Case-Control Viramune (Nevirapine) Toxicogenomics Study
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Attempt to identify genetic polymorphisms in interrogated pathways which may be associated with symptomatic hepatotoxicity or severe cutaneous toxicity observed in case patients within the first 8 weeks of nevirapine therapy.
Condition | Intervention | Phase |
---|---|---|
HIV Infections |
Procedure: DNA Blood Sampling |
Phase 4 |
Study Type: | Interventional |
Study Design: | Intervention Model: Parallel Assignment Primary Purpose: Treatment |
Official Title: | A Case and Control Toxicogenomics Study to Identify Genetic Locus or Loci in Patients Who Have Experienced Symptomatic Hepatotoxicity and Severe Skin Reactions Within the First 8 Weeks of Nevirapine Therapy |
- Endpoints: relationship between nevirapine-related AEs and genetic polymorphisms loci: Drug metabolizing enzymes (e.g., cytochrome P450 isoforms) Drug transporters (e.g., MDR1 and OATP-C) Human Major Histocompatibility Complex region genes
- Descriptive demographics comparing cases with matched controls in an attempt to link genetic polymorphisms associated with symptomatic hepatotoxicity or severe cutaneous toxicity (cases) to gender, race or other patient characteristics.
Enrollment: | 889 |
Study Start Date: | February 2006 |
Primary Completion Date: | September 2008 (Final data collection date for primary outcome measure) |
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Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Inclusion for Case
Male or female patients >=18 years of age with HIV-1 infection who experienced one or more of the following adverse reactions within the first 8 weeks of starting nevirapine therapy:
- Grade 3 or 4 LFT elevation (ALT or AST > 5X ULN) and any symptom consistent with clinical hepatitis (see Appendix 10.1)
- Acute liver failure secondary to nevirapine therapy*
- Functional group III or IV rash
- *Acute liver failure is defined as serious liver injury usually requiring hospitalization that may lead to death or liver transplantation.
Inclusion for Control
- Male or female patients >=18 years of age with HIV-1 infection who have been exposed to nevirapine therapy for at least 18 weeks and who do not meet any of the case inclusion criteria
Exclusion Criteria:
Exclusion for Cases
- Patients with any hepatotoxicity or rash event which in the investigators judgement is not related to nevirapine use (ex. hepatotoxicity due to alcohol or other medicinal use or rash due to other medicinal use).
- Patients who began abacavir or TMP-SMX (trimethoprim/sulfamethoxazole) therapy 2 weeks or less prior to or up to 8 weeks after initiating nevirapine therapy.
Patients with AST or ALT elevations > 5 times the ULN (>= Grade 3) just prior to the initiation of nevirapine therapy.
Exclusion for Controls
- Patients who discontinued nevirapine before completing 18 weeks of dosing with 200 mg/day for 2 weeks followed by 400 mg/day thereafter.
- Patients who developed functional group I, IIa or IIb rash within 18 weeks of starting nevirapine therapy, or any dermatologic condition that could plausibly be attributed to nevirapine.
- Patients with ALT or AST elevations >2.5 X ULN (>Grade 1) within 18 weeks of starting nevirapine therapy.
- Any hepatobiliary adverse event that could possibly be attributed to nevirapine.
Patients who develop any systemic reaction attributable to nevirapine use during the first 18 weeks of nevirapine treatment such as flu-like symptoms, arthralgia, myalgia, or conjunctivitis.
Exclusion for Cases and Controls
- Patients who have participated in the 2NN-Long-term Follow-up study (1100.1454)
- Patients with CD4 count 150 cells/mm3 prior to the initiation of nevirapine therapy (last available result measured 6 months prior to the initiation of nevirapine therapy).
- Evidence of acute co-infection with viral hepatitis.
- Patients taking prednisone, prednisolone, or immuno-modulatory medication within the first 8 weeks of nevirapine therapy.
- Patients who are unwilling to provide blood samples for DNA testing.
- Patients who did not sign informed consent and or authorization to release protected health information per local requirements.
- Patients without available liv
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Study Chair: | Boehringer Ingelheim | Boehringer Ingelheim Pharmaceuticals |
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Additional Information:
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No publications provided
Responsible Party: | Boehringer Ingelheim, Study Chair, Boehringer Ingelheim |
ClinicalTrials.gov Identifier: | NCT00310843 History of Changes |
Other Study ID Numbers: | 1100.1452, 2005-004321-26 |
Study First Received: | March 28, 2006 |
Last Updated: | May 18, 2012 |
Health Authority: | Argentina: Administracion Nacional de Medicamentos, Alimentos y Tecnologia Medica Australia: Responsilble Ethics Committee Canada: Health Canada-Protocol Review not required France: Agence Française de Sécurité Sanitaire des Produits de Santé Germany: BfArM-Bundesinstitut fuer Arzneimittel und Medizinprodukte (Federal Authoriteis for Drugs and Medical Devices) Great Britain: MHRA Netherlands: AMC (Academisch Medisch Centrum) Spain: Spanish Agency for Medicines and Health Products Taiwan: Department of Health, Executive Yuan, Taiwan Thailand: Ministry of Public Health United States: Food and Drug Administration |
Additional relevant MeSH terms:
HIV Infections Acquired Immunodeficiency Syndrome Lentivirus Infections Retroviridae Infections RNA Virus Infections Virus Diseases Sexually Transmitted Diseases, Viral Sexually Transmitted Diseases Immunologic Deficiency Syndromes Immune System Diseases Slow Virus Diseases |
Nevirapine Anti-HIV Agents Anti-Retroviral Agents Antiviral Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Reverse Transcriptase Inhibitors Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on March 07, 2013