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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02295384
Registration number
NCT02295384
Ethics application status
Date submitted
17/11/2014
Date registered
20/11/2014
Date last updated
12/09/2016
Titles & IDs
Public title
Use of Concomitant Medications in HIV-1 Infected Patients in a Large Community Practice in Sydney, Australia
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Scientific title
Use of Concomitant Medications in HIV-1 Infected Patients in a Large Community Practice in Sydney, Australia
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Secondary ID [1]
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Polypharmacy Audit
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
HIV
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Condition category
Condition code
Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Other interventions - Retrospective Audit
Audit Group - Patients attending HHMP in Darlinghurst, Sydney, New South Wales with documented HIV-1 infection from 1st January 2005 to 31st July 2014, who were considered "linked to care" (Attendance during the study period for at least 2 visits \>3 months and \<12 months apart with measured laboratory virological or immunological markers (either on-site or at a co-management site)).
Other interventions: Retrospective Audit
Retrospective Audit
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Quantity of concomitant medications used in patients with HIV-1 infection
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Assessment method [1]
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The pill burden of concomitant medications for patients with HIV-1 infection
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Timepoint [1]
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9.5 years
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Primary outcome [2]
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Types of concomitant medications used in patients with HIV-1 infection
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Assessment method [2]
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Timepoint [2]
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9.5 years
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Secondary outcome [1]
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Total pill load in patients with HIV
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Assessment method [1]
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Timepoint [1]
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9.5 years
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Secondary outcome [2]
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Frequency of drug dosing
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Assessment method [2]
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Timepoint [2]
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9.5 years
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Secondary outcome [3]
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Use of concomitant medications that could have potential drug-drug interaction with stribild (co-formulated elvitegravir/cobicistat/tenofovir/emtricitabine)
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Assessment method [3]
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Timepoint [3]
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9.5 years
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Eligibility
Key inclusion criteria
* Documented HIV-1 infection
* Attendance during the study period for at least 2 visits >3 months and <12 months apart with measured laboratory virological or immunological markers (either on-site or at a co-management site).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Attendance by patient with HIV infection who does not have laboratory markers of HIV viral load or CD4 count
* Incomplete/inaccessible patient records
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Study design
Purpose
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Duration
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Selection
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Timing
Retrospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/11/2014
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/06/2016
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Sample size
Target
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Accrual to date
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Final
1104
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Holdsworth House Medical Practice - Darlinghurst
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Recruitment postcode(s) [1]
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2010 - Darlinghurst
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Funding & Sponsors
Primary sponsor type
Other
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Name
Holdsworth House Medical Practice
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Gilead Sciences
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
For the majority of patients, management of HIV-1 infection involves effective and well tolerated antiretroviral therapy with simplified pill load and dosing, exemplified by the availability of single tablet regimens (STRs) with single tablet once daily dosing. STR therapy has been shown to improve adherence and reduce hospitalisations (Cohen et al., 2013; Sax et al., 2012). However, the aging of the HIV cohort in Australia and globally has raised issues of increasing co-morbidities and consequent polypharmacy to manage these (Jansson \& Wilson, 2012; Edelman et al., 2013). Polypharmacy may not only impact on adherence, but also increases the potential for drug-drug interactions (Holtzman et al., 2013). Stribild, a highly effective STR, contains cobicistat to boost the levels of the component integrase inhibitor, elvitegravir. Cobicistat does not have antiretroviral activity, but acts by inhibiting Cyp3A4 of the cytochrome p450 metabolic pathway. Other drugs metabolized via this pathway may be affected by this drug-drug interaction (Rogatto et al., 2014). Additionally there is evidence of increased risk of nephrotoxicity with co-administration of tenofovir and non-steroidal anti-inflammatory medication (NSAIDS) (Marcotte et al., 2008). Data on use of concomitant medications in Australian patients with HIV is sparse. This study aims to determine, in a large caseload community HIV practice, the use of concomitant medications in HIV, patient pill load and dosing frequency, and potential drug-drug interactions with stribild.
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Trial website
https://clinicaltrials.gov/study/NCT02295384
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Trial related presentations / publications
Jansson J, Wilson DP. Projected demographic profile of people living with HIV in Australia: planning for an older generation. PLoS One. 2012;7(8):e38334. doi: 10.1371/journal.pone.0038334. Epub 2012 Aug 9. Edelman EJ, Gordon KS, Glover J, McNicholl IR, Fiellin DA, Justice AC. The next therapeutic challenge in HIV: polypharmacy. Drugs Aging. 2013 Aug;30(8):613-28. doi: 10.1007/s40266-013-0093-9. Holtzman C, Armon C, Tedaldi E, Chmiel JS, Buchacz K, Wood K, Brooks JT; , and the HOPS Investigators. Polypharmacy and risk of antiretroviral drug interactions among the aging HIV-infected population. J Gen Intern Med. 2013 Oct;28(10):1302-10. doi: 10.1007/s11606-013-2449-6. Epub 2013 Apr 20. Cohen CJ, Meyers JL, Davis KL. Association between daily antiretroviral pill burden and treatment adherence, hospitalisation risk, and other healthcare utilisation and costs in a US medicaid population with HIV. BMJ Open. 2013 Aug 1;3(8):e003028. doi: 10.1136/bmjopen-2013-003028. Sax PE, Meyers JL, Mugavero M, Davis KL. Adherence to antiretroviral treatment and correlation with risk of hospitalization among commercially insured HIV patients in the United States. PLoS One. 2012;7(2):e31591. doi: 10.1371/journal.pone.0031591. Epub 2012 Feb 24. Bpharm SM, Talbot A, Trottier B. Acute renal failure in four HIV-infected patients: Potential association with tenofovir and nonsteroidal anti-inflammatory drugs. Can J Infect Dis Med Microbiol. 2008 Jan;19(1):75-6. doi: 10.1155/2008/370535. No abstract available.
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Public notes
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Contacts
Principal investigator
Name
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Mark Bloch, MBBS, M Med
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Address
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Holdsworth House Medical Practice
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Cohen CJ, Meyers JL, Davis KL. Association between...
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Journal
Sax PE, Meyers JL, Mugavero M, Davis KL. Adherence...
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Journal
Bpharm SM, Talbot A, Trottier B. Acute renal failu...
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Results not provided in
https://clinicaltrials.gov/study/NCT02295384
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