HIV InfectionsPhase 3SPIRALNCT00528892
Switching From PI to RALtegravir in HIV Stable Patients
A Phase 3 study testing Raltegravir and boosted PI in people with HIV Infections, run by Hospital Clinic of Barcelona at 1 site in Spain.
Trial summary
The investigators hypothesis is that switching from a ritonavir-boosted PI to raltegravir may be associated with an at least non-inferior effectiveness, virological response and safety, and even a better tolerability profile with regard to lipid metabolism, insulin resistance, body fat distribution as compared with… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- HIV Infections
- What is being tested?
- Raltegravir and boosted PI
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 282 participants
- Where
- 1 siteSpain
- Study dates
- Jan 2008to Mar 2010
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patient is a male or female at least 18 years of age.
- Women of childbearing potential must have a negative serum pregnancy test (HCG) within 10 days prior to randomization into the study.
- Patients must use adequate birth control measures (barrier method.)
- Patients must be HIV 1 seropositive using standard diagnostic criteria.
- Patients must have two plasma viral RNA measurements below detection limits with the routine ultrasensitive method used at each participating site (at least <50 copies/mL) within 180 days prior to randomization into this study.
- Patients must be on continuous therapy with HAART consisting of a ritonavir-boosted protease-inhibitor (PI) and at least two other antiretroviral agents for at least 6 months prior to randomization into this study, with no planned drug changes in the following 12 months. Boosted PIs can be indinavir, fosamprenavir, saquinavir, lopinavir, atazanavir, tipranavir or darunavir.
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- Patients must be considered clinically stable, in the opinion of the investigator, at the time of entry into the study; i.e., clinical status and all chronic medications should be unchanged for at least 14 days prior to randomization. Patients currently receiving treatment for an opportunistic infection may be allowed into the study as long as the above criteria are met. Prophylaxis for opportunistic infections consistent with standard treatment is permissible. .
- The following laboratory values must be obtained within 2-4 weeks of randomization into the study:
- Hemoglobin >8.0 g/dL.
- Absolute neutrophil count > 750/mm3
- Platelet count > 50,000/ mm3
- Creatinine < 2.0 mg/dL.
- Transaminases (ALAT, ASAT) <5xULN
Who cannot join
- Pregnancy or breast feeding or women planning pregnancy during the study duration.
- Patients on ART regimens not likely to be maintained during the whole study duration
- Prior use of HIV integrase inhibitors.
- Use of any investigational agents (other than ART on expanded access programme) within 90 days of randomization.
- Alcohol or substance abuse which in the opinion of the investigator would interfere with patient compliance or safety.
- Patients with an active opportunistic infection or malignancy. Patients with a chronic, stable opportunistic infection will be allowed to enter this study.
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- Any condition or history of any illness which, in the opinion of the investigator, might confound the results of the study or pose additional risk in administering the study drugs to the patient.
- Any patient with a diagnosis of visceral Kaposi's sarcoma. Patients with lymphedema secondary to cutaneous Kaposi's sarcoma, or with cutaneous or palatal Kaposi's sarcoma that has been treated with systemic immunosuppressive therapy must also be excluded.
- Any patient with a diagnosis of acute hepatitis due to any cause. Patients with chronic hepatitis including chronic hepatitis B surface antigenemia chronic hepatitis C may enter the study as long as they have stable liver function tests and meet all inclusion criteria. Patients with acute exacerbations of chronic hepatitis are excluded.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: An Open-label, Randomized, 48-Week Study to Assess the Safety, Tolerability and Activity of Raltegravir When Replacing the Ritonavir-boosted PI Component of HAART in HIV-Infected Individuals With Viral Load Suppression on a Ritonavir-Boosted PI Containing Regimen.
The investigators hypothesis is that switching from a ritonavir-boosted PI to raltegravir may be associated with an at least non-inferior effectiveness, virological response and safety, and even a better tolerability profile with regard to lipid metabolism, insulin resistance, body fat distribution as compared with continuation of the baseline regimen in HIV-1 seropositive males or females at least 18 years of age and older on ritonavir-boosted PI plus at least 2 other drugs and plasma viral RNA below 50 copies/mL.
- Conditions
- HIV Infections
- Being tested
- Raltegravir, boosted PI
- Keywords
- Treatment Experienced
- Medical subject headings
- HIV Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RaltegravirDrug
switching PI to raltegravir
boosted PIDrug
continue on boosted-PI
| Study group | Role | What they receive |
|---|---|---|
| 1 | Experimental | Switch current boosted-PI to raltegravir 400 mg BID. Receives: Drug: Raltegravir |
| 2 | Active comparator | Continue current regimen (ritonavir-boosted PI plus at least 2 other drugs) Receives: Drug: boosted PI |
What is being measured
The primary outcome is the main question the study is designed to answer.
The proportion of patients with treatment failure (i.e.: those with viral failure, developing new CDC-C events, switching assigned treatment for any cause, withdrawing consent, being lost to follow-up or dying)
Measured: 48 weeks
Secondary outcomes (1)
The proportion of patients with viral failure while on assigned treatment (defined as two consecutive plasma HIV-RNA below detection limits)
Measured: 48 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Sep 2007 (estimated)
- Study startJan 2008
- Primary completionMar 2010
- Study completionMar 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for HIV InfectionsStudies of the same condition, open and under way.
- More trials run by Hospital Clinic of BarcelonaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 282 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hospital Clinic of Barcelona
- Sponsor type
- University, hospital or other
- Investigators
- Jose M Gatell, MD, Principal investigator, Hospital Clinic of Barcelona
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00528892
- Sponsor's protocol ID
- SPIRAL
- Other IDs
- EUDRACT: 2007-003401-27
- Acronym
- SPIRAL
- Status last verified
- May 2008
- First submitted
- 10 Sep 2007
- Last updated
- 31 Mar 2010
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Saumoy M, Sanchez-Quesada JL, Martinez E, Llibre JM, Ribera E, Knobel H, Gatell JM, Clotet B, Curran A, Curto J, Maso M, Ordonez-Llanos J, Podzamczer D. LDL subclasses and lipoprotein-phospholipase A2 activity in suppressed HIV-infected patients switching to raltegravir: Spiral substudy. Atherosclerosis. 2012 Nov;225(1):200-7. doi: 10.1016/j.atherosclerosis.2012.08.010. Epub 2012 Sep 6.
PubMed 23017355Martinez E, Larrousse M, Llibre JM, Gutierrez F, Saumoy M, Antela A, Knobel H, Murillas J, Berenguer J, Pich J, Perez I, Gatell JM; SPIRAL Study Group. Substitution of raltegravir for ritonavir-boosted protease inhibitors in HIV-infected patients: the SPIRAL study. AIDS. 2010 Jul 17;24(11):1697-707. doi: 10.1097/QAD.0b013e32833a608a.
PubMed 20467288
Study at a glance
From the registry record, last updated by the sponsor on 31 Mar 2010. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Open-label, Randomized, 48-Week Study to Assess the Safety, Tolerability and Activity of Raltegravir When Replacing the Ritonavir-boosted PI Component of HAART in HIV-Infected Individuals With Viral Load Suppression on a Ritonavir-Boosted PI Containing Regimen.
- ClinicalTrials.gov ID
- NCT00528892
- Acronym / sponsor ID
- SPIRAL / SPIRAL
- Conditions
- HIV Infections
- Keywords
- Treatment Experienced
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 282 participants (actual)
- Lead sponsor
- Hospital Clinic of BarcelonaUniversity, hospital or other
- Study start
- Jan 2008
- Primary completion
- Mar 2010 (actual)
- Study completion
- Mar 2010 (actual)
- First posted
- 12 Sep 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators hypothesis is that switching from a ritonavir-boosted PI to raltegravir may be associated with an at least non-inferior effectiveness, virological response and safety, and even a better tolerability profile with regard to lipid metabolism, insulin resistance, body fat distribution as compared with continuation of the baseline regimen in HIV-1 seropositive males or females at least 18 years of age and older on ritonavir-boosted PI plus at least 2 other drugs and plasma viral RNA below 50 copies/mL.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 1 | Experimental | Drug: RaltegravirSwitch current boosted-PI to raltegravir 400 mg BID. |
| 2 | Active comparator | Drug: boosted PIContinue current regimen (ritonavir-boosted PI plus at least 2 other drugs) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (13 listed)
- Patient is a male or female at least 18 years of age.
- Women of childbearing potential must have a negative serum pregnancy test (HCG) within 10 days prior to randomization into the study.
- Patients must use adequate birth control measures (barrier method.)
- Patients must be HIV 1 seropositive using standard diagnostic criteria.
- Patients must have two plasma viral RNA measurements below detection limits with the routine ultrasensitive method used at each participating site (at least <50 copies/mL) within 180 days prior to randomization into this study.
Key exclusion criteria (9 listed)
- Pregnancy or breast feeding or women planning pregnancy during the study duration.
- Patients on ART regimens not likely to be maintained during the whole study duration
- Prior use of HIV integrase inhibitors.
- Use of any investigational agents (other than ART on expanded access programme) within 90 days of randomization.
- Alcohol or substance abuse which in the opinion of the investigator would interfere with patient compliance or safety.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Raltegravirswitching PI to raltegravir | Drug | 1 |
| boosted PIcontinue on boosted-PI | Drug | 2 |
Primary outcome
The proportion of patients with treatment failure (i.e.: those with viral failure, developing new CDC-C events, switching assigned treatment for any cause, withdrawing consent, being lost to follow-up or dying)
Time frame: 48 weeks
1 secondary outcome
The proportion of patients with viral failure while on assigned treatment (defined as two consecutive plasma HIV-RNA below detection limits)
Time frame: 48 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Mar 2010.
- Derived from this study: PubMed 23017355Saumoy M, Sanchez-Quesada JL, Martinez E, Llibre JM, Ribera E, Knobel H, Gatell JM, Clotet B, Curran A, Curto J, Maso M, Ordonez-Llanos J, Podzamczer D. LDL subclasses and lipoprotein-phospholipase A2 activity in suppressed HIV-infected patients switching to raltegravir: Spiral substudy. Atherosclerosis. 2012 Nov;225(1):200-7. doi: 10.1016/j.atherosclerosis.2012.08.010. Epub 2012 Sep 6.
- Derived from this study: PubMed 20467288Martinez E, Larrousse M, Llibre JM, Gutierrez F, Saumoy M, Antela A, Knobel H, Murillas J, Berenguer J, Pich J, Perez I, Gatell JM; SPIRAL Study Group. Substitution of raltegravir for ritonavir-boosted protease inhibitors in HIV-infected patients: the SPIRAL study. AIDS. 2010 Jul 17;24(11):1697-707. doi: 10.1097/QAD.0b013e32833a608a.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jose M Gatell, MD principal investigator
Hospital Clinic of Barcelona
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Raltegravir and boosted PI in people with HIV Infections, run by Hospital Clinic of Barcelona at 1 site in Spain.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 13 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Mar 2010. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The proportion of patients with treatment failure (i.e.: those with viral failure, developing new CDC-C events, switching assigned treatment for any cause, withdrawing consent, being lost to follow-up or dying) (time frame: 48 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00528892, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Mar 2010.