Adherence and Acceptability to and Blood Levels of Tenofovir Gel and Tablets in HIV Uninfected Women
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Purpose
A new approach to HIV prevention currently being studied includes the use of microbicides, substances that kill microbes. Tenofovir disoproxil fumarate (TDF) is an oral, FDA-approved, anti-HIV drug, and tenofovir gel is an experimental microbicide. The purpose of this study is to determine the adherence and acceptability to and blood levels of three daily regimens of tenofovir in both oral and gel form.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections |
Drug: Tenofovir disoproxil fumarate Drug: Tenofovir gel |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Pharmacokinetics Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Phase 2 Adherence and Pharmacokinetics Study of Oral and Vaginal Preparations of Tenofovir |
- Self-reported adherence to each regimen [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: No ]
- Proportion of participants who indicate they would be "unlikely" use study product in the future [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: Yes ]
- Area under the concentration-time curve (AUC), maximum serum concentrations (Cmax), and minimum serum concentrations (Cmin) during PK studies [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: No ]
- Proportion of women who report taking at least 90% of expected daily doses, frequency of use, and number of days product missed [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: Yes ]
- Frequency of sexual activity and male condom use [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: No ]
- Time interval between product usage and sexual intercourse and sequence of product use and sexual intercourse [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: No ]
- Reported sharing and quantity of study product [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: No ]
- Grade 3 or higher toxicity for systemic and local effects as defined by the protocol [ Time Frame: Measured through Week 21 ] [ Designated as safety issue: Yes ]
| Enrollment: | 168 |
| Study Start Date: | June 2008 |
| Study Completion Date: | July 2010 |
| Primary Completion Date: | July 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Oral tenofovir disoproxil fumarate (TDF) for Weeks 1 through 6, vaginal tenofovir gel application for Weeks 8 through 13, and oral TDF and vaginal tenofovir gel application for Weeks 15 through 20
|
Drug: Tenofovir disoproxil fumarate
300 mg tablet daily
Other Name: TDF
Drug: Tenofovir gel
1 gm/100 ml of 1% gel vaginally daily
Other Names:
|
|
Experimental: 2
Vaginal tenofovir gel application for Weeks 1 through 6, oral TDF for Weeks 8 through 13, and oral TDF and vaginal tenofovir gel application for Weeks 15 through 20
|
Drug: Tenofovir disoproxil fumarate
300 mg tablet daily
Other Name: TDF
Drug: Tenofovir gel
1 gm/100 ml of 1% gel vaginally daily
Other Names:
|
|
Experimental: 3
Oral TDF and vaginal tenofovir gel application for Weeks 1 through 6, oral TDF for Weeks 8 through 13, and vaginal tenofovir gel application for Weeks 15 through 20
|
Drug: Tenofovir disoproxil fumarate
300 mg tablet daily
Other Name: TDF
Drug: Tenofovir gel
1 gm/100 ml of 1% gel vaginally daily
Other Names:
|
|
Experimental: 4
Oral TDF and vaginal tenofovir gel application for Weeks 1 through 6, vaginal tenofovir gel application for Weeks 8 through 13, and oral TDF for Weeks 15 through 20
|
Drug: Tenofovir disoproxil fumarate
300 mg tablet daily
Other Name: TDF
Drug: Tenofovir gel
1 gm/100 ml of 1% gel vaginally daily
Other Names:
|
|
Experimental: 5
Oral TDF for Weeks 1 through 6, oral TDF and vaginal tenofovir gel application for Weeks 8 through 13, and vaginal tenofovir gel application for Weeks 15 through 20
|
Drug: Tenofovir disoproxil fumarate
300 mg tablet daily
Other Name: TDF
Drug: Tenofovir gel
1 gm/100 ml of 1% gel vaginally daily
Other Names:
|
|
Experimental: 6
Vaginal tenofovir gel application for Weeks 1 through 6, oral TDF and vaginal tenofovir gel application for Weeks 8 through 13, and oral TDF for Weeks 15 through 20
|
Drug: Tenofovir disoproxil fumarate
300 mg tablet daily
Other Name: TDF
Drug: Tenofovir gel
1 gm/100 ml of 1% gel vaginally daily
Other Names:
|
Detailed Description:
It is necessary to monitor both the adherence and blood levels of microbicides in order to gauge its efficacy in a study population. Utilizing an experimental microbicide (tenofovir gel) and an anti-HIV drug (TDF), this study will measure the adherence and acceptability to and blood levels of the two interventions in three separate regimens given to HIV-uninfected women.
The expected duration of participation for each participant is 21 weeks. Study participants will be randomly assigned into one of six study groups, each with a different regimen sequence. Each sequence will consist of three study periods and three wash-out periods. Each study period lasts 6 weeks, followed by a 1 week wash-out period. The regimen assigned for a given study period will include either oral TDF, tenofovir vaginal gel, or both. All participants will be prescribed all three regimens in the order designated by their randomized assignment.
Study visits will occur at Weeks 1, 3, 6, 7, 10, 13, 14, 17, 20, and 21. Medical history, a physical exam, behavioral assessment, and urine, blood, pelvic sample collection, and counseling will occur at all visits. At some study sites rectal swabs may be performed. Counseling will include information regarding contraception, protocol adherence, HIV, HIV/Sexually Transmitted Infection risk reduction, and male condom use. Pharmacokinetic (PK) studies, to be determined by the study site, will occur during all three study periods. These studies may involve additional procedures.
Eligibility| Ages Eligible for Study: | 18 Years to 45 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- General good health
- HIV-uninfected
- Normal menstrual cycle. More information can be found in the protocol.
- Creatinine clearance greater than 70 ml/min
- Sexually active. More information can be found in the protocol.
- Normal Pap smear result within 12 months prior to study entry
- Agrees to not participate in other investigational studies
- Willing to use effective forms of contraception. More information can be found in the protocol.
Exclusion Criteria:
- Adverse reaction to either of the study products
- Adverse reaction to latex
- Currently sexually active with a partner with history of adverse reaction to latex
- More than three sexual partners in the month prior to screening
- Pathologic bone fracture not related to trauma
- Last pregnancy outcome within 90 days or less prior to enrollment
- Gynecologic or genital procedure within 90 days of study entry
- Enrollment in other investigational study within 30 days of study entry
- Nontherapeutic injection drug use within 12 months of screening
- Any social or medical condition that, in the opinion of the investigator, would interfere with the study
- Abnormal laboratory values
- Grade 2 or higher genital lesions, erythema, and/or edema or has any other abnormal physical or pelvic exam finding that, in the opinion of the investigator, would interfere with the study
- Kidney, reproductive, or urinary tract infection requiring treatment. More information on this criterion can be found in the protocol.
- Pregnant, breastfeeding, or intend to become pregnant
- Unwilling to comply with study participation requirements, including attendance at all scheduled study visits
- Per participant report, use of the following at enrollment, and/or anticipated use during the period of study participation - use of a diaphragm, vaginal ring, and/or spermicide for contraception, acyclovir or valacyclovir, post-exposure prophylaxis for HIV exposure, TDF/emtricitabine, non-study vaginal products
Contacts and Locations| United States, Alabama | |
| Alabama Microbicide CRS | |
| Birmingham, Alabama, United States, 35294 | |
| United States, New York | |
| Bronx- Lebanon Hospital Center Clinical Research Site (BLHC CRS) | |
| Bronx, New York, United States | |
| United States, Ohio | |
| Case CRS | |
| Cleveland, Ohio, United States, 44106 | |
| United States, Pennsylvania | |
| Pitt CRS | |
| Pittsburgh, Pennsylvania, United States, 15213-2582 | |
| South Africa | |
| Botha's Hill CRS | |
| Durban, KwaZulu-Natal, South Africa | |
| Umkomaas CRS | |
| Durban, KwaZulu-Natal, South Africa | |
| Uganda | |
| Makerere University- JHU Research Collaboration {MUJHU CARE LTD} CRS | |
| Kampala, Uganda | |
| Study Chair: | Craig W. Hendrix, MD | Johns Hopkins University |
More Information
Additional Information:
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | National Institute of Allergy and Infectious Diseases (NIAID) |
| ClinicalTrials.gov Identifier: | NCT00592124 History of Changes |
| Other Study ID Numbers: | MTN-001, 10617, 1-U01-AI068633-01 |
| Study First Received: | December 31, 2007 |
| Last Updated: | December 28, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
|
Microbicide HIV Seronegativity |
Additional relevant MeSH terms:
|
HIV Infections Acquired Immunodeficiency Syndrome Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Slow Virus Diseases Tenofovir |
Tenofovir disoproxil Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Therapeutic Uses Anti-HIV Agents |
ClinicalTrials.gov processed this record on May 19, 2013