A Study to Assess the Long-term Efficacy (24 Weeks) of MPC-4326 in Combination With a 2-3 Drug OBR Relative to the Efficacy of a 3-4 Drug ARV Regimen in Treatment Experienced HIV-1 Infected Subjects Who Are Failing Current Antiretroviral Therapy

HIV Infections Clinical Trial

Official title:

A Phase 2b Multicenter, Randomized, Open Label, Comparative Trial of MPC-4326 in Combination With a Two to Three Drug Optimized Background Regimen Versus an Optimized, Three to Four Drug Antiretroviral Regimen for the Treatment of Triple Class Antiretroviral Experienced, HIV-1 Infected Subjects Failing Current Therapy

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT01026727
• Other study ID #: MPC-4326-003.01
• Status: Terminated
• Phase: Phase 2
• First received: December 2, 2009
• Last updated: June 10, 2010
• Start date: November 2009
• Est. completion date: June 2010

Study information

• Verified date: June 2010
• Source: Myrexis Inc.
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

This phase 2b study is designed to assess the long-term efficacy (24 weeks) of MPC-4326 in combination with a 2-3 drug optimized background regimen (OBR) relative to the efficacy of a 3-4 antiretroviral (ARV) regimen in treatment experienced, HIV-1 infected subjects.

Description:

Standard antiretroviral therapies for the treatment of HIV/AIDS, while effective for varying lengths of time, can be rendered inadequate for viral suppression by the emergence of drug resistant virus, which can include resistance to entire mechanistic classes of drugs. Thus, there exists a significant unmet medical need for new highly potent antiretroviral agents with novel mechanisms of action. The novel mechanism of action of MPC-4326 suggests that MPC-4326 may have utility for the treatment of HIV-1 infected patients failing current regimens due to the development of drug resistance.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 2
• Est. completion date: June 2010
• Est. primary completion date: June 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Voluntarily consent to participate in the study (sign Informed Consent Form), and able to understand study procedures and complete the study.

2. Be at least 18 years of age at the time of screening.

3. Have a screening plasma HIV-1 RNA value = 1,000 copies/mL

4. Be receiving an ARV regimen containing at least 3 drugs which has been unchanged for at least 8 weeks prior to initial screening.

5. Have at least two fully active ARVs (exclusive of MPC-4326) as determined by a 'maximal response' on the vircoTYPE assay; R5 tropism testing (if applicable); and treatment history (e.g., naïve to enfuvirtide or integrase inhibitors) that can be combined in a regimen containing a maximum of four ARVs for the 3-4d ARV regimen or three ARVs for the 2-3-drug OBR to be combined with MPC-4326.

6. Two NRTIs are not allowed as the only fully-active antiretroviral agents in the 3-4-drug ARV regimen or in the 2-3-drug OBR

7. Must have wild type Gag at position 370 (i.e., no polymorphisms at 370)

8. Have resistance to at least one agent in each of the three 'classic' ARV drug classes (NRTI, NNRTI, PI) to include documented evidence of resistance on prior resistance tests.

9. Females of childbearing potential must agree to the use two forms of contraception from the time of screening until 90 days after completion of dosing.Surfactant-type spermicide gels and contraceptive foam are not recommended, as they increase the rate of HIV transmission.

Exclusion Criteria:

1. Be pregnant or breast feeding

2. Presence of any significant acute illness (as determined by the investigator) within 14 days of study entry.

3. Presence of any AIDS-related opportunistic infection (Category C according to the CDC Classification System for HIV-1 Infection, 1993 Revised Version) that is unstable in the Investigator's opinion or diagnosed in the 30 days prior to study entry (i.e., Run in Period Day 1).

4. A history of cerebrovascular accident or transient ischemic attacks.

5. Subjects with the following laboratory parameters within 14 days prior to first dose of study drug:

1. Hemoglobin < 10 g/dL for men and < 9 g/dL for women

2. Absolute neutrophil count < 1000/mm3

3. Platelet count < 50,000/mm3

4. AST or ALT > 5 times the upper limit of normal inclusive of subjects with a positive HBV surface antigen or HCV antibody test at screening

5. Calculated creatinine clearance (ClCr) <40 mL/min as determined by the Cockcroft-Gault equation

6. Subjects who have received radiation therapy or cytotoxic chemotherapeutic agents within 4 weeks prior to the first dose of study drug.

7. Subjects who have received treatment with immunomodulating agents such as IL-2, a IFN, ß IFN or ? IFN within 4 weeks prior to the first dose of study drug.

8. Subjects who use or require a prohibited therapy within 30 days prior to or while participating in this study.

9. Receipt of an investigational drug or product, or participation in a drug study within a period of 30 days prior to receiving study medication. For investigational drugs with an elimination half life greater than 10 days, this period will be extended to 60 days and for antibody-based products (i.e., CD4 antibody products, etc.) this period will be extended to 3 months.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• HIV Infections

Intervention

Drug:
• MPC-4326 plus a 2-3 drug optimized background regimen (OBR)
For treatment arm #1: the MPC-4326 dose will be selected based on the inclusion of raltegravir (i.e., will be limited to 300 mg BID) or inclusion of darunavir (i.e., will be assigned 400 mg BID) in the OBR. If both raltegravir and darunavir are included in the OBR for a subject, the subject will be limited to 300 mg BID
• 3-4 commercially available antiretroviral drugs
For treatment arm #2: the antiretroviral regimen, dosage and frequency will be selected by the investigator.

Locations

Country	Name	City	State
Canada	Clinique médicale l'Actuel,	Montreal	Quebec
Canada	Clinique Médicale Quartier Latin	Montreal	Quebec
Canada	Sunnybrook Health Sciences Centre	Toronto	Ontario
Canada	University of British Columbia,Downtown Infectuous Diseases Clinic	Vancouver	British Columbia
United States	CARE-ID	Annandale	Virginia
United States	AIDS Research Consortium of Atlanta	Atlanta	Georgia
United States	Central Texas Clinical Research	Austin	Texas
United States	AIDS Healthcare Foundation Research Center	Beverly Hills	California
United States	Community Research Initiative of New England	Boston	Massachusetts
United States	North Bronx Health Care Network	Bronx	New York
United States	North Texas Infectious Disease Consultants, PA	Dallas	Texas
United States	Southwest Infectious Disease	Dallas	Texas
United States	Duke University	Durham	North Carolina
United States	Gary J. Richmond, MD, PA	Fort Lauderdale	Florida
United States	Therafirst Medical Center	Fort Lauderdale	Florida
United States	Therapeutic Concepts, P.A	Houston	Texas
United States	DCOL Center	Longview	Texas
United States	Peter Wolfe, MD, PC	Los Angeles	California
United States	Wohlfeiler, Piperato and Associates, LLC	Miami Beach	Florida
United States	Orlando Immunology Center	Orlando	Florida
United States	Kaiser Permanente Immune Deficiency Clinic	Portland	Oregon
United States	University of Rochester , Strong Memorial Hospital	Rochester	New York
United States	Quest Clinical Research	San Francisco	California
United States	EHS Pulmonary & Critical Care	Spokane	Washington
United States	Whitman Walker Clinic	Washington	District of Columbia

Sponsors (1)

Lead Sponsor	Collaborator
Myrexis Inc.

Countries where clinical trial is conducted

United States,  Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of subjects with a viral load <50 copies/mL at 24 weeks in each treatment group		24-weeks	Yes
Secondary	The key secondary endpoint is to compare the Viral Load Decrease at 24 weeks in the two treatment arms. VLD is defined as the change from baseline log10 viral load.		24 weeks	Yes