Ruxolitinib
Drug10 mg orally twice daily for 5 weeks
NCT Number: NCT02475655
The purpose of this study was to evaluate the safety and tolerability of ruxolitinib in HIV-positive adults who were virologically suppressed and who were on antiretroviral therapy (ART).
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Notify Me18 year–75 year
All sexes
Interventional
Phase 2
Alabama CRS, Birmingham, Alabama, United States
Ruxolitinib is a medication approved by the U.S. Food and Drug Administration (FDA) to treat myelofibrosis, a disorder in which bone marrow is replaced by scar (fibrosis) tissue. Many of the cytokines affected by myelofibrosis are also affected by HIV. Because of this, ruxolitinib may also be a possible treatment for HIV. The purpose of this study was to evaluate the safety and tolerability of ruxolitinib in HIV-positive adults who were on ART and who were virologically suppressed. Researchers evaluated the effect ruxolitinib had on inflammation and immune activation.
This study enrolled HIV-positive adults who were on select ART regimens and who had viral suppression. ART was not provided by the study; participants continued to receive ART from their own health care providers. Participants were randomly assigned to receive either ruxolitinib (Arm A) or no study treatment (Arm B) in 2:1 ratio. Participants in Arm A received ruxolitinib twice a day for 5 weeks. All participants attended study visits at entry (Day 0) and Weeks 1, 2, 4, 5, 10, and 12. These visits included physical examinations, clinical assessments, blood collection, adherence assessments, oral swab collection, and pregnancy testing for female participants. At Weeks 1 and 4, participants in Arm A took part in pharmacokinetic (PK) sampling, which involved having blood drawn several times over 6 to 8 hours.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
10 mg orally twice daily for 5 weeks
Time frame: Entry to Week 5
Events defined as safety milestones are listed below and together makeup the composite endpoint.
Percent experiencing a safety milestone will be reported.
Time frame: Entry to Week 5
Events defined as safety milestones are listed below and together makeup the composite endpoint.
Percent experiencing a safety milestone will be reported.
Time frame: Entry to Week 5
Events defined as safety milestones are listed below.
Percent experiencing each safety milestone will be reported. Safety milestone categories are not mutually exclusive.
Time frame: Entry to Week 5
Number of participants with premature discontinuation of study treatment are summarized.
Time frame: Pre-entry, Entry, Weeks 4 and 5
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Baseline is defined as the geometric mean of the Pre-entry and Entry values. Week 4/5 is defined as the geometric mean of the Week 4 and Week 5 values. Fold change was calculated as the value at Week 4/5 divided by the value at Baseline.
Time frame: Entry to Week 12
Events defined as safety milestones are listed below and together makeup the composite endpoint.
Percent experiencing a safety milestone will be reported.
Time frame: Entry to Week 12
Events defined as safety milestones are listed below and together makeup the composite endpoint.
Percent experiencing a safety milestone will be reported.
Time frame: Entry to Week 12
Events defined as safety milestones are listed below.
Percent experiencing each safety milestone will be reported. Safety milestone categories are not mutually exclusive.
Time frame: Entry to Week 12
Protocol-defined reportable adverse events include: all diagnoses regardless of grade, Grade 3 or higher sign/symptoms or laboratory values, any signs/symptoms or laboratory values that led to a change in treatment or met ICH, EAE, or SAE guidelines. See the Protocol Section References for links to the EAE manual.
This is a subset of the events reported in the Adverse Events section.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
Creatinine clearance was calculated using the Cockcroft Gault equation. The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
Creatinine clearance was calculated using the Cockcroft Gault equation. The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Time frame: Entry, Weeks 1, 2, 4, 5, 10, and 12
The arithmetic mean for each participant was calculated at week 1 and week 2 combined, week 4 and week 5 combined, and week 10 and week 12 combined.
Absolute change was calculated as the value at Week 1/2 minus the value at Entry, the value at Week 4/5 minus the value at Entry, and the value at Week 10/12 minus the value at Entry.
Time frame: Pre-entry, Entry, Weeks 4, 5, 10 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Baseline is defined as the geometric mean of the Pre-entry and Entry values. Week 4/5 is defined as the geometric mean of the Week 4 and Week 5 values. Week 10/12 is defined as the geometric mean of the Week 10 and Week 12 values. Fold change was calculated as the value at Week 10/12 divided by the value at Baseline and the value at Week 4/5 divided by the value at Week 10/12.
Time frame: Pre-entry, Entry, Weeks 4, 5, and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Baseline is defined as the geometric mean of the Pre-entry and Entry values. Week 4/5 is defined as the geometric mean of the Week 4 and Week 5 values. Fold change was calculated as the value at Week 4/5 divided by the value at Baseline, the value at Week 12 divided by the value at Baseline, and the value at Week 12 divided by the value at Week 4/5.
Time frame: Pre-entry, Entry, Weeks 2, 5, and 12
Baseline is defined as the average of pre-entry and entry. Absolute change was calculated as the value at Week 2 minus the value at Baseline, the value at week 5 minus the value at baseline, the value at week 12 minus the value at baseline, and the value at week 5 minus the value at week 12.
Time frame: Entry, Weeks 2, 5, and 12
Participants were required to be virally suppressed, with a plasma HIV-1 RNA level below 40 copies/mL. The number of participants with plasma HIV-1 RNA level above the limit of quantification is reported at each time point.
Time frame: Entry, Weeks 5 and 12
HIV-1 RNA was measured via Single Copy Assay Using Primer in Integrase (iSCA), results were reported as below or above the assay limit of detection (LOD) (LOD = 0.4 copies/mL). GEE models for binary data were used to calculate the relative risk of having HIV-1 RNA by iSCA <0.4 copies/mL (Week 5 compared to Entry, Week 12 compared to Entry, and Week 12 compared to Week 5).
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Pre-entry, Entry, Weeks 4, 5, and 12
Laboratory testing was not performed so the data are not available.
Time frame: Pre-entry, Entry, Weeks 4, 5, and 12
Laboratory testing was not performed so the data are not available.
Time frame: Pre-entry, Entry, Weeks 4, 5, and 12
Laboratory testing was not performed so the data are not available.
Time frame: Pre-entry, Entry, Weeks 4, 5, and 12
Data not available because the testing lab reported that the values were unreliable.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express CD38+HLADR+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express CD38+HLADR+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express CD25hi+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express CD25+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express CD127+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express CD127+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express Ki67+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express Ki67+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express Bcl2+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express Bcl2+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express a4b7+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express a4b7+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD4+) that express CX3CR1+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of parent cells (CD8+) that express CX3CR1+ cells (cellular marker of immune activation and inflammation in the peripheral blood).
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Data not available because the team decided they were no longer clinically relevant, so samples were not tested for CD69.
Time frame: Entry, Weeks 5 and 12
Data not available because the team decided they were no longer clinically relevant, so samples were not tested for PAR-1.
Time frame: Entry, Weeks 5 and 12
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of classical monocytes (CD14+CD16-) that express CD163+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of classical monocytes (CD14+CD16-) that express CCR2+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of classical monocytes (CD14+CD16-) that express CX3CR1+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of inflammatory monocytes (CD14+CD16-) that express CD163+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of inflammatory monocytes (CD14+CD16+) that express CCR2+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of inflammatory monocytes (CD14+CD16+) that express CX3CR1+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of patrolling monocytes (CD14dimCD16+) that express CD163+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of patrolling monocytes (CD14dimCD16+) that express CCR2+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
Absolute change in the percent of patrolling monocytes (CD14dimCD16+) that express CX3CR1+.
Absolute change was calculated as the value at week 5 minus the value at entry, and the value at week 12 minus the value at entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
Time frame: Pre-entry, Entry, and Weeks 1, 2, 4, 5, 10, and 12
Level of CMV shedding was summarized by study week and arm as the percentage of those above and below the assay limit of detection.
Detectable CMV shedding was defined as CMV level > 0 copies/ml of elution. The percentage of participants with detectable CMV at any on-treatment time point (ever shedding at weeks 1, 2, 4, or 5) and any post-treatment time point (ever shedding at weeks 10 or 12) was contrasted between study arms.
Time frame: Week 1 and, Week 4/5; blood samples were drawn pre-dose and at 1-1.5, 2.5-4, 4-6, and 6-8 hours post-dosing
Ruxolitinib plasma concentrations were fitted to a population 2-compartment distribution model, assuming first-order input, distribution and elimination from the plasma compartment, using nonlinear mixed-effects modeling software. We estimated parameter geometric means and proportional variabilities between subjects (IIV when feasible) and the variability in drug absorption between occasions (IOV week 1 and week 4/5), and related distribution volumes to body weight.
Time frame: Entry, Week 5, and Week 12
Data not available because all values were below assay limit.
Time frame: Pre-entry, Entry, Weeks 1, 2, 4, 5, 10, and 12
Data not available because no samples were collected to test for these measures as the team decided they were no longer clinically relevant.
Time frame: Entry, Weeks 5 and 12
All values were log10 transformed prior to calculating change and conducting analyses and back transformed for presentation.
Fold change was calculated as the value at Week 5 divided by the value at Entry and the value at Week 12 divided by the value at Entry.
National Institute of Allergy and Infectious Diseases (NIAID)
Nih
A Randomized, Pilot Study of Ruxolitinib in Antiretroviral-Treated HIV-Infected Adults
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.
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