Switching From Protease Inhibitor (PI) to Etravirine in HIV-1 Infected Subjects With Viremia Suppression

NCT ID: NCT01034917

Last Updated: 2020-01-31

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 43 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2009-12-31
• Study Completion Date: 2011-12-31

Brief Summary

This is a 48 week randomized, prospective, controlled, open-label, proof-of-concept pilot clinical trial.

Patients with HIV-1 infection on HAART PI-based regimen will be randomized to switch from the PI to etravirine (400 mg dissolved in water every 24 hours) or to continue with the same approach.

The aim of the study is to compare the virological efficacy of the etravirine-based regimen with standard PI-containing regimen.

Detailed Description

Etravirine is a second generation non-nucleoside analogue reverse transcriptase inhibitor (NNRTI) approved by the U.S. Food and Drug Administration (FDA) in January 2008 and by the European Medicines Agency in September 2008 for clinical use in adults with incomplete virologic suppression and resistance to previous NNRTI and other antiretroviral classes.

A question that has not been explored is whether subjects with sustained undetectable HIV-1 RNA-levels experiencing antiretroviral-related toxicity can safely switch their current PI to etravirine. This treatment strategy could allow improvements in tolerability and lipid profile and would permit an easy posology (400 mg dissolved in water every 24 hours). We designed a proof-of-concept study to test the efficacy and safety of switching from a Protease Inhibitor (PI) to etravirine in subjects with viral suppression as an antiretroviral strategy of simplification therapy, based on the high antiviral potency, low toxicity, together with its easy posology (in water dissolution).

Patients with HIV-1 infection on HAART PI-based regimen will be randomized to switch from the PI to etravirine (400 mg dissolved in water every 24 hours) or to continue with the same approach.

The primary endpoint would be the percentage of patients who maintain virological suppression at week 48.

Conditions

HIV

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Etravirine group

To switch from the PI to Etravirine 400 mg dissolved in water every 24 hours

Group Type: EXPERIMENTAL

Etravirine 400 mg dissolved in water every 24 hours

Intervention Type: DRUG

Switch from the PI to Etravirine 400 mg dissolved in water every 24 hours

Control group

Continue with the same antiretroviral regimen

Group Type: ACTIVE_COMPARATOR

Continue with the same antiretroviral regimen

Intervention Type: DRUG

Continue with the same antiretroviral regimen

Interventions

Etravirine 400 mg dissolved in water every 24 hours

Switch from the PI to Etravirine 400 mg dissolved in water every 24 hours

Intervention Type: DRUG

Continue with the same antiretroviral regimen

Continue with the same antiretroviral regimen

Intervention Type: DRUG

Other Intervention Names

ETV; CNT

Eligibility Criteria

Inclusion Criteria

1. Adult patient having a diagnosis of HIV-1 infection.

2. Antiretroviral therapy started at least 12 months before, always with a HAART combination including 2 NRTIs plus a PI.

3. Maintained undetectable plasma HIV-1 RNA (VL < 50 copies/mL) since the beginning of antiretroviral therapy, for at least 6 months.

4. Absence of suspected or documented resistance mutations in the RT associated to NNRTIs or to any NRTI.

5. Patient having at least one of the following conditions:

• Dyslipemia (LDL cholesterol >130 mg/dL or triglycerides > 350 mg/dL) derived from their current PI regimen or current use of lipid-lowering agents due to dyslipemia,
• Antiretroviral-related gastrointestinal disturbances, or
• Low patient's satisfaction associated with the current regimen posology (BID regimen, ritonavir use, ritonavir intolerance…).

6. Good treatment adherence.

7. Voluntary written informed consent.

Exclusion Criteria

1. Previous therapy with mono or dual antiretroviral therapies after initial of HAART era.

2. Previous antiretroviral treatment failures, treatment interruptions (A) or blips (B) in viral load (VL > 50 copies/mL).

3. Acute infections or uncontrolled chronic infection in the 2 months previous to the inclusion.

4. Pregnancy or fertile women willing to be pregnant.

5. Clinically significant malabsorption syndrome within 30 days prior to randomization.

(A) Patients who in the past made any interruption of treatment (provide that it has not been in the last year) may be considered candidates for the study, if they meet other criteria for inclusion, since the break in the treatment should not assume the emergence of mutations.

(B) Small blips that are preceded or forwarded by 2 undetectable viral loads will not be taken in care.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 99 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Germans Trias i Pujol Hospital

OTHER

Sponsor Role: lead

Responsible Party

Dra. EUGENIA NEGREDO PUIGMAL

Dra. Eugenia Negredo Puigmal

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Eugenia Negredo, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Fundación FLS de Lucha Contra el Sida, las Enfermedades Infecciosas y la Promoción de la Salud y la Ciencia

Locations

Germans Trias i Pujol University Hospital

Badalona, Barcelona, Spain

Countries

Spain

References

Echeverria P, Bonjoch A, Puig J, Molto J, Paredes R, Sirera G, Ornelas A, Perez-Alvarez N, Clotet B, Negredo E. Randomised study to assess the efficacy and safety of once-daily etravirine-based regimen as a switching strategy in HIV-infected patients receiving a protease inhibitor-containing regimen. Etraswitch study. PLoS One. 2014 Feb 4;9(2):e84676. doi: 10.1371/journal.pone.0084676. eCollection 2014.

Reference Type: DERIVED

PMID: 24503952 (View on PubMed)

Other Identifiers

ETRA-SWITCH

Identifier Type: -

Identifier Source: org_study_id