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HIV InfectionsPhase 3NCT00528957

Safety and Efficacy of Switching From Stavudine or Zidovudine to Tenofovir DF in HIV-1 Infected Children

A Phase 3 study testing Tenofovir DF, Zidovudine and Stavudine in people with HIV Infections, run by Gilead Sciences at 9 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of this study is to assess the efficacy of switching to tenofovir disoproxil fumarate (TDF) compared to continuing stavudine or zidovudine in maintaining virologic suppression in HIV-1 infected children. Read more about this study

Who is it for?
Ages 2 to 15 years
Conditions the study is for
HIV Infections
What is being tested?
Tenofovir DF, Zidovudine and Stavudine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
97 participants
Where
9 sitesin 3 countries
Study dates
28 Dec 2006to 16 Aug 2017
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 2 to 15 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Completed 48 weeks of treatment in Arm 1 or Arm 2 of the study
  • <18 years of age (at the start of the extension)
  • Participants initially randomized to Arm 2 will be given the option to replace stavudine or zidovudine with tenofovir DF in the 96-week extension at the investigator's discretion, if the investigator determines that tenofovir DF is safe and beneficial for the participant.
  • Key Inclusion Criteria for the Second and Third 96-Week Extension and Fourth Open-Ended Extension
  • Completed of treatment with study drug in the first extension phase
  • <18 years of age at the start of the extension. This inclusion criterion is not applicable in those regions where tenofovir DF is not commercially available for treatment of HIV-1 infection in adults.

Who cannot join

  • Participants receiving ongoing therapy with any of the following
  • Nephrotoxic agents
  • Systemic chemotherapeutic agents
  • Systemic corticosteroids
  • Interleukin 2 (IL 2) and other immunomodulating agents
  • Investigational agents
Show all 14Show fewer
  • Pregnant or lactating participants
  • Evidence of a gastrointestinal malabsorption syndrome or chronic nausea or vomiting which may confer an inability to receive an orally administered medication
  • Current alcohol or substance abuse judged by the investigator to potentially interfere with participant compliance
  • Malignancy other than cutaneous Kaposi's sarcoma (KS) or basal cell carcinoma.
  • Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic therapy within 15 days prior to screening
  • Prior history of significant renal disease (ie, nephrotic syndrome, renal dysgenesis, polycystic kidney disease, congenital nephrosis)
  • Prior history of significant bone disease (ie, osteomalacia, chronic osteomyelitis, osteogenesis imperfecta, osteochondroses, multiple bone fractures)
  • Note: Other protocol defined Inclusion/ Exclusion criteria may apply.

Trial locations and contacts

9 sites in 3 countries.

9 sites in 3 countries

United States6 sites
  • Children's Diagnostic and Treatment Center, Inc

    Fort Lauderdale, Florida, 33316

  • University of Florida, Jacksonville

    Jacksonville, Florida, 32209

  • Jeffrey Goodman Special Care Clinic

    Los Angeles, California, 90027

  • University California Los Angeles, School of Medicine, Pediatric, Infectious Diseases

    Los Angeles, California, 90095

  • St. Jude Children's Research Hospital

    Memphis, Tennessee, 38105

  • St. Christopher's Hospital for Children

    Philadelphia, Pennsylvania, 19134

Other trials in United States

United Kingdom2 sites
  • Great Ormond Street Hospital

    London

  • Imperial College London, Paediatrics Infectious Diseases

    London

Other trials in United Kingdom

Panama1 site
  • Hospital del Nino

    Panama City

Other trials in Panama

About this study

Official title: A Phase III, Randomized, Open-Label Study Comparing the Safety and Efficacy of Switching Stavudine or Zidovudine to Tenofovir Disoproxil Fumarate Versus Continuing Stavudine or Zidovudine in Virologically Suppressed HIV-Infected Children Taking Highly Active Antiretroviral Therapy

The primary objective of this study is to assess the efficacy of switching to tenofovir disoproxil fumarate (TDF) compared to continuing stavudine or zidovudine in maintaining virologic suppression in HIV-1 infected children.

Conditions
HIV Infections
Being tested
Tenofovir DF, Zidovudine, Stavudine
Keywords
Phase 3, Randomized, Open-Label, Treatment-Experienced, Highly Active Antiretroviral Therapy, HIV, Tenofovir DF, Pediatrics
Medical subject headings
HIV Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tenofovir DFDrug

    Also called Viread®

    Tenofovir DF (oral powder or tablet): 300-mg tablets for participants > 37 kg; 8-mg/kg oral powder (up to 300 mg) for participants ≤ 37 kg. During the extension phase, participants whose weight increases to > 37 kg may be switched from the oral powder to the tenofovir DF tablet.

  • ZidovudineDrug

    Zidovudine as prescribed by the investigator prior to study entry (pediatric participants < 30 kg: 1 mg/kg/dose given every 12 hours; pediatric participants ≥ 30 kg: 30 mg twice daily).

  • StavudineDrug

    Stavudine as prescribed by the investigator prior to study entry (pediatric participants 6 weeks to 12 years of age: 160 mg/m^2 every 8 hours; pediatric participants > 12 years of age: 300 mg twice daily).

Study groups in NCT00528957
Study groupRoleWhat they receive
Tenofovir DFExperimentalNot described
Receives: Drug: Tenofovir DF
stavudine or zidovudineActive comparatorNot described
Receives: Drug: Zidovudine; Drug: Stavudine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Week 48

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 48 weeks of exposure to randomized study drug.

    Measured: 48 weeks

Secondary outcomes (45)
  1. Virologic Success at 48 Weeks (HIV-1 RNA Cutoff at 400 Copies/mL, Snapshot)

    This is the percentage of participants with virologic success after 48 weeks of exposure to randomized study drug. The percentage of participants achieving HIV-1 RNA < 400 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

    Measured: 48 weeks

  2. Virologic Success at 48 Weeks (HIV-1 RNA Cutoff at 50 Copies/mL, Snapshot)

    This is the percentage of participants with virologic success after 48 weeks of exposure to randomized study drug. The percentage of participants achieving HIV-1 RNA < 50 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

    Measured: 48 weeks

  3. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Week 96

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 96 weeks of exposure to TDF.

    Measured: 96 weeks

  4. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Week 144

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 144 weeks of exposure to TDF.

    Measured: 144 weeks

  5. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 192 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 192 weeks of exposure to TDF.

    Measured: 192 weeks

  6. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 240 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 240 weeks of exposure to TDF.

    Measured: 240 weeks

  7. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 288 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 288 weeks of exposure to TDF.

    Measured: 288 weeks

  8. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 336 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 336 weeks of exposure to TDF.

    Measured: 336 weeks

  9. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 384 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 384 weeks of exposure to TDF.

    Measured: 384 weeks

  10. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 432 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 432 weeks of exposure to TDF.

    Measured: 432 weeks

  11. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 480 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 480 weeks of exposure to TDF.

    Measured: 480 weeks

  12. Percentage of Participants With HIV-1 RNA < 400 Copies/mL at 528 Weeks

    This is the percentage of participants with HIV-1 RNA < 400 copies/mL after 528 weeks of exposure to TDF.

    Measured: 528 weeks

  13. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 48 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 48 weeks of exposure to randomized study drug.

    Measured: 48 weeks

  14. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 96 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 96 weeks of exposure to TDF.

    Measured: 96 weeks

  15. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 144 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 144 weeks of exposure to TDF.

    Measured: 144 weeks

  16. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 192 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 192 weeks of exposure to TDF.

    Measured: 192 weeks

  17. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 240 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 240 weeks of exposure to TDF.

    Measured: 240 weeks

  18. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 288 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 288 weeks of exposure to TDF.

    Measured: 288 weeks

  19. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 336 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 336 weeks of exposure to TDF.

    Measured: 336 weeks

  20. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 384 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 384 weeks of exposure to TDF.

    Measured: 384 weeks

  21. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 432 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 432 weeks of exposure to TDF.

    Measured: 432 weeks

  22. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 480 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 480 weeks of exposure to TDF.

    Measured: 480 weeks

  23. Percentage of Participants With HIV-1 RNA < 50 Copies/mL at 528 Weeks

    This is the percentage of participants with HIV-1 RNA < 50 copies/mL after 528 weeks of exposure to TDF.

    Measured: 528 weeks

  24. Change From Baseline in CD4 Percentage at 48 Weeks

    This is the change from baseline in CD4 percentage after 48 weeks of exposure to randomized study drug.

    Measured: Baseline and 48 weeks

  25. Change From Baseline in CD4 Percentage at 96 Weeks

    This is the change from baseline in CD4 percentage after 96 weeks of exposure to TDF.

    Measured: Baseline and 96 weeks

  26. Change From Baseline in CD4 Percentage at 144 Weeks

    This is the change from baseline in CD4 percentage after 144 weeks of exposure to TDF.

    Measured: Baseline and 144 weeks

  27. Change From Baseline in CD4 Percentage at 192 Weeks

    This is the change from baseline in CD4 percentage after 192 weeks of exposure to TDF.

    Measured: Baseline and 192 weeks

  28. Change From Baseline in CD4 Percentage at 240 Weeks

    This is the change from baseline in CD4 percentage after 240 weeks of exposure to TDF.

    Measured: Baseline and 240 weeks

  29. Change From Baseline in CD4 Percentage at 288 Weeks

    This is the change from baseline in CD4 percentage after 288 weeks of exposure to TDF.

    Measured: Baseline and 288 weeks

  30. Change From Baseline in CD4 Percentage at 336 Weeks

    This is the change from baseline in CD4 percentage after 336 weeks of exposure to TDF.

    Measured: Baseline and 336 weeks

  31. Change From Baseline in CD4 Percentage at 384 Weeks

    This is the change from baseline in CD4 percentage after 384 weeks of exposure to TDF.

    Measured: Baseline and 384 weeks

  32. Change From Baseline in CD4 Percentage at 432 Weeks

    This is the change from baseline in CD4 percentage after 432 weeks of exposure to TDF.

    Measured: Baseline and 432 weeks

  33. Change From Baseline in CD4 Percentage at 480 Weeks

    This is the change from baseline in CD4 percentage after 480 weeks of exposure to TDF.

    Measured: Baseline and 480 weeks

  34. Change From Baseline in CD4 Percentage at 528 Weeks

    This is the change from baseline in CD4 percentage after 528 weeks of exposure to TDF.

    Measured: Baseline and 528 weeks

  35. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 48 Weeks

    This is the change from baseline in CD4 cell count after 48 weeks of exposure to randomized study drug.

    Measured: Baseline and 48 weeks

  36. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 96 Weeks

    This is the change from baseline in CD4 cell count after 96 weeks of exposure to TDF.

    Measured: Baseline and 96 weeks

  37. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 144 Weeks

    This is the change from baseline in CD4 cell count after 144 weeks of exposure to TDF.

    Measured: Baseline and 144 weeks

  38. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 192 Weeks

    This is the change from baseline in CD4 cell count after 192 weeks of exposure to TDF.

    Measured: Baseline and 192 weeks

  39. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 240 Weeks

    This is the change from baseline in CD4 cell count after 240 weeks of exposure to TDF.

    Measured: Baseline and 240 weeks

  40. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 288 Weeks

    This is the change from baseline in CD4 cell count after 288 weeks of exposure to TDF.

    Measured: Baseline and 288 weeks

  41. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 336 Weeks

    This is the change from baseline in CD4 cell count after 336 weeks of exposure to TDF.

    Measured: Baseline and 336 weeks

  42. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 384 Weeks

    This is the change from baseline in CD4 cell count after 384 weeks of exposure to TDF.

    Measured: Baseline and 384 weeks

  43. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 432 Weeks

    This is the change from baseline in CD4 cell count after 432 weeks of exposure to TDF.

    Measured: Baseline and 432 weeks

  44. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 480 Weeks

    This is the change from baseline in CD4 cell count after 480 weeks of exposure to TDF.

    Measured: Baseline and 480 weeks

  45. Change From Baseline in CD4 Cell Count (Cells/mm^3) at 528 Weeks

    This is the change from baseline in CD4 cell count after 528 weeks of exposure to TDF.

    Measured: Baseline and 528 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Sep 2007 (estimated)
  2. Study start28 Dec 2006
  3. Primary completion6 Apr 2009
  4. Study completion16 Aug 2017

Resources

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
97 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00528957
Sponsor's protocol ID
GS-US-104-0352
Other IDs
2007-003418-32
Status last verified
Feb 2018
First submitted
3 Jan 2007
Last updated
14 Mar 2018
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Saez-Llorens X, Castano E, Rathore M, Church J, Deville J, Gaur A, Estripeaut D, White K, Arterburn S, Enejosa JV, Cheng AK, Chuck SL, Rhee MS. A randomized, open-label study of the safety and efficacy of switching stavudine or zidovudine to tenofovir disoproxil fumarate in HIV-1-infected children with virologic suppression. Pediatr Infect Dis J. 2015 Apr;34(4):376-82. doi: 10.1097/INF.0000000000000289.

    PubMed 25760565

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tenofovir DF, Zidovudine and Stavudine in people with HIV Infections, run by Gilead Sciences at 9 sites in 3 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 6 inclusion and 14 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 14 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States, United Kingdom, Panama. 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 22 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?

Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Week 48 (time frame: 48 weeks). 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 NCT00528957, which also lists 1 linked publication.

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 14 Mar 2018.

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