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This is a phase I, open-label, controlled drug interaction study to determine the effects of darunavir plus ritonavir on the pharmacokinetics of the hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, rosuvastatin, in HIV-1-seronegative subjects.
Twelve HIV-negative healthy volunteers will be randomized to one of two groups. Group 1 would receive rosuvastatin 10mg daily (Treatment A) in interval 1 for 7 days, followed by a washout period of at least 7 days. In interval 2, darunavir/ritonavir 600/100mg bid (Treatment B) would be administered for 7 days, followed by another 7 day washout period. Lastly, in interval 3 subjects will administer darunavir/ritonavir and rosuvastatin (Treatment C) for total of 7 days. Group 2 will administer Treatment B in interval 1 for 7 days, followed by a washout period of 7 days, then treatment A in interval 2 for 7 days followed by another 7 day washout period. Group 2 would then co-administer rosuvastatin and darunavir/ritonavir for the last 7 days. Intensive PK sampling will be performed on day 7, 21 and 35 following a meal.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| B | Active Comparator | Darunavir+ritonavir x 7 days; Rosuvastatin x 7 days; Combination x 7 days |
|
| A | Active Comparator | Rosuvastatin x 7 days; darunavir+ritonavir x 7 days; Combination x 7 days |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| darunavir, ritonavir, rosuvastatin | Drug | darunavir 600 mg twice daily for 7 days ritonavir 100 mg twice daily for 7 days rosuvastatin 10 mg once daily for 7 days Combination of all three drugs for 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Cmax of Rosuvastatin | 7 days | |
| AUC of Rosuvastatin | 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| To Investigate the Effect of Rosuvastatin on the Steady State Pharmacokinetics of Darunavir/Ritonavir. | Geometric mean of the Concentration minimum of darunavir and ritonavir in the presence and absence of rosuvastatin. | 45 days |
| To Compare the Change in Low-density Lipoprotein (LDL) Cholesterol With Rosuvastatin Therapy Alone, Darunavir/Ritonavir Therapy Alone and With the Co-administration of Rosuvastatin and Darunavir/Ritonavir. |
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Inclusion Criteria:
Exclusion Criteria:
History or evidence of current use of alcohol, barbiturate, amphetamine, recreational or narcotic drug use, which in the investigator's opinion would compromise subject's safety and/or compliance with the trial procedures.
Currently active significant gastrointestinal, cardiovascular, neurologic, psychiatric, metabolic, renal, hepatic, respiratory, inflammatory, or infectious disease, that in the opinion of the investigator would represent a contraindication to study enrollment.
Creatinine clearance of ≤ 60mL/min.
Currently significant diarrhea, gastric stasis, or constipation that in the investigator's opinion could influence drug absorption or bioavailability.
eruptions, drug allergies, food allergy, dermatitis, eczema, psoriasis, or urticaria, that in the opinion of the investigator would represent a contraindication to study enrollment.
Previously demonstrated clinically significant allergy or hypersensitivity to any of the excipients of the medications administered in the trial.
History of significant drug allergy such as, but not limited to, sulphonamides and penicillins. Prezista is a sulphonamide. The potential for cross-sensitivity between drugs in the sulphonamide class and Prezista in HIV-negative subjects is unknown.
Use of concomitant medication, including investigational, prescription, and over-the-counter products and dietary supplements with the following exceptions: aspirin, acetaminophen, anti-histamines such as diphenhydramine, inhalers for asthma, daily multivitamins, mineral supplements and hormonal oral contraceptives. Concomitant medication other than those listed above must have been discontinued at least 7 days before study entry.
Female subjects of childbearing potential without use of effective nonhormonal birth control methods, or not willing to continue practicing these birth control methods for at least 30 days after the end of the treatment period; Note: Estrogen-based hormonal contraception may not be reliable when taking Prezista, therefore to be eligible for this trial, women of childbearing potential should either:
Women with tubal ligation are required to use one non-hormonal contraceptive method.
Women who are postmenopausal for at least 2 years, and women with total hysterectomy are considered of non-childbearing potential.
A positive pregnancy test or breast feeding at screening.
Participation in an investigational drug trial within 90 days prior to the first intake of trial medication.
Donation of blood or plasma within 60 days preceding the first trial-related blood drawing.
Subjects with the following laboratory abnormalities at screening as defined by the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events ("DAIDS grading table") and in accordance with the normal ranges of the trial clinical laboratory:
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| Name | Affiliation | Role |
|---|---|---|
| Carl J Fichtenbaum, MD | University of Cincinnati | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Cincinnati AIDS Clinical Trials Unit | Cincinnati | Ohio | 45267 | United States |
1 subject was excluded based upon elevated triglyceride level prior to randomization
Subjects were recruited from the community between September 2008 and March 2009
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| ID | Title | Description |
|---|---|---|
| FG000 | B-Darunavir+Ritonavir Initial Arm | Darunavir+ritonavir x 7 days; Rosuvastatin x 7 days; Combination x 7 days |
| FG001 | A-Rosuvastatin Initial Arm | Rosuvastatin x 7 days; darunavir+ritonavir x 7 days; Combination x 7 days |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | B-Darunavir+Ritonavir Initial Arm | Darunavir+ritonavir x 7 days; Rosuvastatin x 7 days; Combination x 7 days |
| BG001 | A-Rosuvastatin Initial Arm | Rosuvastatin x 7 days; darunavir+ritonavir x 7 days; Combination x 7 days |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Cmax of Rosuvastatin | Analysis of 12 subjects who completed all 3 PK visits | Posted | Geometric Mean | 90% Confidence Interval | ng/mL | 7 days |
|
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Darunavir+Ritonavir | Darunavir 600 mg and ritonavir 100 mg twice daily x 7 days |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | General disorders | Systematic Assessment |
No clinical outcome data beyond 7 days is available. Cannot necessarily extrapolate directly to persons with HIV.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Carl J. Fichtenbaum | University of Cincinnati College of Medicine | 513-584-6361 | carl.fichtenbaum@uc.edu |
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| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D050171 | Dyslipidemias |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
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| ID | Term |
|---|---|
| D000069454 | Darunavir |
| D019438 | Ritonavir |
| D000068718 | Rosuvastatin Calcium |
| ID | Term |
|---|---|
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D002219 | Carbamates |
| D000144 |
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|
| rosuvastatin, darunavir, ritonavir | Drug | rosuvastatin 10 mg daily for 7 days; darunavir 600 mg twice daily for 7 days with ritonavir 100 mg twice daily for 7 days; Combination of all three for 7 days |
|
|
LDL values |
| 45 days |
| Withdrawal by Subject |
|
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Primary | AUC of Rosuvastatin | Analysis of 12 subjects who completed all 3 PK visits | Posted | Geometric Mean | 90% Confidence Interval | ng*hr/mL | 7 days |
|
|
|
| Secondary | To Investigate the Effect of Rosuvastatin on the Steady State Pharmacokinetics of Darunavir/Ritonavir. | Geometric mean of the Concentration minimum of darunavir and ritonavir in the presence and absence of rosuvastatin. | Participants taking all three medications | Posted | Geometric Mean | 90% Confidence Interval | ng/mL | 45 days |
|
|
|
| Secondary | To Compare the Change in Low-density Lipoprotein (LDL) Cholesterol With Rosuvastatin Therapy Alone, Darunavir/Ritonavir Therapy Alone and With the Co-administration of Rosuvastatin and Darunavir/Ritonavir. | LDL values | Individuals taking medications with measurements of LDL | Posted | Median | Inter-Quartile Range | mg/dL | 45 days |
|
|
|
| 0 |
| 15 |
| 6 |
| 15 |
| EG001 | Rosuvastatin | Rosuvastatin 10 mg daily x 7 days | 0 | 14 | 4 | 14 |
| EG002 | Darunavir, Ritonavir and Rosuvastatin | Darunavir 600 mg and Ritonavir 100 mg twice daily with Rosuvastatin 10 mg daily x 7 days | 0 | 12 | 4 | 12 |
| Nausea | Gastrointestinal disorders | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
|
| Skin Rash | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| Elevated AST | Hepatobiliary disorders | Systematic Assessment | Grade I < 2 x ULN |
|
| Muscle Weakness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Sinus congestion | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Upper respiratory infection | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Elevated CPK | Musculoskeletal and connective tissue disorders | Systematic Assessment | Grade I < 3 x ULN |
|
| Anemia | Blood and lymphatic system disorders | Systematic Assessment | Grade I: 10-12 gm/dL |
|
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| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| D052439 | Lipid Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D005663 | Furans |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D013844 | Thiazoles |
| D001393 | Azoles |
| D005464 | Fluorobenzenes |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D011743 | Pyrimidines |
| Title | Measurements |
|---|---|
|
| Ritonavir Cmin with Rousuvastatin present |
|