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N/A N=214 Randomized Triple-blind Diagnostic

Vitamin D Absorption in HIV Infected Young Adults Being Treated With Tenofovir Containing cART

HIV Infection

Enrolled (actual)
214
Serious AEs
5.1%
Results posted
Mar 2019
Primary outcome: Primary: Percent Change From Baseline to Week 48 in Dual Energy X-ray Absorptiometry (DXA)-Measured BMD at the Spine for the Randomized Study Groups — 0.19; 0.09 percent change — p=0.1166

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Vitamin D3 50,000 IU (Dietary_supplement); Vitamin D3 placebo (Dietary_supplement)
Age
Pediatric, Adult · 16+ yrs
Sex
All
Sponsor
University of North Carolina, Chapel Hill
Primary completion
Jun 2016

Outcome Measures

OutcomeResultp-value
PRIMARY
Percent Change From Baseline to Week 48 in Dual Energy X-ray Absorptiometry (DXA)-Measured BMD at the Spine for the Randomized Study Groups
0.19; 0.09 0.1166
SECONDARY
Percent Change From Baseline to Week 24 of BMC of Whole Body for the Randomized Study Groups
0.25; 0.07
SECONDARY
Percent Change From Baseline to Week 48 of BMC of Whole Body for the Randomized Study Groups
0.08; 0.07 0.8383
SECONDARY
Percent Change From Baseline to Week 24 of Lumbar Spine (L1-L4) BMD for the Randomized Study Groups
0.94; 0.42
SECONDARY
Change From Baseline to Week 24 of Lumbar Spine (L1-L4) BMD Z-score for the Randomized Study Groups
0.00; 0.00
SECONDARY
Change From Baseline to Week 48 of Lumbar Spine (L1-L4) BMD Z-score for the Randomized Study Groups
0.00; -0.10 0.1378
SECONDARY
Percent Change From Baseline to Week 24 of Femoral Neck BMD for the Randomized Study Groups
-0.10; -0.04
SECONDARY
Percent Change From Baseline to Week 48 of Femoral Neck BMD for the Randomized Study Groups
-0.30; -0.11 0.4686
SECONDARY
Change From Baseline to Week 24 of Femoral Neck BMD Z-score for the Randomized Study Groups
0.00; 0.00
SECONDARY
Change From Baseline to Week 48 of Femoral Neck BMD Z-score for the Randomized Study Groups
0.00; 0.00 0.7601
SECONDARY
Percent Change From Baseline to Week 24 of Total Hip BMD for the Randomized Study Groups
-0.27; 0.00
SECONDARY
Percent Change From Baseline to Week 48 of Total Hip BMD for the Randomized Study Groups
-0.17; -0.42 0.3978
SECONDARY
Change From Baseline to Week 24 of Total Hip BMD Z-score for the Randomized Study Groups
0.00; 0.00
SECONDARY
Change From Baseline to Week 48 of Total Hip BMD Z-score for the Randomized Study Groups
0.00; 0.00 0.1187
SECONDARY
Change in SCr From Baseline to Week 12.
0.03; 0.02
SECONDARY
Change in SCr From Baseline to Week 24.
0.02; 0.02
SECONDARY
Change in SCr From Baseline to Week 48.
0.03; 0.01 0.5098
SECONDARY
Change From Baseline to Week 48 in Glucose Homeostasis (Fasting Insulin)
0.45; -0.83 0.2550
SECONDARY
Change From Baseline to Week 48 in Glucose Homeostasis (Fasting Glucose)
0.05; -0.20 0.6499
SECONDARY
Change From Baseline to Week 48 in Glucose Homeostasis (Homeostasis Model Assessment of Insulin Resistance (HOMA-IR))
0.07; -0.15 0.2348
SECONDARY
Change From Baseline to Week 12 in Serum Calcium (SCa)
-0.02; 0.08
SECONDARY
Change From Baseline to Week 24 in Serum Calcium (SCa)
-0.04; 0.08
SECONDARY
Change From Baseline to Week 48 in Serum Calcium (SCa)
0.00; 0.04 0.2648
SECONDARY
Change From Baseline to Week 12 in CTX
-0.03; -0.02
SECONDARY
Change From Baseline to Week 24 in CTX
-0.03; -0.02
SECONDARY
Change From Baseline to Week 48 in CTX
-0.08; -0.09 0.3728
SECONDARY
Change From Baseline to Week 12 in OC
0.15; -0.10
SECONDARY
Change From Baseline to Week 24 in OC
0.09; -0.22
SECONDARY
Change From Baseline to Week 48 in OC
-0.93; -0.48 0.7825
SECONDARY
Change From Baseline to Week 12 in BAP
-1.05; -1.74
SECONDARY
Change From Baseline to Week 24 in BAP
-2.54; -2.03
SECONDARY
Change From Baseline to Week 48 in BAP
-2.71; -2.19 0.1950
SECONDARY
Change From Baseline to Week 12 in FGF23
3.31; 3.90
SECONDARY
Change From Baseline to Week 24 in FGF23
2.93; 3.65
SECONDARY
Change From Baseline to Week 48 in FGF23
4.77; 3.15 0.7127
SECONDARY
Change From Baseline to Week 12 in PTH
-2.17; -0.82
SECONDARY
Change From Baseline to Week 24 in PTH
-0.25; -1.71
SECONDARY
Change From Baseline to Week 48 in PTH
-2.21; -0.96 0.4676
SECONDARY
Change From Baseline to Week 12 in Actual Free 1,25-OHD
106.50; 53.23
SECONDARY
Change From Baseline to Week 24 in Actual Free 1,25-OHD
98.61; 59.36
SECONDARY
Change From Baseline to Week 48 in Actual Free 1,25-OHD
63.73; 25.66 0.0210 sig
SECONDARY
Change From Baseline to Week 12 in 1,25-OHD
15.61; 6.06
SECONDARY
Change From Baseline to Week 24 in 1,25-OHD
12.90; 8.58
SECONDARY
Change From Baseline to Week 48 in 1,25-OHD
10.52; 2.74 0.0144 sig
SECONDARY
Change From Baseline to Week 12 in 25-OHD
16.33; 6.91
SECONDARY
Change From Baseline to Week 24 in 25-OHD
18.60; 6.78
SECONDARY
Change From Baseline to Week 48 in 25-OHD
17.80; 2.64 < 0.0001 sig
SECONDARY
Change From Baseline to Week 12 in TRP %
-0.71; 0.04
SECONDARY
Change From Baseline to Week 24 in TRP %
-0.59; -0.88
SECONDARY
Change From Baseline to Week 48 in TRP %
-1.55; 0.62 0.0814
SECONDARY
Change From Baseline to Week 12 in SPO4
0.00; 0.02
SECONDARY
Change From Baseline to Week 24 in SPO4
-0.06; 0.03
SECONDARY
Change From Baseline to Week 48 in SPO4
-0.03; -0.12 0.4808
SECONDARY
Change From Baseline to Week 12 in UCa/Ucr
0.00; 0.00
SECONDARY
Change From Baseline to Week 24 in UCa/Ucr
0.01; 0.01
SECONDARY
Change From Baseline to Week 48 in UCa/Ucr
0.00; 0.01 0.3870
SECONDARY
Change in Estimated GFR From Baseline to Week 12.
0.00; 0.00
SECONDARY
Change in Estimated GFR From Baseline to Week 24.
0.00; 0.00
SECONDARY
Change in Estimated GFR From Baseline to Week 48.
-1.91; 0.00 0.4290
SECONDARY
Change in UGluc From Baseline to Week 48
-0.42; -0.43 0.9186
SECONDARY
Change in URBP/UCr Ratio From Baseline to Week 48
-1.06; -4.72 0.4016
SECONDARY
Change in UB2MG From Baseline to Week 48
5.19; 10.75 0.5810
SECONDARY
Change in UProt/ UCr Ratio From Baseline to Week 48
0.00; 0.00 0.1570
SECONDARY
25-OHD Serum Concentration by Randomized Study Group at Week 12
35.14; 23.97
SECONDARY
25-OHD Serum Concentration by Randomized Study Group at Week 24
37.04; 23.30
SECONDARY
25-OHD Serum Concentration by Randomized Study Group at Week 48
36.89; 20.55
SECONDARY
Effect of Concurrent Treatment With Efavirenz on 25-OHD Serum Concentration: Concentration at Baseline by Efavirenz Use
17.02; 19.61
SECONDARY
Effect of Concurrent Treatment With Efavirenz on 25-OHD Serum Concentration: Concentration at Week 48 by Efavirenz Use
28.24; 29.68
SECONDARY
Effect of Concurrent Treatment With Efavirenz on 25-OHD Serum Concentration: Change in Concentration From Baseline to Week 48 by Efavirenz Use
10.97; 9.79 <0.0001 sig
SECONDARY
Effect of Concurrent Treatment With Ritonavir on 25-OHD Serum Concentration: Concentration at Baseline by Ritonavir Use
18.62; 18.69
SECONDARY
Effect of Concurrent Treatment With Ritonavir on 25-OHD Serum Concentration: Concentration at Week 48 by Ritonavir Use
29.46; 28.92
SECONDARY
Effect of Concurrent Treatment With Ritonavir on 25-OHD Serum Concentration: Change in Concentration From Baseline to Week 48 by Ritonavir Use
10.55; 10.02 < 0.0001 sig

Summary

This is a 48 week randomized double-blind, placebo-controlled prospective cohort study of adolescents and young adults with HIV infection in the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) who are currently being treated with cART that includes tenofovir disoproxil fumarate (TDF) as one component of the regimen that includes at least three Food and Drug Administration (FDA)-approved antiretroviral (ARV) drugs for at least 180 days.

Eligibility Criteria

Inclusion Criteria

To be considered eligible for enrollment, an individual must meet the criteria listed below at the time of randomization:

NOTE: If the DXA scan is scheduled prior to randomization, all eligibility criteria must be met prior to performing the DXA scan.

  • Age 16 years and 0 days to 24 years and 364 days;
  • Behaviorally infected with HIV (e.g., sexual contact, injection drug use; not infected by perinatal transmission, blood transfusion, or at age younger than 9 years);
  • HIV-1 infection as documented in subject's medical record by at least one of the following criteria:
  • reactive HIV screening test result with an antibody based FDA-licensed assay followed by a positive supplemental assay (e.g., HIV-1 Western Blot, HIV-1 Indirect Immunofluorescence, Antibody Differentiation Assay (Multispot)); or
  • positive HIV-1 DNA polymerase chain reaction (PCR) assay; or
  • plasma HIV-1 quantitative RNA assay >1, 000 copies/mL; or
  • positive plasma HIV-1 RNA qualitative assay
  • Subjects must have at least one documented HIV viral load that is below 200 copies/mL collected following initiation of TDF containing cART and greater than 90 days prior to randomization; no HIV viral load above 200 copies/mL if measured within the 90 days prior to randomization; and an HIV viral load obtained at screening that is below 200 copies/mL.
  • Currently being treated for at least 180 days by the time of randomization with a TDF containing cART with at least 2 other FDA approved ARVs (NOTE: This may include a TDF-containing fixed drug combination medication);
  • Negative serum hepatitis B surface antigen (HBsAg) at screening or by history within 4 weeks prior to screening (see section 7.1.3);
  • Willingness and ability to remain on the same cART regimen for the duration of study participation;
  • Willingness and ability to participate in the study, follow all study procedures for the duration of study participation, and provide written informed consent or assent with parental permission, if applicable; and
  • For females of child-bearing potential, agreement to use a minimum of one proven-effective method of birth control and willingness to postpone pregnancy for the duration of study participation (see section 5.3.2 for permitted hormonal contraceptives)

Exclusion Criteria

To be considered eligible for enrollment, an individual must not meet any of the criteria listed below at the time of randomization:

NOTE: If the DXA scan is scheduled prior to randomization, all eligibility criteria must be met prior to performing the DXA scan.

  • Prior hypersensitivity to vitamin D;
  • History of sarcoidosis, arteriosclerosis, renal stones, glomerulonephritis, interstitial kidney disease, nephrotic syndrome, hypercalcemia, osteoporosis and/or other bone diseases, clinical diagnosis of hypoparathyroidism or hyperparathyroidism;
  • Lactation or pregnancy currently or within the past 24 weeks;
  • Chemotherapy or radiation therapy for malignancy within the past 12 months;
  • Known presence of GI disease that, in the opinion of the clinician, would interfere with study agent administration or absorption (e.g. Crohn's, Colitis);
  • For subjects ≥ 18 years, confirmed creatinine clearance Upper Limit Normal (ULN) for local laboratory values (see section 7.1.3);
  • Active Grade 3 or higher clinical or laboratory toxicity except atazanavir (ATV) associated indirect hyperbilirubinemia (see section 9.5.2.2);
  • Weight is > 350 pounds (lbs) or 159 kilograms (kgs);
  • Positive hepatitis C antibody by history or at screening (see section 7.1.3); and
  • Use of any medications as specified in sections 5.3.1, 5.3.3 and 5.4.
  • Females Only: Use of certain hormonal contraceptives as specified in the protocol.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01751646). 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.

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