Randomized, Double-Blind, Placebo-Controlled, Multicenter Study Exploring the Safety, Tolerability, and Antiviral Effect of Substituting 600 mg Racivir for 3TC in HIV-Infected Subjects Who Have the M184V Mutation and Are Currently Failing on a HAART Regimen Containing Lamivudine
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 11
- 主要终点
- Change from baseline in virological response of HIV (log10 HIV-RNA levels) at the end of week 2
研究概览
简要总结
Racivir ® (RCV) is an experimental drug which means it is not approved for use by the United States Food and Drug Administration (FDA), but it can be used in research studies like this one. RCV (Racivir®) is part of a class of drugs known as "Nucleoside Reverse Transcriptase Inhibitors" (NRTIs), which are intended to block a further increase in the amount of HIV virus in the body. Laboratory research suggests that RCV (Racivir®) may be effective in patients who have developed resistance to other NRTIs, particularly 3TC (lamivudine, Epivir®). However, a study of RCV (Racivir®) has not been done with patients who have previously been treated with other HAART (Highly Active Antiretroviral Therapy -- taking multiple HIV drugs at once) medications including 3TC (lamivudine, Epivir®).
The purpose of this study is to evaluate the safety and effectiveness of RCV (Racivir®) when used together with other HIV drugs in people who have previously been treated with 3TC (lamivudine, Epivir®) and are failing with their current HAART treatments. This study will include a total of 60 HIV infected, HAART-experienced subjects currently receiving 3TC (lamivudine, Epivir®) as part of their HAART therapy. The study will take place at approximately 11 study sites in the US and Latin America.
详细描述
The study is divided into four periods: a 'Screening' period which can last up to 30 days in duration, a 'Blinded Treatment' period which can last up to 4 weeks in duration, a 'Follow-up' period which is 28 days in duration, and an 'Open-label Treatment' period that some subjects will be given the option to participate in and which can last up to 20 weeks.
If eligible subjects decide to participate in this research study, they will be randomized, which is like picking chances from a hat, to get RCV (Racivir®) alone, 3TC (lamivudine, Epivir®) alone, or RCV and 3TC (lamivudine, Epivir®) in combination. This is a "double-blind study". This means that neither the subject nor the study doctor and study staff will know if subjects are receiving RCV (Racivir®), 3TC (lamivudine, Epivir®), or RCV (Racivir®) and 3TC (lamivudine, Epivir®). This needs to be done to make sure the researchers obtain the information needed to see if RCV (Racivir®) is safe and as effective as 3TC (lamivudine, Epivir®). In case of an emergency, the study doctor will be able to find out immediately what study drug subjects were receiving. With this exception, by signing the consent form subjects agree that they will not be able to find out what medications they are taking, because this is a "double-blind" study, it is necessary to use placebo tablets. A placebo is a tablet that does not contain any active drug, but is made to look just like the study drug.
Subjects will be given three bottles of study medication. They will be asked to take one tablet from each bottle once a day by mouth, in addition to their current HAART drugs, not including 3TC. The 3TC in their current HAART regimen must be discontinued prior to beginning the study medication. It is important that subjects follow all directions when taking the study drugs.
After completing the first 14 days of the blinded treatment period, subjects will be given the option to continue on their current randomized therapy, including their current study medication, for an additional 1-2 weeks. On Day 15, a blood sample will be collected to determine the amount of HIV virus in the blood. Once the results from that blood sample are available, subjects will be told the amount of how much HIV virus changed in the blood during the first 14 days of treatment. Subjects will also be told if they were receiving RCV (Racivir®) alone, 3TC (lamivudine, Epivir®) alone, or a combination of RCV (Racivir®) and 3TC (lamivudine, Epivir®).
If subjects were receiving RCV (Racivir®), to continue in the open-label treatment period, the amount of virus in the blood must drop by at least 2/3 during the first 14 days of the blinded treatment period. For example, if subjects enter the study with 10,000 copies of the HIV virus per milliliter (ml) of blood, then to continue in the open-label period, the virus level must drop to 3,162 copies or less, per ml of blood. Open-label means that participating subjects and the study doctor or study staff will know what treatment subjects were receiving.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Treatment
- 盲法
- Double
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Males and females who are between 18 years (or the legal age of consent, whichever is older) and 65 years of age. Females may be enrolled following a negative pregnancy test if:
- •a) they are documented to be surgically sterile or post-menopausal [amenorrhea >1 year and FSH >30mU/mL]; --OR-- b) they are using a hormonal birth control method (oral contraceptives, contraceptive implants); --OR-- c) they are using a barrier method of contraception (male or female condoms, diaphragm, cervical cap) with a spermicide.
- •Subjects with a positive history of HIV-infection, documented by a licensed HIV antibody ELISA assay and confirmed either by Western blot, positive HIV blood culture, positive HIV serum antigen or plasma viremia.
- •Subjects currently on an accepted, stable HAART regimen that includes lamivudine for at least 60 days prior to screening.
- •Subjects who, in the opinion of the investigator, are failing their current HAART regimen.
- •Subjects who have an HIV-RNA copy number of ≥ 2000 copies/mL as determined by FDA-approved, Roche PCR assay (Amplicor HIV-1 Monitor® Test, v1.5 - Quantitative).
- •Subjects who have a CD4-lymphocyte count ≥ 50 cells/mm
- •Subjects who have the M184V HIV mutation, as determined by the FDA-approved Bayer assay, TRUGENE® HIV-1 Genotyping Kit and the OpenGene® DNA Sequencing System.
- •Subjects who are able and willing to provide written, informed consent.
- •Subjects who are able and willing to comply with the requirements of this study.
排除标准
- •Subjects who have a current or recent (< 30 days) opportunistic infection characteristic of AIDS (Category C according to the CDC Classification System for HIV-1 Infection, 1993 Revised Version).
- •Subjects currently on a (-)-FTC regimen.
- •Subjects with Q151M mutation.
- •Subjects with T69S insertions.
- •Female subjects who are pregnant or breastfeeding.
- •Subjects enrolled in other investigational drug protocols or subjects who have received other investigational agents within 30 days prior to the first dose of study medication. For investigational drugs with an elimination half-life greater than 15 days, this will be extended to 60 days.
- •Subjects with malabsorption syndromes possibly affecting drug absorption (e.g. Crohn's disease, chronic pancreatitis, etc).
- •Subjects with acute hepatitis B and/or C, except for subjects who, at the discretion of the investigator, have a chronic, but stable hepatitis infection.
- •Subjects with the following laboratory parameters within 30 days prior to the first dose of study medication: *Hemoglobin <10.0 g/dL; *Absolute neutrophil count (ANC) <1000/mm3; *Platelet count <100,000/mm3; *AST or ALT >5 times the upper limit of normal, without the presence of an underlying illness, other than HIV or acute hepatitis, judged by the investigator to likely cause such chronic enzyme abnormalities; *Pancreatic amylase >1.5 times the upper limit of normal.
- •Subjects who have received an HIV vaccination within 6 months prior to the first dose of study medication.
- •Subjects who have received radiation therapy or cytotoxic chemotherapeutic agents within 30 days prior to the first dose of study medication.
- •Subjects who, in the opinion of the investigator, are unable to comply with the dosing schedule and protocol evaluations.
结局指标
主要结局
Change from baseline in virological response of HIV (log10 HIV-RNA levels) at the end of week 2
Change from baseline in CD4+ count at the end of week 2
Adverse events
次要结局
- Proportion of subjects in each treatment arm with viral load reduction ≥ 0.5 log10 from baseline
- Proportion of subjects in each treatment arm with viral load below 50 copies/mL