Post-prandial Lipid Effects of Raltegravir (RAL) vs Ritonavir -Boosted Darunavir (DRV-r) in Anti-retroviral Therapy (ART)- Naive Adults or Adults Recommencing ART. - Full Text View

Purpose

This is a research study into the effects of three drugs used to treat HIV infection. Some drugs used to treat HIV have been associated with changes in blood fats such as cholesterol that could be harmful over the long-term, because these blood fat changes have been associated with a small, increased risk of heart disease and stroke in some studies of adults with HIV. Now that HIV can be controlled for long periods in most patients, and because heart disease is one of the biggest causes of illness and death in the general population, it is important to develop new HIV treatments that control HIV effectively but do not cause abnormal blood fats.

Hypothesis: That Raltegravir will result in less post-prandial lipid disturbances than ritonavir-boosted darunavir.

Condition	Intervention	Phase
HIV Cardiovascular Disease	Drug: raltegravir plus truvada Drug: Darunavir, ritonavir, tenofovir/emtricitabine (Truvada)	Phase 4


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Pharmacokinetics/Dynamics Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Post-prandial Lipid Effects of Raltegravir (RAL) vs Ritonavir-boosted Darunavir (DRV-r) in Anti-retroviral Therapy (ART)-Naive Adults or Adults Recommencing ART.

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS

Drug Information available for: Emtricitabine Tenofovir Ritonavir Tenofovir Disoproxil Fumarate Darunavir Raltegravir Darunavir ethanolate Truvada Raltegravir potassium

U.S. FDA Resources

Further study details as provided by St Vincent's Hospital, Sydney:

Primary Outcome Measures:

To compare the effects of ritonavir plus darunavir daily to raltegravir twice daily on post prandial lipid responses over 24 weeks [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
Fasting samples will be taken for total cholesterol, LDL and HDL cholesterol, and triglycerides. Repeat lipid samples will be collected before a high fat meal is consumed. After the meal is completed , blood will be collected at 1, 2, 3, and 4 hours at baseline, week 4 and week 24 visits.

Secondary Outcome Measures:

safety [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]
Safety parameters will be assessed by measurement of urea and electrolytes, LFTs, urine protein to creatinine ratio
Other metabolic parameters [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
Fasting metabolic parameters will be assessed. Study staff and participants will be blinded to the results fo these tests until completion of the study or parameters become sginificantly abnormal
Arterial stiffness [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]


Enrollment:	25
Study Start Date:	November 2010
Study Completion Date:	July 2014
Primary Completion Date:	July 2014 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: 1.Raltegravir plus truvada Raltegravir 400mg twice daily plus truvada 300mg/200mg once daily for 24 weeks	Drug: Darunavir, ritonavir, tenofovir/emtricitabine (Truvada) Darunavir two 400mg tablets with one ritonavir 100mg capsule once daily plus Tenofovir/emtricitabine (Truvada) one 300mg/200mg tablet once daily with food for 24 weeks Other Names: Prezista Norvir Tenofovir/emtricitabine
Active Comparator: 2. ritonavir boosted darunavir plus truvada Darunavir 800mg with ritonavir 100mg plus truvada 300mg/200mg once daily for 24 weeks	Drug: raltegravir plus truvada raltegravir 400 mg tablet with truvada 300/200 mg tablet for 24 weeks Other Names: tenofovir disoproxil fumarate Isentress

Eligibility


Ages Eligible for Study:	18 Years and older (Adult, Senior)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Provision of signed, informed consent
Age >18 years
HIV infection documented by HIV antibody test and Western Blot prior to study entry
No previous ART OR no ART for 6 months prior to randomisation
CD4+ count of <500 cells/mm or viral load >10,000 copies/ml within 60 days prior to randomisation
No genotypic resistance to Raltegravir, Tenofovir/emtricitabine, Darunavir, Ritonavir
Body mass index less than 30kg/m2

Exclusion Criteria:

Primary HIV infection within the last 6 months
Active infection or opportunistic illness within the previous 30 days
Use of any medication contra-indicated with ritonavir-boosted darunavir or raltegravir
Use of lipid-lowering therapy
Diabetes mellitus (fasting glucose >7.0mml/l or a prior diagnosis of diabetes)
Use of oral prednisolone > 7.5mg daily or equivalent
pregnancy or Breast feeding
proven hypersensitivity to one or more components of the study meal

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01258439

Locations


Australia, New South Wales
Holdsworth House Medical Practice
Sydney, New South Wales, Australia, 2010
St Vincent Hospital, Clinical Research Program
Sydney, New South Wales, Australia, 2010

Sponsors and Collaborators

St Vincent's Hospital, Sydney

Merck Sharp & Dohme Corp.

Investigators


Principal Investigator:	Andrew D Carr, Professor	St Vincent's Hospital, Sydney, Australia

More Information


Responsible Party:	Andrew Carr, Head, Clinical Research Program, St Vincent's Hospital, Sydney
ClinicalTrials.gov Identifier:	NCT01258439 History of Changes
Other Study ID Numbers:	ROaR+
Study First Received:	December 9, 2010
Last Updated:	January 8, 2015
Health Authority:	Australia: Therapeutic Goods Administration

Keywords provided by St Vincent's Hospital, Sydney:


HIV cardiovascular disease post prandial lipids ritonavir	darunavir raltegravir arterial stiffness tonometry

Additional relevant MeSH terms:


Cardiovascular Diseases Ritonavir Darunavir Tenofovir Raltegravir Potassium Emtricitabine Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination HIV Protease Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action	Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Cytochrome P-450 CYP3A Inhibitors Cytochrome P-450 Enzyme Inhibitors Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors HIV Integrase Inhibitors Integrase Inhibitors

ClinicalTrials.gov processed this record on September 29, 2016

Post-prandial Lipid Effects of Raltegravir (RAL) vs Ritonavir -Boosted Darunavir (DRV-r) in Anti-retroviral Therapy (ART)- Naive Adults or Adults Recommencing ART. (ROaR+)