HIV, Inflammation Clinical Trial
Official title:
A Phase 1 Study of CC-11050 in Human Immunodeficiency Virus-1-Infected Adults With Suppressed Plasma Viremia on Antiretroviral Therapy
Verified date | November 2, 2018 |
Source | National Institutes of Health Clinical Center (CC) |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Background:
When there is a threat to the body, the immune system triggers inflammation. Too much
inflammation can damage the body or cause painful symptoms. Some people with HIV feel sick
after they start HIV drugs because their recovering immune systems cause too much
inflammation. Or their immune systems can become activated all the time. This can cause
serious health problems. Researchers want to test if the drug CC-11050 helps treat
inflammation in people taking HIV drugs.
Objectives:
To test if CC-11050 is safe and well-tolerated for people with HIV who are taking HIV drugs.
To see if it reduces inflammation.
Eligibility:
People ages 18 and older with HIV who have been on antiretroviral therapy for at least 1
year.
Design:
Participants will be screened with:
Medicine review
Physical exam and medical history
Blood and urine tests
Chest x-ray
Electrocardiogram (ECG): Soft electrodes on the skin record heart signals.
Participants will be randomly assigned to take capsules of either CC-11050 or a placebo. They
will take the capsules every day for 12 weeks. They will continue to take their HIV drugs.
Participants will have a baseline visit within 2 months of screening. This includes:
Physical exam and medical history
Blood and urine tests
ECG
Leukapheresis: Blood is removed by a needle in one arm and passed through a machine that
removes white blood cells. The rest of the blood is returned through a needle in the other
arm.
Participants will have follow-up visits 2, 4, 8, 12, and 16 weeks after the baseline visit.
These may include repeats of some of the baseline tests.
Status | Completed |
Enrollment | 38 |
Est. completion date | November 2, 2018 |
Est. primary completion date | May 15, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
- INCLUSION CRITERIA: 1. Adults (greater than or equal to 18 years) 2. Body mass index (BMI) less than or equal to 35 kg/m2 3. On ART for a minimum of 1 year and on a stable regimen (according to DHHS guidelines) for at least 3 months prior to screening 4. Plasma HIV-1 RNA level <50 copies/mL at screening (patients with 50-499 <500 copies/mL at screening may be asked to return for rescreening in four (4) weeks or later 5. Men and women must be willing to take appropriate precautions to prevent pregnancy as described below 6. Willingness to undergo genetic testing 7. Willingness to allow storage of specimens for future analysis 8. Negative serum or urine pregnancy test (for women of childbearing potential) 9. Under the care of a primary care physician outside of the NIH Contraception: The effects of CC-11050 on the developing human fetus are unknown. For this reason, subjects must agree to not become pregnant. Females of childbearing potential must have a pregnancy test before initiating the study agent and at each study visit. Because of the risk involved, male and female study participants who engage in sexual activities that can result in pregnancy must agree to use of a male or female condom at every potentially reproductive sexual encounter, AS WELL AS one of the other methods listed below, beginning at the baseline visit and continuing until 3 months after discontinuation of the study agent. Acceptable methods are as follows: - Hormonal contraception [e.g. consistent use of oral contraceptive pill daily or other hormonal method such as contraceptive implant or injection] (must be started 1 month prior to receiving the first dose of study agent) - Diaphragm or cervical cap - Intrauterine device (IUD) - Male partner with a vasectomy During the study, if a participant becomes pregnant or suspects they are pregnant, they should inform the study staff and their primary care physician immediately. The study medication will be stopped immediately and if on CC-11050 they will be referred to a high risk pregnancy specialist and followed by the study team for the remainder of the pregnancy or the rest of the study, whichever occurs later. EXCLUSION CRITERIA: 1. Body mass index (BMI) less than or equal to 18.5 kg/m2 2. Protease inhibitor-based ART regimen 3. ART regimen which includes Cobicistat 4. Absence of alternate available ART options in case of virologic failure 5. Serum ALT or AST value Grade >2 or total bilirubin greater than the ULN unless it is indirect due to Gilbert s disease 6. History of chronic hepatitis B (+HbsAg or +HBV DNA in plasma) and/or C - treated chronic hepatitis C with SVR > 2 years will be accepted. 7. Cirrhosis of the liver, or any known active or chronic liver disease 8. Recent history (<30 days) of infection requiring inpatient hospitalization or systemic therapy 9. Depression. Patients who report depression or, are suspected or known to have depression and are on stable anti-depressants will undergo Psychiatry evaluation and clinical assessments to determine eligibility. These assesments will be done by a psychiatrist and may include: Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Montreal Cognitive Assessment(MoCA). The BDI, STAI, and MoCA will be administered to patients being considered for study enrollment. The BDI and STAI may be repeated at least once during follow-up visits in those deemed eligible to participate. 10. Current breastfeeding 11. Current or anticipated treatment with immunomodulating agents (such as systemic corticosteroids, interleukins, interferons) or any agent with known anti-HIV activity (other than antiretrovirals approved for use in the treatment of HIV) 12. Any experimental medications within 4 weeks prior to screening or anticipated use of such medications during the trial. 13. Current (4 weeks prior to the first dose of study drug,) or anticipated use of antimetabolites; alkylating agents; or drugs other than ART, herbal preparations (including St. John s wort), and foods (including grapefruit) known to affect activity of the CYP3A4 enzyme pathway 14. Use of thalidomide, lenalidomide, pomalidomide, systemic corticosteroids within 4 weeks of screening 15. Any prior history of PDE4 inhibitor use 16. History of pancreatitis, elevated lipase (less than or equal to 1.5 above the upper limit of normal) or triglyceride level >500 mg/dL. 17. History of clinically significant metabolic, endocrine, hepatic, renal, hematologic, pulmonary, gastrointestinal, autoimmune or cardiovascular disorders 18. Uncontrolled hypertension (persistent measurements over 140/90) 19. Bradycardia, defined as a sinus rhythm <50 beats/min (bpm) 20. History or presence of a clinically significant abnormal ECG 21. History of malignancy except cured basal or squamous cell carcinoma of the skin or cutaneous Kaposi s sarcoma not requiring systemic therapy during the trial 22. Receipt of radiation or cytotoxic chemotherapeutic agents, unless fully recovered from disease by the time of the first dose of study drug as determined by the opinion of the Investigator, or anticipated use of such agents during the study period 23. Any condition or significant problems that, based on the judgment of the investigator, would increase risk to the subject or would interfere with the subject s ability to comply with protocol requirements. Co-enrollment Guidelines: Co-enrollment in other trials is restricted, other than enrollment on observational studies or those evaluating the use of a licensed medication. Study staff should be notified of co-enrollment as it may require the approval of the study investigators. |
Country | Name | City | State |
---|---|---|---|
United States | National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda | Maryland |
Lead Sponsor | Collaborator |
---|---|
National Institute of Allergy and Infectious Diseases (NIAID) |
United States,
Andrade BB, Singh A, Narendran G, Schechter ME, Nayak K, Subramanian S, Anbalagan S, Jensen SM, Porter BO, Antonelli LR, Wilkinson KA, Wilkinson RJ, Meintjes G, van der Plas H, Follmann D, Barber DL, Swaminathan S, Sher A, Sereti I. Mycobacterial antigen driven activation of CD14++CD16- monocytes is a predictor of tuberculosis-associated immune reconstitution inflammatory syndrome. PLoS Pathog. 2014 Oct 2;10(10):e1004433. doi: 10.1371/journal.ppat.1004433. eCollection 2014 Oct. — View Citation
Marzi A, Feldmann H. Ebola virus vaccines: an overview of current approaches. Expert Rev Vaccines. 2014 Apr;13(4):521-31. doi: 10.1586/14760584.2014.885841. Epub 2014 Feb 27. Review. — View Citation
Schafer PH, Chen P, Fang L, Wang A, Chopra R. The pharmacodynamic impact of apremilast, an oral phosphodiesterase 4 inhibitor, on circulating levels of inflammatory biomarkers in patients with psoriatic arthritis: substudy results from a phase III, randomized, placebo-controlled trial (PALACE 1). J Immunol Res. 2015;2015:906349. doi: 10.1155/2015/906349. Epub 2015 Apr 20. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Frequency and severity of AEs and SAEs in subjects receiving study agent vs placebo | 12/30/2016 | ||
Secondary | Plasma HIV-1 RNA levels by both conventional and single-copy assay at Weeks 0,2,4,8, and 12 | week 12 | ||
Secondary | CD4+ T cell counts and percentages at weeks 2,4,8 and 12 | week 12 | ||
Secondary | Markers of systemic inflammation (TNF, IL-6, CRP, IFNy, sCD14, D-dimer) at weeks 2,4,8 and 12 | week 12 |