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HIVPhase 3PRINCE2NCT01335698

Phase IIIB Study Evaluating the Effects of Atazanavir Powder With Ritonavir in HIV-infected Pediatric Patients

A Phase 3 study testing Atazanavir Sulphate and Ritonavir in people with HIV, run by Bristol-Myers Squibb at 32 sites in 11 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 purpose of this study is to describe the safety, efficacy, and pharmacokinetics of a regimen of atazanavir powder boosted with ritonavir and an optimized dual nucleoside reverse transcriptase inhibitor in pediatric patients aged ≥3 months to <11 years. Read more about this study

Who is it for?
Ages 3 months to 11 years
Conditions the study is for
HIV
What is being tested?
Atazanavir Sulphate and Ritonavir
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
32 sitesin 11 countries
Study dates
27 May 2011to 22 Jan 2018
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 3 months to 11 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Confirmed HIV-1 infection diagnosed by protocol criteria
  • Screening HIV RNA level ≥1000 copies/mL
  • ≥3 months to <11 years of age at time of first treatment
  • Antiretroviral-naive or -experienced
  • At screening, all participants must have genotypic sensitivity to atazanavir and at least 2 nucleoside reverse transcriptase inhibitors (NRTIs), which must be approved for pediatric use at the local country.
  • Antiretroviral-experienced patients must also have documented phenotypic sensitivity at screening to atazanavir (Fold Change in susceptibility <2.2) and to at least 2 NRTIs that are approved in their country

Who cannot join

  • Experienced participants who received atazanavir or atazanavir/ritonavir at any time prior to study enrollment or who have a history of 2 or more protease inhibitor failures
  • Antiretroviral-naïve or -experienced HIV-1-infected patients with contraindication to study medications
  • Cardiac rhythm abnormalities
  • Need for tenofovir
  • Weight <5 or ≥35kg
  • >Grade 2 abnormality in aspartate transaminase/alanine transaminase levels
  • Coinfection with either hepatitis B or C virus
  • Any active Centers for Disease Control and Prevention Category C clinical condition

Trial locations and contacts

32 sites in 11 countries.

32 sites in 11 countries

South Africa8 sites
  • Local Institution

    Benoni, Gauteng, 1501

  • Local Institution

    Bloemfontein, Free State, 9301

  • Local Institution

    Coronationville, Gauteng, 2092

  • Local Institution

    Parrow Valley, Western Cape, 7505

  • Local Institution

    Port Elizabeth, Eastern Cape, 6001

  • Local Institution

    Port Elizabeth, Eastern Cape, 6014

  • Local Institution

    Pretoria, Gauteng, 0001

  • Local Institution

    Soweto, Gauteng, 2001

Other trials in South Africa

Mexico6 sites
  • Local Institution

    Df, Mexico City, 06720

  • Local Institution

    Guadalajara, Jalisco, 44160

  • Local Institution

    Guadalajara, Jalisco, 44280

  • Local Institution

    Mérida, Yucatán, 97000

  • Local Institution

    Oaxaca City, 71256

  • Local Institution

    Puebla City, 72000

Other trials in Mexico

Brazil4 sites
  • Local Institution

    Porto Alegre, Rio Grande do Sul, 90020-090

  • Local Institution

    Porto Alegre, Rio Grande do Sul, 90035-903

  • Local Institution

    Recife, Pernambuco, 50070-500

  • Local Institution

    Ribeirão Preto, São Paulo, 14049-900

Other trials in Brazil

Russia3 sites
  • Local Institution

    Saint Petersburg, 189635

  • Local Institution

    Saint Petersburg, 198103

  • Local Institution

    Smolensk, 214006

Other trials in Russia

United States2 sites
  • SUNY Upstate Medical University

    Syracuse, New York, 13210

  • Children'S National Medical Center

    Washington D.C., District of Columbia, 20010

Other trials in United States

Argentina2 sites
  • Local Institution

    Buenos Aires, Bs As, Buenos Aires, 1141

  • Local Institution

    Bunos Aires, Buenos Aires, 1425

Other trials in Argentina

Chile2 sites
  • Local Institution

    Santiago, Santiago Metropolitan, 8380418

  • Local Institution

    Santiago, Santiago Metropolitan

Other trials in Chile

Spain2 sites
  • Local Institution

    Barcelona, 08950

  • Local Institution

    Madrid, 28041

Other trials in Spain

Poland1 site
  • Local Institution

    Warsaw, 01-201

Other trials in Poland

Romania1 site
  • Local Institution

    Bucharest, 72205

Other trials in Romania

United Kingdom1 site
  • Local Institution

    Birmingham, WEST Midlands, B9 5ST

Other trials in United Kingdom

About this study

Official title: A Prospective Single Arm, Open-label, International, Multicenter Study to Evaluate the Safety, Efficacy and Pharmacokinetics of Atazanavir (ATV) Powder Boosted With Ritonavir (RTV) With an Optimized NRTI Background Therapy, in Human Immunodeficiency Virus (HIV) Infected, Antiretroviral, Naive and Experienced Pediatric Subjects From 3 Months to Less Than 11 Years.(Pediatric Atazanavir International Clinical Evaluation: the PRINCE II Study)

The purpose of this study is to describe the safety, efficacy, and pharmacokinetics of a regimen of atazanavir powder boosted with ritonavir and an optimized dual nucleoside reverse transcriptase inhibitor in pediatric patients aged ≥3 months to <11 years.

Conditions
HIV
Being tested
Atazanavir Sulphate, Ritonavir
Keywords
Pediatric

What participants receive

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

  • Atazanavir SulphateDrug

    Also called Reyataz, BMS-232632

  • RitonavirDrug

    Also called Norvir

Study groups in NCT01335698
Study groupRoleWhat they receive
Stage 1: Atazanavir + RitonavirExperimentalParticipants received atazanavir powder orally (dosed by weight: 5 to <10 kg=150 mg, 5 to <10 kg=200 mg, 10 to <15 kg=200 mg, 15 to <25 kg=250 mg, 25 to <35 kg=300 mg) once daily for 24 to 48 weeks or a weight ≥35 kg. Participants also received ritonavir once daily for 24 to 48 weeks or weight ≥35 kg in the form of 80-mg/mL solution, orally (dosed by weight 5 to <25 kg=80 mg, 25 to <35 kg=100 mg); 100-mg capsule, orally (dosed by weight 25 to <35 kg=100 mg); or 100-mg tablet, orally (dosed by weight 25 to <35 kg=100 mg)
Receives: Drug: Atazanavir Sulphate; Drug: Ritonavir

What is being measured

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

  1. Number of Participants Who Died and With Adverse Events (AEs) Leading to Discontinuation, Hyperbilirubinemia, Jaundice, First-degree Arterioventricular Block, Tachycardia, and Rash on ATV Powder

    AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment.

    Measured: Day one to week 300 (approximately 22-Jan-2018)

  2. Number of Participants Who Experienced a SAE on ATV Powder

    SAE= any of the the following: is life-threatening (defined as an event in which the subject was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe), requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is an important medical event (defined as a medical event(s) that may not be immediately life threatening or result in death or hospitalization but, based upon appropriate medical and scientific judgment, may jeopardize the subject or may require intervention [eg, medical, surgical] to prevent one of the other serious outcomes listed in the definition above.) Examples of such events include, but are not limited to, intensive treatment in an emergency room or at home for allergic bronchospasm; blood dyscrasias or convulsions that do not result in hospitalization

    Measured: Day one to week 300 (approximately 22-Jan-2018)

  3. Number of Participants With A Center of Disease Control and Prevention (CDC) Class C AIDS Event on ATV Powder

    The CDC disease staging system assesses the severity of HIV disease by CD4 cell counts and by the presence of specific HIV-related conditions. CD4 counts are classified as 1: ≥500 cells/µL, 2: 200-499 cells/µL, and 3: <200 cells/µL. Children with HIV infection are also classified in each of several categories. Category N: Not symptomatic. Category A: Mildly symptomatic. Category B: Moderately symptomatic. Category C: Severely symptomatic.

    Measured: Day one to week 300 (approximately 22-Jan-2018)

  4. Number of Participants With Laboratory Test Results Meeting the Criteria for Grade 3-4 Abnormality on ATV Powder

    Criteria of the Division of AIDS for grading the severity of adult and pediatric adverse events as follows: Grade (Gr) 1=mild; Gr 2=moderate; Gr 3=severe; Gr 4=potentially life-threatening. Neutrophils (absolute) (adult and infants >7 days): Gr 1=1.000-1300/mm^3; Gr 2=750-999 mm^3; Gr 3=500-749 mm^3; Gr 4= <500 mm^3. Alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase: Gr 1=1.25-2.5*upper limit of normal (ULN); Gr 2=2.6-5.0*ULN; Gr 3=5.1-10.0*ULN; Gr 4= >10.0*ULN. Bilirubin, total (adults and infants >14 days): Gr 1=1.1-1.5*ULN; Gr 2=1.6-2.5*ULN; Gr 3=2.6-5.0*ULN; Gr 4= >5.0*ULN. Lipase: Gr 1=1.1-1.5*ULN; Gr 2=1.6-3.0*ULN; Gr 3=3.1-5.0*ULN; Gr 4= >5.0*ULN. Bicarbonate, serum low: Gr 1=16.0 mEq/L-<lower limit of normal; Gr 2=11.0-15.9 mEq/L; Gr 3=8.0-10.9 mEq/L; Gr 4= <8 mEq/L. By criteria of the World Health Organization: Amylase: Gr 1=1.0-1.39*ULN; Gr 2=1.40-2.09*ULN; Gr 3.=2.10-5.0*ULN; Gr 4= >5.0*ULN.

    Measured: Day one to week 300 (approximately 22-Jan-2018)

Secondary outcomes (8)
  1. Number of Participants With HIV RNA <50 Copies/mL and <400 Copies/mL in the Week 24 Atazanavir Powder Cohort and the Eligible Week 48 Atazanavir Powder Cohort

    Virologic success includes patients with HIV RNA <50 copies/mL. Two cohorts were assessed: The Atazanavir Powder Cohort=patients who received treatment and did not switch to capsule before analysis Week 24 or before their HIV RNA Week 24 assessment, and the Eligible Week 48 Atazanavir Powder Cohort=patients who initiated study treatment at least 48 weeks before last person last visit and did not switch to capsule before analysis Week 48 or before their HIV RNA Week 48 assessment.

    Measured: Day 1 of treatment to weeks 24 and 48

  2. Mean Change From Baseline in HIV RNA on ATV Powder

    Human immunodeficiency virus ribonucleic acid (HIV RNA) change from baseline using observed values

    Measured: Baseline to Weeks 24 and 48

  3. Mean Change From Baseline in CD4 Percent on ATV Powder

    Change in CD4 percent using observed values

    Measured: Baseline to Weeks 24 and 48

  4. CD4 Cell Count Changes From Baseline on ATV Powder

    CD4 cell count change from baseline using observed values

    Measured: Baseline to Weeks 24 and 48

  5. Number of Participants With Emergent Genotypic Substitutions on ATV Powder Through Week 48

    Newly emergent substitutions are on-treatment substitutions that were not detected at baseline.Viral rebound in the resistance analysis was defined as: Less than a 1 log10 drop from baseline in plasma HIV RNA level by Week 16, confirmed by a second plasma HIV RNA level redrawn within 2 and 4 weeks from original sample. Or, a plasma HIV RNA level >200 c/mL after Week 24, confirmed by a second plasma HIV RNA level redrawn within 2 and 4 weeks from original sample. Or, repeated plasma HIV RNA level ≥50 c/mL after Week 48. Viral rebound was defined as a plasma HIV RNA level ≥400 c/mL at any time in a patient who had previously achieved a plasma HIV RNA level <50 c/mL. Or, a plasma HIV RNA level ≥50 c/mL and <1,000 c/mL followed by a return to virologic suppression was considered a viral blip and not a viral rebound. NRTI=nucleoside reverse transcriptase inhibitor

    Measured: Baseline through Week 48

  6. Maximum Observed Plasma Concentration (Cmax)

    To describe the PK profile of ATV powder formulation with RTV in pediatric subjects weighing 25 - < 35 kg and/or 6 to < 11 years of age and for the new 5 - < 10 kg cohort (200 mg ATV and 80 mg RTV) in terms of ATV Cmax

    Measured: Baseline to Week 2

  7. Minimum Plasma Concentration (Cmin)

    To describe the PK profile of ATV powder formulation with RTV in pediatric subjects weighing 25 - < 35 kg and/or 6 to < 11 years of age and for the new 5 - < 10 kg cohort (200 mg ATV and 80 mg RTV) in terms of ATV Cmin

    Measured: Baseline to Week 2

  8. Area Under the Concentration-Time Curve [AUC(TAU)]

    To describe the PK profile of ATV powder formulation with RTV in pediatric subjects weighing 25 - < 35 kg and/or 6 to < 11 years of age and for the new 5 - < 10 kg cohort (200 mg ATV and 80 mg RTV) in terms of ATV AUC

    Measured: Baseline to Week 2

Timeline

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

  1. First posted14 Apr 2011 (estimated)
  2. Study start27 May 2011
  3. Primary completion10 Sep 2014
  4. Study completion22 Jan 2018

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
160 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01335698
Sponsor's protocol ID
AI424-451
Other IDs
2010-024537-23
Acronym
PRINCE2
Status last verified
Oct 2018
First submitted
13 Apr 2011
Last updated
9 Nov 2018
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Atazanavir Sulphate and Ritonavir in people with HIV, run by Bristol-Myers Squibb at 32 sites in 11 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 8 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 9 Nov 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 32 sites in South Africa, Mexico, Brazil, Russia, United States and 6 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 8 Feb 2016). 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?

Number of Participants Who Died and With Adverse Events (AEs) Leading to Discontinuation, Hyperbilirubinemia, Jaundice, First-degree Arterioventricular Block, Tachycardia, and Rash on ATV Powder (time frame: Day one to week 300 (approximately 22-Jan-2018)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Nov 2018.

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