Comparison of Liquid Kaletra and Low Dose Kaletra Tablets - Full Text View

Purpose

Kaletra (a combination drug with lopinavir and ritonavir) is one of a few effective medications that are approved and available for young children who are HIV+. The liquid form is reported to have a very nasty taste and presents difficulties for the children who must take the medication twice a day and for their parents who must enforce the medication regimen. The children are often well into their teens before they weigh enough to be able to take the adult dose tablet (200mg/50mg). A new smaller dose tablet (100mg/25mg) is now available. However, it is not known if the liquid and tablet act the same in children. The purpose of this study is to switch children from the baseline treatment with the liquid to the study intervention treatment with 100mg/25mg tablet form of Kaletra. The study will compare children pre-switch and post-switch in terms of how well their HIV is controlled . Comparisons of parent and child satisfaction will also be made. Eight to 10 HIV+ children currently well managed with a medications including liquid Kaletra will be invited to switch from the liquid to the low dose Kaletra tablet. The parent and/or child will complete a satisfaction survey for the liquid Kaletra and lab values will be taken from the chart. At the time of the switch and 1, 3 and 6 months post switch blood tests will be drawn and the parent and/or child will complete the satisfaction survey. In addition, at the switch and 1 month post switch, a day will be spent in clinic with 5 blood draws to see how much of the drug is in the blood stream at different times after the medicine is taken.

Condition	Intervention
HIV Infections	Drug: Low dose Kaletra tablets


Study Type:	Interventional
Study Design:	Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Comparison of Liquid Kaletra and Low Dose Kaletra Tablets in HIV-Positive Children

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS

Drug Information available for: Lopinavir

Genetic and Rare Diseases Information Center resources: Children's Interstitial Lung Disease

U.S. FDA Resources

Further study details as provided by Phoenix Children's Hospital:

Primary Outcome Measures:

Absolute CD4 and CD4 % [ Time Frame: Baseline, 4 weeks, 12 weeks, 26 weeks ] [ Designated as safety issue: Yes ]
Number of participants who had no clinically significant deterioration in absolute CD4 and % CD4 count for the duration of the study. Absolute CD4 and Percent CD4 counts were determined by single or dual platform analysis performed on blood samples by Phoenix Children's Hospital Laboratory, Sonora Quest Laboratory or Labcorp Laboratory. Clinically significant change was determine to be a deterioration in both Absolute CD4 to less than 500 and %CD4 to less than 25%.
Lopinavir (Lpv) and Ritonavir (Rtv) Maximumu Plasma Concentration (CMax) Liquid [ Time Frame: Baseline ] [ Designated as safety issue: No ]
Cmax values at baseline (participants are taking liquid Kaletra as part of baseline treatment). Time points for data collection: 0, 2hrs post dose, 4 hrs post dose, 8 hrs post dose.
Lopinavir and Ritonavir Area Under the Curve (AUC) Liquid Kaletra [ Time Frame: Baseline ] [ Designated as safety issue: No ]
Area under the curve values for lopinavir at baseline when participants are taking liquid Kaletra as part of their baseline treatment. Time points for data collection: 0, 2 hrs post, 4 hrs post, 6 hrs post, 8 hrs post.
Lopinavir AUC Ratio of Baseline:Week 4 [ Time Frame: Baseline, week 4 ] [ Designated as safety issue: No ]
Ratio of AUC at baseline (liquid)to week 4 (reduced dose tablet). AUC data were collected at 0, 2, 4, 6, and 8 hours post dose.
Viral Load (VL) [ Time Frame: Baseline, Week 4, Week 12 and Week 24 ] [ Designated as safety issue: Yes ]
Number of participants who maintained their Viral load undetectable (< 20 copies/ml) for the duration of the study
Lopinavir (Lpv) and Ritonavir (Rtv) Cmax at 4 Weeks [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
Lpv and rtv Cmax at 4 weeks when participants are receiving study intervention, low dose Kaletra. Time points for data collection: 0, 2hrs, 4hrs, 6hrs, 8hrs
Lopinavir and Ritonavir AUC on Low Dose Tablet [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
Lopinavir and Ritonavir AUC at 4 weeks when participants are receiving the study intervention, low dose tablet formulation of Kaletra. Data collection points for AUC were 0, 2, 4, 6, and 8 hours post dose.

Secondary Outcome Measures:

Patient Satisfaction [ Time Frame: Baseline, 1 month ] [ Designated as safety issue: No ]
Patient Satisfaction Survey. Eight item Likert scale of patient satisfaction with their HIV treatment regimen for patients 7 years of age and older. Items scores are summed to compute a total score. Total scores are reported with a minimum of 0 and a maximum of 32, with higher scores indicating higher satisfaction.
Symptoms Across All Patients [ Time Frame: Baseline, 1 month, 3 months, 6 months ] [ Designated as safety issue: No ]
Cumulative tally of symptoms for each patients across all visits. Targetted symptoms were asked for at each visit and patients and parents were encouraged to report additional symptoms that were experienced. Each patient got a score for the total number of symptoms at each visit. Scores were totalled, but it the same symptoms occurred continuously it was counted as 1 symptom.
Parent Satisfaction [ Time Frame: Baseline, 4 week, 12 weeks and 24 weeks ] [ Designated as safety issue: No ]
Parent Satisfaction Survey. Eight item Likert scale of parent/guardian satisfaction with the child's HIV treatment regimen. Item scores are summed to compute a total score. Total scores are reported with a minimum of 0 and a maximum of 32, with higher scores indicating higher satisfaction.


Enrollment:	8
Study Start Date:	October 2008
Study Completion Date:	July 2011
Primary Completion Date:	July 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Low dose Kaletra tablets Patients will serve as their own controls as they are switched from the baseline treatment with liquid Kaletra to the study intervention treatment with Low Dose Tablet Kaletra (100mg/25mg)	Drug: Low dose Kaletra tablets Lopinavir/Ritonavir tablets 100mg/25mg Other Name: lopinavir/ritonavir 100mg/25mg

Eligibility


Ages Eligible for Study:	3 Years to 18 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

HIV+ children aged 3-18.
Baseline treatment includes liquid Kaletra
currently on a stable (on same regimen > 3 months, Viral Load< 5,000), Highly Active Antiretroviral Therapy (HAART) regimen
able to take pills or willing to undergo pill training prior to enrollment
weight must be greater than or equal to 15kg

Exclusion Criteria:

Unable to swallow pills
Concomitant treatment with Rifampin or St. John's Wort which have been shown to decrease plasma concentrations of lopinavir.
Concurrent use of drugs primarily metabolized by CYP3A, which metabolizes ritonavir: Astemizole, Cisapride, Dihydroergotamine, Ergonovine, Ergotamine, Flecainide, Lovastatin, Methylergonovine, Midazolam, Pimozide, Propafenone, Simvastatin, terfenadine, Triazolam
Baseline treatment does NOT include Kaletra

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: NCT00762320

Locations


United States, Arizona
Phoenix Children's Hospital
Phoenix, Arizona, United States, 85016

Sponsors and Collaborators

Phoenix Children's Hospital

Abbott

Investigators


Principal Investigator:	Janice Piatt, MD	Phoenix Children's Hospital

More Information

No publications provided


Responsible Party:	Janice Piatt, Medical Director, Bill Holt Clinic, Phoenix Children's Hospital
ClinicalTrials.gov Identifier:	NCT00762320 History of Changes
Other Study ID Numbers:	08-017
Study First Received:	September 29, 2008
Results First Received:	November 14, 2013
Last Updated:	February 5, 2014
Health Authority:	United States: Institutional Review Board

Keywords provided by Phoenix Children's Hospital:


HIV Kaletra treatment Experienced

Additional relevant MeSH terms:


Lopinavir Anti-HIV Agents Anti-Infective Agents Anti-Retroviral Agents Antiviral Agents Enzyme Inhibitors	HIV Protease Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Protease Inhibitors Therapeutic Uses

ClinicalTrials.gov processed this record on February 27, 2015