Comparison of Treatment Simplification by LPV/r vs Current Treatment Continuation in HIV-Infected Patients

NCT ID: NCT00140751

Last Updated: 2013-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

186 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-10-31

Study Completion Date

2008-01-31

Brief Summary

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The purpose of this study is to compare the efficacy and tolerance of a treatment simplification by a Lopinavir/ritonavir monotherapy versus continuation of current treatment in HIV-infected patients

Detailed Description

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Highly active antiretroviral therapy (HAART) has made a significant impact on the natural history of HIV-1 infection, but toxicities and complexities of therapy limit long-term efficacy, and make simpler yet effective HAART regimens highly desirable. Previous attempts to 'de-intensify' protease inhibitor (PI)-based therapy by discontinuing reverse transcriptase inhibitors (RTI) after achieving viral suppression met with failure, probably because plasma levels of most individually administered PI are too low to inhibit viral replication consistently.

Low-dose ritonavir substantially enhances lopinavir plasma levels, and lopinavir/ritonavir (LPV/r) is effective as part of a combination therapy in both naive and PI-experienced patients. Furthermore, lopinavir is known to have a high genetic barrier to selection of resistance. LPV/r monotherapy could thus have the right combination of potency, favorable pharmacokinetics, and high genetic barrier needed to suppress viral replication and prevent the selection of lopinavir resistance. Preliminary results with "maintenance"LPV/r monotherapy show interesting results but data from randomized studies are needed.

Conditions

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HIV Infections

Keywords

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HIV-1 Treatment simplification Lopinavir/ritonavir Treatment Experienced HIV Seropositivity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Simplification

The patients included in this arm are on Monotherapy of Kaletra (Lopinavir/ritonavir)during 48 weeks

Group Type EXPERIMENTAL

Lopinavir/ritonavir (drug)

Intervention Type DRUG

Continued

The patients included in this arm continue their treatment without any changes

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Lopinavir/ritonavir (drug)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age \> or = 18 years
* Confirmed HIV-1 seropositivity
* Antiretroviral treatment stable since 3 months at least
* HIV-1 ARN load \< 50 copies/mL since 6 months at least
* Signed consent form
* No history of treatment failure (= viral load \> 1000 copies/mL) including a protease inhibitor
* No opportunistic infection in the previous 6 months

Exclusion Criteria

* Neutrophils \< 750/mm3
* Hemoglobin \< 8 g/dL
* Platelets \< 60,000/mm3
* Creatinin \> 150 micromoles/L
* SGOT \> 5 NUL (Normal Upper Limit)
* SGPT \> 5 NUL
* Current IL-2 treatment
* HBV infection treated or not by lamivudine or tenofovir
* Pregnancy or feeding
* Enrollment in another study not compliant with KALESOLO Study group assignment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott

INDUSTRY

Sponsor Role collaborator

Institut de Médecine et d'Epidémiologie Appliquée - Fondation Internationale Léon M'Ba

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean-Luc MEYNARD, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hôpital Saint-Antoine - Service des Maladies Infectieuses et Tropicales (Paris, France)

Locations

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Hôpital Pierre Zobda-Quitman - Service de Maladies Infectieuses et Tropicales

Fort-de-France, Martinique, France

Site Status

Centre Hospitalier de la Région Annecienne (CHRA) - Service d'Infectiologie

Annecy, , France

Site Status

Hôpital Jean Verdier - Unité de Maladies Infectieuses

Bondy, , France

Site Status

Hôpital Pellegrin - Service de Médecine Interne et Maladies Infectieuses

Bordeaux, , France

Site Status

Hôpital Saint-André - Service de Médecine Interne et Maladies Infectieuses

Bordeaux, , France

Site Status

Hôpital Saint-André - Service de Médecine Interne et Maladies Tropicales

Bordeaux, , France

Site Status

Hôpital Côte de Nacre - Service des Maladies Infectieuses

Caen, , France

Site Status

Hôpital Henri Mondor - Service d'Immunologie Clinique

Créteil, , France

Site Status

Hôpital Raymond Poincaré - Service des Maladies Infectieuses et Tropicales

Garches, , France

Site Status

Hôpital A. Michallon - Service des Maladies Infectieuses

Grenoble, , France

Site Status

Hôpital Bicêtre - Service de Médecine Interne

Le Kremlin-Bicêtre, , France

Site Status

Hôpital Nord - CISIH

Marseille, , France

Site Status

Hôpital Sainte-Marguerite - Unité Médicale CISIH

Marseille, , France

Site Status

Hôpital Gui de Chauliac - Service de Maladies Infectieuses et Tropicales

Montpellier, , France

Site Status

Hôpital de l'Archet - Service d'Infectiologie

Nice, , France

Site Status

Hôpital Saint-Antoine - Service des Maladies Infectieuses et Tropicales

Paris, , France

Site Status

Groupe Hospitalier Pitié-Salpêtrière - Service de Maladies Infectieuses et Tropicales

Paris, , France

Site Status

Groupe Hospitalier Pitié-Salpêtrière - Service de Médecine Interne 1

Paris, , France

Site Status

Hôpital-Fondation Saint-Joseph - Service des Maladies Infectieuses

Paris, , France

Site Status

Hôpital Européen Georges Pompidou (HEGP) - Département d'Immunologie

Paris, , France

Site Status

Hôpital Tenon - Service des Maladies Infectieuses et Tropicales

Paris, , France

Site Status

Hôpital Pontchaillou - Service des Maladies Infectieuses

Rennes, , France

Site Status

Hôpital Civil - Hôpital de Jour du CISIH - Clinique Médicale A

Strasbourg, , France

Site Status

Hôpital Gustave Dron - Service des Maladies Infectieuses

Tourcoing, , France

Site Status

Hôpital de Brabois Adultes - Service de Maladies Infectieuses et Tropicales

Vandœuvre-lès-Nancy, , France

Site Status

Countries

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France

References

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Mocroft A, Ledergerber B, Katlama C, Kirk O, Reiss P, d'Arminio Monforte A, Knysz B, Dietrich M, Phillips AN, Lundgren JD; EuroSIDA study group. Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Lancet. 2003 Jul 5;362(9377):22-9. doi: 10.1016/s0140-6736(03)13802-0.

Reference Type BACKGROUND
PMID: 12853195 (View on PubMed)

Yeni PG, Hammer SM, Hirsch MS, Saag MS, Schechter M, Carpenter CC, Fischl MA, Gatell JM, Gazzard BG, Jacobsen DM, Katzenstein DA, Montaner JS, Richman DD, Schooley RT, Thompson MA, Vella S, Volberding PA. Treatment for adult HIV infection: 2004 recommendations of the International AIDS Society-USA Panel. JAMA. 2004 Jul 14;292(2):251-65. doi: 10.1001/jama.292.2.251.

Reference Type BACKGROUND
PMID: 15249575 (View on PubMed)

Bartlett JA, DeMasi R, Quinn J, Moxham C, Rousseau F. Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults. AIDS. 2001 Jul 27;15(11):1369-77. doi: 10.1097/00002030-200107270-00006.

Reference Type BACKGROUND
PMID: 11504958 (View on PubMed)

Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998 Mar 26;338(13):853-60. doi: 10.1056/NEJM199803263381301.

Reference Type BACKGROUND
PMID: 9516219 (View on PubMed)

Murphy R, Gazzard B. Antiretroviral treatment guidelines. AIDS. 2003 Jun;17 Suppl 2:S1. doi: 10.1097/00002030-200306002-00001. No abstract available.

Reference Type BACKGROUND
PMID: 12870522 (View on PubMed)

Bucher HC, Kofler A, Nuesch R, Young J, Battegay M, Opravil M. Meta-analysis of randomized controlled trials of simplified versus continued protease inhibitor-based antiretroviral therapy in HIV-1-infected patients. AIDS. 2003 Nov 21;17(17):2451-9. doi: 10.1097/00002030-200311210-00007.

Reference Type BACKGROUND
PMID: 14600516 (View on PubMed)

Drechsler H, Powderly WG. Switching effective antiretroviral therapy: a review. Clin Infect Dis. 2002 Nov 15;35(10):1219-30. doi: 10.1086/343050. Epub 2002 Oct 21.

Reference Type BACKGROUND
PMID: 12410482 (View on PubMed)

Martinez E, Conget I, Lozano L, Casamitjana R, Gatell JM. Reversion of metabolic abnormalities after switching from HIV-1 protease inhibitors to nevirapine. AIDS. 1999 May 7;13(7):805-10. doi: 10.1097/00002030-199905070-00009.

Reference Type BACKGROUND
PMID: 10357379 (View on PubMed)

Moyle G, Baldwin C, Mandalia S, Comitis S, Burn P, Gazzard B. Changes in metabolic parameters and body shape after replacement of protease inhibitor With efavirenz in virologically controlled HIV-1-positive persons: single-arm observational cohort. J Acquir Immune Defic Syndr. 2001 Dec 1;28(4):399-401. doi: 10.1097/00126334-200112010-00016. No abstract available.

Reference Type BACKGROUND
PMID: 11707680 (View on PubMed)

Lambert-Niclot S, Grude M, Meynard JL, Marcelin AG, Valantin MA, Flandre P, Izopet J, Moinot L, Bouteloup V, Calvez V, Katlama C, Girard PM, Morand-Joubert L. Ultrasensitive Human Immunodeficiency Virus Type 1 Viral Load as a Marker of Treatment Choice for Simplification Strategies. Clin Infect Dis. 2018 Nov 28;67(12):1883-1889. doi: 10.1093/cid/ciy382.

Reference Type DERIVED
PMID: 29767684 (View on PubMed)

Meynard JL, Bouteloup V, Landman R, Bonnard P, Baillat V, Cabie A, Kolta S, Izopet J, Taburet AM, Mercie P, Chene G, Girard PM; KALESOLO Study Group. Lopinavir/ritonavir monotherapy versus current treatment continuation for maintenance therapy of HIV-1 infection: the KALESOLO trial. J Antimicrob Chemother. 2010 Nov;65(11):2436-44. doi: 10.1093/jac/dkq327. Epub 2010 Sep 15.

Reference Type DERIVED
PMID: 20843990 (View on PubMed)

Related Links

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http://www.imea.fr/

Click here for more information about this study: KALESOLO

Other Identifiers

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KALESOLO

Identifier Type: -

Identifier Source: secondary_id

IMEA-030

Identifier Type: -

Identifier Source: org_study_id