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HIV - Human Immunodeficiency VirusEarly Phase 1COMONCT02144688

COMO: Cognition Study With HIV+ Patients (CTNPT 015)

A Early Phase 1 study testing Change in antiretrovirals in people with HIV - Human Immunodeficiency Virus and Cognitive Symptoms, run by Marie-Josée Brouillette at 1 site in Canada.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to contribute evidence towards the potential to improve cognition in HIV+ individuals experiencing cognitive decline through personalized change in antiretroviral (ARV) medication. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Change in antiretrovirals
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
1 siteCanada
Study dates
Jun 2011to Mar 2016
Phase
Early Phase 1
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

  • are 18 years and older
  • have the capacity to give informed consent as determined by the research nurse
  • have unexplained cognitive decline (reported either by the patient or an outside informant)
  • have been on a stable ART regimen for > 6 months
  • have an undetectable viral load in plasma for at least 6 months (a single blip of ≤ 150 copies/mL will be accepted)
  • have not had a change in medications that could potentially interfere with cognition in the past 4 months

Who cannot join

  • detectable VL in the plasma
  • past history of dementia
  • past history of Central Nervous System opportunistic infection or stroke
  • current substance abuse ( as per DSM-IV criteria) other than cigarettes
  • coagulopathy
  • thrombocytopenia
  • use of Coumadin
  • intra-cranial hypertension

Trial locations and contacts

1 site in 1 country.

Canada1 site

  • Montreal Chest Institute - Chronic Viral Illness Service - McGill University Health Centre (MUHC)

    Montreal, Quebec, H2X 2P4

Other trials in Canada

About this study

Official title: CTNPT 015 - Pilot Project to Implement a Step-wise Investigation That Includes Cerebrospinal (CSF) Analysis as a Standard of Care for HIV+ Individuals With Cognitive Symptoms

The purpose of this study is to contribute evidence towards the potential to improve cognition in HIV+ individuals experiencing cognitive decline through personalized change in antiretroviral (ARV) medication. To that end, following a comprehensive evaluation to identify confounding clinical conditions, study participants will undergo a lumbar puncture to: (i) measure viral load (at 2 copies/ml); (ii) identify Cerebrospinal Fluid (CSF) genotype and tropism; and (iii) measure concentration of antiretroviral agents. When indicated from the CSF analysis, a personalized change in ARV will be implemented. Cognition will be measured in all at study entry and 6 months later.

Being tested
Change in antiretrovirals
Keywords
Human Immunodeficiency Virus, HIV, Cognitive symptoms, Cognitive evaluation, Neuropsychological testing, Quality of life, Anxiety, Viral load, Antiretroviral, Cerebrospinal fluid, Lumbar puncture, Magnetic resonance imaging, MRI
Medical subject headings
Acquired Immunodeficiency Syndrome, Neurobehavioral Manifestations, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Change in antiretroviralsDrug

    Change in ARVs to improve cognition: Personalized change in antiretrovirals will be based on CSF analysis

Study groups in NCT02144688
Study groupRoleWhat they receive
Change in ARVs to improve cognitionExperimentalChange in ARVs to improve cognition: Personalized change in antiretrovirals will be based on CSF analysis
Receives: Drug: Change in antiretrovirals

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in neurocognitive functioning over 6 months

    Cognition will be assessed at study entry and 6 months with the following tests: Letter Fluency, Category Fluency, Letter-Number Sequencing, Digit-Symbol, Symbol Search, Grooved Pegboard, Hopkins Verbal Learning Test-Revised, Stroop, Brief Visuospatial Memory Test-Revised, Tower of London, Trail Making Test A and B, Spatial Span, Montreal Cognitive Assessment (MoCA), and a brief computerized battery of tests (B-CAM).

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 May 2014 (estimated)
  2. Study startJun 2011
  3. Primary completionMar 2016
  4. Study completionMar 2016

Why it stopped: In 14 participants who had LP, very low level viremia was found in only 1

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02144688
Sponsor's protocol ID
CTNPT 015
Acronym
COMO
Status last verified
Mar 2016
First submitted
29 Mar 2014
Last updated
16 Mar 2016
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Undecided

Publications

  • Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, Clifford DB, Cinque P, Epstein LG, Goodkin K, Gisslen M, Grant I, Heaton RK, Joseph J, Marder K, Marra CM, McArthur JC, Nunn M, Price RW, Pulliam L, Robertson KR, Sacktor N, Valcour V, Wojna VE. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007 Oct 30;69(18):1789-99. doi: 10.1212/01.WNL.0000287431.88658.8b. Epub 2007 Oct 3.

    PubMed 17914061

  • Morrison NE, Collins FM. Immunogenicity of an aerogenic BCG vaccine in T-cell-depleted and normal mice. Infect Immun. 1975 May;11(5):1110-21. doi: 10.1128/iai.11.5.1110-1121.1975.

    PubMed 123519

  • Becker JT, Lopez OL, Dew MA, Aizenstein HJ. Prevalence of cognitive disorders differs as a function of age in HIV virus infection. AIDS. 2004 Jan 1;18 Suppl 1:S11-8.

    PubMed 15075493

  • Canestri A, Lescure FX, Jaureguiberry S, Moulignier A, Amiel C, Marcelin AG, Peytavin G, Tubiana R, Pialoux G, Katlama C. Discordance between cerebral spinal fluid and plasma HIV replication in patients with neurological symptoms who are receiving suppressive antiretroviral therapy. Clin Infect Dis. 2010 Mar 1;50(5):773-8. doi: 10.1086/650538.

    PubMed 20100092

  • Carey CL, Woods SP, Gonzalez R, Conover E, Marcotte TD, Grant I, Heaton RK; HNRC Group. Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection. J Clin Exp Neuropsychol. 2004 May;26(3):307-19. doi: 10.1080/13803390490510031.

    PubMed 15512922

  • Cherner M, Ellis RJ, Lazzaretto D, Young C, Mindt MR, Atkinson JH, Grant I, Heaton RK; HIV Neurobehavioral Research Center Group. Effects of HIV-1 infection and aging on neurobehavioral functioning: preliminary findings. AIDS. 2004 Jan 1;18 Suppl 1:S27-34.

    PubMed 15075495

  • Cysique LA, Vaida F, Letendre S, Gibson S, Cherner M, Woods SP, McCutchan JA, Heaton RK, Ellis RJ. Dynamics of cognitive change in impaired HIV-positive patients initiating antiretroviral therapy. Neurology. 2009 Aug 4;73(5):342-8. doi: 10.1212/WNL.0b013e3181ab2b3b. Epub 2009 May 27.

    PubMed 19474412

  • Cysique LA, Brew BJ. Neuropsychological functioning and antiretroviral treatment in HIV/AIDS: a review. Neuropsychol Rev. 2009 Jun;19(2):169-85. doi: 10.1007/s11065-009-9092-3. Epub 2009 May 9.

    PubMed 19424802

  • Cysique LA, Maruff P, Brew BJ. Variable benefit in neuropsychological function in HIV-infected HAART-treated patients. Neurology. 2006 May 9;66(9):1447-50. doi: 10.1212/01.wnl.0000210477.63851.d3.

    PubMed 16682686

  • De Luca A, Ciancio BC, Larussa D, Murri R, Cingolani A, Rizzo MG, Giancola ML, Ammassari A, Ortona L. Correlates of independent HIV-1 replication in the CNS and of its control by antiretrovirals. Neurology. 2002 Aug 13;59(3):342-7. doi: 10.1212/wnl.59.3.342.

    PubMed 12177366

  • Ellis RJ, Moore DJ, Childers ME, Letendre S, McCutchan JA, Wolfson T, Spector SA, Hsia K, Heaton RK, Grant I. Progression to neuropsychological impairment in human immunodeficiency virus infection predicted by elevated cerebrospinal fluid levels of human immunodeficiency virus RNA. Arch Neurol. 2002 Jun;59(6):923-8. doi: 10.1001/archneur.59.6.923.

    PubMed 12056927

  • Florkowski CM. Sensitivity, specificity, receiver-operating characteristic (ROC) curves and likelihood ratios: communicating the performance of diagnostic tests. Clin Biochem Rev. 2008 Aug;29 Suppl 1(Suppl 1):S83-7.

    PubMed 18852864

  • Hardy DJ, Vance DE. The neuropsychology of HIV/AIDS in older adults. Neuropsychol Rev. 2009 Jun;19(2):263-72. doi: 10.1007/s11065-009-9087-0. Epub 2009 Feb 27.

    PubMed 19247836

  • McCutchan JA, Wu JW, Robertson K, Koletar SL, Ellis RJ, Cohn S, Taylor M, Woods S, Heaton R, Currier J, Williams PL. HIV suppression by HAART preserves cognitive function in advanced, immune-reconstituted AIDS patients. AIDS. 2007 May 31;21(9):1109-17. doi: 10.1097/QAD.0b013e3280ef6acd.

    PubMed 17502721

  • Jones RN, Gallo JJ. Dimensions of the Mini-Mental State Examination among community dwelling older adults. Psychol Med. 2000 May;30(3):605-18. doi: 10.1017/s0033291799001853.

    PubMed 10883716

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing Change in antiretrovirals in people with HIV - Human Immunodeficiency Virus and Cognitive Symptoms, run by Marie-Josée Brouillette at 1 site in Canada.

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 6 inclusion and 8 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: stopped early, as of the sponsor's last update on 16 Mar 2016. 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 Canada. 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?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

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 was stopped early (reason given: In 14 participants who had LP, very low level viremia was found in only 1). Results are not available in the source record.

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?

Changes in neurocognitive functioning over 6 months (time frame: 6 months). 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 NCT02144688, which also lists 30 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 16 Mar 2016.

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