Pharmacokinetics of Emtricitabine/Tenofovir/Efavirenz in HIV-infected Patients With Tuberculosis (PETE)
Primary Purpose
Tuberculosis, HIV Infections
Status
Unknown status
Phase
Phase 2
Locations
Tanzania
Study Type
Interventional
Intervention
Emtricitabine/tenofovir/efavirenz
Sponsored by
About this trial
This is an interventional treatment trial for Tuberculosis focused on measuring Tuberculosis, HIV, Coinfection, Pharmacokinetics, Emtricitabine, Tenofovir, Rifampin, Efavirenz, Treatment Naive
Eligibility Criteria
Inclusion Criteria:
- A smear-positive pulmonary tuberculosis, based on positive smear of at least two sputum samples with Ziehl-Neelsen (ZN) staining.
- HIV-infected as documented by positive HIV antibody test.
- Subject is at least 18 years of age at the day of the first dosing of study medication.
- Subject is able and willing to sign the Informed Consent Form prior to screening evaluations.
- CD4 cell count > 50 copies/mm3.
- Karnofsky score > 40.
- Willing and able to regularly attend the Kibung'oto National Tuberculosis Hospital (KNTH) clinic.
Exclusion Criteria:
- History of sensitivity/idiosyncrasy to the drug or chemically related compounds or excipients, which may be employed in the trial.
- Previously treated for HIV infection with antiretroviral agents.
- Pregnant or breastfeeding.
- Relevant history or current condition that might interfere with drug absorption, distribution, metabolism or excretion.
- A history of severe psychiatric disease such as psychosis, schizophrenia, etc.
- Inability to understand the nature and extent of the trial and the procedures required.
- Abnormal serum transaminases or creatinine, determined as levels being > 5 times upper limit of normal.
- Active hepatobiliary or hepatic disease (Non B Chronic Hepatitis B/C co-infection is allowed).
- CD4 cell count > 350 cells/mm3.
Sites / Locations
- Kibong'oto National Tuberculosis HospitalRecruiting
Outcomes
Primary Outcome Measures
Pharmacokinetic parameters of emtricitabine, tenofovir and efavirenz
Pharmacokinetic parameters of the tuberculostatic agents
Secondary Outcome Measures
Biochemistry and haematology samples for safety
Questioning about occurrence of adverse events
CD4 count and HIV-1 RNA
Sputum staining and culture
Full Information
NCT ID
NCT00474435
First Posted
May 16, 2007
Last Updated
December 16, 2010
Sponsor
African Poverty Related Infection Oriented Research Initiative
Collaborators
Radboud University Medical Center, Kilimanjaro Christian Medical Centre, Tanzania
1. Study Identification
Unique Protocol Identification Number
NCT00474435
Brief Title
Pharmacokinetics of Emtricitabine/Tenofovir/Efavirenz in HIV-infected Patients With Tuberculosis
Acronym
PETE
Official Title
The Pharmacokinetics of Co-formulated Emtricitabine/Tenofovir/Efavirenz in HIV-infected Patients With Smear-positive Pulmonary Tuberculosis in the Kilimanjaro Region, Tanzania
Study Type
Interventional
2. Study Status
Record Verification Date
December 2008
Overall Recruitment Status
Unknown status
Study Start Date
November 2008 (undefined)
Primary Completion Date
December 2009 (Anticipated)
Study Completion Date
December 2009 (Anticipated)
3. Sponsor/Collaborators
Name of the Sponsor
African Poverty Related Infection Oriented Research Initiative
Collaborators
Radboud University Medical Center, Kilimanjaro Christian Medical Centre, Tanzania
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
In this pilot study the pharmacokinetics and safety of the antiretroviral combination of co-formulated emtricitabine/tenofovir/efavirenz will be studied in HIV-positive patients with pulmonary tuberculosis (TB) who are concomitantly treated with a standard rifampin-containing tuberculostatic regimen. It is expected that this antiretroviral combination causes minimal drug interactions with the rifampin-containing anti-tuberculosis medication.
Detailed Description
The primary objectives of this pilot study in 30 patients are:
To determine the effect of rifampin-containing tuberculostatic treatment on the pharmacokinetic profile of emtricitabine+tenofovir+efavirenz, when co-formulated in one tablet, in HIV-infected patients with smear-positive pulmonary tuberculosis in Tanzania.
To determine the effect of the emtricitabine+tenofovir+efavirenz regimen on the pharmacokinetics of tuberculostatics in the same population.
The secondary objectives are:
To determine the safety of co-administration of emtricitabine+tenofovir+efavirenz with treatment for smear-positive pulmonary tuberculosis.
To determine the short-term (24 weeks) virological efficacy on HIV of an emtricitabine+tenofovir+efavirenz regimen in patients with smear-positive pulmonary tuberculosis.
To determine the short-term bacteriological efficacy on smear-positive tuberculosis of the co-administration of a standard regimen for tuberculosis and an emtricitabine+tenofovir+efavirenz regimen.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberculosis, HIV Infections
Keywords
Tuberculosis, HIV, Coinfection, Pharmacokinetics, Emtricitabine, Tenofovir, Rifampin, Efavirenz, Treatment Naive
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
Emtricitabine/tenofovir/efavirenz
Intervention Description
Co-formulated in one tablet (taken once daily by oral administration):
emtricitabine 200 mg
tenofovir DF 300 mg
efavirenz 600 mg
Primary Outcome Measure Information:
Title
Pharmacokinetic parameters of emtricitabine, tenofovir and efavirenz
Time Frame
Two 24 hour pharmacokinetic (PK) curves (week 8 and 28)
Title
Pharmacokinetic parameters of the tuberculostatic agents
Time Frame
Pharmacokinetic (PK) samples at 2 hours and 6 hours postdose (week 2 and 8)
Secondary Outcome Measure Information:
Title
Biochemistry and haematology samples for safety
Time Frame
Samples at screening, baseline, week 2, 4, 6, 8, 12, 16, 24, 28
Title
Questioning about occurrence of adverse events
Time Frame
At baseline, week 2, 4, 6, 8, 12, 16, 24, 28
Title
CD4 count and HIV-1 RNA
Time Frame
At screening, week 4, week 16 and week 28
Title
Sputum staining and culture
Time Frame
At screening, week 4, 8, and 28
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
A smear-positive pulmonary tuberculosis, based on positive smear of at least two sputum samples with Ziehl-Neelsen (ZN) staining.
HIV-infected as documented by positive HIV antibody test.
Subject is at least 18 years of age at the day of the first dosing of study medication.
Subject is able and willing to sign the Informed Consent Form prior to screening evaluations.
CD4 cell count > 50 copies/mm3.
Karnofsky score > 40.
Willing and able to regularly attend the Kibung'oto National Tuberculosis Hospital (KNTH) clinic.
Exclusion Criteria:
History of sensitivity/idiosyncrasy to the drug or chemically related compounds or excipients, which may be employed in the trial.
Previously treated for HIV infection with antiretroviral agents.
Pregnant or breastfeeding.
Relevant history or current condition that might interfere with drug absorption, distribution, metabolism or excretion.
A history of severe psychiatric disease such as psychosis, schizophrenia, etc.
Inability to understand the nature and extent of the trial and the procedures required.
Abnormal serum transaminases or creatinine, determined as levels being > 5 times upper limit of normal.
Active hepatobiliary or hepatic disease (Non B Chronic Hepatitis B/C co-infection is allowed).
CD4 cell count > 350 cells/mm3.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gibson Kibiki, MMed, PhD
Phone
+255 754 572767
Email
gkibiki@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jossy van den Boogaard, MD
Phone
+255 787 148431
Email
jossyvandenboogaard@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Boeree, MD, PhD
Organizational Affiliation
University Lungcentre Dekkerswald, Groesbeek / University Medical Centre Nijmegen, the Netherlands
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David Burger, PharmD, PhD
Organizational Affiliation
University Medical Centre Nijmegen, the Netherlands
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gibson Kibiki, MMed, PhD
Organizational Affiliation
Kilimanjaro Christian Medical Centre,Moshi,Tanzania
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kibong'oto National Tuberculosis Hospital
City
Moshi
State/Province
Kilimanjaro Region
ZIP/Postal Code
P.O. Box 12
Country
Tanzania
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liberate Mleoh, MD
Phone
027 2756194
Email
lmleoh@yahoo.com
First Name & Middle Initial & Last Name & Degree
Gibson Kibiki, MMed, PhD
First Name & Middle Initial & Last Name & Degree
Elton Kisanga, B-Pharm, PhD
First Name & Middle Initial & Last Name & Degree
Liberate Mleoh, MD
First Name & Middle Initial & Last Name & Degree
Jossy van den Boogaard, MD
First Name & Middle Initial & Last Name & Degree
Hadija Semvua, B-Pharm, MPH
First Name & Middle Initial & Last Name & Degree
Charles Mtabho, MD, MPH
12. IPD Sharing Statement
Citations:
PubMed Identifier
11081535
Citation
Bowen EF, Rice PS, Cooke NT, Whitfield RJ, Rayner CF. HIV seroprevalence by anonymous testing in patients with Mycobacterium tuberculosis and in tuberculosis contacts. Lancet. 2000 Oct 28;356(9240):1488-9. doi: 10.1016/S0140-6736(00)02876-2.
Results Reference
background
PubMed Identifier
9295244
Citation
Msamanga GI, Fawzi WW. The double burden of HIV infection and tuberculosis in sub-Saharan Africa. N Engl J Med. 1997 Sep 18;337(12):849-51. doi: 10.1056/NEJM199709183371210. No abstract available.
Results Reference
background
PubMed Identifier
11741165
Citation
Dean GL, Edwards SG, Ives NJ, Matthews G, Fox EF, Navaratne L, Fisher M, Taylor GP, Miller R, Taylor CB, de Ruiter A, Pozniak AL. Treatment of tuberculosis in HIV-infected persons in the era of highly active antiretroviral therapy. AIDS. 2002 Jan 4;16(1):75-83. doi: 10.1097/00002030-200201040-00010.
Results Reference
background
PubMed Identifier
11432536
Citation
Burman WJ, Gallicano K, Peloquin C. Comparative pharmacokinetics and pharmacodynamics of the rifamycin antibacterials. Clin Pharmacokinet. 2001;40(5):327-41. doi: 10.2165/00003088-200140050-00002.
Results Reference
background
PubMed Identifier
11996607
Citation
Finch CK, Chrisman CR, Baciewicz AM, Self TH. Rifampin and rifabutin drug interactions: an update. Arch Intern Med. 2002 May 13;162(9):985-92. doi: 10.1001/archinte.162.9.985.
Results Reference
background
PubMed Identifier
12126459
Citation
Lopez-Cortes LF, Ruiz-Valderas R, Viciana P, Alarcon-Gonzalez A, Gomez-Mateos J, Leon-Jimenez E, Sarasanacenta M, Lopez-Pua Y, Pachon J. Pharmacokinetic interactions between efavirenz and rifampicin in HIV-infected patients with tuberculosis. Clin Pharmacokinet. 2002;41(9):681-90. doi: 10.2165/00003088-200241090-00004.
Results Reference
background
PubMed Identifier
8363370
Citation
Burger DM, Meenhorst PL, Koks CH, Beijnen JH. Pharmacokinetic interaction between rifampin and zidovudine. Antimicrob Agents Chemother. 1993 Jul;37(7):1426-31. doi: 10.1128/AAC.37.7.1426.
Results Reference
background
PubMed Identifier
10417493
Citation
Gallicano KD, Sahai J, Shukla VK, Seguin I, Pakuts A, Kwok D, Foster BC, Cameron DW. Induction of zidovudine glucuronidation and amination pathways by rifampicin in HIV-infected patients. Br J Clin Pharmacol. 1999 Aug;48(2):168-79. doi: 10.1046/j.1365-2125.1999.00987.x.
Results Reference
background
PubMed Identifier
15156433
Citation
Friedland G, Abdool Karim S, Abdool Karim Q, Lalloo U, Jack C, Gandhi N, El Sadr W. Utility of tuberculosis directly observed therapy programs as sites for access to and provision of antiretroviral therapy in resource-limited countries. Clin Infect Dis. 2004 Jun 1;38 Suppl 5:S421-8. doi: 10.1086/421407.
Results Reference
background
PubMed Identifier
12626888
Citation
Droste JA, Aarnoutse RE, Koopmans PP, Hekster YA, Burger DM. Evaluation of antiretroviral drug measurements by an interlaboratory quality control program. J Acquir Immune Defic Syndr. 2003 Mar 1;32(3):287-91. doi: 10.1097/00126334-200303010-00007.
Results Reference
background
PubMed Identifier
14982771
Citation
Holland DT, DiFrancesco R, Stone J, Hamzeh F, Connor JD, Morse GD; Adult and Pediatric AIDS Clinical Trials Group Pharmacology Laboratory Committees, Pediatric AIDS Clinical Trials Group. Quality assurance program for clinical measurement of antiretrovirals: AIDS clinical trials group proficiency testing program for pediatric and adult pharmacology laboratories. Antimicrob Agents Chemother. 2004 Mar;48(3):824-31. doi: 10.1128/AAC.48.3.824-831.2004.
Results Reference
background
PubMed Identifier
11192870
Citation
Marzolini C, Telenti A, Decosterd LA, Greub G, Biollaz J, Buclin T. Efavirenz plasma levels can predict treatment failure and central nervous system side effects in HIV-1-infected patients. AIDS. 2001 Jan 5;15(1):71-5. doi: 10.1097/00002030-200101050-00011.
Results Reference
background
Learn more about this trial
Pharmacokinetics of Emtricitabine/Tenofovir/Efavirenz in HIV-infected Patients With Tuberculosis
We'll reach out to this number within 24 hrs