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
About this trial
This is an interventional treatment trial for HIV Infections
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
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
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
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Bioavailability of 2 Different Nevirapine Extended Release Formulations Compared to Viramune® in HIV-1 Infected Subjects
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