High Dose Vitamin D and Calcium for Bone Health in Individuals Initiating HAART

NCT ID: NCT01403051

Last Updated: 2018-10-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

167 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-30

Study Completion Date

2013-02-28

Brief Summary

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This study was done with people who were infected with HIV and needed to start treatment for their HIV disease. The purpose of this study is to see if taking vitamin D and calcium will help prevent the bone loss that sometimes happens when people start HIV treatment. For this study, the following HIV treatment (or HAART) were provided in the form of a single tablet that contains three different drugs: efavirenz/emtricitabine/tenofovir (EFV/FTC/TDF). These drugs are approved by the FDA to treat HIV infection. The HIV treatment provided is common for people who are taking HIV drugs for the first time. The risks seen with this HIV treatment are the same that you would encounter when taking these drugs outside of the study. The lists of risks of this HIV treatment are included in this document because the drugs are provided by the study, not because the drugs are being tested. The purpose of the study is only to look at the impact of high doses of vitamin D and calcium in preventing bone loss. There are no study objectives related to HIV treatment (EFV/FTC/TDF).

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

DOUBLE

Participants Investigators

Study Groups

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Arm A: EFV/FTC/TDF plus vitamin D3 and calcium carbonate

Participants were administered FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla), calcium carbonate and vitamin D3 4000 IU.

Group Type EXPERIMENTAL

EFV/FTC/TDF

Intervention Type DRUG

FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla) 600 mg/200 mg/ 300 mg tablet taken orally once daily at bedtime on an empty stomach.

Calcium Carbonate

Intervention Type DRUG

Calcium carbonate 500 mg tablet taken orally twice daily with food for 48 weeks.

Vitamin D3

Intervention Type DRUG

One Vitamin D3 4000 IU capsule taken orally once daily with food for 48 weeks.

Arm B: EFV/FTC/TDF plus vitamin D placebo and calcium placebo

Participants were administered FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla), a placebo for calcium carbonate, and a placebo for vitamin D3.

Group Type EXPERIMENTAL

EFV/FTC/TDF

Intervention Type DRUG

FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla) 600 mg/200 mg/ 300 mg tablet taken orally once daily at bedtime on an empty stomach.

Placebo for calcium carbonate

Intervention Type DRUG

A placebo for calcium carbonate twice daily taken orally as one x 0 mg tablets with food for 48 weeks

Placebo for vitamin D3

Intervention Type DRUG

A placebo for vitamin D3 once daily taken orally as one capsule with food for 48 weeks.

Interventions

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EFV/FTC/TDF

FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla) 600 mg/200 mg/ 300 mg tablet taken orally once daily at bedtime on an empty stomach.

Intervention Type DRUG

Calcium Carbonate

Calcium carbonate 500 mg tablet taken orally twice daily with food for 48 weeks.

Intervention Type DRUG

Vitamin D3

One Vitamin D3 4000 IU capsule taken orally once daily with food for 48 weeks.

Intervention Type DRUG

Placebo for calcium carbonate

A placebo for calcium carbonate twice daily taken orally as one x 0 mg tablets with food for 48 weeks

Intervention Type DRUG

Placebo for vitamin D3

A placebo for vitamin D3 once daily taken orally as one capsule with food for 48 weeks.

Intervention Type DRUG

Other Intervention Names

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Atripla

Eligibility Criteria

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Inclusion Criteria

* HIV-1 infection
* No evidence of any exclusionary resistance mutations based on results from any genotype assay from any laboratory that has a CLIA (Clinical Laboratory Improvement Amendments) certification or its equivalent. Results must be available from testing any time in the past or must be obtained prior to entry and reviewed by the site investigator.
* ARV drug-naïve (\<=10 days of ART at any time prior to entry) and no ARV drugs taken within the past 30 days.
* CD4+ cell count of any value obtained within 90 days prior to study entry at any laboratory that has a CLIA certification or its equivalent.
* HIV-1 RNA \>1000 copies/mL obtained within 90 days prior to study entry at any laboratory that has a CLIA certification or its equivalent.
* Certain laboratory values obtained within 30 days prior to entry (as indicated in section 4.1.6 of the protocol.
* Serum calcium \< 10.5 mg/dL within 30 days prior to entry.
* For women of reproductive potential, negative serum or urine pregnancy test within 48 hours prior to initiating study medications.
* Subjects must refrain from participating in a conception process (i.e., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization) and if participating in sexual activity that could lead to pregnancy, the subject/partner must use at least two of the reliable forms of contraceptive listed in section 4.1.9 of the protocol.
* 25-OH vitamin D \>=10 ng/mL and \<75 ng/mL.
* Ability and willingness of subject or legally authorized representative to provide informed consent.

Exclusion Criteria

* Current or prior use of bisphosphonate therapy.
* Use of vitamin D supplements greater than 800 IU/day within 30 days prior to entry.
* Use of calcium supplements greater than 500 mg/day within 30 days prior to entry.
* Known allergy/sensitivity or any hypersensitivity to components of study drugs or their formulations.
* Any oral, intravenous, or inhaled steroids within the 30 days prior to enrollment(intranasal steroid use is allowed).
* Use of androgenic hormones or growth hormones.
* Receipt of systemic cytotoxic chemotherapy within 30 days prior to entry.
* Pregnancy or currently breastfeeding.
* Documentation of acute opportunistic infections within 30 days prior to entry.
* Serious illness requiring systemic treatment and/or hospitalization until subject either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 7 days prior to entry.
* Weight \>300 lbs (exceeds weight limit of DXA scanners).
* History of nephrolithiasis (kidney stones).
* History of osteoporosis (as documented by DXA scan) or fragility fracture.
* Clinically active thyroid disease (use of thyroid hormone replacement therapy permitted but TSH must be in normal range).
* Current imprisonment or involuntary incarceration in a medical facility for psychiatric illness.
* Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
* Any condition that, in the opinion of the site investigator, would compromise the subject's ability to participate in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role collaborator

Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Edgar (Turner) Overton, MD

Role: STUDY_CHAIR

Alabama Therapeutics CRS

Michael T Yin, MD, MS

Role: STUDY_CHAIR

HIV Prevention & Treatment CRS

Locations

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Alabama Therapeutics CRS (5801)

Birmingham, Alabama, United States

Site Status

Usc Crs (1201)

Los Angeles, California, United States

Site Status

UCLA CARE Center CRS (601)

Los Angeles, California, United States

Site Status

Stanford CRS (501)

Palo Alto, California, United States

Site Status

Ucsd, Avrc Crs (701)

San Diego, California, United States

Site Status

Ucsf Aids Crs (801)

San Francisco, California, United States

Site Status

Harbor-UCLA Med. Ctr. CRS (603)

Torrance, California, United States

Site Status

University of Colorado Hospital CRS (6101)

Aurora, Colorado, United States

Site Status

Georgetown University CRS (GU CRS) (1008)

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

Site Status

The Ponce de Leon Ctr. CRS (5802)

Atlanta, Georgia, United States

Site Status

Northwestern University CRS (2701)

Chicago, Illinois, United States

Site Status

Rush University Medical Center (2702)

Chicago, Illinois, United States

Site Status

IHV Baltimore Treatment CRS (4651)

Baltimore, Maryland, United States

Site Status

Massachusetts General Hospital ACTG CRS (101)

Boston, Massachusetts, United States

Site Status

Brigham and Women's Hosp. ACTG CRS (107)

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Med. Ctr., ACTG CRS (103)

Boston, Massachusetts, United States

Site Status

Washington University CRS (2101)

St Louis, Missouri, United States

Site Status

New Jersey Medical School-Adult Clinical Research Ctr. CRS (31477)

Newark, New Jersey, United States

Site Status

Cornell CRS (7804)

New York, New York, United States

Site Status

NY Univ. HIV/AIDS CRS (401)

New York, New York, United States

Site Status

HIV Prevention & Treatment CRS (30329)

New York, New York, United States

Site Status

AIDS Care CRS (1108)

Rochester, New York, United States

Site Status

University of Rochester ACTG CRS (1101)

Rochester, New York, United States

Site Status

Bronx-Lebanon Hosp. Ctr. CRS (31469)

The Bronx, New York, United States

Site Status

Unc Aids Crs (3201)

Chapel Hill, North Carolina, United States

Site Status

Duke University Medical Center Adult CRS (1601)

Durham, North Carolina, United States

Site Status

Regional Center for Infectious Disease, Wendover Medical Center CRS (3203)

Greensboro, North Carolina, United States

Site Status

Univ. of Cincinnati CRS (2401)

Cincinnati, Ohio, United States

Site Status

Case CRS (2501)

Cleveland, Ohio, United States

Site Status

MetroHealth CRS (2503)

Cleveland, Ohio, United States

Site Status

The Ohio State Univ. AIDS CRS (2301)

Columbus, Ohio, United States

Site Status

Hosp. of the Univ. of Pennsylvania CRS (6201)

Philadelphia, Pennsylvania, United States

Site Status

Pittsburgh CRS (1001)

Pittsburgh, Pennsylvania, United States

Site Status

The Miriam Hosp. ACTG CRS (2951)

Providence, Rhode Island, United States

Site Status

Vanderbilt Therapeutics CRS (3652)

Nashville, Tennessee, United States

Site Status

Trinity Health and Wellness Center CRS (31443)

Dallas, Texas, United States

Site Status

Houston AIDS Research Team CRS (31473)

Houston, Texas, United States

Site Status

University of Washington AIDS CRS (1401)

Seattle, Washington, United States

Site Status

Puerto Rico-AIDS CRS (5401)

San Juan, , Puerto Rico

Site Status

Countries

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United States Puerto Rico

References

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Yin MT, Chan ES, Brown TT, Kinslow J, Martinson J, Landay A, Melbourne KM, Ribaudo HJ, Overton ET; A5280 Study Team. Vitamin D does not modulate immune-mediated bone loss during ART initiation. Antivir Ther. 2019;24(5):355-362. doi: 10.3851/IMP3316.

Reference Type DERIVED
PMID: 31085814 (View on PubMed)

Yin MT, Chan ES, Brown TT, Tebas P, McComsey GA, Melbourne KM, Napoli A, Hardin WR, Ribaudo HJ, Overton ET; A5280 Study Team. Racial differences in calculated bioavailable vitamin D with vitamin D/calcium supplementation. AIDS. 2017 Nov 13;31(17):2337-2344. doi: 10.1097/QAD.0000000000001621.

Reference Type DERIVED
PMID: 28832406 (View on PubMed)

Overton ET, Chan ES, Brown TT, Tebas P, McComsey GA, Melbourne KM, Napoli A, Hardin WR, Ribaudo HJ, Yin MT. Vitamin D and Calcium Attenuate Bone Loss With Antiretroviral Therapy Initiation: A Randomized Trial. Ann Intern Med. 2015 Jun 16;162(12):815-24. doi: 10.7326/M14-1409.

Reference Type DERIVED
PMID: 26075752 (View on PubMed)

Other Identifiers

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1U01AI068636

Identifier Type: NIH

Identifier Source: secondary_id

View Link

ACTG A5280

Identifier Type: -

Identifier Source: org_study_id

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