Trial Outcomes & Findings for Genetic Predictors of Variability in the Drug-drug Interaction Between Darunavir/Ritonavir and Pravastatin (NCT NCT00630734)

NCT ID: NCT00630734

Last Updated: 2014-05-22

Results Overview

AUC of pravastatin when administered with darunavir/ritonavir divided by AUC of pravastatin when administered alone. The AUC was measured over a 24-hour dosing interval.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

32 participants

Primary outcome timeframe

0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Results posted on

2014-05-22

Participant Flow

Healthy volunteers were recruited from the Denver metro area between March 2008 and September 2009.

Participants were genetically screened for solute carrier organic anion transporter family, member 1B1 (SLCO1B1) diplotypes as follows: Group 1, \*1A/\*1A (reference diplotype); Group 2, \*1A/\*1B or \*1B/\*1B diplotypes; and Group 3, subjects with at least one copy of the \*5, \*15, or \*17 haplotype.

Participant milestones

Participant milestones
Measure
SLCO1B1 Group 1
SLCO1B1 \*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18.
SLCO1B1 Group 3
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Overall Study
STARTED
11
13
8
Overall Study
COMPLETED
9
12
7
Overall Study
NOT COMPLETED
2
1
1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Genetic Predictors of Variability in the Drug-drug Interaction Between Darunavir/Ritonavir and Pravastatin

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1 \*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Total
n=28 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=5 Participants
12 Participants
n=7 Participants
7 Participants
n=5 Participants
28 Participants
n=4 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Continuous
36 years
STANDARD_DEVIATION 11 • n=5 Participants
37 years
STANDARD_DEVIATION 12 • n=7 Participants
39 years
STANDARD_DEVIATION 11 • n=5 Participants
36 years
STANDARD_DEVIATION 11 • n=4 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
9 Participants
n=7 Participants
4 Participants
n=5 Participants
15 Participants
n=4 Participants
Sex: Female, Male
Male
7 Participants
n=5 Participants
3 Participants
n=7 Participants
3 Participants
n=5 Participants
13 Participants
n=4 Participants
Region of Enrollment
United States
9 participants
n=5 Participants
12 participants
n=7 Participants
7 participants
n=5 Participants
28 participants
n=4 Participants

PRIMARY outcome

Timeframe: 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

AUC of pravastatin when administered with darunavir/ritonavir divided by AUC of pravastatin when administered alone. The AUC was measured over a 24-hour dosing interval.

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Relative Change in Pravastatin Area Under the Plasma Concentration-time Curve (AUC) Over the Dosing Interval
1.09 ng*hr/ml
Interval 0.73 to 1.46
1.59 ng*hr/ml
Interval 0.83 to 2.36
1.75 ng*hr/ml
Interval 0.52 to 2.97

PRIMARY outcome

Timeframe: 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Cmax of pravastatin when administered with darunavir/ritonavir divided by the Cmax of pravastatin when administered alone.

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Relative Change in Pravastatin Maximum Plasma Concentration (Cmax)
1.11 ng/ml
Interval 0.69 to 1.53
1.69 ng/ml
Interval 0.83 to 2.55
2.32 ng/ml
Interval 0.24 to 4.4

SECONDARY outcome

Timeframe: 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Dosing interval of 24 hours

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Pravastatin Alone: Pravastatin Area Under the Plasma Concentration-time Curve (AUC) Over the Dosing Interval
63 ng*h/ml
Standard Deviation 25.2
86.6 ng*h/ml
Standard Deviation 36.3
123.4 ng*h/ml
Standard Deviation 80.1

SECONDARY outcome

Timeframe: 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Pravastatin Alone: Pravastatin Maximum Plasma Concentration (Cmax)
27.7 ng/ml
Standard Deviation 15.4
33.3 ng/ml
Standard Deviation 17.1
46.2 ng/ml
Standard Deviation 38.6

SECONDARY outcome

Timeframe: 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Dosing interval of 24 hours

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Pravastatin + Darunavir/Ritonavir: Pravastatin Area Under the Plasma Concentration-time Curve (AUC) Over the Dosing Interval
68.4 ng*h/ml
Standard Deviation 37.3
106.8 ng*h/ml
Standard Deviation 47.9
145.7 ng*h/ml
Standard Deviation 36.9

SECONDARY outcome

Timeframe: 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 20, 24 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Pravastatin + Darunavir/Ritonavir: Pravastatin Maximum Plasma Concentration (Cmax)
30.1 ng/ml
Standard Deviation 19.7
42.4 ng/ml
Standard Deviation 23.0
52.8 ng/ml
Standard Deviation 11.6

OTHER_PRE_SPECIFIED outcome

Timeframe: 0, 1, 2, 3, 4, 5, 6, 8, 12 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

AUC of darunavir over a 12-hour dosing interval.

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Darunavir Area Under the Plasma Concentration-time Curve (AUC) Over the Dosing Interval
58552 ng*h/ml
Standard Deviation 29442
63679 ng*h/ml
Standard Deviation 16985
60156 ng*h/ml
Standard Deviation 13909

OTHER_PRE_SPECIFIED outcome

Timeframe: 0, 1, 2, 3, 4, 5, 6, 8, 12 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Cmax of darunavir over a 12-hour dosing interval

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Darunavir Maximum Plasma Concentration (Cmax)
7770 ng/ml
Standard Deviation 3483
8047 ng/ml
Standard Deviation 2023
7789 ng/ml
Standard Deviation 1467

OTHER_PRE_SPECIFIED outcome

Timeframe: 0, 1, 2, 3, 4, 5, 6, 8, 12 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

AUC of ritonavir over a 12-hour dosing interval.

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Ritonavir Area Under the Plasma Concentration-time Curve (AUC) Over the Dosing Interval
5239 ng*hr/ml
Standard Deviation 3835
7178 ng*hr/ml
Standard Deviation 3520
7907 ng*hr/ml
Standard Deviation 3618

OTHER_PRE_SPECIFIED outcome

Timeframe: 0,1, 2, 3, 4, 5, 6, 8, 12 hours post-dose

Population: The population analyzed included participants who completed the pravastatin alone phase and the pravastatin + darunavir/ritonavir phase of the study.

Cmax of ritonavir over a 12-hour dosing interval

Outcome measures

Outcome measures
Measure
SLCO1B1 Group 1
n=9 Participants
SLCO1B1\*1A/\*1A diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 2
n=12 Participants
SLCO1B1 \*1A/\*1B or \*1B/\*1B diplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
SLCO1B1 Group 3
n=7 Participants
Carriers of at least one SLCO1B1 \*5, \*15, or \*17 haplotype; Pravastatin 40 mg by mouth daily on days 1-4, washout on days 5-11, darunavir/ritonavir 600/100 mg by mouth twice daily on days 12-18, with pravastatin 40 mg added back on days 15-18
Ritonavir Maximum Plasma Concentration (Cmax)
844 ng/ml
Standard Deviation 708
1143 ng/ml
Standard Deviation 649
1279 ng/ml
Standard Deviation 748

Adverse Events

Pravastatin Alone

Serious events: 0 serious events
Other events: 13 other events
Deaths: 0 deaths

Darunavir/Ritonavir Alone

Serious events: 0 serious events
Other events: 22 other events
Deaths: 0 deaths

Pravastatin + Darunavir/Ritonavir

Serious events: 1 serious events
Other events: 18 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Pravastatin Alone
n=32 participants at risk
Pravastatin 40 mg by mouth daily on days 1-4; Includes 32 participants who received at least one dose of pravastatin 40 mg during days 1-4.
Darunavir/Ritonavir Alone
n=31 participants at risk
Darunavir/Ritonavir 600/100 mg by mouth twice daily on days 12-14; Includes 31 participants who received at least one dose of darunavir/ritonavir during days 12-14.
Pravastatin + Darunavir/Ritonavir
n=28 participants at risk
Darunavir/ritonavir 600/100 mg by mouth twice daily and pravastatin 40 mg by mouth once daily on days 15-18. Includes 28 participants who received at least one dose of darunavir/ritonavir and pravastatin during days 15-18.
General disorders
Angioedema
0.00%
0/32
0.00%
0/31
3.6%
1/28 • Number of events 1

Other adverse events

Other adverse events
Measure
Pravastatin Alone
n=32 participants at risk
Pravastatin 40 mg by mouth daily on days 1-4; Includes 32 participants who received at least one dose of pravastatin 40 mg during days 1-4.
Darunavir/Ritonavir Alone
n=31 participants at risk
Darunavir/Ritonavir 600/100 mg by mouth twice daily on days 12-14; Includes 31 participants who received at least one dose of darunavir/ritonavir during days 12-14.
Pravastatin + Darunavir/Ritonavir
n=28 participants at risk
Darunavir/ritonavir 600/100 mg by mouth twice daily and pravastatin 40 mg by mouth once daily on days 15-18. Includes 28 participants who received at least one dose of darunavir/ritonavir and pravastatin during days 15-18.
General disorders
Headache
25.0%
8/32 • Number of events 8
25.8%
8/31 • Number of events 8
21.4%
6/28 • Number of events 6
General disorders
Fatigue
6.2%
2/32 • Number of events 2
16.1%
5/31 • Number of events 5
3.6%
1/28 • Number of events 1
Gastrointestinal disorders
Constipation
6.2%
2/32 • Number of events 2
6.5%
2/31 • Number of events 2
0.00%
0/28
Musculoskeletal and connective tissue disorders
Muscle pain
9.4%
3/32 • Number of events 3
9.7%
3/31 • Number of events 3
10.7%
3/28 • Number of events 3
General disorders
Dizziness
6.2%
2/32 • Number of events 2
0.00%
0/31
3.6%
1/28 • Number of events 1
General disorders
Hypoalbuminemia
10.7%
3/28 • Number of events 3
9.7%
3/31 • Number of events 3
7.1%
2/28 • Number of events 2
Gastrointestinal disorders
Nausea/Vomiting/Dyspepsia/Abdominal Pain
0.00%
0/32
38.7%
12/31 • Number of events 12
10.7%
3/28 • Number of events 3
Gastrointestinal disorders
Diarrhea
3.1%
1/32 • Number of events 1
25.8%
8/31 • Number of events 8
46.4%
13/28 • Number of events 13
Gastrointestinal disorders
Anorexia
0.00%
0/32
6.5%
2/31 • Number of events 2
3.6%
1/28 • Number of events 1
Musculoskeletal and connective tissue disorders
Shoulder/Neck Pain
3.1%
1/32 • Number of events 1
9.7%
3/31 • Number of events 3
3.6%
1/28 • Number of events 1

Additional Information

Christina Aquilante, Pharm.D.

University of Colorado Denver

Phone: 303-724-6126

Results disclosure agreements

  • Principal investigator is a sponsor employee Prior to publication or presentation, the PI will provide the sponsor with at least 60 days for review of a manuscript
  • Publication restrictions are in place

Restriction type: OTHER