HIV InfectionsPhase 3NCT00389207
Nevirapine or Atazanavir/Ritonavir Given With Emtricitabine/Tenofovir in Human Immunodeficiency Virus (HIV)-1-infected Treatment Naive Adults
A Phase 3 study testing nevirapine bid, nevirapine qd and atazanavir in people with HIV Infections, run by Boehringer Ingelheim at 68 sites in 10 countries.
Trial summary
Primary purpose of this study is to compare the efficacy and safety of two different nevirapine (Viramune) dosing regimens (once daily (QD) and twice daily (BID) application) and of atazanavir/ritonavir (Reyataz/Norvir), all on an emtricitabine/tenofovir disoproxil fumarate (DF) (Truvada) background. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- HIV Infections
- What is being tested?
- nevirapine bid, nevirapine qd and atazanavir
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 576 participants
- Where
- 68 sitesin 10 countries
- Study dates
- Oct 2006to Feb 2011
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed informed consent in accordance with Good Clinical Practice (GCP) and local regulatory requirements prior to trial participation
- HIV-1-infected males or females >= 18 years of age with positive serology confirmed by Western blot
- No previous antiretroviral treatment (of more than 7 days)
- Males with CD4+ counts of < 400 cells/mm3 and females with CD4+ counts of < 250 cells/mm3
- NVP- and ATZ/r susceptibility based on HIV-1 genotypic resistance report
- Adequate renal function defined as a calculated creatinine clearance (CLCr) >= 50 ml/min according to the Cockcroft-Gault formula
- Karnofsky score >= 70
- Acceptable medical history, as assessed by the investigator
Who cannot join
- Active drug abuse or chronic alcoholism at the investigator's discretion
- Hepatic cirrhosis stage Child-Pugh B or C
- Female patients of child-bearing potential who:
- have a positive serum pregnancy test at screening or during the study,
- are breast feeding,
- are planning to become pregnant,
Show all 17Show fewer
- are not willing to use a barrier method of contraception, or are not willing to use methods of contraception other than ethinyl estradiol containing oral contraceptives
- Laboratory parameters Division of Acquired Immunodeficiency Syndrome (DAIDS) > grade 2 (triglycerides > DAIDS grade 3; total cholesterol no restrictions)
- Active hepatitis B or C disease, defined as HBsAg-positive or Hepatitis C-Virus-Ribo Nucleic Acid (HCV-RNA)- positive with Aspartate Transaminase/Alanine Transaminase (AST/ALT) > 2.5x Upper Limit of Normal (ULN) (DAIDS grade 1)
- Hypersensitivity to any ingredients of the test products
- Have therapy with nephrotoxic drugs (e.g., aminoglycosides, amphotericin B, vancomycin, cidofovir, foscarnet, cisplatin, pentamidine, tacrolimus, cyclosporine) or potential competitors of renal excretion (e.g., cidofovir, acyclovir, valacyclovir, ganciclovir, valganciclovir, probenecid, high-dose non-steroidal anti-inflammatory drugs (i.e., ibuprofen)) within 3 months prior to study screening or are expected to receive these during the study
- Patients who are receiving other concomitant treatments which are not permitted
- Use of other investigational medications within 30 days before study entry or during the trial
- Use of immunomodulatory drugs within 30 days before study entry or during the trial (e.g., interferon, cyclosporin, hydroxyurea, interleukin 2, chronic treatment with prednisone)
- Patients with Progressive Multifocal Leukoencephalopathy (PML), Visceral Kaposi's Sarcoma (KS), and/or any lymphoma
- Any AIDS defining illness that is unresolved, symptomatic or not stable on treatment for at least 12 weeks at screening visit
- Patients who are receiving systemic treatment for malignant disease
Trial locations and contacts
68 sites in 10 countries.
68 sites in 10 countries
Germany17 sites
1100.1470.49001 Boehringer Ingelheim Investigational Site
Berlin
1100.1470.49002 Boehringer Ingelheim Investigational Site
Berlin
1100.1470.49003 Boehringer Ingelheim Investigational Site
Bochum
1100.1470.49018 Boehringer Ingelheim Investigational Site
Bonn
1100.1470.49014 Boehringer Ingelheim Investigational Site
Düsseldorf
1100.1470.49008 Boehringer Ingelheim Investigational Site
Erlangen
1100.1470.49035 Boehringer Ingelheim Investigational Site
Frankfurt
1100.1470.49036 Boehringer Ingelheim Investigational Site
Frankfurt am Main
1100.1470.49033 Boehringer Ingelheim Investigational Site
Freiburg/Breisgau
1100.1470.49016 Boehringer Ingelheim Investigational Site
Hamburg
1100.1470.49031 Boehringer Ingelheim Investigational Site
Hamburg
1100.1470.49037 Boehringer Ingelheim Investigational Site
Hamburg
1100.1470.49020 Boehringer Ingelheim Investigational Site
Hanover
1100.1470.49038 Boehringer Ingelheim Investigational Site
Magdeburg
1100.1470.49034 Boehringer Ingelheim Investigational Site
München
1100.1470.49000 Boehringer Ingelheim Investigational Site
Ulm
1100.1470.49032 Boehringer Ingelheim Investigational Site
Würzburg
Spain14 sites
1100.1470.34013 Boehringer Ingelheim Investigational Site
Alcalá de Henares (Madrid)
1100.1470.34008 Boehringer Ingelheim Investigational Site
Badalona
1100.1470.34002 Boehringer Ingelheim Investigational Site
Barcelona
1100.1470.34003 Boehringer Ingelheim Investigational Site
Barcelona
1100.1470.34004 Boehringer Ingelheim Investigational Site
Donostia / San Sebastian
1100.1470.34009 Boehringer Ingelheim Investigational Site
L'Hospitalet de Llobregat
1100.1470.34010 Boehringer Ingelheim Investigational Site
Madrid
1100.1470.34012 Boehringer Ingelheim Investigational Site
Madrid
1100.1470.34014 Boehringer Ingelheim Investigational Site
Madrid
1100.1470.34015 Boehringer Ingelheim Investigational Site
Madrid
1100.1470.34019 Boehringer Ingelheim Investigational Site
Málaga
1100.1470.34007 Boehringer Ingelheim Investigational Site
Sabadell (Barcelona)
1100.1470.34006 Boehringer Ingelheim Investigational Site
Santa Cruz de Tenerife
1100.1470.34011 Boehringer Ingelheim Investigational Site
Vigo
Italy8 sites
1100.1470.39001 Boehringer Ingelheim Investigational Site
Bergamo
1100.1470.39003 Boehringer Ingelheim Investigational Site
Bologna
1100.1470.39012 Ospedale Sant'Anna
Como
1100.1470.39006 Boehringer Ingelheim Investigational Site
Ferrara
1100.1470.39010 Boehringer Ingelheim Investigational Site
Lecco
1100.1470.39004 Boehringer Ingelheim Investigational Site
Torino
1100.1470.39009 Boehringer Ingelheim Investigational Site
Torrette Di Ancona
1100.1470.39007 Boehringer Ingelheim Investigational Site
Varese
Mexico6 sites
1100.1470.55006 Boehringer Ingelheim Investigational Site
Aguascalientes
1100.1470.55004 Boehringer Ingelheim Investigational Site
Col Obregón
1100.1470.55008 Boehringer Ingelheim Investigational Site
Col. Los Filtros, San Luis Potosí
1100.1470.55001 Boehringer Ingelheim Investigational Site
Col. Toriello Guerra
1100.1470.55007 Boehringer Ingelheim Investigational Site
Guadalajara Jal.
1100.1470.55003 Boehringer Ingelheim Investigational Site
Tlalpan-México D,F
United Kingdom6 sites
1100.1470.44004 Boehringer Ingelheim Investigational Site
Birmingham
1100.1470.44001 Boehringer Ingelheim Investigational Site
London
1100.1470.44002 Boehringer Ingelheim Investigational Site
London
1100.1470.44005 Boehringer Ingelheim Investigational Site
London
1100.1470.44006 Boehringer Ingelheim Investigational Site
London
1100.1470.44003 Boehringer Ingelheim Investigational Site
Manchester
Argentina4 sites
1100.1470.54004 Boehringer Ingelheim Investigational Site
Capital Federal
1100.1470.54002 Boehringer Ingelheim Investigational Site
Córdoba
1100.1470.54003 Boehringer Ingelheim Investigational Site
Mar del Plata
1100.1470.54001 Boehringer Ingelheim Investigational Site
Rosario
Poland4 sites
1100.1470.48003 Boehringer Ingelheim Investigational Site
Bydgoszcz
1100.1470.48001 Boehringer Ingelheim Investigational Site
Chorzów
1100.1470.48002 Boehringer Ingelheim Investigational Site
Szczecin
1100.1470.48004 Boehringer Ingelheim Investigational Site
Warsaw
Switzerland4 sites
1100.1470.41004 Boehringer Ingelheim Investigational Site
Bern
1100.1470.41001 Boehringer Ingelheim Investigational Site
Lugano
1100.1470.41003 Boehringer Ingelheim Investigational Site
Sankt Gallen
1100.1470.41002 Boehringer Ingelheim Investigational Site
Zurich
Portugal3 sites
1100.1470.35102 Boehringer Ingelheim Investigational Site
Cascais
1100.1470.35101 Boehringer Ingelheim Investigational Site
Lisbon
1100.1470.35103 Boehringer Ingelheim Investigational Site
Porto
Romania2 sites
1100.1470.40001 Boehringer Ingelheim Investigational Site
Bucharest
1100.1470.40002 Boehringer Ingelheim Investigational Site
Bucharest
About this study
Official title: Randomized, Open Label Study Evaluating the Lipid Profile Difference and Efficacy of a Combined Therapy Including Tenofovir, Emtricitabine + Atazanavir / r or NVP in Naive HIV - 1 Infected Patients.
Primary purpose of this study is to compare the efficacy and safety of two different nevirapine (Viramune) dosing regimens (once daily (QD) and twice daily (BID) application) and of atazanavir/ritonavir (Reyataz/Norvir), all on an emtricitabine/tenofovir disoproxil fumarate (DF) (Truvada) background. Patients will receive either nevirapine (NVP) 200 mg twice daily, or NVP 400 mg once daily , or ritonavir-boosted atazanavir (ATZ/r), all in combination with emtricitabine (FTC) and tenofovir DF (TDF).
All patients receiving NVP will start at 200 mg once daily for 2 weeks, because it has been demonstrated that this lead-in dosing regimen reduces the frequency of NVP-induced rash. At Visit 3 (Week 2), patients increase the NVP dose to either 200 mg twice daily or to 400 mg once daily. Patients receiving ATZ/r will be treated with ATZ 300 mg once daily, boosted by 100 mg ritonavir (RTV) once daily. Background antiretroviral therapy for all patients consists of one tablet of Truvada. Treatment duration is 48 weeks (primary endpoint) with an extension to 144 weeks. Patients may also participate in the metabolic sub-study, comparing NVP and ATZ/r for signs and symptoms of lipodystrophy and serum lipid/glycaemic abnormalities.
- Conditions
- HIV Infections
- Being tested
- nevirapine bid, nevirapine qd, atazanavir
- Medical subject headings
- HIV Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
nevirapine bidDrug
nevirapine twice daily
nevirapine qdDrug
nevirapine once daily
atazanavirDrug
atazanavir once daily
| Study group | Role | What they receive |
|---|---|---|
| NVP bid | Active comparator | nevirapine (NVP) 200 mg BID in combination with emtricitabine (FTC) and tenofovir DF (TDF) Receives: Drug: nevirapine bid |
| NVP qd | Experimental | nevirapine (NVP) 400 mg QD in combination with emtricitabine (FTC) and tenofovir DF (TDF) Receives: Drug: nevirapine qd |
| ATZ/r | Active comparator | ritonavir-boosted atazanavir in combination with emtricitabine (FTC) and tenofovir DF (TDF) Receives: Drug: atazanavir |
What is being measured
The primary outcome is the main question the study is designed to answer.
Treatment Response at Week 48
Treatment response is defined as a viral load (VL) <50 copies/mL measured at two consecutive visits prior to Week 48 and without subsequent rebound or change of antiretroviral (ARV) therapy prior to Week 48.
Measured: From baseline to Week 48
Secondary outcomes (33)
Treatment Response at Week 48 (TLOVR Algorithm)
Treatment response is defined as a VL <50 copies/mL measured at two consecutive visits up to Week 48 and without subsequent rebound or change of ARV therapy up to Week 48, based on time to loss of virologic response (TLOVR) algorithm, as a sensitivity analysis for the primary analysis.
Measured: From baseline to Week 48
Proportion of Patients With VL < 50 Copies/ml
VL <50 copies/mL among observed patients on treatment at each visit, with the final visit at Week 144 or end of trial (EOT) for the patient
Measured: From baseline to Weeks 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132 and 144/EOT
Proportion of Patients With VL < 400 Copies/ml
VL <400 copies/mL among observed patients on treatment at each visit, with the final visit at Week 144 or end of trial (EOT)
Measured: From baseline to Weeks 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132 and 144/EOT
Change in CD4+ Count From Baseline
Change in CD4+ cell count from baseline among patients on treatment at each visit, with the final visit at Week 144 or EOT
Measured: From baseline to Weeks 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132 and 144/EOT
Change in Framingham Score From Baseline
Change in the estimated risk of cardiovascular disease using the Framingham algorithm from baseline to after 48, 96 and 144 weeks, last observation carried forward (LOCF). The score is based on age, gender, systolic blood pressure, total cholesterol, high density lipoprotein cholesterol and smoking status. Scores range from 0 to 21 with higher scores indicating a greater risk.
Measured: From baseline to Weeks 48, 96 and 144/EOT
Change in Mental Health Summary (MHS) Score From Baseline
Quality of life (QoL) assessment by change in MHS score from baseline to after 48, 96 and 144 weeks (observed cases), from the Medical Outcomes Study HIV Health Survey (MOS-HIV), a 35-item self-administered questionnaire including 10 scales covering: health perceptions, pain, physical functioning, role functioning, social and cognitive functioning, mental health, energy/fatigue, health distress, and QoL. The MHS is a weighted average of the 10 scales and ranges from 0 to 100 with higher scores indicating better QoL.
Measured: From baseline to Weeks 48, 96 and 144/EOT
Change in Physical Health Summary (PHS) Score From Baseline
QoL assessment by change in PHS score from baseline to after 48, 96 and 144 weeks (observed cases), from the MOS-HIV, a 35-item self-administered questionnaire including 10 scales covering: health perceptions, pain, physical functioning, role functioning, social and cognitive functioning, mental health, energy/fatigue, health distress, and QoL. The PHS is a weighted average of the 10 scales and ranges from 0 to 100 with higher scores indicating better QoL.
Measured: From baseline to Weeks 48, 96 and 144/EOT
Number of Patients Hospitalized
Cost effectiveness assessment by number of patients hospitalized
Measured: From baseline to Week 24, Week 24 to 48, Week 48 to 96, and Week 96 to 144/EOT
Non-scheduled Physician Visits
Cost effectiveness assessment by number of patients with non-scheduled physician visits
Measured: From baseline to Week 24, Week 24 to 48, Week 48 to 96, and Week 96 to 144/EOT
Genotypic Resistance Associated With Virologic Failure
Number of treatment-emergent drug-associated substitutions in patients with virological failure up to Week 48. The total number of genotypic mutations in those patients who were virologic failures is given, not the number of patients with mutations.
Measured: From baseline to Week 48
Treatment-emergent AIDS-defining Illness
Treatment-emergent AIDS-defining illness (tr.-emerg. AIDS-def.illness) including worsening during treatment
Measured: From baseline to Week 144
Treatment-emergent AIDS-defining Illness Leading to Death
Patients with an AIDS-defining illness leading to death broken out by treatment. Statistical analysis shows time to death from AIDS-defining illness.
Measured: From baseline to Week 144
Lipodystrophy
Number of patients with AE lipodystrophy
Measured: From baseline to Week 144
Serum Lipid Abnormalities
Number of patients with AE elevated serum lipids (i.e. hypercholesterolaemia)
Measured: From baseline to Week 144
Glycaemic Abnormalities
Number of patients with AE elevated serum glucose
Measured: From baseline to Week 144
Treatment Response at Week 96
Treatment response is defined as a viral load (VL) <50 copies/mL measured at two consecutive visits prior to Week 96 and without subsequent rebound or change of antiretroviral (ARV) therapy prior to Week 96.
Measured: From baseline to Week 96
Treatment Response at Week 144
Treatment response is defined as a viral load (VL) <50 copies/mL measured at two consecutive visits prior to Week 144 and without subsequent rebound or change of antiretroviral (ARV) therapy prior to Week 144.
Measured: From baseline to Week 144
Proportion of Patients With Virological Rebound With VL >=50 Copies/mL After CVR (Confirmed Virological Response) at Week 24, 48, 96, 144
The analyses of virologic rebound were performed on the original values at each visit(ORGV) rather than calculated results within time windows (CAL)
Measured: at Week 24, 48, 96, 144
Proportion of Patients With Virological Rebound With VL >=400 Copies/mL After CVR at Week 24, 48, 96, 144
The analyses of virologic rebound were performed on the original values at each visit(ORGV) rather than calculated results within time windows (CAL)
Measured: at Week 24, 48, 96, 144
Proportion of Patients With Virologic Failure at Week 48, 96, 144
Measured: at Week 48, 96, 144
Time to Treatment Response (First Confirmed VL<50 Copies/mL)
Time to treatment response was defined as the time from start of treatment until the first measurement of the first confirmed virological response
Measured: baseline to week 144
Time to Loss of Virologic Response (Rebound)
Time to loss of virologic response (TLOVR) was defined as the time from start of treatment to the first measurement showing VL ≥ 50 copies/mL in the first virologic rebound, after having a confirmed virological response.
Measured: Baseline to week 144
Time to Treatment Failure
Treatment failure is defined as the occurrence of the first of at least one of the following events: early discontinuation of trial drug, change in ARV therapy, failure to achieve an HIV RNA count < 50 copies/mL up to Visit 10 (week 48) or loss of virologic response
Measured: baseline to week 144
Change in the Calculated Glomerular Filtration Rate (GFR) at Week 48, 96 and 144
Calculations based on the MDRD algorithm.
Measured: From baseline to Week 48, 96, 144
Proportion of Patients With >= DAIDS Grade 2 Laboratory Abnormalities
Measured: week 148
Proportion of Patients Reporting Rash of Any Severity
Proportion of Patients reporting rash of any severity
Measured: week 148
Proportion of Patients Reporting Hepatic Events of Any Severity
Proportion of Patients reporting hepatic events of any severity
Measured: week 148
Proportion of Patients Reporting CNS (Central Nervous System) Side Effects of Any Severity
Proportion of Patients reporting CNS (central nervous system) side effects of any severity
Measured: week 148
Change of Cholesterol Values From Baseline to Week 48, 96, 144
Changes frombaseline in total cholesterol, LDL-cholesterol(LDL-c) and HDL
Measured: baseline to week 48, 96, 144
Changes of Apolipoprotein Values From Baseline to Week 48, 96, 144
Changes frombaseline apolipoprotein A1 \& B
Measured: baseline to week 48, 96, 144
Change of hsCRP From Baseline to Week 48, 96, 144
Change of hsCRP from baseline to week 48, 96, 144
Measured: baseline to week 48, 96, 144
Change of Total Triglycerides From Baseline to Week 48, 96, 144
Change of total triglycerides from baseline to week 48, 96, 144
Measured: baseline to week 48, 96, 144
Change of Total Cholesterol to HDL-cholesterol Ratio From Baseline to Week 48, 96, 144
Change of Total cholesterol to HDL-cholesterol ratio from baseline to week 48, 96, 144
Measured: baseline to week 48, 96, 144
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Oct 2006 (estimated)
- Study startOct 2006
- Primary completionFeb 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for HIV InfectionsStudies of the same condition, open and under way.
- More trials run by Boehringer IngelheimThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 576 participants (actual)
Sponsor and investigators
- Lead sponsor
- Boehringer Ingelheim
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Boehringer Ingelheim, Study chair, Boehringer Ingelheim
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00389207
- Sponsor's protocol ID
- 1100.1470
- Other IDs
- 2005-004330-40, 2005
- Status last verified
- Dec 2013
- First submitted
- 17 Oct 2006
- Last updated
- 27 Jan 2014
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Seclen E, Soriano V, Gonzalez MM, Martin-Carbonero L, Gellermann H, Distel M, Kadus W, Poveda E. Impact of baseline HIV-1 tropism on viral response and CD4 cell count gains in HIV-infected patients receiving first-line antiretroviral therapy. J Infect Dis. 2011 Jul 1;204(1):139-44. doi: 10.1093/infdis/jir218.
PubMed 21628668Soriano V, Arasteh K, Migrone H, Lutz T, Opravil M, Andrade-Villanueva J, Antunes F, Di Perri G, Podzamczer D, Taylor S, Domingo P, Gellermann H, de Rossi L; ARTEN investigators. Nevirapine versus atazanavir/ritonavir, each combined with tenofovir disoproxil fumarate/emtricitabine, in antiretroviral-naive HIV-1 patients: the ARTEN Trial. Antivir Ther. 2011;16(3):339-48. doi: 10.3851/IMP1745.
PubMed 21555816
Study at a glance
From the registry record, last updated by the sponsor on 27 Jan 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized, Open Label Study Evaluating the Lipid Profile Difference and Efficacy of a Combined Therapy Including Tenofovir, Emtricitabine + Atazanavir / r or NVP in Naive HIV - 1 Infected Patients.
- ClinicalTrials.gov ID
- NCT00389207
- Acronym / sponsor ID
- 1100.1470
- Conditions
- HIV Infections
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 576 participants (actual)
- Lead sponsor
- Boehringer IngelheimIndustry (pharma, biotech, devices)
- Study start
- Oct 2006
- Primary completion
- Feb 2011 (actual)
- First posted
- 18 Oct 2006 (estimated)
- Results
- Posted 26 Mar 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary purpose of this study is to compare the efficacy and safety of two different nevirapine (Viramune) dosing regimens (once daily (QD) and twice daily (BID) application) and of atazanavir/ritonavir (Reyataz/Norvir), all on an emtricitabine/tenofovir disoproxil fumarate (DF) (Truvada) background. Patients will receive either nevirapine (NVP) 200 mg twice daily, or NVP 400 mg once daily , or ritonavir-boosted atazanavir (ATZ/r), all in combination with emtricitabine (FTC) and tenofovir DF (TDF).
All patients receiving NVP will start at 200 mg once daily for 2 weeks, because it has been demonstrated that this lead-in dosing regimen reduces the frequency of NVP-induced rash. At Visit 3 (Week 2), patients increase the NVP dose to either 200 mg twice daily or to 400 mg once daily. Patients receiving ATZ/r will be treated with ATZ 300 mg once daily, boosted by 100 mg ritonavir (RTV) once daily. Background antiretroviral therapy for all patients consists of one tablet of Truvada. Treatment duration is 48 weeks (primary endpoint) with an extension to 144 weeks. Patients may also participate in the metabolic sub-study, comparing NVP and ATZ/r for signs and symptoms of lipodystrophy and serum lipid/glycaemic abnormalities.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| NVP bid | Active comparator | Drug: nevirapine bidnevirapine (NVP) 200 mg BID in combination with emtricitabine (FTC) and tenofovir DF (TDF) |
| NVP qd | Experimental | Drug: nevirapine qdnevirapine (NVP) 400 mg QD in combination with emtricitabine (FTC) and tenofovir DF (TDF) |
| ATZ/r | Active comparator | Drug: atazanavirritonavir-boosted atazanavir in combination with emtricitabine (FTC) and tenofovir DF (TDF) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Signed informed consent in accordance with Good Clinical Practice (GCP) and local regulatory requirements prior to trial participation
- HIV-1-infected males or females >= 18 years of age with positive serology confirmed by Western blot
- No previous antiretroviral treatment (of more than 7 days)
- Males with CD4+ counts of < 400 cells/mm3 and females with CD4+ counts of < 250 cells/mm3
- NVP- and ATZ/r susceptibility based on HIV-1 genotypic resistance report
Key exclusion criteria (17 listed)
- Active drug abuse or chronic alcoholism at the investigator's discretion
- Hepatic cirrhosis stage Child-Pugh B or C
- Female patients of child-bearing potential who:
- Laboratory parameters Division of Acquired Immunodeficiency Syndrome (DAIDS) > grade 2 (triglycerides > DAIDS grade 3; total cholesterol no restrictions)
- Active hepatitis B or C disease, defined as HBsAg-positive or Hepatitis C-Virus-Ribo Nucleic Acid (HCV-RNA)- positive with Aspartate Transaminase/Alanine Transaminase (AST/ALT) > 2.5x Upper Limit of Normal (ULN) (DAIDS grade 1)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| nevirapine bidnevirapine twice daily | Drug | NVP bid |
| nevirapine qdnevirapine once daily | Drug | NVP qd |
| atazanaviratazanavir once daily | Drug | ATZ/r |
Primary outcome
Treatment Response at Week 48
Time frame: From baseline to Week 48
Treatment response is defined as a viral load (VL) <50 copies/mL measured at two consecutive visits prior to Week 48 and without subsequent rebound or change of antiretroviral (ARV) therapy prior to Week 48.
33 secondary outcomes
Treatment Response at Week 48 (TLOVR Algorithm)
Time frame: From baseline to Week 48
Proportion of Patients With VL < 50 Copies/ml
Time frame: From baseline to Weeks 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132 and 144/EOT
Proportion of Patients With VL < 400 Copies/ml
Time frame: From baseline to Weeks 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132 and 144/EOT
Change in CD4+ Count From Baseline
Time frame: From baseline to Weeks 4, 8, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132 and 144/EOT
Change in Framingham Score From Baseline
Time frame: From baseline to Weeks 48, 96 and 144/EOT
Change in Mental Health Summary (MHS) Score From Baseline
Time frame: From baseline to Weeks 48, 96 and 144/EOT
Change in Physical Health Summary (PHS) Score From Baseline
Time frame: From baseline to Weeks 48, 96 and 144/EOT
Number of Patients Hospitalized
Time frame: From baseline to Week 24, Week 24 to 48, Week 48 to 96, and Week 96 to 144/EOT
Non-scheduled Physician Visits
Time frame: From baseline to Week 24, Week 24 to 48, Week 48 to 96, and Week 96 to 144/EOT
Genotypic Resistance Associated With Virologic Failure
Time frame: From baseline to Week 48
Treatment-emergent AIDS-defining Illness
Time frame: From baseline to Week 144
Treatment-emergent AIDS-defining Illness Leading to Death
Time frame: From baseline to Week 144
Lipodystrophy
Time frame: From baseline to Week 144
Serum Lipid Abnormalities
Time frame: From baseline to Week 144
Glycaemic Abnormalities
Time frame: From baseline to Week 144
Treatment Response at Week 96
Time frame: From baseline to Week 96
Treatment Response at Week 144
Time frame: From baseline to Week 144
Proportion of Patients With Virological Rebound With VL >=50 Copies/mL After CVR (Confirmed Virological Response) at Week 24, 48, 96, 144
Time frame: at Week 24, 48, 96, 144
Proportion of Patients With Virological Rebound With VL >=400 Copies/mL After CVR at Week 24, 48, 96, 144
Time frame: at Week 24, 48, 96, 144
Proportion of Patients With Virologic Failure at Week 48, 96, 144
Time frame: at Week 48, 96, 144
Time to Treatment Response (First Confirmed VL<50 Copies/mL)
Time frame: baseline to week 144
Time to Loss of Virologic Response (Rebound)
Time frame: Baseline to week 144
Time to Treatment Failure
Time frame: baseline to week 144
Change in the Calculated Glomerular Filtration Rate (GFR) at Week 48, 96 and 144
Time frame: From baseline to Week 48, 96, 144
Proportion of Patients With >= DAIDS Grade 2 Laboratory Abnormalities
Time frame: week 148
Proportion of Patients Reporting Rash of Any Severity
Time frame: week 148
Proportion of Patients Reporting Hepatic Events of Any Severity
Time frame: week 148
Proportion of Patients Reporting CNS (Central Nervous System) Side Effects of Any Severity
Time frame: week 148
Change of Cholesterol Values From Baseline to Week 48, 96, 144
Time frame: baseline to week 48, 96, 144
Changes of Apolipoprotein Values From Baseline to Week 48, 96, 144
Time frame: baseline to week 48, 96, 144
Change of hsCRP From Baseline to Week 48, 96, 144
Time frame: baseline to week 48, 96, 144
Change of Total Triglycerides From Baseline to Week 48, 96, 144
Time frame: baseline to week 48, 96, 144
Change of Total Cholesterol to HDL-cholesterol Ratio From Baseline to Week 48, 96, 144
Time frame: baseline to week 48, 96, 144
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Jan 2014.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 21628668Seclen E, Soriano V, Gonzalez MM, Martin-Carbonero L, Gellermann H, Distel M, Kadus W, Poveda E. Impact of baseline HIV-1 tropism on viral response and CD4 cell count gains in HIV-infected patients receiving first-line antiretroviral therapy. J Infect Dis. 2011 Jul 1;204(1):139-44. doi: 10.1093/infdis/jir218.
- Derived from this study: PubMed 21555816Soriano V, Arasteh K, Migrone H, Lutz T, Opravil M, Andrade-Villanueva J, Antunes F, Di Perri G, Podzamczer D, Taylor S, Domingo P, Gellermann H, de Rossi L; ARTEN investigators. Nevirapine versus atazanavir/ritonavir, each combined with tenofovir disoproxil fumarate/emtricitabine, in antiretroviral-naive HIV-1 patients: the ARTEN Trial. Antivir Ther. 2011;16(3):339-48. doi: 10.3851/IMP1745.
- Related InfoLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Boehringer Ingelheim study chair
Boehringer Ingelheim
68 sites in 10 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing nevirapine bid, nevirapine qd and atazanavir in people with HIV Infections, run by Boehringer Ingelheim at 68 sites in 10 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Jan 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 68 sites in Germany, Spain, Italy, Mexico, United Kingdom and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 26 Mar 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Treatment Response at Week 48 (time frame: From baseline to Week 48). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00389207, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jan 2014.