Randomized Trial to Evaluate Suppressive Effect of High-Dose Valacyclovir Versus Once-Daily Valacyclovir on Persons With HSV-2 - Full Text View

Sponsor:	University of Washington
Collaborator:	GlaxoSmithKline
Information provided by:	University of Washington
ClinicalTrials.gov Identifier:	NCT00362297

Purpose

The purpose of the research study is to evaluate the effectiveness of high-dose valacyclovir compared to once daily valacyclovir for reduction of asymptomatic HSV-2 genital shedding in persons with genital herpes.

The study will enroll men and women who are 18 years or older, test positive to HSV-2 (by blood test) and have had a first outbreak of HSV-2 within the past 6 months or have had at least 4 genital herpes outbreaks in the past year. Participants must be HIV negative and willing to stop taking suppressive therapy for HSV for the one week wash out period. (Females only: You must not be pregnant or breast-feeding). Both men and women will be asked to use an effective form of birth control.

Involvement in the study will last 11-weeks and you will be asked to visit the clinic every 2-weeks. At each visit, you will be given medication to take daily (either once daily valacyclovir or high dose valacyclovir; you will receive both medications at some point during this study). We will ask you to give a blood sample for liver, kidney and blood count testing at each visit. There will be a total of 8 study visits and each visit will last approximately 30 minutes. We will ask that you complete a daily symptom diary and collected daily home swabs 4-times a day, everyday during the study. Each daily home swab will take less than 3 minutes to perform.

Condition	Intervention	Phase
Genital Herpes	Drug: valacyclovir	Phase IV

Study Type:	Interventional
Study Design:	Treatment, Randomized, Open Label, Active Control, Crossover Assignment, Efficacy Study
Official Title:	A Randomized, Cross-Over Study to Evaluate the Suppressive Effect of High-Dose Valacyclovir Versus Once Daily Valacyclovir on Herpes Simplex Virus Type 2 Genital Shedding in Herpes Simplex Virus-2 Seropositive Adults

Resource links provided by NLM:

MedlinePlus related topics: Herpes Simplex

Drug Information available for: Valaciclovir Valacyclovir hydrochloride

U.S. FDA Resources

Further study details as provided by University of Washington:

Primary Outcome Measures:

Frequency of HSV-2 total shedding from the genital tract as measured by PCR, calculated using a per-day shedding rate in participants treated with high-dose valacyclovir as compared to once-daily valacyclovir. [ Time Frame: 11 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Frequency of subclinical shedding from the genital tract as measured by PCR, calculated using a per-day shedding rate in participants treated with high-dose valacyclovir as compared to once-daily valacyclovir. [ Time Frame: 11 weeks ] [ Designated as safety issue: No ]
Frequency of lesional shedding from the genital tract as measured by PCR, calculated using a per day shedding rate in participants treated with high-dose valacyclovir as compared to once-daily valacyclovir. [ Time Frame: 11 weeks ] [ Designated as safety issue: No ]
Number of herpes recurrences, defined clinically as >=1 successive day on which genital lesions are present, in participants treated with high-dose valacyclovir as compared to once-daily valacyclovir. [ Time Frame: 11 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment:	82
Study Start Date:	September 2006
Estimated Study Completion Date:	September 2011
Estimated Primary Completion Date:	September 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Active Comparator	Drug: valacyclovir 1000 mg orally three times daily for 5 weeks
2: Active Comparator	Drug: valacyclovir 500 mg orally once daily for 5 weeks

Detailed Description:

Screening Assessment

Patients will be assessed for their eligibility to enter the study at a screening visit. After signing informed consent they will undergo a medical history and the following information will be recorded in the Case Report Form (CRF):

Demographic Data: Date of birth, sex, marital status, education and race
Previous antiviral medication taken
History of sexually transmitted infections and sexual history.
Women of childbearing potential will undergo a urine pregnancy test. Serologic samples for HSV-2 and HIV will be obtained. Part of the blood sample will also be used for safety labs.

Start of Study Visit (Day 0) and Day 14, 28, 35, 42, 56, 70, and 77 Follow-Up Visits.

Eligible patients will return to clinic to be given study drug and a patient diary card on which to record concomitant medications, signs and symptoms, and adverse experiences. The investigator will instruct the patient on daily home viral sample collection, taking the study drug, and completing the diary card. The patient will be instructed to return to clinic in 2 weeks, +/- 2 days. Medication compliance will be assessed at each visit using pill counts. Safety labs will be performed on day 14, 28, 35, 56, 70 and 77.

Crossover Study Visit Prior To Washout Period (Day 35-41)

Participants will not be given study drug or placebo during the 7-day washout period. Participants will not be required to obtain swabs during the washout period.

Daily Home Viral Sample Collection

Participants will collect swabs from the genital mucosa four times per day and store the samples in PCR media with preprinted labels. Women will swab the cervicovaginal, vulvar and perianal areas, and men will swab the penile and perianal. Every two weeks, they will return the samples to the Virology Research Clinic when they present for additional study drug and assessment.

Final Study Visit (Day 77)

At the final study visit at Day 77 or for premature discontinuation, the investigator will perform the activities at the regular study visits, with the exception of the dispensation of study drug.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

18 years or older;
HSV-2 seropositive by Western Blot;
not receiving any drugs with known anti-HSV-2 activity for study duration;
history of primary genital herpes infection within past 6 months OR history of 4 or more HSV recurrences per year during the past year OR 4 or more recurrences per year prior to initiation of suppressive antiviral therapy; or shedding HSV-2 from genital mucosa on >25% of days in shedding session performed at the VRC within the last 2 years.
able to comply with the study protocol;
women of child bearing potential who are sexually active with men must be using a medically accepted method of contraception as judged by the investigator;
women of child-bearing potential must have a negative pregnancy test (urine) at screening visit;
in general good health, without other serious medical conditions and specifically with normal renal and hepatic function, as determined by the patient's medical history;
planning to remain resident in the area of the study center for the duration of the study participation;
HIV seronegative.

Exclusion Criteria:

hypersensitivity to acyclovir or valacyclovir;
pregnant women;
HIV positive or other immunosuppressed state, including chronic steroid use. Intermittent nasal or topical steroids are acceptable

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00362297

Contacts

Contact: Christine Johnston, MD

(206) 720-4340

vrc@u.washington.edu

Locations

United States, Washington
University of Washington Virology Research Clinic	Recruiting
Seattle, Washington, United States, 98122
Contact: Christine Johnston, MD 206-720-4340 vrc@u.washington.edu
Principal Investigator: Christine Johnston, MD

Sponsors and Collaborators

University of Washington

GlaxoSmithKline

Investigators

Principal Investigator:

Christine Johnston, MD

University of Washington

More Information

No publications provided

Responsible Party:	University of Washington ( Christine Johnston, MD, MPH )
Study ID Numbers:	30520-D, GSK VAL R147
Study First Received:	August 8, 2006
Last Updated:	August 31, 2009
ClinicalTrials.gov Identifier:	NCT00362297 History of Changes
Health Authority:	United States: Institutional Review Board

Additional relevant MeSH terms:

Herpes Simplex
Anti-Infective Agents
Sexually Transmitted Diseases, Viral
Herpes Genitalis
Genital Diseases, Male
Antiviral Agents
Pharmacologic Actions
Herpesviridae Infections

Virus Diseases
Genital Diseases, Female
Valacyclovir
Acyclovir
Therapeutic Uses
Sexually Transmitted Diseases
DNA Virus Infections

ClinicalTrials.gov processed this record on February 08, 2010