High Dose Vitamin D and Calcium for Bone Health in Individuals Initiating HAART
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Purpose
This study is being done with people who are infected with HIV and need to start treatment for their HIV disease. The purpose of this study is to see if taking vitamin D and calcium will help prevent the bone loss that sometimes happens when people start HIV treatment. For this study, the following HIV treatment (or HAART) will be provided in the form of a single tablet that contains three different drugs: efavirenz/emtricitabine/tenofovir (EFV/FTC/TDF). These drugs are approved by the FDA to treat HIV infection. The HIV treatment provided is common for people who are taking HIV drugs for the first time. The risks seen with this HIV treatment are the same that you would encounter when taking these drugs outside of the study. The lists of risks of this HIV treatment are included in this document because the drugs are provided by the study, not because the drugs are being tested. The purpose of the study is only to look at the impact of high doses of vitamin D and calcium in preventing bone loss; the HIV treatment is not being tested.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV-1 Infection |
Drug: Atripla Drug: Calcium Carbonate Drug: Vitamin D3 Drug: Placebo for calcium carbonate Drug: Placebo for vitamin D3 |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | A Prospective, Randomized, Double-Blind Phase II Trial of High-Dose Vitamin D and Calcium for Bone Health in HIV-Infected Individuals Initiating Highly Active Antiretroviral Therapy (HAART) |
- Efficacy endpoint [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]The efficacy endpoint is the percent change from baseline in bone mineral density (BMD) at total hip (as measured by DXA scan) at 48 weeks
- The percent change from baseline in bone mineral density (BMD) at at spine (as measured by DXA scan) at 48 weeks [ Time Frame: Week 48 ] [ Designated as safety issue: No ]
- The change from baseline in vitamin D level at 24 and 48 weeks [ Time Frame: Weeks 24 and 48 ] [ Designated as safety issue: No ]
- The changes from baseline in markers of bone turnover (osteocalcin, bone alkaline phosphatase, serum C-telopeptide, interleukin-6, and high-sensitivity C-reactive protein) at 24 and 48 weeks. [ Time Frame: Weeks 24 and 48 ] [ Designated as safety issue: No ]
- The changes from baseline in markers of inflammation at 24 and 48 weeks [ Time Frame: Weeks 24 and 48 ] [ Designated as safety issue: No ]
- The change from baseline in insulin sensitivity (HOMA-IR) at 24 and 48 weeks [ Time Frame: Weeks 24 and 48 ] [ Designated as safety issue: No ]
- The changes from baseline in total cholesterol and LDL cholesterol at 24 and 48 weeks [ Time Frame: Weeks 24 and 48 ] [ Designated as safety issue: No ]
- The change from baseline in urinary phosphate excretion at 12, 24, and 48 weeks [ Time Frame: Weeks 12, 24 and 48 ] [ Designated as safety issue: No ]
- The change from baseline in CD4+ count at 4, 12, 24 and 48 weeks [ Time Frame: Weeks 4, 12, 24 and 48 ] [ Designated as safety issue: No ]
- Occurrence of Grade ≥ 3 adverse events and selected Grade ≥ 2 adverse events related to hypercalcemia [ Time Frame: Week 48 ] [ Designated as safety issue: Yes ]
| Enrollment: | 167 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | March 2013 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm A: EFV/FTC/TDF plus vitamin D3 and calcium carbonate
The participant will be administered FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla), calcium carbonate and vitamin D3 4000 IU.
|
Drug: Atripla
The participant will be administered FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla) 600 mg/200 mg/ 300 mg tablet taken orally once daily at bedtime on an empty stomach.
Drug: Calcium Carbonate
Calcium carbonate 500 mg tablet taken orally twice daily with food for 48 weeks.
Drug: Vitamin D3
One Vitamin D3 4000 IU capsule taken orally once daily with food for 48 weeks.
|
|
Experimental: Arm B: EFV/FTC/TDF plus vitamin D placebo and calcium placebo
The participant will be administered FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla), a placebo for calcium carbonate, and a placebo for vitamin D3.
|
Drug: Atripla
The participant will be administered FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla) 600 mg/200 mg/ 300 mg tablet taken orally once daily at bedtime on an empty stomach.
Drug: Placebo for calcium carbonate
A placebo for calcium carbonate twice daily taken orally as one x 0 mg tablets with food for 48 weeks
Drug: Placebo for vitamin D3
A placebo for vitamin D3 once daily taken orally as one capsule with food for 48 weeks.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- HIV-1 infection
- No evidence of any exclusionary resistance mutations based on results from any genotype assay from any laboratory that has a CLIA (Clinical Laboratory Improvement Amendments) certification or its equivalent. Results must be available from testing any time in the past or must be obtained prior to entry and reviewed by the site investigator.
- ARV drug-naïve (<=10 days of ART at any time prior to entry) and no ARV drugs taken within the past 30 days.
- CD4+ cell count of any value obtained within 90 days prior to study entry at any laboratory that has a CLIA certification or its equivalent.
- HIV-1 RNA >1000 copies/mL obtained within 90 days prior to study entry at any laboratory that has a CLIA certification or its equivalent.
- Certain laboratory values obtained within 30 days prior to entry (as indicated in section 4.1.6 of the protocol.
- For women of reproductive potential, negative serum or urine pregnancy test within 48 hours prior to initiating study medications.
- Subjects must refrain from participating in a conception process (i.e., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization) and if participating in sexual activity that could lead to pregnancy, the subject/partner must use at least two of the reliable forms of contraceptive listed in section 4.1.9 of the protocol.
- 25-OH vitamin D >=10 ng/mL and <75 ng/mL.
- Ability and willingness of subject or legally authorized representative to provide informed consent.
Exclusion Criteria:
- Current or prior use of bisphosphonate therapy.
- Use of vitamin D supplements greater than 800 IU/day within 30 days prior to entry.
- Use of calcium supplements greater than 500 mg/day within 30 days prior to entry.
- Known allergy/sensitivity or any hypersensitivity to components of study drugs or their formulations.
- Any oral, intravenous, or inhaled steroids within the 30 days prior to enrollment(intranasal steroid use is allowed).
- Use of androgenic hormones or growth hormones.
- Receipt of systemic cytotoxic chemotherapy within 30 days prior to entry.
- Pregnancy or currently breastfeeding.
- Documentation of acute opportunistic infections within 30 days prior to entry.
- Serious illness requiring systemic treatment and/or hospitalization until subject either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 7 days prior to entry.
- Weight >300 lbs (exceeds weight limit of DXA scanners).
- History of nephrolithiasis (kidney stones).
- History of osteoporosis (as documented by DXA scan) or fragility fracture.
- Clinically active thyroid disease (use of thyroid hormone replacement therapy permitted but TSH must be in normal range).
- Current imprisonment or involuntary incarceration in a medical facility for psychiatric illness.
- Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
- Any condition that, in the opinion of the site investigator, would compromise the subject's ability to participate in the study.
Contacts and Locations
Show 39 Study Locations| Study Chair: | Edgar (Turner) Overton, MD | Alabama Therapeutics CRS |
| Study Chair: | Michael T Yin, MD, MS | HIV Prevention & Treatment CRS |
More Information
No publications provided
| Responsible Party: | AIDS Clinical Trials Group |
| ClinicalTrials.gov Identifier: | NCT01403051 History of Changes |
| Other Study ID Numbers: | ACTG A5280, 1U01AI068636 |
| Study First Received: | July 25, 2011 |
| Last Updated: | October 24, 2012 |
| Health Authority: | United States: Federal Government |
Additional relevant MeSH terms:
|
HIV Infections Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Calcium, Dietary Cholecalciferol Vitamin D Ergocalciferols Calcium Carbonate Vitamins |
Tenofovir disoproxil Tenofovir Efavirenz, emtricitabine, tenofovir disoproxil fumarate drug combination Bone Density Conservation Agents Physiological Effects of Drugs Pharmacologic Actions Antacids Molecular Mechanisms of Pharmacological Action Micronutrients Growth Substances Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Anti-Retroviral Agents Antiviral Agents |
ClinicalTrials.gov processed this record on May 22, 2013