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The First Failure Study

Phase 4
Terminated
Conditions
HIV Infections
HIV
Interventions
Registration Number
NCT01118871
Lead Sponsor
Imperial College London
Brief Summary

The purpose of this study is to look at two different antiretroviral treatment options in individuals who are about to commence their second antiretroviral treatment.

This study will assess important clinical and laboratory differences between these two therapeutic options. Potential differences include: differences in body fat distribution, in lipid parameters, in adherence and in neurocognitive (brain) function. This study is looking to show differences in body fat distribution between the two study treatment arms. Differences in lipids, viral load, adherence, cardiac and bone biomarkers and neurocognitive function will also be assessed. There is also a lumbar puncture sub study participants can also take part in.

The total duration of involvement in the trial will be up to 96 weeks (approximately 2 years) plus a screening visit 1 - 4 weeks prior to the start of the study. Including visit the clinic on 12 occasions (screening visit, baseline visit, weeks 2, 4, 8, 12, 24, 36, 48, 64, 80 and 96)

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
3
Inclusion Criteria
  • HIV-1 infected males or females
  • over 18 years of age
  • signed informed consent
  • currently receiving a stable antiretroviral regimen comprising of:
  • two or more licensed NRTIs
  • one licensed NNRTI or boosted protease inhibitor
  • no previous protease inhibitor resistance documented on HIV-1 genotypic resistance testing
  • failure of current antiretroviral regimen due to:
  • toxicity, intolerance or virological failure if receiving an NNRTI containing regimen at screening
  • toxicity or intolerance if receiving a boosted-protease inhibitor regimen at screening (with plasma HIV RNA < 400 copies/mL at screening)
  • willing to modify antiretroviral therapy, in accordance with the randomisation assignment
  • no previous exposure to etravirine
  • subjects in good health upon medical history, physical exam, and laboratory testing in the opinion of the investigator
  • have no serologic evidence of active HBV infection evidenced by negative hepatitis B surface antigen
  • female subjects who are heterosexually active and of childbearing potential (i.e., not surgically sterile or at least two years post menopausal) must practice contraception as follows from screening through completion of the study:
  • barrier contraceptives (condom, diaphragm with spermicide)
  • IUD or Depo PLUS a barrier contraceptive
  • female subjects of childbearing potential must have a negative pregnancy test.
Exclusion Criteria
  • current alcohol abuse or drug dependence
  • pregnancy
  • active opportunistic infection or significant co-morbidities
  • current prohibited concomitant medication
  • a likelihood of diminished response to any of the study treatment arms, in the opinion of the investigator, based on HIV genotypic resistance testing

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard of careDarunavir, Ritonavir, Truvada-
NRTI sparing armDarunavir, Ritonavir and Etravirine-
Primary Outcome Measures
NameTimeMethod
Mean change from baseline in peripheral and central adipose tissueweek 48 and 96

As measured by DEXA, between treatment arms.

Secondary Outcome Measures
NameTimeMethod
Percentage of patients <50 copies HIV-1 RNA/mL96 weeks

At all study points to weeks 48 and 96 between treatment arms.

Mean change from baseline Lipodystrophy Case Definition score96 weeks

Between treatment arms

Describe aspects of immune reconstitution disease (IRD)96 weeks

Across the treatment arms

Time to change in randomly assigned therapy96 weeks

between treatment arms

• Comparison of total number of patients with any serious adverse events (SAEs), and the cumulative incidence of SAEs96 week s

Between the treatment arms

Comparison of quality of life and results of adherence questionnaires96 weeks

Between the treatment arms

Mean change from baseline of absolute CD4+ T cell count96 weeks

between treatment arms

Mean change from baseline in fasting lipid and glycaemia parameters96 weeks

between treatment arms

Patterns of genotypic HIV resistance associated with virological treatment failure96 weeks

Across the treatment arms

Mean change from baseline in cardiac and bone biomarker levelsWeek 96

between treatment arms

Trial Locations

Locations (1)

St. Mary's Hospital

🇬🇧

London, United Kingdom

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