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Pharmacokinetics of Efavirenz in HIV-1 Infected Subjects With Hepatic Impairment

Primary Purpose

HIV Infections, Hepatic Impairment

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
efavirenz containing antiretroviral regimen
efavirenz containing antiretroviral regimen
efavirenz containing antiretroviral regimen
efavirenz containing antiretroviral regimen
Sponsored by
Bristol-Myers Squibb
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: HIV-1 infection with or without Hepatitis B or C infection Stable antiretroviral regimen containing efavirenz and nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) for at least 1 month Mild, moderate or severe hepatic impairment with hepatic cirrhosis Exclusion Criteria: Acute flare of hepatitis Positive pregnancy test for a female Significant acute medical illness in past 2 months Use of agents known to significantly affect liver metabolism Change in medications to treat a chronic disease in the past 2 months

Sites / Locations

  • Johns Hopkins University School Of Medicine
  • Uthscsa
  • Virginia Commonwealth University Health Systems
  • Local Institution

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Arm Label

EFV600mg Participants With Mild Hepatic Impairment

EFV600mg Participants With Moderate Hepatic Impairment

EFV600mg Participants With Severe Hepatic Impairment

EFV600mg Participants With Normal Hepatic Function

Arm Description

Outcomes

Primary Outcome Measures

Maximum Plasma Concentration (Cmax)
Cmax was obtained directly from the concentration-time data.
Minimum Plasma Concentration (Cmin)
Cmin was obtained directly from the concentration-time data.
Area Under the Plasma Concentration-time Curve Over the Dosing Interval of 24 Hours (AUC[TAU])
The AUC(TAU), from time 0 to the time of the last measurable concentration (t), was calculated by the linear trapezoidal rule.
Time to Reach Maximum Observed Plasma Concentration (Tmax)
Tmax was obtained directly from the concentration-time data.

Secondary Outcome Measures

Number of Participants Who Died or Experienced Other Serious Adverse Events (SAEs)
An SAE was defined as any adverse event (AE) occurring at any dose that; resulted in death; was life threatening; resulted in a persistent or significant disability/incapacity; resulted in/prolonged an existing in-patient hospitalization; was a congenital anomaly/birth defect; was a cancer; or was an overdose.
Number of Participants Who Experienced AEs
AEs were defined as any new untoward medical occurrences or worsening of a pre-existing medical condition in a participant administered a medicinal product, whether or not considered related to the medicinal product.
Number of Participants Who Experienced AEs Leading to Study Drug Discontinuation
AEs were defined as any new untoward medical occurrences or worsening of a pre-existing medical condition in a participant administered a medicinal product, whether or not considered related to the medicinal product. Participants who discontinued the study due to an AE were recorded.
Number of Participants With Marked Abnormalities (MAs) in Hematology Measurements
MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following hematology MA definitions specify the criteria for the data presented. Low platelet count: <0.85 x lower limit of normal (LLN) (or if pre-treatment value <LLN, then <0.85 x pre-treatment value). Low leukocytes: <0.9 x LLN (or if pre-treatment value <LLN, then <0.85 x pre-treatment value. If pre-treatment value >upper limit of normal [ULN], then <LLN). Low neutrophils+bands (absolute): <=1.500 10^3 cells/microliter (uL). Low lymphocytes (absolute): <0.750 10^3 cells/uL.
Number of Participants With Serum Chemistry MAs
MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following serum chemistry MA definitions specify the criteria for MAs in the data presented. High bilirubin (total): >1.1 x ULN (or if pre-treatment value >ULN, then >1.25 x pre-treatment value). High creatinine: >1.33 x pre-treatment value. Low albumin: <0.9 x LLN (or if pre-treatment value <LLN, then <0.9 x pre-treatment value). High amylase (total): >2 x pre-treatment value.
Number of Participants With Urinalysis MAs
MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following urinalysis MA definitions specify the criteria for MAs in the data presented. The presence of white blood cells (WBCs) and red blood cells (RBCs) in the urine was graded on a scale: 0 = no cells present (negative); trace =a small number of cells present; then 1+, 2+, 3+ and 4+, denoting increasingly "positive" urine results (ie, WBCs/RBCs present in the urine). The MA for both WBCs and RBCs was >= 2+ (or, if pre-treatment value >=2+, then >= 4+).
Number of Participants With Identified Electrocardiogram (ECG) Abnormalities
ECG abnormalities are findings that are clinically meaningful by the judgment of the investigator. A 12-lead ECG was performed and all ECG recordings were evaluated by the investigator. Abnormalities, if present at any study time point, were listed.
Number of Participants With Clinically Meaningful Vital Signs Measures
Vital signs were recorded throughout the study and included investigations related to body temperature, respiratory rate, seated blood pressure (systolic and diastolic), and heart rate. The investigator used his/her clinical judgement to decide whether or not abnormalities in vital signs were clinically meaningful.
Number of Participants With Abnormal Physical Examination Findings at Baseline (Screening and/or Day 1)
The physical examination included an evaluation of the participant's height and body mass index (BMI) (at screening only), and weight. Abnormal physical examination are findings that are clinically meaningful by the judgment of the investigator

Full Information

First Posted
September 9, 2005
Last Updated
September 7, 2010
Sponsor
Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT00162097
Brief Title
Pharmacokinetics of Efavirenz in HIV-1 Infected Subjects With Hepatic Impairment
Official Title
Pharmacokinetics of Efavirenz During Treatment of HIV-1 Infected Subjects With Hepatic Impairment.
Study Type
Interventional

2. Study Status

Record Verification Date
September 2010
Overall Recruitment Status
Completed
Study Start Date
November 2004 (undefined)
Primary Completion Date
March 2008 (Actual)
Study Completion Date
March 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Bristol-Myers Squibb

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study was to assess the steady-state pharmacokinetics (PK) of efavirenz (EFV) in human immunodeficiency virus type 1 (HIV-1) infected subjects on stable antiretroviral regimens containing EFV, and having selected degrees of hepatic impairment or normal hepatic function.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
EFV600mg Participants With Mild Hepatic Impairment
Arm Type
Experimental
Arm Title
EFV600mg Participants With Moderate Hepatic Impairment
Arm Type
Experimental
Arm Title
EFV600mg Participants With Severe Hepatic Impairment
Arm Type
Experimental
Arm Title
EFV600mg Participants With Normal Hepatic Function
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
efavirenz containing antiretroviral regimen
Other Intervention Name(s)
Sustiva, BMS-561525
Intervention Description
Capsule or Tablet, Oral, once daily for 2 days
Intervention Type
Drug
Intervention Name(s)
efavirenz containing antiretroviral regimen
Other Intervention Name(s)
Sustiva, BMS-561525
Intervention Description
Capsule or Tablet, Oral, once daily for 2 days
Intervention Type
Drug
Intervention Name(s)
efavirenz containing antiretroviral regimen
Other Intervention Name(s)
Sustiva, BMS-561525
Intervention Description
Capsule or Tablet, Oral, once daily for 2 days
Intervention Type
Drug
Intervention Name(s)
efavirenz containing antiretroviral regimen
Other Intervention Name(s)
Sustiva, BMS-561525
Intervention Description
Capsule or Tablet, Oral, once daily for 2 days
Primary Outcome Measure Information:
Title
Maximum Plasma Concentration (Cmax)
Description
Cmax was obtained directly from the concentration-time data.
Time Frame
Blood samples were collected at time 0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12 and 24 hours post-dose, relative to administration of PM or AM dose.
Title
Minimum Plasma Concentration (Cmin)
Description
Cmin was obtained directly from the concentration-time data.
Time Frame
Blood samples were collected at time 0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12 and 24 hours post-dose, relative to administration of PM or AM dose.
Title
Area Under the Plasma Concentration-time Curve Over the Dosing Interval of 24 Hours (AUC[TAU])
Description
The AUC(TAU), from time 0 to the time of the last measurable concentration (t), was calculated by the linear trapezoidal rule.
Time Frame
Blood samples were collected at time 0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12 and 24 hours post-dose, relative to administration of PM or AM dose.
Title
Time to Reach Maximum Observed Plasma Concentration (Tmax)
Description
Tmax was obtained directly from the concentration-time data.
Time Frame
Blood samples were collected at time 0 (pre-dose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12 and 24 hours post-dose, relative to administration of PM or AM dose.
Secondary Outcome Measure Information:
Title
Number of Participants Who Died or Experienced Other Serious Adverse Events (SAEs)
Description
An SAE was defined as any adverse event (AE) occurring at any dose that; resulted in death; was life threatening; resulted in a persistent or significant disability/incapacity; resulted in/prolonged an existing in-patient hospitalization; was a congenital anomaly/birth defect; was a cancer; or was an overdose.
Time Frame
From screening (within 21 days of Day 1 dosing) to the study discharge day (Day 2 for AM dosing or Day 3 for PM dosing). Participants were monitored for SAEs up to 30 days after study discharge.
Title
Number of Participants Who Experienced AEs
Description
AEs were defined as any new untoward medical occurrences or worsening of a pre-existing medical condition in a participant administered a medicinal product, whether or not considered related to the medicinal product.
Time Frame
From screening (within 21 days of Day 1 dosing) to the study discharge day (Day 2 for AM dosing or Day 3 for PM dosing).
Title
Number of Participants Who Experienced AEs Leading to Study Drug Discontinuation
Description
AEs were defined as any new untoward medical occurrences or worsening of a pre-existing medical condition in a participant administered a medicinal product, whether or not considered related to the medicinal product. Participants who discontinued the study due to an AE were recorded.
Time Frame
From screening (within 21 days of Day 1 dosing) to the study discharge day (Day 2 for AM dosing or Day 3 for PM dosing).
Title
Number of Participants With Marked Abnormalities (MAs) in Hematology Measurements
Description
MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following hematology MA definitions specify the criteria for the data presented. Low platelet count: <0.85 x lower limit of normal (LLN) (or if pre-treatment value <LLN, then <0.85 x pre-treatment value). Low leukocytes: <0.9 x LLN (or if pre-treatment value <LLN, then <0.85 x pre-treatment value. If pre-treatment value >upper limit of normal [ULN], then <LLN). Low neutrophils+bands (absolute): <=1.500 10^3 cells/microliter (uL). Low lymphocytes (absolute): <0.750 10^3 cells/uL.
Time Frame
Throughout study, from screening (within 21 days of Day 1 dosing) through Day 3.
Title
Number of Participants With Serum Chemistry MAs
Description
MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following serum chemistry MA definitions specify the criteria for MAs in the data presented. High bilirubin (total): >1.1 x ULN (or if pre-treatment value >ULN, then >1.25 x pre-treatment value). High creatinine: >1.33 x pre-treatment value. Low albumin: <0.9 x LLN (or if pre-treatment value <LLN, then <0.9 x pre-treatment value). High amylase (total): >2 x pre-treatment value.
Time Frame
Throughout study, from screening (within 21 days of Day 1 dosing) through Day 3.
Title
Number of Participants With Urinalysis MAs
Description
MAs are laboratory measurements marked as abnormal, per pre-defined study criteria, at any study time point. The following urinalysis MA definitions specify the criteria for MAs in the data presented. The presence of white blood cells (WBCs) and red blood cells (RBCs) in the urine was graded on a scale: 0 = no cells present (negative); trace =a small number of cells present; then 1+, 2+, 3+ and 4+, denoting increasingly "positive" urine results (ie, WBCs/RBCs present in the urine). The MA for both WBCs and RBCs was >= 2+ (or, if pre-treatment value >=2+, then >= 4+).
Time Frame
Throughout study, from screening (within 21 days of Day 1 dosing) through Day 3.
Title
Number of Participants With Identified Electrocardiogram (ECG) Abnormalities
Description
ECG abnormalities are findings that are clinically meaningful by the judgment of the investigator. A 12-lead ECG was performed and all ECG recordings were evaluated by the investigator. Abnormalities, if present at any study time point, were listed.
Time Frame
From screening (within 21 days of Day 1 dosing) to the study discharge day (Day 2 for AM dosing or Day 3 for PM dosing)
Title
Number of Participants With Clinically Meaningful Vital Signs Measures
Description
Vital signs were recorded throughout the study and included investigations related to body temperature, respiratory rate, seated blood pressure (systolic and diastolic), and heart rate. The investigator used his/her clinical judgement to decide whether or not abnormalities in vital signs were clinically meaningful.
Time Frame
From screening (within 21 days of Day 1 dosing) to the study discharge day (Day 2 for AM dosing or Day 3 for PM dosing)
Title
Number of Participants With Abnormal Physical Examination Findings at Baseline (Screening and/or Day 1)
Description
The physical examination included an evaluation of the participant's height and body mass index (BMI) (at screening only), and weight. Abnormal physical examination are findings that are clinically meaningful by the judgment of the investigator
Time Frame
From screening (within 21 days of Day 1 dosing) to the study discharge day (Day 2 for AM dosing or Day 3 for PM dosing)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HIV-1 infection with or without Hepatitis B or C infection Stable antiretroviral regimen containing efavirenz and nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) for at least 1 month Mild, moderate or severe hepatic impairment with hepatic cirrhosis Exclusion Criteria: Acute flare of hepatitis Positive pregnancy test for a female Significant acute medical illness in past 2 months Use of agents known to significantly affect liver metabolism Change in medications to treat a chronic disease in the past 2 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bristol-Myers Squibb
Organizational Affiliation
Bristol-Myers Squibb
Official's Role
Study Director
Facility Information:
Facility Name
Johns Hopkins University School Of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Uthscsa
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Virginia Commonwealth University Health Systems
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
Local Institution
City
Milano
ZIP/Postal Code
20127
Country
Italy

12. IPD Sharing Statement

Learn more about this trial

Pharmacokinetics of Efavirenz in HIV-1 Infected Subjects With Hepatic Impairment

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