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Atazanavir (BMS-232632) in Combination With Ritonavir or Saquinavir, and Lopinavir/Ritonavir, Each With Tenofovir and a Nucleoside in Subjects With HIV

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00035932
First Posted: May 8, 2002
Last Update Posted: December 24, 2010
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.
Information provided by:
Bristol-Myers Squibb
Results First Submitted: October 14, 2010  
Study Type: Interventional
Study Design: Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: None (Open Label);   Primary Purpose: Treatment
Condition: HIV Infections
Interventions: Drug: Atazanavir + ritonavir + tenofovir + nucleoside
Drug: Atazanavir + saquinavir + tenofovir + nucleoside
Drug: Lopinavir/ritonavir + tenofovir + nucleoside

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
No text entered.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
571 human immunodeficiency virus (HIV)-infected participants were enrolled; 358 (63%) were randomized to treatment. Of the 213 not randomized, 194 did not meet eligibility criteria; other reasons include duplicate enrollment (4), accrual closed (1), noncompliance (1), serious adverse event (2), patient request (11), missing information (4).

Reporting Groups
  Description
ATV 300 mg / RTV

atazanavir (ATV) 300 mg + ritonavir (RTV) 100 mg + tenofovir (TDF) 300 mg + nucleoside of choice

ATV , RTV, and TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study
ATV 400 mg / SQV

ATV 400 mg + saquinavir (SQV) 1200 mg + TDF 300 mg + nucleoside of choice

ATV, SQV, and TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study
LPV / RTV

lopinavir (LPV)/RTV 400/100 mg + TDF 300 mg + nucleoside of choice

LPV/RTV twice daily, TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study

Participant Flow:   Overall Study
    ATV 300 mg / RTV   ATV 400 mg / SQV   LPV / RTV
STARTED   119 [1]   110 [2]   118 [3] 
Discontinued Prior to Week 48 Visit   26   29   13 
Discontinued Between Weeks 48 and 96   26   27   30 
Discontinued on or After Week 96   4   4   6 
COMPLETED   63 [4]   50 [5]   69 [6] 
NOT COMPLETED   56   60   49 
Adverse Event                10                9                9 
Death                0                0                1 
Disease Progression / Relapse                1                1                0 
Lost to Follow-up                4                4                3 
Noncompliance                6                7                6 
Protocol Violation While on Study                0                1                2 
Withdrawal by Subject                1                5                0 
Study Termination by Sponsor                1                0                0 
Lack of Efficacy                33                33                28 
[1] 120 randomized, 119 treated
[2] 115 randomized, 110 treated
[3] 123 randomized, 118 treated
[4] 63 remained on treatment, 0 completed at Week 96
[5] 50 remained on treatment, 0 completed at Week 96
[6] 59 remained on treatment, 10 completed at Week 96



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
ATV 300 mg / RTV

ATV 300 mg + RTV 100 mg + TDF 300 mg + nucleoside of choice

ATV , RTV, and TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study
ATV 400 mg / SQV

ATV 400 mg + SQV 1200 mg + TDF 300 mg + nucleoside of choice

ATV, SQV, and TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study
LPV / RTV

LPV/RTV 400/100 mg + TDF 300 mg + nucleoside of choice

LPV/RTV twice daily, TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study
Total Total of all reporting groups

Baseline Measures
   ATV 300 mg / RTV   ATV 400 mg / SQV   LPV / RTV   Total 
Overall Participants Analyzed 
[Units: Participants]
 		 120   115   123   358 
Age 
[Units: Years]
Median (Full Range) 		 39 
 (24 to 71)  		 41 
 (26 to 74)  		 39 
 (25 to 72)  		 40 
 (24 to 74) 
Gender 
[Units: Participants]
 		       
Female   24   26   27   77 
Male   96   89   96   281 
Race/Ethnicity, Customized 
[Units: Participants]
 		       
White   75   70   71   216 
Hispanic/Latino   27   26   27   80 
Black   18   16   21   55 
Other   0   3   4   7 
Region of Enrollment 
[Units: Participants]
 		       
South America   56   55   54   165 
North America   39   38   47   124 
Europe   25   22   22   69 
Acquired Immunodeficiency Virus (AIDS) 
[Units: Participants]
 		       
Yes   33   33   36   102 
No   87   82   87   256 
Intravenous (IV) Drug Use 
[Units: Participants]
 		       
Yes   8   7   8   23 
No   112   108   115   335 
Cluster of Differentiation 4 (CD4) cell count 
[Units: Cells/mm^3]
Median (Full Range) 		 317 
 (40 to 1025)  		 286 
 (42 to 1543)  		 283 
 (14 to 1238)  		 297 
 (14 to 1543) 
Human Immunodeficiency Virus Ribonucleic Acid (HIV RNA) 
[Units: Log10 c/mL]
Median (Full Range) 		 4.44 
 (2.60 to 5.88)  		 4.42 
 (2.60 to 5.88)  		 4.47 
 (2.60 to 5.88)  		 4.45 
 (2.60 to 5.88) 


  Outcome Measures
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1.  Primary:   Mean Change From Baseline in HIV Ribonucleic Acid (RNA) at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 1

2.  Primary:   Mean Change From Baseline in HIV RNA at Week 48   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 2

3.  Primary:   Mean Change From Baseline in HIV RNA at Week 96   [ Time Frame: Baseline, Week 96 ]
  Show Outcome Measure 3

4.  Secondary:   Mean Change From Baseline in HIV RNA at Week 2   [ Time Frame: Baseline, Week 2 ]
  Show Outcome Measure 4

5.  Secondary:   Participants Achieving Virologic Half Log Suppression (Limit of Quantification [LOQ] = 400 c/mL) at Week 24 (Overall and by Protease Inhibitor [PI] Sensitivity)   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 5

6.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 400 c/mL) at Week 48, (Overall and by PI Sensitivity)   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 6

7.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 400 c/mL) at Week 96   [ Time Frame: Baseline, Week 96 ]
  Show Outcome Measure 7

8.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 50 c/mL) at Week 24   [ Time Frame: Week 24 ]
  Show Outcome Measure 8

9.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 50 c/mL) at Week 24, by PI Sensitivity   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 9

10.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 50 c/mL) at Week 48   [ Time Frame: Week 48 ]
  Show Outcome Measure 10

11.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 50 c/mL) at Week 48, by PI Sensitivity   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 11

12.  Secondary:   Participants Achieving Virologic Half Log Suppression (LOQ = 50 c/mL) at Week 96   [ Time Frame: Week 96 ]
  Show Outcome Measure 12

13.  Secondary:   Participants Achieving Treatment Response (LOQ = 400 c/mL) Without Prior Failure at Week 24   [ Time Frame: Week 24 ]
  Show Outcome Measure 13

14.  Secondary:   Participants Achieving Treatment Response (LOQ = 400 c/mL) Without Prior Failure at Week 48   [ Time Frame: Week 48 ]
  Show Outcome Measure 14

15.  Secondary:   Participants Achieving Treatment Response (LOQ = 400 c/mL) Without Prior Failure at Week 96   [ Time Frame: Week 96 ]
  Show Outcome Measure 15

16.  Secondary:   Participants Achieving Treatment Response (LOQ = 50 c/mL) Without Prior Failure at Week 24   [ Time Frame: Week 24 ]
  Show Outcome Measure 16

17.  Secondary:   Participants Achieving Treatment Response (LOQ = 50 c/mL) Without Prior Failure at Week 48   [ Time Frame: Week 48 ]
  Show Outcome Measure 17

18.  Secondary:   Participants Achieving Treatment Response (LOQ = 50 c/mL) Without Prior Failure at Week 96   [ Time Frame: Week 96 ]
  Show Outcome Measure 18

19.  Secondary:   Change From Baseline in CD4 Cell Count at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 19

20.  Secondary:   Change From Baseline in CD4 Cell Count at Week 48   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 20

21.  Secondary:   Change From Baseline in CD4 Cell Count at Week 96   [ Time Frame: Baseline, Week 96 ]
  Show Outcome Measure 21

22.  Secondary:   Correlation of ATV Minimum Plasma Concentration (Cmin), Inhibitory Quotient (IQ), and Number of Protease Inhibitor (PI) Mutations at Baseline With HIV RNA Change From Baseline at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 22

23.  Secondary:   Correlation of ATV Minimum Plasma Concentration (Cmin), Inhibitory Quotient (IQ), and Number of Protease Inhibitor (PI) Mutations at Baseline With HIV RNA Change From Baseline at Week 48   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 23

24.  Secondary:   Correlation of ATV Minimum Plasma Concentration (Cmin) Inhibitory Quotient (IQ), and Number of PI Mutations at Baseline and CD4 Cell Count Change From Baseline at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 24

25.  Secondary:   Correlation of ATV Minimum Plasma Concentration (Cmin) Inhibitory Quotient (IQ), and Number of PI Mutations at Baseline and CD4 Cell Count Change From Baseline at Week 48   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 25

26.  Secondary:   Lipid Mean Percent Change From Baseline at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 26

27.  Secondary:   Lipid Mean Percent Change From Baseline at Week 48   [ Time Frame: Week 48 ]
  Show Outcome Measure 27

28.  Secondary:   Lipid Mean Percent Change From Baseline at Week 96, Observed Values   [ Time Frame: Week 96 ]
  Show Outcome Measure 28

29.  Secondary:   Deaths, Serious Adverse Events (SAEs), and Adverse Events (AEs) Through Week 48   [ Time Frame: From Enrollment through Week 48 ]
  Show Outcome Measure 29

30.  Secondary:   Most Common AEs and AEs of Interest Through Week 48   [ Time Frame: From Enrollment to Week 48 ]
  Show Outcome Measure 30

31.  Secondary:   Fasting Glucose Mean Change From Baseline at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 31

32.  Secondary:   Fasting Glucose Mean Change From Baseline at Week 48   [ Time Frame: Week 48 ]
  Show Outcome Measure 32

33.  Secondary:   Grade 3/4 Laboratory Abnormalities Through Week 48   [ Time Frame: From Enrollment to Week 48 ]
  Show Outcome Measure 33

34.  Secondary:   Fridericia-corrected QT (QTcF) Interval and Change From Baseline by Analysis Time Point   [ Time Frame: Baseline, Week 4 predose, 2-3 hours postdose, 6-12 hours postdose, Week 12, Week 24, Week 48 ]
  Show Outcome Measure 34

35.  Secondary:   PR Interval and Change From Baseline by Analysis Time Point   [ Time Frame: Baseline, Week 4 predose, 2-3 hours postdose, 6-12 hours postdose, Week 12, Week 24, Week 48 ]
  Show Outcome Measure 35

36.  Secondary:   Adherence to Regimen Though Week 48 Based on MACS the Multicenter AIDS Cohort Study (MACS) Adherence Questionnaire   [ Time Frame: Baseline, Week 24, Week 48 ]
  Show Outcome Measure 36

37.  Secondary:   Mean Score of European Quality of Life-5 Dimensions (EQ-5D) Health Index Score at Baseline, Mid-Study (Week 24), and Final (Week 48)   [ Time Frame: Baseline, Week 24, Week 48 ]
  Show Outcome Measure 37

38.  Secondary:   Mean Score of European Quality of Life-5 Dimensions (EQ-5D) Visual Analog Scale (VAS) at Baseline, Mid-Study (Week 24), and Final (Week 48)   [ Time Frame: Baseline, Week 24, Week 48 ]
  Show Outcome Measure 38

39.  Secondary:   Number of Participants Utilizing Resources for Managing Lipid Elevation   [ Time Frame: Baseline, Week 24, Week 48 ]
  Show Outcome Measure 39

40.  Secondary:   Mean ATV, RTV and SQV Minimum Concentration (Cmin) Values   [ Time Frame: collected at the pre-dose time point after receiving atazanavir for at least four weeks ]
  Show Outcome Measure 40

41.  Secondary:   HIV IC50 at Week 24   [ Time Frame: Week 24 ]
  Hide Outcome Measure 41

Measure Type Secondary
Measure Title HIV IC50 at Week 24
Measure Description IC50: inhibitory concentration of drug required to reduce viral replication by 50%.
Time Frame Week 24  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
Participants with evaluable IC50 measurements; as-randomized population (refers to the treatment regimen assigned at randomization).

Reporting Groups
  Description
ATV 300 mg / RTV

ATV 300 mg + RTV 100 mg + TDF 300 mg + nucleoside of choice

ATV , RTV, and TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study
ATV 400 mg / SQV

ATV 400 mg + SQV 1200 mg + TDF 300 mg + nucleoside of choice

ATV, SQV, and TDF once daily, nucleoside per label 48 Weeks and then for as long as subject is in need of therapy through study

Measured Values
   ATV 300 mg / RTV   ATV 400 mg / SQV 
Participants Analyzed 
[Units: Participants]
 		 40   21 
HIV IC50 at Week 24 
[Units: ng/mL]
Mean (Standard Error) 		 17.83  (4.04)   22.84  (11.65) 

No statistical analysis provided for HIV IC50 at Week 24



42.  Secondary:   Inhibitory Quotient at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 42

43.  Secondary:   Inhibitory Quotient at Week 48   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 43

44.  Secondary:   HIV RNA Level - Treated Subjects With Evaluable Cmins at Week 24   [ Time Frame: Baseline, Week 24 ]
  Show Outcome Measure 44

45.  Secondary:   HIV RNA Level - Treated Subjects With Evaluable Cmins at Week 48   [ Time Frame: Baseline, Week 48 ]
  Show Outcome Measure 45


  Serious Adverse Events
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  Other Adverse Events
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  Limitations and Caveats
  Hide Limitations and Caveats

Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.


  More Information
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