HIV Infections Clinical Trial
Official title:
A Phase III, Randomized, Placebo-Controlled, Double-Blind Trial of an Angiotensin Receptor Blocker (Valsartan) and Highly Active Antiretroviral Therapy (HAART) Versus HAART Alone for the Treatment of HIV-Associated Nephropathy
The angiotensin receptor blocker (ARB) valsartan is a drug commonly used to treat high blood pressure. Valsartan may also help slow down the progression of kidney disease in HIV infected people. The purpose of this study is to compare valsartan and antiretroviral therapy (ART) to ART alone in slowing kidney disease progression in people with HIV.
ART for the treatment of HIV may slow the progression of HIV-associated nephropathy (HIVAN)
to end-stage renal disease (ESRD); nevertheless, it is predicted that many HIV infected
patients on ART will reach ESRD by the next decade. Medications that affect the
renin-angiotensin system, such as the ARB valsartan, may be useful in treating HIVAN. In a
small study of HIV infected patients with HIVAN treated with the angiotensin-converting
enzyme inhibitor (ACEI) fosinopril, kidney function was stable in patients who took the
ACEI, but function decreased in patients who did not. These data are promising, and suggest
that an ARB like valsartan may also slow the progression of HIVAN and improve patients'
prognosis. This study will compare valsartan and ART to ART alone in slowing kidney disease
progression in people with HIV.
This study will last 96 weeks. All participants will continue taking their current ART
regimen during the study and will be randomly assigned to one of two arms: Arm 1 will
receive valsartan daily, while Arm 2 will receive placebo daily. Doses of drug or placebo
may be adjusted during the first 8 weeks based on blood pressure readings taken during the
study. In addition, if patients are on other antihypertensive drugs, dosage adjustments may
be necessary for those drugs during the study. No ART or antihypertensive drugs other than
valsartan will be provided by the study. Study visits will occur every week until Week 8,
then every 8 weeks until the end of the study at Week 96. Study visits will include physical
examination, medication assessment, and blood pressure readings. In addition, blood
collection will occur at entry, Weeks 2, 4, 6, and 8, and every 8 weeks thereafter.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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