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This is a phase IV, multicenter, prospective, randomised, crossover, double blind, placebo-controlled and proof of concept clinical trial.
All subjects fulfilling inclusion criteria will be randomised to add either TDF/FTC co-formulation (group A) or placebo (Group B) to their current PI/r regimen, i.e.: DRV/r 800/100 mg QD or LPV/r 400/100 BID. This will be followed by a crossover addition of TDF/FTC co-formulation or placebo.
Randomization will be centralised in the CRO FLS-Research Support and will be stratified by DRV/r or LPV/r intake at baseline to ensure equal distribution in both arms. TDF/FTC co-formulation or Placebo will be provided in a double-blinded fashion, i.e.: neither the treating physician nor the patient will know whether the patient is receiving TDF/FTC or placebo.
All subjects will receive dietary counselling to promote lipid-lowering diet provided by a specialised dietician throughout the study.
The expected duration of the study for each participant will be 36 weeks. There will be 6 visits: screening, baseline and weeks 4, 12, 24 and 36.
This is a phase IV, multicenter,, prospective, randomised, crossover, double blind, placebo-controlled and proof of concept clinical trial. The trial was conducted in a total sample of 60 patients (30 patients per group), which assures adequate power to detect differences. This study is adequate to demonstrate the lipid-lowering effect of TDF/FTC co-formulation addition in patients with dyslipidemia and stable monotherapy antiretroviral treatment.
All subjects fulfilling inclusion criteria will be randomised to add either TDF/FTC co-formulation (group A) or placebo (Group B) to their current PI/r regimen, i.e.: DRV/r 800/100 mg QD or LPV/r 400/100 BID. This will be followed by a crossover addition of TDF/FTC co-formulation or placebo.
In Group A the expected changes in cholesterol values, regarding baseline, can be observed 3 months after TDF/FTC addition. After this, a period of 3 months with placebo will act as a washout period, allowing establishing comparisons intra-patient. Finally, another period of 3 months with placebo will permit to establish comparisons with the first 3-month TDF/FTC intervention. In Group B, subjects will follow a 3-month placebo period, later a 3-month TDF/FTC intervention and finally a placebo period that will act as a wash-out.
Randomization will be centralised in the CRO FLS-Research Support and will be stratified by DRV/r or LPV/r intake at baseline to ensure equal distribution in both arms. TDF/FTC co-formulation or Placebo will be provided in a double-blinded fashion, i.e.: neither the treating physician nor the patient will know whether the patient is receiving TDF/FTC or placebo.
All subjects will receive dietary counselling to promote lipid-lowering diet provided by a specialised dietician throughout the study.
The expected duration of the study for each participant will be 36 weeks. There will be 6 visits: screening, baseline and weeks 4, 12, 24 and 36.
The date for the inclusion of the first patient was November 2011 and the end of the last patient follow-up has been in February 2014. The enrolment period has been 18 months. The final study report will be submitted before November 2014.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TDF/FTC (3 months) + Placebo (6 months) | Experimental | TDF/FTC (3 months) + Placebo (6 months) |
|
| Placebo (3 months) + TDF/FTC (3 months) + Placebo (3 months) | Placebo Comparator | Placebo (3 months) + TDF/FTC (3 months) + Placebo (3 months) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Truvada® (300 mg tenofovir disoproxil fumarato/200 mg emtricitabine) | Drug | TDF/FTC 300/200mg daily during 3 months + Placebo during 6 months |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total fasting cholesterol | Baseline, week 4, 12, 24 and 36 | |
| LDL-cholesterol | Baseline, week 4, 12, 24 and 36 |
| Measure | Description | Time Frame |
|---|---|---|
| CD4 cell count | Baseline, week 4, 12, 24 and 36 | |
| Changes in liver enzymes | Baseline, week 4, 12, 24 and 36 | |
| Changes in phosphate |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Germans Trias i Pujol Hospital | Badalona | Barcelona | 08916 | Spain | ||
| Hospital Valle Hebrón |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25870325 | Derived | Santos JR, Saumoy M, Curran A, Bravo I, Llibre JM, Navarro J, Estany C, Podzamczer D, Ribera E, Negredo E, Clotet B, Paredes R; Tenofovir/emtricitabine inflUence on LIPid metabolism (TULIP) Study Group. The lipid-lowering effect of tenofovir/emtricitabine: a randomized, crossover, double-blind, placebo-controlled trial. Clin Infect Dis. 2015 Aug 1;61(3):403-8. doi: 10.1093/cid/civ296. Epub 2015 Apr 13. |
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|
| Placebo | Drug | Placebo during 3 months + TDF/FTC 300/200mg daily during 3 months + Placebo during 3 months |
|
|
| Baseline, week 4, 12, 24 and 36 |
| Changes in creatinine | Baseline, week 4, 12, 24 and 36 |
| Changes in glomerular filtration rate | Baseline, week 4, 12, 24 and 36 |
| Changes in HDL cholesterol | Baseline, week 4, 12, 24 and 36 |
| Changes in triglycerides | Baseline, week 4, 12, 24 and 36 |
| Adverse events | Baseline, week 4, 12, 24 and 36 |
| Resistance mutations | Baseline, week 4, 12, 24 and 36 |
| lipid-lowering drugs | Baseline, week 4, 12, 24 and 36 |
| Barcelona |
| Barcelona |
| 08035 |
| Spain |
| Hospital de Bellvitge | L'Hospitalet de Llobregat | Barcelona | Spain |
| ID | Term |
|---|---|
| D050171 | Dyslipidemias |
| ID | Term |
|---|---|
| D052439 | Lipid Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D000069480 | Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination |
| ID | Term |
|---|---|
| D000068698 | Tenofovir |
| D063065 | Organophosphonates |
| D009943 | Organophosphorus Compounds |
| D009930 | Organic Chemicals |
| D000068679 | Emtricitabine |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D000225 | Adenine |
| D011687 | Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D003853 | Deoxyribonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D004338 | Drug Combinations |
| D004364 | Pharmaceutical Preparations |
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