Pharmacokinetics of Raltegravir During Third Trimester Pregnancy and Post-Partum - Full Text View

Purpose

This study will evaluate the pharmacokinetic disposition of raltegravir in pregnant HIV-1 infected women. These results will be compared to pharmacokinetic data obtained following pregnancy as well as to studies previously carried out in nonpregnant women and male patients. By determining the disposition characteristics for this specific patient population, antiretroviral (ARV) dosing can be optimized during pregnancy. Appropriate dosing is necessary to minimize adverse effects, slow progression of disease, and further reduce the risk for vertical transmission. Data will also be obtained on genital tract penetration and placenta transfer of raltegravir to the newborn.

The subjects enrolled in this study will take an antiretroviral based regimen containing raltegravir twice daily both during and after their pregnancy. The specific regimen will be chosen by their own primary care provider based on their antiretroviral history and resistance testing. They will undergo a series of blood sampling for pharmacokinetic analysis over 12 hours on two occasions; a) during their 3rd trimester and b) approximately 3 months postpartum. Concentrations of raltegravir in the infant will be assessed by cord and infant blood sample at delivery and a blood sample at approximately 3 months of age.

Hypothesis: The pharmacokinetic exposure of raltegravir as measured by the 12 hour area under the plasma concentration versus time curve (AUC0-12h) during third trimester pregnancy is similar to the AUC0-12h estimated three months post-partum.

Condition
HIV Infections


Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Pharmacokinetics of Raltegravir During Third Trimester Pregnancy and Post-Partum

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS HIV/AIDS and Pregnancy Postpartum Care

Drug Information available for: Raltegravir Raltegravir potassium

U.S. FDA Resources

Further study details as provided by University of California, San Francisco:

Biospecimen Retention: Samples Without DNA

Plasma Cervicovaginal lavage fluid Endocervical canal fluid


Enrollment:	0
Study Start Date:	February 2008

Eligibility


Ages Eligible for Study:	16 Years and older (Child, Adult, Senior)
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

Preliminary eligibility will be determined by the study investigators, research staff, and the patient's primary pregnancy healthcare provider. During a dedicated visit to the primary investigator's office, potential participants will undergo a screening examination including review of physical exam and blood work obtained by their primary pregnancy provider within two weeks of study enrollment. Those that qualify will then provide written consent and be able to continue in the study.

Criteria

Inclusion Criteria:

Female, 16 years old or older
Pregnant, at least 14 weeks gestation in order to initiate raltegravir treatment if decided by their pregnancy health care provider. The first pharmacokinetic study visit occurs no sooner than 26 weeks gestation (3rd trimester)
Normal fetal heart motion by ultrasound, vital signs and brief physical exam as conducted by their primary pregnancy health care provider within two weeks of study entry (part of their standard prenatal care)
Intolerance or resistance to at least two classes of antiretroviral agents
Availability of a raltegravir-optimized background regimen based on referring provider's selection and resistance testing
English or Spanish speaking

Exclusion Criteria:

Inability to follow study protocol or drug administration
Women who are planning to breastfeed (this is not recommended for HIV-infected women to reduce HIV transmission to the baby)
Women unable to sign informed consent
Women with a history of anaphylaxis or other life threatening adverse event associated with antiretroviral therapy

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: NCT00689910

Locations


United States, California
East Bay AIDS Center
Oakland, California, United States, 94609
UC Davis
Sacramento, California, United States, 95817
San Francisco General Hospital
San Francisco, California, United States, 94110
UC San Francisco
San Francisco, California, United States, 94110

Sponsors and Collaborators

University of California, San Francisco

Merck Sharp & Dohme Corp.

More Information


Responsible Party:	Francesca Aweeka, University of California, San Francisco
ClinicalTrials.gov Identifier:	NCT00689910 History of Changes
Other Study ID Numbers:	PK of Ral in Pregnant Women
Study First Received:	June 2, 2008
Last Updated:	March 28, 2012
Health Authority:	United States: Food and Drug Administration

Keywords provided by University of California, San Francisco:


pharmacokinetics pregnancy Raltegravir	HIV antiretroviral Treatment of HIV in pregnant women with Raltegravir

Additional relevant MeSH terms:


HIV Infections Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases	Raltegravir Potassium Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents HIV Integrase Inhibitors Integrase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 27, 2016