History of an HIV-associated malignancy, including Kaposi sarcoma or lymphoma of any type, treated with systemic chemotherapy or immunotherapy.
  8. Active or recent non-HIV-associated malignancy requiring systemic chemotherapy or surgery within 36 months prior to study entry, or for whom such therapy is expected within the following 12 months. Surgical removal of minor localized skin cancers is not exclusionary.
  9. Use of prohibited medications within 30 days prior to study entry or planned use during study participation.
  10. Known allergy, sensitivity, or hypersensitivity to ixazomib or its formulation.
  11. Active drug or alcohol use or dependence that, in the investigator's opinion, would interfere with adherence to study requirements.
  12. Acute or serious illness requiring systemic treatment or hospitalization within 30 days prior to study entry.
  13. Anticipated change in antiretroviral regimen during the 24 weeks following study entry.
  14. Current uncontrolled cardiovascular symptoms, including uncontrolled hypertension (systolic blood pressure above 140 mmHg or diastolic blood pressure above 90 mmHg), uncontrolled cardiac arrhythmia, symptomatic congestive heart failure, unstable angina, or myocardial infarction within 24 weeks prior to study entry.
  15. Any serious medical or psychiatric illness that in the investigator's opinion could interfere with completion of protocol treatment.
  16. Known gastrointestinal disease or procedure that could interfere with oral absorption or tolerance of ixazomib, including difficulty swallowing.
  17. Previous treatment with ixazomib.
  18. Known resistance to two or more classes of antiretrovirals.

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：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：四人间

武器和干预

参与者组/臂
干预/治疗
实验性的：Ixazomib

Ixazomib 4 mg orally once weekly for a total of 25 doses over 24 weeks.
药品：Ixazomib 4 mg

One Ixazomib 4 mg capsule should be taken by mouth with a full glass of water on an empty stomach at least 1 hour before or 2 hours after food once a week on the same day and approximately the same time each week

其他名称：
  • 宁拉罗
  • MLN9708
安慰剂比较：Placebo

Placebo for Ixazomib orally once weekly for a total of 25 doses over 24 weeks.
药品：Placebo

One Placebo for Ixazomib capsule should be taken by mouth with a full glass of water on an empty stomach at least 1 hour before or 2 hours after food once a week on the same day and approximately the same time each week

研究衡量的是什么？

主要结果指标

结果测量
大体时间
Proportion of Ixazomib-Treated Participants With at Least One Grade 3 or Higher Adverse Event Related to Study Treatment.
大体时间：Entry (Week 0) to Week 28
Entry (Week 0) to Week 28
Frequency of Ixazomib-Treated Participants Who Prematurely Discontinue Study Treatment for Reasons That Are Deemed Related to Study Treatment.
大体时间：Entry (Week 0) to Week 24
Entry (Week 0) to Week 24
Post-Dose Plasma HIV-1 RNA Levels Measured by Multireplicate Single-Copy Assay (SCA)
大体时间：Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24

次要结果测量

结果测量
大体时间
Intact Proviral DNA Levels Measured by the Intact Proviral DNA Assay (IPDA)
大体时间：Screening, Entry (Week 0), and Weeks 4, 24, and 28
Screening, Entry (Week 0), and Weeks 4, 24, and 28
Plasma HIV-1 RNA Levels Measured by Multireplicate Single-Copy Assay (SCA)
大体时间：Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
Cell-Associated HIV RNA Levels
大体时间：Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24
Cell-Associated HIV RNA/DNA Ratio
大体时间：Screening, Entry (Week 0), and Weeks 4, 24, and 28
Screening, Entry (Week 0), and Weeks 4, 24, and 28

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。

赞助

National Institute of Allergy and Infectious Diseases (NIAID)

合作者

Takeda

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 (估计的)

2026年11月23日

初级完成 (估计的)

2027年10月8日

研究完成 (估计的)

2027年11月5日

研究注册日期

首次提交

2026年10月13日

首先提交符合 QC 标准的

2026年10月13日

首次发布 (实际的)

2026年10月19日

研究记录更新

最后更新发布 (实际的)

2026年11月12日

上次提交的符合 QC 标准的更新

2026年11月10日

最后验证

2026年11月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • A5420
  • 39030 (其他标识符：DAIDS Document ID)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

是的

IPD 计划说明

Individual participant data that underlie results in the publication, after deidentification.

IPD 共享时间框架

Beginning 3 months following publication and available throughout period of funding of the Advancing Clinical Therapeutics Globally (ACTG) by NIH

IPD 共享访问标准

With whom? Researchers who provide a methodologically sound proposal for use of the data that is approved by the ACTG.

For what types of analyses? To achieve aims in the proposal approved by the ACTG.

By what mechanism will data be made available? Researchers may submit a request for access to data using the ACTG "Data Request" form at: https://actgnetwork.org/submit-a-proposal/. Researchers of approved proposals will need to sign an ACTG Data Use Agreement before receiving the data.

IPD 共享支持信息类型

  • 研究方案
  • 树液

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

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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