Safety and Activity of the Oral HIV Entry Inhibitor AMD11070 in HIV Infected Patients - Full Text View

Sponsors and Collaborators:	National Institute of Allergy and Infectious Diseases (NIAID) Adult AIDS Clinical Trials Group
Information provided by:	National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:	NCT00089466

Purpose

New treatment options are critical for treatment-experienced HIV infected patients with drug resistance. HIV entry inhibitors have been shown effective in patients with resistance to other anti-HIV drugs. This study will test the safety and anti-HIV activity of eight different doses of the HIV entry inhibitor AMD11070 (also known as AMD070) in HIV infected patients.

Condition	Intervention	Phase
HIV Infections	Drug: AMD11070	Phase I Phase II

MedlinePlus related topics: AIDS

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Dose Comparison, Parallel Assignment, Safety/Efficacy Study
Official Title:	Phase IB/IIA Dose-Finding Safety and Activity Study of AMD11070 (An Orally Administered CXCR4 Entry Inhibitor) in HIV-Infected Subjects

Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:

Dose-limiting toxicities of Grade 3 or greater [ Time Frame: during the 10 days of treatment or the 7 days after stopping treatment ] [ Designated as safety issue: Yes ]
Reduction in X4-tropic virus from baseline of 1 log10 relative luciferase units (rlu) [ Time Frame: day 10 ] [ Designated as safety issue: No ]

Enrollment:	6
Study Start Date:	November 2004
Primary Completion Date:	November 2006 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
A: Experimental 200 mg AMD11070 every 12 hours	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
B: Experimental 400 mg AMD11070 every 12 hours	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
C: Experimental 600 mg AMD11070 every 12 hours	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
D: Experimental 800 mg AMD11070 every 12 hours	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
E: Experimental 1000 mg AMD11070 daily	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
F: Experimental 1500 mg AMD11070 daily	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
G: Experimental 1000 mg AMD11070 every 12 hours	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.
H: Experimental 2000 mg AMD11070 daily	Drug: AMD11070 AMD11070 taken daily. Dosage dependent on arm.

Detailed Description:

AMD11070 is an oral HIV-1 entry inhibitor that targets the CXCR4 receptor on T cells. AMD11070 has been shown safe and well-tolerated in Phase I clinical trials in HIV uninfected people. The goal of this study is to evaluate the safety and antiretroviral activity of eight dose levels of AMD11070 in HIV infected adults with X4-tropic virus. Pharmacokinetics (PK) of AMD11070 will also be studied.

This study will last 90 days. All participants will receive medication for 10 days. There are eight cohorts in this study, with a maximum of six participants per cohort. Cohort A will receive 200 mg AMD11070 every 12 hours; Cohort B will receive 400 mg AMD11070 every 12 hours; Cohort C will receive 600 mg AMD11070 every 12 hours; Cohort D will receive 800 mg AMD11070 every 12 hours; Cohort E will receive 1000 mg AMD11070 daily; Cohort F will receive 1500 mg AMD11070 daily; Cohort G will receive 1000 mg AMD11070 every 12 hours; and Cohort H will receive 2000 mg AMD11070 daily. Cohorts B, C, D, and E will open sequentially, provided no more than one of six participants in the preceding cohort experiences dose-limiting toxicity (DLT) based on safety evaluations through Day 17. Cohort G will open to enrollment when Cohort E is filled; Cohort H will open to enrollment when Cohort F is filled. Cohort F will open to enrollment provided no more than one of six participants of Cohorts E and G experiences DLT. All study participants will be offered to receive open-label AMD11070 through a separate long-term safety study.

Participants will either be admitted to the general clinical research center (GCRC) for the dosing period or have dosing, PK testing, and other study monitoring done on an outpatient basis, depending on the study site. Participants admitted to the GCRC for the dosing period will be allowed daytime passes from the GCRC on Days 4, 6, 7, 8, and 9. During the study, participants will have continuous heart monitoring, serial electrocardiograms (EKGs), and vital sign checks. Fasting blood collection will occur on Days 5 and 10. Trough PK testing will occur at entry and on Days 1, 2, 3, 4, 6, 8, and 11. Intensive 24-hour PK testing and 24-hour urine collection will occur on Days 10 and 11. After treatment, targeted physicals and urine collection will occur on Days 17, 30, and 90, and additional blood collection will occur on Days 17, 21, 30, and 90. Participants will undergo an EKG on Days 17 and 90. Participants will also undergo an opthalmologic evaluation and questionnaire sometime after receiving AMD11070.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

HIV-1 infected
Have X4- or dual/mixed-tropic virus confirmed no more than 56 days prior to study entry
HIV-1 viral load of 5,000 copies/ml or more within 60 days prior to study entry
If female, willing to discontinue hormonal contraception 1 week prior to study entry
Willing to use acceptable forms of contraception

Exclusion Criteria:

Antiretroviral treatment within 14 days prior to study entry
Other prescription medications, herbal supplements, or aspirin within 7 days prior to study entry. Patients taking medication for prophylaxis for Pneumocystis carinii pneumonia (PCP) are not excluded. Patients taking medications approved by protocol officials are not excluded, provided they have been on a stable dose for at least 14 days prior to study entry.
Nonsteroidal anti-inflammatory drugs (NSAIDS), over the counter medications, or other supplements (including multivitamins) within 1 day prior to study entry
Heavy exercise within 24 hours before study entry evaluations are done
Immunizations within 30 days prior to study entry
Radiation therapy, cytotoxic chemotherapeutic agents, or immunomodulatory agents within 30 days prior to study entry
Current use of some CYP substrates, inhibitors, or inducers. Use of CYP450 substrates is allowed, except for CYP2D6 and CYP2C8 substrates.
Current use of P-gp inducers or inhibitors
Allergy or sensitivity to study drug or its formulations
Active infection or acute illness within 14 days prior to study entry, including HIV-associated opportunistic infections
History of heart abnormalities. Patients with any repolarization delay (QTc interval of greater than 500 msec) or a history of additional risk factors for torsade de pointes (e.g., heart failure, hypokalemia) are also excluded.
Drug or alcohol abuse or dependence or other medical or psychological condition that, in the opinion of the investigator, would interfere with the study or put participants at undue risk
Chronic diarrhea, defined as having more than 3 stools/day for more than 4 weeks prior to study entry
Pregnant or breastfeeding

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00089466

Locations

United States, Alabama
University of Alabama at Birmingham
Birmingham, Alabama, United States, 35924-2050
United States, Colorado
University of Colorado Health Sciences Center, Denver
Denver, Colorado, United States, 80262-3706
United States, Georgia
Emory University
Atlanta, Georgia, United States, 30308
United States, Indiana
Indiana University Hospital
Indianapolis, Indiana, United States, 46202-5250
Methodist Hospital of Indiana
Indianapolis, Indiana, United States, 46202-5250
Wishard Hospital
Indianapolis, Indiana, United States, 46202
United States, New York
University of Rochester Medical Center
Rochester, New York, United States, 14642-0001
The Cornell Clinical Trials Unit
New York, New York, United States, 10021
NYU/Bellevue
New York, New York, United States, 10016-6481
Cornell Clinical Trials Unit
New York, New York, United States, 10011
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
United States, Ohio
University of Cincinnati
Cincinnati, Ohio, United States, 45267-0405
MetroHealth Medical Center
Cleveland, Ohio, United States, 44109
United States, Tennessee
Comprehensive Care Clinic
Nashville, Tennessee, United States, 37203
United States, Texas
University of Texas, Galveston
Galveston, Texas, United States, 77555-0435
Dallas VA Medical Center
Dallas, Texas, United States, 75235-9173

Sponsors and Collaborators

National Institute of Allergy and Infectious Diseases (NIAID)

Adult AIDS Clinical Trials Group

Investigators

Study Chair:

Michael S. Saag, MD

University of Alabama at Birmingham

More Information

Click here for more information about AMD11070 This link exits the ClinicalTrials.gov site

Click here for more information about the HIV life cycle This link exits the ClinicalTrials.gov site

Haga clic aquí para ver información sobre este ensayo clínico en español. This link exits the ClinicalTrials.gov site

Publications:

De Clercq E. Emerging anti-HIV drugs. Expert Opin Emerg Drugs. 2005 May;10(2):241-73.

Moore JP, Kitchen SG, Pugach P, Zack JA. The CCR5 and CXCR4 coreceptors--central to understanding the transmission and pathogenesis of human immunodeficiency virus type 1 infection. AIDS Res Hum Retroviruses. 2004 Jan;20(1):111-26. Review.

Reeves JD, Piefer AJ. Emerging drug targets for antiretroviral therapy. Drugs. 2005;65(13):1747-66.

Ruibal-Ares BH, Belmonte L, Bare PC, Parodi CM, Massud I, de Bracco MM. HIV-1 infection and chemokine receptor modulation. Curr HIV Res. 2004 Jan;2(1):39-50. Review.

Shaheen F, Collman RG. Co-receptor antagonists as HIV-1 entry inhibitors. Curr Opin Infect Dis. 2004 Feb;17(1):7-16.

Responsible Party:	DAIDS ( Rona Siskind )
Study ID Numbers:	ACTG A5210
Study First Received:	August 5, 2004
Last Updated:	September 4, 2008
ClinicalTrials.gov Identifier:	NCT00089466
Health Authority:	United States: Food and Drug Administration

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):

Entry Inhibitors
CXCR4 Entry Inhibitors
Treatment Experienced
Treatment Naive

Study placed in the following topic categories:

Virus Diseases
Signs and Symptoms
Sexually Transmitted Diseases, Viral
HIV Infections

Sexually Transmitted Diseases
Acquired Immunodeficiency Syndrome
Retroviridae Infections
Immunologic Deficiency Syndromes

Additional relevant MeSH terms:

RNA Virus Infections
Slow Virus Diseases
Immune System Diseases
Lentivirus Infections
Infection

ClinicalTrials.gov processed this record on January 14, 2009