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Exploratory Study of Tipranavir and Ritonavir in Multiple Protease Inhibitor-experienced HIV Patients

Phase 2
Completed
Conditions
HIV Infections
Interventions
Drug: Nucleoside Reverse Transcriptase Inhibitor (NRTI)
Drug: Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)
Registration Number
NCT02238314
Lead Sponsor
Boehringer Ingelheim
Brief Summary

The primary objective was to evaluate the antiviral activity and safety of two regimens of tipranavir (500 mg BID or 1000 mg BID) plus ritonavir (100 mg BID) administered in combination with 1 new nucleoside reverse transcriptase inhibitor (NRTI) + efavirenz in multiple protease-inhibitor-experienced HIV-1 positive patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
41
Inclusion Criteria
  • Multiple (two or more) PI-experience. Eligible patients must have had exposure to at least two antiretroviral regimens containing a single protease inhibitor or a regimen containing dual protease inhibitors
  • In the investigator's opinion, the patient had adhered to PI-containing regimens
  • Exposure of ≥ 3 months to the current PI therapy
  • Exposure of ≥ 4 months to the prior PI therapy with single PI-containing regimens
  • Stable PI-containing regimen for at least 2 months prior to study entry
  • HIV-1-RNA ≥ 5,000 copies/mL
  • Cluster of differentiation (CD)4+ cell count ≥ 50 cells/mm**3
  • At least one new NRTI option available
  • Age ≥ 13 years
  • Acceptable screening laboratory values that indicated adequate baseline organ function at the time of screening. Laboratory values were considered acceptable if the severity was ≤ Grade 1 (AIDS Clinical Trial Group (ACTG) Grading Scale). Stable Grade 2 abnormalities were permitted if the values had been demonstrated and documented for at least ≥ 2 months.
  • Acceptable medical history, physical examination, electrocardiogram, and chest X-ray prior to entry into the treatment phase of the study
  • Agreement to use a barrier contraceptive method of birth control for at least 30 days prior to study drug administration, during the study, and 30 days after the end of the study
  • Ability to swallow numerous tablets and capsules without difficulty
  • Ability to understand and provide informed consent. Minors were required to have approval of a parent or legal guardian
Exclusion Criteria
  • Prior exposure, defined as > 7 treatment days, to nonnucleoside reverse transcriptase inhibitor (NNRTIs) including, but not limited to: nevirapine, efavirenz, delavirdine, atevirdine, MKC-442, loviride, and HBY-097
  • Clinically significant active or acute (onset within the month previous to study entry) medical problems, including the following: opportunistic infections, such as active cryptococcosis, Pneumocystis carinii pneumonia, herpes zoster, histoplasmosis, or cytomegalovirus or nonopportunistic diseases, including, but not limited to, progressive multifocal leukoencephalopathy, lymphoma, or malignancy requiring systemic therapy
  • Prior exposure (> 7 days) to tipranavir
  • History of clinically significant nervous system or muscle diseases, seizure disorder, or psychiatric disorder that might impair adherence to the protocol
  • Taking of any known P450 3A enzyme-inducing drugs within 30 days of study entry and including the following: rifabutin, rifampin, carbamazepine, dexamethasone, phenobarbital, phenytoin, sulfadimidine, sulfinpyrazone, or troleandomycin
  • Hypersensitivity to tipranavir and/or ritonavir
  • Use of interferons, interleukins, HIV vaccines, or any active immunizations within 30 days prior to study entry
  • Taking of any investigational medication with the exception of adefovir dipivoxil (Preveon™) and amprenavir (Agenerase™) within 30 days of study entry
  • Pregnancy or lactation (serum β-human chorionic gonadotrophin test had to have been negative within 14 days of study entry)
  • Evidence of active substance abuse, which in the investigator's opinion, could affect compliance to the protocol
  • In the investigator's judgment, inability to comply with the protocol requirements for reasons other than those specified

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tipranavir low doseNon-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-
Tipranavir low doseTipranavir low dose-
Tipranavir high doseNucleoside Reverse Transcriptase Inhibitor (NRTI)-
Tipranavir low doseNucleoside Reverse Transcriptase Inhibitor (NRTI)-
Tipranavir high doseTipranavir high dose-
Tipranavir high doseNon-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-
Tipranavir low doseRitonavir-
Tipranavir high doseRitonavir-
Primary Outcome Measures
NameTimeMethod
Change from baseline in HIV-1 RNA concentrationsweeks 16, 24, 48 and 80
Occurrence of HIV-1 RNA levels below the limit of quantitation (BLQ) (400 copies/mL)up to 112 weeks

measured by the Roche Amplicor HIV-1 Monitor™ polymerase chain reaction (PCR) Method

Occurrence of HIV-1 RNA levels BLQ (50 copies/mL)up to 112 weeks

measured by the Roche Amplicor UltraSensitive™ PCR Method

Number of patients with treatment-emergent and drug-related adverse events (AEs)up to 115 weeks
Number of patients with serious adverse events (SAEs)up to 115 weeks
Number of patients with grade 3 and 4 laboratory abnormalitiesup to 115 weeks
Secondary Outcome Measures
NameTimeMethod
Change from baseline in cluster of differentiation (CD) 4+ cell count responsesweeks 24, 48 and 80
Change from baseline in CD8+ cell count responsesweeks 24, 48 and 80
Time to new or recurring AIDS-defining illnessup to 115 weeks
Time to new or recurring HIV-related illnessup to 115 weeks
Time to deathup to 115 weeks
Occurrence of AIDS-defining illness,up to 115 weeks
Occurrence of HIV-related illness,up to 115 weeks
Occurrence of deathup to 115 weeks
Time to virologic failureup to 115 weeks

defined as plasma HIV-1 RNA values \>400 copies/mL or a 0.5 log reduction from baseline at two consecutive time points

Change from baseline in cholesterolup to 115 weeks
Change from baseline in HDLup to 115 weeks
Change from baseline in triglyceridesup to 115 weeks
Steady-state plasma concentrationsup to week 24
Fold-change in concentration required to produce 50% of inhibition (IC 50)Baseline, weeks 24, 48 and 80

sequence-based HIV-1 analysis (genotyping) and drugs susceptibility assays (phenotyping)

Change from baseline in blood glucoseup to 115 weeks
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