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Evaluate the efficacy and safety of immune checkpoint inhibitors combined with chidamide as an "activate and kill" strategy to extend viral rebound time, reduce the HIV reservoir, and achieve functional cure.
This project plans to conduct a prospective randomized controlled study, using immune checkpoint inhibitors combined with chidamide, while applying antiretroviral therapy interruption(ATI) to further enhance the immune killing effect of this strategy, with the aim of accelerating the clearance of the HIV reservoir and delaying the time of viral rebound, thereby achieving a functional cure for AIDS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | Placebo Comparator | Saline 50ml q3w ×2 |
|
| Experimental sindilizumab | Experimental | 100mg of sindilizumab, was dissolved in 50ml normal saline, q3w was administered ×2 |
|
| Experimental sindilizumab and sidarbenamide | Experimental | 100mg of sindilizumab, was dissolved into 50ml of normal saline q3w ×2+ sidarbenamide 10mg biw orally for 2 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PD-1 inhibitor | Drug | 100mg of sindilizumab, was dissolved into 50ml of normal saline q3w ×2 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time interval from antiretroviral therapy interruption to antiretroviral treatment restart | From baseline to the date of antiretroviral treatment restart, up to 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The ratio of HIV RNA<50 copies /ml was maintained at 12 weeks | 12 weeks | |
| Changes in HIV DNA levels from baseline to antiretroviral treatment restart | From baseline to the date of antiretroviral treatment restart, up to 12 weeks |
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Inclusion Criteria:
Exclusion Criteria:
Have suffered from any serious acute disease within 8 weeks;
Subjects with a history of active autoimmune disease or autoimmune disease requiring systemic treatment;
Pre-treatment/exposure to any other immune checkpoint inhibitor [e.g., anti-programmed cell death protein 1(PD-1), anti-PD-L1, anti-PD-L2, anti-CTLA4, etc.].
The patient has received the following treatment:
Laboratory tests meet the following standards:
Twelve-lead electrocardiogram was abnormal and clinically significant at the time of enrollment;
Interstitial changes were detected by chest CT at the time of enrollment;
Subjects with severe heart disease, symptomatic or asymptomatic arrhythmia;
Patients with co-infection such as HBV, HCV, syphilis, diabetes, and other liver diseases;
Subjects with a history of active or suspected malignancy or malignancy (other than basal cell skin cancer or cervical cancer in situ) within five years.
Subjects with a history of tuberculosis or active tuberculosis.
Subjects with psychiatric or substance abuse disorders known to interfere with the requirements of the experiment.
Subjects who received immunomodulatory or immunosuppressive therapy in the 24 weeks prior to first taking the study drug.
Pregnant and lactating women;
Mental illness or drug abuse interferes with the conduct of the test.
Histone deacetylase inhibitors, such as valproic acid, butyrate, phenyl butyrate, etc., but can be included after a 28-day washout period;
Patients with severe cardiac insufficiency [New York College of Cardiology (NYHA) Grade IV for cardiac insufficiency];
any arterial thromboembolism event, including myocardial infarction, unstable angina pectoris, cerebrovascular accident, or transient ischemic attack, occurred within 6 months prior to treatment induction; Standardized treatment of uncontrolled hypertension (systolic blood pressure ≥150mmHg or diastolic blood pressure ≥100mmHg); Cardiomyopathy;
Patients had significant QT/QTC intervals during the screening period (Fridericia formula: QTcF=QT/RR0.33) prolonged (e.g., repeated measurements show a QTc interval >450 ms, or there is another risk of torsive ventricular TdP [e.g., heart failure, hypokalemia, familial long QT syndrome]) or combined use of drugs that may cause a prolonged QT/QTc interval;
Allergic or anti-drug antibodies to the drug or excipient used in this test are known.
The researchers judged that they were not suitable to participate in this experiment.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jun Chen, MD | Contact | 021-37990333 | qtchenjun@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Jun Chen, MD | Shanghai Public Health Clinical Center | Principal Investigator |
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| ID | Term |
|---|---|
| D000082082 | Immune Checkpoint Inhibitors |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D000074322 | Antineoplastic Agents, Immunological |
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| Sidarbenamide | Drug | Sidarbenamide 10mg biw orally for 2 weeks |
|
| Saline (NaCl 0,9 %) (placebo) | Drug | Saline 50ml Q3W ×2 |
|
|
| Incidence of drug-related adverse events before antiretroviral treatment restart | From date of randomization to the date of antiretroviral treatment restart, up to 14 weeks. |
| Changes in HIV-specific CD8+ T response from baseline with Day8 and Day29 and ART restart | From baseline to Day 8, Day 29 and antiretroviral treatment restart, up to 12 weeks |
| Changes in PD-1 (+) CD4 T cells and CD8 T cells from baseline at Day8 and Day29 and ART restart | From baseline to Day 8, Day 29 and antiretroviral treatment restart, up to 12 weeks |
| D000970 | Antineoplastic Agents |
| D045506 | Therapeutic Uses |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |