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| Sponsor: | University of Pennsylvania |
|---|---|
| Collaborators: |
National Institutes of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) Hoffmann-La Roche |
| Information provided by: | University of Pennsylvania |
| ClinicalTrials.gov Identifier: | NCT00594880 |
Purpose
The objective of the study is to compare two different doses of Peg-INF-α-2A (90 or 180 ug/wk) for their ability to maintain viral control when initiated 5 weeks before ART (antiretroviral therapy) interruption in HIV positive, ART-suppressed subjects (viral load <50 copies/ml) as determined by observing the percentages of viral load measurements <400 copies/ml between the two arms over a 24-week period, corresponding to the Pegasys monotherapy period (exclusive of dual ART/Pegasys 5-week period). Primary analysis will be an "intent to treat" analysis and will address the hypothesis that two different doses of Peg-INF-α-2A (90 and 180 ug/week) will be similarly effective at inhibiting viral replication.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections |
Drug: Pegasys (ART Replacement Therapy) |
Phase II |
| Study Type: | Interventional |
| Study Design: | Treatment, Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study |
| Official Title: | Antiviral Activity of Peg-IFN-Alpha-2A in Chronic HIV-1 Infection |
| Estimated Enrollment: | 52 |
| Study Start Date: | January 2008 |
| Estimated Study Completion Date: | January 2010 |
| Estimated Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
1: Active Comparator
180 ug/week dose of Peg-IFN-Alpha-2A
|
Drug: Pegasys (ART Replacement Therapy)
Peg-IFN-Alpha-2A 180 ug/week for 29 weeks
|
|
2: Active Comparator
90 ug/week dose of Peg-IFN-Alpha-2A
|
Drug: Pegasys (ART Replacement Therapy)
Peg-IFN-Alpha-2A 90 ug/week for 29 weeks
|
The high toxicity of current Anti-Retroviral Therapy (ART) regimens has driven a number of studies investigating therapeutic approaches aimed at reducing drug exposure while maintaining the beneficial effects of immune reconstitution. Preliminary observations in HCV/HIV co-infected individuals already support an antiviral effect by Pegylated Interferon-Alpha-2A (Peg-IFN-Alpha-2A:Pegasys®) on HIV-1 replication; however, the ability of Peg-IFN-Alpha-2A (as a single agent) to maintain long-term suppression of HIV-1 replication in patients who interrupt ART after having achieved immune reconstitution remains undetermined. The rationale for addressing two doses of Peg-IFN-Alpha-2A (180 and 90 ug/week) is based on the antiviral activity reported with both doses and the lower incidence of adverse events associated with doses lower than that approved for HCV therapy (90 versus 180ug/week).
The long-range goal of this proposal is to determine if Peg-IFN-Alpha-2A monotherapy can sustain HIV-1 suppression in the absence of ART in infected individuals. Our short-range goal is to determine the safety, viral suppressive potential and immune correlates of Peg-IFN-Alpha-2A administered upon the cessation of suppressive ART.
Based on the current literature and our preliminary studies, we hypothesize that weekly doses of 90 or 180 ug/wk of Peg-IFN-Alpha-2A administered to pharmacologically-suppressed HIV-infected individuals in the course of antiretroviral therapy (ART) discontinuation will result in equivalent frequency of viral control, with the lower dose resulting in measurably lower rate and intensity of therapy-related adverse events (AE).
We propose to compare two different doses of Peg-IFN-Alpha-2A (90 or 180 ug/wk) as a simplification step to ART, for their ability to maintain viral load suppression when initiated 5 weeks before ART interruption in HIV-infected, ART-suppressed patients (VL<50 copies/ml). Briefly, control will be determined by the the percentages of viral load measurements <400 copies/ml between the two arms over a period of 24 weeks, corresponding to the Pegasys monotherapy period (exclusive of dual ART/Pegasys 5-week period). A threshold of 400 is used based on the known potential for blipping on ART between 50 and 400 copies/ml with no clinical consequence to sustained suppression thereafter (JAMA 2005, 293:817-829). Primary analysis will be an "intent to treat" analysis and will address the hypothesis that two different doses of Peg-IFN-Alpha-2A (90 and 180 ug/week) will be similarly effective at inhibiting viral replication.
The secondary objectives of the research are:
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contacts and Locations| Contact: Craig R Carty, MSc | 215-662-8217 | craig.carty@uphs.upenn.edu |
| Contact: Jay Kostman, MD | 215-662-9908 ext 8693 | jay.kostman@uphs.upenn.edu |
| United States, Pennsylvania | |
| The Wistar Institute | Recruiting |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Contact: Luis Montaner, DVM, PhD 215-898-9143 montaner@wistar.org | |
| Contact: Livio Azzoni, MD, PhD 215-898-1752 azzoni@wistar.org | |
| Principal Investigator: Luis Montaner, DVM, PhD | |
| Sub-Investigator: Livio Azzoni, MD, PhD | |
| Sub-Investigator: Jihed Chehimi, PhD | |
| Sub-Investigator: Emmanouil Papasavvas, PhD | |
| Penn-Presbyterian Medical Center | Recruiting |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Contact: Craig R Carty, MSc 215-662-8217 craig.carty@uphs.upenn.edu | |
| Contact: Jay Kostman, MD 215-662-9908 ext 8693 jay.kostman@uphs.upenn.edu | |
| Principal Investigator: Jay Kostman, MD | |
| Drexel University College of Medicine | Recruiting |
| Philadelphia, Pennsylvania, United States, 19102 | |
| Contact: Sharon Lewis, RN. BSN 215-762-3251 sharon.lewis@drexelmed.edu | |
| Contact: Jeffrey Jacobson, MD 215-762-1668 jeffrey.jacobson@drexelmed.edu | |
| Principal Investigator: Jeffrey Jacobson, MD | |
| Hospital of the University of Pennsylvania | Recruiting |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Contact: Craig R Carty, MSc 215-662-8217 craig.carty@uphs.upenn.edu | |
| Contact: Joseph Quinn, RN 215-349-8092 joseph.quinn@uphs.upenn.edu | |
| Principal Investigator: Pablo Tebas, MD | |
| Jonathan Lax Immune Disorders Clinic | Recruiting |
| Philadelphia, Pennsylvania, United States, 19107 | |
| Contact: Angela Kapalko, PA-C 215-985-4448 ext 126 akapalko@fight.org | |
| Contact: Karam Mounzer, MD 215-985-4448 mounzerk@fight.org | |
| Principal Investigator: Karam Mounzer, MD | |
| Study Chair: | Luis Montaner, DVM, PhD | The Wistar Institute |
| Principal Investigator: | Jay Kostman, MD | Penn-Presbyterian Medical Center |
| Principal Investigator: | Pablo Tebas, MD | University of Pennsylvania |
| Principal Investigator: | Jeffrey Jacobson, MD | Drexel University College of Medicine |
| Principal Investigator: | Karam Mounzer, MD | Jonathan Lax Immune Disorders Clinic- Philadelphia FIGHT |
More Information
| Responsible Party: | The Wistar Institute's Immunopathogenesis Laboratory ( Luis Montaner, DVM, PhD., MSc. Protocol Chair ) |
| Study ID Numbers: | DAIDS-ES 10401, R01 AI065279 |
| Study First Received: | January 4, 2008 |
| Last Updated: | January 25, 2009 |
| ClinicalTrials.gov Identifier: | NCT00594880 History of Changes |
| Health Authority: | United States: Food and Drug Administration; United States: Federal Government; United States: Institutional Review Board |
|
HIV HIV-1 Pegasys Peg-IFN-Alpha-2A Viral Suppression ART cessation |
Immune function Innate Immunity Immune Function Toxicity Immune-based therapy Treatment interruption |
|
Communicable Diseases Anti-Infective Agents Sexually Transmitted Diseases, Viral Slow Virus Diseases Immunologic Factors Antineoplastic Agents Physiological Effects of Drugs Infection Therapeutic Uses Angiogenesis Modulating Agents Growth Inhibitors Retroviridae Infections Interferon-alpha RNA Virus Infections |
Immune System Diseases Growth Substances Acquired Immunodeficiency Syndrome Antiviral Agents Angiogenesis Inhibitors Immunologic Deficiency Syndromes Pharmacologic Actions Virus Diseases HIV Infections Sexually Transmitted Diseases Lentivirus Infections Peginterferon alfa-2a Interferon Alfa-2a |