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DRIVE-2: Darunavir and Rilpivirine Interactions With Levonorgestrel Implant

Sponsor
Makerere University (Other)
Overall Status
Unknown status
CT.gov ID
NCT03589027
Collaborator
University of Nebraska (Other), University of Pittsburgh (Other), University of Liverpool (Other)
60
Enrollment
1
Location
2
Arms
21.8
Anticipated Duration (Months)
2.8
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This study will evaluate the pharmacokinetic properties of Rilpivirine and Darunavir when used in combination with Levonorgestrel

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

Despite the benefits of hormonal contraceptives, significant drug-drug interactions (DDIs) with some antiretroviral therapies (ART) represent a barrier to effective family planning methods for HIV-infected women. It is therefore critical to generate data on the combined use of hormonal contraceptives and ART. This study is a prospective, non-randomized, open-label, parallel, two-group, sparse-sampling pharmacokinetic (PK) study to describe levonorgestrel (LNG) PK parameters in two treatment groups (rilpivirine or darunavir- based ART) in 60 HIV-1 infected women. The primary endpoint is the comparison of the mean LNG concentrations at month 6 between the rilpivirine or darunavir treatment groups versus historical controls. This study will provide information on effective ART options for HIV positive women who opt for the contraceptive implant as a family planning method of choice.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
60 participants
Allocation:
Non-Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
A prospective, non-randomized, open-label, parallel, two-group, sparse-sampling pharmacokinetic (PK) study to describe levonorgestrel (LNG) PK parameters in two treatment groups (Rilpivirine or Darunavir- based ART) in 60 HIV-1 infected women.A prospective, non-randomized, open-label, parallel, two-group, sparse-sampling pharmacokinetic (PK) study to describe levonorgestrel (LNG) PK parameters in two treatment groups (Rilpivirine or Darunavir- based ART) in 60 HIV-1 infected women.
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Pharmacokinetic Evaluation of Levonorgestrel Implant in HIV-Infected Women on Darunavir Versus Rilpivirine-based Antiretroviral Therapy
Actual Study Start Date :
Aug 7, 2018
Anticipated Primary Completion Date :
Jun 1, 2019
Anticipated Study Completion Date :
Jun 1, 2020

Arms and Interventions

Arm Intervention/Treatment
Experimental: Rilpivirine arm

All subjects will be administered oral rilpivirine 25mg once daily together with the rest of their oral antiretroviral combination plus a levonorgestrel two-rod subdermal implant (75mg/rod) through out the study period

Drug: Levonorgestrel two rod sub-dermal implant
Levonorgestrel (75 mg/rod), 2 rods (150 mg) inserted subdermally
Other Names:
  • Levonorgestrel
  • Jadelle

    • Drug: Rilpivirine
    Oral ripilvirine 25mg once daily
    Other Names:
  • Edurant

    		•
    Experimental: Darunavir arm

    All subjects will be administered oral darunavir/ritonavir 600/100mg twice daily together with the rest of their oral antiretroviral combination plus a levonorgestrel two-rod subdermal implant (75mg/rod) through out the study period

    Drug: Levonorgestrel two rod sub-dermal implant
    Levonorgestrel (75 mg/rod), 2 rods (150 mg) inserted subdermally
    Other Names:
  • Levonorgestrel
  • Jadelle

    • Drug: Darunavir+Ritonavir
    Oral DRV/r 600/100mg twice daily
    Other Names:
  • DRV/r

    		•

    Outcome Measures

    Primary Outcome Measures

    1. Levonorgestrel concentrations: Change in mean levonorgestrel (LNG) concentrations [6 months]

      Comparison of the mean levonorgestrel (LNG) concentrations at month 6 between the rilpivirine (RPV) or darunavir (DRV) treatment groups versus historical controls

    Secondary Outcome Measures

    1. Change in mean rilpivirine concentration [12 months]

      Rilpivirine mean concentration change prior to implant placement and then over the duration of the study time period.

    2. Change in mean darunavir concentration [12 months]

      Darunavir mean concentration change prior to implant placement and then over the duration of the study time period.

    3. Adverse events [12 months]

      Any signs and symptoms related to hormone exposure, including abnormal vaginal bleeding and local or systemic adverse events observed during the study period in both study groups.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 45 Years
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:

    1. Evidence of a personally signed and dated informed consent document indicating that the participant has been informed of all pertinent aspects of the study.

    2. Participants who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

    3. Women age 18 years to 45 years

    4. Diagnosed with HIV infection

    5. Medically eligible for the LNG subdermal implant as a contraceptive method based on the WHO Medical Eligibility Criteria for Contraceptive Use11

    6. Receiving EFV- or LPV/r-based ART for a minimum of 1 year

    7. If not abstinent, must agree to use an effective non-hormonal method of contraception for the duration of the study including male and female condoms or the copper-T intrauterine device.

    8. Participants must have a negative urine pregnancy test at entry and report no unprotected sex since the last menstrual period or in the last two weeks.

    Exclusion Criteria:

    1. HIV RNA greater than 50 copies/mL at the screening visit

    2. CD4 count below 200 cells/mm3 at the screening visit

    3. History of virologic failure on the current regimen (two consecutive viral load results equal to or greater than 400 copies/mL)

    4. Serum hemoglobin less than 9.0 g/dl at screening

    5. Elevations in serum levels of alanine transaminase (ALT) above 5 times the upper limit of normal

    6. Elevations in serum creatinine above 2.5 times the upper limit of normal

    7. Use of drugs known to be contraindicated with LNG, RPV (for women taking EFV-based ART), or DRV (for women taking LPV-based ART) within 30 days of study entry. Due to the dynamic nature of drug interactions related to antiretroviral therapy, the study team will review all concomitant medications at screening based on the US Department of Health and Human Services drug interaction table 14 and the University of Liverpool HIV drug interaction tables (www.hiv-druginteractions.org)

    8. Currently pregnant or postpartum <30 days at study entry.

    9. Breastfeeding women within 6 months of delivery.

    10. Patients with a history of hypersensitivity to LNG implant, undiagnosed vaginal bleeding, diagnosed or suspected sex hormone dependent neoplasia, benign or malignant liver tumor, or thromboembolic disease.

    11. Presence of any active clinically significant disease or life-threatening disease that, in the investigator's opinion, would compromise the subject's safety or outcome of the study.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Infectious Diseases Institue Kampala Uganda 256

    Sponsors and Collaborators

    • Makerere University
    • University of Nebraska
    • University of Pittsburgh
    • University of Liverpool

    Investigators

    • Principal Investigator: Mohammed Lamorde, PhD, Infectious Diseases Institute

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Infectious Diseases Institute, Head of Department, Prevention Care and Treatment Infectious Diseases Institute, Makerere University College of Health Sciences, Makerere University
    ClinicalTrials.gov Identifier:
    NCT03589027
    Other Study ID Numbers:
    • PK22
    First Posted:
    Jul 17, 2018
    Last Update Posted:
    Mar 28, 2019
    Last Verified:
    Mar 1, 2019
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:
    Ritonavir
    Darunavir
    Rilpivirine
    Levonorgestrel

    Study Results

    No Results Posted as of Mar 28, 2019