Double Protease Inhibitor to Darunavir Switch Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00531557
Recruitment Status : Completed
First Posted : September 19, 2007
Last Update Posted : August 16, 2010
Information provided by:
St Stephens Aids Trust

September 18, 2007
September 19, 2007
August 16, 2010
September 2007
November 2008   (Final data collection date for primary outcome measure)
The proportion of subjects maintaining viral suppression (< 50 copies/mL) [ Time Frame: 48 weeks ]
Same as current
Complete list of historical versions of study NCT00531557 on Archive Site
• CD4+ count at screening, baseline, weeks 4, 12, 24, 36 and at the end of the study period • Viral suppression below 50 copies/mL and below 500 copies/mL at 4, 12, 24, 36 and 48 weeks • Laboratory abnormalities and adverse events at baseline, 4 [ Time Frame: 48 weeks ]
Same as current
Not Provided
Not Provided
Double Protease Inhibitor to Darunavir Switch Study
Phase IV Cohort Study Assessing Feasibility of Substituting Double Ritonavir-boosted Protease Inhibitors With Ritonavir-boosted Darunavir in HIV-infected Individuals With Viral Suppression on Highly Active Antiretroviral Therapy.

The purpose of the study is to study the effects of switching from an antiretroviral combination that includes two ritonavir boosted protease inhibitors to replacement of these two protease inhibitors with a new protease inhibitor called Darunavir (also boosted with ritonavir).

The study will investigate the effect of the switch on viral load (the levels of the HIV virus in the blood), on immunological parameters (CD4 count) and on other safety parameters and also on quality of life.

In a subgroup of patients the impact of the switch on the body's response to the hormone insulin will also be measured (Euglycaemic clamp sub group)

HIV-RNA and CD4+ cell count to monitor virological and immunological response on switching to DRV/r.

Routine safety bloods to include haematology and biochemistry (including U&E, fasted glucose and insulin, liver function test, fasting cholesterol and triglycerides and serum lactate measurements).

Quality of life EuroQOL questionnaires at baseline, and throughout the study to evaluate quality of life in the continued treatment/ treatment switch arms.

A sub group of 10 patients will undergo two euglycaemic clamp procedures in order to determine the extent of glucose disposal. The first clamp will be performed prior to the switching from a double boosted PI therapy to DRV/r and the second one following administration of DRV/r for 4 weeks.

Phase 4
Intervention Model: Single Group Assignment
Masking: None (Open Label)
HIV Infections
Drug: Darunavir ritonavir
Darunavir 600mg BID with ritonavir 100mg BID administered orally.
Intervention: Drug: Darunavir ritonavir
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
November 2008
November 2008   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  1. HIV-1 infected as documented by a licensed HIV-1 antibody ELISA test
  2. At least 18 years of age
  3. Currently on an antiretroviral regimen including a ritonavir boosted double protease inhibitor
  4. The subject is virologically suppressed with a viral load < 50 copies/mL for three months or longer
  5. The subject has a CD4+ count above 100 cells/mL
  6. ≤ Three DRV associated mutations on previous genotypic resistance test -or if no resistance test available, likely to have ≤ four protease inhibitor mutations based on their clinical history
  7. If the subject is a woman of child bearing potential, she must agree to use a barrier method of contraception
  8. The ability to understand and sign a written informed consent form, prior to participation in any screening procedures and must be willing to comply with all study requirements

Exclusion Criteria:

  1. Pregnant or lactating women
  2. Individuals with prior darunavir exposure
  3. Previous allergic or hypersensitivity reaction to darunavir
  4. Clinical or laboratory evidence of significantly decreased hepatic function or decompensation, irrespective of liver enzyme levels (liver insufficiency)
  5. Subjects diagnosed with acute viral hepatitis at screening
  6. Subjects with a grade 3 or 4 laboratory abnormality as defined by DAIDS grading table (see appendix 3: DAIDS AE grading Table), with the following exceptions unless clinical assessment foresees an immediate health risk to the subject:

    • Subjects with pre-existing diabetes or with asymptomatic glucose grade 3 or 4 elevations
    • Subjects with asymptomatic triglyceride or cholesterol elevations of grade 3 or 4.
  7. Presence of any currently active AIDS defining illness (Category C conditions according to the CDC Classification System for HIV Infection 1993) with the following exceptions: Stable cutaneous Kaposi's Sarcoma (i.e., no internal organ involvement other than oral lesions) that is unlikely to require any form of systemic therapy during the study; Wasting syndrome due to HIV infection.

    Note: An AIDS defining illness that is not clinically stabilized for at least 30 days will be considered as currently active.

  8. Active drug abuse, including alcohol or recreational drugs, which, in the opinion of the investigator, is expected to interfere with the subject's ability to adhere to the study procedures and treatment regimen. Subjects on a methadone program will be accepted if deemed appropriate by the investigator.
Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
United Kingdom
Not Provided
Not Provided
Dr Mark Nelson, St Stephens Aids Trust
St Stephens Aids Trust
Not Provided
Principal Investigator: Mark Nelson Chelsea & Westminser Healthcare NHS Trust
St Stephens Aids Trust
August 2010

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP