Raltegravir and Atazanavir Dosing Strategy Study (SPARTA)
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| ClinicalTrials.gov Identifier: NCT00874523 |
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Recruitment Status :
Completed
First Posted : April 2, 2009
Last Update Posted : April 12, 2012
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Sponsor:
Kirby Institute
Information provided by (Responsible Party):
Kirby Institute
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Brief Summary:
To compare the steady-state pharmacokinetics and short-term efficacy and safety of two dosing strategies of raltegravir and atazanavir in virologically suppressed HIV-infected adults receiving atazanavir-containing combination antiretroviral therapy.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| HIV Infection | Drug: atazanavir plus raltegravir | Phase 3 |
Current HIV treatment guidelines recommend the construction of combination regimens comprising a minimum of three agents from at least two drug classes. There are problems with the current recommendations for although treatments are effective, their success is often limited by tolerability, adverse effects and the need to take many pills. Antiretroviral adherence remains vital and regimens should be simplified wherever possible to facilitate maximal adherence. The recent availability of the potent HIV integrase inhibitor, raltegravir, provides an opportunity to explore moves away from current regimen components. Evidence to support the use of novel regimens must be generated through adequately powered randomized clinical trials. However, before such trials can be undertaken, preliminary data to define the pharmacokinetics, safety and tolerability of these regimens are needed to minimize unnecessary risk for participants. This eight week study will investigate the steady-state pharmacokinetics, and short-term safety and efficacy of two dosing strategies (once and twice daily) of raltegravir plus atazanavir in treatment experienced HIV-infected adults.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 26 participants |
| Allocation: | Randomized |
| Intervention Model: | Crossover Assignment |
| Masking: | None (Open Label) |
| Primary Purpose: | Treatment |
| Official Title: | A Randomised, Open-label, Cross-over Study to Examine the Pharmacokinetics and Short-term Safety and Efficacy of Two Dosing Strategies of Raltegravir Plus Atazanavir in HIV-infected Patients |
| Study Start Date : | July 2009 |
| Actual Primary Completion Date : | July 2011 |
| Actual Study Completion Date : | July 2011 |
| Arm | Intervention/treatment |
|---|---|
| Active Comparator: Arm A |
Drug: atazanavir plus raltegravir
atazanavir 300 mg + raltegravir 400 mg twice daily for 4 weeks then atazanavir 300 mg + ritonavir 100 mg + raltegravir 800 mg once daily for 4 weeks
Other Names:
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| Active Comparator: Arm B |
Drug: atazanavir plus raltegravir
atazanavir 300 mg + ritonavir 100 mg + raltegravir 800 mg once daily for 4 weeks then atazanavir 300 mg + raltegravir 400 mg twice daily for 4 weeks
Other Names:
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Primary Outcome Measures :
- comparison of the mean steady-state atazanavir trough plasma concentrations for once (C24) and twice (C12) daily dosing strategies [ Time Frame: 4 and 8 weeks ]
Secondary Outcome Measures :
- comparison of mean steady-state raltegravir trough plasma concentrations for once (C24) and twice (C12) daily dosing [ Time Frame: 4 and 8 weeks ]
- comparison of steady-state pharmacokinetic profiles of once and twice-daily atazanavir [ Time Frame: 4 and 8 weeks ]
- comparison of the steady-state pharmacokinetic profiles of once and twice-daily raltegravir [ Time Frame: 4 and 8 weeks ]
- change from baseline in fasting lipid and glycaemic parameters [ Time Frame: weeks 4 and 8 and overall ]
- change from baseline in CD4+ T-lymphocyte count [ Time Frame: weeks 4 and 8 and overall ]
- change from baseline in HIV-RNA [ Time Frame: weeks 4 and 8 and overall ]
- all adverse events attributable to study treatment [ Time Frame: week 8 ]
- all serious, grade 3 or 4 clinical adverse events, and any adverse event leading to premature cessation of study treatment [ Time Frame: week 8 ]
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- aged ≥ 18 years with laboratory evidence of HIV-1 infection
- currently receiving 3 or more unchanged antiretroviral agents including atazanavir (with or without ritonavir boosting) for at least 24 weeks prior to study entry
- plasma HIV RNA less than 50 copies/mL for at least 24 weeks prior to study entry
- provide written, informed consent.
Exclusion Criteria :
- prior clinical/virological failure on a PI-containing regimen
- no clinical history of primary HIV-1 protease mutations identified in local baseline genotypic analysis of HIV with interpretation using current IAS-USA Drug Resistance Mutations in HIV-1
- women: pregnant, breastfeeding, or not willing to use adequate contraception (including barrier contraception) if of child-bearing potential
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laboratory abnormalities at screening:
- absolute neutrophil count (ANC) < 750 cells/mL
- haemoglobin less than 8.5 g/dL
- platelet count less than 50 000 cells/mL
- AST, ALT > 5 times the upper limit of normal
- serum bilirubin > 5 times the upper limit of normal
- chronic active hepatitis B infection defined by presence of serum viral hepatitis B surface antigen (HBsAg) or HBV DNA-positive
- any malabsorption syndrome likely to affect drug absorption
- concurrent therapy with human growth hormone or other immunomodulatory agents
- concomitant medication contraindicated for use with either atazanavir or raltegravir therapy
- any inter-current illness requiring hospitalisation
- current excessive alcohol or illicit substance use
- unlikely to be able to remain in follow-up for the protocol-defined period.
Information from the National Library of Medicine
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): NCT00874523
Locations
| Australia, New South Wales | |
| Holdsworth House Medical Practice | |
| Sydney, New South Wales, Australia, 2010 | |
| St Vincent's Hospital | |
| Sydney, New South Wales, Australia, 2010 | |
Sponsors and Collaborators
Kirby Institute
Investigators
| Principal Investigator: | David A Cooper, MD DSc | Kirby Institute/UNSW |
| Responsible Party: | Kirby Institute |
| ClinicalTrials.gov Identifier: | NCT00874523 History of Changes |
| Other Study ID Numbers: |
SPARTA |
| First Posted: | April 2, 2009 Key Record Dates |
| Last Update Posted: | April 12, 2012 |
| Last Verified: | April 2010 |
Keywords provided by Kirby Institute:
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raltegravir atazanavir HIV infections |
pharmacokinetics antiretroviral agents treatment experienced |
Additional relevant MeSH terms:
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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 Atazanavir Sulfate |
Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents HIV Integrase Inhibitors Integrase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action HIV Protease Inhibitors Protease Inhibitors |