Pharmacokinetic and Safety Study of Raltegravir and Atazanavir in a Once Daily Dose Regimen in HIV-1 Infected Patients (PRADA)
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Purpose
The licensed dose of raltegravir is 400 mg twice daily with or without food. Raltegravir is metabolized predominantly through glucuronidation by UGT1A1. Atazanavir increases the plasma concentrations of raltegravir 400 mg twice daily by 72% due to inhibition of UGT 1A1.
This suggests that combined use of atazanavir and a lower dose frequency of raltegravir, once daily for example, is possible. Another reason why raltegravir most likely can be applied is that its pharmacodynamic effect is not related to Cmin but to AUC which is expected to be similar for an 800mg QD dose when compared to 400mg BD. Phase III clinical trials evaluating QD dosing of raltegravir are currently ongoing and interim results are expected to be published in mid 2009.
A regimen of atazanavir and raltegravir in combination with lamivudine or emtricitabine may be a well tolerated and effective NNRTI-, and ritonavir-sparing regimen that could be an attractive option for both first and second line (after NRTI/NNRTI failure) treatment regimens.
| Condition | Intervention | Phase |
|---|---|---|
|
HIV Infection HIV Infections |
Drug: raltegravir QD Drug: atazanavir Drug: lamivudine (or emtricitabine) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Pharmacokinetics/Dynamics Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Pharmacokinetic and Safety Pilotstudy of RAltegravir and Atazanavir in a Once DAily Dose Regimen in HIV-1 Infected Patients (PRADA) |
- pharmacokinetics of raltegravir [ Time Frame: after two weeks of reference treatment and after two weeks of test treatment ] [ Designated as safety issue: No ]
- Viral load [ Time Frame: after two weeks treatment with the reference treatment and after two weeks treatment with the test treatment ] [ Designated as safety issue: Yes ]
- Adverse events [ Time Frame: entire trial ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 20 |
| Study Start Date: | July 2009 |
| Study Completion Date: | January 2011 |
| Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Raltegravir BID-QD
Week 1-4
Week 5-8
|
Drug: raltegravir QD
Raltegravir 800mg QD
Drug: atazanavir
atazanavir
Drug: lamivudine (or emtricitabine)
lamivudine (or emtricitabine)
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- HIV-infected as documented by positive HIV antibody test and confirmed by Western Blot.
- Subject is at least 18 years of age at the day of screening.
- Subject is able and willing to sign the Informed Consent Form prior to screening evaluations.
- HIV-1 RNA < 40 copies/mL for at least 6 months on antiretroviral therapy.
- Subject has no history of previous virological failure or documented resistance mutations
Exclusion Criteria:
- History of sensitivity/idiosyncrasy to the drug or chemically related compounds or excipients, which may be employed in the trial.
- Relevant history or current condition that might interfere with drug absorption, distribution, metabolism or excretion.
- Inability to understand the nature and extent of the trial and the procedures required.
- Pregnant female (as confirmed by an HCG test performed less than 3 weeks before the first dose) or breast-feeding female.
- Abnormal serum transaminases determined as levels being > 5 times upper limit of normal (see Appendix A for normal ranges of clinical laboratory values).
- Concomitant use of medications that interfere with raltegravir or atazanavir pharmacokinetics: rifampicin, irinotecan, midazolam, triazolam, ergotamine, dihydroergotamine, cisapride, pimozide, lovastatin, simvastatin, indinavir, proton pump inhibitors, H2 receptor antagonists, St. john's wort, Ginkgo Biloba, didanosine, tenofovir, efavirenz, nevirapine, antacids, clarithromycin, phenytoin, phenobarbital, carbamazepine.
- Active hepatobiliary or hepatic disease (including chronic hepatitis B infection).
- Alcohol abuse.
Contacts and Locations| Germany | |
| University of Bonn | |
| Bonn, Germany | |
| Netherlands | |
| Rijnstate Hospital Arnhem | |
| Arnhem, Netherlands | |
| Radboud University Medical Centre Nijmegen | |
| Nijmegen, Netherlands | |
| Erasmus Medical Center Rotterdam | |
| Rotterdam, Netherlands | |
| Principal Investigator: | David Burger | Radboud University |
More Information
No publications provided
| Responsible Party: | D.M. Burger, PhD, PharmD, Radboud University Medical Centre Nijmegen |
| ClinicalTrials.gov Identifier: | NCT00943540 History of Changes |
| Other Study ID Numbers: | UMCN-AKF 08.07 |
| Study First Received: | July 21, 2009 |
| Last Updated: | January 7, 2011 |
| Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Keywords provided by Radboud University:
|
pharmacokinetics single dose raltegravir Treatment experienced |
Additional relevant MeSH terms:
|
HIV Infections Acquired Immunodeficiency Syndrome Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Slow Virus Diseases Lamivudine Atazanavir |
Emtricitabine Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Therapeutic Uses Anti-HIV Agents HIV Protease Inhibitors Protease Inhibitors |
ClinicalTrials.gov processed this record on June 17, 2013