ClinicalTrials.gg
TerminatedNCT00440271Updated Jun 27, 2014Results posted

SPRING: Safety, Efficacy, Pharmacokinetics of tipRanavir/r IN Race/Gender HIV+ Patients Randomized to TDM or SoC

A Phase 3 interventional study of tipranavir and ritonavir in HIV Infections, sponsored by Boehringer Ingelheim. Terminated at 30 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2014-06-27.

Sponsored by Boehringer Ingelheim · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
33
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The primary purpose of this study is to:

  1. Demonstrate the safety and efficacy of tipranavir/ritonavir (TPV/r) among a racially diverse HIV+ population (males and females) who are three-class (nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), and protease inhibitor (PI)) experienced with documented resistance to more than one PI.
  2. Determine pharmacokinetic data in this racially and gender diverse population.
  3. Determine the potential utility of using therapeutic drug monitoring (TDM) in improving efficacy outcomes.
02

Conditions studied

  • HIV Infections

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03

In context

HIV Infections

4,340 studies on the registry are indexed under HIV Infections; 240 are open to participants now.

This study's enrollment of 33 is below the median of 83 across 3,312 interventional studies indexed under HIV Infections.

Browse HIV Infections studies →

Lead sponsor

Boehringer Ingelheim is the lead sponsor of 2,297 studies on the registry; 56 are open to participants now.

Of its 166 completed or terminated interventional studies of FDA-regulated products, 121 (73%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Main inclusion criteria for the study are:

  1. HIV-1 infected adults, men and women at least 18 years of age.
  2. 3-class (nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), and protease inhibitor (PI)) treatment-experienced (min of 3-months duration for each class) with resistance to more than one PI (on screening resistance testing). NNRTI-naïve patients who have genotypically documented NNRTI-resistance mutations on past or screening resistance testing would be eligible.
  3. CD4+ T lymphocyte count >=50 cells/mm3.
  4. HIV-1 viral load >=1,000 copies/mL at screening.
  5. The antiretroviral (ARV) study treatment regimen must consist of TPV/r in combo with an optimized background regimen (OBR) of 2-4 agents: N(t)RTIs (NRTI or NtRTI), enfuvirtide (ENF), and/or, where available, a trial approved expanded access program (EAP) investigational agent.
  6. Acceptable screening laboratory values that indicate adequate baseline organ function.
  7. Acceptable medical history with a chest X-ray without evidence of active disease and an electrocardiogram (ECG) without clinically important abnormalities within one year of the study.
  8. A reliable method of barrier contraception will be used by all female patients who are of childbearing potential.

Exclusion criteria

Exclusion Criteria:

Main exclusion criteria for the study are:

  1. Known hypersensitivity to the tipranavir (TPV) or ritonavir (RTV).
  2. ARV medication naïve.
  3. Genotypic resistance to TPV (defined as a TPV mutation score >7).
  4. Patients on recent drug holiday, defined as off antiretroviral (ARV) medications for at least 7 consecutive days within the month prior to screening.
  5. Prior tipranavir use.
  6. Inability to adhere to the requirements of the protocol.
  7. Patients with prior history of hemorrhagic stroke or intracranial aneurysm.
  8. Patients with a history of ischemic stroke, neurosurgery or skull trauma within 4 weeks prior to screening.
  9. History of Progressive Multifocal Leukoencephalopathy, Visceral Kaposi's Sarcoma, and/or any malignancy.
  10. Any acquired immunodeficiency syndrome (AIDS) defining illness that is unresolved, symptomatic or not stable on treatment for at least 12 weeks at screening visit.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
33 participants (actual)

Study arms

  • Other
    Standard of Care (SoC)

    Standard of Care (SOC) Arm = Tipranavir/ritonavir (TPV/r) capsules taken orally at a dose of 500 mg/200 mg twice a day (BID) plus optimized background regimen (OBR). No TPV/r dose changes were permitted.

    Drug: tipranavir · Drug: ritonavir · Drug: Optimized Background Regimen (OBR)

  • Other
    Therapeutic Drug Monitoring (TDM)

    Therapeutic Drug Monitoring (TDM) Arm = Patients began by receiving standard of care (SOC) tipranavir/ritonavir (TPV/r) capsules orally at a dose of 500 mg/200 mg twice a day (BID) plus optimized background regimen (OBR) followed, if needed, by TPV or ritonavir (RTV) dose adjustments at Week 4, 6, 10, 14, 18, 22, 26 and 30 based on viral response, phenotypic inhibitory quotient (IQ), and TPV trough concentrations.

    Drug: tipranavir · Drug: ritonavir · Drug: Optimized Background Regimen (OBR)

Interventions

  • Patients received between two and four active anti-retroviral medications based on resistance testing results, as background treatment, and remained on these for the duration of the trial.

    Also known as: Nucleoside Reverse Transcriptase Inhibitors (NRTIs),, Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs),, Enfuvirtide,, Maraviroc,, Raltegravir

06

What researchers measure

Primary outcomes

  1. Treatment Response at Week 48

    percentage of participants whose viral load \<50 copies/mL at Week 48

    Time frame: after 48 weeks of treatment

Secondary outcomes

  1. Percentage of Participants Whose Viral Load <50 Copies/mL at Each Visit Including Visits at Weeks 24 and 48

    Time frame: after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

  2. Percentage of Participants Whose Viral Load <400 Copies/mL at Each Visit Including Visits at Weeks 24 and 48

    Time frame: after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

  3. Percentage of Participants Whose ≥1 log10 Drop in Viral Load From Baseline at All Visits, Including Visits at Weeks 24 and 48

    Time frame: after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

  4. Change in Viral Load From Baseline at Each Visit

    Time frame: after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

  5. Time to Treatment Failure

    For patients who never achieve a confirmed virologic response, time to treatment failure is defined as 0. For patients who achieve a confirmed virologic response, time to treatment failure is the earliest time of either: death, permanent discontinuation of the study drug or loss to follow-up, introduction of a new anti-retroviral drug to the regimen if it is not solely related to either toxicity or intolerance clearly attributable to a background drug, but not the study drug, or first occurrence of a VL \>50 copies/mL at two consecutive measurements after having achieved a VL \<50 copies/mL.

    Time frame: after Day 1 of treatment

  6. Time to New AIDS or AIDS Related Progression Event or Death

    Time frame: after Day 1 of treatment

  7. Change in CD4+ and CD8+ Cell Counts From Baseline at Each Visit Including Visits at Week 24 and Week 48

    Time frame: after 2 weeks of treatment till Week 48 (Weeks 2, 4, 8, 12, 24, 36, and 48)

  8. Change in Ratio of CD38+/CD8+ From Baseline to Week 48

    Time frame: after 2 weeks of treatment till Week 48 (Weeks 2, 4, 8, 12, 24, 36, and 48)

  9. Tipranavir (TPV) and Ritonavir (RTV) Trough Concentrations at Week 2, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

    Time frame: after 2 weeks of treatment till Week 48 (Weeks 2, 4, 8, 12, 24, 36, and 48)

  10. Patients Adherence With Study Medication Based on Pill Count

    Time frame: after 4 weeks of treatment

  11. Occurrence of TPV Inhibitory Quotient (IQ) >60 at Each Visit Where TPV Concentration is Measured

    Time frame: after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

  12. Occurrence of TPV Trough Concentration >120 μM

    Time frame: after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

  13. Post-dose TPV and RTV Concentrations at Week 4

    Time frame: Week 4

07

Results

Posted Nov 26, 2009
Limitations and caveats
The study was terminated early due to low patient enrollment, and, therefore, no analysis was performed on the primary and secondary endpoints

Participant flow

Participant flow — Overall Study
MilestoneStandard of Care (SoC)Therapeutic Drug Monitoring (TDM)
Started1518
Completed33
Not completed1215
Withdrew: Protocol violation11
Withdrew: Adverse event01
Withdrew: Lost to follow-up10
Withdrew: Withdrawal by subject02
Withdrew: Lack of efficacy01
Withdrew: Due to closure of trial810
Withdrew: Other20

Outcome measures

PrimaryTreatment Response at Week 48

percentage of participants whose viral load \<50 copies/mL at Week 48

Time frame:
after 48 weeks of treatment

No measurements were reported for this outcome.

SecondaryPercentage of Participants Whose Viral Load <50 Copies/mL at Each Visit Including Visits at Weeks 24 and 48
Time frame:
after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryPercentage of Participants Whose Viral Load <400 Copies/mL at Each Visit Including Visits at Weeks 24 and 48
Time frame:
after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryPercentage of Participants Whose ≥1 log10 Drop in Viral Load From Baseline at All Visits, Including Visits at Weeks 24 and 48
Time frame:
after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryChange in Viral Load From Baseline at Each Visit
Time frame:
after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryTime to Treatment Failure

For patients who never achieve a confirmed virologic response, time to treatment failure is defined as 0. For patients who achieve a confirmed virologic response, time to treatment failure is the earliest time of either: death, permanent discontinuation of the study drug or loss to follow-up, introduction of a new anti-retroviral drug to the regimen if it is not solely related to either toxicity or intolerance clearly attributable to a background drug, but not the study drug, or first occurrence of a VL \>50 copies/mL at two consecutive measurements after having achieved a VL \<50 copies/mL.

Time frame:
after Day 1 of treatment

No measurements were reported for this outcome.

SecondaryTime to New AIDS or AIDS Related Progression Event or Death
Time frame:
after Day 1 of treatment

No measurements were reported for this outcome.

SecondaryChange in CD4+ and CD8+ Cell Counts From Baseline at Each Visit Including Visits at Week 24 and Week 48
Time frame:
after 2 weeks of treatment till Week 48 (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryChange in Ratio of CD38+/CD8+ From Baseline to Week 48
Time frame:
after 2 weeks of treatment till Week 48 (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryTipranavir (TPV) and Ritonavir (RTV) Trough Concentrations at Week 2, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48
Time frame:
after 2 weeks of treatment till Week 48 (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryPatients Adherence With Study Medication Based on Pill Count
Time frame:
after 4 weeks of treatment

No measurements were reported for this outcome.

SecondaryOccurrence of TPV Inhibitory Quotient (IQ) >60 at Each Visit Where TPV Concentration is Measured
Time frame:
after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryOccurrence of TPV Trough Concentration >120 μM
Time frame:
after 2 weeks of treatment (Weeks 2, 4, 8, 12, 24, 36, and 48)

No measurements were reported for this outcome.

SecondaryPost-dose TPV and RTV Concentrations at Week 4
Time frame:
Week 4

No measurements were reported for this outcome.

Adverse events

Collected over 48 weeks of treatment plus 30 days follow-up. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Standard of Care (SoC)—0/15 (0%)12/15 (80%)
Therapeutic Drug Monitoring (TDM)—0/18 (0%)15/18 (83.3%)
Most frequent other events
Showing 10 of 60
Most frequent other events
EventStandard of Care (SoC)Therapeutic Drug Monitoring (TDM)
DiarrhoeaGastrointestinal disorders5/153/18
VomitingGastrointestinal disorders1/154/18
FatigueGeneral disorders3/150/18
NauseaGastrointestinal disorders2/151/18
Muscle spasmsMusculoskeletal and connective tissue disorders2/150/18
Pain in extremityMusculoskeletal and connective tissue disorders2/150/18
RashSkin and subcutaneous tissue disorders2/151/18
Blood triglycerides increasedInvestigations1/152/18
DizzinessNervous system disorders0/152/18
TinnitusEar and labyrinth disorders1/150/18

Baseline characteristics

Age, Continuous
Age, Continuous(years)Standard of Care (SoC)Therapeutic Drug Monitoring (TDM)Total
Mean46.1 ± 8.243.2 ± 10.644.5 ± 9.6
Sex: Female, Male
Sex: Female, Male(Participants)Standard of Care (SoC)Therapeutic Drug Monitoring (TDM)Total
Female369
Male121224
08

Study locations

30 sites
  • 1182.98.033 Boehringer Ingelheim Investigational Site
    Washington D.C., District of Columbia, United States
  • 1182.98.018 Boehringer Ingelheim Investigational Site
    Clearwater, Florida, United States
  • 1182.98.014 Boehringer Ingelheim Investigational Site
    Fort Lauderdale, Florida, United States
  • 1182.98.041 Boehringer Ingelheim Investigational Site
    Orlando, Florida, United States
  • 1182.98.004 Boehringer Ingelheim Investigational Site
    Decatur, Georgia, United States
  • 1182.98.002 Boehringer Ingelheim Investigational Site
    Kansas City, Missouri, United States
  • 1182.98.016 Boehringer Ingelheim Investigational Site
    New York, New York, United States
  • 1182.98.026 Boehringer Ingelheim Investigational Site
    New York, New York, United States
  • 1182.98.034 Boehringer Ingelheim Investigational Site
    Stony Brook, New York, United States
  • 1182.98.040 Boehringer Ingelheim Investigational Site
    Huntersville, North Carolina, United States
  • 1182.98.006 Boehringer Ingelheim Investigational Site
    Akron, Ohio, United States
  • 1182.98.007 Boehringer Ingelheim Investigational Site
    Cincinnati, Ohio, United States
  • 1182.98.020 Boehringer Ingelheim Investigational Site
    Oklahoma City, Oklahoma, United States
  • 1182.98.029 Boehringer Ingelheim Investigational Site
    Philadelphia, Pennsylvania, United States
  • 1182.98.023 Boehringer Ingelheim Investigational Site
    Austin, Texas, United States
  • 1182.98.009 Boehringer Ingelheim Investigational Site
    Houston, Texas, United States
  • 1182.98.5405 CENTRO de INFECTOLOGIA y ASISTENCIA (CIAS)
    Capital Federal ,Buenos Aires, Argentina
  • 1182.98.5403 Centro Hospital Higa - Dr Oscar Alende
    Mar del Plata, Argentina
  • 1182.98.5402 Caici
    Rosario, Argentina
  • 1182.98.55002 Hospital DIA
    Sacomã - São Paulo, Brazil
  • 1182.98.55004 Unidade de Referência em doenças Infecciosas Preveníveis
    Santo André, Brazil
  • 1182.98.55001 Universidade Federal de Sao Paulo
    São Paulo, Brazil
  • 1182.98.55003 Centro de Referência e Treinamento - DST/AIDS
    Vila Mariana - Sao Paulo, Brazil
  • 1182.98.1007 Boehringer Ingelheim Investigational Site
    Quebec, Ste Foy, Quebec, Canada
  • 1182.98.4903 Boehringer Ingelheim Investigational Site
    Bochum, Germany
  • 1182.98.4908 Boehringer Ingelheim Investigational Site
    Hamburg, Germany
  • 1182.98.3907 Boehringer Ingelheim Investigational Site
    Torino, Italy
  • 1182.98.3402
    Barcelona, Spain
  • 1182.98.3405
    Madrid, Spain
  • 1182.98.3406
    Madrid, Spain
09

References and documents

Related links

10

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Feb 2007 and a primary completion of Oct 2008. It does not say whether these dates are actual or estimated.

Results were first posted in Nov 2009, 1 year 1 month after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 26, 2007
First posted
Feb 27, 2007
Start
Feb 2007
Primary completionActual
Oct 2008
Results first posted
Nov 26, 2009
Last update
Jun 27, 2014
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 27, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00440271
Responsible party
Sponsor
First posted
Feb 27, 2007
Start date
Feb 2007
Primary completion
Oct 2008
Results posted
Nov 26, 2009
Last update
Jun 27, 2014

Study contacts

Boehringer Ingelheim
study chair · Boehringer Ingelheim
View the source record on ClinicalTrials.gov ↗

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