Antiretroviral Therapy Intensification With Raltegravir or Addition of Hyper-immune Bovine Colostrum in HIV-1 Infected Patients With Suboptimal CD4+ T Cell Response (CORAL)
Primary Purpose
HIV Infections
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Raltegravir
Hyper-immune Bovine Colostrum
raltegravir placebo
Hyper-immune Bovine Colostrum placebo
raltegravir and hyper-immune bovine colostrum
Sponsored by
About this trial
This is an interventional treatment trial for HIV Infections focused on measuring HIV, antiretroviral therapy intensification, suboptimal CD4+ T cell response, virological suppression, bovine colostrum, raltegravir
Eligibility Criteria
Inclusion Criteria:
- Documented HIV-1 infection
- Age >18 years
- Signed informed consent
- Receiving combination ART (cART) for at least 12 months with a stable cART regimen for a minimum of 6 months. A formulation change or modification of dosage schedule is acceptable (for example ritonavir - boosted lopinavir capsules for tablets, abacavir (ABC) or tenofovir (TDF) and lamivudine (3TC) or emtricitabine (FTC) as single agents for ABC/3TC or TDF/FTC fixed dose combinations)
- Two consecutive plasma HIV RNA viral load measurements <50 (or <400 copies/mL depending upon lowest level of detection of the local assay) in the 9 months preceding the screening visit. A single isolated HIV RNA viral load >50 (or >400) copies/mL will not exclude the patient provided the viral load result >50 (or 400) copies/mL on therapy follows a previous result <50 (or 400) copies/mL, and there is a follow-up result <50 copies/mL at least one week following the >50 (or 400) copies/mL reading in the absence of a change to any component of the ART regimen.
- CD4+ T cell count <350 cells/µL throughout the 6 months preceding the screening visit with <50 cells/µL increase in the last 12 months
Exclusion Criteria:
- Receiving a cART regimen containing an integrase inhibitor
- Anticipated change of cART in the 24 weeks following randomisation
- Participating in study with an investigational compound or device within 30 days of signing informed consent
- Use of immune modulating therapies or immunosuppressive medications within 60 days prior to study entry. Patients using inhaled or nasal steroids are not excluded
- Pregnant or breastfeeding woman
- Cow's milk allergy
- Concurrent treatment with phenobarbitol, phenytoin or rifampicin.
- A known cause of impaired CD4+ T cell gain: for example, patients with splenomegaly or individuals whose current cART regimen contains both tenofovir and didanosine
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Placebo Comparator
Arm Label
Raltegravir, bovine colostrum
Hyper-immune bovine colostrum
Raltegravir
Placebo
Arm Description
Raltegravir and hyper-immune bovine colostrum
Hyper-immune bovine colostrum and Raltegravir placebo
Raltegravir and Hyper-immune Bovine Colostrum Placebo
Raltegravir placebo and hyper-immune bovine colostrum placebo
Outcomes
Primary Outcome Measures
Mean Change From Baseline CD4+ Cell Count
Comparison of normalised mean change from baseline CD4+ cell count
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00772590
Brief Title
Antiretroviral Therapy Intensification With Raltegravir or Addition of Hyper-immune Bovine Colostrum in HIV-1 Infected Patients With Suboptimal CD4+ T Cell Response
Acronym
CORAL
Official Title
Randomised Double-blind Placebo Controlled Study to Measure the Effect of Antiretroviral Therapy (ART) Intensification With Raltegravir and/or Hyper-immune Bovine Colostrum on CD4+ T Cell Count in ART Treated, HIV-1 Infected Individuals With Suboptimal CD4+ T Cell Responses
Study Type
Interventional
2. Study Status
Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
March 2009 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
June 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kirby Institute
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
A research study to measure the effect on CD4 counts of adding to current anti-retroviral regimen raltegravir with or without hyper-immune bovine colostrum.
Detailed Description
The primary objective of this study is to measure the effect on CD4+ T cell outcome as measured by the mean time weighted CD4+ T cell count change over 24 weeks of two interventions: (I) cART intensification with raltegravir and (II) cART combined with hyper-immune bovine colostrum in HIV-1 infected individuals who have failed to achieve a CD4+ T cell count greater than 350 cells/µL despite persistent HIV plasma viraemia below 50 copies/mL on cART.
Eligible patients will be randomised to one of four arms. I. Raltegravir + hyper-immune bovine colostrum placebo II. Raltegravir placebo + hyper-immune bovine colostrum III. Raltegravir + hyper-immune bovine colostrum IV. Raltegravir placebo + hyper-immune bovine colostrum placebo
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
HIV, antiretroviral therapy intensification, suboptimal CD4+ T cell response, virological suppression, bovine colostrum, raltegravir
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Factorial Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
75 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Raltegravir, bovine colostrum
Arm Type
Experimental
Arm Description
Raltegravir and hyper-immune bovine colostrum
Arm Title
Hyper-immune bovine colostrum
Arm Type
Experimental
Arm Description
Hyper-immune bovine colostrum and Raltegravir placebo
Arm Title
Raltegravir
Arm Type
Experimental
Arm Description
Raltegravir and Hyper-immune Bovine Colostrum Placebo
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Raltegravir placebo and hyper-immune bovine colostrum placebo
Intervention Type
Drug
Intervention Name(s)
Raltegravir
Intervention Description
Tablets, 400mg, twice daily
Intervention Type
Drug
Intervention Name(s)
Hyper-immune Bovine Colostrum
Intervention Description
Tablet, 1800mg, twice daily
Intervention Type
Other
Intervention Name(s)
raltegravir placebo
Other Intervention Name(s)
placebo
Intervention Description
One tablet, twice daily
Intervention Type
Other
Intervention Name(s)
Hyper-immune Bovine Colostrum placebo
Intervention Description
Three tablets twice daily
Intervention Type
Drug
Intervention Name(s)
raltegravir and hyper-immune bovine colostrum
Other Intervention Name(s)
Raltegravir + hyper-immune bovine colostrum
Intervention Description
400mg twice daily raltegravir and 1800mg twice daily of hyper-immune bovine colostrum
Primary Outcome Measure Information:
Title
Mean Change From Baseline CD4+ Cell Count
Description
Comparison of normalised mean change from baseline CD4+ cell count
Time Frame
24 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Documented HIV-1 infection
Age >18 years
Signed informed consent
Receiving combination ART (cART) for at least 12 months with a stable cART regimen for a minimum of 6 months. A formulation change or modification of dosage schedule is acceptable (for example ritonavir - boosted lopinavir capsules for tablets, abacavir (ABC) or tenofovir (TDF) and lamivudine (3TC) or emtricitabine (FTC) as single agents for ABC/3TC or TDF/FTC fixed dose combinations)
Two consecutive plasma HIV RNA viral load measurements <50 (or <400 copies/mL depending upon lowest level of detection of the local assay) in the 9 months preceding the screening visit. A single isolated HIV RNA viral load >50 (or >400) copies/mL will not exclude the patient provided the viral load result >50 (or 400) copies/mL on therapy follows a previous result <50 (or 400) copies/mL, and there is a follow-up result <50 copies/mL at least one week following the >50 (or 400) copies/mL reading in the absence of a change to any component of the ART regimen.
CD4+ T cell count <350 cells/µL throughout the 6 months preceding the screening visit with <50 cells/µL increase in the last 12 months
Exclusion Criteria:
Receiving a cART regimen containing an integrase inhibitor
Anticipated change of cART in the 24 weeks following randomisation
Participating in study with an investigational compound or device within 30 days of signing informed consent
Use of immune modulating therapies or immunosuppressive medications within 60 days prior to study entry. Patients using inhaled or nasal steroids are not excluded
Pregnant or breastfeeding woman
Cow's milk allergy
Concurrent treatment with phenobarbitol, phenytoin or rifampicin.
A known cause of impaired CD4+ T cell gain: for example, patients with splenomegaly or individuals whose current cART regimen contains both tenofovir and didanosine
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sean Emery, BSc (Hons), PhD
Organizational Affiliation
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
21930607
Citation
Byakwaga H, Kelly M, Purcell DF, French MA, Amin J, Lewin SR, Haskelberg H, Kelleher AD, Garsia R, Boyd MA, Cooper DA, Emery S; CORAL Study Group. Intensification of antiretroviral therapy with raltegravir or addition of hyperimmune bovine colostrum in HIV-infected patients with suboptimal CD4+ T-cell response: a randomized controlled trial. J Infect Dis. 2011 Nov 15;204(10):1532-40. doi: 10.1093/infdis/jir559. Epub 2011 Sep 19.
Results Reference
result
Learn more about this trial
Antiretroviral Therapy Intensification With Raltegravir or Addition of Hyper-immune Bovine Colostrum in HIV-1 Infected Patients With Suboptimal CD4+ T Cell Response
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