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Phase 4 Completed N=392 Randomized Treatment

KIVEXA Vs TRUVADA, Both Administered With Efavirenz, In ART-Naive Subjects

Infection, Human Immunodeficiency Virus I · HIV
Source: ClinicalTrials.gov NCT00549198 ↗
Enrolled (actual)
392
Serious AEs
13.3%
Results posted
Oct 2010
Primary outcomePrimary: Mean Change From Baseline in Estimated Glomerular Filtration Rate (GFR), Calculated by Modification of Diet in Renal Disease (MDRD) Equation, at Week 48 — 0.22; 1.18 milliliters per minute (mL/min)/1.73 m^2 — p=0.435

Summary

Recently, the fixed-dose combinations (FDC) KIVEXA™ (abacavir/lamivudine) and TRUVADA (tenofovir disoproxil fumarate/emtricitabine) have facilitated the usage of once-daily regimens. However data from head-to-head randomized trials comparing these two FDCs as part of an initial regimen are not available at present. The long-term toxicity profiles of these regimens are of particular importance, as treatment of HIV is currently life-long and therefore, minimizing long-term toxicity and maximizing adherence and duration of regimen maintenance are critical therapy objectives. The primary endpoint is estimated glomerular filtration rate (GFR), as measured by the modified diet in renal disease (MDRD) equation, a validated estimate of renal function.

Outcome Measures

OutcomeResultp-value
PRIMARY
Mean Change From Baseline in Estimated Glomerular Filtration Rate (GFR), Calculated by Modification of Diet in Renal Disease (MDRD) Equation, at Week 48
0.22; 1.18 0.435
SECONDARY
Mean Change From Baseline in Estimated Glomerular Filtration Rate (GFR), Calculated by Modification of Diet in Renal Disease (MDRD) Equation, at Week 24
2.78; 0.43 0.057
SECONDARY
Mean Change From Baseline in Estimated Glomerular Filtration Rate (GFR), Calculated by Modification of Diet in Renal Disease (MDRD) Equation, at Week 96
1.48; -1.15 0.060
SECONDARY
Mean Change From Baseline in Estimated GFR, Calculated by Cockcroft-Gault Equation, at Week 24
4.27; 2.54 0.186
SECONDARY
Mean Change From Baseline in Estimated GFR, Calculated by Cockcroft-Gault Equation, at Week 48
2.66; 3.80 0.413
SECONDARY
Mean Change From Baseline in Estimated GFR, Calculated by Cockcroft-Gault Equation, at Week 96
4.37; 2.68 0.315
SECONDARY
Number of Participants With Decline From Baseline in Estimated GFR, Calculated by MDRD and Cockcroft-Gault Equations, of >=10 mL/Min/1.73 m^2 (mL/Min for Cockcroft-Gault), >=20 mL/Min/1.72 m^2, >=10%, and >=20% at Week 24
16; 26; 16; 20; 4; 6
SECONDARY
Number of Participants With Decline From Baseline in Estimated GFR, Calculated by MDRD and Cockcroft-Gault Equations, of >=10 mL/Min/1.73m^2 (mL/Min for Cockcroft-Gault), >=20 mL/Min/1.72m^2, >=10%, and >=20% at Week 48
23; 21; 15; 14; 4; 3
SECONDARY
Number of Participants With Decline From Baseline in Estimated GFR, Calculated by MDRD and Cockcroft-Gault Equations, of >=10 mL/Min/1.73m^2 (mL/Min for Cockcroft-Gault), >=20 mL/Min/1.72m^2, >=10%, and >=20% at Week 96
15; 38; 11; 19; 4; 7
SECONDARY
Number of Participants With National Kidney Foundation Chronic Kidney Disease Stage 1, 2, 3, 4, or 5 Categories of Renal Function at Week 24
97; 114; 11; 15; 5; 5
SECONDARY
Number of Participants With National Kidney Foundation Chronic Kidney Disease Stage 1, 2, 3, 4, or 5 Categories of Renal Function at Week 48
12; 19; 90; 106; 7; 5
SECONDARY
Number of Participants With National Kidney Foundation Chronic Kidney Disease Stage 1, 2, 3, 4, or 5 Categories of Renal Function at Week 96
11; 18; 75; 83; 3; 4
SECONDARY
Percent Change From Baseline in Lumbar Spine Bone Mineral Density (BMD), Measured by Dual-energy X-ray Absorptiometry (DXA), at Week 24
-2.12; -3.30 <0.001 sig
SECONDARY
Percent Change From Baseline in Hip Bone Mineral Density (BMD), Measured by Dual-energy X-ray Absorptiometry (DXA), at Week 24
-1.19; -2.73 <0.001 sig
SECONDARY
Percent Change From Baseline in Lumbar Spine Bone Mineral Density (BMD), Measured by Dual-energy X-ray Absorptiometry (DXA), at Week 48
-1.59; -2.41 0.036 sig
SECONDARY
Percent Change From Baseline in Hip Bone Mineral Density (BMD), Measured by Dual-energy X-ray Absorptiometry (DXA), at Week 48
-1.90; -3.56 <0.001 sig
SECONDARY
Percent Change From Baseline in Lumbar Spine Bone Mineral Density (BMD), Measured by Dual-energy X-ray Absorptiometry (DXA), at Week 96
-0.87; -1.70 0.112
SECONDARY
Percent Change From Baseline in Hip Bone Mineral Density (BMD), Measured by Dual-energy X-ray Absorptiometry (DXA), at Week 96
-2.17; -3.55 <0.001 sig
SECONDARY
Number of Participants With a Decline From Baseline in Lumbar Spine and Hip Bone Mineral Density (BMD) >=2.0% and >=6.0% at Week 24
73; 115; 10; 17; 38; 93
SECONDARY
Number of Participants With a Decline From Baseline in Lumbar Spine and Hip Bone Mineral Density (BMD) >=2.0% and >=6.0% at Week 48
51; 84; 5; 13; 54; 111
SECONDARY
Number of Participants With a Decline From Baseline in Lumbar Spine and Hip Bone Mineral Density (BMD) >=2.0% and >=6.0% at Week 96
21; 39; 3; 8; 33; 52
SECONDARY
Number of Participants Meeting World Health Organization (WHO) Criteria for Osteopenia (T-score of -2.5 to -1.0) and Osteoporosis (T-score of <-2.5) at Week 24
41; 68; 16; 9; 38; 54
SECONDARY
Number of Participants Meeting World Health Organization (WHO) Criteria for Osteopenia (T-score of -2.5 to -1.0) and Osteoporosis (T-score of <-2.5) at Week 48
41; 57; 15; 5; 37; 50
SECONDARY
Number of Participants Meeting World Health Organization (WHO) Criteria for Osteopenia (T-score of -2.5 to -1.0) and Osteoporosis (T-score of <-2.5) at Week 96
21; 34; 5; 3; 20; 31
SECONDARY
Number of Participants Experiencing an Adverse Event (AE) Leading to Discontinuation by Week 24
26; 14; 11; 1; 2; 3
SECONDARY
Number of Participants Experiencing an Adverse Event (AE) Leading to Discontinuation by Week 48
29; 21; 11; 1; 0; 2
SECONDARY
Number of Participants Experiencing an Adverse Event (AE) Leading to Discontinuation by Week 96
33; 28; 11; 1; 0; 8
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting Total Cholesterol at Week 24
54; 104; 47; 29; 32; 9
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting Total Cholesterol at Week 48
46; 96; 52; 37; 36; 9
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting Total Cholesterol at Week 96
39; 86; 49; 47; 46; 10
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Low-density Lipoprotein (LDL) at Week 24
22; 46; 41; 43; 22; 11
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Low-density Lipoprotein (LDL) at Week 48
20; 42; 38; 46; 27; 12
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Low-density Lipoprotein (LDL) at Week 96
18; 37; 35; 46; 29; 17
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting High-density Lipoprotein (HDL) at Week 24
19; 36; 72; 66; 10; 9
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting High-density Lipoprotein (HDL) at Week 48
17; 28; 67; 73; 18; 10
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting High-density Lipoprotein (HDL) at Week 96
11; 23; 66; 75; 25; 13
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting Triglycerides at Week 24
63; 78; 21; 19; 23; 9
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting Triglycerides at Week 48
55; 70; 22; 23; 30; 12
SECONDARY
Number of Participants With the Indicated Change From Baseline in National Cholesterol Education Program (NCEP) Thresholds for Fasting Triglycerides at Week 96
47; 55; 25; 31; 34; 20
SECONDARY
Number of Participants With the Indicated Treatment-emergent Division of AIDS (DAIDS) Toxicities at Week 24
6; 1; 0; 0; 8; 3
SECONDARY
Number of Participants With the Indicated Treatment-emergent Division of AIDS (DAIDS) Toxicities at Week 48
7; 1; 0; 0; 9; 3
SECONDARY
Number of Participants With the Indicated Treatment-emergent Division of AIDS (DAIDS) Toxicities at Week 96
9; 1; 0; 0; 13; 5
SECONDARY
Number of Participants With HIV-1 RNA <50 Copies/Milliliter (c/mL) and 400 c/mL at Week 24
126; 144; 147; 168
SECONDARY
Number of Participants With HIV-1 RNA <50 Copies/Milliliter (c/mL) and 400 c/mL at Week 48
121; 145; 130; 151
SECONDARY
Number of Participants With HIV-1 RNA <50 Copies/Milliliter (c/mL) and 400 c/mL at Week 96
98; 113; 110; 126
SECONDARY
Change From Baseline in Cluster Difference 4 (CD4+) Cell Count at Week 24
110.0; 100.0
SECONDARY
Change From Baseline in Cluster Difference 4 (CD4+) Cell Count at Week 48
150.0; 150.0
SECONDARY
Change From Baseline in Cluster Difference 4 (CD4+) Cell Count at Week 96
235.0; 220.0
SECONDARY
Number of Participants Classified as Protocol-defined Failures With Treatment-emergent Resistance to Study Drug in the Indicated Viruses at Week 96
4; 0; 4; 0; 2; 0
SECONDARY
Number of Participants Who Indicated "Yes" or "No" to the Question of Whether Unplanned Healthcare Resources Were Utilized
60; 49; 118; 134; 56; 47

Eligibility Criteria

Inclusion Criteria

  • Subject is at least 18 years of age.
  • Subject is antiretroviral-naïve (defined as having no previous therapy with any NNRTI and 14 days of prior therapy with any other antiretroviral).
  • Subject has plasma HIV-1 RNA 1, 000 copies/mL at screening. This test may be repeated once within the 45-day screening window.
  • Subject is willing and able to understand and provide written informed consent prior to participation in this study.
  • A female is eligible to enter and participate in the study if she is of:
  • Non-childbearing potential (i.e., physiologically incapable of becoming pregnant, including any female who is post-menopausal); or,
  • Child-bearing potential, has a negative pregnancy test at screen and agrees to one of the following methods of contraception (any contraception method must be used consistently and correctly, i.e., in accordance with both the approved product label and the instructions of a physician):

Complete abstinence from intercourse from 2 weeks prior to administration of the investigational products, throughout the study, and for at least 2 weeks after discontinuation of all study medications Double barrier method (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide). Hormonal contraception will not be considered adequate for inclusion into this study Any intrauterine device (IUD) with published data showing that the expected failure rate is 5 times the upper limit of normal.

  • Subjects with a history of thyroid disease, hyperparathyroid disease, chronic hyper or hypocalcemia, vitamin D deficiency, or receiving thyroid hormone or parathyroid hormone replacement within 28 days prior to screening.
  • Subjects with a history of systemic inflammatory arthritis.
  • Subjects who are hepatitis B positive at screening.
  • Subject requires treatment with radiation therapy or cytotoxic chemotherapeutic agents.
  • Subject has received treatment with an HIV-1 immunotherapeutic vaccine or any agents with documented activity against HIV-1 in vitro within 28 days prior to Screening, or an anticipated need during the study.
  • Subjects who require treatment with any of the following medications within 28 days of commencement of investigational product, or an anticipated need during the study:
  • Medications with significant drug-drug interactions with efavirenz:voriconazole, terfenadine, astemizole, cisapride, ergot alkaloids (dihydroergotamine, ergonovine, ergotamine, methylergonovine), midazolam, triazolam, St. John's wort, carbamazepine, phenytoin, phenobarbital, rifampin, pimozide, bepridil
  • Medications which may impact on bone mineral density: oral or systemic corticosteroids, anticonvulsants, heparin, warfarin, cyclosporine, bisphosphonates, calcitonin, parathyroid hormone, Vitamin D supplements and analogues, Calcium supplements, oestrogen or progesterone replacement (oral hormonal contraception permitted), raloxifene, tamoxifen, testosterone or anabolic steroid replacement/supplements.
  • Systemic interleukins or interferons
  • Subject has a history of allergy to any of the protocol-specified medications or any excipients therein.
  • Subject has evidence of genotypic resistance at screening (according to central lab interpretation) or prior documented evidence of genotypic and/or phenotypic (above threshold for reduced susceptibility) resistance to any of the following drugs: efavirenz, abacavir, lamivudine, tenofovir, emtricitabine.
  • Subjects who are unsuitable for DEXA scanning should be excluded, including 1) Less than three vertebra in the range of L1 to L4 that are suitable for BMD measurement by DEXA, or 2) Bilateral hip replacement.
  • The subject has previously participated in an experimental drug and/or vaccine trial(s) within 60 days or 5 half-lives, or twice the duration of the biological effect of the experimental drug or vaccine - whichever is longer, prior to screening for the study.
  • The subject will participate simultaneously in another clinical study.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00549198). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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