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HIVPhase 1/2LOLIPOPNCT03836833

Lopinavir/r/ Lamivudine/ Abacavir as an Easy to Use Paediatric Formulation

A Phase 1/2 study testing ABC/3TC/LPV/r granules (30/15/40/10 mgs) and LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs) in people with HIV, run by Drugs for Neglected Diseases at 3 sites in Uganda.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

A phase I/II, open label, randomized crossover pharmacokinetic, safety and acceptability study of the Abacavir/Lamivudine/ Lopinavir/Ritonavir (30/15/ 40/10mg ;4-in-1) Fixed-Dose Combination vs. Lopinavir/Ritonavir (40/10mg pellets) plus dual Abacavir/Lamivudine (60/30mg tablets) in HIV infected Children. Read more about this study

Who is it for?
Ages 4 weeks and older
Conditions the study is for
HIV
What is being tested?
ABC/3TC/LPV/r granules (30/15/40/10 mgs) and LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
3 sitesUganda
Study dates
4 Jun 2019to Dec 2019
Phase
Phase 1/2
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 4 weeks and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Children > 4 weeks old and weighing ≥3 and <25 kg at the time of enrolment
  • Past or current documentation of a confirmed diagnosis of HIV infection defined as two positive assays from two different samples. The two results may be in any combination of the following:
  • At any age: HIV-1 DNA PCR positive
  • Documented past HIV-1 RNA viral load > 1,000 copies/mL plasma
  • At any age >18 months of age: HIV-1 antibody reactive on two different rapid tests based on national testing algorithm
  • ARV treatment eligible children with LPV-based treatment indication* as defined by country-specific guidelines or the WHO paediatric treatment guidelines and confirmed by the investigator
Show all 11Show fewer
  • HIV RNA viral load <1000 copies/mL (suppressed) at the screening visit*
  • Inability to swallow LPV/r tablets
  • Parent or guardian able and willing to provide written informed consent.
  • For lowest weight band (≥3 and ≤ 5.9kgs) ONLY: under treatment for at least 3 weeks but not more than 12 weeks.
  • Does not apply to the youngest children (≥3 and ≤ 5.9kgs)

Who cannot join

  • Planned or concurrent use of NNRTIs, integrase inhibitors, entry inhibitors, or Protease Inhibitors (PIs) other than LPV/r.
  • Treatment failure with proven resistances to PIs.
  • Contraindication to use of PIs
  • Clinical condition requiring the use of a prohibited medication (see section 7.6) in association with LPV/r, ABC/3TC (Refer to section 7.2- 7.3 of the IB)
  • Pulmonary Tuberculosis and any clinically significant disease or finding during screening that, in the investigator's opinion, would compromise participation in this study.
  • Treatment with experimental drugs (except for LPV/r Pellets) for any indication within 30 days prior to study entry
  • Anticipated transfer of care to a non-participating health facility during the study period

Trial locations and contacts

3 sites in 1 country.

Isabelle Andrieux-Meyer, MD contact

+41 22 906 92 68

iandrieux-meyer@dndi.org

Uganda3 sites, 3 recruiting
  • Baylor College of Medicine Children's Foundation Uganda

    Kampala

    Prof. Adeodata Kekitiinwa, MBChM, MMeD, +256772462686, akekitiinwa@baylor-uganda.org

    Recruiting
  • Joint Clinical research Centre

    Kampala

    Victor Musiime, MBChB,PhD, +256 417 723000, vmusiime@jcrc.org.ug

    Recruiting
  • Epicentre Mbarara Research Centre

    Mbarara

    Prof. Juliet Mwanga, MBChB, MMED, +256 793328748, juliet.mwanga@epicentre.msf.org

    Recruiting

Other trials in Uganda

About this study

Official title: Pharmacokinetic, Safety and Acceptability Study of the Abacavir/Lamivudine/Lopinavir/Ritonavir/-30/15/ 40/10mg vs. Lopinavir/Ritonavir 40/10mg Pellets Plus Dual Abacavir/Lamivudine-60/30mg Tablets in HIV Infected Children

A phase I/II, open label, randomized crossover pharmacokinetic, safety and acceptability study of the Abacavir/Lamivudine/ Lopinavir/Ritonavir (30/15/ 40/10mg ;4-in-1) Fixed-Dose Combination vs. Lopinavir/Ritonavir (40/10mg pellets) plus dual Abacavir/Lamivudine (60/30mg tablets) in HIV infected Children.

The study is intended to support the adoption of the 4-in-1 by healthcare providers and will provide data that may support its registration in certain countries. The study will be carried out in HIV-infected children in Uganda weighing 3 to 25 kg (inclusive) and unable to swallow tablets and will provide supportive clinical data on the pharmacokinetics, safety, tolerability and acceptability of the 4-in-1.

Read the detailed description

The primary objective is to estimate the population average exposure to LPV, ABC and 3TC provided by the 4-in-1 formulation in HIV-infected children dosed per WHO weight bands.

The secondary objectives:

  • To determine the proportion of children overall, and within each weight band, with a lopinavir C12 <1.0 mg/L while receiving the 4-in-1 formulation
  • To evaluate and compare the safety and tolerability of the 4-in-1 formulation versus a reference treatment regimen.
  • To compare the bioavailability of LPV, ABC and 3TC in the 4-in-1 formulation versus a reference treatment regimen.
  • To assess post exposure CD4 and viral load
  • To assess the factors that contribute to acceptability of the new 4-in-1 formulation.
Conditions
HIV
Being tested
ABC/3TC/LPV/r granules (30/15/40/10 mgs), LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs)

What participants receive

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

  • ABC/3TC/LPV/r granules (30/15/40/10 mgs)Drug

    Also called 4in1 Granules

    This is a fixed dose combination. Each capsule contains Lopinavir (40mg), Ritonavir (10mg), Abacavir (30mg) and Lamivudine (15mg) in granules formulation.

    Dosage according to patient's weight:

    Between 3 and 5.9kg: 2 capsules twice a day Between 6 and 9.9kg: 3 capsules twice a day Between 10 and 13.9kg: 4 capsules twice a day Between 14 and 19.9kg: 5 capsules twice a day Between 20 and 24.9kg: 6 capsules twice a day

  • LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs)Drug

    Also called L PV/r Pellets Plus ABC/3TC tablets

    Lopinavir/Ritonavir (40/10mg pellets) plus dual Abacavir/Lamivudine (60/30mg dispersible tablets)

    Dosage according to patient's weight:

    LPV/r Pellets:

    Between 3 and 5.9kg: 2 capsules twice a day Between 6 and 9.9kg: 3 capsules twice a day Between 10 and 13.9kg: 4 capsules twice a day Between 14 and 19.9kg: 5 capsules twice a day Between 20 and 24.9kg: 6 capsules twice a day

    ABC/3TC:

    Between 3 and 5.9kg: 1 tablet twice a day Between 6 and 9.9kg: 1.5 tablets twice a day Between 10 and 13.9kg: 2 tablets twice a day Between 14 and 19.9kg: 2.5 tablets twice a day Between 20 and 24.9kg: 3 tablets twice a day

Study groups in NCT03836833
Study groupRoleWhat they receive
4in1 granulesExperimentalAbacavir/Lamivudine/ Lopinavir/Ritonavir (30/15/ 40/10mg ;4-in-1) Fixed-Dose Combination in granules formulation administered twice daily for at least 3 weeks, Followed by Lopinavir/Ritonavir (40/10mg pellets) plus dual Abacavir/Lamivudine (60/30mg dispersible tablets) administered twice daily for at least 3 weeks.
Receives: Drug: ABC/3TC/LPV/r granules (30/15/40/10 mgs); Drug: LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs)
LPV/r Pellets Plus ABC/3TCExperimentalLopinavir/Ritonavir (40/10mg pellets) plus dual Abacavir/Lamivudine (60/30mg dispersible tablets) administered twice daily for at least 3 weeks. Followed by Abacavir/Lamivudine/ Lopinavir/Ritonavir (30/15/ 40/10mg ;4-in-1) Fixed-Dose Combination in granules formulation administered twice daily for at least 3 weeks
Receives: Drug: ABC/3TC/LPV/r granules (30/15/40/10 mgs); Drug: LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs)

What is being measured

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

  1. 0 -12 hours Area under the curve plasma concentration versus time for LPV, ABC and 3TC in the 4-in- formulation

    0 -12 hours Area under the curve plasma concentration versus time for LPV, ABC and 3TC in the 4-in- formulation

    Measured: 0-12 hours

Secondary outcomes (14)
  1. Plasma concentration at 12 hours for LPV in the 4in1 formulation

    Plasma concentration at 12 hours for LPV in the 4in1 formulation

    Measured: 12 hours

  2. Peak plasma concentration (Cmax) of LPV, ABC and 3TC with the 4-in-1 formulation.

    Plasma concentration maximum of LPV, ABC and 3TC with the 4-in-1 formulation.

    Measured: 3-5 weeks

  3. Concentration time maximum for LPV, ABC and 3TC with the 4-in-1 formulation.

    Concentration time maximum for LPV, ABC and 3TC with the 4-in-1 formulation.

    Measured: 3-5 weeks

  4. Clearance function for LPV, ABC and 3TC with the 4-in-1 formulation.

    Clearance function for LPV, ABC and 3TC with the 4-in-1 formulation.

    Measured: 3-5 weeks

  5. Geometric mean ratio (GMR) of steady state LPV, ABC and 3TC versus time (0-12) in the 4-in-1 formulation versus the reference treatment regimen

    Geometric mean ratio (GMR) of steady state LPV, ABC and 3TC versus time (0-12) in the 4-in-1 formulation versus the reference treatment regimen.

    Measured: 0 - 12 hours

  6. Area under curve plasma concentration versus time (0-12) in the 4-in-1 formulation versus the reference treatment regimen.

    Area under curve plasma concentration versus time (0-12) in the 4-in-1 formulation versus the reference treatment regimen.

    Measured: 0 - 12 hours

  7. Geometric mean ratio (GMR) of steady state LPV, ABC and 3TC in the 4-in-1 formulation versus the reference treatment regimen.

    Geometric mean ratio (GMR) of steady state LPV, ABC and 3TC in the 4-in-1 formulation versus the reference treatment regimen.

    Measured: 0 - 12 hours

  8. Peak plasma concentration in the 4-in-1 formulation versus the reference treatment regimen.

    Peak plasma concentration in the 4-in-1 formulation versus the reference treatment regimen.

    Measured: 3-5 weeks

  9. Safety: A description of the proportion of children experiencing an Adverse event or Serious Adverse event binomial distribution compared between the two formulations.

    Safety: A description of the proportion of children experiencing an Adverse event or Serious Adverse event binomial distribution compared between the two formulations.

    Measured: 6-8 weeks

  10. Safety: Summary of the number and percent of subjects with documented Grade 3 or higher adverse events; each summary will be conducted overall and by formulation

    Safety: Summary of the number and percent of subjects with documented Grade 3 or higher adverse events; each summary will be conducted overall and by formulation

    Measured: 6-8 weeks

  11. Proportion of children with viral load <1000 copies/ml

    Comparison of proportion of children with viral load less than 1000 copies/ml at baseline and at end of the study.

    Measured: 6-8 weeks

  12. Changes in CD4 counts compared to baseline

    Changes in CD4 counts compared to baseline

    Measured: 6-8 week

  13. Changes in CD4 percentage compared to baseline

    Changes in CD4 percentage compared to baseline

    Measured: 6-8 weeks

  14. Acceptability: Description of factors that affect acceptability of the 4 in1 formulation

    Description of factors that affect acceptability of the 4in1 formulation as reported by the caregivers

    Measured: 6-8 weeks

Timeline

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

  1. First posted11 Feb 2019
  2. Study start4 Jun 2019
  3. Primary completionNov 2019 (estimated)
  4. Study completionDec 2019 (estimated)

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
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03836833
Sponsor's protocol ID
DNDi-4in1-01-PHIV
Acronym
LOLIPOP
Status last verified
May 2019
First submitted
13 Dec 2018
Last updated
7 Jun 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Rotsaert A, Ogara C, Mwanga-Amumpaire J, Kekitiinwa AR, Musiime V, Najjingo E, Kisitu GP, Nazzinda R, Nambi E, Lee J, Diallo M, Kyomuhendo F, Waweru M, Andrieux-Meyer I, Nostlinger C. Acceptability of a new 4-in-1 Abacavir/Lamivudine/Lopinavir/Ritonavir paediatric fixed-dose combination: the caregiver-child dyads' perspective. Ther Adv Infect Dis. 2023 Mar 21;10:20499361231159993. doi: 10.1177/20499361231159993. eCollection 2023 Jan-Dec.

    PubMed 36968554

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing ABC/3TC/LPV/r granules (30/15/40/10 mgs) and LPV/r Pellets (40/10mgs) plus ABC/3TC (60/30mgs) in people with HIV, run by Drugs for Neglected Diseases at 3 sites in Uganda.

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 11 inclusion and 7 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: status not confirmed, as of the sponsor's last update on 7 Jun 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Uganda. 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 combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Isabelle Andrieux-Meyer, MD (+41 22 906 92 68, iandrieux-meyer@dndi.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

0 -12 hours Area under the curve plasma concentration versus time for LPV, ABC and 3TC in the 4-in- formulation (time frame: 0-12 hours). 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 NCT03836833, which also lists 1 linked publication.

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 7 Jun 2019.

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