This is a 48 week randomized, prospective, controlled, open-label, proof-of-concept pilot clinical trial. Patients with HIV-1 infection on HAART PI-based regimen will be randomized to switch from the PI to etravirine (400 mg dissolved in water every 24 hours) or to continue with the same approach. The aim of the study is to compare the virological efficacy of the etravirine-based regimen with standard PI-containing regimen.
Etravirine is a second generation non-nucleoside analogue reverse transcriptase inhibitor (NNRTI) approved by the U.S. Food and Drug Administration (FDA) in January 2008 and by the European Medicines Agency in September 2008 for clinical use in adults with incomplete virologic suppression and resistance to previous NNRTI and other antiretroviral classes. A question that has not been explored is whether subjects with sustained undetectable HIV-1 RNA-levels experiencing antiretroviral-related toxicity can safely switch their current PI to etravirine. This treatment strategy could allow improvements in tolerability and lipid profile and would permit an easy posology (400 mg dissolved in water every 24 hours). We designed a proof-of-concept study to test the efficacy and safety of switching from a Protease Inhibitor (PI) to etravirine in subjects with viral suppression as an antiretroviral strategy of simplification therapy, based on the high antiviral potency, low toxicity, together with its easy posology (in water dissolution). Patients with HIV-1 infection on HAART PI-based regimen will be randomized to switch from the PI to etravirine (400 mg dissolved in water every 24 hours) or to continue with the same approach. The primary endpoint would be the percentage of patients who maintain virological suppression at week 48.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
43
Switch from the PI to Etravirine 400 mg dissolved in water every 24 hours
Continue with the same antiretroviral regimen
Germans Trias i Pujol University Hospital
Badalona, Barcelona, Spain
Viral load
Time frame: week 48 after baseline
CD4+/CD8+ T lymphocytes count
Time frame: evolution from baseline to week 48
Genotypic test
Time frame: if virologic failure occurs
Lipid profile: total, HDL-, LDL-cholesterol and triglyceride levels
Time frame: evolution from baseline to week 48
Administration of lipid-lowering drugs throughout the study
Time frame: from baseline to week 48
Cardiovascular risk assessed by the SCORE equation
Time frame: evolution from baseline to week 48
Patient's satisfaction assessed by 2 scales of type Likert
Time frame: evolution from baseline to week 48
Adverse events related to antiretroviral treatment
Time frame: from baseline to week 48
Etravirine plasma trough concentration
Time frame: Week 4
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