Pharmacokinetics of Atazanavir /Dolutegravir/Lamivudine Regimen as Maintenance Regimen
- Conditions
- HIV-1 Infection
- Interventions
- Registration Number
- NCT02566707
- Lead Sponsor
- Radboud University Medical Center
- Brief Summary
During the past years the treatment of HIV-1 infection has transformed towards chronic treatment. Patients are being treated with antiretroviral drugs for many years and become older. The risk of developing side-effects due to long term antiretroviral therapy is therefore more and more likely. New alternative once-daily maintenance regimes are needed for those who are extensively pre-treated and experience side-effects or toxicity on standard treatment combinations. A possible once-daily, fully active maintenance regimen is the combination of atazanavir (unboosted), dolutegravir and lamivudine (PRADAII regimen). This combination is expected to be a safe, once-daily maintenance regimen with a favorable side-effect profile. The combination suits patients with intolerance and/or resistance to NRTIs, NNRTIs and ritonavir, who have a suppressed viral load. However, for this new combination the pharmacokinetic profile is unknown and there are no data on short-term and long-term safety and efficacy. This study wille therefore asses the pharmacokinetics, safety and efficacy in a small number of HIV-1 infected patients.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 9
- HIV-infected as documented by positive HIV antibody test and confirmed by Western Blot.
- Subject is in need for a switch in maintenance regimen due to adverse effects, toxicities, simplification and/or resistance.
- Subject is at least 18 years of age at the day of screening.
- Subject is able and willing to sign the Informed Consent Form prior to screening evaluations.
- HIV-1 RNA < 40 copies/mL for at least 6 months on antiretroviral therapy prior to inclusion.
- Subject has no documented resistance mutations to PIs, INSTIs or lamivudine.
- Documented history of sensitivity/idiosyncrasy to medicinal products or excipients.
- Relevant history or current condition that might interfere with drug absorption, distribution, metabolism or excretion.
- Inability to understand the nature and extent of the trial and the procedures required.
- Pregnant female (as confirmed by an HCG test performed less than 3 weeks before the first dose) or breast-feeding female.
- Abnormal serum transaminases determined as levels being > 5 times upper limit of normal.
- Renal failure determined as an estimated Glomerular Filtration Rate (eGFR) < 50 ml/min (MDRD-based).
- Concomitant use of medications that interfere with atazanavir, dolutegravir or lamivudine pharmacokinetics: oxcarbazepine, phenytoin, phenobarbital, carbamazepine, St. John's wort, rifampicin, clarithromycin, H2 receptor antagonists, proton pump inhibitors, irinotecan, midazolam, triazolam, buprenorphine, aprepitant, modafinil, imatinib, co-trimoxazole, other antiretroviral drugs.
- Concomitant use of medications that are contraindicated for use with atazanavir, dolutegravir or lamivudine: alfuzosin, dofetilide, pimozide, quetiapine, quinidine, bepridil, simvastatin, atorvastatin, lovastatin, sildenafil (as for use in pulmonary arterial hypertension), cladribine.
- Active hepatobiliary or hepatic disease (including chronic hepatitis B or C infection).
- Alcohol abuse.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description PRADAII regimen Atazanavir Use of PRADAII regimen during 12 weeks. This regimen consists of atazanavir 400 mg QD, dolutegravir 50 mg QD, lamivudine 300 mg QD. PRADAII regimen Dolutegravir Use of PRADAII regimen during 12 weeks. This regimen consists of atazanavir 400 mg QD, dolutegravir 50 mg QD, lamivudine 300 mg QD. PRADAII regimen Lamivudine Use of PRADAII regimen during 12 weeks. This regimen consists of atazanavir 400 mg QD, dolutegravir 50 mg QD, lamivudine 300 mg QD.
- Primary Outcome Measures
Name Time Method Area under the plasma concentration versus time curve (AUC) of atazanavir, dolutegravir and lamivudine week 2 Pharmacokinetic parameters of atazanavir, dolutegravir and lamivudine
- Secondary Outcome Measures
Name Time Method efficacy (viral load) week 2, 6 and 12 efficacy (viral load) of the combination of atazanavir, dolutegravir and lamivudine
number of adverse events week 2, 6 and 12 number of adverse events of the combination of atazanavir, dolutegravir and lamivudine
Trial Locations
- Locations (4)
St. Elisabeth
🇳🇱Tilburg, Netherlands
Rijstate
🇳🇱Arnhem, Netherlands
Radboud University Nijmegen Medical Centre
🇳🇱Nijmegen, Netherlands
University of Bonn
🇩🇪Bonn, Germany