Reducing Heavy Drinking to Optimize HIV/AIDS Treatment and Prevention (DAWN)
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Purpose
This is a double-blind placebo-controlled study to evaluate the effect of Naltrexone (NTX) and counseling on highly active antiretroviral treatment (HAART) medication adherence in a cohort of HIV-infected patients who report heavy drinking, or meet criteria for alcohol abuse and/or dependence, and inadequate (< 95%) HAART adherence. All patients will receive a behavioral intervention, termed Medical Management/Medication Coaching or MM/MC. MM/MC incorporates the behavioral platform Medical Management (MM) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded COMBINE Study to reduce heavy alcohol use with Medication Coaching (MC), a manualized treatment designed to improve HAART medication adherence in HIV-infected patients with substance use disorders.
| Condition | Intervention | Phase |
|---|---|---|
|
Reduction in Heavy Drinking in Patients With HIV |
Drug: Naltrexone Other: Placebo + Medication Management/Medication Coaching |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Reducing Heavy Drinking to Optimize HIV/AIDS Treatment and Prevention |
- To compare the efficacy of NTX +MM/MC versus placebo +MM/MC on adherence to HAART. [ Time Frame: One year ] [ Designated as safety issue: No ]NTX +MM/MC will lead to improved adherence to HAART when compared to placebo + MM/MC.
- To compare the efficacy of NTX +MM/MC versus placebo +MM/MC in reducing days of heavy drinking. [ Time Frame: One year ] [ Designated as safety issue: No ]NTX +MM/MC will lead to greater reductions in the number of days of heavy drinking when compared to placebo + MM/MC.
| Estimated Enrollment: | 154 |
| Study Start Date: | April 2011 |
| Estimated Study Completion Date: | November 2015 |
| Estimated Primary Completion Date: | November 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: NTX + MM/MC
Naltrexone + Medical Management/Medication Coaching
|
Drug: Naltrexone
NTX arm will receive monthly extended release NTX doses at 380mg (4 mL), administered as an intramuscular gluteal injection at 4-week intervals.
Other Name: Vivitrol
|
|
Placebo Comparator: Placebo + MM/MC
Placebo plus Medical Management/Medication Coaching
|
Other: Placebo + Medication Management/Medication Coaching
Placebo + Medication Management/Medication Coaching
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Be HIV-infected.
- Currently be prescribed HAART medication or be eligible to receive HAART medication.
- Report less than 95% adherence to their HAART medication.
- Report heavy drinking 4 or more times in the past 4 weeks, or meet current criteria for alcohol abuse or dependence. Heavy drinking is defined as 4 or more drinks for women and 5 or more drinks for men on one occasion.
- Be at least 18 years old.
- Be able to understand English and provide informed consent.
Exclusion Criteria:
- Be psychotic or severely psychiatrically disabled.
- Be currently enrolled in formal treatment for alcohol (excluding self-help, e.g. Alcoholics Anonymous)
- Have medical conditions that would preclude completing or be of harm during the course of the study.
- Have laboratory or clinical evidence of significant liver dysfunction (alanine aminotransferase (ALT) or aspartate aminotransferase (AST) greater than 5 times the upper limit of the normal range) or cirrhosis with a Child-Pugh classification greater than A or B.
- Have a known contraindication to NTX therapy (e.g. requiring opioid medication for pain).
Be pregnant, nursing or unable to use an effective method of birth control (women).
-
Contacts and Locations| Contact: Jon Savant, B.S. | 203-314-3674 | jsavant@aptfoundation.org |
| Contact: Sarah Caffrey, B.S. | 203-314-3674 | scaffrey@aptfoundation.org |
| United States, Connecticut | |
| Yale University School of Medicine | Recruiting |
| New Haven, Connecticut, United States, 06510 | |
| Contact: Jon Savant, B.S. 201-781-4650 jsavant@aptfoundation.org | |
| VACT Healthcare System | Recruiting |
| New Haven, Connecticut, United States, 06516 | |
| Contact: Sarah Caffrey 203-314-3674 scaffrey@aptfoundation.org | |
| Principal Investigator: | Lynn E Sullivan (Fiellin), MD | Yale University |
More Information
No publications provided
| Responsible Party: | Lynn E. Fiellin, Associate Professor, Yale University |
| ClinicalTrials.gov Identifier: | NCT01227044 History of Changes |
| Other Study ID Numbers: | HIC0909005730, 1RO1AA018923 |
| Study First Received: | October 20, 2010 |
| Last Updated: | January 23, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Yale University:
|
Substance Abuse Counseling Adherence (medication) Alcohol Abuse Highly Active Antiretroviral Therapy (HAART) |
Naltrexone Vivitrol HIV |
Additional relevant MeSH terms:
|
Naltrexone Narcotic Antagonists Physiological Effects of Drugs Pharmacologic Actions |
Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 17, 2013