Study of Once Daily Elvucitabine Versus Lamivudine in Subjects With a Documented M184V Mutation (Resistance)
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Purpose
HIV-1 infected patients receiving long-term therapy with lamivudine or emtricitabine (nucleoside reverse transcriptase inhibitors [NRTIs]) are at risk for the development of a mutation at position M184 on the HIV reverse transcriptase gene. This mutation confers resistance to both drugs (> 100 fold increase in IC50).
In-vitro studies with elvucitabine have shown that HIV-1 isolates with the M184V mutation show only a 10-fold increase in IC50 as compared to wild type HIV-1. Achillion Pharmaceutical's intention is to demonstrate that 10 mg of elvucitabine, administered once per day for 14 days with continued background anti-HIV-1 medications, will demonstrate a fall in HIV-1 RNA plasma levels, as compared to baseline. The data from this study will guide dosing in future long-term studies in HIV-1 infected patients with the M184V mutation.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections |
Drug: elvucitabine Drug: Lamivudine |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A 14 Day Randomized, Double Blind, Study of Once Daily Elvucitabine Versus Lamivudine in Subjects With a Documented M184V Mutation |
- Reduction in viral load [ Time Frame: 14 days ]
- safety [ Time Frame: 14 days ]
| Estimated Enrollment: | 20 |
| Study Start Date: | March 2006 |
| Study Completion Date: | October 2007 |
| Arms | Assigned Interventions |
|---|---|
| Experimental: A |
Drug: elvucitabine
Elvucitabine 10 mg QD for 14days
|
| Active Comparator: B |
Drug: Lamivudine
Lamivudine 300 mg QD for 14 days
|
Detailed Description:
Protocol Title: A 14-Day, Randomized, Double-Blind, Comparative Viral Kinetic Study of Elvucitabine Versus Lamivudine Administered Once Daily to HIV-1 Infected Subjects With a Documented M184V Variant Protocol Number: ACH443-014A Clinical Phase: 2a Primary Objectives: • To assess the viral kinetics of 10 mg of elvucitabine administered once daily (QD) for 14 days in combination with background antiretroviral therapy in HIV-1-infected subjects with a documented M184V variant
- To demonstrate the antiviral activity of 10 mg of elvucitabine administered QD for 14 days in combination with background antiretroviral therapy as compared with lamivudine in combination with background antiretroviral therapy in HIV-1 infected subjects with a documented M184V variant
- To assess the safety of elvucitabine therapy in HIV-1 infected subjects with a documented M184V variant Number of Subjects: 20 Number of Study Centers: Multi-center study Study Population: HIV-1 infected subjects who are presently failing an antiretroviral therapy regimen containing lamivudine or emtricitabine, genotypically demonstrate a MI84V variant, and have an HIV RNA plasma level ≥ 2,000 and ≤ 150,000 copies/mL. Study Design: HIV-1 infected subjects, with a documented M184V variant, will be randomized to receive elvucitabine 10 mg QD or lamivudine 300 mg QD for 14 days. Subjects must be receiving a stable antiretroviral regimen (defined as no change in antiretroviral therapy for at least 4 weeks prior to randomization) that includes lamivudine or emtricitabine. At 72 hours prior to randomization, only lamivudine or emtricitabine will be stopped for washout; subjects will continue to receive the other drugs in their prescribed regimen (background antiretroviral therapy) during the 72-hour washout period. Subjects will then be randomized to receive blinded elvucitabine or lamivudine in a 1:1 ratio and continue to receive their prescribed background antiretroviral therapy for 14 days on an outpatient basis. Subjects will be followed for an additional 14 days post-treatment for safety, unless they enroll into the ACH443-018 extension study where they will continue to be treated and followed for safety.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Clinically stable HIV-1 infected patients
- Ages > 18 and < 65 years
- Documented M184V mutation
- CD4 cell count > 100 cells/mL
- Plasma HIV-1 RNA levels > 5000 and < 150,000 copies/mL
- Currently receiving lamivudine or emtricitabine
- Other hematologic and metabolic parameters must be met.
- Provide written informed consent
- Other inclusion criteria apply.
Exclusion Criteria:
- Hepatitis B antigen positive
- HIV-1 genotype positive for more than or equal to 4 protease mutations
- HIV-1 genotype positive for more than or equal to 2 non-nucleoside reverse transcriptase inhibitor (NNRTI) mutations
- Previous therapy with cytotoxic or myelosuppressive drugs in the past 3 months
- Evidence or history of cirrhosis
- Women who are pregnant or breast feeding
- Other exclusion criteria apply.
Contacts and Locations| United States, Alabama | |
| UAB Birmingham | |
| Birmingham, Alabama, United States, 35294 | |
| United States, California | |
| University of California at Davis | |
| Sacramento, California, United States, 95817 | |
| United States, Florida | |
| University of Miami School of Medicine | |
| Miami, Florida, United States, 33136 | |
| Orlando Immunology Center | |
| Orlando, Florida, United States, 32803 | |
| Olayemi Osiyemi | |
| West Palm Beach, Florida, United States, 33401 | |
| United States, Georgia | |
| ACRA | |
| Atlanta, Georgia, United States, 30308 | |
| United States, New York | |
| Beth Israel Medical Center | |
| New York, New York, United States, 10003 | |
| United States, Ohio | |
| University of Cincinnati | |
| Cincinnati, Ohio, United States, 45242 | |
| Principal Investigator: | Judith Feinberg, MD | University of Cincinnati College of Pharmacy, Cincinnati, OH |
| Principal Investigator: | Donna Mildvan, MD | Beth Israel Medical Center, Infectious Diseases, Baird Hall, NY, NY |
| Principal Investigator: | Richard Pollard, MD | UC Davis Medical Center, Div. of Infectious Diseases, Sacramento, CA |
| Principal Investigator: | Michael Saag, MD | UAB Medical Center, AIDS Outpatient Clinic, Birmingham, AL |
| Principal Investigator: | Dushyantha Jayaweera, MD | University of Miami School of Medicine, Infectious Disease Research Unit, Miami, FL |
| Principal Investigator: | Edwin DeJesus, MD | Orlando Immunology Center |
| Principal Investigator: | Melanie Thompson, MD | ACRA Atlanta Georgia |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00312039 History of Changes |
| Other Study ID Numbers: | ACH443-014A |
| Study First Received: | April 5, 2006 |
| Last Updated: | October 30, 2007 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Achillion Pharmaceuticals:
|
HIV-1 treatment experienced |
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 |
Lamivudine 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 23, 2013