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Pilot Study With Isentress (Raltegravir) and Epzicom (Abacavir/Lamivudine) in Treatment Naive HIV-Infected Subjects (SHIELD)

Primary Purpose

HIV Infections

Status
Unknown status
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Raltegravir and Abacavir/Lamivudine
Sponsored by
Denver Infectious Disease Consultants, PLLC
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring HIV infections

Eligibility Criteria

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

Inclusion Criteria:

  • Antiretroviral naïve defined as ≤7 days of ART prior to study entry
  • Negative for HLA-B*5701 allele
  • Screening HIV-1 RNA >1,000 copies/mL
  • Screening laboratory values:

    • Hemoglobin > 8.0 g/dL
    • Platelet count >50,000/mm3
    • AST (SGOT), ALT (SGPT), and alkaline phosphatase <5 x ULN
    • Total bilirubin <2.5 x ULN
    • Absolute neutrophil count >500/mm3
    • Calculated creatinine clearance (CrCL) ≥50 mL/min by Cockcroft-Gault:
    • For men, (140 - age in years) x (body weight in kg) ÷ (serum creatinine in mg/dL x 72) = CrCl (mL/min)*
    • For women, multiply the result by 0.85 = CrCl (mL/min)
  • A female subject is eligible to participate in the study if she is of:
  • Non-childbearing potential (i.e., physiologically incapable of becoming pregnant, including any female who is pre-menarchial or post-menopausal); or,
  • Childbearing potential with a negative pregnancy test at screen and agrees to use one of the following methods of contraception (any contraception method must be used consistently and correctly, i.e., in accordance with both the product label and the instructions of a physician):
  • Agreement for complete abstinence from intercourse from 2 weeks prior to administration of investigational products, throughout the study, and for 2 weeks after discontinuation of all study medications.
  • Double barrier contraception (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide);
  • Any intrauterine device (IUD) with published data showing that the expected failure rate is less than 1% per year (not all IUDs meet this criterion);
  • Any other method with published data showing that the lowest expected failure rate for the method is less than 1% per year.
  • Men and women age (≥18 years).
  • Ability and willingness of subject to give written informed consent.

Exclusion Criteria:

  • Screening HIV-1 genotype indicating the presence of any of the following mutations: K65R, L74V, and Y115F or a combination of two or more thymidine analog mutations (M41L, D67N, K70R, K219Q or E) that include changes at either L210 or T215, associated with ABC and 3TC resistance, and mutations Q148H/R/K and N155H associated with RTG resistance.
  • Currently pregnant or breast-feeding.
  • Hepatitis B infection with chronic viral replication (HBsAg+).
  • Presence of a serious medical condition, including but not limited to congestive heart failure, cardiomyopathy or other cardiac dysfunction, which in the opinion of the investigator would compromise the safety of the subject.
  • Use of immunomodulators (e.g., interleukins, interferons, cyclosporine), HIV vaccine, systemic cytotoxic chemotherapy, or investigational therapy within 30 days prior to study entry. NOTE: Use of corticosteroids for acute therapy for PCP is permitted. Prednisone at a daily dose of 10 mg or less (physiologic replacement dose) or short course corticosteroid therapy (≤ 10 days) is permitted.
  • Known allergy/sensitivity to study drugs or their formulations.
  • Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
  • Illnesses that are determined serious by the site investigator, (i.e. requiring systemic treatment and/or hospitalization) until subject either completes therapy or is clinically stable on therapy, for at least 7 days prior to study entry.
  • Requirement for medications that are not allowed to be taken with study treatment.
  • Current imprisonment or involuntary incarceration in a medical facility for psychiatric or physical (e.g. infectious disease) illness.

Sites / Locations

  • Spectrum Medical Group
  • Denver Infectious Disease Consultants, PLLC
  • Southwest CARE Center

Outcomes

Primary Outcome Measures

To evaluate the efficacy and safety of RTG and ABC/3TC over 48 weeks in ART-naive HIV-infected subjects.

Secondary Outcome Measures

To assess the immunologic response, changes in fasting lipids, renal function, and development of resistance of the study regimen

Full Information

First Posted
August 20, 2008
Last Updated
January 27, 2009
Sponsor
Denver Infectious Disease Consultants, PLLC
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT00740064
Brief Title
Pilot Study With Isentress (Raltegravir) and Epzicom (Abacavir/Lamivudine) in Treatment Naive HIV-Infected Subjects
Acronym
SHIELD
Official Title
A Pilot Study of Highly Active Antiretroviral Therapy Using Isentress (Raltegravir) and Epzicom (Abacavir/Lamivudine) in Antiretroviral Naive HIV-Infected Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
January 2009
Overall Recruitment Status
Unknown status
Study Start Date
May 2008 (undefined)
Primary Completion Date
August 2009 (Anticipated)
Study Completion Date
November 2009 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Denver Infectious Disease Consultants, PLLC
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To evaluate the efficacy and safety of Raltegravir and Epzicom over 48 weeks in ART-naive HIV-infected subjects.
Detailed Description
This is a single-arm, multicenter, open-label, pilot study to evaluate the efficacy, safety, and tolerability of RTG BID and ABC/3TC QD. A total of 30 subjects will be enrolled at 3 U.S. sites. The study includes a 30-day screening period, a treatment period (baseline through week 48), and a follow-up visit, 2 to 4 weeks after the last study visit, as needed to resolve any ongoing AEs or to confirm virologic status. Virologic failure (VF) is defined as having either virologic non-response or virologic rebound. Virologic failure is confirmed by having 2 consecutive plasma HIV-1 RNA levels taken at least 2 weeks apart according to the following definitions: virologic rebound is defined as HIV-1 RNA level ≥400 copies/mL after initial response of HIV-1 RNA <400 copies/mL or >1 log10 copies/mL increase above nadir; virologic non-response is defined as HIV-1 RNA >400 copies/mL at week 24. Subjects will be discontinued from the study if virologic failure is confirmed. When a subject is suspected to have virologic failure, a confirmatory HIV-1 RNA must be performed at an unscheduled visit between 2 weeks and 4 weeks after the initial assessment, and a plasma sample collected for resistance testing. Subjects who experience symptoms consistent with a clinically suspected ABC HSR must permanently discontinue ABC/3TC, and will be allowed to substitute study-provided fixed-dose combination ZDV/3TC 150/300 mg (COMBIVIR®) BID for ABC/3TC and remain in the study.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Raltegravir and Abacavir/Lamivudine
Other Intervention Name(s)
Isentress, Epzicom, RTG, ABC/3TC
Intervention Description
Raltegravir 400mg BID Abacavir/Lamivudine 1 tablet QD
Primary Outcome Measure Information:
Title
To evaluate the efficacy and safety of RTG and ABC/3TC over 48 weeks in ART-naive HIV-infected subjects.
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
To assess the immunologic response, changes in fasting lipids, renal function, and development of resistance of the study regimen
Time Frame
48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Antiretroviral naïve defined as ≤7 days of ART prior to study entry Negative for HLA-B*5701 allele Screening HIV-1 RNA >1,000 copies/mL Screening laboratory values: Hemoglobin > 8.0 g/dL Platelet count >50,000/mm3 AST (SGOT), ALT (SGPT), and alkaline phosphatase <5 x ULN Total bilirubin <2.5 x ULN Absolute neutrophil count >500/mm3 Calculated creatinine clearance (CrCL) ≥50 mL/min by Cockcroft-Gault: For men, (140 - age in years) x (body weight in kg) ÷ (serum creatinine in mg/dL x 72) = CrCl (mL/min)* For women, multiply the result by 0.85 = CrCl (mL/min) A female subject is eligible to participate in the study if she is of: Non-childbearing potential (i.e., physiologically incapable of becoming pregnant, including any female who is pre-menarchial or post-menopausal); or, Childbearing potential with a negative pregnancy test at screen and agrees to use one of the following methods of contraception (any contraception method must be used consistently and correctly, i.e., in accordance with both the product label and the instructions of a physician): Agreement for complete abstinence from intercourse from 2 weeks prior to administration of investigational products, throughout the study, and for 2 weeks after discontinuation of all study medications. Double barrier contraception (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide); Any intrauterine device (IUD) with published data showing that the expected failure rate is less than 1% per year (not all IUDs meet this criterion); Any other method with published data showing that the lowest expected failure rate for the method is less than 1% per year. Men and women age (≥18 years). Ability and willingness of subject to give written informed consent. Exclusion Criteria: Screening HIV-1 genotype indicating the presence of any of the following mutations: K65R, L74V, and Y115F or a combination of two or more thymidine analog mutations (M41L, D67N, K70R, K219Q or E) that include changes at either L210 or T215, associated with ABC and 3TC resistance, and mutations Q148H/R/K and N155H associated with RTG resistance. Currently pregnant or breast-feeding. Hepatitis B infection with chronic viral replication (HBsAg+). Presence of a serious medical condition, including but not limited to congestive heart failure, cardiomyopathy or other cardiac dysfunction, which in the opinion of the investigator would compromise the safety of the subject. Use of immunomodulators (e.g., interleukins, interferons, cyclosporine), HIV vaccine, systemic cytotoxic chemotherapy, or investigational therapy within 30 days prior to study entry. NOTE: Use of corticosteroids for acute therapy for PCP is permitted. Prednisone at a daily dose of 10 mg or less (physiologic replacement dose) or short course corticosteroid therapy (≤ 10 days) is permitted. Known allergy/sensitivity to study drugs or their formulations. Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements. Illnesses that are determined serious by the site investigator, (i.e. requiring systemic treatment and/or hospitalization) until subject either completes therapy or is clinically stable on therapy, for at least 7 days prior to study entry. Requirement for medications that are not allowed to be taken with study treatment. Current imprisonment or involuntary incarceration in a medical facility for psychiatric or physical (e.g. infectious disease) illness.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Benjamin Young, MD, PhD
Organizational Affiliation
Denver Infectious Disease Consultants, PLLC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Spectrum Medical Group
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85012
Country
United States
Facility Name
Denver Infectious Disease Consultants, PLLC
City
Denver
State/Province
Colorado
ZIP/Postal Code
80220
Country
United States
Facility Name
Southwest CARE Center
City
Santa Fe
State/Province
New Mexico
ZIP/Postal Code
87505-4765
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Pilot Study With Isentress (Raltegravir) and Epzicom (Abacavir/Lamivudine) in Treatment Naive HIV-Infected Subjects

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