Study of Darunavir/r + Tenofovir/Emtricitabine vs. Darunavir/r + Raltegravir in HIV-infected Antiretroviral naïve Subjects (ANRS 143)
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Purpose
The triple therapy darunavir/r + tenofovir/emtricitabine is likely to become a relevant first-line treatment option in the years to come. The dual combination of boosted darunavir + raltegravir is an innovative treatment option that combines two potent new antiretroviral drugs, one of which belongs to a new drug class (integrase inhibitor). The expected efficacy profile of this combination is promising. Moreover, this combination might have a better tolerance profile and has the advantage of sparing the NRTI class.
In the context of tenofovir/emtricitabine currently being a reference backbone in first-line antiretroviral regimens, we hypothesise that, in combination with darunavir/r, raltegravir may be an alternative option if its efficacy is non-inferior to tenofovir/emtricitabine.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infections |
Drug: darunavir/ritonavir QD + raltegravir BID Drug: darunavir/r QD + tenofovir/emtricitabine QD (fixed dose combination) |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | An Open-label Randomised Two-year Trial Comparing Two First-line Regimens in HIV-infected Antiretroviral naïve Subjects: Darunavir/r + Tenofovir/Emtricitabine vs. Darunavir/r + Raltegravir (ANRS 143/NEAT 001) |
- Time to virologic or clinical failure, as the first occurrence of one of six protocol-defined components [ Time Frame: minimum 2 years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 800 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | August 2013 |
| Estimated Primary Completion Date: | August 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: darunavir/r + tenofovir/emtricitabine |
Drug: darunavir/r QD + tenofovir/emtricitabine QD (fixed dose combination)
darunavir 800 mg, i.e. 2 tablets of 400 mg once daily (QD) ritonavir 100 mg, 1 tablet once daily (QD) tenofovir/emtricitabine 245/200 mg, fixed dose combination, 1 tablet once daily (QD) |
| Experimental: darunavir/r + raltegravir |
Drug: darunavir/ritonavir QD + raltegravir BID
darunavir 800 mg, i.e. 2 tablets of 400 mg once daily (QD) ritonavir 100 mg, 1 tablet once daily (QD) raltegravir 400 mg, 1 tablet twice daily (BID) |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient with confirmed HIV infection
- Age ≥ 18 years
- Written informed consent
- Male patient or non-pregnant, non-lactating female
- No previous treatment with any antiretroviral drugs
- HIV-1 RNA > 1000 copies/ml
- Indication to start an antiretroviral treatment as long as subject has also a CD4 cell count ≤ 500/mm3 either at screening or on a sample taken within 3 months before screening
- No major IAS-USA mutations on genotypic testing at the screening visit or on any historical genotype, if available
Non-inclusion Criteria:
- Woman without effective contraception method (recommended contraception during the trial is mechanical + a second method other than an oral contraceptive)
- Pregnant or breastfeeding woman
- Woman expecting to conceive during the study
- HIV-2 co-infection
- Creatinine clearance < 60 ml/mn (Cockcroft & Gault equation), alkaline phosphatase, ASAT, or ALAT ≥ 5 ULN
- Patient with significant impairment of hepatic function, defined as serum albumin < 2.8 g/dl or INR > 1.7 or presence of ascites, in the absence of another explanation for the abnormal finding
- CD4 > 500/mm3 at screening, except in case of symptomatic HIV disease (defined by conditions qualifying for CDC category B or C) or CD4 ≤ 500/mm3 on a sample taken within 3 months before screening.
- Any major IAS-USA mutation conferring resistance to one or more of reverse transcriptase or protease inhibitors on genotypic testing at screening
- Mycobacteriosis under treatment
- Malignancy requiring chemotherapy or radiotherapy
- Positive HBs Ag
- HCV infection for which specific treatment is ongoing or planned during the first year on trial treatment
- Known hypersensitivity to one of the trial drugs or its excipients
- Contraindicated concomitant treatment
- Anticipated non-compliance with the protocol
- Participation in another clinical trial with an on-going exclusion period at screening
- Subject under legal guardianship or incapacitation
- Subject, who in the opinion of the investigator, is unable to complete the study period
Contacts and Locations
Show 77 Study Locations| Study Chair: | François Raffi, Professor | Nantes University Hospital |
More Information
No publications provided
| Responsible Party: | French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS) |
| ClinicalTrials.gov Identifier: | NCT01066962 History of Changes |
| Other Study ID Numbers: | 2009-015113-44, 2009-015113-44 |
| Study First Received: | February 9, 2010 |
| Last Updated: | May 23, 2012 |
| Health Authority: | Austria: Federal Ministry for Health and Women Belgium: Federal Agency for Medicinal Products and Health Products Denmark: Danish Medicines Agency France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) Germany: Federal Institute for Drugs and Medical Devices Greece: National Organization of Medicines Hungary: National Institute of Pharmacy Ireland: Irish Medicines Board Italy: The Italian Medicines Agency Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) Poland: Office for Registration of Medicinal Products, Medical Devices and Biocidal Products Portugal: National Pharmacy and Medicines Institute Spain: Spanish Agency of Medicines Sweden: Medical Products Agency United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Keywords provided by French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS):
|
HIV-infected antiretroviral naïve subjects |
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 Ritonavir Darunavir Tenofovir |
Tenofovir disoproxil Emtricitabine HIV Protease Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Therapeutic Uses Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors |
ClinicalTrials.gov processed this record on May 19, 2013