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Bioavailability of 2 Different Nevirapine Extended Release Formulations Compared to Viramune® in HIV-1 Infected Subjects

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
NVP XR 400 mg (KCR 25%)
NVP XR 400 mg (KCR 20%)
NVP XR 300 mg (KCR 25%)
NVP XR 300 mg (KCR 20%)
high-fat breakfast
NVP IR 200 mg (Viramune®)
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • HIV-1 infected males or females ≥ 18 and ≤ 60 years of age
  • Body mass index 18.5 to 29.9 kg/m2, inclusive
  • Signed and dated written informed consent prior to admission to the study in accordance with Good Clinical Practice and local legislation
  • Treated with a stable Viramune® BID based regimen since at least 12 weeks prior to study entry. If however, the subject's current Viramune® treatment consists of two 200mg tablets once daily (prescribed off label), the subject is allowed to participate if he/she agrees to switch to Viramune® 200mg twice daily, 14 days before the start of Nevirapine Extended Release.
  • An HIV-1 viral load of ≤ 50 c/mL at screening
  • Acceptable screening laboratory values that indicate adequate baseline organ function with the following exceptions:

    • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST)

      ≤2.5 times the upper limit of normal (ULN) (DAIDS Grade 1) or

    • Gamma-glutamyl transferase (GGT) <2.5 times ULN (DAIDS Grade 1)
  • Willingness to abstain from alcoholic beverages for 24 hours prior to intensive pharmakokinetic sampling days
  • Willingness to abstain from ingesting substances which may alter drug plasma levels by interaction with the cytochrome P450 system during the study
  • Willingness to abstain from grapefruit and grapefruit juice, Seville oranges and juice, and St John's wort or milk thistle starting 14 days prior to administration of study medication until the end of the study, and
  • Karnofsky performance score ≥70

Exclusion Criteria:

  • Current treatment with any PI
  • Participation in another trial with an investigational medicine within two months prior to Day 1 of this study
  • Serum creatinine levels >1.5 times ULN at screening
  • History of acute illness within 60 days prior to Day 1, which would make the subject, in the opinion of the investigator, unsuitable for the trial
  • History or evidence of severe illness, malignancy or any other conditions which would make the subjects, in the opinion of the investigator, unsuitable for the trial
  • Any evidence of a clinically relevant concomitant disease, including gastrointestinal, hepatic, renal disorders of clinical relevance
  • Surgery of the gastrointestinal tract (except appendectomy and herniotomy)
  • Diseases of the central nervous system (such as epilepsy) or psychiatric disorders or neurological disorders
  • Chronic or relevant acute infections other than HIV-1 (e.g. hepatitis B virus (HBV), hepatitis C virus (HCV) co infection: A chronic or acute HBV infections is defined as: HBs Ag positive. Chronic or acute HCV infection is defined as: HCV Ab positive and 1 confirmed positive viral load measurement preceding study entry)
  • Alcohol or substance abuse within 6 months prior to screening or during the study
  • Inability to comply with protocol requirements
  • Screening laboratory values <DAIDS grade 1
  • All fertile males or females, and their respective partner(s) not willing to use two forms of effective contraception. A double-barrier method must be used. A double-barrier method is defined as e.g.: 1) a condom with spermicidal jelly or with a foam suppository; 2) a diaphragm with spermicide; or 3) a male condom and a diaphragm
  • Female of child-bearing potential who:

    • Has a positive serum pregnancy test at screening,
    • Is breastfeeding,
    • Is planning to become pregnant, or
    • Is not willing to use barrier method protection or require ethinyl estradiol administration
  • Any AIDS-defining illness that is unresolved, symptomatic, or not stable on treatment for at least 12 weeks before the screening visit
  • HIV-2 infection

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm 7

    Arm 8

    Arm 9

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Active Comparator

    Arm Label

    NVP XR 400 mg (KCR 25%) fasted

    NVP XR 400 mg (KCR 25%) fed

    NVP XR 400 mg (KCR 20%) fasted

    NVP XR 400 mg (KCR 20%) fed

    NVP XR 300 mg (KCR 25%) fasted

    NVP XR 300 mg (KCR 25%) fed

    NVP XR 300 mg (KCR 20%) fasted

    NVP XR 300 mg (KCR 20%) fed

    NVP IR 200 mg (Viramune®)

    Arm Description

    Outcomes

    Primary Outcome Measures

    AUCτ,ss (area under the concentration-time curve of the analyte in plasma at steady state over the time dosing interval τ)
    Cmin,ss (minimum measured concentration of the analyte in plasma at steady state over the time dosing interval τ)
    Cmax,ss (maximum measured concentration of the analyte in plasma at steady state over the time dosing interval τ)

    Secondary Outcome Measures

    Cmax,ss / Cmin,ss ratio
    %PTF (percentage peak-trough fluctuation)
    tmax,ss (time from dosing to the maximum concentration of the analyte in plasma at steady state over the time dosing interval τ)
    CL/F,ss (apparent clearance of the analyte in the plasma after extravascular administration at steady state)
    Cavg (average measured concentration of the analyte in plasma at steady state)
    Number of patients with adverse events (AEs)
    Number of patients with clinically relevant changes in clinical laboratory tests
    Number of patients with abnormal detectable viral load
    Number of patients with clinically relevant changes in vital signs (blood pressure, pulse rate)
    Number of patients with clinically relevant changes in 12-lead electrocardiogram (ECG)
    Number of patients with clinically relevant changes in physical examination
    Assessment of tolerability by the investigator on a 4-point scale

    Full Information

    First Posted
    July 17, 2014
    Last Updated
    July 17, 2014
    Sponsor
    Boehringer Ingelheim
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02194179
    Brief Title
    Bioavailability of 2 Different Nevirapine Extended Release Formulations Compared to Viramune® in HIV-1 Infected Subjects
    Official Title
    Steady State Bioavailability of 2 Different Nevirapine Extended Release Formulations Compared to Steady State 400 mg of Viramune® (200 mg BID), in HIV-1 Infected Subjects, an Open Label, Non Randomised, Multidose and Multistage Parallel Group Study. (ERVIR)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2006 (undefined)
    Primary Completion Date
    May 2007 (Actual)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Boehringer Ingelheim

    4. Oversight

    5. Study Description

    Brief Summary
    The objective was to establish the pharmacokinetic (PK) profile at steady state of two different nevirapine (NVP) extended release (XR) formulations at 300 mg or 400 mg daily (QD) under fasted and fed conditions in comparison with the commercially available NVP immediate release (IR) tablet at 200 mg BID (400 mg/day).

    6. Conditions and Keywords

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

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    NVP XR 400 mg (KCR 25%) fasted
    Arm Type
    Experimental
    Arm Title
    NVP XR 400 mg (KCR 25%) fed
    Arm Type
    Experimental
    Arm Title
    NVP XR 400 mg (KCR 20%) fasted
    Arm Type
    Experimental
    Arm Title
    NVP XR 400 mg (KCR 20%) fed
    Arm Type
    Experimental
    Arm Title
    NVP XR 300 mg (KCR 25%) fasted
    Arm Type
    Experimental
    Arm Title
    NVP XR 300 mg (KCR 25%) fed
    Arm Type
    Experimental
    Arm Title
    NVP XR 300 mg (KCR 20%) fasted
    Arm Type
    Experimental
    Arm Title
    NVP XR 300 mg (KCR 20%) fed
    Arm Type
    Experimental
    Arm Title
    NVP IR 200 mg (Viramune®)
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    NVP XR 400 mg (KCR 25%)
    Intervention Type
    Drug
    Intervention Name(s)
    NVP XR 400 mg (KCR 20%)
    Intervention Type
    Drug
    Intervention Name(s)
    NVP XR 300 mg (KCR 25%)
    Intervention Type
    Drug
    Intervention Name(s)
    NVP XR 300 mg (KCR 20%)
    Intervention Type
    Other
    Intervention Name(s)
    high-fat breakfast
    Intervention Type
    Drug
    Intervention Name(s)
    NVP IR 200 mg (Viramune®)
    Primary Outcome Measure Information:
    Title
    AUCτ,ss (area under the concentration-time curve of the analyte in plasma at steady state over the time dosing interval τ)
    Time Frame
    up to day 22
    Title
    Cmin,ss (minimum measured concentration of the analyte in plasma at steady state over the time dosing interval τ)
    Time Frame
    up to day 22
    Title
    Cmax,ss (maximum measured concentration of the analyte in plasma at steady state over the time dosing interval τ)
    Time Frame
    up to day 22
    Secondary Outcome Measure Information:
    Title
    Cmax,ss / Cmin,ss ratio
    Time Frame
    up to day 22
    Title
    %PTF (percentage peak-trough fluctuation)
    Time Frame
    up to day 22
    Title
    tmax,ss (time from dosing to the maximum concentration of the analyte in plasma at steady state over the time dosing interval τ)
    Time Frame
    up to day 22
    Title
    CL/F,ss (apparent clearance of the analyte in the plasma after extravascular administration at steady state)
    Time Frame
    up to day 22
    Title
    Cavg (average measured concentration of the analyte in plasma at steady state)
    Time Frame
    up to day 22
    Title
    Number of patients with adverse events (AEs)
    Time Frame
    up to day 57
    Title
    Number of patients with clinically relevant changes in clinical laboratory tests
    Time Frame
    Baseline, up to day 37
    Title
    Number of patients with abnormal detectable viral load
    Time Frame
    Baseline, up to day 37
    Title
    Number of patients with clinically relevant changes in vital signs (blood pressure, pulse rate)
    Time Frame
    Baseline, up to day 37
    Title
    Number of patients with clinically relevant changes in 12-lead electrocardiogram (ECG)
    Time Frame
    Baseline, day 23
    Title
    Number of patients with clinically relevant changes in physical examination
    Time Frame
    Baseline, up to day 37
    Title
    Assessment of tolerability by the investigator on a 4-point scale
    Time Frame
    up to day 37

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: HIV-1 infected males or females ≥ 18 and ≤ 60 years of age Body mass index 18.5 to 29.9 kg/m2, inclusive Signed and dated written informed consent prior to admission to the study in accordance with Good Clinical Practice and local legislation Treated with a stable Viramune® BID based regimen since at least 12 weeks prior to study entry. If however, the subject's current Viramune® treatment consists of two 200mg tablets once daily (prescribed off label), the subject is allowed to participate if he/she agrees to switch to Viramune® 200mg twice daily, 14 days before the start of Nevirapine Extended Release. An HIV-1 viral load of ≤ 50 c/mL at screening Acceptable screening laboratory values that indicate adequate baseline organ function with the following exceptions: Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤2.5 times the upper limit of normal (ULN) (DAIDS Grade 1) or Gamma-glutamyl transferase (GGT) <2.5 times ULN (DAIDS Grade 1) Willingness to abstain from alcoholic beverages for 24 hours prior to intensive pharmakokinetic sampling days Willingness to abstain from ingesting substances which may alter drug plasma levels by interaction with the cytochrome P450 system during the study Willingness to abstain from grapefruit and grapefruit juice, Seville oranges and juice, and St John's wort or milk thistle starting 14 days prior to administration of study medication until the end of the study, and Karnofsky performance score ≥70 Exclusion Criteria: Current treatment with any PI Participation in another trial with an investigational medicine within two months prior to Day 1 of this study Serum creatinine levels >1.5 times ULN at screening History of acute illness within 60 days prior to Day 1, which would make the subject, in the opinion of the investigator, unsuitable for the trial History or evidence of severe illness, malignancy or any other conditions which would make the subjects, in the opinion of the investigator, unsuitable for the trial Any evidence of a clinically relevant concomitant disease, including gastrointestinal, hepatic, renal disorders of clinical relevance Surgery of the gastrointestinal tract (except appendectomy and herniotomy) Diseases of the central nervous system (such as epilepsy) or psychiatric disorders or neurological disorders Chronic or relevant acute infections other than HIV-1 (e.g. hepatitis B virus (HBV), hepatitis C virus (HCV) co infection: A chronic or acute HBV infections is defined as: HBs Ag positive. Chronic or acute HCV infection is defined as: HCV Ab positive and 1 confirmed positive viral load measurement preceding study entry) Alcohol or substance abuse within 6 months prior to screening or during the study Inability to comply with protocol requirements Screening laboratory values <DAIDS grade 1 All fertile males or females, and their respective partner(s) not willing to use two forms of effective contraception. A double-barrier method must be used. A double-barrier method is defined as e.g.: 1) a condom with spermicidal jelly or with a foam suppository; 2) a diaphragm with spermicide; or 3) a male condom and a diaphragm Female of child-bearing potential who: Has a positive serum pregnancy test at screening, Is breastfeeding, Is planning to become pregnant, or Is not willing to use barrier method protection or require ethinyl estradiol administration Any AIDS-defining illness that is unresolved, symptomatic, or not stable on treatment for at least 12 weeks before the screening visit HIV-2 infection

    12. IPD Sharing Statement

    Links:
    URL
    http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/1100/1100.1489_U08-2197-01.pdf
    Description
    Related Info

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    Bioavailability of 2 Different Nevirapine Extended Release Formulations Compared to Viramune® in HIV-1 Infected Subjects

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