The study will compare the safety and efficacy of an investigation nucleoside analog reverse transcriptase inhibitor (NRTI), dexelvucitabine (DFC), to an approved NRTI, lamivudine (3TC) in HIV treatment-experienced patients who are resistant to 3 classes of antiretroviral therapies (NRTIs, PIs and NNRTIs). Patients meeting eligibility requirements will have a new 'optimized' background regimen (OBR) selected for them by their investigator based on prior ARV treatment history and the results of HIV genotype and phenotype tests performed during the screening period. In addition to treatment with the new OBR, patients will be randomized to receive treatment with either DFC or 3TC in a blinded fashion. There is a 50 percent chance a patient will receive DFC or 3TC. Treatment in the study may continue for up to 96 weeks. Patients with an inadequate response to therapy after 16 weeks will have the option to change their OBR and the option to switch to receive the other study medication (i.e., DFC to 3TC or 3TC to DFC).
The study will compare the safety and efficacy of an investigational nucleoside analog reverse transcriptase inhibitor (NRTI), dexelvucitabine (DFC) 200 mg once daily, to an approved NRTI, lamivudine (3TC) 300 mg once daily in treatment experienced patients with HIV that is resistant to 3 classes of antiretroviral therapies (NRTIs, PIs and NNRTIs). Patients meeting eligibility requirements will have a new 'optimized' background regimen (OBR) selected for them based on prior treatment history, and results of HIV genotype and phenotype performed during screening. In addition to the OBR patients will be randomized to receive at at one to one ratio DFC or 3TC in a blinded fashion. The OBR may include any approved HIV treatments except 3TC, FTC, ddI, d4T and ddC. Medications available through expanded access may also be available to selected patients. Treatment in the study will continue for up to 96 weeks with primary endpoints at 24 and 48 weeks of therapy. Patients with an inadequate response to therapy after 16 weeks will have the option to change their OBR and the option to switch study medication (DFC to 3TC or 3TC to DFC). A total of 250 patients will be enrolled.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
250
nucleoside inhibitor of HIV Reverse Transcriptase
Unnamed facility
Long Beach, California, United States
Unnamed facility
Brandon, Florida, United States
Unnamed facility
Fort Lauderdale, Florida, United States
Unnamed facility
Miami, Florida, United States
Unnamed facility
Plantation, Florida, United States
Unnamed facility
Atlanta, Georgia, United States
Unnamed facility
Chicago, Illinois, United States
Unnamed facility
New York, New York, United States
Unnamed facility
Portland, Oregon, United States
Unnamed facility
Dallas, Texas, United States
...and 1 more locations
Percent of subjects with >= 1.0 log10 decrease in viral load from Baseline to Week 24 based on non-completer equals failure (NC=F)
Time frame: Week 48 compared to baseline
Percent of subjects at 48 weeks with sustained suppression of viral load >= 1.0 log10 below baseline as determined by time-to-loss of virological response (TLOVR)
Time frame: Week 48 compared to baseline
Median change in viral load from Baseline to Week 24 and to Week 48
Time frame: Week 24 or Week 48 compared to baseline
Proportion of subjects in each treatment arm with viral load reduction greater than the over all study median viral load reduction
Time frame: Week 24 and Week 48
Proportion of subjects with a viral load measurement <400 copies/mL at Week 24 and Week 48
Time frame: Week 24 and Week 48 compared to baseline
Proportion of subjects with a viral load measurement <50 copies/mL at Week 24 and Week 48
Time frame: Week 24 and Week 48 compared to Baseline
Median change in subset of T lymphocytes (CD4+) cell count from Baseline to Week 24 and Week 48
Time frame: Week 24 and Week 48 compared to baseline
Proportion of subjects with a 50% decrease and/or 100 cell/mm3 decrease in CD4+ cell count to Week 24 and to Week 48
Time frame: Week 24 and Week 48 compared to baseline
Proportion of subjects who "crossed-over" to receive treatment with the other blinded study medication
Time frame: Week 16 and visits thereafter
Number of Centers for Disease Control (CDC) Class C adverse events and deaths by treatment arm
Time frame: approximately every 2 to 4 weeks for laboratory testing
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