NCT01902186

Brief Summary

Given the high prevalence of bone alteration in the course of HIV infection or antiretroviral treatment and the favourable properties of raltegravir the investigators designed this pilot randomized and controlled study. Adult female HIV-positive patients on successful treatment with tenofovir/emtricitabine plus atazanavir plus ritonavir will be randomized either to continue such a regimen or to switch to raltegravir plus atazanavir plus ritonavir. Bone mineral density changes will be compared in the two groups at 48 weeks: the hypothesis is that removing tenofovir and using tenofovir will increase bone mineral density at 48 weeks.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
4

participants targeted

Target at below P25 for phase_4

Timeline
Completed

Started Sep 2014

Typical duration for phase_4

Geographic Reach
1 country

2 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 10, 2013

Completed
8 days until next milestone

First Posted

Study publicly available on registry

July 18, 2013

Completed
1.1 years until next milestone

Study Start

First participant enrolled

September 1, 2014

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2016

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2016

Completed
Last Updated

October 17, 2018

Status Verified

October 1, 2018

Enrollment Period

2.3 years

First QC Date

July 10, 2013

Last Update Submit

October 14, 2018

Conditions

Keywords

HIVosteopeniat-scoreDEXAtenofovirraltegravir

Outcome Measures

Primary Outcomes (1)

  • Variations from baseline in DEXA-measured bone mineral density (t-score, spine and femur)

    48 weeks

Secondary Outcomes (2)

  • variations from baseline in CTX (C-terminal telopeptide of type I collagen) and OC (Osteocalcin)

    24 and 48 weeks

  • To assess the variation in renal function

    48 weeks

Other Outcomes (6)

  • Cholesterol changes at 48 weeks in the two arms

    48 weeks

  • Triglycerides changes in the two arms

    48 weeks

  • Glucose Fasting Levels changes in the two arms

    48 weeks

  • +3 more other outcomes

Study Arms (2)

raltegravir

EXPERIMENTAL

raltegravir and atazanavir and ritonavir

Drug: raltegravir and atazanavir and ritonavir

tenofovir/emtricitabine

ACTIVE COMPARATOR

tenofovir/emtricitabine and atazanavir and ritonavir

Drug: tenofovir/emtricitabine and atazanavir and ritonavir

Interventions

switch tenofovir/emtricitabine to raltegravir

Also known as: Isentress (raltegravir), Reyataz (atazanavir), Norvir (ritonavir)
raltegravir

no change in antiretroviral treatment; patients will continue their regimen (tenofovir/emtricitabine and atazanavir and ritonavir)

Also known as: tenofovir/emtricitabine (Truvada), atazanavir (Reyataz), ritonavir (norvir)
tenofovir/emtricitabine

Eligibility Criteria

Age18 Years - 80 Years
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult HIV-positive female patients;
  • osteopenia (t-score from -1 to -2.5);
  • On antiretroviral treatment with tenofovir/emtricitabine and atazanavir/ritonavir (300/100 mg) for at least six months;
  • Plasma HIV RNA below 50 copies/ml since six months;
  • Premenopausal women: female patients at any phase of the reproductive period with regular menstrual cycles and normal FSH (\< 25 ng/mL) That would probably exclude patients with ovarian or endocrinological dysfunctions. Pre and postmenopausal should be therefore well-characterized.
  • Women in menopausal period (the menopause was defined as 12 months of amenorrhoea without any pathological or physiological cause and using the endocrinological definition of ovary insufficiency (LH (Luteic hormone) \>25ng/mL, FSH (follicule stimulating hormone)\>25ng/mL and E2 (Estradiol)\<30ng/mL).
  • Each premenopausal sexually active subject of child-bearing potential must agree to use a medically accepted method of contraception while receiving protocol-specified medication and for 3 months after stopping the medication.Medically accepted methods of contraception include condoms (male or female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide, medically prescribed IUD (intrauterine device), inert or copper-containing IUD, hormone-releasing IUD, systemic hormonal contraceptive, and surgical sterilization (eg, hysterectomy or tubal ligation).
  • Postmenopausal women are not required to use contraception.

You may not qualify if:

  • History or current evidence of any condition, therapy, laboratory abnormality or other circumstance that might confound the results of the study, or interfere with the patient's participation for the full duration of the study, such that it is not in the best interest of the patient to participate.
  • Documented resistance to Raltegravir or/and Atazanavir.
  • Patient with significant hypersensitivity or other contraindication to any of the components of the study drugs.
  • Patient has a current (active) diagnosis of acute hepatitis due to any cause
  • Patient with coinfection HIV/HBV (Human Hepatitis virus B)
  • Liver cirrhosis
  • Osteoporosis (t-score less than 2.5).
  • Secondary endocrinological cause of low BMD (Bone mineral density)
  • Chronic steroid intake;
  • Chronic kidney disease (estimated glomerular filtration rate below 60 ml/min);
  • Concomitant use of bisphosphonate.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of Milano

Milan, Italy

Location

University of Torino

Torino, Italy

Location

MeSH Terms

Conditions

HIV InfectionsBone Diseases, Metabolic

Interventions

Raltegravir PotassiumAtazanavir SulfateRitonavirTenofovirEmtricitabineEmtricitabine, Tenofovir Disoproxil Fumarate Drug Combination

Condition Hierarchy (Ancestors)

Blood-Borne InfectionsCommunicable DiseasesInfectionsSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System DiseasesBone DiseasesMusculoskeletal DiseasesMetabolic DiseasesNutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

PyrrolidinonesPyrrolidinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsPyridinesOligopeptidesPeptidesAmino Acids, Peptides, and ProteinsThiazolesSulfur CompoundsOrganic ChemicalsAzolesOrganophosphonatesOrganophosphorus CompoundsAdeninePurinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingDeoxycytidineCytidinePyrimidine NucleosidesPyrimidinesDeoxyribonucleosidesNucleosidesNucleic Acids, Nucleotides, and NucleosidesDrug CombinationsPharmaceutical Preparations

Study Officials

  • Giovanni Di Perri, MD, PhD

    University of Turin, Italy

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Full professor of Infectious Diseases

Study Record Dates

First Submitted

July 10, 2013

First Posted

July 18, 2013

Study Start

September 1, 2014

Primary Completion

December 1, 2016

Study Completion

December 1, 2016

Last Updated

October 17, 2018

Record last verified: 2018-10

Locations