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    Summary
    EudraCT Number:2005-001866-15
    Sponsor's Protocol Code Number:1182.71
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2007-06-28
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2005-001866-15
    A.3Full title of the trial
    Ensayo clínico multicéntrico, prospectivo, aleatorizado y abierto, para comparar la seguridad y eficacia de Aptivus potenciado con dosis bajas de ritonavir (Tipranavir, TPV/r) frente a Prezista® (Darunavir, DRV/r) en pacientes ampliamente pretratados con las tres clases de antirretrovirales (ITIN, ITINN e IP) y que presenten resistencia a más de un IP.
    POTENT: Evaluación Prospectiva de Tipranavir frente a Darunavir en el tratamiento de pacientes que hayan sido tratados previamente
    A.3.2Name or abbreviated title of the trial where available
    POTENT
    A.4.1Sponsor's protocol code number1182.71
    A.7Trial is part of a Paediatric Investigation Plan Information not present in EudraCT
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorBoehringer Ingelheim España, S.A.
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing support
    B.4.2Country
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisation
    B.5.2Functional name of contact point
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Aptivus® (tipranavir) 250mg cápsulas de gelatina blanda
    D.2.1.1.2Name of the Marketing Authorisation holderBoehringer Ingelheim International GmbH
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Capsule, soft
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMP
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNtipranavir
    D.3.9.1CAS number 174484-41-4
    D.3.9.2Current sponsor codeTPV
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Norvir® 100mg Capsulas
    D.2.1.1.2Name of the Marketing Authorisation holderAbbott Laboratories Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Capsule, soft
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMP
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNritonavir
    D.3.9.2Current sponsor codeRTV
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Prezista® 300mg comprimidos recubiertos
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International NV
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMP
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNdarunavir
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Infección por VIH
    MedDRA Classification
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    El criterio principal de valoración de este estudio es el tiempo transcurrido hasta el fracaso virológico, utilizando CV< 50 copias/ml para determinar la respuesta virológica (y CV ≥ 500 para determinar el rebote virológico).
    E.2.2Secondary objectives of the trial
    •La variable secundaria de evaluación clave para este estudio será la respuesta al tratamiento a las 48 semanas, usando una CV < 50 como criterio de respuesta con el enfoque de que los pacientes que no han completado el estudio son fallos (NCF) para manejar a los pacientes que discontinuen la medicación del ensayo de forma prematura

    Otros criterios de valoración secundarios incluyen:
    • Un análisis de intención de tratar (ITT) de la respuesta virológica (respuesta virológica ITT) a las 48 semanas utilizando domo criterio de respuesta la CV <50
    • Respuesta en cada visita utilizando como criterios de respuesta una CV < 50 copias/ml, CV < 400 copias/ml y un descenso de 1 log10 copias/ml con respecto al valor basal, mediante los tres métodos para el manejo de las discontinuaciones farmacológicas (principal), NCF (secundario principal) e ITT (secundario))
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Consentimiento informado firmado antes de participar en el estudio.
    2. Hombres y mujeres infectados por VIH-1 > 18 años de edad.
    3. Pacientes ampliamente pretratados con tres clases de ARV (ITIN, ITINN e IP) (durante un mínimo de 3 meses para cada clase) y que presenten resistencia a más de un IP en el fenotipo virtual (prueba de resistencia) que se realiza en la visita de selección.
    4. El régimen de base optimizado de los pacientes debe contener una de las siguientes opciones de ARV:
    • Un mínimo de dos inhibidores nucleosídos/nucleotídos de la transcriptasa inversa (ITIN) genotípicamente activos reportados como “respuesta máxima” o “sensibles” en el informe del fenotipo virtual realizado en la visita de selección.
    • Un mínimo de un ITIN genotípicamente activo reportado como “respuesta máxima” o “sensible” en el informe del fenotipo virtual realizado en la visita de selección más Enfuvirtide si no se ha utilizado antes.
    • Un mínimo de un ITIN genotípicamente activo reportado como “respuesta máxima” o “sensible” en el informe del fenotipo virtual realizado en la visita de selección más un inhibidor de la integrasa si no se ha utilizado previamente y si se puede obtener a través de un programa de acceso expandido y está permitido por las autoridades reguladoras locales.
    • Un mínimo de un ITIN genotípicamente activo reportado como “respuesta máxima” o “sensible” en el informe del fenotipo virtual realizado en la visita de selección más el antagonista del receptor de la quimiocina CCR5 Maraviroc (Pfizer) si se puede obtener a través de un programa de acceso expandido, no se ha utilizado anteriormente y está permitido por las autoridades reguladoras locales.
    • Uno o ningún ITIN genotípicamente activo reportado como “respuesta máxima” o “sensible” en el informe del fenotipo virtual realizado en la visita de selección más dos de los siguientes fármacos, Enfuvirtide, inhibidor de la integrasa y Maraviroc si están dispones, no se han utilizado previamente y están permitidos por las autoridades reguladoras locales.
    Para los pacientes que tomaron anteriormente 3TC (lamivudina) o FTC (Emtricitabina), estos fármacos no se consideran sensibles, a pesar del resultado obtenido en la prueba del fenotipo virtual.
    5. Pacientes que han estado recibiendo un tratamiento actual con IP (en fracaso) durante al menos 8 semanas antes de la aleatorización.
    6. Carga viral del VIH ≥ 1.000 copias/ml en la visita de selección.
    7. Recuento de linfocitos CD4+ ≥ 50 células/mm3 en la visita de selección.
    8. Puntuación en la escala de Karnofsky ≥ 70 (Anexo 10.7).
    9. Valores analíticos aceptables que indiquen una función orgánica basal adecuada en la visita de selección. Los valores analíticos se consideran aceptables si se aplica lo siguiente:
    • ALT ≤ 2,5 x LSN y AST ≤ 2,5 x LSN (≤ DAIDS Grado 1, Anexo 10.1).
    • Cualquier grado en la escala DAIDS relativo a los niveles de colesterol o triglicéridos, GGT, CPK o LDH es aceptable.
    • Análisis de orina: hematuria y proteinuria (≤ Grado 2 de la escala DAIDS).
    • Hematología: hemoglobina, recuento absoluto de neutrófilos (ANC) (≤ grado 2 en la escala DAIDS).
    • Bioquímica: glucosa, ácido úrico (≤ Grado 2 de la escala DAIDS).
    • Los demás valores analíticos (≤ Grado 1 en la escala DAIDS)
    10. Disposición para iniciar quimioprofilaxis guiada por el recuento de células CD4+ para prevenir las infecciones oportunistas tal como se define en el Anexo 10.3.2.
    11. Disposición para no ingerir sustancias que puedan alterar los niveles plasmáticos del fármaco del estudio por interacción con el sistema del citocromo P450 (indicados en el Apartado 4.2.2 y el Anexo 10.5 del protocolo) durante el estudio
    E.4Principal exclusion criteria
    1. Uso previo de TPV o DRV.
    2. Resistencia genotípica completa (reportada como “respuesta mínima”) a TPV o DRV en la prueba del fenotipo virtual realizada en la visita de selección:
    • Se define “Respuesta mínima” como el cambio por encima del valor de corte superior clínico de Virco.
    3. Mujeres en edad fértil que:
    • Presentan una prueba de embarazo en suero positiva en la visita de selección o durante el estudio,
    • está en periodo de lactancia,
    • tiene previsto quedarse embarazada,
    • no deseen utilizar un método anticonceptivo de barrera o requieren la administración de etinil estradiol. Los métodos anticonceptivos de barrera incluyen diafragma con espermicida, preservativos para mujeres, tapones cervicales y preservativos.
    4. Presentan antecedentes de leucoencefalopatía multifocal progresiva (LMP), sarcoma de Kaposi visceral (SK) y/o una neoplasia maligna.
    5. Cualquier enfermedad definitoria de SIDA (Apartado 10.3.1) no resuelta, sintomática o inestable, que lleve en tratamiento durante al menos 12 semanas en el momento de la visita de selección.
    6. Uso de fármacos inmunomoduladores (como interferón, ciclosporina, hidroxiurea e interleukina-2) en los 30 días anteriores a la aleatorización.
    7. Uso actual de quimioterapia citotóxica sistémica.
    8. Incapacidad para cumplir los requisitos del protocolo, incluido el abuso de sustancias activas según el criterio del investigador.
    9. Todas las contraindicaciones del producto que se indican en las Fichas Técnicas de Aptivus, Prezista y Norvir
    E.5 End points
    E.5.1Primary end point(s)
    El criterio principal de valoración de este estudio es el tiempo transcurrido hasta el fracaso virológico, utilizando CV< 50 copias/ml para determinar la respuesta virológica (y CV ≥ 500 para determinar el rebote virológico)
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) Yes
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.3.1Comparator description
    Darunavir
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.4.1Number of sites anticipated in Member State concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA100
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    Ultima Visita (semana 50) del último paciente participante del estudio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months6
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.3Elderly (>=65 years) Yes
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state50
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 400
    F.4.2.2In the whole clinical trial 800
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2007-09-14
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2007-09-07
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2008-09-20
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