Trial Outcomes & Findings for Efficacy of Atazanavir/Ritonavir Monotherapy as Maintenance in Patients With Viral Suppression (NCT NCT01511809)

NCT ID: NCT01511809

Last Updated: 2024-02-09

Results Overview

Proportion of patients with treatment failure defined as having one of the following events: confirmed viral rebound (CVR) or treatment discontinuation for any cause. CVR was established when 2 consecutive viral load values (HIV-1 RNA)\>50 copies/mL occurred within 2 weeks during follow-up. In case of CVR, patients treated with atazanavir/ritonavir monotherapy had to re-introduce their previous 2NRTIs (re-intensification) and, if not suppressed (HIV-1 RNA \<50 copies /ml) after 12 weeks, discontinued from the study. Re-intensification was considered as treatment failure in the primary analysis conducted according to the intention-to-treat principle (intention-to-treat analysis with re-intensification equal failure, ITT=Failure) while it was not in the secondary analysis (intention-to-treat analysis with re-intensification equal success, ITT=Success).

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

117 participants

Primary outcome timeframe

Up to week 48

Results posted on

2024-02-09

Participant Flow

Participant milestones

Participant milestones
Measure
Atazanavir/Ritonavir Monotherapy
Patients will simplify therapy to ATV/RTV 300mg/100mg OD as monotherapy Atazanavir/ritonavir monotherapy: Monotherapy Simplification Strategy with Atazanavir/ritonavir 300/100 mg once daily for 96 weeks.
Atazanavir/Ritonavir Triple Therapy
Patients will continue the same regimen ATV/RTV 300mg/100mg OD plus 2 NRTIs as backbone
Overall Study
STARTED
58
59
Overall Study
COMPLETED
51
52
Overall Study
NOT COMPLETED
7
7

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Efficacy of Atazanavir/Ritonavir Monotherapy as Maintenance in Patients With Viral Suppression

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Atazanavir/Ritonavir Monotherapy
n=51 Participants
Patients will simplify therapy to ATV/RTV 300mg/100mg OD as monotherapy Atazanavir/ritonavir monotherapy: Monotherapy Simplification Strategy with Atazanavir/ritonavir 300/100 mg once daily for 96 weeks.
Atazanavir/Ritonavir Triple Therapy
n=52 Participants
Patients will continue the same regimen ATV/RTV 300mg/100mg OD plus 2 NRTIs as backbone
Total
n=103 Participants
Total of all reporting groups
Age, Continuous
41.4 years
n=5 Participants
41.7 years
n=7 Participants
41.5 years
n=5 Participants
Sex: Female, Male
Female
9 Participants
n=5 Participants
7 Participants
n=7 Participants
16 Participants
n=5 Participants
Sex: Female, Male
Male
42 Participants
n=5 Participants
45 Participants
n=7 Participants
87 Participants
n=5 Participants
Region of Enrollment
Italy
51 participants
n=5 Participants
52 participants
n=7 Participants
103 participants
n=5 Participants
nadir CD4+
274 cells/mm3
n=5 Participants
278 cells/mm3
n=7 Participants
276 cells/mm3
n=5 Participants
Years of antiretroviral treatment
25 years
n=5 Participants
25 years
n=7 Participants
25 years
n=5 Participants
HIV-1 RNA <50 copies/ml
20 months
n=5 Participants
18 months
n=7 Participants
19 months
n=5 Participants
HIV-RNA at ARV start
79399 copies/mL
n=5 Participants
42630 copies/mL
n=7 Participants
59062 copies/mL
n=5 Participants
CD4+
599 cells/mm3
n=5 Participants
570 cells/mm3
n=7 Participants
575 cells/mm3
n=5 Participants
HCV coinfection
Present
11 participants
n=5 Participants
10 participants
n=7 Participants
21 participants
n=5 Participants
HCV coinfection
Absent
40 participants
n=5 Participants
42 participants
n=7 Participants
82 participants
n=5 Participants

PRIMARY outcome

Timeframe: Up to week 48

Proportion of patients with treatment failure defined as having one of the following events: confirmed viral rebound (CVR) or treatment discontinuation for any cause. CVR was established when 2 consecutive viral load values (HIV-1 RNA)\>50 copies/mL occurred within 2 weeks during follow-up. In case of CVR, patients treated with atazanavir/ritonavir monotherapy had to re-introduce their previous 2NRTIs (re-intensification) and, if not suppressed (HIV-1 RNA \<50 copies /ml) after 12 weeks, discontinued from the study. Re-intensification was considered as treatment failure in the primary analysis conducted according to the intention-to-treat principle (intention-to-treat analysis with re-intensification equal failure, ITT=Failure) while it was not in the secondary analysis (intention-to-treat analysis with re-intensification equal success, ITT=Success).

Outcome measures

Outcome measures
Measure
Atazanavir/Ritonavir Monotherapy
n=51 Participants
Patients will simplify therapy to ATV/RTV 300mg/100mg OD as monotherapy Atazanavir/ritonavir monotherapy: Monotherapy Simplification Strategy with Atazanavir/ritonavir 300/100 mg once daily for 96 weeks.
Atazanavir/Ritonavir Triple Therapy
n=52 Participants
Patients will continue the same regimen ATV/RTV 300mg/100mg OD plus 2 NRTIs as backbone
Proportion of Patients With Treatment Failure (TF)
ITT=Failure analysis
27.5 percentage of patients
15.4 percentage of patients
Proportion of Patients With Treatment Failure (TF)
ITT=Success analysis
7.9 percentage of patients
15.4 percentage of patients

SECONDARY outcome

Timeframe: week 96

Proportion of pts with confirmed virological and treatment failure at w96. Change in CD4 cell counts. Occurrence of viral resistance to atazanavir in pts with confirmed virologic failure. Proportion of pts with adverse events, with ≥grade 2 adverse events or abnormal laboratory tests, proportion of pts with side effects leading to discontinuation. Body fat redistribution and vertebral and femoral bone mineral density. Adherence changes; changes in HIV-associated neurocognitive disorders. Difference in levels of activated Tcells and pro-inflammatory cytokines between treatment groups.

Outcome measures

Outcome data not reported

Adverse Events

Atazanavir/Ritonavir Monotherapy

Serious events: 2 serious events
Other events: 1 other events
Deaths: 0 deaths

Atazanavir/Ritonavir Triple Therapy

Serious events: 0 serious events
Other events: 7 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Atazanavir/Ritonavir Monotherapy
n=51 participants at risk
Patients will simplify therapy to ATV/RTV 300mg/100mg OD as monotherapy Atazanavir/ritonavir monotherapy: Monotherapy Simplification Strategy with Atazanavir/ritonavir 300/100 mg once daily for 96 weeks.
Atazanavir/Ritonavir Triple Therapy
n=52 participants at risk
Patients will continue the same regimen ATV/RTV 300mg/100mg OD plus 2 NRTIs as backbone
Cardiac disorders
acute coronary stenosis
2.0%
1/51 • Up to week 48
0.00%
0/52 • Up to week 48
Respiratory, thoracic and mediastinal disorders
left basal pneumonia
2.0%
1/51 • Up to week 48
0.00%
0/52 • Up to week 48

Other adverse events

Other adverse events
Measure
Atazanavir/Ritonavir Monotherapy
n=51 participants at risk
Patients will simplify therapy to ATV/RTV 300mg/100mg OD as monotherapy Atazanavir/ritonavir monotherapy: Monotherapy Simplification Strategy with Atazanavir/ritonavir 300/100 mg once daily for 96 weeks.
Atazanavir/Ritonavir Triple Therapy
n=52 participants at risk
Patients will continue the same regimen ATV/RTV 300mg/100mg OD plus 2 NRTIs as backbone
Hepatobiliary disorders
acute hepatitis
2.0%
1/51 • Up to week 48
1.9%
1/52 • Up to week 48
Renal and urinary disorders
nephrolitiasis
0.00%
0/51 • Up to week 48
3.8%
2/52 • Up to week 48
Hepatobiliary disorders
cholecystitis due to cholelithiasis
0.00%
0/51 • Up to week 48
1.9%
1/52 • Up to week 48
Renal and urinary disorders
hyperuricemia
0.00%
0/51 • Up to week 48
1.9%
1/52 • Up to week 48
Renal and urinary disorders
gross haematuria with proteinuria
0.00%
0/51 • Up to week 48
3.8%
2/52 • Up to week 48

Additional Information

Dr. Antonella Castagna

Ospedale San Raffaele

Phone: 00390226437934

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place