Patient Preference, Sleep Quality, and Anxiety/Depression: A Randomized Comparison of Etravirine and Efavirenz (SWITCH-EE)
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Purpose
Efavirenz causes neuropsychiatric side effects and sleep disturbance, including vivid dreams, dizziness, and abnormal tiredness. These symptoms are frequent during the first weeks of treatment, with subsequent attenuation but may not completely resolve even years after efavirenz initiation.
The investigators plan a twelve week, randomized, placebo-controlled, double-blind study. In group 1, efavirenz will be replaced with efavirenz placebo plus etravirine, in group 2, efavirenz would be continued, and etravirine placebo given in addition. After six weeks, patients in group 1 would switch to the regimen of group 2, and vice versa.
The primary endpoint of the trial will be patient preference. Sleep quality, daytime sleepiness, and anxiety will also be investigated.
| Condition | Intervention |
|---|---|
|
Sleep Disorders |
Drug: etravirine Drug: efavirenz |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | Patient Preference, Sleep Quality, and Anxiety/Depression: A Randomized Comparison of Etravirine and Efavirenz |
- Symptoms and neurological side effects of study drugs [ Time Frame: baseline, week 6 and week 12 ] [ Designated as safety issue: Yes ]
- Levels of daytime sleepiness [ Time Frame: baseline, week 6 and week 12 ] [ Designated as safety issue: Yes ]
- Sleep Quality [ Time Frame: baseline, week 6 and week 12 ] [ Designated as safety issue: Yes ]
- Patient preference [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
- Symptoms of depression, anxiety and stress will be assessed [ Time Frame: baseline, week 6 and week 12 ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 50 |
| Study Start Date: | November 2008 |
| Study Completion Date: | June 2009 |
| Primary Completion Date: | November 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
patients treats with etravirine for 6 weeks
|
Drug: etravirine
Patient receives etravirine/ placebo or efavirenz / placebo
|
|
Experimental: 2
patients treats with efavirenz for 6 weeks
|
Drug: efavirenz
patient receives efavirenz / placebo or etravirine / placebo
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adult patients > 18 years
- Signing the study consent form and agree to change ART regimen
- Stable HAART including EFV since at least 3 months
- HIV-RNA below 50 copies for at least 3 months
Exclusion Criteria:
- No major psychiatric disease (psychosis, severe depression) diagnosed before the initiation of EFV
- Mentally incompetent patients
- Pregnancy or lactation Women of childbearing potential must use one or two reliable contraceptive methods during the trial, from day 1 to the end of week 12. Acceptable methods include the birth control pill, IUD, condoms with spermicides. Non-acceptable methods include (non-exhaustive list): Withdrawal, calendar (Onigo method), or spermicides alone.
Concomitant renal or hepatic disease:
- Creatinine above 150 micromol/L
- Transaminases above 5 times upper normal limit
- Prothrombin (Quick) value below 50%
Contacts and Locations| Switzerland | |
| Geneva Hospital | |
| Geneva, Switzerland, 1211 | |
| Principal Investigator: | Bernard BH Hirschel, Professor | Geneva Hospital |
More Information
Additional Information:
No publications provided
| Responsible Party: | Alain Nguyen, Dr, Doctor, University Hospital, Geneva |
| ClinicalTrials.gov Identifier: | NCT00792584 History of Changes |
| Other Study ID Numbers: | 08-136 |
| Study First Received: | November 17, 2008 |
| Last Updated: | September 9, 2011 |
| Health Authority: | Switzerland: Swissmedic |
Keywords provided by University Hospital, Geneva:
|
etravirine efavirenz anxiety depression sleep quality HIV |
NNRTI Tritherapy compliance stocrin To replace efavirenz in long-term users with etravirine To investigate effect of such replacement on patient preference, sleep quality, daytime sleepiness, and anxiety |
Additional relevant MeSH terms:
|
Anxiety Disorders Depression Depressive Disorder Sleep Disorders Parasomnias Mental Disorders Behavioral Symptoms Mood Disorders Nervous System Diseases Neurologic Manifestations Signs and Symptoms |
Efavirenz 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 June 18, 2013