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    Summary
    EudraCT Number:2010-021785-30
    Sponsor's Protocol Code Number:A4001095
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2011-09-28
    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 number2010-021785-30
    A.3Full title of the trial
    A MULTICENTER, RANDOMIZED, DOUBLE BLIND, COMPARATIVE TRIAL OF MARAVIROC + DARUNAVIR/RITONAVIR VERSUS EMTRICITABINE/TENOFOVIR + DARUNAVIR/RITONAVIR FOR THE TREATMENT OF ANTIRETROVIRAL NAÏVE HIV INFECTED PATIENTS WITH CCR5 TROPIC HIV 1
    Ensayo multicéntrico, aleatorizado, doble ciego, comparativo de
    maraviroc + darunavir/ritonavir frente a emtricitabina/tenofovir +
    darunavir/ritonavir para el tratamiento de los pacientes infectados por
    el VIH-1 con tropismo por CCR5 no tratados previamente con
    antirretrovirales
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to find out whether maraviroc given once daily is as effective as Truvada given once daily in treating HIV-infected patients never previously treated with maraviroc.
    Estudio para averiguar si maraviroc dado una vez al día es tan efectivo
    como Truvada administrado una vez al día en el tratamiento de pacientes
    infectados por VIH y que no han sido tratados con maraviroc
    A.4.1Sponsor's protocol code numberA4001095
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorViiV Healthcare UK Limited
    B.1.3.4CountryUnited Kingdom
    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 supportPfizer, S.L.U.
    B.4.2CountrySpain
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc
    B.5.2Functional name of contact pointClinical Trials.gov Call Centre
    B.5.3 Address:
    B.5.3.1Street Address235 E 42nd Street
    B.5.3.2Town/ cityNew York
    B.5.3.3Post codeUnited States
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1 800 718 1021
    B.5.5Fax number+1 303 739 1119
    B.5.6E-mailClinicalTrials.govCallCentre@pfizer.com
    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 Celsentri
    D.2.1.1.2Name of the Marketing Authorisation holderViiV Healthcare UK 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.3.1Product namemaraviroc
    D.3.2Product code UK-427,857
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNMaraviroc
    D.3.9.1CAS number 376348-65-1
    D.3.9.2Current sponsor codeUK-427,857
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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) No
    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 No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    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 No
    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 RoleComparator
    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 Truvada
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences International 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.3.1Product nameemtricitabine & tenofovir
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEMTRICITABINE
    D.3.9.1CAS number 143491-57-0
    D.3.9.4EV Substance CodeSUB01882MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTENOFOVIR DISOPROXYL FUMARATE
    D.3.9.1CAS number 147127-20-6
    D.3.9.4EV Substance CodeSUB04721MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number245
    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) No
    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 No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    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 No
    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 RoleComparator
    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
    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.3.1Product nameDarunavir
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDARUNAVIR
    D.3.9.1CAS number 206361-99-1
    D.3.9.4EV Substance CodeSUB25394
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number800
    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) No
    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 No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    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 No
    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: 4
    D.1.2 and D.1.3IMP RoleComparator
    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
    D.2.1.1.2Name of the Marketing Authorisation holderAbbott Laboratories
    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.3.1Product nameRitonavir
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRITONAVIR
    D.3.9.1CAS number 155213-67-5
    D.3.9.4EV Substance CodeSUB10342MIG
    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) No
    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 No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    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 No
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    HIV infection
    Infección por VIH
    E.1.1.1Medical condition in easily understood language
    HIV infection
    Infección por VIH
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.0
    E.1.2Level LLT
    E.1.2Classification code 10068341
    E.1.2Term HIV-1 infection
    E.1.2System Organ Class 10021881 - Infections and infestations
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To assess whether maraviroc (SelzentryTM, Celsentri®) administered once daily (QD) is non inferior to a reference regimen of emtricitabine/tenofovir administered QD each in combination with darunavir/ritonavir in the treatment of antiretroviral naïve HIV 1 infected subjects as measured by the proportion of subjects with HIV 1 RNA below the limits of assay detection (<50 copies of HIV 1 RNA per milliliter of plasma) at Week 48.
    Evaluar si maraviroc (SelzentryTM, Celsentri®) administrado una vez al
    día (1 v/día) no es inferior a un régimen de referencia de
    emtricitabina/tenofovir administrado una vez al día cada uno de ellos en
    combinación con darunavir/ritonavir en el tratamiento de sujetos
    infectados por el VIH-1 no tratados previamente con antirretrovirales
    según lo determinado mediante la proporción de sujetos con ARN del
    VIH-1 por debajo de los límites de detección del análisis (< 50 copias de
    ARN del VIH-1 por mililitro de plasma) en la semana 48.
    E.2.2Secondary objectives of the trial
    1. To assess the safety and tolerability of maraviroc when administered in combination with darunavir/ritonavir.
    2. To assess the utility of genotype testing or the enhanced Trofile assay (ESTA) for tropism testing in predicting virologic outcomes of a maraviroc containing regimen.
    3. To compare the proportion of subjects with HIV 1 RNA below the limits of assay detection at Week 96 for maraviroc versus emtricitabine/tenofovir.
    4. To compare the differences in the magnitude of changes in CD4+ and CD8+ cell counts and CD4+/CD8+ ratio from baseline through Weeks 48 and 96 for maraviroc versus emtricitabine/tenofovir.
    5. To examine tropism change and the evolution of viral resistance in virologic failure subjects.
    6. To compare the effects on peripheral fat distribution and trunk to limb fat ratio of maraviroc versus emtricitabine/tenofovir.
    7. To compare the effects on bone mineral density of maraviroc versus emtricitabine/tenofovir
    Eval seg y tolerab de maraviroc cuando se adm en combinación con
    darunavir/ritonavir. Eval utilidad del análisis genotípico o del análisis
    Trofile mejorado (ESTA) para analizar el tropismo a la hora de predecir
    los resultados virológicos de un régimen con maraviroc. Comp la
    proporción de sujetos con ARN del VIH-1 por debajo de los límites de
    detección del análisis en la semana 96 entre maraviroc y
    emtricitabina/tenofovir. Comp diferencias en magnitud de variación de
    los recuentos de linfocitos CD4+ y CD8+ y cociente CD4+/CD8+ entre
    momento basal y semanas 48 y 96 entre maraviroc y
    emtricitabina/tenofovir. Anal cambio de tropismo y evolución de
    resistencia viral en suje con fracaso virológico. Comp efectos sobre
    distribución de grasa periférica y cociente de grasa entre tronco y
    extremidades (mediante DEXA) entre maraviroc y
    emtricitabina/tenofovir. Comp efec sobre densidad mineral ósea
    (mediante DEXA y marcadores séricos) entre maraviroc y
    emtricitabina/tenofovir.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Title: The Dual Energy X-ray Absorptiometry (DEXA) Scan Sub-Study
    Date: 20 September 2011
    Objectives: (i) To compare the effects on peripheral fat distribution and trunk to limb fat ratio (using DEXA scan) of maraviroc versus emtricitabine/tenofovir
    (ii) To compare the effects on bone mineral density (using DEXA scan and serum markers) of maraviroc versus emtricitabine/tenofovir
    Absorciometría radiológica de doble energía (DEXA) entre maraviroc y
    emtricitabina/tenofovir.
    Fecha: 12 de mayo de 2011
    (i) Comparar los efectos sobre la distribución de la grasa periférica y el
    cociente de grasa entre tronco y extremidades (mediante absorciometría
    radiológica de doble energía DEXA) entre maraviroc y
    emtricitabina/tenofovir.
    (ii) Comparar los efectos sobre la densidad mineral ósea (mediante
    DEXA y marcadores séricos) entre maraviroc y emtricitabina/tenofovir
    E.3Principal inclusion criteria
    1. Evidence of a personally signed and dated informed consent document indicating that the subject (or a legally acceptable representative) has been informed of all pertinent aspects of the study
    2. At least 18 years of age at the Screening Visit.
    3. Plasma HIV 1 RNA equal to or more than 1,000 copies/mL measured at the Screening Visit.
    4. CD4 count equal to or more than 100 cells/mm3 at Screening.
    5. Have only R5 HIV 1 at Screening as verified by a randomized tropism assay.
    6. A negative urine pregnancy test at Screening and at the Baseline Visit, prior to receiving the first dose of study medication, for Women of Child Bearing Potential (WOCBP).
    NOTE: WOCBP include any female who has experienced menarche and who has not undergone hysterectomy, bilateral oophorectomy or tubal ligation or any other successful surgical sterilization or is not post menopausal (age >45 years, amenorrheic for >2 years, and serum FSH levels >30 IU/L). Even women who are using oral, implanted or injectable contraceptive hormones or mechanical products (intrauterine devices; barrier methods: eg. condom or diaphragm with spermicidal) to prevent pregnancy, who are practising abstinence, or who have a partner that is sterile (eg, vasectomy), should be considered to be of child bearing potential.
    7. WOCBP, male study subjects and their partners must use two forms of contraception one of which is effective barrier contraception throughout the study and for at least 28 days following the last dose of study medication. WOCBP must use another acceptable method of contraception from screening to at least 28 days after the trial. Acceptable contraception includes the following:
    ? Oral, transdermal, implantable, or injectable hormone therapy;
    ? Effective intrauterine devices;
    ? Vasectomized partner;
    ? Double barrier contraceptive methods.
    8. Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
    9. Subjects who have consented to participate in the DEXA scan sub study must be equal to or less than 136 kg (300 lb) in weight and equal to or less than 1.95 m (6ft. 4.8 inches) in height and have a body mass index equal to or less than 40 kg/m2
    1. Prueba de un documento de consentimiento informado, firmado y
    fechado personalmente, que indique que se ha informado al sujeto (o a
    su representante legal) de todos los aspectos pertinentes del estudio.
    2. Edad mínima de 18 años en la visita de selección.
    3. ARN del VIH-1 en plasma ? 1.000 copias/ml en la visita de selección.
    4. Recuento de CD4 ? 100 células/mm3 en la visita de selección.
    5. Presencia exclusiva de VIH-1 R5 en la visita de selección verificada
    mediante un análisis del tropismo aleatorizado.
    6. Resultados negativos en pruebas de embarazo en orina realizadas en
    las visitas de selección y basal, antes de la primera dosis de medicación
    del estudio, en el caso de mujeres en edad fértil (MEF).
    NOTA: se considera MEF a toda mujer que haya experimentado la
    menarquia y que no se haya sometido a una histerectomía, ovariectomía
    bilateral, ligadura de trompas u otra esterilización quirúrgica
    satisfactoria, y que no sea posmenopáusica (de > 45 años de edad, en
    amenorrea durante > 2 años y concentraciones séricas de FSH > 30
    UI/l). Se considera MEF a toda mujer que utilice anticonceptivos orales,
    implantados o inyectables, o productos mecánicos (dispositivos
    intrauterinos, métodos de barrera, por ejemplo, preservativo o
    diafragma con espermicida) para evitar el embarazo, que practiquen la
    abstinencia o cuya pareja sea estéril (por ejemplo, vasectomía).
    7. Las MEF, los varones participantes y sus parejas deberán utilizar dos
    métodos anticonceptivos (uno de los cuales será un anticonceptivo de
    barrera) durante todo el estudio y hasta al menos 28 días después de la
    administración de la última dosis de la medicación del estudio. Las MEF
    deberán utilizar otro método anticonceptivo aceptable desde la selección
    y hasta al menos 28 días después del estudio. Los métodos
    anticonceptivos aceptables son:
    ? Tratamiento hormonal oral, transdérmico, implantable o inyectable.
    ? Dispositivos intrauterinos eficaces.
    ? Pareja vasectomizada.
    ? Métodos anticonceptivos de doble barrera.
    8. Sujetos dispuestos a cumplir las visitas programadas, el plan de
    tratamiento, los análisis clínicos y otros procedimientos del estudio y
    capaces de hacerlo.
    9. Los sujetos que hayan aceptado participar en el subestudio de DEXA
    deben pesar ? 136 kg, medir ? 1,95 m y tener un índice de masa
    corporal ? 40 kg/m2.
    E.4Principal exclusion criteria
    1. Suspected or documented active, untreated HIV 1 related Opportunistic Infection (OI) or other condition requiring acute therapy (eg, acute hepatitis C virus infection) at the time of randomization to treatment. [Subjects on a stable (>1 month) secondary OI prophylaxis regimen or chronic treatment with stable disease (eg, for hepatitis C virus infection) are eligible for the study; subjects on a primary OI prophylaxis regimen of any duration are also eligible for the study].
    2. Treatment for an active opportunistic infection, or unexplained temperature >38.5°C (101.3º F) for 7 consecutive days, within 30 days prior to screening.
    3. Prior treatment with any other HIV antiretroviral therapy for more than 14 days at any time.
    4. Active alcohol consumption equal to or more than 30 g ethanol per day in males and equal to or more than 20 g per day in females.
    5. Substance abuse sufficient, in the Investigator?s judgment, to prevent adherence to study medication and/or Follow Up.
    6. Lactating women or planned pregnancy during the study period.
    7. Initiation of therapy with a potentially myelosuppressive, neurotoxic, hepatotoxic and/or cytotoxic agent within 60 days prior to screening or the expected need for such therapy during the study period.
    8. Malignancy requiring parenteral or oral chemotherapy that must be continued for the duration of the study.
    9. Documented or suspected acute hepatitis or pancreatitis within 30 days prior to Randomization
    10. Renal insufficiency defined as a serum creatinine greater than 3 times the upper limit of normal or a creatinine clearance of less than 50 mL/min, as calculated by the Cockcroft and Gault equation.
    11. Potentially life threatening (Grade 4) laboratory abnormality or medical condition (according to the Division of AIDS table for grading severity of adult adverse experiences.
    12. ALT equal to or more than 5.0xULN;
    13. Subjects with chronic Hepatitis B (HBsAg positive).
    14. Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), known biliary abnormalities (with the exception of Gilbert?s syndrome or asymptomatic gallstones).
    15. Clinically significant malabsorption syndrome (eg, equal to or more than 6 loose stools per day for at least 7 consecutive days) within 30 days prior to Screening.
    16. Inability to tolerate oral medication.
    17. Concomitant therapy with other investigational agents.
    18. The following medications being taken by the subject at the time of randomization to treatment that must be continued during the study period, including immunomodulators (for the treatment of HIV 1 infection), and any contraindicated medication described in the package inserts of maraviroc (Selzentry, Celsentri), darunavir (Prezista), ritonavir (Norvir) and emtricitabine/tenofovir (Truvada).
    19. Any evidence of genotypic/phenotypic resistance to darunavir, tenofovir, and emtricitabine.
    20. CXCR4 using virus detected using randomized tropism determination or repeated failure to obtain an interpretable tropism result.
    21. Any safety, behavioral, clinical, or administrative reasons that, in the Investigator?s judgment, would potentially compromise study compliance or the ability to evaluate safety/efficacy.
    22. Have a known hypersensitivity to darunavir, ritonavir, tenofovir, emtricitabine, to maraviroc or any of its excipients, including soy lecithin or dyes of those drugs as described in the package inserts, or known hypersensitivity or allergy to peanuts.
    23. Participation in other interventional studies within 30 days before the current study begins and/or during study participation
    24. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the Investigator, would make the patientsubject inappropriate for entry into this study.
    25. Subjects who are investigational site staff members or subjects who are the Sponsor?s employees directly involved in the conduct of the trial.
    26. Subjects who have consented to participate in the DEXA scan sub study who have implants in the lumbar spine or have multiple vertebral fracture or severe degenerative disease (eg, scoliosis, osteophytes, sclerosis, etc.) in the range L1 L4 which prevents reliable spine bone mineral density measurement
    27. Subjects who have consented to participate in the DEXA scan sub study who have implants in both hips or bilateral disease or deformity which prevents reliable hip bone mineral density measurement
    28. Subjects who have consented to participate in the DEXA scan sub study who are receiving osteoporosis drug treatment within 30 days prior to Screening and/or during study participation.
    Sospe o certeza documen de infec oportunista relac con VIH-1, activa y
    no tratada, u otro trastorno que requiera trata inmediato (infec aguda
    por el virus de hepa C) en momento de aleatorización al trata. [Suj que
    estén recibiendo un rég de profilaxis estable (>1mes) secund a para IO o
    trata crónico con enfer estable (para una infec por virus hepa C) podrán
    participar en el estu; suj que estén recibiendo régimen de profilaxis
    primaria de IO de cualquier duración también podrán participar en el
    estudio]. NT: no se podrá iniciar trata con trimetoprim-sulfametoxazol
    en 15d previos aleatorización al trata del estu, pero se podrá mantener si
    suj recibe una pauta estable. Trata para una infección oportunista activa
    o fiebre idiopática >38,5°C durante 7d consecutivos, en 30d previos a
    selec. Trata previo con cualquier otro antirretroviral durante más de 14d
    en cualquier momen. Consumo activo de alcoh ?30g etanol día en va y ?
    20g día en muj. Toxicomanía sufi para impedir adherencia al trata del
    estu o seguimiento, a criterio del investig. Muj lact o que tengan previsto
    quedarse embarazadas durante período del estu. Inicio de un trata con
    un fármaco potencial mielodepresor, neurotóxico, hepatotóxico o
    citotóxico en 60d previos a selección, o necesidad prevista de dicho trata
    durante período del estu. Neoplasia maligna que precise quimioterapia
    parenteral u oral que deba mantenerse durante estu. Pancreatitis o
    hepatitis aguda confirmada o presunta en 30d previos a aleatorización.
    Insufi renal definida como creatinina sérica mayor de 3 v el límite supe
    de normalidad o un acla de creatinina menor de 50ml/min, calculado
    mediante ecuación de Cockcroft y Gault (ap 1). Anomalía analítica o
    trastorno médico potencial mortal (gra 4) (arreglo a tab de Div of AIDS
    para clas intensi de AAAA en adul, v el ap 2). Los suj con elevaciones de
    triglicéridos, colesterol o CPK de gra 4 podrán participar en estu después
    de que monitor médico lo valore y confirme su elegibilidad. Cualquier
    otro resultado analítico que sea de gra 3 o super deberá comentarse con
    monitor médico para confirmar elegibilidad del suj. ALT ?5,0 v el LSN.
    Suj con hepa B crónica (HBsAg positivo). Hepatopatía inestable (definida
    por presencia de ascitis, encefalopatía, coagulopatía, hipoalbuminemia,
    varices esofágicas o gástricas o ictericia persistente), anomalías biliares
    conocidas (excep síndrom Gilbert o colelitiasis asintomática). Hepa C
    crónica estable es aceptable, si suj cumple demás criterios de participa
    en estu. Investig deberán valorar cuidadosamente si se precisa trata
    específ para hepa C; se excluirá a suj que requerirán previsiblemente tal
    trata durante parte aleatorizada del estu. Sínd de malabsorción
    clínicamente import (?6 deposiciones sueltas día, durante al menos 7d
    segui) en 30d previos selección. Intolerancia a medicación por v oral.
    Trata concomitante con otros fármacos experimentales. Toma siguientes
    medicamentos por parte del suj en momento de aleatorización al trata
    que deban mantenerse durante período del estu, como
    inmunomoduladores (para trata de infec por VIH-1) y toda medicación
    contraindicada descrita en prospec de maraviroc (Selzentry?,
    Celsentri®), darunavir (Prezista?), ritonavir (Norvir?) y
    emtricitabina/tenofovir (Truvada®). Prueb resistencia
    genotípica/fenotípica a darunavir, tenofovir y emtricitabina. Virus contropismo por CXCR4 detectado mediante deter del tropismo aleatorizada
    o incapacidad repetida de obtener resultado de tropismo interpretable.
    Cualquier motivo de segu, conductual, clínico o administra que, en
    opinión del invest, pueda afectar cumplimiento del estu o capacidad de
    eval a segu o efica. Presen hipersensibilidad conocida a darunavir,
    ritonavir, tenofovir, emtricitabina, maraviroc o a cualquiera de sus
    excipien, inclu lecitina de soja o colorantes descritos en f-t, o
    hipersensibilidad o alergia conocida a cacahuetes. Participa en otros estu
    de intervención durante 30d previos al inicio del estu actual o durante
    permanencia en el mismo. Cualquier otro trastorno médico o psiquiátrico
    grave, agudo o crónico, o cualquier anomalía analítica que pueda
    aumentar el riesgo asociado a parti en el estu o a adminis del produc en
    investi o interferir en interpretación de resultados del estu y, en opinión
    del inves, impedir participa en este estu. Suj que sean miemb del perso
    del centro de investiga o empl del promotor direct implicados en
    realización del ensayo. Suj que hayan aceptado participar en subest
    DEXA y tengan implantes en columna lumbar, varias fracturas
    vertebrales o enfer raquídea degenerativa grave (escoliosis, osteofitos,
    esclerosis) de L1-L4 que impidan determinación fiable de densidad
    mineral ósea de columna. Suj que hayan aceptado participar en subest
    DEXA y tengan implantes en ambas caderas o una enferm o deformidad
    bilateral de las mismas que impidan una deter fiable de densidad mineral
    ósea de cadera.
    E.5 End points
    E.5.1Primary end point(s)
    The proportion of subjects with plasma HIV 1 RNA <50 copies/mL at Week 48.
    El criterio de valoración principal de este estudio es la proporción de
    sujetos con ARN del VIH-1 en plasma < 50 copias/ml en la semana 48
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 48
    Semana 48
    E.5.2Secondary end point(s)
    1. Safety: Frequency, severity and relationship of adverse events to test drug; serious adverse events; discontinuations due to adverse events; and frequency and severity of abnormal laboratory values.
    2. The relationship between the proportion of subjects with plasma HIV 1 RNA <50 copies/mL at the Week 48 and Week 96 visits and the screening tropism test (Genotype test or ESTA) in the maraviroc-containing regimen..
    3. Virologic Response:
    Proportion of subjects with plasma HIV RNA <50 copies/mL at Week 96.
    4. Immunological Response at Week 48 and Week 96:
    a. Changes in CD4+ T lymphocyte (CD4) cell counts and percent change from Baseline;
    b. Changes in CD8+ T lymphocyte (CD8) cell counts and percent change from Baseline;
    c. Changes in CD4+/CD8+ ratio and changes from Baseline.
    5. Evolution of viral resistance and tropism change between Screening or Baseline and the time of confirmation of virologic failure or the last on treatment time point:
    a. HIV 1 tropism (Genotype test)
    b. For virologic failure with R5 virus, viral resistance to maraviroc (maraviroc treated subjects only).
    c. Viral resistance (Genotype and Phenotype) to nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) and non nucleoside reverse transcriptase inhibitors (NNRTI) [reverse transcriptase inhibitors, RTI] and protease inhibitors (PI).
    6. Changes in peripheral fat distribution and trunk to limb fat ratio (using DEXA scan) from Baseline and at Weeks 48 and 96 (approximately 109 subjects per treatment arm).
    7. Changes in bone mineral density (using DEXA scan and serum markers) from Baseline and at Weeks 48 and 96 (approximately 109 subjects per treatment arm).
    1. Seguridad: frecuencia, intensidad y relación de los acontecimientos
    adversos con el fármaco experimental, acontecimientos adversos graves,
    retiradas por acontecimientos adversos y frecuencia e intensidad de los
    valores analíticos anormales.
    2. Relación entre la proporción de sujetos con ARN del VIH-1 en plasma
    < 50 copias/ml en las visitas de las semanas 48 y 96 y el análisis del
    tropismo en la selección (análisis genotípico o ESTA) en el grupo del
    régimen con maraviroc.
    3. Respuesta virológica:
    Proporción de sujetos con ARN del VIH en plasma < 50 copias/ml en la
    semana 96.
    4. Respuesta inmunológica en las semanas 48 y 96:
    a. Variaciones de los recuentos de linfocitos T CD4+ (CD4) y variación
    porcentual con respecto al momento basal.
    b. Variaciones de los recuentos de linfocitos T CD8+ (CD8) y variación
    porcentual con respecto al momento basal.
    c. Variaciones del cociente CD4+/CD8+ y variaciones con respecto al
    momento basal.
    5. Evolución de la resistencia viral y la variación del tropismo entre la
    selección o el momento basal y el momento de confirmación del fracaso
    virológico o el último momento de valoración durante el tratamiento:
    a. Tropismo del VIH-1 (análisis genotípico).
    b. En caso de fracaso virológico con virus R5, resistencia del virus a
    maraviroc (sólo en los sujetos tratados con maraviroc).
    c. Resistencia viral (genotipo y fenotipo) a los inhibidores de la
    transcriptasa inversa análogos de nucleósidos/nucleótidos (ITIN) e
    inhibidores de la transcriptasa inversa no análogos de nucleósidos
    (ITINN) [inhibidores de la transcriptasa inversa, ITI] e inhibidores de la
    proteasa (IP).
    6. Variaciones de la distribución de la grasa periférica y el cociente de
    grasa entre tronco y extremidades (mediante DEXA) entre el momento
    basal y las semanas 48 y 96 (aproximadamente 109 sujetos por grupo de
    tratamiento).
    7. Variaciones de la densidad mineral ósea (mediante DEXA y
    marcadores séricos) entre el momento basal y las semanas 48 y 96
    (aproximadamente 109 sujetos por grupo de tratamiento).
    E.5.2.1Timepoint(s) of evaluation of this end point
    Weeks 48 and 96
    Semanas 48 y 96
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    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) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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.8.2.4Number of treatment arms in the trial2
    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 Yes
    E.8.4.1Number of sites anticipated in Member State concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA86
    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 No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    Brazil
    Canada
    Colombia
    Mexico
    United States
    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
    LVLS
    Ultima visita del ultimo paciente
    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 months9
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days0
    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.1.2.1Number of subjects for this age range: 800
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 4
    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 state45
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 278
    F.4.2.2In the whole clinical trial 804
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    After participation in the study (week 96), the Sponsor will no longer provide study drugs except if the provision of such study drugs is mandated by local regulations. Hence, the patients will be transitioned to receive optimized regimens containing commercially available drugs by Physician?s prescription.
    Después de la participación en el estudio (semana 96) el promotor no
    suministrará ninguna de las medicaciones. Así los pacientes parsarán a
    recibir sus tratamientos comercializados mediante prescripción médica.
    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 Decision2011-11-16
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2011-11-08
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2014-01-28
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    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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