Pharmacokinetics of Rifabutin Combined With Antiretroviral Therapy in Patients With TB/HIV Co-infection in Vietnam
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The overall aim of the project is to evaluate rifabutin (RBT) as a replacement for rifampicin (RMP), for the combined treatment of tuberculosis and HIV infection. RBT represents an alternative to RMP for HIV infected patients as its half-life is longer and the enzymatic induction effect appears to be less important on the associated antiretroviral therapy (ART) drugs.
This phase II trial is to determine precisely the pharmacokinetics parameters of RBT in combination with different ART regimens in Vietnamese HIV infected patients with pulmonary tuberculosis, in order to define optimal doses that will be further tested in a larger phase III trial comparing safety, tolerability and efficacy of RBT and RMP regimens.
Condition | Intervention | Phase |
---|---|---|
HIV Infections Tuberculosis |
Drug: rifabutin in combination with lopinavir boosted by ritonavir - dosing schedule 1 Drug: rifabutin in combination with lopinavir boosted by ritonavir - dosing schedule 2 |
Phase 2 |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Bio-availability Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Treatment |
Official Title: | Pharmacokinetics of Rifabutin Combined With Antiretroviral Therapy in the Treatment of Tuberculosis Patient With HIV Infection in Vietnam : A Phase II Trial |
- Area under the curve (AUC) of rifabutine measured (a)before introduction of ART;(b)after ART initiation (two different doses of RBT in combination with lopinavir/ritonavir) [ Time Frame: 2, 5 and 8 weeks after randomisation ] [ Designated as safety issue: No ]
- Area under the curve (AUC) of lopinavir/ritonavir in combination with two doses of rifabutine [ Time Frame: 5 and 8 weeks after randomisation ] [ Designated as safety issue: No ]
- Safety : proportion of patients with grade 3 and grade 4 adverse events [ Time Frame: through out the trial ] [ Designated as safety issue: Yes ]
Estimated Enrollment: | 32 |
Study Start Date: | June 2010 |
Estimated Study Completion Date: | December 2012 |
Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: 1
RBT (150 mg TPW during 3 weeks switch to 150mg OD for the following 3 weeks) associated with LPV/r based ART
|
Drug: rifabutin in combination with lopinavir boosted by ritonavir - dosing schedule 1
3TC(300mg)/D4t(60mg)/LPV/r(800mg/200mg)+INH/PZA/EMT/Rifabutin(150 mg TPW 3 wks switch to 150 mg OD 4 wks);
|
Experimental: 2
RBT (150 mg OD during 3 weeks switch to 150mg TPW for the following 3 weeks) associated with LPV/r based ART
|
Drug: rifabutin in combination with lopinavir boosted by ritonavir - dosing schedule 2
3TC(300mg)/D4t(60mg)/LPV/r(800mg/200mg)+INH/PZA/EMT/Rifabutin(150 mg OD 3 wks switch to 150 mg TPW 4 wks);
|
Detailed Description:
Patients will be offered to participated in the study when they start TB treatment. All the enrolled patients will immediately be switched to rifabutin and randomized, to one of the RBT doses that will be then adapted to the allocated RBT regimen according to a cross over scheme. Three full pharmacokinetics profile will be performed at different time point : before initiation of ARV, after three weeks of the first RBT dosage and after three weeks of the secondRBT dosage. Patients will then be referred to the national program for further treatment. A follow-up visit will be planned at the end of the antiTB treatment.
![](https://webarchive.library.unt.edu/web/20130305100956im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
Ages Eligible for Study: | 18 Years to 65 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Pulmonary tuberculosis defined as either
- at least 2 sputum smears positive for AFB
- 1 sputum smear positive for AFB and a chest radiograph compatible with active tuberculosis
- 1 sputum culture positive and and a chest radiograph compatible with active tuberculosis
- a clinical history and chest radiograph compatible with active tuberculosis and 2 sputum smear negative for AFB
- Positive HIV antibody and CD4 count <=250 /mm3
- Weight > 40 kg
- No history of ART
- No grade 3 or 4 clinical or laboratory findings
- Negative pregnancy test and appropriate contraceptive measures during the duration of the trial for female of childbearing age
- Having a firm home address that is readily accessible
- Karnofsky score>=80%
Exclusion Criteria:
- History of TB or MDR TB treatment
- Concomitant OI requiring additional anti-infectious treatment
- Formal contraindication to any drug used in the trial
- Diabetes mellitus requiring drug treatment
- Recreational drug or alcohol abuse
- History of drug hypersensitivity to TB or related medications
- Interrupted TB therapy for more than 1 week
- Less than 90% adherent to first 6 weeks of intensive phase chemotherapy
- Mental illness that could impair ability to give informed consent or result in poor adherence to trial protocol and therapy
- Neutropenia <1200 /L, anaemia <6.8 g/dL, liver function test > grade 2
- Requiring concomitant medications that may potentially interact with study drugs
- Pregnant or lactating women
- Karnofsky score >80%
- Any condition rendering the patient unable to understand the nature, scope, and possible consequences of thes study and to provide consent
![](https://webarchive.library.unt.edu/web/20130305100956im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
Vietnam | |
Pham Ngoc Tach Hospital | |
Ho Chi Minh City, Vietnam |
Principal Investigator: | Anthony D. Harries, PhD | The international Union Against Tuberculosis and Lung Diseases (IUATLD), Paris, France |
Principal Investigator: | Huy Dung Nguyen, MD | Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam |
![](https://webarchive.library.unt.edu/web/20130305100956im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
No publications provided
Responsible Party: | French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS) ( French National Agency for Research on AIDS and Viral Hepatitis ) |
ClinicalTrials.gov Identifier: | NCT00651066 History of Changes |
Other Study ID Numbers: | ANRS12150b |
Study First Received: | March 28, 2008 |
Last Updated: | July 11, 2012 |
Health Authority: | Vietnam: Ministry of Health |
Keywords provided by French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS):
HIV Tuberculosis Rifabutin Pharmacokinetics Vietnam |
Additional relevant MeSH terms:
HIV Infections Acquired Immunodeficiency Syndrome Tuberculosis 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 Mycobacterium Infections Actinomycetales Infections Gram-Positive Bacterial Infections |
Bacterial Infections Rifabutin Lopinavir Ritonavir Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Antibiotics, Antitubercular Antitubercular Agents HIV Protease Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-HIV Agents |
ClinicalTrials.gov processed this record on March 03, 2013