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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02394730
Registration number
NCT02394730
Ethics application status
Date submitted
16/03/2015
Date registered
20/03/2015
Titles & IDs
Public title
Attenuation of D-dimer Using Vorapaxar to Target Inflammatory and Coagulation Endpoints
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Scientific title
A Double Blind Randomised Comparison of Vorapaxar Versus Placebo for the Treatment of HIV Associated Inflammation and Coagulopathy in Patients With Well Controlled HIV Replication
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Secondary ID [1]
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AI000585-26-288416
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Secondary ID [2]
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2014-01-ADV
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Universal Trial Number (UTN)
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Trial acronym
ADVICE
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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
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - vorapaxar
Treatment: Drugs - Placebo
Experimental: vorapaxar - 2.5mg of vorapaxar po qd
Placebo comparator: Placebo - sugar pill po qd
Treatment: Drugs: vorapaxar
2.5mg of vorapaxar taken orally once daily for 12 weeks
Treatment: Drugs: Placebo
Sugar pill taken orally once daily for 12 weeks
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Intervention code [1]
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Treatment: Drugs
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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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Mean Percent Change From Baseline for D-dimer (ng/mL) to the Average of Weeks 8 and 12
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Assessment method [1]
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Mean of week 8 and week 12 minus week 0 (on log10 scale) then back transforming the log10 difference to obtain percentage change from baseline.
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Timepoint [1]
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at week 8 and week 12
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Secondary outcome [1]
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Number of Participants in Each Treatment Group With Plasma HIV-1 RNA <50 Copies/mL
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Assessment method [1]
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Number of participants in each treatment group with plasma HIV-1 RNA \<50 copies/mL at week 18
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Timepoint [1]
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at week 18
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Secondary outcome [2]
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Mean Change From Baseline to Week 12 in CD4+ Cell Counts
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Assessment method [2]
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Mean of week 12 CD4+ cell count minus mean of week 0 CD4+ cell count
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Timepoint [2]
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at week 12
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Secondary outcome [3]
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Mean Change From Baseline to Week 12 in CD8+ Cell Counts
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Assessment method [3]
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Mean of week 12 CD8+ cell count minus mean of week 0 CD4+ cell count
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Timepoint [3]
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at week 12
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Secondary outcome [4]
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Number of Patients in Each Treatment Group With D-dimer <165ng/mL at Week 12
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Assessment method [4]
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Number of patients in each treatment group with d-dimer \<165ng/mL at week 12
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Timepoint [4]
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week 12
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Secondary outcome [5]
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Number of Patients in Each Treatment Group With D-dimer > or Equal to 165ng/mL at Week 18
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Assessment method [5]
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Number of patients in each treatment group with d-dimer \> or equal to 165ng/mL at week 18
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Timepoint [5]
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week 18
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Secondary outcome [6]
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Mean Change From Baseline in log10 D-Dimer
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Assessment method [6]
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Differences between treatment groups in mean change from week 0 log10 d-dimer to week 18
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Timepoint [6]
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at week 18
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Secondary outcome [7]
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Mean Change From Baseline in log10 Hs-CRP at Week 18
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Assessment method [7]
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Differences between treatment groups in mean change from baseline log10 hs-CRP to week 18. ie Week 18 log10 hs-CRP minus week 0 log10 hs-CRP
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Timepoint [7]
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at week 18
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Secondary outcome [8]
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Percent Change From Baseline Hs-CRP (ug/mL) to the Average of Week 8 and Week 12
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Assessment method [8]
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Mean of week 8 and week 12 minus week 0 (on log10 scale) then back transformed the log10 difference to obtain percentage change from baseline.
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Timepoint [8]
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week 8 and 12
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Secondary outcome [9]
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Mean Percent Change From Baseline IL-6 (pg/mL) to the Average of Week 8 and Week 12
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Assessment method [9]
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Mean of week 8 and week 12 minus week 0 (on log10 scale) then back transformed the log10 difference to obtain percentage change from baseline.
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Timepoint [9]
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at week 8 and week 12
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Secondary outcome [10]
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Differences Between Treatment Groups in Mean Change From Baseline log10 IL-6
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Assessment method [10]
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Differences between treatment groups in mean change from baseline log10 IL-6 at week 18
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Timepoint [10]
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at week 18
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Secondary outcome [11]
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Total Number of Participants With BARC Type 1, 2, 3, 4, or 5 Bleeding Episodes
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Assessment method [11]
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Bleeding Academic Research Consortium (BARC) Definitions for Bleeding Events Type 1 -bleeding that is not actionable and does not cause the patient to seek unscheduled performance of studies, hospitalization, or treatment by a healthcare professional; may include episodes leading to self-discontinuation of medical therapy by the patient without consulting a healthcare professional Type 2 - overt, actionable sign of haemorrhage (eg, more bleeding than would be expected for a clinical circumstance, including bleeding found by imaging alone) that does not fit the criteria for type 3, 4, or 5 but does meet at least one of the following criteria: (1) requiring nonsurgical, medical intervention by a healthcare professional, (2) leading to hospitalization or increased level of care, or (3) prompting evaluation Type 3- Bleeding requiring surgical intervention for control (excluding dental/nasal/skin/hemorrhoid) Type 4 - Coronary Artery Bypass Graft procedure-related bleeding Type 5 -
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Timepoint [11]
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at week 18
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Secondary outcome [12]
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Total Number of Participants With Any SAE Between Baseline and Week 18
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Assessment method [12]
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Total number of participants with any SAE between baseline and week 18
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Timepoint [12]
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week 18
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Secondary outcome [13]
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Total Number of Participants With Any AE Between Baseline to Week 18
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Assessment method [13]
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Total number of participants with any AE between week 0 to week 18
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Timepoint [13]
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week 18
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Secondary outcome [14]
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Changes From Baseline in Renal Function Measured by the CKD-EPI Estimate of Creatinine Clearance at Week 12
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Assessment method [14]
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Changes from baseline in renal function measured by the CKD-EPI estimate of creatinine clearance at week 12
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Timepoint [14]
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at week 12
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Eligibility
Key inclusion criteria
1. HIV-1 positive by licensed diagnostic test
2. aged =40 years
3. plasma HIV RNA <50 copies/mL for at least 24 weeks
4. screening CD4+ cell count > 50 cells/mm3
5. treated for at least 12 weeks with a suppressive regimen of combination antiretroviral therapy that does not include HIV protease inhibitors and/or NNRTIs (except rilpivirine)
6. plasma d-dimer >200ng/mL (>0.2µg/mL or >0.2mg/L) fibrinogen equivalent units or >100ng/mL (>0.1 µg/mL or >0.1mg/L) d-dimer units in the absence of established cause (deep vein thrombosis/embolism)
7. provision of written informed consent
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Minimum age
40
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
1. Absolute neutrophil count (ANC) <1000 cells/µL
2. hemoglobin <10.0 g/dL
3. platelet count <75,000 cells/µL
4. AST and/or ALT >2.5 x ULN
5. estimated glomerular filtration rate <30mL/min/1.73m2 ) using CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation
6. history of myocardial infarction or unstable atherosclerotic disease
7. history of ischemic stroke or transient ischaemic attack (TIA)
8. active peptic/duodenal ulcer or other bleeding disorder within the previous 12 months
9. intent to have surgery within the 6 month period after randomisation
10. current use of aspirin or P2Y12 antiplatelet therapy
11. use of anticoagulants, (eg. heparin or warfarin), fibrinolytic therapy, chronic use (more than 5 consecutive days) of nonsteroidal anti-inflammatory drugs (NSAIDS), strong CYP3A4 inhibitors or inducers. See Manual of Operations for full list of medications to avoid.
12. participants unlikely to be able to remain in follow-up
13. pregnant or nursing mothers
14. in the clinical judgement of the investigator, participation in this trial is deemed inappropriate as this may conflict with the well-being of the participant.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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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
1/09/2015
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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
1/01/2018
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Sample size
Target
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Accrual to date
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Final
65
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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St Vincent's Hospital - Darlinghurst
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Recruitment hospital [2]
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Taylor Square Private Clinic - Darlinghurst
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Recruitment hospital [3]
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Melbourne Sexual Health Centre - Carlton
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Recruitment hospital [4]
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Monash Medical Centre - Melbourne
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Recruitment hospital [5]
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Northside Clinic - North Fitzroy
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Recruitment postcode(s) [1]
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2010 - Darlinghurst
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Recruitment postcode(s) [2]
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3053 - Carlton
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Recruitment postcode(s) [3]
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3168 - Melbourne
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Recruitment postcode(s) [4]
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3068 - North Fitzroy
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Maryland
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Country [2]
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United States of America
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State/province [2]
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Minnesota
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Funding & Sponsors
Primary sponsor type
Government body
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Name
Kirby Institute
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Address
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Country
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Other collaborator category [1]
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Government body
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Name [1]
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National Institute of Allergy and Infectious Diseases (NIAID)
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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University of Minnesota
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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University of Melbourne
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Address [3]
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Country [3]
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Other collaborator category [4]
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Commercial sector/industry
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Name [4]
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Merck Sharp & Dohme LLC
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Address [4]
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Country [4]
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Ethics approval
Ethics application status
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Summary
Brief summary
ADVICE is a randomised, international, double-blind, placebo-controlled trial. The purpose of the ADVICE study is to compare the safety and efficacy of vorapaxar in reducing d-dimer expression and markers of cellular immune activation over a period of 12 weeks among people with HIV infection who are successfully treated with combination antiretroviral therapy containing an HIV integrase inhibitor. A secondary objective of the study will be to demonstrate that following cessation of vorapaxar in patients with well controlled HIV replication there will be an increase in the levels of d-dimer over a 6 week period. 60 participants from 4 clinical sites in Australia and the USA will be recruited and followed for a minimum of 18 weeks.
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Trial website
https://clinicaltrials.gov/study/NCT02394730
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Trial related presentations / publications
ADVICE study group. Vorapaxar for HIV-associated inflammation and coagulopathy (ADVICE): a randomised, double-blind, placebo-controlled trial. Lancet HIV. 2018 Oct;5(10):e553-e559. doi: 10.1016/S2352-3018(18)30214-5. Epub 2018 Sep 23. Erratum In: Lancet HIV. 2019 Dec;6(12):e815. doi: 10.1016/S2352-3018(19)30009-8.
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Public notes
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Contacts
Principal investigator
Name
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Sean Emery
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Address
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University of NSW, Kirby Institute
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Country
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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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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/30/NCT02394730/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/30/NCT02394730/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT02394730