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A Study to Test the Safety and Effectiveness of Dexelvucitabine, an Investigational Nucleoside Reverse Transcriptase Inhibitor (NRTI), to Lamivudine, an Approved NRTI, in HIV Treatment-Experienced Patients Who Are Resistant to Protease Inhibitors, NRTIs and Non-NRTIs
This study has been terminated.
First Received: March 7, 2006   Last Updated: April 3, 2006   History of Changes
Sponsored by: Incyte Corporation
Information provided by: Incyte Corporation
ClinicalTrials.gov Identifier: NCT00300573
  Purpose

The study will compare the safety and efficacy of an investigation nucleoside analog reverse transcriptase inhibitor (NRTI), dexelvucitabine (DFC), to an approved NRTI, lamivudine (3TC) in HIV treatment-experienced patients who are resistant to 3 classes of antiretroviral therapies (NRTIs, PIs and NNRTIs).

Patients meeting eligibility requirements will have a new 'optimized' background regimen (OBR) selected for them by their investigator based on prior ARV treatment history and the results of HIV genotype and phenotype tests performed during the screening period. In addition to treatment with the new OBR, patients will be randomized to receive treatment with DFC or 3TC in a blinded fashion. There is a 50 percent chance a patient will receive DFC or 3TC. Treatment in the study may continue for up to 96 weeks. Patients with an inadequate response to therapy after 16 weeks will have the option to change their OBR and the option to switch to receive the other study medication (i.e., DFC to 3TC or 3TC to DFC).


Condition Intervention Phase
HIV Infections
Human Immunodeficiency Virus
Drug: Dexelvucitabine
Phase II

MedlinePlus related topics: AIDS
Drug Information available for: 2',3'-Dideoxy-2',3'-didehydro-5-fluorocytidine Lamivudine Elvucitabine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double-Blind, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Randomized, Double-Blind, Phase II Study Comparing the Anti-Retroviral Safety and Efficacy of Dexelvucitabine (DFC) 200 Mg Once Daily to Lamivudine (3TC) 300 Mg Once Daily in Addition to Optimized Background Therapy in HIV-1 Infected Subjects Who Have Failed and/or Harbor HIV With Resistance Mutations to NRTIs, PIs, and NNRTIs

Further study details as provided by Incyte Corporation:

Primary Outcome Measures:
  • Percent of subjects with >= 1.0 log10 decrease in viral load from Baseline to Week 24 based on non-completer equals failure (NC=F)
  • Percent of subjects at 48 weeks with sustained suppression of viral load >= 1.0 log10 below baseline as determined by time-to-loss of virological response (TLOVR)

Secondary Outcome Measures:
  • Median change in viral load from Baseline to Week 24 and to Week 48
  • Proportion of subjects in each treatment arm with viral load reduction greater than the over all study median viral load reduction
  • Proportion of subjects with a viral load measurement <400 copies/mL at Week 24 and Week 48
  • Proportion of subjects with a viral load measurement <50 copies/mL at Week 24 and Week 48
  • Median change in subset of T lymphocytes (CD4+) cell count from Baseline to Week 24 and Week 48
  • Proportion of subjects with a 50% decrease and/or 100 cell/mm3 decrease in CD4+ cell count to Week 24 and to Week 48
  • Proportion of subjects who "crossed-over" to receive treatment with the other blinded study medication
  • Number of Centers for Disease Control (CDC) Class C adverse events and deaths by treatment arm

Estimated Enrollment: 250
Study Start Date: February 2006
Detailed Description:

The study will compare the safety and efficacy of an investigational nucleoside analog reverse transcriptase inhibitor (NRTI), dexelvucitabine (DFC) 200 mg once daily, to an approved NRTI, lamivudine (3TC) 300 mg once daily in treatment experienced patients with HIV that is resistant to 3 classes of antiretroviral therapies (NRTIs, PIs and NNRTIs). Patients meeting eligibility requirements will have a new 'optimized' background regimen (OBR) selected for them based on prior treatment history, and results of HIV genotype and phenotype performed during screening. In addition to the OBR patients will be randomized to receive at at one to one ratio DFC or 3TC in a blinded fashion. The OBR may include any approved HIV treatments except 3TC, FTC, ddI, d4T and ddC. Medications available through expanded access may also be available to selected patients. Treatment in the study will continue for up to 96 weeks with primary endpoints at 24 and 48 weeks of therapy. Patients with an inadequate response to therapy after 16 weeks will have the option to change their OBR and the option to switch study medication (DFC to 3TC or 3TC to DFC). A total of 250 patients will be enrolled.

  Eligibility

Ages Eligible for Study:   16 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • a) Male (at birth) subjects, between 16 years (or the legal age of consent, whichever is older) and 75 years of age, utilizing adequate contraceptive methods.
  • b) Female (at birth) subjects between 16 years (or the legal age of consent, whichever is older) and 75 years of age.
  • Women of childbearing potential may be enrolled following a negative serum pregnancy test. If participating in activity that could lead to pregnancy, women shall agree to use TWO forms of contraception as listed in # 1-4 below (at least one must be a barrier method) while receiving protocol-specified medication and for 2 months after stopping the medication.

    1. Condom (male or female) with or without a spermicidal agent
    2. Diaphragm or cervical cap with spermicide
    3. IUD
    4. Hormonal-based contraception
  • Women who are not of reproductive potential (documented to be surgically sterile or postmenopausal [defined as amenorrhea >1 year and follicle stimulating hormone {FSH} >30 mU/mL]) are eligible to be enrolled without a serum pregnancy test and will not be required to use contraception.
  • Subjects treated with a HAART regimen(s), including a minimum of 3 drugs, for at least 3 months and who have been on a stable HAART regimen for a minimum of 8 weeks prior to the Screening visit. The HAART regimen must also remain stable from the Screening visit until randomization on Day 0 in order for the subject to qualify for enrollment.
  • Demonstrate evidence of failure of at least 3 drug classes, defined as #s 1-3 below:

    1. Prior NRTI use and presence of one or more NRTI-resistance-conferring mutations, including mutations at RT amino acids 41L, 65R, 67N, 70R, 74V or 74I, 184V or 184I, 210W, 215Y or 215F, and/or 219Q or 219E.
    2. Presence of one or more NNRTI-resistance conferring mutations, including mutations at RT amino acids 100I, 101E or 101P, 103N, 106A or 106M, 188L, and/or 190A or 190S or 190E at Screening or documented to be present on a prior genotype OR documented evidence of prior NNRTI use of at least 2 months duration with viral load ≥1000 copies/mL after at least 2 months of treatment.
    3. Prior ritonavir-boosted PI use AND presence of one or more PI-resistance-conferring mutations, including mutations at protease amino acids 33F, 46I or 46L, 50V, 82A or 82F or 82T or 82S, 84V, and/or 90M.
  • Demonstrate a Screening plasma HIV RNA concentration of ³1000 copies/mL (Roche Amplicor HIV-1 Monitor® Test, v1.5 – Quantitative assay) and, in the expert judgment of the investigator, be failing the current regimen.
  • Be able and willing to provide written informed consent.
  • Be able and willing to comply, in the opinion of the investigator, with the requirements of this study.

Exclusion Criteria:

  • Current or recent (<30 days) opportunistic infection (Category C according to the Centers for Disease Control (CDC) Classification System for HIV-1 Infection, 1993 Revised Version) that is not being controlled by medication in the judgment of the investigator.
  • Subjects who are, in the opinion of the investigator, unable to comply with the dosing schedule and protocol evaluations.
  • Pregnant women or women who are breastfeeding
  • Current alcohol or drug use, which in the expert judgment of the investigator, will interfere with the subject’s ability to comply with the protocol requirements.
  • Subjects treated with dexelvucitabine (formerly known as Reverset) in a prior investigational drug protocol.
  • Subjects with a history of acute or chronic pancreatitis.
  • Subjects with acute hepatitis B and/or C infection.
  • Subjects with unstable chronic hepatitis.
  • Subjects with chronic renal failure requiring dialysis.
  • Subjects currently receiving 3TC or FTC as part of a regimen for treatment of stable, chronic HBV infection. Subjects with stable chronic HBV infection who are being treated with entecavir, adefovir, or tenofovir are eligible to enroll.
  • Subjects with the following laboratory parameters within 35 days prior to first dose of study medication:

    • Hemoglobin <9.0 g/dL (males) or <8.0 g/dL (females)
    • Absolute neutrophil count (ANC) <750/mm3
    • Platelet count <75 000/mm3
    • Aspartate aminotransaminase (AST [SGOT]) or alanine aminotransaminase (ALT [SGPT]) >5 X upper limit of normal (ULN)
    • Serum lipase >1.5 X ULN
    • Serum creatinine > 3.0 x ULN
  • Subjects who have received an HIV prophylactic or corrective vaccination within 6 months prior to the first dose of study medication.
  • Subjects who have received radiation therapy or cytotoxic chemotherapeutic agents and have not recovered from side effects prior to the first dose of study medication.
  • Subjects with RT mutations Q151M or T69SS on Screening genotype.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00300573

Locations
United States, California
Long Beach, California, United States, 90813
United States, Florida
Brandon, Florida, United States
Miami, Florida, United States
Fort Lauderdale, Florida, United States
Plantation, Florida, United States, 33317
United States, Georgia
Atlanta, Georgia, United States, 30309
United States, Illinois
Chicago, Illinois, United States, 60657
United States, New York
New York, New York, United States, 10018
United States, Oregon
Portland, Oregon, United States, 97209
United States, Texas
Dallas, Texas, United States
Puerto Rico
San Juan, Puerto Rico, 00909
Sponsors and Collaborators
Incyte Corporation
  More Information

No publications provided

Study ID Numbers: INCB 08721-204, EudraCT #:2006-000096-16
Study First Received: March 7, 2006
Last Updated: April 3, 2006
ClinicalTrials.gov Identifier: NCT00300573     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Incyte Corporation:
dexelvucitabine
DFC
Treatment Experienced
HIV-1

Study placed in the following topic categories:
Virus Diseases
Sexually Transmitted Diseases, Viral
Anti-Retroviral Agents
HIV Infections
Sexually Transmitted Diseases
Acquired Immunodeficiency Syndrome
Lamivudine
Antiviral Agents
Retroviridae Infections
Immunologic Deficiency Syndromes
Protease Inhibitors
Reverse Transcriptase Inhibitors

Additional relevant MeSH terms:
Anti-Infective Agents
RNA Virus Infections
Sexually Transmitted Diseases, Viral
Slow Virus Diseases
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Acquired Immunodeficiency Syndrome
Enzyme Inhibitors
Infection
Antiviral Agents
Pharmacologic Actions
Immunologic Deficiency Syndromes
Reverse Transcriptase Inhibitors
Virus Diseases
Anti-Retroviral Agents
HIV Infections
Therapeutic Uses
Sexually Transmitted Diseases
Lentivirus Infections
Retroviridae Infections
Nucleic Acid Synthesis Inhibitors

ClinicalTrials.gov processed this record on May 07, 2009