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Maraviroc Plus Darunavir/Ritonavir for Treatment-Naïve Patients Infected With R5-tropic HIV-1 (MIDAS)

Primary Purpose

HIV-1 Infection, HIV Infections

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
maraviroc
darunavir
ritonavir
Sponsored by
Northwestern University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1 Infection focused on measuring Treatment naive

Eligibility Criteria

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

Inclusion Criteria:

  • HIV-1 infection, as documented by any licensed HIV test kit and confirmed by Western blot, HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA any time prior to study entry
  • Plasma HIV-1 RNA 5, 000 to 500,000 copies/mL obtained within 90 days prior to study entry
  • Exclusive R5 tropism based on enhanced sensitivity Trofile assay done within 90 days prior to entry
  • CD4 cell count > 100 cells/mm3 within 90 days prior to study entry
  • HIV genotype (for RT and protease) performed at any time before study entry (Subjects with single or combination NNRTI or NRTI RAM(s) at screening are permitted)
  • ARV drug-naïve, defined as no previous ARV treatment at any time prior to study entry
  • Negative result from a hepatitis B surface antigen test performed within 90 days prior to study entry
  • Negative result from a hepatitis C antibody test performed within 90 days prior to study entry
  • Laboratory values obtained within 30 days prior to study entry:

    • ANC >=750/mm3
    • Hemoglobin >=10 g/dL
    • Platelets >=50,000/mm3
    • AST (SGOT), ALT (SGPT), and alkaline phosphatase <=5 x ULN
    • Calculated creatinine clearance (CrCl) >=30 mL/min, as estimated by the Cockcroft-Gault equation*
  • Negative serum or urine pregnancy test within 48 hours prior to study entry for women with reproductive potential
  • If participating in sexual activity that could lead to pregnancy, the study subjects with reproductive potential must use one form of contraceptive while receiving protocol-specified medications and for 60 days after stopping the medications.
  • Men and women age >=18 years
  • Ability and willingness of subject or legal guardian/representative to provide informed consent

Exclusion Criteria:

  • Serious illness requiring systemic treatment and/or hospitalization until candidate either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 7 days prior to study entry
  • Screening HIV genotype obtained any time prior to study entry with any DRV RAM (V11I, V32I, L33F, I47V, I50V, I54L, I54M, T74P, L76V, I84V, and L89V)
  • Treatment within 30 days prior to study entry with immune modulators such as systemic steroids, interleukins, interferons, granulocyte colony-stimulating factor (G-CSF), erythropoietin, or any investigational therapy. NOTE: Subjects receiving stable physiologic glucocorticoid doses (defined as prednisone ≤10 mg/day [or equivalent] as a stable or tapering dose) are permitted. Subjects receiving corticosteroids for acute therapy for PCP or asthma exacerbation, or receiving a short course (defined as ≤2 weeks of pharmacologic glucocorticoid therapy) are permitted
  • Breast-feeding
  • Requirement for any medication that is prohibited with a study medication
  • Known allergy/sensitivity to study drugs or their formulations. A history of sulfa allergy is not an exclusion
  • Active drug or alcohol use or dependence that could interfere with adherence to study requirements

Sites / Locations

  • Quest Clinical Research
  • University of Miami
  • Northwestern University
  • CORECenter
  • University of Nebraska

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Maraviroc plus darunavir/ritonavir

Arm Description

Single arm open label trial of maraviroc 150 mg plus darunavir/ritonavir 800/100 mg once daily for 96 weeks

Outcomes

Primary Outcome Measures

Percentage of Participants With Plasma HIV-1 RNA >50
Percentage of participants with confirmed plasma HIV-1 RNA > 50 copies/mL

Secondary Outcome Measures

Percentage of Participants With Virologic Failure or Off Study Treatment Regimen
Percentage of participants with virologic failure (confirmed plasma HIV-1 RNA > 50 copies/mL) or off study treatment regimen (composite end point)
Percentage of Participants With Plasma HIV-1 RNA >50 Copies/mL
Percentage of participants with confirmed plasma HIV-1 RNA level >50 copies/mL
Signs/Symptoms or Laboratory Toxicities of Grade 3 or Higher
Signs/symptoms or laboratory toxicities of Grade 3 or higher, or of any grade which led to a permanent change or discontinuation of study treatment regimen
Drug Resistance Mutations and Co-receptor Tropism Assessed by Trofile ES
Drug Adherence, Number of Participants With Missed Doses
Drug adherence, assessed as number of participants with missed doses over four-day recall
Trough Concentrations (Ctrough) of Maraviroc
Average trough concentration (Ctrough) of maraviroc
Median CD4 Count Change From Baseline
Median changes from baseline in peripheral CD4+ T-cell count
Proportion of Participants With Plasma HIV-1 RNA >50 Copies/mL
Proportion of participants with confirmed plasma HIV-1 RNA level >50 copies/mL

Full Information

First Posted
October 8, 2009
Last Updated
August 26, 2014
Sponsor
Northwestern University
Collaborators
Pfizer, Tibotec, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT00993148
Brief Title
Maraviroc Plus Darunavir/Ritonavir for Treatment-Naïve Patients Infected With R5-tropic HIV-1
Acronym
MIDAS
Official Title
Maraviroc Plus Darunavir/Ritonavir Study for Treatment-Naïve Patients Infected With R5-tropic HIV-1 Based on Enhanced Sensitivity Trofile
Study Type
Interventional

2. Study Status

Record Verification Date
August 2014
Overall Recruitment Status
Completed
Study Start Date
May 2010 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
April 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Northwestern University
Collaborators
Pfizer, Tibotec, Inc

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to evaluate the safety and efficacy of a novel combination antiretroviral therapy regimen consisting of maraviroc plus darunavir/ritonavir in treatment-naive patients infected with R5-tropic HIV-1. The hypothesis is that in treatment-naive subjects infected with R5-tropic HIV-1, combination antiretroviral therapy with maraviroc plus darunavir/ritonavir is well tolerated and efficacious.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1 Infection, HIV Infections
Keywords
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
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Maraviroc plus darunavir/ritonavir
Arm Type
Experimental
Arm Description
Single arm open label trial of maraviroc 150 mg plus darunavir/ritonavir 800/100 mg once daily for 96 weeks
Intervention Type
Drug
Intervention Name(s)
maraviroc
Other Intervention Name(s)
Selzentry
Intervention Description
150 mg tab by mouth once daily for 96 weeks
Intervention Type
Drug
Intervention Name(s)
darunavir
Other Intervention Name(s)
Prezista
Intervention Description
800 mg tab by mouth once daily for 96 weeks
Intervention Type
Drug
Intervention Name(s)
ritonavir
Other Intervention Name(s)
norvir
Intervention Description
100 mg capsule by mouth once daily for 96 weeks
Primary Outcome Measure Information:
Title
Percentage of Participants With Plasma HIV-1 RNA >50
Description
Percentage of participants with confirmed plasma HIV-1 RNA > 50 copies/mL
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Percentage of Participants With Virologic Failure or Off Study Treatment Regimen
Description
Percentage of participants with virologic failure (confirmed plasma HIV-1 RNA > 50 copies/mL) or off study treatment regimen (composite end point)
Time Frame
24 weeks
Title
Percentage of Participants With Plasma HIV-1 RNA >50 Copies/mL
Description
Percentage of participants with confirmed plasma HIV-1 RNA level >50 copies/mL
Time Frame
48 weeks
Title
Signs/Symptoms or Laboratory Toxicities of Grade 3 or Higher
Description
Signs/symptoms or laboratory toxicities of Grade 3 or higher, or of any grade which led to a permanent change or discontinuation of study treatment regimen
Time Frame
96 weeks
Title
Drug Resistance Mutations and Co-receptor Tropism Assessed by Trofile ES
Time Frame
At study entry and at the time of virologic failure
Title
Drug Adherence, Number of Participants With Missed Doses
Description
Drug adherence, assessed as number of participants with missed doses over four-day recall
Time Frame
Week 24
Title
Trough Concentrations (Ctrough) of Maraviroc
Description
Average trough concentration (Ctrough) of maraviroc
Time Frame
24 hours
Title
Median CD4 Count Change From Baseline
Description
Median changes from baseline in peripheral CD4+ T-cell count
Time Frame
96 weeks
Title
Proportion of Participants With Plasma HIV-1 RNA >50 Copies/mL
Description
Proportion of participants with confirmed plasma HIV-1 RNA level >50 copies/mL
Time Frame
96 weeks

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 HIV test kit and confirmed by Western blot, HIV-1 culture, HIV-1 antigen, plasma HIV-1 RNA, or a second antibody test by a method other than ELISA any time prior to study entry Plasma HIV-1 RNA 5, 000 to 500,000 copies/mL obtained within 90 days prior to study entry Exclusive R5 tropism based on enhanced sensitivity Trofile assay done within 90 days prior to entry CD4 cell count > 100 cells/mm3 within 90 days prior to study entry HIV genotype (for RT and protease) performed at any time before study entry (Subjects with single or combination NNRTI or NRTI RAM(s) at screening are permitted) ARV drug-naïve, defined as no previous ARV treatment at any time prior to study entry Negative result from a hepatitis B surface antigen test performed within 90 days prior to study entry Negative result from a hepatitis C antibody test performed within 90 days prior to study entry Laboratory values obtained within 30 days prior to study entry: ANC >=750/mm3 Hemoglobin >=10 g/dL Platelets >=50,000/mm3 AST (SGOT), ALT (SGPT), and alkaline phosphatase <=5 x ULN Calculated creatinine clearance (CrCl) >=30 mL/min, as estimated by the Cockcroft-Gault equation* Negative serum or urine pregnancy test within 48 hours prior to study entry for women with reproductive potential If participating in sexual activity that could lead to pregnancy, the study subjects with reproductive potential must use one form of contraceptive while receiving protocol-specified medications and for 60 days after stopping the medications. Men and women age >=18 years Ability and willingness of subject or legal guardian/representative to provide informed consent Exclusion Criteria: Serious illness requiring systemic treatment and/or hospitalization until candidate either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 7 days prior to study entry Screening HIV genotype obtained any time prior to study entry with any DRV RAM (V11I, V32I, L33F, I47V, I50V, I54L, I54M, T74P, L76V, I84V, and L89V) Treatment within 30 days prior to study entry with immune modulators such as systemic steroids, interleukins, interferons, granulocyte colony-stimulating factor (G-CSF), erythropoietin, or any investigational therapy. NOTE: Subjects receiving stable physiologic glucocorticoid doses (defined as prednisone ≤10 mg/day [or equivalent] as a stable or tapering dose) are permitted. Subjects receiving corticosteroids for acute therapy for PCP or asthma exacerbation, or receiving a short course (defined as ≤2 weeks of pharmacologic glucocorticoid therapy) are permitted Breast-feeding Requirement for any medication that is prohibited with a study medication Known allergy/sensitivity to study drugs or their formulations. A history of sulfa allergy is not an exclusion Active drug or alcohol use or dependence that could interfere with adherence to study requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Babafemi Taiwo, MD
Organizational Affiliation
Northwestern University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Quest Clinical Research
City
San Francisco
State/Province
California
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
CORECenter
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Nebraska
City
Omaha
State/Province
Nebraska
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23797691
Citation
Taiwo B, Acosta EP, Ryscavage P, Berzins B, Lu D, Lalezari J, Castro J, Adeyemi O, Kuritzkes DR, Eron JJ, Tsibris A, Swindells S. Virologic response, early HIV-1 decay, and maraviroc pharmacokinetics with the nucleos(t)ide-free regimen of maraviroc plus darunavir/ritonavir in a pilot study. J Acquir Immune Defic Syndr. 2013 Oct 1;64(2):167-73. doi: 10.1097/QAI.0b013e3182a03d95.
Results Reference
result

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Maraviroc Plus Darunavir/Ritonavir for Treatment-Naïve Patients Infected With R5-tropic HIV-1

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