Safety and Efficacy of Cobicistat-boosted Atazanavir Compared to Ritonavir-boosted Atazanavir in Combination With Emtricitabine/Tenofovir Disoproxil Fumarate in HIV-1 Infected, Antiretroviral Treatment-Naive Adults

NCT ID: NCT00892437

Last Updated: 2016-02-15

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

85 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-05-31

Study Completion Date

2015-01-31

Brief Summary

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The objective of this study is to evaluate the safety and efficacy of a regimen containing cobicistat-boosted atazanavir (ATV+COBI) plus emtricitabine/tenofovir disoproxil fumarate (Truvada®; FTC/TDF) versus ritonavir-boosted atazanavir (ATV+RTV) plus FTC/TDF in HIV-1 infected, antiretroviral treatment-naive adults.

Participants will be randomized in a 2:1 ratio. Randomization will be stratified by HIV-1 RNA level (≤ 100,000 copies/mL or \> 100,000 copies/mL) at screening. After Week 48, participants will continue to take their blinded study drug and attend visits every 12 weeks until treatment assignments are unblinded, at which point all participants will return for an unblinding visit and be given the option to participate in an open-label rollover extension and receive ATV+COBI+FTC/TDF until COBI tablets become commercially available, or until Gilead Sciences elects to terminate the study.

Detailed Description

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Conditions

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HIV-1 Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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ATV+COBI+FTC/TDF

COBI + RTV placebo +ATV+FTC/TDF for 48 weeks

Group Type EXPERIMENTAL

COBI

Intervention Type DRUG

Cobicistat (COBI) 150 mg tablet administered orally once daily

ATV

Intervention Type DRUG

Atazanavir (ATV) 300 mg capsule administered orally once daily

FTC/TDF

Intervention Type DRUG

Emtricitabine (FTC) 200 mg/tenofovir disoproxil fumarate (TDF) 300 mg fixed-dose combination tablet administered orally once daily

RTV placebo

Intervention Type DRUG

Placebo to match RTV administered orally once daily

ATV+RTV+FTC/TDF

RTV + COBI placebo +ATV+FTC/TDF for 48 weeks

Group Type ACTIVE_COMPARATOR

RTV

Intervention Type DRUG

Ritonavir (RTV) 100 mg soft gelatin capsule administered orally once daily

ATV

Intervention Type DRUG

Atazanavir (ATV) 300 mg capsule administered orally once daily

FTC/TDF

Intervention Type DRUG

Emtricitabine (FTC) 200 mg/tenofovir disoproxil fumarate (TDF) 300 mg fixed-dose combination tablet administered orally once daily

COBI placebo

Intervention Type DRUG

Placebo to match COBI administered orally once daily

Interventions

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COBI

Cobicistat (COBI) 150 mg tablet administered orally once daily

Intervention Type DRUG

RTV

Ritonavir (RTV) 100 mg soft gelatin capsule administered orally once daily

Intervention Type DRUG

ATV

Atazanavir (ATV) 300 mg capsule administered orally once daily

Intervention Type DRUG

FTC/TDF

Emtricitabine (FTC) 200 mg/tenofovir disoproxil fumarate (TDF) 300 mg fixed-dose combination tablet administered orally once daily

Intervention Type DRUG

COBI placebo

Placebo to match COBI administered orally once daily

Intervention Type DRUG

RTV placebo

Placebo to match RTV administered orally once daily

Intervention Type DRUG

Other Intervention Names

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Tybost® GS-9350 Norvir® Reyataz® Truvada®

Eligibility Criteria

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Inclusion Criteria

* Ability to understand and sign a written informed consent form
* Plasma HIV-1 RNA levels ≥ 5,000 copies/mL
* No prior use of any approved or experimental anti-HIV drug
* Normal ECG (or if abnormal, determined by the investigator to be not clinically significant)
* Adequate renal function (estimated glomerular filtration rate ≥ 80 mL/min according to the Cockcroft-Gault formula)
* Hepatic transaminases ≤ 2.5 × upper limit of normal
* Total bilirubin ≤ 1.5 mg/dL, or normal direct bilirubin
* Adequate hematologic function (absolute neutrophil count ≥ 1000/mm\^3; platelets ≥ 50,000/mm\^3; hemoglobin ≥ 8.5 g/dL)
* Cluster of differentiation 4 (CD4) cell count \> 50 cells/µL
* Serum amylase ≤ 1.5 × ULN (subjects with serum amylase \>1.5 × ULN remained eligible if serum lipase is ≤ 1.5 × ULN)
* Normal thyroid-stimulating hormone
* Negative serum pregnancy test (females of childbearing potential only)
* Males and females of childbearing potential must agree to utilize highly effective contraception methods from screening throughout the duration of study treatment and for 30 days following the last dose of study drugs
* Age ≥ 18 years
* Life expectancy ≥ 1 year

Exclusion Criteria

* New AIDS-defining condition diagnosed within the 30 days prior to screening
* Documented drug resistance to nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), or primary PI resistance mutation(s)
* Hepatitis B surface antigen positive
* Hepatitis C antibody positive
* Participants experiencing cirrhosis
* Participants experiencing ascites
* Participants experiencing encephalopathy
* Females who are breastfeeding
* Positive serum pregnancy test (female of childbearing potential)
* Vaccinated within 90 days of study dosing
* History or family history of Long QT Syndrome or have a family history of sudden cardiac death or unexplained death in an otherwise healthy individual under the age of 30 years
* Presence or history of cardiovascular disease, cardiomyopathy, and/or cardiac conduction abnormalities
* Prolonged QTcF (QT interval corrected for heart rate using Fridericia's formula) interval at screening (eg, a prolongation of the QTcF interval of greater than 450 msec for males and greater than 470 msec for females)
* PR interval greater than or equal to 200 msec or less than or equal to 120 msec on ECG at screening
* QRS greater than or equal to 120 msec on ECG at screening
* Implanted defibrillator or pacemaker
* Subjects receiving ongoing therapy with any disallowed medications
* Current alcohol or substance use judged to potentially interfere with subject study compliance
* History of or ongoing malignancy (including untreated carcinoma in-situ) other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, noninvasive cutaneous squamous carcinoma
* Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to baseline
* Participation in any other clinical trial without prior approval
* Medications contraindicated for use with ATV, RTV, FTC, or TDF
* Any known allergies to the excipients of ATV capsules, RTV capsules, COBI tablets or FTC/TDF tablets
* Any other clinical condition or prior therapy that would make the subject unsuitable for the study or unable to comply with the dosing requirements
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gilead Sciences

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marshall Fordyce, MD

Role: STUDY_CHAIR

Gilead Sciences

Locations

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Southwest Center for HIV/AIDS

Phoenix, Arizona, United States

Site Status

Health for Life Clinic, PLLC

Little Rock, Arkansas, United States

Site Status

AIDS Healthcare Foundation-Research Center

Beverly Hills, California, United States

Site Status

The Living Hope Foundation

Long Beach, California, United States

Site Status

Peter J. Ruane, MD, Inc.

Los Angeles, California, United States

Site Status

Orange Coast Medical Group

Newport Beach, California, United States

Site Status

David J. Shamblaw, MD Inc.

San Diego, California, United States

Site Status

Metropolis Medical

San Francisco, California, United States

Site Status

Denver Infectious Disease Consultants, PLLC

Denver, Colorado, United States

Site Status

Dupont Circle Physicians Group

Washington D.C., District of Columbia, United States

Site Status

Whitman Walker Clinic

Washington D.C., District of Columbia, United States

Site Status

Capital Medical Associates PC

Washington D.C., District of Columbia, United States

Site Status

Gary Richmond, MD, PA, Inc.

Fort Lauderdale, Florida, United States

Site Status

Wohlfeiler, Piperato and Associates, LLC

Miami Beach, Florida, United States

Site Status

ValuehealthMD, LLC

Orlando, Florida, United States

Site Status

St. Joseph's Comprehensive Research Institute

Tampa, Florida, United States

Site Status

AIDS Research Consortium of Atlanta

Atlanta, Georgia, United States

Site Status

Infectious Disease Specialists of Atlanta (IDSA)

Decatur, Georgia, United States

Site Status

Northstar Medical Center

Chicago, Illinois, United States

Site Status

Chase Brexton Health Services, Inc.

Baltimore, Maryland, United States

Site Status

Be Well Medical Center

Berkley, Michigan, United States

Site Status

Central West Healthcare

St Louis, Missouri, United States

Site Status

Southampton Healthcare, Inc.

St Louis, Missouri, United States

Site Status

Saint Michael's Medical Center

Newark, New Jersey, United States

Site Status

Southwest C.A.R.E. Center

Santa Fe, New Mexico, United States

Site Status

Rosedale Infectious Diseases

Huntersville, North Carolina, United States

Site Status

Nicholaos Bellos, MD, PA

Dallas, Texas, United States

Site Status

AIDS Arms/ Peabody Health Center

Dallas, Texas, United States

Site Status

Gordon E. Crofoot, MD, PA

Houston, Texas, United States

Site Status

Therapeutic Concepts, P.A.

Houston, Texas, United States

Site Status

TribalMed

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Elion R, Cohen C, Gathe J, Shalit P, Hawkins T, Liu HC, Mathias AA, Chuck SL, Kearney BP, Warren DR; GS-US-216-0105 Study Team. Phase 2 study of cobicistat versus ritonavir each with once-daily atazanavir and fixed-dose emtricitabine/tenofovir df in the initial treatment of HIV infection. AIDS. 2011 Sep 24;25(15):1881-6. doi: 10.1097/QAD.0b013e32834b4d48.

Reference Type RESULT
PMID: 21811136 (View on PubMed)

Other Identifiers

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GS-US-216-0105

Identifier Type: -

Identifier Source: org_study_id

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