A Study of 141W94 Used Alone or in Combination With Zidovudine Plus 3TC in HIV-Infected Patients
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| ClinicalTrials.gov Identifier: NCT00001085 |
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Recruitment Status :
Completed
First Posted : August 31, 2001
Last Update Posted : February 16, 2012
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To determine the proportion of patients whose plasma HIV-1 RNA level remains below a detectable level (less than 500/ml) after 24 weeks of study therapy with either 141W94 monotherapy or 141W94 plus zidovudine (ZDV) and lamivudine (3TC). To determine the safety and tolerability of 141W94 monotherapy and the combination of 141W94 plus 3TC in patients with HIV infection.
Although dramatic inhibition of HIV-1 replication is achieved with ritonavir or indinavir monotherapy, in both cases maximum suppression required combination treatment together with nucleoside analog RT inhibitors. This study tests the hypothesis that monotherapy with 141W94 doses that result in Cmin levels far in excess of the IC90 corrected for plasma protein binding for HIV-1 can achieve the same virologic and immunologic effects in terms of magnitude and durability, as has been observed with combinations of other protease inhibitors plus nucleoside analogs.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| HIV Infections | Drug: Amprenavir Drug: Lamivudine Drug: Zidovudine | Phase 2 |
Although dramatic inhibition of HIV-1 replication is achieved with ritonavir or indinavir monotherapy, in both cases maximum suppression required combination treatment together with nucleoside analog RT inhibitors. This study tests the hypothesis that monotherapy with 141W94 doses that result in Cmin levels far in excess of the IC90 corrected for plasma protein binding for HIV-1 can achieve the same virologic and immunologic effects in terms of magnitude and durability, as has been observed with combinations of other protease inhibitors plus nucleoside analogs.
In this randomized, double-blind study, patients' HIV RNA is screened 30 days prior to entry. Patients satisfying enrollment criteria must have been on a stable antiretroviral regimen for 30 days prior to study screening and remain on the same regimen until entry. Patients are stratified based on the screening HIV-1 RNA copy number obtained within 30 days of entry: 5,000 - 50,000 copies/ml versus greater than 50,000 copies/ml. In addition, patients are stratified based on previous antiretroviral use: naive versus experienced. Patients are randomized to one of 2 treatment arms: Arm A - 141W94, plus Zidovudine (ZDV) and Lamivudine (3TC) or Arm B - 141W94, plus ZDV placebo and 3TC placebo.
[AS PER AMENDMENT 8/25/97: Patients assigned to the monotherapy arm are advised to discontinue their study medication immediately and initiate antiretroviral therapy with indinavir, nevirapine, stavudine and 3TC, as outlined in ACTG 347 roll-over protocol, ACTG 373. Patients in the three-drug arm continue on study therapy.] [AS PER AMENDMENT 12/19/97: Patients receive study treatment for 56 weeks and are followed through week 68.]
| Study Type : | Interventional (Clinical Trial) |
| Enrollment : | 94 participants |
| Primary Purpose: | Treatment |
| Official Title: | A Randomized, Double-Blind, Phase II Study of 141W94 (VX-478) Monotherapy vs. 141W94 (VX-478) Plus ZDV Plus 3TC in HIV Infected Individuals |
| Actual Study Completion Date : | September 1998 |
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| Ages Eligible for Study: | 13 Years and older (Child, Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria
Concurrent Medication:
Allowed:
- Chemoprophylaxis for Pneumocystis carinii pneumonia is required for all patients who have a CD4 cell count <= 200 cells/mm3.
- Topical and/or oral antifungal agents, except for those listed in excluded medications.
- Treatment, maintenance or chemoprophylaxis with approved agents for opportunistic infections as clinically indicated, unless listed in excluded medications.
- All antibiotics as clinically indicated.
- Systemic corticosteroid use for <= 21 days for acute problems is permitted as medically indicated; chronic systemic corticosteroid use is not permitted.
- Recombinant erythropoietin and granulocyte colony-stimulating factor as medically indicated.
Regularly prescribed medications such as:
- antipyretics, analgesics, allergy medications, antidepressants, sleep medications, oral contraceptives (a barrier method is also required for this study), megestrol acetate, testosterone or any other medications, as medically indicated.
- Alternative therapies such as vitamins, acupuncture and visualization techniques are permitted (excluding herbal medications).
NOTE:
- Patients should report the use of these therapies; alternative therapies will be recorded.
Patients must have:
- HIV-1 infection as documented by ELISA and confirmed.
- >= 5,000 HIV-1 RNA copies/ml (within 30 days prior to study entry).
- CD4 cell count >= 50 cells/mm3 within 60 days prior to study entry.
- Signed, informed consent for patients < 18 years of age.
Prior Medication: Required:
- Patients must be on a stable antiretroviral regimen for 30 days prior to study screening and remain on the same regimen until entry.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
- Any active infection requiring acute treatment within 14 days prior to entry.
- A malignancy that requires systemic therapy other than minimal Kaposi's sarcoma.
NOTE:
- Patients with minimal Kaposi's sarcoma, defined as <= 5 cutaneous lesions and no visceral disease or tumor-associated edema, will be allowed to enroll as long as they do not require systemic therapy for Kaposi's sarcoma.
Patients with the following prior symptoms and conditions are excluded:
- Inability to tolerate ZDV 500-600 mg daily if ZDV was administered previously. Intolerance to ZDV is defined as any grade toxicity that resulted in a dose reduction or termination of ZDV.
Prior Medication:
Excluded:
- Any 3TC therapy prior to entry.
- Any HIV-1 protease inhibitor therapy prior to study entry (e.g., saquinavir, ritonavir, indinavir, nelfinavir, 141W94).
- Any immunomodulator therapy within 30 days prior to entry.
- Active immunization within 30 days prior to entry.
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Any antiretroviral therapy change within 30 days prior to study screening.
1. Concurrent use of non-protocol specified antiretroviral agents; either investigational or licensed.
- Immunomodulators that affect immunologic or virologic indices such as systemic corticosteroids, thalidomide, or cytokines.
- Concomitant use of rifabutin and/or rifampin.
- Investigational drugs other than 141W94/VX-478.
- Systemic cytotoxic chemotherapy.
- Oral astemizole (Hismanal), carbamazepine (Tegretol), dexamethasone (Decadron), ketoconazole (Nizoral), itraconazole (Sporanox), phenobarbital, phenytoin (Dilantin), terfenadine (Seldane), cisapride (Propulsid), triazolam (Halcion) and midazolam (Versed).
- Herbal medications.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00001085
| United States, Alabama | |
| Alabama Therapeutics CRS | |
| Birmingham, Alabama, United States, 35294 | |
| United States, California | |
| USC CRS | |
| Los Angeles, California, United States, 900331079 | |
| United States, Colorado | |
| University of Colorado Hospital CRS | |
| Aurora, Colorado, United States, 80262 | |
| United States, Florida | |
| Univ. of Miami AIDS CRS | |
| Miami, Florida, United States, 331361013 | |
| United States, Georgia | |
| The Ponce de Leon Ctr. CRS | |
| Atlanta, Georgia, United States, 30308 | |
| United States, Illinois | |
| Northwestern University CRS | |
| Chicago, Illinois, United States, 60611 | |
| Cook County Hosp. CORE Ctr. | |
| Chicago, Illinois, United States, 60612 | |
| Rush Univ. Med. Ctr. ACTG CRS | |
| Chicago, Illinois, United States, 60612 | |
| United States, Massachusetts | |
| Bmc Actg Crs | |
| Boston, Massachusetts, United States, 02118 | |
| Beth Israel Deaconess Med. Ctr., ACTG CRS | |
| Boston, Massachusetts, United States, 02215 | |
| United States, Missouri | |
| St. Louis ConnectCare, Infectious Diseases Clinic | |
| St Louis, Missouri, United States, 63112 | |
| Washington U CRS | |
| St. Louis, Missouri, United States | |
| United States, New York | |
| NY Univ. HIV/AIDS CRS | |
| New York, New York, United States, 10016 | |
| United States, North Carolina | |
| Unc Aids Crs | |
| Chapel Hill, North Carolina, United States, 275997215 | |
| United States, Pennsylvania | |
| Hosp. of the Univ. of Pennsylvania CRS | |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Study Chair: | Murphy R | ||
| Study Chair: | Gulick R |
Publications:
| Responsible Party: | National Institute of Allergy and Infectious Diseases (NIAID) |
| ClinicalTrials.gov Identifier: | NCT00001085 History of Changes |
| Other Study ID Numbers: |
ACTG 347 11317 ( Registry Identifier: DAIDS ES ) |
| First Posted: | August 31, 2001 Key Record Dates |
| Last Update Posted: | February 16, 2012 |
| Last Verified: | February 2012 |
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
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HIV-1 Drug Therapy, Combination Acquired Immunodeficiency Syndrome Zidovudine HIV Protease Inhibitors Lamivudine |
RNA, Viral VX 478 Reverse Transcriptase Inhibitors Anti-HIV Agents Viral Load |
Additional relevant MeSH terms:
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HIV Infections Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Lamivudine Zidovudine Amprenavir Reverse Transcriptase Inhibitors |
Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Anti-HIV Agents Antimetabolites Antibiotics, Antitubercular Antitubercular Agents Anti-Bacterial Agents HIV Protease Inhibitors Protease Inhibitors |