Study Of An Investigational Regimen Including FDA Approved HIV Drugs In HIV-Infected Pediatric Subjects

This study has been completed.

Sponsor:

Collaborator:

GlaxoSmithKline

Information provided by (Responsible Party):

ViiV Healthcare

ClinicalTrials.gov Identifier:

NCT00071760

First received: October 30, 2003

Last updated: December 6, 2012

Last verified: December 2012

History of Changes

Results First Received: March 2, 2012

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized; Endpoint Classification: Pharmacokinetics Study; Intervention Model: Parallel Assignment; Masking: Open Label; Primary Purpose: Treatment
Condition:	Infection, Human Immunodeficiency Virus
Interventions:	Drug: GW433908 Drug: ritonavir

Participant Flow

Hide Participant Flow

Recruitment Details

Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
59 unique participants (par.) received >=1 investigational product (IP) dose; however, 1 par. was not given a randomization number and therefore was not enrolled into the study. Thus, the number of par. enrolled in the protocol record=58. 5/59 par. receiving only single doses of IP are not included in the Intent-to-Treat Exposed Population (N=54).

Pre-Assignment Details

Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
Per protocol, the initial intention was to enroll par. to receive fosamprenavir; however, ultimately, no par. were enrolled into cohorts to receive repeat dosing of fosamprenavir without ritonavir boosting. The 59 par. who received >=1 IP dose were included in the Safety Population.

Reporting Groups

	Description
FPV/RTV BID	Human immunodeficiency virus (HIV)-1-infected pediatric participants were enrolled based on age in Cohort 1 (6 months to <2 years) or Cohort 2 (4 weeks to <6 months). Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per preliminary data at Week 2, the chronic dosing regimen for Cohort 1 was 45/7 mg/kg FPV/RTV BID, then changed to 45/7 mg/kg FPV/RTV BID with an increase to 60/7 mg/kg FPV/RTV BID at Week 2; later, per another analysis, all additional participants enrolled remained on 45/7 mg/kg FPV/RTV BID throughout. Per data for Cohort 1, participants in Cohort 2 underwent one SDV (45/7 mg/kg FPV/RTV), followed by individualized dosing (30/7 mg/kg to 60/10 mg/kg FPV/RTV BID). Additional enrolled participants in Cohort 2 later received 45/10 mg/kg FPV/RTV BID.

Description

FPV/RTV BID

Human immunodeficiency virus (HIV)-1-infected pediatric participants were enrolled based on age in Cohort 1 (6 months to <2 years) or Cohort 2 (4 weeks to <6 months). Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per preliminary data at Week 2, the chronic dosing regimen for Cohort 1 was 45/7 mg/kg FPV/RTV BID, then changed to 45/7 mg/kg FPV/RTV BID with an increase to 60/7 mg/kg FPV/RTV BID at Week 2; later, per another analysis, all additional participants enrolled remained on 45/7 mg/kg FPV/RTV BID throughout. Per data for Cohort 1, participants in Cohort 2 underwent one SDV (45/7 mg/kg FPV/RTV), followed by individualized dosing (30/7 mg/kg to 60/10 mg/kg FPV/RTV BID). Additional enrolled participants in Cohort 2 later received 45/10 mg/kg FPV/RTV BID.

Participant Flow: Overall Study

	FPV/RTV BID
STARTED	54
Ongoing	25
COMPLETED	0
NOT COMPLETED	54
Adverse Event	3
Lost to Follow-up	4
Protocol Violation	1
Withdrawal by Subject	3
Insufficient Viral Load Response	3
Pulmonary Tuberculosis	1
Unavailability of RTV	8
Relocation	1
Investigator's Recommendation (Rec.)	4
Study Team Rec./Resistance	1
Ongoing	25

Baseline Characteristics

Hide Baseline Characteristics

Reporting Groups

	Description
FPV/RTV BID	Human immunodeficiency virus (HIV)-1-infected pediatric participants were enrolled based on age in Cohort 1 (6 months to <2 years) or Cohort 2 (4 weeks to <6 months). Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per preliminary data at Week 2, the chronic dosing regimen for Cohort 1 was 45/7 mg/kg FPV/RTV BID, then changed to 45/7 mg/kg FPV/RTV BID with an increase to 60/7 mg/kg FPV/RTV BID at Week 2; later, per another analysis, all additional participants enrolled remained on 45/7 mg/kg FPV/RTV BID throughout. Per data for Cohort 1, participants in Cohort 2 underwent one SDV (45/7 mg/kg FPV/RTV), followed by individualized dosing (30/7 mg/kg to 60/10 mg/kg FPV/RTV BID). Additional enrolled participants in Cohort 2 later received 45/10 mg/kg FPV/RTV BID.

Description

FPV/RTV BID

Baseline Measures

	FPV/RTV BID
Number of Participants [units: participants]	54
Age [units: Months] Mean ± Standard Deviation	8.6 ± 6.43
Gender [units: Participants]
Female	31
Male	23
Race/Ethnicity, Customized [units: participants]
Black	44
White/Caucasian	2
American Indian	8

Outcome Measures

Show All Outcome Measures

1. Primary:

Plasma Amprenavir (APV) AUC (0-tau[τ]) [ Time Frame: Week 48 ]

Show Outcome Measure 1

2. Primary:

Plasma APV Cmax [ Time Frame: Week 48 ]

Show Outcome Measure 2

3. Primary:

Plasma APV Cτ [ Time Frame: Week 48 ]

Show Outcome Measure 3

4. Primary:

Plasma APV CL/F Following Dosing Expressed in mL/Min/kg [ Time Frame: Week 48 ]

Show Outcome Measure 4

5. Primary:

Plasma APV CL/F Following Dosing Expressed in mL/Min [ Time Frame: Week 48 ]

Show Outcome Measure 5

6. Primary:

Plasma Unbound APV Cτ [ Time Frame: Week 48 ]

Show Outcome Measure 6

7. Primary:

Plasma Unbound APV Percent Protein Binding (%Cτ) [ Time Frame: Week 48 ]

Show Outcome Measure 7

8. Primary:

Median Change From Baseline in Alanine Amino Transferase (ALT) and Aspartate Amino Transferase (AST) at Weeks 4, 12, 24, 36, and 48 [ Time Frame: Baseline (Day 1) and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 8

9. Primary:

Median Change From Baseline in Cholesterol, Glucose, High Density Lipoprotein (HDL) Cholesterol, Low Density Lipoprotein (LDL) Cholesterol, Triglyceride (TG), Potassium, and Sodium at Weeks 4, 12, 24, 36, and 48 [ Time Frame: Baseline (Day 1) and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 9

10. Primary:

Median Change From Baseline in Serum Lipase at Weeks 4, 12, 24, and 48 [ Time Frame: Baseline (Day 1) and Weeks 4, 12, 24, and 48 ]

Show Outcome Measure 10

11. Primary:

Number of Participants With the Indicated Treatment-emergent (TE) Grade 3/4 Laboratory Abnormalities [ Time Frame: Baseline (Day 1) until Week 48 ]

Show Outcome Measure 11

12. Primary:

Number of Participants With the Indicated Treatment-emergent (TE) Grade 3/4 Adverse Events (AE) [ Time Frame: Baseline (Day 1) until Week 48 ]

Show Outcome Measure 12

13. Primary:

Number of Participants Who Permanently Discontinued the Treatment Due to an AE [ Time Frame: Baseline (Day 1) until Week 48 ]

Show Outcome Measure 13

14. Secondary:

Number of Participants With Plasma HIV-1 Ribonucleic Acid (RNA) <400 Copies Per Milliliter at Baseline and Weeks 4, 12, 24, 36, and 48 (MSD=F) [ Time Frame: Baseline and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 14

15. Secondary:

Median Plasma HIV-1 RNA (log10 Copies/mL) at Baseline and Weeks 4, 12, 24, 36, and 48 (Observed Analysis) [ Time Frame: Baseline and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 15

16. Secondary:

Median Change From Baseline in Plasma HIV-1 RNA (log10 Copies/mL) at Weeks 4, 12, 24, 36, and 48 (Observed Analysis) [ Time Frame: Baseline and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 16

17. Secondary:

Number of Participants With at Least a 1.0 log10 HIV-1 RNA Decrease From Baseline at Weeks 4, 12, 24, 36, and 48 (MSD=F Analysis) [ Time Frame: Baseline and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 17

18. Secondary:

Median Percent Cluster of Differentiation Antigen 4 (CD4+) Cell Count at Baseline and at Weeks 4, 12, 24, 36, and 48 [ Time Frame: Baseline and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 18

19. Secondary:

Median Percent Change From Baseline in CD4+ Cell Count at Weeks 4, 12, 24, 36, and 48 [ Time Frame: Baseline and Weeks 4, 12, 24, 36, and 48 ]

Show Outcome Measure 19

20. Secondary:

Number of Participants With the Indicated Virological Outcome at Week 48 [ Time Frame: Week 48 ]

Show Outcome Measure 20

21. Secondary:

Plasma Ritonavir (RTV) AUC (0-τ) [ Time Frame: Week 48 ]

Show Outcome Measure 21

22. Secondary:

Plasma RTV Cmax [ Time Frame: Week 48 ]

Show Outcome Measure 22

23. Secondary:

Plasma RTV Cτ [ Time Frame: Week 48 ]

Show Outcome Measure 23

24. Secondary:

Plasma RTV CL/F Expressed in mL/Min/kg [ Time Frame: Week 48 ]

Hide Outcome Measure 24

Measure Type	Secondary
Measure Title	Plasma RTV CL/F Expressed in mL/Min/kg
Measure Description	Apparent clearance of drug from plasma following extravascular administration (CL/F) was calculated as dose in mg/kg units divided by AUC(0-τ). Normalizing CL/F for bodyweight allows for comparison of CL/F across populations.
Time Frame	Week 48
Safety Issue	No

Population Description

Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
PK Population. Only those participants contributing data were analyzed.

Reporting Groups

	Description
FPV/RTV BID: 4 Weeks to <6 Months	Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per data for Cohort 1, participants in Cohort 2 underwent one SDV (45/7 mg/kg FPV/RTV), followed by individualized dosing (30/7 mg/kg to 60/10 mg/kg FPV/RTV BID). Additional enrolled participants in Cohort 2 later received 45/10 mg/kg FPV/RTV BID.
FPV/RTV BID: 6 Months to <2 Years	Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per preliminary data at Week 2, the chronic dosing regimen for Cohort 1 was 45/7 mg/kg FPV/RTV BID, then changed to 45/7 mg/kg FPV/RTV BID with an increase to 60/7 mg/kg FPV/RTV BID at Week 2; later, per another analysis, all additional participants enrolled remained on 45/7 mg/kg FPV/RTV BID throughout.

Description

FPV/RTV BID: 4 Weeks to <6 Months

Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per data for Cohort 1, participants in Cohort 2 underwent one SDV (45/7 mg/kg FPV/RTV), followed by individualized dosing (30/7 mg/kg to 60/10 mg/kg FPV/RTV BID). Additional enrolled participants in Cohort 2 later received 45/10 mg/kg FPV/RTV BID.

FPV/RTV BID: 6 Months to <2 Years

Participants initially underwent two single dose visits (SDV): 30 milligrams per kilogram (mg/kg) fosamprenavir (FPV) oral suspension, 30/6 mg/kg FPV/ritonavir (RTV) oral solution, followed by individualized dosing (30/7 mg/kg BID to 60/10 mg/kg FPV/RTV twice a day [BID]). Per preliminary data at Week 2, the chronic dosing regimen for Cohort 1 was 45/7 mg/kg FPV/RTV BID, then changed to 45/7 mg/kg FPV/RTV BID with an increase to 60/7 mg/kg FPV/RTV BID at Week 2; later, per another analysis, all additional participants enrolled remained on 45/7 mg/kg FPV/RTV BID throughout.

Measured Values

	FPV/RTV BID: 4 Weeks to <6 Months	FPV/RTV BID: 6 Months to <2 Years
Number of Participants Analyzed [units: participants]	11	22
Plasma RTV CL/F Expressed in mL/Min/kg [units: mL/min/kg] Geometric Mean ( 95% Confidence Interval )
7 mg/kg BID, n=2, 22	58.668 ( NA to NA ) ^[1]	14.960 ( 9.762 to 22.927 )
10 mg/kg BID, n=11, 2	12.118 ( 6.435 to 22.818 )	8.938 ( NA to NA ) ^[1]

[1]	The 95% CI is not available because the number of participants analyzed is 2.

No statistical analysis provided for Plasma RTV CL/F Expressed in mL/Min/kg

25. Secondary:

Plasma RTV CL/F Expressed in mL/Min [ Time Frame: Week 48 ]

Show Outcome Measure 25

26. Secondary:

Number of Confirmed Virologic Failure Participants (Par.) With Treatment-emergent HIV Genotypic Resistance in Reverse Transcriptase and Protease [ Time Frame: Baseline through Week 48 ]

Show Outcome Measure 26

27. Secondary:

Number of Confirmed Virologic Failure Participants (Par.) With Treatment-emergent Reductions in Drug Susceptibility (DS) [ Time Frame: Baseline through Week 48 ]

Show Outcome Measure 27

28. Secondary:

Number of Participants Reporting Perfect Adherence Over the 3 Days and Last Weekend Prior to the Study Visits at Weeks 2, 12, 24, and 48 as Assessed by the Study Coordinator Using the Adherence Questionnaire [ Time Frame: Weeks 2, 12, 24, and 48 ]

Show Outcome Measure 28

29. Secondary:

Number of Participants With the Indicated Response Scores for the Parent/Guardian (P/G) Perception of FPV Oral Suspension Questionnaire: Items 1 to 4 [ Time Frame: Weeks 2, 24, and 48/premature study discontinuation ]

Show Outcome Measure 29

30. Secondary:

Number of Participants With the Indicated Response Scores for the Parent/Guardian Perception of the Child’s Assessment of FPV Oral Suspension Questionnaire: Items (I) 5 to 10 [ Time Frame: Weeks (W) 2, 24, and 48/premature study discontinuation ]

Show Outcome Measure 30

31. Secondary:

Correlation Between Steady-state Plasma APV PK Parameters to Changes in Plasma HIV-1 RNA Concentrations, CD4+ Percentages, and/or the Occurrence of Adverse Events [ Time Frame: Week 48 ]

Show Outcome Measure 31

32. Secondary:

Plasma FPV AUC (0-τ) [ Time Frame: Week 48 ]

Show Outcome Measure 32

33. Secondary:

Plasma FPV Cmax and Cτ [ Time Frame: Week 48 ]

Show Outcome Measure 33

34. Secondary:

Plasma FPV CL/F Expressed in mL/Min/kg [ Time Frame: Week 48 ]

Show Outcome Measure 34

35. Secondary:

Plasma FPV CL/F Expressed in mL/Min [ Time Frame: Week 48 ]

Show Outcome Measure 35

Serious Adverse Events

Show Serious Adverse Events

Other Adverse Events

Show Other Adverse Events

More Information

Hide More Information

Certain Agreements:

Principal Investigators are NOT employed by the organization sponsoring the study.

There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

The agreement is:

	The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
	The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
	Other disclosure agreement that restricts the right of the PI to discuss or publish trial results after the trial is completed. Restriction Description: GSK agreements may vary with individual investigators, but will not prohibit any investigator from publishing. GSK supports the publication of results from all centers of a multi-center trial but requests that reports based on single-site data not precede the primary publication of the entire clinical trial.

Limitations and Caveats

Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.

Results Point of Contact:

Name/Title: GSK Response Center
Organization: ViiV Healthcare
phone: 866-435-7343

No publications provided

Responsible Party:	ViiV Healthcare
ClinicalTrials.gov Identifier:	NCT00071760 History of Changes
Other Study ID Numbers:	APV20002
Study First Received:	October 30, 2003
Results First Received:	March 2, 2012
Last Updated:	December 6, 2012
Health Authority:	Spain: Spanish Agency of Medicines United States: Food and Drug Administration

To Top