Safety of Maraviroc in HIV-1 Infected Subjects Coinfected with Hepatitis B and/or Hepatitis C virus

• Conditions: HIV infection; MedDRA version: 17.0Level: LLTClassification code 10020192Term: HIV-1System Organ Class: 100000004862; Therapeutic area: Diseases [C] - Virus Diseases [C02]

• Registration Number: EUCTR2010-021994-35-HU
• Lead Sponsor: ViiV Healthcare UK Limited

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2011-05-02
• Last Update Posted: 10 July 2015

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

1. Men or women at least 18 years of age available for a follow-up period of at least 148 weeks;
2. Undetectable HIV-1 RNA for at least 3 months prior to the screening visit;
3. Treatment with current antiretroviral therapy (3-6 drugs excluding low-dose ritonavir) for at least 5 months;
4. Detectable HCV RNA and/or Hepatitis B surface antigen (HBsAg) positive;
5. Willing to initiate and remain on randomized treatment without any changes or additions to the background treatment, except for toxicity management or upon virologic failure;
6. HBV co-infected subjects must be taking a HAART regimen active against HBV or HBV-specific antivirals, and they must not stop any drug with anti-HBV activity
while participating in this study, due to the risk of developing life-threatening hepatic flares;
7. A negative pregnancy test for women who are of childbearing potential (WOCBP) and the results must be available and documented in the source documents prior tostudy entry at the baseline visit.
NOTE: WOCBP includes any female who has experienced menarche and who has not undergone hysterectomy, bilateral oopherectomy or tubal ligation, or is not
post-menopausal (aged >45 yrs, amenorheic for >2yrs, and serum FSH levels >30 IU/L). Even women who are using mechanical products (intrauterine devices, barrier methods) to prevent pregnancy, who are practicing abstinence, or who have a partner that is sterile (eg, vasectomy) should be considered of CBP.
8. WOCBP, males and their partners must use 2 forms of contraception one of which is effective barrier contraception throughout the study and for at least 28 days following the last dose of study medication. WOCBP must use another acceptable method of contraception from screening to at least 28 days after the trial. Acceptable contraception includes the following:
? Oral, transdermal, implantable, or injectable hormone therapy;
? Effective intrauterine devices;
? Vasectomized partner;
? Double barrier contraceptive methods;
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 115
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 5

Exclusion Criteria

1. Currently receiving maraviroc;
2. Suspected or documented active, untreated HIV-1 related opportunistic infections (OI) or other condition requiring acute therapy at the time of randomization. Subjects on a stable secondary OI prophylaxis regimen (>1 month) are eligible for the study, and subjects on a primary OI prophylaxis regimen of any duration are also eligible for the study;
NOTE: Trimethoprim-sulfamethoxazole may not be initiated within 30 days prior to screening but may be continued if subject is on stable therapy. The use of isoniazid is prohibited.
3. Treatment for an active opportunistic infection, or unexplained temperature >38.5°C for 7 consecutive days within 30 days prior to screening;
4. Prior treatment with maraviroc or another CCR5 antagonist for more than 14 days at any time;
5. Active alcohol consumption of not less than 30g ethanol per day in males and not less than 20g ethanol per day in females;
6. Substance abuse sufficient in the Investigator’s judgment to prevent adherence to study medication and/or follow up. Subjects receiving methadone or buprenorphine replacement therapy is allowed in the study;
7. Lactating women, or planned pregnancy during the trial period;
8. Malignancy requiring parenteral or oral chemotherapy that must be continued for the duration of the trial;
9. Subjects receiving treatment for HCV infection or who anticipate the need to initiate HCV treatment after randomization. Subjects who were previously treated for HCV and are still HCV-positive are eligible for the study;
10. Documented or suspected acute hepatitis or pancreatitis within 30 days prior to screening;
11. Renal insufficiency defined as a creatinine clearance of =80 mL/min (as calculated by the Cockcroft and Gault equation) (Appendix 2);
12. Any of the following laboratory abnormalities:
? ALT and/or AST levels >5 times the ULN (ACTG Grade 3);
? Direct bilirubin >1.5 times the ULN;
? Prothrombin time prolonged >6 sec;
? Serum albumin <2.8 g/dL;
? Absolute neutrophil count =750 cells/mm3;
? Platelet count =50,000 cells/mm3;
? Hemoglobin =7 g/dL.
13. History of bleeding esophageal varices, ascites, encephalopathy, persistent jaundice or decompensated cirrhosis;
14. Child-Pugh Class C category (score >9) (Appendix 3);
15. Evidence of other known underlying liver disease including autoimmune hepatitis, metabolic liver disease, known biliary abnormalities (exception – Gilbert’s syndrome or asymptomatic gallstones), hemochromatosis, genetic liver disease, or drug-induced liver disease;
16. Clinically significant malabsorption syndrome (eg, not less than 6 loose stools per day for at least 7 consecutive days) within 30 days prior to screening;
17. Inability to tolerate oral medication;
18. Concomitant therapy with other investigational agents;
19. The following medications being taken by the subject at the time of randomization that must be continued during the study period, including immunomodulators (for the treatment of HIV-1 infection), isoniazid, rifampin, rifapentine, rifabutin, St. John’s Wort and/or drugs that are contraindicated with any of the antiretroviral agents in the regimen;
20. Known hypersensitivity or contraindication to any components of maraviroc, including soy lecithin, or peanuts;
21. Participation in other studies within 30 days before the current study begins and/or during study participation
22. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the r

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Secondary Objective: A number of secondary objectives through Week 144 include an assessment of the potential antifibrotic activity of maraviroc, and liver histology, as well as, virologic response, immunologic response, safety and tolerability, pharmacokinetics, and changes in HCV RNA and HBV DNA.;Primary end point(s): Percentage of subjects with Grade 3 and Grade 4 ALT abnormalities defined as >5x upper limit of normal (ULN) for subjects whose baseline ALT =ULN, or >3.5x baseline for subjects whose baseline ALT >ULN, at Week 48 in the maraviroc arm versus the placebo arm.;Timepoint(s) of evaluation of this end point: Week 48;Main Objective: To describe the incidence of Grade 3 and Grade 4 alanine aminotransferase (ALT) abnormalities defined as >5x upper limit of normal (ULN) for subjects whose baseline ALT =ULN, or >3.5x baseline for subjects whose baseline ALT >ULN, at Week 48 in the maraviroc versus the placebo arm.