HIV Infections Clinical Trial
Official title:
Understanding Changes in Treatment-related Regional Bone Turnover Using 18F-fluoride-PET/CT in HIV-1-infected Men: PETRAM Study
This is a 48 week study to explore the pathogenesis of HIV treatment related bone disease by using a novel imaging technique, 18F-Fluoride Positron Emission Tomography (18F-PET/CT), which measures regional bone formation. The study will include other standard methods (serum bone markers and DXA) for comparison. Patients enrolled will have baseline, week 24 and week 48 assessment, with baseline being the date of replacing tenofovir disoproxil fumarate (TDF) in their HIV treatment regimen with tenofavir alafenamide fumarate (TAF), compared to a control group continuing TDF. Allocation to change to TAF or continue TDF will be randomised to allow an unbiased assessment of bone changes.
Study Design:
This is an observational, open-label, non-randomised, single centre, 48-week study to explore
the utility of a novel scanning platform exploring bone turnover during an immediate or
deferred (for 48 weeks) switch from Eviplera® to Odefsey® in HIV-1 infected men aged 40 years
or older, and stable on Eviplera®.
Participants:
HIV-1-infected males, aged ≥40 years, on Eviplera® >24 weeks, with plasma HIV RNA (pVL)
<50cp/mL and without any known history of osteoporosis.
Groups to be Compared: 1. HIV-1-infected males aged ≥40, stable on Eviplera® (rilpivirine
(RPV)/emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF)) and remaining on EvipleraÒ for
48 weeks on study; 2. HIV-1-infected males aged ≥40 years, switched to Odefsey®
(RPV/FTC/tenofovir alafenamide (TAF)) at study enrollment.
Study Hypothesis: We hypothesis that there will be ongoing subclinical loss of bone at the
hip and lumbar spine as measured by 18F-fluoride-PET/CT in those remaining of Eviplera®, and
in those switching to Odefsey® there will be reversal of some of this subclinical loss at 24
and 48 weeks post switch.
Primary Outcome Measure(s):To determine the change in regional bone formation at the hip and
lumbar spine as measured by 18F-fluoride-PET/CT at 24 weeks post switch from Eviplera® to
Odefsey®.
Secondary Outcome Measure(s): 1. Change in regional bone formation at the hip and lumbar
spine as measured by 18F-fluoride-PET/CT at 48 weeks post switch from Eviplera® to Odefsey®;
2. Assess safety and tolerability of switching to Odefsey®; 3. To compare DXA changes at the
hip and lumbar spine to those detected on 18F-fluoride-PET/CT; 4. Measure changes in
plasma/serum bone biomarkers over 24 and 48 weeks; 5. To measure the changes in FRAX® score
at week 48.
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