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Microboosting of Atazanavir 300 mg With 50 mg Versus 100mg Ritonavir Daily in HIV-infected Patients: a Pharmacokinetic Study

Primary Purpose

HIV Infection

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
atazanavir 300mg boosted with ritonavir 50 mg
Sponsored by
Ottawa Hospital Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for HIV Infection focused on measuring PK, pharmacokinetic, HIV-infected, atazanavir, ritonavir

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients meeting the following criteria will be eligible for participation in this study:

    1. Signed informed consent prior to any study-related activities.
    2. Documented HIV infection.
    3. Male or female patients between 18 and 70 years of age inclusively.
    4. Medication history, vital signs and physical exam adequately showing no signs of acute illness at screening, as per the assessment by the physician.
    5. Patients must be willing to stop using any herbal or natural health products for 4 weeks prior to and during the study including:

      • Grapefruit, grapefruit juice, St. John's Wort and any others as determined by the investigators.
    6. Patients must be on an antiretroviral regimen with atazanavir/ ritonavir 300/100 mg daily as the only protease inhibitor plus any combination of nucleoside reverse transcriptase inhibitors, for at least four weeks.
    7. VL<40 copies/mL on the most recent measurement, during treatment with atazanavir 300 mg daily and ritonavir 100 mg daily, which must be within 12 weeks of the study start date.
    8. Reproductive Status: Definition of Women of Child-Bearing Potential (WOCBP). WOCBP comprises women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or who are not post-menopausal (see definition below).

      • WOCBP must be using an acceptable method of contraception to avoid pregnancy throughout the study and for up to 4 weeks after the last dose of study drug in such a manner that the risk of pregnancy is minimized.
      • WOCBP must have a negative serum or urine pregnancy test result (minimum sensitivity 25 IU/L or equivalent units of HCG) within 0 to 72 hours before the first dose of study drug.
      • Women must not be breast-feeding.
      • Sexually active fertile men must use effective birth control if their partners are WOCBP

Exclusion Criteria:

Patients meeting one or more of the following criteria will be excluded from the study:

  1. Female patients of childbearing potential who:

    1. Has a positive urine pregnancy test at screening.
    2. Have not been using a barrier method of contraception (such as diaphragm with spermicidal cream/jelly or condoms with spermicidal foam), for at least 3 months prior to participation in the study.
    3. Is not willing or able to use a reliable method of barrier contraception during the study.
    4. Is breastfeeding.
  2. Patients with prior history of treatment failure on a PI based regimen, or with genotypic evidence of resistance associated mutations to protease inhibitors.
  3. Use of any medication listed in Appendix I within 4 weeks prior to screening.
  4. Use of any over-the-counter or prescription medications in the two weeks prior to Day 1 of the study that may interfere with absorption, distribution, metabolism or excretion of the study medications.
  5. Inability to adhere to protocol.
  6. Patients may be excluded from the study for other reasons, at the investigator's discretion.

Sites / Locations

  • The Ottawa Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

atazanavir 300mg boosted with ritonavir 100mg

Arm Description

Two period drug interaction. Period one: atazanavir 300mg boosted with ritonavir 100 mg once daily as part of current treatment standard of care. Period two: atazanavir 300 mg boosted with ritonavir 50 mg once daily for study days 2-8 inclusive

Outcomes

Primary Outcome Measures

Pharmacokinetics
main pharmacokinetic parameters of atazanavir: AUC0-24h, Cmax and Cmin.

Secondary Outcome Measures

adverse events
the main pharmacokinetic parameters of ritonavir: AUC0-24h, Cmax and Cmin, , adverse events and preference, as reported by patients during the study period.

Full Information

First Posted
January 10, 2014
Last Updated
September 21, 2015
Sponsor
Ottawa Hospital Research Institute
Collaborators
Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT02034838
Brief Title
Microboosting of Atazanavir 300 mg With 50 mg Versus 100mg Ritonavir Daily in HIV-infected Patients: a Pharmacokinetic Study
Official Title
Microboosting of Atazanavir 300 mg With 50 mg Versus 100 mg Ritonavir Daily in HIV-infected Patients: a Pharmacokinetic Study
Study Type
Interventional

2. Study Status

Record Verification Date
September 2015
Overall Recruitment Status
Completed
Study Start Date
January 2014 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ottawa Hospital Research Institute
Collaborators
Bristol-Myers Squibb

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open-label, single group study to determine the pharmacokinetic profile of atazanavir 300 mg daily boosted with ritonavir 100mg daily in HIV-infected patients over a period of 9 days. Ritonavir and atazanavir are protease inhibitors used to treat HIV. However, ritonavir, when used at low doses (up to 100mg) does not have HIV activity, but will enhance (boost) the blood concentrations of other drugs like atazanavir. Recently, a study showed that taking 50mg of ritonavir administered in an oral solution led to similar blood concentrations of atazanavir than when given with 100mg of ritonavir. Potential benefits associated with a lower dose of ritonavir may include a reduction of side effects such as upset stomach and an improvement in cholesterol level. This study will look at the amount of atazanavir into your blood when given with ritonavir in a tablet formulation at 50mg or 100mg with standard atazanavir dose (300mg).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infection
Keywords
PK, pharmacokinetic, HIV-infected, atazanavir, ritonavir

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
atazanavir 300mg boosted with ritonavir 100mg
Arm Type
Experimental
Arm Description
Two period drug interaction. Period one: atazanavir 300mg boosted with ritonavir 100 mg once daily as part of current treatment standard of care. Period two: atazanavir 300 mg boosted with ritonavir 50 mg once daily for study days 2-8 inclusive
Intervention Type
Drug
Intervention Name(s)
atazanavir 300mg boosted with ritonavir 50 mg
Other Intervention Name(s)
Reyataz, ATV, Norvir, RTV
Intervention Description
atazanavir 300 mg with ritonavir 100 mg once a day at 8:00 am for study day 1 and 9. atazanavir 300 mg with ritonavir 50 mg once a day at 8:00 am for 7 consecutive days (study days 2-8)
Primary Outcome Measure Information:
Title
Pharmacokinetics
Description
main pharmacokinetic parameters of atazanavir: AUC0-24h, Cmax and Cmin.
Time Frame
9 days
Secondary Outcome Measure Information:
Title
adverse events
Description
the main pharmacokinetic parameters of ritonavir: AUC0-24h, Cmax and Cmin, , adverse events and preference, as reported by patients during the study period.
Time Frame
9 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients meeting the following criteria will be eligible for participation in this study: Signed informed consent prior to any study-related activities. Documented HIV infection. Male or female patients between 18 and 70 years of age inclusively. Medication history, vital signs and physical exam adequately showing no signs of acute illness at screening, as per the assessment by the physician. Patients must be willing to stop using any herbal or natural health products for 4 weeks prior to and during the study including: Grapefruit, grapefruit juice, St. John's Wort and any others as determined by the investigators. Patients must be on an antiretroviral regimen with atazanavir/ ritonavir 300/100 mg daily as the only protease inhibitor plus any combination of nucleoside reverse transcriptase inhibitors, for at least four weeks. VL<40 copies/mL on the most recent measurement, during treatment with atazanavir 300 mg daily and ritonavir 100 mg daily, which must be within 12 weeks of the study start date. Reproductive Status: Definition of Women of Child-Bearing Potential (WOCBP). WOCBP comprises women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or who are not post-menopausal (see definition below). WOCBP must be using an acceptable method of contraception to avoid pregnancy throughout the study and for up to 4 weeks after the last dose of study drug in such a manner that the risk of pregnancy is minimized. WOCBP must have a negative serum or urine pregnancy test result (minimum sensitivity 25 IU/L or equivalent units of HCG) within 0 to 72 hours before the first dose of study drug. Women must not be breast-feeding. Sexually active fertile men must use effective birth control if their partners are WOCBP Exclusion Criteria: Patients meeting one or more of the following criteria will be excluded from the study: Female patients of childbearing potential who: Has a positive urine pregnancy test at screening. Have not been using a barrier method of contraception (such as diaphragm with spermicidal cream/jelly or condoms with spermicidal foam), for at least 3 months prior to participation in the study. Is not willing or able to use a reliable method of barrier contraception during the study. Is breastfeeding. Patients with prior history of treatment failure on a PI based regimen, or with genotypic evidence of resistance associated mutations to protease inhibitors. Use of any medication listed in Appendix I within 4 weeks prior to screening. Use of any over-the-counter or prescription medications in the two weeks prior to Day 1 of the study that may interfere with absorption, distribution, metabolism or excretion of the study medications. Inability to adhere to protocol. Patients may be excluded from the study for other reasons, at the investigator's discretion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William Cameron, MD, FRCPC
Organizational Affiliation
The Ottawa Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Ottawa Hospital
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada

12. IPD Sharing Statement

Links:
URL
http://www.ohri.ca/ciu/
Description
Info on The Ottawa Hospital -General Campus Clinical Investigation Unit

Learn more about this trial

Microboosting of Atazanavir 300 mg With 50 mg Versus 100mg Ritonavir Daily in HIV-infected Patients: a Pharmacokinetic Study

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