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Buprenorphine/Raltegravir Pharmacokinetic Interaction Study

Primary Purpose

HIV Infection, HIV Infections

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Raltegravir
Sponsored by
Yale University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infection focused on measuring HIV, Pharmacokinetics, Pharmacodynamics, Buprenorphine, Raltegravir, HIV seronegativity, Interaction

Eligibility Criteria

21 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Patients who are opioid dependent on long-term buprenorphine/naloxone (BUP/NLX) maintenance (minimum of 4 weeks) and who must remain at a stable dose of buprenorphine for at least 3 weeks deemed by the investigator to have acceptable medical history, physical examination and clinical laboratory evaluations consistent with BUP maintenance will be eligible to participate in the study.
  • Body weight >60 kg for males and >40 kg for females
  • Male or females, ages > 21 to < 60 years.
  • Women of childbearing potential (WOCBP) must not be nursing or pregnant and must be on adequate non-hormonal contraception to avoid pregnancy. WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours prior to the start of Study Day 1.

Exclusion Criteria:

  • WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 4 weeks before and after the study.
  • Use of an oral, injectable or implantable hormonal contraceptive agent within 3 months of enrollment and throughout the study.
  • Women who are currently pregnant or breastfeeding.
  • History or current evidence of any significant acute or chronic medical illness that, within the investigator's discretion, would interfere with the conduct or interpretation of the study.
  • Proven or suspected acute hepatitis at the time of study entry
  • Any major surgery within 4 weeks of enrollment. Minor surgical procedures requiring local anesthesia are exceptions.
  • Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks of enrollment.
  • Blood transfusion within 4 weeks of enrollment.
  • Inability to tolerate oral medication.
  • Inability to tolerate venipuncture and/or absence of secure venous access.
  • Inability to refrain from smoking during in-residence period
  • Evidence of organ dysfunction or any clinically relevant (as determined by the investigator) deviations from the norms observed in a buprenorphine/naloxone treated population in physical examination, vital signs, or clinical laboratory determinations.
  • Positive breathalyzer alcohol test, or positive urine screen for barbiturates, benzodiazepines, amphetamines, cocaine or opioids other than buprenorphine/naloxone.
  • Subjects with AST, ALT or bilirubin > 3.0X the upper limit of normal
  • Hemoglobin < 9 g/dL, and platelet count < 75,000/mm3.
  • Positive serum or urine for HCG.
  • History of any significant drug allergy, drug rash or sensitivity to any class of drugs relevant to the study drugs.
  • HIV antibody positive
  • Exposure to any investigational drug within 4 weeks of enrollment and throughout the study.
  • Prior exposure to Raltegravir.
  • Use of any agent (prescribed or otherwise) within 2 weeks of dosing, that is known or suspected to induce or inhibit drug metabolizing enzymes (e.g., cimetidine and compounds in the barbiturate and phenothiazine classes), affect renal tubular secretion (e.g., probenecid, beta-lactam antibiotics), gastrointestinal motility (e.g., metoclopramide, propantheline, loperamide, or narcotic analgesics or opioids other than buprenorphine/naloxone), or uric acid metabolism (e.g., allopurinol) or gastrointestinal pH (including antacids, H2-receptor antagonists, proton pump inhibitors etc.).
  • Use of over-the-counter medications and herbal preparations, within 1 week prior to enrollment and throughout the study.
  • Use of St. John's Wort (Hypericum) within four weeks prior to study enrollment and throughout the study.
  • Consumption of grapefruit or grapefruit juice within 1 week of study entry and throughout the study.

Sites / Locations

  • Yale University School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bup/Ral

Arm Description

Buprenorphine and Raltegravir co-administration

Outcomes

Primary Outcome Measures

Area Under the Curve (AUC) of BUP/NLX With Raltegravir (hr*ng/mL)
PK parameters of BUP were determined by non-compartmental methods. AUC of BUP was determined by use of the trapezoidal rule.

Secondary Outcome Measures

Full Information

First Posted
March 6, 2009
Last Updated
October 19, 2012
Sponsor
Yale University
Collaborators
National Institute on Drug Abuse (NIDA), Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00858962
Brief Title
Buprenorphine/Raltegravir Pharmacokinetic Interaction Study
Official Title
A Study of the Pharmacokinetic and Pharmacodynamic Interactions Between Raltegravir (Isentress) and Buprenorphine
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Completed
Study Start Date
March 2009 (undefined)
Primary Completion Date
December 2009 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Yale University
Collaborators
National Institute on Drug Abuse (NIDA), Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main purpose of this protocol is to study the effect of an HIV medication known as Raltegravir on Buprenorphine in people who have been receiving the same dose of Buprenorphine for at least 3 weeks before study entry. This will be determined by giving Raltegravir along with Buprenorphine and by measuring the amount of Raltegravir and Buprenorphine in the blood. The investigators will also learn about the effects of Buprenorphine on Raltegravir and about the safety of taking these two medications together.
Detailed Description
A large number of people who are infected with HIV have acquired it through injection drug use. Some of these people are currently being treated with Buprenorphine for their addiction and with medications for HIV infection. Raltegravir is a medication that was approved by the Food and Drug Administration (FDA) for the treatment of HIV infection. Raltegravir acts by making it more difficult for the virus that causes AIDS to multiply and cause more damage to the immune system in someone who is HIV infected. Earlier studies looking at the effect of Buprenorphine and HIV medications have shown that Buprenorphine and some HIV medications act differently when taken together. It is important to learn if taking Buprenorphine and HIV medications together results in changes in the blood level of either medication. If the HIV medication affects the level of Buprenorphine in the blood, an individual taking Buprenorphine and HIV medications may experience symptoms of withdrawal, even while taking their usual dose of Buprenorphine. On the other hand, if Buprenorphine decreases the amount of HIV medication in the blood, then the HIV medication may be less effective in controlling HIV infection. It is therefore important to learn if Raltegravir and Buprenorphine will affect each other when taken together. In order to learn about the effects of Buprenorphine and Raltegravir, we will need to measure the amount of Buprenorphine in your blood for 24 hours before you have taken Raltegravir and then compare that to the amount of Buprenorphine in your blood after you have taken Buprenorphine and Raltegravir together .

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infection, HIV Infections
Keywords
HIV, Pharmacokinetics, Pharmacodynamics, Buprenorphine, Raltegravir, HIV seronegativity, Interaction

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bup/Ral
Arm Type
Experimental
Arm Description
Buprenorphine and Raltegravir co-administration
Intervention Type
Drug
Intervention Name(s)
Raltegravir
Other Intervention Name(s)
Isentress
Intervention Description
400 mg of raltegravir orally twice daily together with normally prescribed stable dose of buprenorphine for a minimum of 4 days and up to 14 days.
Primary Outcome Measure Information:
Title
Area Under the Curve (AUC) of BUP/NLX With Raltegravir (hr*ng/mL)
Description
PK parameters of BUP were determined by non-compartmental methods. AUC of BUP was determined by use of the trapezoidal rule.
Time Frame
6-14 days after beginning co-administration of drugs

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Patients who are opioid dependent on long-term buprenorphine/naloxone (BUP/NLX) maintenance (minimum of 4 weeks) and who must remain at a stable dose of buprenorphine for at least 3 weeks deemed by the investigator to have acceptable medical history, physical examination and clinical laboratory evaluations consistent with BUP maintenance will be eligible to participate in the study. Body weight >60 kg for males and >40 kg for females Male or females, ages > 21 to < 60 years. Women of childbearing potential (WOCBP) must not be nursing or pregnant and must be on adequate non-hormonal contraception to avoid pregnancy. WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours prior to the start of Study Day 1. Exclusion Criteria: WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 4 weeks before and after the study. Use of an oral, injectable or implantable hormonal contraceptive agent within 3 months of enrollment and throughout the study. Women who are currently pregnant or breastfeeding. History or current evidence of any significant acute or chronic medical illness that, within the investigator's discretion, would interfere with the conduct or interpretation of the study. Proven or suspected acute hepatitis at the time of study entry Any major surgery within 4 weeks of enrollment. Minor surgical procedures requiring local anesthesia are exceptions. Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks of enrollment. Blood transfusion within 4 weeks of enrollment. Inability to tolerate oral medication. Inability to tolerate venipuncture and/or absence of secure venous access. Inability to refrain from smoking during in-residence period Evidence of organ dysfunction or any clinically relevant (as determined by the investigator) deviations from the norms observed in a buprenorphine/naloxone treated population in physical examination, vital signs, or clinical laboratory determinations. Positive breathalyzer alcohol test, or positive urine screen for barbiturates, benzodiazepines, amphetamines, cocaine or opioids other than buprenorphine/naloxone. Subjects with AST, ALT or bilirubin > 3.0X the upper limit of normal Hemoglobin < 9 g/dL, and platelet count < 75,000/mm3. Positive serum or urine for HCG. History of any significant drug allergy, drug rash or sensitivity to any class of drugs relevant to the study drugs. HIV antibody positive Exposure to any investigational drug within 4 weeks of enrollment and throughout the study. Prior exposure to Raltegravir. Use of any agent (prescribed or otherwise) within 2 weeks of dosing, that is known or suspected to induce or inhibit drug metabolizing enzymes (e.g., cimetidine and compounds in the barbiturate and phenothiazine classes), affect renal tubular secretion (e.g., probenecid, beta-lactam antibiotics), gastrointestinal motility (e.g., metoclopramide, propantheline, loperamide, or narcotic analgesics or opioids other than buprenorphine/naloxone), or uric acid metabolism (e.g., allopurinol) or gastrointestinal pH (including antacids, H2-receptor antagonists, proton pump inhibitors etc.). Use of over-the-counter medications and herbal preparations, within 1 week prior to enrollment and throughout the study. Use of St. John's Wort (Hypericum) within four weeks prior to study enrollment and throughout the study. Consumption of grapefruit or grapefruit juice within 1 week of study entry and throughout the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert D Bruce, MD
Organizational Affiliation
Yale University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States

12. IPD Sharing Statement

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Buprenorphine/Raltegravir Pharmacokinetic Interaction Study

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