Vedolizumab (Anti-alpha4beta7) in Subjects With HIV Infection Undergoing Analytical Treatment Interruption
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|ClinicalTrials.gov Identifier: NCT02788175|
Recruitment Status : Completed
First Posted : June 2, 2016
Results First Posted : December 16, 2019
Last Update Posted : February 24, 2020
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In most people infected with human immunodeficiency virus (HIV), their immune system cannot control HIV infection. They need drugs called combination antiretroviral therapy (cART) to control the HIV. When people stop cART treatment, their immune system cannot control the infection again. They can also become resistant to cART and have lasting side effects. Researchers want to test if the drug vedolizumab is effective at controlling HIV infection without the need for cART.
To test if vedolizumab is safe and can control the amount of HIV in the blood when cART is not taken.
People ages 18-65 who have HIV and are being treated with cART
Participants will be screened with:
Electrocardiogram: Soft, sticky patches on the chest, arms, and legs measure heart activity.
Blood and urine tests
Participants will have a baseline visit. This will be 2-5 hours each day for 1-2 days. It will include repeats of the screening tests and:
Leukapheresis: Blood is removed through a needle in the arm. A machine separates the white blood cells from the blood. The rest of the blood is returned to the participant.
Neurologic exam: The nerves and reflexes are tested.
First vedolizumab infusion through an arm vein
Participants will have visits every 4 weeks for 30 weeks. These will include:
Repeats of baseline tests
Participants will have more visits for blood draws.
Participants will keep taking cART until after the week 22 infusion.
After discontinuing cART at study week 22, participants will be seen every two weeks to monitor the CD4 count and the level of HIV in the blood. Some of these visits will occur in between infusion visits and will only take about 1 hour to complete. cART will be restarted if a participant's HIV levels go up to high, or if their CD4 cell counts decreases by too much.
For the follow-up phase, participants will have visits every 4 weeks for 24 weeks. These will include blood tests and a physical exam.
|Condition or disease||Intervention/treatment||Phase|
|HIV||Biological: Entyvio (Vedolizumab)||Phase 1|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||26 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||An Exploratory, Open-Label Study of Vedolizumab (Anti-alpha4beta7 Antibody) in Subjects With HIV Infection Undergoing Analytical Treatment Interruption|
|Study Start Date :||May 28, 2016|
|Actual Primary Completion Date :||March 4, 2019|
|Actual Study Completion Date :||March 4, 2019|
Experimental: HIV-infected Adults on cART
HIV-infected Adults (age 18 - 65) on CART with suppressed viremia
Biological: Entyvio (Vedolizumab)
A humanized monoclonal antibody that specifically binds to the alpha4beta7 integrin with MAdCAM-1, which in turn inhibits the migration of T-lymphocytes across the endothelium into GALT
- Number of Grade 2 or Higher Related Adverse Events [ Time Frame: From the start of the initial infusion until up to 72 weeks. ]The primary endpoint was the number of grade 2 or higher adverse events, including serious adverse events, that were probably or definitely related to vedolizumab.
- Number of Subjects Who Met Criteria to Restart Antiretroviral Therapy Before Week 48 [ Time Frame: From Week 22 until up to 48 weeks. ]The secondary endpoint was defined as number of subjects who experienced plasma viremia following ATI and met criteria to restart cART before week 48 [a confirmed >30% decline in baseline CD4+ T Cell count or an absolute CD4+ T Cell count in the setting of detectable HIV viremia (>40 copies/mL); a sustained (>4weeks) HIV RNA level of > 1000 copies/mL, or any HIV related symptoms or pregnancy.]
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, Learn About Clinical Studies.
|Ages Eligible for Study:||18 Years to 65 Years (Adult, Older Adult)|
|Sexes Eligible for Study:||All|
|Accepts Healthy Volunteers:||No|
- Age, 18 - 65 years
- Documented HIV-1 infection and clinically stable
- In general good health, with an identified primary health care provider for medical management of HIV infection and willing to maintain a relationship with a primary health care provider for medical management of HIV infection while participating in the study
- CD4+ T cell count >450 cells/mm3 at screening
Documentation of continuous cART treatment with suppression of plasma viral level below the limit of detection for more than or equal 2 years. Subjects with blips (i.e., detectable viral levels on cART) prior to screening may be included provided they satisfy the following criteria:
- The blips are <400 copies/mL, and
- Succeeding viral levels return to levels below the limit of detection on subsequent testing
- Willingness to undergo ATI
Laboratory values within pre-defined limits at screening:
- Absolute neutrophil count >1,000/mm3
- Hemoglobin (Hgb) levels >10.0 g/dL for men and >9.0 g/dL for women
- Platelet count >100,000/mm3
- Prothrombin time (PT) and partial thromboplastin time (PTT) <1.5 upper limit of normal (ULN)
- Estimated glomerular filtration rate (eGFR) of greater than or equal to 50 mL/min as determined by the NIH Clinical Center laboratory
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels of <1.1 x ULN. Total bilirubin <1.1 x ULN (unless subject is taking atazanavir or has Gilbert s Syndrome)
- Willingness to have samples stored for future research
Participation of Women:
Contraception: The effects of vedolizumab on the developing human fetus are unknown. For this reason, men and women of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation.
- Chronic hepatitis B, as evidenced by a positive test for hepatitis B surface antigen (HBsAg), or chronic hepatitis C virus (HCV) infection, as evidenced by a positive test for HCV RNA. Subjects with a positive test for HCV antibody and a negative test for HCV RNA are eligible.
- Documented nadir CD4+ T cell count <200 cells /mm3
- Documented multiclass antiretroviral drug resistance that, in the judgment of the investigator, would pose a risk of virologic failure should additional mutations develop during the study
- HIV immunotherapy or vaccine(s) received within 1 year prior to screening
- Any licensed or experimental non-HIV vaccination (e.g., hepatitis B, influenza, pneumococcal polysaccharide) received within 2 weeks prior to study enrollment
- Receipt of other investigational study agent within 28 days of enrollment
- Any active malignancy that may require systemic chemotherapy or radiation therapy
- Systemic immunosuppressive medications received within 3 months prior to enrollment. The following are not excluded:  corticosteroid nasal spray or inhaler;  topical corticosteroids for mild, uncomplicated dermatitis; and  oral/parenteral corticosteroids administered for non-chronic conditions not expected to recur (length of therapy less than or equal to 10 days, with completion in more than or equal to 30 days prior to enrollment)
History or other clinical evidence of:
- Significant or unstable cardiac disease (e.g., angina, congestive heart failure, recent myocardial infarction)
- Severe illness, chronic liver disease, malignancy, immunodeficiency other than HIV, active systemic infection other than HIV, or any other condition that, in the opinion of the investigator, would make the subject unsuitable for the study
- Active or latent tuberculosis, regardless of treatment history
- Neurologic or neuropsychiatric disorder, the symptoms of which mimic PML and could interfere with the assessment of safety (e.g. history of encephalitis with motor sequela, stroke with sequela, severe major depressive disorder, severe bipolar disorder, seizure disorder)
- Active drug or alcohol abuse or any other pattern of behavior that, in the opinion of the investigator, would interfere with adherence to study requirements
- Pregnancy or breast-feeding
Co-enrollment Guidelines: Co-enrollment in other trials is restricted, other than enrollment on observational studies. Study staff should be notified of co-enrollment as it will require the approval of the Principal Investigator.
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): NCT02788175
|United States, Maryland|
|National Institutes of Health Clinical Center|
|Bethesda, Maryland, United States, 20892|
|Principal Investigator:||Michael C Sneller, M.D.||National Institute of Allergy and Infectious Diseases (NIAID)|
Documents provided by National Institutes of Health Clinical Center (CC) ( National Institute of Allergy and Infectious Diseases (NIAID) ):
|Responsible Party:||National Institute of Allergy and Infectious Diseases (NIAID)|
|Other Study ID Numbers:||
|First Posted:||June 2, 2016 Key Record Dates|
|Results First Posted:||December 16, 2019|
|Last Update Posted:||February 24, 2020|
|Last Verified:||March 4, 2019|
|Studies a U.S. FDA-regulated Drug Product:||Yes|
|Studies a U.S. FDA-regulated Device Product:||No|
HIV Immune Therapy
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
RNA Virus Infections
Immunologic Deficiency Syndromes
Immune System Diseases