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Phase 2 Safety and Efficacy Study of Bevirimat Functional Monotherapy in HIV Treatment-Experienced Patients for 2 Weeks*

Phase 2
Completed
Conditions
HIV Infections
Interventions
Drug: matching placebo
Registration Number
NCT00511368
Lead Sponsor
Myrexis Inc.
Brief Summary

The purpose of this study is to evaluate antiretroviral activity of up to five different oral doses administered for two weeks of bevirimat versus placebo in HIV treatment experienced patients, who have documented genotypic resistance to at least one major mutation from the IAS-USA list (2007)of resistance mutations for NRTIs, NNRTIs, or PIs. Patients will also be monitored for side effects, and the pharmacokinetics of bevirimat will be determined.

Detailed Description

Bevirimat (PA103001-04) represents a new class of antivirals that blocks HIV replication by disrupting virus maturation; specifically, by inhibiting a late step in the Gag processing cascade. Short term (7-10 days) functional monotherapy studies (conducted in patients with detectable viral loads on a failing regimen)help in determining the potency of the drug, and enable dose finding. This is a two part (A and B)randomized, placebo-controlled, double-blind, multiple-dose, dose-escalation study in HIV treatment-experienced patients on a failing regimen (harboring resistance mutations to at least one member of the NRTI, NNRTI or PI classes. The antiretroviral activity, safety, and pharmacokinetics of up to 5 different dose levels of bevirimat will be compared to placebo when added to a failing approved antiretroviral regimen. The study is conducted in two parts: A and B. In Part A following 14 days of daily dosing patients commenced a new optimized ART regimen in addition to their randomized treatment. In Part Part B dosing with the randomized treatment ends after the initial 14 days of daily dosing.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
92
Inclusion Criteria
  • Male or female. Females of child-bearing potential, must have a documented negative pregnancy test and be willing to utilize double-barrier contraception through-out the study period.
  • Have HIV-1-infection.
  • Have a screening plasma HIV-1 RNA value, measured by the Roche Amplicor assay, of 2,000 - 250,000 copies/ml (inclusive).
  • Have documented evidence of genotypic resistance in their medical records (at screening) or have resistance at screening by genotype to any major mutation from the IAS-USA list of resistance drug mutations, defined as: NRTI resistance: M41L, K65R, D67N, K70R, K70E, L74V, Y115F, M184V, M184V/I, L210W, T215Y/F, K219Q/E; NNRTI resistance: L100I, K103N, V106M, V106A/M, V108I, Y181C, Y181C/I, Y188L, Y188C/L/H, G190S/A, G190A, P225H; Major PI resistance: D30N, V32I, L33F, M46I/L, I47V/A, G48V, I50L, I50V, I54M/L, L76V, V82A/F/T, V82A/F/T/S, V82L/T, I84V, N88S, L90M
  • Be receiving an antiretroviral therapy regimen containing at least 3 drugs (regimens containing ritonavir must not exceed a total daily dose of 400 mg) which has been unchanged for at least 8 weeks prior to initial screening.
  • Be able to receive an optimized background regimen.
  • Be free from any acute infection or serious medical illness within 14 days prior to study entry.
  • Be informed of the nature of the study and provide written informed consent.
  • Be willing to comply with the meal requirements described in the protocol.
Exclusion Criteria
  • Current opportunistic infection characteristic of AIDS
  • Patients unable or unwilling to comply with the dosing schedule and protocol evaluations.
  • Patients with malabsorption syndromes affecting drug absorption.
  • Patients with systolic blood pressure < 90 mmHg or > 140 mmHg or diastolic blood pressure < 60 mmHg or > 90 mmHg measured in a semi-recumbent position after at least 10 minutes of rest at the screening or qualification visit.
  • A history of seizures (excluding pediatric febrile seizures), migraines, cluster and/or chronic headaches, cerebrovascular accident (CVA) or transient ischemic attacks (TIA).
  • Patients with abnormal Hemoglobin (< 10.0 g/dL for men and < 9.0 g/dL for women), Neutrophil count (< 1000/mm3), Platelet count (< 100,000/mm3), AST or ALT > 2.5 times the upper limit of normal (patients with a positive HBV surface antigen or HCV antibody test at screening must have AST and ALT no more than 1.5 times the upper limit of normal)
  • Patients who have received radiation therapy or cytotoxic chemotherapeutic agents, immunomodulating agents, HIV immunotherapeutic vaccine, an investigational drug or product, or participation in a drug study within 4 weeks prior to the first dose of study drug.
  • A history of alcoholism or drug addiction within the past 1 year (unless enrolled in a treatment program and approved by the sponsor). Recent use of any recreational drugs (except marijuana).
  • A history of difficulty donating blood or inadequate venous access.
  • The donation of blood or plasma within 30 days prior to receiving study medication.

Note: patients with a CD4 count <100 cells/mm3 will be considered for enrollment following discussion and agreement between the Investigator and the Sponsor.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
1matching placeboplacebo
2matching placeboBevirimat
2BevirimatBevirimat
Primary Outcome Measures
NameTimeMethod
HIV-1 RNA change from baseline over the first 14 days of study14 days
Secondary Outcome Measures
NameTimeMethod
safety and tolerability; pharmacokinetics14 days

Trial Locations

Locations (18)

Whitman-Walker Clinic

🇺🇸

Washington, District of Columbia, United States

UCLA Medical Center

🇺🇸

Los Angeles, California, United States

University Hospitals of Cleveland

🇺🇸

Cleveland, Ohio, United States

Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

Drexel University College of Medicine

🇺🇸

Philadelphia, Pennsylvania, United States

Gary Richmond

🇺🇸

Fort Lauderdale, Florida, United States

Southwest Infectious Diseases

🇺🇸

Dallas, Texas, United States

AIDS Research Consortium of Atlanta, Inc.

🇺🇸

Atlanta, Georgia, United States

Orlando Immunology Center

🇺🇸

Orlando, Florida, United States

George Washington University Medical Center

🇺🇸

Washington, District of Columbia, United States

University of Colorado Health Science Center

🇺🇸

Denver, Colorado, United States

Quest Clinical Research

🇺🇸

San Francisco, California, United States

Northwestern University Feinberg School of Medicine

🇺🇸

Chicago, Illinois, United States

Central Texas Clinical Research

🇺🇸

Austin, Texas, United States

The Research Insitute

🇺🇸

Boston, Massachusetts, United States

UNC at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

University of Texas Medical Branch Internal Medicine

🇺🇸

Galveston, Texas, United States

Miriam Hospital/Brown University

🇺🇸

Providence, Rhode Island, United States

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