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Pharmacokinetics and Safety Study of Tipranavir in Combination With Low Dose Ritonavir in Human Immunodeficiency Virus (HIV)-Infected Children

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
TPV oral solution
TPV oral solution
RTV oral solution
RTV oral solution
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections

Eligibility Criteria

2 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria: Males and females between 2 and 18 years of age. A confirmed diagnosis of HIV-1 infection as defined by two positive assays from two different samples taken at least two weeks apart. The two results may be any combination of the following: HIV ribonucleic acid (RNA) detected by reverse transcriptase (RT)-polymerase chain reaction(PCR) or HIV proviral deoxyribonucleic acid (DNA) detected by PCR HIV culture p24 antigen detection Licensed HIV enzyme-linked immunosorbent assay (ELISA) with confirmatory Western blot Viral load > 1500 RNA copies/mL. Acceptable screening laboratory values indicative of adequate baseline organ function. Laboratory values are considered acceptable if severity is no higher than Grade 1 for all tests defined by the Division of Acquired Immunodeficiency Syndrome (DAIDS) Table for Grading Severity of Pediatric Adverse Experiences (> 3 months of age) with the following exceptions: Grade 2 gamma-glutamyl transferase Grade 2 cholesterol Grade 2 triglycerides Signed informed consent prior to study participation from the patient or a legal guardian. Active assent must be given by the patient if the child and/or adolescent is capable of understanding the provided study information (this applies to children with the intellectual age of 7 years or greater) In the opinion of the investigator, an ability to take medications and comply with the requirements of the protocol. Exclusion criteria: Female patients of childbearing potential who: have a positive serum pregnancy test at screening are breast feeding are planning on becoming pregnant are not willing to use two methods of contraception to include at least one barrier method (e.g. latex condom plus spermicidal jelly/foam) Active hepatitis B or C disease defined as hepatitis B surface antigen (HBsAg) positivity or hepatitis C (HCV) antibody or RNA positivity with aspartate aminotransferase(AST)/ alanine aminotransferase(ALT) > Grade 2. Life expectancy < 12 months. Patients who are unwilling to abstain from ingesting contraindicated medications and substances which may significantly affect plasma levels of the study medications, notably: Grapefruit juice or Seville oranges Herbal preparations containing St. John's Wort or milk thistle Garlic supplements Active substance abuse. Use of investigational medications or vaccines within 28 days before study entry or during the trial. Some expanded access antiretroviral medications may be acceptable, but must be approved by sponsor. Requirement for any therapy for malignancy or immunomodulatory drug (e.g. interferon, cyclosporine, hydroxyurea, interleukin-2) within 28 days of study entry. Replacement intravenous gamma globulin treatment is acceptable. Any active opportunistic infection within 28 days before study entry or other clinically significant findings that may compromise the outcome of the study. Patients with malabsorption, severe chronic diarrhea or vomiting (more than two episodes of moderate or severe intensity, not attributed to medication therapy and lasting more than four days) within 28 days of the study. Evidence or symptoms of encephalopathy or developmental delay that would reduce compliance.

Sites / Locations

  • 1182.14.00001 Boehringer Ingelheim Investigational Site
  • 1182.14.00006 Boehringer Ingelheim Investigational Site
  • 1182.14.00010 Boehringer Ingelheim Investigational Site
  • 1182.14.00004 Boehringer Ingelheim Investigational Site
  • 1182.14.00008 Boehringer Ingelheim Investigational Site
  • 1182.14.00009 Boehringer Ingelheim Investigational Site
  • 1182.14.00002 Boehringer Ingelheim Investigational Site
  • 1182.14.00007 Boehringer Ingelheim Investigational Site
  • 1182.14.00003 Boehringer Ingelheim Investigational Site
  • 1182.14.5401 Fundación Huésped
  • 1182.14.55002
  • 1182.14.55003
  • 1182.14.11002 Boehringer Ingelheim Investigational Site
  • 1182.14.11001 Boehringer Ingelheim Investigational Site
  • 1182.14.33004 Boehringer Ingelheim Investigational Site
  • 1182.14.33005 Boehringer Ingelheim Investigational Site
  • 1182.14.33006 Boehringer Ingelheim Investigational Site
  • 1182.14.33003 Boehringer Ingelheim Investigational Site
  • 1182.14.33001 Boehringer Ingelheim Investigational Site
  • 1182.14.33002 Boehringer Ingelheim Investigational Site
  • 1182.14.49002 Boehringer Ingelheim Investigational Site
  • 1182.14.49001 Boehringer Ingelheim Investigational Site
  • 1182.14.49004 Boehringer Ingelheim Investigational Site
  • 1182.14.39001 Boehringer Ingelheim Investigational Site
  • 1182.14.39003 Boehringer Ingelheim Investigational Site
  • 1182.14.52001 CLINDI (Clínica de Inmunodeficiencias)
  • 1182.14.52002
  • 1182.14.00005 Boehringer Ingelheim Investigational Site
  • 1182.14.34002 Boehringer Ingelheim Investigational Site
  • 1182.14.34001 Boehringer Ingelheim Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

TPV/r 290/115 mg/m^2

TPV/r 375/150 mg/m^2

Arm Description

TPV and RTV oral solution low dose

TPV and RTV oral solution high dose

Outcomes

Primary Outcome Measures

Number of Severe (DAIDS Grades 3 or 4) Adverse Events Related to Drug for Treated Patients by Age Group and Formulation
Intensity of adverse events were graded by the investigator based on the DAIDS standardized table (Division of AIDS, National Institute of Health). DAIDS Grade 3 (Severe) and Grade 4 (Life Threatening) were identified.
Number of Patients With Severe (DAIDS Grades 3 or 4) Laboratory Abnormalities by Age Group and Formulation
Intensity of adverse events were graded by the investigator based on the DAIDS standardized table (Division of AIDS, National Institute of Health). DAIDS Grade 3 (Severe) and Grade 4 (Life Threatening) were identified.

Secondary Outcome Measures

Number Patients With at Least 1 log10 Viral Load Reduction From Baseline at Week 24 (Non-completers Considered Failures)
Number Patients With at Least 1 log10 Viral Load Reduction From Baseline at Week 48 (Non-completers Considered Failures)
Number Patients With at Least 1 log10 Viral Load Reduction From Baseline at Week 100 (Non-completers Considered Failures)
Number Patients With HIV RNA <400 Copies/mL at Week 24 (Non-completers Considered Failures)
Number Patients With HIV RNA <400 Copies/mL at Week 48 (Non-completers Considered Failures)
Number Patients With HIV RNA <400 Copies/mL at Week 100 (Non-completers Considered Failures)
Number Patients With HIV RNA <50 Copies/mL at Week 24 (Non-completers Considered Failures)
Number Patients With HIV RNA <50 Copies/mL at Week 48 (Non-completers Considered Failures)
Number Patients With HIV RNA <50 Copies/mL at Week 100 (Non-completers Considered Failures)
Baseline Median Viral Load log10 Copies/mL
Median Change From Baseline in Viral Load log10 Copies/mL at Week 24 (Last Observation Carried Forward)
Median Change From Baseline in Viral Load log10 Copies/mL at Week 48 (Last Observation Carried Forward)
Median Change From Baseline in Viral Load log10 Copies/mL at Week 100 (Last Observation Carried Forward)
Baseline Median CD4+ Cell Count (Cells/mm3)
Median Change From Baseline in CD4+ Cell Count (Cells/mm3) at Week 24 (Last Observation Carried Forward)
Median Change From Baseline in CD4+ Cell Count (Cells/mm3) at Week 48 (Last Observation Carried Forward)
Median Change From Baseline in CD4+ Cell Count (Cells/mm3) at Week 100 (Last Observation Carried Forward)
Median Baseline CD4 Percent
Percentage of lymphocytes that are CD4 cells
Median Change From Baseline in CD4 Percent at Week 24 (Last Observation Carried Forward)
Percentage of lymphocytes that are CD4 cells
Median Change From Baseline in CD4 Percent at Week 48 (Last Observation Carried Forward)
Percentage of lymphocytes that are CD4 cells
Median Change From Baseline in CD4 Percent at Week 100 (Last Observation Carried Forward)
Percentage of lymphocytes that are CD4 cells
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 8
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 16
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 24
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 48

Full Information

First Posted
February 9, 2004
Last Updated
April 25, 2014
Sponsor
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT00076999
Brief Title
Pharmacokinetics and Safety Study of Tipranavir in Combination With Low Dose Ritonavir in Human Immunodeficiency Virus (HIV)-Infected Children
Official Title
Multiple-dose, Open-label, Randomized, Safety and Pharmacokinetic Study of Tipranavir in Combination With Low-dose Ritonavir in HIV-infected Pediatric Patients
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
November 2003 (undefined)
Primary Completion Date
June 2010 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
The primary objective of this study is to assess the safety and tolerability of tipranavir (TPV) oral formulation and soft gelatin capsules together with low-dose ritonavir in HIV-infected children and adolescents, to provide information concerning the pharmacokinetic characteristics of tipranavir and ritonavir in this age group, and to determine the relative bioavailability of the TPV liquid formulation and TPV capsule formulation in adolescents switching from liquid to capsule. The secondary objective of this study is the determination of the dose of topranavir and ritonavir (TPV/r) in children and adolescents between 2 and 18 years of age required for an adult equivalent systemic exposure of TPV/r 500 mg / 200 mg.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
115 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TPV/r 290/115 mg/m^2
Arm Type
Experimental
Arm Description
TPV and RTV oral solution low dose
Arm Title
TPV/r 375/150 mg/m^2
Arm Type
Experimental
Arm Description
TPV and RTV oral solution high dose
Intervention Type
Drug
Intervention Name(s)
TPV oral solution
Intervention Description
Tipranavir oral solution
Intervention Type
Drug
Intervention Name(s)
TPV oral solution
Intervention Description
Tipranavir oral solution
Intervention Type
Drug
Intervention Name(s)
RTV oral solution
Intervention Description
Ritonavir oral solution
Intervention Type
Drug
Intervention Name(s)
RTV oral solution
Intervention Description
Ritonavir oral solution
Primary Outcome Measure Information:
Title
Number of Severe (DAIDS Grades 3 or 4) Adverse Events Related to Drug for Treated Patients by Age Group and Formulation
Description
Intensity of adverse events were graded by the investigator based on the DAIDS standardized table (Division of AIDS, National Institute of Health). DAIDS Grade 3 (Severe) and Grade 4 (Life Threatening) were identified.
Time Frame
up to 288 weeks
Title
Number of Patients With Severe (DAIDS Grades 3 or 4) Laboratory Abnormalities by Age Group and Formulation
Description
Intensity of adverse events were graded by the investigator based on the DAIDS standardized table (Division of AIDS, National Institute of Health). DAIDS Grade 3 (Severe) and Grade 4 (Life Threatening) were identified.
Time Frame
up to 288 weeks
Secondary Outcome Measure Information:
Title
Number Patients With at Least 1 log10 Viral Load Reduction From Baseline at Week 24 (Non-completers Considered Failures)
Time Frame
baseline, week 24
Title
Number Patients With at Least 1 log10 Viral Load Reduction From Baseline at Week 48 (Non-completers Considered Failures)
Time Frame
baseline, week 48
Title
Number Patients With at Least 1 log10 Viral Load Reduction From Baseline at Week 100 (Non-completers Considered Failures)
Time Frame
baseline, week 100
Title
Number Patients With HIV RNA <400 Copies/mL at Week 24 (Non-completers Considered Failures)
Time Frame
baseline, week 24
Title
Number Patients With HIV RNA <400 Copies/mL at Week 48 (Non-completers Considered Failures)
Time Frame
baseline, week 48
Title
Number Patients With HIV RNA <400 Copies/mL at Week 100 (Non-completers Considered Failures)
Time Frame
baseline, week 100
Title
Number Patients With HIV RNA <50 Copies/mL at Week 24 (Non-completers Considered Failures)
Time Frame
baseline, week 24
Title
Number Patients With HIV RNA <50 Copies/mL at Week 48 (Non-completers Considered Failures)
Time Frame
baseline, week 48
Title
Number Patients With HIV RNA <50 Copies/mL at Week 100 (Non-completers Considered Failures)
Time Frame
baseline, week 100
Title
Baseline Median Viral Load log10 Copies/mL
Time Frame
baseline
Title
Median Change From Baseline in Viral Load log10 Copies/mL at Week 24 (Last Observation Carried Forward)
Time Frame
baseline, week 24
Title
Median Change From Baseline in Viral Load log10 Copies/mL at Week 48 (Last Observation Carried Forward)
Time Frame
baseline, week 48
Title
Median Change From Baseline in Viral Load log10 Copies/mL at Week 100 (Last Observation Carried Forward)
Time Frame
baseline, week 100
Title
Baseline Median CD4+ Cell Count (Cells/mm3)
Time Frame
baseline
Title
Median Change From Baseline in CD4+ Cell Count (Cells/mm3) at Week 24 (Last Observation Carried Forward)
Time Frame
baseline, week 24
Title
Median Change From Baseline in CD4+ Cell Count (Cells/mm3) at Week 48 (Last Observation Carried Forward)
Time Frame
baseline, week 48
Title
Median Change From Baseline in CD4+ Cell Count (Cells/mm3) at Week 100 (Last Observation Carried Forward)
Time Frame
baseline, week 100
Title
Median Baseline CD4 Percent
Description
Percentage of lymphocytes that are CD4 cells
Time Frame
baseline
Title
Median Change From Baseline in CD4 Percent at Week 24 (Last Observation Carried Forward)
Description
Percentage of lymphocytes that are CD4 cells
Time Frame
baseline, week 24
Title
Median Change From Baseline in CD4 Percent at Week 48 (Last Observation Carried Forward)
Description
Percentage of lymphocytes that are CD4 cells
Time Frame
baseline, week 48
Title
Median Change From Baseline in CD4 Percent at Week 100 (Last Observation Carried Forward)
Description
Percentage of lymphocytes that are CD4 cells
Time Frame
baseline, week 100
Title
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 8
Time Frame
week 8
Title
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 16
Time Frame
week 16
Title
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 24
Time Frame
week 24
Title
Number Patients With Compliance With Tipranavir Treatment Between 95 and 120 Percent at Week 48
Time Frame
week 48

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Males and females between 2 and 18 years of age. A confirmed diagnosis of HIV-1 infection as defined by two positive assays from two different samples taken at least two weeks apart. The two results may be any combination of the following: HIV ribonucleic acid (RNA) detected by reverse transcriptase (RT)-polymerase chain reaction(PCR) or HIV proviral deoxyribonucleic acid (DNA) detected by PCR HIV culture p24 antigen detection Licensed HIV enzyme-linked immunosorbent assay (ELISA) with confirmatory Western blot Viral load > 1500 RNA copies/mL. Acceptable screening laboratory values indicative of adequate baseline organ function. Laboratory values are considered acceptable if severity is no higher than Grade 1 for all tests defined by the Division of Acquired Immunodeficiency Syndrome (DAIDS) Table for Grading Severity of Pediatric Adverse Experiences (> 3 months of age) with the following exceptions: Grade 2 gamma-glutamyl transferase Grade 2 cholesterol Grade 2 triglycerides Signed informed consent prior to study participation from the patient or a legal guardian. Active assent must be given by the patient if the child and/or adolescent is capable of understanding the provided study information (this applies to children with the intellectual age of 7 years or greater) In the opinion of the investigator, an ability to take medications and comply with the requirements of the protocol. Exclusion criteria: Female patients of childbearing potential who: have a positive serum pregnancy test at screening are breast feeding are planning on becoming pregnant are not willing to use two methods of contraception to include at least one barrier method (e.g. latex condom plus spermicidal jelly/foam) Active hepatitis B or C disease defined as hepatitis B surface antigen (HBsAg) positivity or hepatitis C (HCV) antibody or RNA positivity with aspartate aminotransferase(AST)/ alanine aminotransferase(ALT) > Grade 2. Life expectancy < 12 months. Patients who are unwilling to abstain from ingesting contraindicated medications and substances which may significantly affect plasma levels of the study medications, notably: Grapefruit juice or Seville oranges Herbal preparations containing St. John's Wort or milk thistle Garlic supplements Active substance abuse. Use of investigational medications or vaccines within 28 days before study entry or during the trial. Some expanded access antiretroviral medications may be acceptable, but must be approved by sponsor. Requirement for any therapy for malignancy or immunomodulatory drug (e.g. interferon, cyclosporine, hydroxyurea, interleukin-2) within 28 days of study entry. Replacement intravenous gamma globulin treatment is acceptable. Any active opportunistic infection within 28 days before study entry or other clinically significant findings that may compromise the outcome of the study. Patients with malabsorption, severe chronic diarrhea or vomiting (more than two episodes of moderate or severe intensity, not attributed to medication therapy and lasting more than four days) within 28 days of the study. Evidence or symptoms of encephalopathy or developmental delay that would reduce compliance.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Boehringer Ingelheim
Organizational Affiliation
Boehringer Ingelheim
Official's Role
Study Chair
Facility Information:
Facility Name
1182.14.00001 Boehringer Ingelheim Investigational Site
City
Los Angeles
State/Province
California
Country
United States
Facility Name
1182.14.00006 Boehringer Ingelheim Investigational Site
City
Los Angeles
State/Province
California
Country
United States
Facility Name
1182.14.00010 Boehringer Ingelheim Investigational Site
City
Hartford
State/Province
Connecticut
Country
United States
Facility Name
1182.14.00004 Boehringer Ingelheim Investigational Site
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
1182.14.00008 Boehringer Ingelheim Investigational Site
City
North Worcester
State/Province
Massachusetts
Country
United States
Facility Name
1182.14.00009 Boehringer Ingelheim Investigational Site
City
Springfield
State/Province
Massachusetts
Country
United States
Facility Name
1182.14.00002 Boehringer Ingelheim Investigational Site
City
Cleveland
State/Province
Ohio
Country
United States
Facility Name
1182.14.00007 Boehringer Ingelheim Investigational Site
City
Memphis
State/Province
Tennessee
Country
United States
Facility Name
1182.14.00003 Boehringer Ingelheim Investigational Site
City
Houston
State/Province
Texas
Country
United States
Facility Name
1182.14.5401 Fundación Huésped
City
Capital Federal
Country
Argentina
Facility Name
1182.14.55002
City
São Paulo
Country
Brazil
Facility Name
1182.14.55003
City
São Paulo
Country
Brazil
Facility Name
1182.14.11002 Boehringer Ingelheim Investigational Site
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
1182.14.11001 Boehringer Ingelheim Investigational Site
City
Montreal
State/Province
Quebec
Country
Canada
Facility Name
1182.14.33004 Boehringer Ingelheim Investigational Site
City
Lyon cedex 3
Country
France
Facility Name
1182.14.33005 Boehringer Ingelheim Investigational Site
City
Nantes cedex 1
Country
France
Facility Name
1182.14.33006 Boehringer Ingelheim Investigational Site
City
Paris cedex 12
Country
France
Facility Name
1182.14.33003 Boehringer Ingelheim Investigational Site
City
Paris cedex 14
Country
France
Facility Name
1182.14.33001 Boehringer Ingelheim Investigational Site
City
Paris cedex 15
Country
France
Facility Name
1182.14.33002 Boehringer Ingelheim Investigational Site
City
Paris
Country
France
Facility Name
1182.14.49002 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
1182.14.49001 Boehringer Ingelheim Investigational Site
City
Frankfurt/Main
Country
Germany
Facility Name
1182.14.49004 Boehringer Ingelheim Investigational Site
City
München
Country
Germany
Facility Name
1182.14.39001 Boehringer Ingelheim Investigational Site
City
Padova
Country
Italy
Facility Name
1182.14.39003 Boehringer Ingelheim Investigational Site
City
Roma
Country
Italy
Facility Name
1182.14.52001 CLINDI (Clínica de Inmunodeficiencias)
City
México, D.F.
Country
Mexico
Facility Name
1182.14.52002
City
México, D.F.
Country
Mexico
Facility Name
1182.14.00005 Boehringer Ingelheim Investigational Site
City
San Juan
Country
Puerto Rico
Facility Name
1182.14.34002 Boehringer Ingelheim Investigational Site
City
Barcelona
Country
Spain
Facility Name
1182.14.34001 Boehringer Ingelheim Investigational Site
City
Madrid
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
23995585
Citation
Salazar JC, Cahn P, Della Negra M, De Aquino MZ, Robinson PA, Jelaska A, Mikl J. Efficacy and safety of tipranavir coadministered with ritonavir in HIV-1-infected children and adolescents: 5 years of experience. Pediatr Infect Dis J. 2014 Apr;33(4):396-400. doi: 10.1097/INF.0000000000000038.
Results Reference
derived
PubMed Identifier
18753862
Citation
Salazar JC, Cahn P, Yogev R, Negra MD, Castelli-Gattinara G, Fortuny C, Flynn PM, Giaquinto C, Ruan PK, Smith ME, Mikl J, Jelaska A; PACTG 1051/BI Study Team. Efficacy, safety and tolerability of tipranavir coadministered with ritonavir in HIV-1-infected children and adolescents. AIDS. 2008 Sep 12;22(14):1789-98. doi: 10.1097/QAD.0b013e32830c481b.
Results Reference
derived
Links:
URL
http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/1182/1182.14_U11-3187.pdf
Description
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Pharmacokinetics and Safety Study of Tipranavir in Combination With Low Dose Ritonavir in Human Immunodeficiency Virus (HIV)-Infected Children

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