RAltegravir Switch STudy: Effects on Endothelial Recovery (RASSTER)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.

Verified December 2013 by S.F.L. van Lelyveld, UMC Utrecht.
Recruitment status was: Recruiting

Sponsor:

Collaborator:

Merck Sharp & Dohme Corp.

Information provided by (Responsible Party):

S.F.L. van Lelyveld, UMC Utrecht

ClinicalTrials.gov Identifier:

NCT01453933

First received: October 10, 2011

Last updated: December 17, 2013

Last verified: December 2013

History of Changes

Purpose

Treatment with HIV-infection with protease inhibitors is associated with high blood lipids and higher chance for cardiovascular complications. The RASSTER study aims to investigate the effect of switching the protease inhibitor lopinavir/ritonavir to raltegravir on vessel wall function and inflammation,and activation of the immune system. we hypothesize that with this intervention these parameters will improve. Since decreased vessel wall function and inflammation are initial steps in the process of atherosclerosis, it is important to know this data when treating HIV-infected patients.

Condition	Intervention	Phase
HIV Infection Endothelial Dysfunction	Drug: raltegravir	Phase 4


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Crossover Assignment Masking: None (Open Label) Primary Purpose: Treatment
Official Title:	Phase IV, Randomized, Open Label, Crossover, Intervention Trial to Investigate the Effect of the Switch of Lopinavir/Ritonavir to Raltegravir on Endothelial Function, Chronic Inflammation, Immune Activation and HIV Replication <50 Copies/ml

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS

Drug Information available for: Ritonavir Lopinavir Raltegravir Raltegravir potassium

U.S. FDA Resources

Further study details as provided by S.F.L. van Lelyveld, UMC Utrecht:

Primary Outcome Measures:

Change in flow mediated dilatation (FMD) of the brachial artery [ Time Frame: week 8, week16 ]
Change in flow-mediated dilatation (FMD) of the brachial artery after 8 weeks of raltegravir treatment as compared to the control group (treatment with lopinavir/ritonavir)

Secondary Outcome Measures:

Change in markers of chronic inflammation [ Time Frame: Baseline, week 2, week 4, week 8, week 10, week 12 and week 16 ]
Change in markers of immune activation [ Time Frame: Baseline, week 2, week 4, week 8, week 10, week 12 and week 16 ]
Change in markers of endothelial function [ Time Frame: Baseline, week 2, week 4, week 8, week 10, week 12 and week 16 ]
Changes in plasma HIV-RNA below 50 copies/ml [ Time Frame: Baseline, week 8, week 16 ]


Estimated Enrollment:	24
Study Start Date:	January 2012
Estimated Study Completion Date:	December 2014
Estimated Primary Completion Date:	October 2014 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: Raltegravir At baseline, lopinavir-ritonavir will be switched to raltegravir (cross-over after 8 weeks).	Drug: raltegravir Switch of lopinavir/ritonavir to raltegravir 400 mg BID (duration 8 weeks) Other Name: Isentress
No Intervention: Lopinavir/ritonavir Subjects will continue lopinavir/ritonavir (cross-over after 8 weeks)

Detailed Description:

Fixed dose combination lopinavir/ritonavir (LPV/r) is a widespread used antiretroviral drug belonging to the class of protease inhibitors (PIs). PIs are associated with an increased risk of myocardial infarction. However, data is available suggesting increased levels of plasma lipids are not the sole explanation for this observation. Treatment with LPV/r might lead to a decrease of endothelial function as well, thus explaining the increased risk of myocardial infarction besides increased plasma lipids. Raltegravir is a registered antiretroviral drug with no known cardiovascular side effects. We hypothesize that switching LPV/r to raltegravir in HIV-infected patients with suppressed plasma viral load (<50 copies/ml) will lead to an improvement of endothelial function.

Objective:

First, to assess the effect of the switch of lopinavir/ritonavir to raltegravir on endothelial function.
Second, to assess the effect of the intervention mentioned above on markers of endothelial function; immune activation; chronic inflammation; and, on plasma HIV-RNA below the cut-off of 50 copies/ml.

Eligibility


Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Age ≥ 18 years
HIV-1 infection
Treatment with antiretroviral regimen containing lopinavir/ritonavir for at least the previous 3 months
No other protease inhibitors besides lopinavir/ritonavir in antiretroviral regimen
Subjects must have a minimum period of viral suppression (plasma HIV-RNA < 50 copies/ml) of 6 months
Subjects will not have a history of virological failure on antiretroviral therapy
Results of previous resistance testing allowing replacement of lopinavir/ritonavir by raltegravir
CD4+ cell count > 200 cells/µL
Signed informed consent

Exclusion Criteria:

Pregnancy
Breastfeeding
Raltegravir hypersensitivity
Treatment of underlying malignancy
Renal insufficiency requiring dialysis
Acute or decompensated chronic hepatitis (Child-Pugh score C)
Modification of antiretroviral regimen in the previous 3 months

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: NCT01453933

Contacts


Contact: Steven FL van Lelyveld, MD		s.f.l.vanlelyveld@umcutrecht.nl
Contact: Andy IM Hoepelman, MD, PhD		i.m.hoepelman@umcutrecht.nl

Locations


Netherlands
Onze Lieve Vrouwe Gasthuis	Recruiting
Amsterdam, Noord Holland, Netherlands, 1091 AC
Contact: Guido van den Berk, MD, PhD G.E.L.vandenBerk@olvg.nl
University Medical Center Utrecht	Recruiting
Utrecht, Netherlands, 3584CX
Contact: Steven FL van Lelyveld, MD s.f.l.vanlelyveld@umcutrecht.nl
Contact: Andy IM Hoepelman, MD, PhD i.m.hoepelman@umcutrecht.nl
Sub-Investigator: Steven FL van Lelyveld, MD
Principal Investigator: Andy IM Hoepelman, MD, PhD

Sponsors and Collaborators

UMC Utrecht

Merck Sharp & Dohme Corp.

Investigators


Principal Investigator:	Andy IM Hoepelman, MD	University Medical Center Utrecht, The Netherlands
Study Director:	Steven FL van Lelyveld, MD	University Medical Center Utrecht, The Netherlands

More Information


Responsible Party:	S.F.L. van Lelyveld, principal investigator, UMC Utrecht
ClinicalTrials.gov Identifier:	NCT01453933 History of Changes
Other Study ID Numbers:	RASSTER2010
Study First Received:	October 10, 2011
Last Updated:	December 17, 2013

Keywords provided by S.F.L. van Lelyveld, UMC Utrecht:


Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Lopinavir/ritonavir

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 Ritonavir Lopinavir Raltegravir Potassium	HIV Protease Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Cytochrome P-450 CYP3A Inhibitors Cytochrome P-450 Enzyme Inhibitors HIV Integrase Inhibitors Integrase Inhibitors

ClinicalTrials.gov processed this record on September 18, 2017

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