A Clinical Trial Comparing the Efficacy of Darunavir/Ritonavir Monotherapy Versus a Triple Combination Therapy Containing Darunavir/Ritonavir and 2 Nucleoside/Nucleotide Reverse Transcriptase Inhibitors in Patients With Undetectable Plasma HIV-1 RNA on Current Treatment (PROTEA)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Janssen-Cilag International NV
ClinicalTrials.gov Identifier:
NCT01448707
First received: June 2, 2011
Last updated: June 12, 2014
Last verified: June 2014

June 2, 2011
June 12, 2014
March 2012
January 2015   (final data collection date for primary outcome measure)
confirmed virologic response [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
the percentage of patients who have plasma human immunodeficiency virus type-1 (HIV-1) ribonucleic acid (RNA) levels <50 copies/mL after 48 weeks of follow-up after switching to DRV/ritonavir (rtv) monotherapy versus triple therapy containing DRV/rtv
Same as current
Complete list of historical versions of study NCT01448707 on ClinicalTrials.gov Archive Site
  • change from baseline in neurocognitive function [ Time Frame: baseline, 48 and 96 Weeks or early withdrawal ] [ Designated as safety issue: No ]
    change in neurocognitive function of DRV/rtv monotherapy versus triple therapy containing DRV/rtv over 48 and 96 weeks. Neurocognitive function will be measured by Hopkins Verbal Learning Test (verbal learning and memory), Colour Trail Test (psychomotor speed and cognitive flexibility) and Grooved Pegboard Test (psychomotor speed and fine motor function).
  • rate of plasma HIV-1 RNA suppression [ Time Frame: baseline, 48 and 96 Weeks or early withdrawal ] [ Designated as safety issue: No ]
    the rate of plasma HIV-1 RNA suppression after 48 and 96 weeks of follow-up to DRV/rtv monotherapy versus triple therapy containing DRV/rtv, using the time to loss of virologic response (TLOVR) method
  • correlation of plasma HIV-1 RNA and neurocognitive function [ Time Frame: baseline, 48 and 96 Weeks or early withdrawal ] [ Designated as safety issue: No ]
    the correlation between plasma HIV-1 RNA and Hopkins Verbal Learning Test, Colour Trail Test and Grooved Pegboard Test of DRV/rtv monotherapy versus triple therapy containing DRV/rtv at Weeks 48 and 96
  • treatment-emergent phenotypic drug resistance [ Time Frame: at Weeks 48 and 96 ] [ Designated as safety issue: No ]
    the loss of treatment options of DRV/rtv monotherapy versus triple therapy containing DRV/rtv at Weeks 48 and 96, as defined by treatment-emergent phenotypic drug resistance
  • the viral genotype of subjects treated with DRV/rtv monotherapy versus triple therapy containing DRV/rtv over 48 and 96 weeks [ Time Frame: over 48 and 96 Weeks ] [ Designated as safety issue: No ]
    the viral genotype of subjects treated with DRV/rtv monotherapy versus triple therapy containing DRV/rtv over 48 and 96 weeks.
Same as current
Not Provided
Not Provided
 
A Clinical Trial Comparing the Efficacy of Darunavir/Ritonavir Monotherapy Versus a Triple Combination Therapy Containing Darunavir/Ritonavir and 2 Nucleoside/Nucleotide Reverse Transcriptase Inhibitors in Patients With Undetectable Plasma HIV-1 RNA on Current Treatment
PROTEAse Inhibitor (DRV/Rtv) in Mono- or Triple Therapy in Suppressed HIV-1 Infected Subjects

The purpose of this study is to compare the efficacy, safety and tolerability of darunavir/ritonavir 800/100 mg monotherapy with a triple combination therapy containing darunavir/ritonavir 800/100 mg and 2 nucleoside/nucleotide reverse transcriptase inhibitors (N[t]RTIs) in approximately 260 Human Immunodeficiency Virus-1 (HIV-1) infected patients who have been on Highly Active AntiRetroviral Therapy (HAART) medication and have a plasma Viral Load below 50 copies/mL for at least 48 weeks. Also the changes in neurocognitive function will be compared throughout the study.

This is phase IIIb, randomised (study medication is assigned by chance), open-label (both the patient and the study physician will know to which treatment group the patient is assigned) trial to compare the efficacy, safety and tolerability of darunavir/ritonavir (DRV/rtv) 800/100 mg once daily monotherapy with a triple combination therapy containing DRV/rtv 800/100 mg once daily and an investigator-selected background of 2 other anti-HIV drugs of the class nucleoside/nucleotide reverse transcriptase inhibitors (N[t]RTIs). The investigator-selected N[t]RTIs will be a dual combination of either be abacavir (ABC), lamivudine (3TC), zidovudine (AZT), tenofovir disoproxil fumarate (TDF) or emtricitabine (FTC). Approximately 260 HIV-1 infected patients, who have received HAART for at least 48 weeks, have not changed their treatment within the last 8 weeks, and who have documented evidence of plasma viral load (plasma HIV-1 RNA) below 50 copies/mL for at least 48 weeks prior to being screened, will participate in the study. The study period includes a screening period of maximum 6 weeks, a 4-week run-in period, a 96 week treatment period, followed by a 4 weeks follow-up period. At the start of the 4-week run-in period all patients will replace their 3rd agent (non-nucleoside reverse transcriptase (NNRTI), protease inhibitor (PI) or integrase inhibitor) of the HAART medication with DRV/rtv and continue with the 2 N[t]RTIs. After 4 weeks the patient will be randomly assigned (like flipping a coin) to either the monotherapy group or the triple therapy group. If assigned to the monotherapy group, the 2 N[t]RTIs will be stopped and only DRV/rtv is continued. If assigned to the triple therapy group, DRV/rtv will be continued together with 2 N[t]RTIs, which can be the same as already taken or are switched to new N[t]RTIs. The main purpose of this study is to demonstrate that DRV/rtv monotherapy is as effective as a triple combination therapy containing DRV/rtv and 2N[t]RTIs. In addition, the study will look at overall safety and tolerability between the two treatment groups. During the study, patients' health will be monitored by physical examination, checking of vital signs (blood pressure / pulse), and laboratory testing on blood and urine samples. Also blood samples will be drawn to measure the antiviral effectiveness (i.e., decrease of the plasma viral load to a level <50 HIV-1 RNA copies/mL) and immunology assessments (to assess the body's immune system). A battery of neurocognitive function tests will be performed during the study visits. A sub-study will take place in selected hospitals. Approximately 100 patients will have 2 additional tests done, at the start of the run-in phase and after 48-weeks of randomisation. For this substudy a lumbar puncture (extraction of cerebrospinal fluid [CSF] from the spinal canal) for laboratory testing (antiviral effectiveness, pharmacokinetic analysis, biochemistry and immune markers) and an additional blood sample for pharmacokinetic analysis (to measure the drug level in blood) will be taken. The study hypothesis is that, after 48 weeks of randomised treatment, DRV/rtv monotherapy is as effective as the triple therapy containing DRV/rtv plus 2 N[t]RTIs. Two 400 mg tablets of darunavir and one 100 mg tablet ritonavir together once daily orally within 30 minutes after completion of a meal, for 100 weeks. The intake of the investigator-selected N[t]RTIs as according the local prescribing information.

Interventional
Phase 3
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Human Immunodeficiency Virus (HIV) Infections
  • Acquired Immunodeficiency Syndrome (AIDS) Virus
  • Drug: Darunavir
    Darunavir (DRV): type = exact number, unit = mg, number = 800, form = tablet, route = oral use
  • Drug: Ritonavir
    ritonavir (rtv): type = exact number, unit = mg, number = 100, form = tablet, route = oral use
  • Experimental: Darunavir monotherapy
    Darunavir (DRV) + ritonavir (rtv): 2 tablets DRV 400 mg should be taken together with 1 tablet rtv 100 mg within 30 minutes after a meal
    Interventions:
    • Drug: Darunavir
    • Drug: Ritonavir
  • Active Comparator: Triple therapy containing darunavir
    Darunavir (DRV) + ritonavir (rtv) + 2 N[t]RTIs: 2 tablets DRV 400 mg should be taken together with 1 tablet rtv 100 mg within 30 minutes after a meal in combination with 2 N[t]RTIs (an investigator-selected dual combination of either abacavir (ABC), lamivudine (3TC), zidovudine (AZT), tenofovir disoproxil fumarate (TDF) or emtricitabine (FTC)
    Interventions:
    • Drug: Darunavir
    • Drug: Ritonavir
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
274
March 2015
January 2015   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • HIV-1 infection
  • receiving HAART for at least 48 weeks
  • Have plasma HIV-1 RNA <50 copies/mL for at least 48 weeks prior to screening
  • Be taking the same antiretroviral (ARV) combination for at least 8 weeks before screening
  • Have the preference, together with the physician, to change the current HAART regimen for reasons of simplification and/or toxicity

Exclusion Criteria:

  • Has a history of virologic failure defined as 2 consecutive plasma HIV-1 RNA >500 copies/mL while on previous or current antiretroviral therapy
  • Has a history of any primary PI mutations
  • Has clinical or laboratory evidence of significantly decreased hepatic function or decompensation, irrespective of liver enzyme levels (liver insufficiency)
  • Is diagnosed with acute viral hepatitis at screening or before Baseline 1
  • Is co-infected with hepatitis B
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Austria,   Belgium,   Denmark,   France,   Germany,   Hungary,   Ireland,   Israel,   Poland,   Spain,   Sweden,   Switzerland,   United Kingdom
 
NCT01448707
CR018370, TMC114IFD3003, 2011-001635-23, PROTEA
Yes
Janssen-Cilag International NV
Janssen-Cilag International NV
Not Provided
Study Director: Janssen-Cilag International NV Clinical Trial Janssen-Cilag International NV
Janssen-Cilag International NV
June 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP