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A 48-Week, Randomised, Study to Describe the Pharmacokinetic Profile and Durability of Atazanavir-Saquinavir-Ritonavir Once Daily and Describe the Pharmacokinetic Profile of Saquinavir-Ritonavir Using Saquinavir 500mg Formulation: the ASK-500 Study (ASK-500)

Primary Purpose

HIV Infections

Status
Completed
Phase
Not Applicable
Locations
Australia
Study Type
Interventional
Intervention
saquinavir 500 formulation
cross-over arm
Sponsored by
Kirby Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring Pharmacokinetics, atazanavir, saquinavir, ritonavir, HIV

Eligibility Criteria

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

Inclusion Criteria: HIV-1 infected individuals aged 18 years or over On stable antiretroviral therapy for at least three months consisting of nucleoside reverse transcriptase inhibitors and protease inhibitors OR On stable antiretroviral therapy for at least three months consisting of atazanavir-saquinavir-ritonavir Undetectable HIV RNA viral load for past three months Exclusion Criteria: Individuals receiving on non-nucleoside reverse transcriptase inhibitors within the past three months Individuals currently receiving other enzyme inducing agents (as per Individuals receiving ritonavir at doses greater than 100 mg bid Active AIDS defining illnesses Previously documented intolerance or virological failure to saquinavir Previously documented intolerance or virological failure to atazanavir Patients who are co-infected with Hepatitis B and are likely to require, in their clinician's opinion, HBV nucleoside therapy during the study. Female patients who are pregnant, breastfeeding, or who plan to become pregnant during the study Any current clinical or laboratory parameter of ACTG Grade 4 (except lipids & CK) Evidence of ongoing alcohol and/or drug or substance abuse that would result in the patient being unreliable in fulfilling the conditions of this protocol Prior non-adherence to antiretroviral treatment regimens that would result in the patient being unreliable in fulfilling the conditions of this protocol Evidence of active opportunistic infection, intercurrent illness, drug toxicity or any other condition that would preclude the patient from taking the prescribed antiretroviral regimen Conditions that might interfere with evaluation of the disease under study. Conditions/allergies that may compromise the safety of the patient.

Sites / Locations

  • St Vincents Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

saquinavir at baseline

other boosted PI at baseline

Arm Description

patients receiving NRTIs + saquinavir + ritonavir 1000/100 mg BID at entry switch from 200 mg SQV capsules to 500 mg SQV tablets following PK at day 0. After PK at day 8 NRTIs ceased and regimen changed to ATV/SQV/RTV 300/1500/100 QD using 500 mg SQV formulation and continued to week 48

Patients receiving NRTIs + PI/RTV randomised at baseline to receive ATV/SQVRTV 300/1500/100 QD using 500 mg SQV formulation or ATV/SQV/RTV 300/1600/100 QD using 200 mg formulation. Following PK at day 7, SQV formulation switched with second PK assessment at day 15. Patients then receive ATV/SQV/RTV 300/1500/100 QD to week 48.

Outcomes

Primary Outcome Measures

To compare the pharmacokinectic profile of ATV-SQV-RTV using SQV 500 and 200 formulations.
To compare the pharmacokinetic profile of SQV/r 1000/100mg bid using SQV 500 and 200 formulations.
To assess the durability and safety of a once daily double boosted PI regimen comprised of ATV300 - SQV1500 - RTV100
To assess the decay pharmacokinetics

Secondary Outcome Measures

Assessment of adherence to medications.
Assessment of changes to CD4 lymphocyte count
Assessment of changes in lipid parameters
Assessment of changes in monocyte mRNA

Full Information

First Posted
September 13, 2005
Last Updated
June 25, 2009
Sponsor
Kirby Institute
Collaborators
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT00192608
Brief Title
A 48-Week, Randomised, Study to Describe the Pharmacokinetic Profile and Durability of Atazanavir-Saquinavir-Ritonavir Once Daily and Describe the Pharmacokinetic Profile of Saquinavir-Ritonavir Using Saquinavir 500mg Formulation: the ASK-500 Study
Acronym
ASK-500
Official Title
A 48-Week, Randomised, Study to Describe the Pharmacokinetic Profile and Durability of Atazanavir-Saquinavir-Ritonavir Once Daily and Describe the Pharmacokinetic Profile of Saquinavir-Ritonavir Using Saquinavir 500mg Formulation.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2009
Overall Recruitment Status
Completed
Study Start Date
November 2004 (undefined)
Primary Completion Date
May 2006 (Actual)
Study Completion Date
May 2006 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Kirby Institute
Collaborators
Hoffmann-La Roche

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Saquinavir and Atazanavir are drugs used in combination therapy to treat HIV disease. Saquinavir is currently available in a 200 milligram capsule. Most individuals currently on saquinavir require to take 5 tablets twice a day. In an attempt to reduce this number of pills, a new capsule has been developed containing 500 milligrams of saquinavir. This study will assess: i) blood drug levels in individuals taking both saquinavir formulations, ii) blood drug levels in individuals taking both saquinavir formulations when given with atazanavir, iii) 48 weeks of follow up for individuals receiving the new saquinavir formulation with atazanavir as HIV therapy.
Detailed Description
BACKGROUND The development of anti-HIV therapy for the treatment of HIV disease has improved the quality of life and survival of many people with HIV. However the treatments do not always work over long periods, as medications are often difficult to take due to side effects and a large numbers of pills to be taken. This has lead researchers to look for new ways to treat HIV with medications that require fewer numbers of pills and have fewer side effects. Atazanavir and saquinavir are two drugs used to treat HIV and come from the same class of drugs known as the protease inhibitors. Atazanavir has the advantage of being taken only once a day. Saquinavir is available in a new formulation (type of pill), which will require fewer numbers of pills to be taken daily. AIM The purpose of this study is to investigate the use of these two drugs used together with ritonavir as a once daily HIV treatment, which will consist of 6 tablets. Furthermore this study will look at blood drug levels in individuals on atazanavir, saquinavir and ritonavir with and without the new saquinavir formulation to ensure blood levels of these drugs are adequate. For individuals currently on the old saquinavir formulation, this study will also look at blood drug levels before and after changing to the new formulation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
Pharmacokinetics, atazanavir, saquinavir, ritonavir, HIV

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
saquinavir at baseline
Arm Type
Experimental
Arm Description
patients receiving NRTIs + saquinavir + ritonavir 1000/100 mg BID at entry switch from 200 mg SQV capsules to 500 mg SQV tablets following PK at day 0. After PK at day 8 NRTIs ceased and regimen changed to ATV/SQV/RTV 300/1500/100 QD using 500 mg SQV formulation and continued to week 48
Arm Title
other boosted PI at baseline
Arm Type
Experimental
Arm Description
Patients receiving NRTIs + PI/RTV randomised at baseline to receive ATV/SQVRTV 300/1500/100 QD using 500 mg SQV formulation or ATV/SQV/RTV 300/1600/100 QD using 200 mg formulation. Following PK at day 7, SQV formulation switched with second PK assessment at day 15. Patients then receive ATV/SQV/RTV 300/1500/100 QD to week 48.
Intervention Type
Drug
Intervention Name(s)
saquinavir 500 formulation
Intervention Description
NRTIs + SQV/RTV 1000/100 mg BID using 200 mg SQV capsules switched at entry to ATV/SQV/RTV 300/1500/100 mg QD using 500 mg SQV tablet for 48 weeks with PK at days 0 and 8.
Intervention Type
Drug
Intervention Name(s)
cross-over arm
Intervention Description
either ATV/SQV/RTV 300/1500/100 QD (500 mg SQV tabs) for 7 days then after PK SQV changed to 1600 mg QD (200 mg caps) with PK day 15, or ATV/SQV/RTV 300/1600/100 QD for 7 days with switch to SQV 1500 mg QD. After day 15 PK both groups switch to ATV/SQV/RTV 300/1500/100 QD to week 48
Primary Outcome Measure Information:
Title
To compare the pharmacokinectic profile of ATV-SQV-RTV using SQV 500 and 200 formulations.
Time Frame
week 48
Title
To compare the pharmacokinetic profile of SQV/r 1000/100mg bid using SQV 500 and 200 formulations.
Time Frame
week 48
Title
To assess the durability and safety of a once daily double boosted PI regimen comprised of ATV300 - SQV1500 - RTV100
Time Frame
week 48
Title
To assess the decay pharmacokinetics
Time Frame
week 48
Secondary Outcome Measure Information:
Title
Assessment of adherence to medications.
Time Frame
week 48
Title
Assessment of changes to CD4 lymphocyte count
Time Frame
week 48
Title
Assessment of changes in lipid parameters
Time Frame
week 48
Title
Assessment of changes in monocyte mRNA
Time Frame
week 48

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: HIV-1 infected individuals aged 18 years or over On stable antiretroviral therapy for at least three months consisting of nucleoside reverse transcriptase inhibitors and protease inhibitors OR On stable antiretroviral therapy for at least three months consisting of atazanavir-saquinavir-ritonavir Undetectable HIV RNA viral load for past three months Exclusion Criteria: Individuals receiving on non-nucleoside reverse transcriptase inhibitors within the past three months Individuals currently receiving other enzyme inducing agents (as per Individuals receiving ritonavir at doses greater than 100 mg bid Active AIDS defining illnesses Previously documented intolerance or virological failure to saquinavir Previously documented intolerance or virological failure to atazanavir Patients who are co-infected with Hepatitis B and are likely to require, in their clinician's opinion, HBV nucleoside therapy during the study. Female patients who are pregnant, breastfeeding, or who plan to become pregnant during the study Any current clinical or laboratory parameter of ACTG Grade 4 (except lipids & CK) Evidence of ongoing alcohol and/or drug or substance abuse that would result in the patient being unreliable in fulfilling the conditions of this protocol Prior non-adherence to antiretroviral treatment regimens that would result in the patient being unreliable in fulfilling the conditions of this protocol Evidence of active opportunistic infection, intercurrent illness, drug toxicity or any other condition that would preclude the patient from taking the prescribed antiretroviral regimen Conditions that might interfere with evaluation of the disease under study. Conditions/allergies that may compromise the safety of the patient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David A Cooper, MD
Organizational Affiliation
Kirby Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
St Vincents Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia

12. IPD Sharing Statement

Citations:
PubMed Identifier
17479946
Citation
Winston A, Mallon PW, Satchell C, MacRae K, Williams KM, Schutz M, Law M, Cooper DA, Emery S. The safety, efficacy, and pharmacokinetic profile of a switch in antiretroviral therapy to saquinavir, ritonavir, and atazanavir alone for 48 weeks and a switch in the saquinavir formulation. Clin Infect Dis. 2007 Jun 1;44(11):1475-83. doi: 10.1086/517507. Epub 2007 Apr 18.
Results Reference
result
Links:
URL
http://www.med.unsw.edu.au/nchecr/
Description
National Centre in HIV Epidemiology and Clinical Research Homepage

Learn more about this trial

A 48-Week, Randomised, Study to Describe the Pharmacokinetic Profile and Durability of Atazanavir-Saquinavir-Ritonavir Once Daily and Describe the Pharmacokinetic Profile of Saquinavir-Ritonavir Using Saquinavir 500mg Formulation: the ASK-500 Study

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