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Safety Study of Lopinavir/Ritonavir With Raltegravir in HIV-infected Patients

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
lopinavir/ritonavir and raltegravir
Sponsored by
Saint Michael's Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring HIV, Protease Inhibitor, Integrase Inhibitor, Treatment Experienced, Naive

Eligibility Criteria

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

Inclusion Criteria:

  1. HIV-1 infection, as documented by any licensed ELISA test kit, and confirmed by Western blot, positive HIV-1 blood culture, positive HIV serum antigen, or plasma viremia at any time prior to study entry. If no record exists, testing must occur at screening.
  2. Males and non-pregnant females > 18 years of age. (Children are being excluded as they are immunologically different than adults)
  3. HIV-1 RNA > 1000 copies/ml for both patient naive and experienced to antiretroviral therapy in order for phenotypic susceptibility to be performed. There in no inclusion criteria for CD4 count.
  4. Treatment experienced patients , defined as having taken medications from two of the following three classes of antiretrovirals: NRTI, NNRTI, or PI must have phenotypic susceptability to lopinavir/ritonavir as resulted by Phenosense GT
  5. Laboratory tests ( Cbc w/diff, comprehensive metabolic panel) within pre-specified limits
  6. Able to sign the informed consent, and is willing to comply with the requirements of this clinical trial.
  7. Available for at least 52 weeks of follow up
  8. If female and of child bearing potential must consent to remain abstinent throughout the study period and for 30 days after the last dose of study medications.( this is standard language)

Exclusion Criteria:

  1. Pregnant or breast-feeding woman (pregnant women are being excluded as drug kinetics are different in pregnancy and the dynamics of immune reconstitution are unknown in this group)
  2. Current treatment for malignancy other than basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or isolated cutaneous Kaposi's Sarcoma that is not being treated; those with prior cancer diagnosis, such as lymphomas must have been disease-free for at least 5 years
  3. Absolute neutrophil count < 500, platelet count < 50,000, hemoglobin < 8 gm/dL
  4. Evidence of end-organ disease, defined as follows: renal (calculated creatinine clearance of less than 50 mL/min); liver (liver-associated enzymes > 3 times the upper limits of normal)
  5. Grade 3 (ACTG Grading Scale) or higher cholesterol or triglyceride elevations
  6. Acute, serious infection requiring prescription drug therapy within 30 days prior to study entry
  7. In the opinion of the investigator, there is evidence of an active ongoing opportunistic infection
  8. Must not currently be undergoing treatment for an opportunistic infection.
  9. Use of immune stimulation agents known to impact CD4 cell count in the peripheral circulation, to include IL2, interferon, G-CSF, GM-CSF, etc.
  10. Use of immune suppressant drugs, with the exception of < 10 mg/day of prednisone .
  11. Unwillingness to remain abstinent for duration of study
  12. Experimental vaccines, to include HIV vaccines.
  13. Patient who is currently enrolled in an experimental protocol, or is receiving an experimental medication.
  14. Patients on 2 NRTIs with an NNRTI and a PI combination will not be allowed in the study.

Sites / Locations

  • Saint Michael's Medical Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

1

Arm Description

open label single arm

Outcomes

Primary Outcome Measures

The primary objective of this trial is to evaluate the percentage of patients with HIV-1 RNA below 50 copies at week 48 receiving lopinavir/ritonavir in combination with raltegravir

Secondary Outcome Measures

To evaluate the effect of lopinavir/ritonavir in combination with raltegravir in maintaining virological suppression
To evaluate the change from baseline in plasma HIV-1 RNA at weeks 12, 24, 36, and 48

Full Information

First Posted
September 12, 2008
Last Updated
July 19, 2011
Sponsor
Saint Michael's Medical Center
Collaborators
Abbott
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1. Study Identification

Unique Protocol Identification Number
NCT00752037
Brief Title
Safety Study of Lopinavir/Ritonavir With Raltegravir in HIV-infected Patients
Official Title
Safety and Efficacy of Lopinavir/Ritonavir in Combination With Raltegravir in HIV-infected Patients
Study Type
Interventional

2. Study Status

Record Verification Date
September 2008
Overall Recruitment Status
Completed
Study Start Date
September 2008 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Saint Michael's Medical Center
Collaborators
Abbott

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A single center, open label, 48-week study of lopinavir/ritonavir in combination with raltegravir. 30 patients, both naïve and experienced, will be enrolled. 15 treatment naïve patients and 15 treatment experienced patients enrolled
Detailed Description
This is an open-labeled, non-randomized exploratory trial in selected volunteers who meet the stated enrollment criteria. This study will assess the impact of lopinavir/ritonavir in combination with raltegravir on HIV-1 Patients will be evaluated frequently over the 52 weeks of the protocol. Patients will be seen at screening, baseline, week 4, 12, 24, 36, 48, and 52, to include physical examination, assessment for the development of AIDS-defining conditions, hematology, chemistry, lipid profile, CD4, CD8 cell counts, plasma HIV-1 RNA ultrasensitive, and assessment of adverse events. If HIV-1 RNA becomes detectable, this will be repeated for confirmation with 2 weeks. HIV genotyping and phenotyping will be performed on patients who demonstrate repetitive plasma viral load levels of > 1,000 copies/mL. An interim analysis will be performed when all patients have reached the week 24 visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
HIV, Protease Inhibitor, Integrase Inhibitor, Treatment Experienced, Naive

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Other
Arm Description
open label single arm
Intervention Type
Drug
Intervention Name(s)
lopinavir/ritonavir and raltegravir
Other Intervention Name(s)
Kaletra, Isentress
Intervention Description
lopinavir/ritonavir 400/100 mg po b.id. in combination with raltegravir 400 mg po b.i.d.
Primary Outcome Measure Information:
Title
The primary objective of this trial is to evaluate the percentage of patients with HIV-1 RNA below 50 copies at week 48 receiving lopinavir/ritonavir in combination with raltegravir
Time Frame
week 48
Secondary Outcome Measure Information:
Title
To evaluate the effect of lopinavir/ritonavir in combination with raltegravir in maintaining virological suppression
Time Frame
weeks 12, 24, 36, and 48
Title
To evaluate the change from baseline in plasma HIV-1 RNA at weeks 12, 24, 36, and 48
Time Frame
weeks 12, 24, 36, and 48

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HIV-1 infection, as documented by any licensed ELISA test kit, and confirmed by Western blot, positive HIV-1 blood culture, positive HIV serum antigen, or plasma viremia at any time prior to study entry. If no record exists, testing must occur at screening. Males and non-pregnant females > 18 years of age. (Children are being excluded as they are immunologically different than adults) HIV-1 RNA > 1000 copies/ml for both patient naive and experienced to antiretroviral therapy in order for phenotypic susceptibility to be performed. There in no inclusion criteria for CD4 count. Treatment experienced patients , defined as having taken medications from two of the following three classes of antiretrovirals: NRTI, NNRTI, or PI must have phenotypic susceptability to lopinavir/ritonavir as resulted by Phenosense GT Laboratory tests ( Cbc w/diff, comprehensive metabolic panel) within pre-specified limits Able to sign the informed consent, and is willing to comply with the requirements of this clinical trial. Available for at least 52 weeks of follow up If female and of child bearing potential must consent to remain abstinent throughout the study period and for 30 days after the last dose of study medications.( this is standard language) Exclusion Criteria: Pregnant or breast-feeding woman (pregnant women are being excluded as drug kinetics are different in pregnancy and the dynamics of immune reconstitution are unknown in this group) Current treatment for malignancy other than basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or isolated cutaneous Kaposi's Sarcoma that is not being treated; those with prior cancer diagnosis, such as lymphomas must have been disease-free for at least 5 years Absolute neutrophil count < 500, platelet count < 50,000, hemoglobin < 8 gm/dL Evidence of end-organ disease, defined as follows: renal (calculated creatinine clearance of less than 50 mL/min); liver (liver-associated enzymes > 3 times the upper limits of normal) Grade 3 (ACTG Grading Scale) or higher cholesterol or triglyceride elevations Acute, serious infection requiring prescription drug therapy within 30 days prior to study entry In the opinion of the investigator, there is evidence of an active ongoing opportunistic infection Must not currently be undergoing treatment for an opportunistic infection. Use of immune stimulation agents known to impact CD4 cell count in the peripheral circulation, to include IL2, interferon, G-CSF, GM-CSF, etc. Use of immune suppressant drugs, with the exception of < 10 mg/day of prednisone . Unwillingness to remain abstinent for duration of study Experimental vaccines, to include HIV vaccines. Patient who is currently enrolled in an experimental protocol, or is receiving an experimental medication. Patients on 2 NRTIs with an NNRTI and a PI combination will not be allowed in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jihad Slim, MD
Organizational Affiliation
Saint Michael's Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Saint Michael's Medical Center
City
Newark
State/Province
New Jersey
ZIP/Postal Code
07102
Country
United States

12. IPD Sharing Statement

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Safety Study of Lopinavir/Ritonavir With Raltegravir in HIV-infected Patients

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