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Safety and Effectiveness of Emtricitabine, Efavirenz, and Didanosine in HIV Infected Children Who Have Taken Few or No Anti-HIV Drugs
This study has been completed.
First Received: May 31, 2001   Last Updated: October 8, 2009   History of Changes
Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
Collaborator: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00016718
  Purpose

Treatment of HIV-infected patients involves combining drugs from different classes of anti-HIV drugs. One preferred regimen for adults is 2 nucleoside reverse transcriptase inhibitors (NRTIs) and 1 protease inhibitor (PI). For children, this regimen may be too complicated or the drugs may be too difficult to take by mouth. The purpose of this study is to determine the long-term safety and effectiveness of daily didanosine (ddI), efavirenz (EFV), and emtricitabine (FTC) in pediatric patients who have taken few or no anti-HIV drugs.


Condition Intervention Phase
HIV Infections
Drug: Didanosine
Drug: Efavirenz
Drug: Emtricitabine
Phase I
Phase II

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study
Official Title: An Open-Label Study to Evaluate the Safety, Tolerance, Antiviral Activity, and Pharmacokinetics of Emtricitabine in Combination With Efavirenz and Didanosine in a Once-Daily Regimen in HIV Infected, Antiretroviral Therapy Naive or Very Limited Antiretroviral Exposed Pediatric Subjects

Resource links provided by NLM:


Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Development of Grade 3 or 4 adverse events attributed to the study treatment [ Time Frame: Throughout study ] [ Designated as safety issue: Yes ]
  • Suppression of HIV viral load to less than 400 copies/ml and 50 copies/ml at Week 16 [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  • Time to virologic failure at or after Week 16 [ Time Frame: Throughout study after Week 16 ] [ Designated as safety issue: No ]

Enrollment: 53
Study Start Date: June 2005
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
All patients will receive ddI, EFV, and FTC together once daily. Study visits will occur at study entry, Weeks 2 and 4, and every 4 weeks thereafter.
Drug: Didanosine
Antiretroviral
Drug: Efavirenz
Antiretroviral
Drug: Emtricitabine
Antiretroviral

Detailed Description:

Anti-HIV treatment options are limited for pediatric patients because combination therapies recommended for adults may not be appropriate for children or adolescents. Few PIs are available in formulations appropriate for pediatric patients, and complex dosing schedules and food requirements may be detrimental to treatment adherence. A once-daily regimen of the NRTIs ddI and FTC and the nonnucleoside reverse transcriptase inhibitor (NNRTI) EFV has been shown safe and well tolerated in adults. This study will evaluate the long-term safety and efficacy of a ddI, FTC, and EFV regimen in pediatric patients.

Patients will be followed for a maximum of 192 weeks; all patients will receive ddI, EFV, and FTC together once daily. Study visits will occur at study entry, Weeks 2 and 4, and every 4 weeks thereafter. Blood collection, medical history assessment, and a physical exam will occur at all visits; urine collection will occur at selected visits. Intensive pharmacokinetic (PK) studies will be done at Weeks 2 and 12 to determine if dose adjustments are required for any of the drugs. If virologic failure is determined, PK studies will be repeated 4 weeks after adjustments in therapy. Parents or guardians will be asked to complete treatment adherence questionnaires at some visits. Some patients may also be asked to participate in an additional PK study after Week 16 or week 96.

  Eligibility

Ages Eligible for Study:   90 Days to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • HIV infected
  • Antiretroviral naive OR have received no more than 56 days of drugs to prevent mother-to-child transmission of HIV OR have received less than 7 total days of antiretroviral therapy
  • Viral load of 5,000 copies/ml or more
  • Parent or guardian willing to provide informed consent, if applicable
  • Willing to use acceptable forms of contraception

Exclusion Criteria:

  • Allergic to study medications or their formulations
  • Kidney disease
  • Positive for hepatitis B or C
  • AIDS-related or other infection requiring treatment at study entry
  • Taking drugs to treat tuberculosis
  • Taking anti-HIV drugs other than those included in this study
  • Taking any investigational drugs
  • Anti-cancer drugs within 1 year of study screening
  • Serious medical event within 21 days of study screening
  • Active or history of pancreatitis
  • Require certain medications. Patients requiring short courses of steroids (less than 14 days) for asthma are not excluded.
  • Active or history of significant peripheral neuropathy
  • Difficulty with food or severe chronic diarrhea within 30 days before study entry
  • Unable to eat at least 1 meal per day (or to feed at least 3 times per day, for infants) because of chronic nausea, vomiting, swallowing problems, or stomach upset
  • Unable to swallow oral medications
  • Pregnant or breastfeeding
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00016718

  Hide Study Locations
Locations
United States, Alabama
Univ of Alabama at Birmingham - Pediatric
Birmingham, Alabama, United States, 35233
United States, Arizona
Phoenix Childrens Hospital
Phoenix, Arizona, United States, 85006
United States, California
UCSF / Moffitt Hosp - Pediatric
San Francisco, California, United States, 941430105
Los Angeles County - USC Med Ctr
Los Angeles, California, United States, 90033
United States, Colorado
Children's Hosp of Denver
Denver, Colorado, United States, 802181088
United States, Connecticut
Connecticut Childrens Med Ctr (Pediatric)
Farmington, Connecticut, United States, 06030-3805
United States, District of Columbia
Howard Univ Hosp
Washington, District of Columbia, United States, 20060
United States, Florida
Univ of Miami (Pediatric)
Miami, Florida, United States, 33161
Univ of Florida Health Science Ctr / Pediatrics
Jacksonville, Florida, United States, 32209
North Broward Hospital District
Fort Lauderdale, Florida, United States, 33316
United States, Illinois
Chicago Children's Memorial Hosp
Chicago, Illinois, United States, 606143394
Univ of Chicago Children's Hosp
Chicago, Illinois, United States, 60637
Cook County Hospital
Chicago, Illinois, United States, 60612-7324
United States, Louisiana
Tulane Univ, Charity Hosp of New Orleans
New Orleans, Louisiana, United States, 70112
United States, Massachusetts
Children's Hosp of Boston
Boston, Massachusetts, United States, 021155724
Univ of Massachusetts Med School
Worcester, Massachusetts, United States, 016550001
United States, Mississippi
Univ of Mississippi Med Ctr
Jackson, Mississippi, United States, 39213
United States, Missouri
St. Louis Children's Hosp
St. Louis, Missouri, United States, 63108
St. Louis Children's Hospital
St. Louis, Missouri, United States, 63110
United States, New York
NYU/Bellevue Hosp
New York, New York, United States, 10016
State Univ of New York at Stony Brook
Stony Brook, New York, United States, 117948111
Metropolitan Hosp Ctr
New York, New York, United States, 10029
SUNY Health Sciences Ctr at Syracuse / Pediatrics
Syracuse, New York, United States, 13210
Columbia Presbyterian Med Ctr
New York, New York, United States, 10032
Bronx Lebanon Hospital Center
Bronx, New York, United States, 10457
United States, North Carolina
Duke Univ Med Ctr
Durham, North Carolina, United States, 277103499
United States, South Carolina
Med Univ of South Carolina
Charleston, South Carolina, United States, 294253312
United States, Tennessee
Saint Jude Children's Research Hosp of Memphis
Memphis, Tennessee, United States, 381052794
United States, Texas
Texas Children's Hosp / Baylor Univ
Houston, Texas, United States, 77030
United States, Virginia
Children's Hospital of the King's Daughters
Norfolk, Virginia, United States, 23507
Puerto Rico
San Juan City Hosp
San Juan, Puerto Rico, 009367344
Univ of Puerto Rico / Univ Children's Hosp AIDS
San Juan, Puerto Rico, 009365067
Sponsors and Collaborators
Investigators
Study Chair: Ross E. McKinney, Jr., MD Duke University
Study Chair: Mobeen H. Rathore, MD Pediatric Infectious Diseases/Immunology, University of Florida Health Science Center
  More Information

Additional Information:
Publications:
Responsible Party: DAIDS ( Rona Siskind )
Study ID Numbers: ACTG P1021, PACTG P1021, IMPAACT P1021, 10038
Study First Received: May 31, 2001
Last Updated: October 8, 2009
ClinicalTrials.gov Identifier: NCT00016718     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
Didanosine
Drug Therapy, Combination
Drug Administration Schedule
Reverse Transcriptase Inhibitors
Anti-HIV Agents
Pharmacokinetics
Deoxycytidine
Efavirenz
Treatment Naive

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Sexually Transmitted Diseases, Viral
Slow Virus Diseases
Molecular Mechanisms of Pharmacological Action
Infection
Reverse Transcriptase Inhibitors
Emtricitabine
Anti-Retroviral Agents
Therapeutic Uses
Retroviridae Infections
Nucleic Acid Synthesis Inhibitors
Efavirenz
RNA Virus Infections
Anti-HIV Agents
Immune System Diseases
Acquired Immunodeficiency Syndrome
Enzyme Inhibitors
Antiviral Agents
Immunologic Deficiency Syndromes
Pharmacologic Actions
Virus Diseases
Didanosine
HIV Infections
Sexually Transmitted Diseases
Lentivirus Infections

ClinicalTrials.gov processed this record on November 27, 2009