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CTRI Number  CTRI/2015/06/005929 [Registered on: 18/06/2015] Trial Registered Prospectively
Last Modified On: 27/11/2015
Post Graduate Thesis  No 
Type of Trial  BA/BE 
Type of Study    
Study Design  Randomized, Crossover Trial 
Public Title of Study   Bioequivalence study comparing Nevirapine Extended Release Tablet 400 mg of Apotex Inc. and Viramune® XR Extended-Release Tablet 400 mg of Boehringer Ingelheim Pty Limited., Australia in Patients Under Fasting Conditions in adult HIV-1 Infected patients stabilized on Nevirapine 
Scientific Title of Study   An Open-Label, Randomized, Two-Treatment, Two Period, Two Sequence, Crossover, Multicentre, Multiple Dose, Steady State Bioequivalence study of Nevirapine Extended Release Tablet 400 mg of Apotex Inc. and Viramune® XR Extended-Release Tablet 400 mg of Boehringer Ingelheim Pty Limited., Australia in Patients Under Fasting Conditions. 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
CRL111428, Version 1.0 dated 20 Dec 2014  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  DrCharu Gautam 
Designation  Associate VP – Global Clinical Operation 
Affiliation  Cliantha Research Ltd. 
Address  Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat. Cliantha House, Opp. Pushparaj Tower,Near Judges Bungalow Road, Bodakdev Ahmadabad

Ahmadabad
GUJARAT
380054
India 
Phone  07966135655  
Fax  07966135641  
Email  cgautam@clianthatrials.com  
 
Details of Contact Person
Scientific Query
 
Name  DrCharu Gautam 
Designation  Associate VP – Global Clinical Operation 
Affiliation  Cliantha Research Ltd. 
Address  Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat. Cliantha House, Opp. Pushparaj Tower,Near Judges Bungalow Road, Bodakdev Ahmadabad

Ahmadabad
GUJARAT
380054
India 
Phone  07966135655  
Fax  07966135641  
Email  cgautam@clianthatrials.com  
 
Details of Contact Person
Public Query
 
Name  Dr Chirag Shah 
Designation  Head- Clinical Trials 
Affiliation  Cliantha Research Limited  
Address  Sigma-1 Corporate, Off S.G.Highway, Bodakdev, Ahmedabad, Gujarat. Cliantha House, Opp. Pushparaj Tower,Near Judges Bungalow Road, Bodakdev Ahmadabad

Ahmadabad
GUJARAT
380054
India 
Phone  07966135631  
Fax  07966135641  
Email  cshah@clianthatrials.com  
 
Source of Monetary or Material Support  
Apotex Inc. 
 
Primary Sponsor  
Name  Apotex Inc 
Address  150 Signet Drive, Toronto, Ontario, Canada M9L 1T9 Tel: 1-416-401-7601 Fax: 1-416-401-3872  
Type of Sponsor  Pharmaceutical industry-Global 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 9  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Anand Modi  BAPS Pramukhswami Hospital  First Floor, Department of Medicine,Shri Pramukhswami maharaj marg, Adjan Char Rasta, Adajan, Surat-395009, Gujarat, India.
Surat
GUJARAT 
09825312027

bapsclinicalresearch@gmail.com 
Dr John Thomas Ramapuram  Kasturba Medical College Hospital  Department of General Medicine-II, 1st floor,Attavar, Mangalore-575 001, Karnataka, India
Uttara Kannada
KARNATAKA 
08242425092

john@ramapuram.net 
Dr Jai Prakash Kawlani  Mavens Hospital  Department of Medicine, Ground Floor,N-37, Vaishali Nagar, Ajmer, Rajasthan- 305 001, India
Ajmer
RAJASTHAN 
7737651589

drjaiprakashkewalani@gmail.com 
Dr Keyur Shah  Medilink Hospital,   Department of Medicine, 1st Floor Medilink Hospital Nr. Shyamal Cross Road, 132 Ft. Ring Road, Satellite, Ahmedabad- 380 015, Gujarat, India
Ahmadabad
GUJARAT 
9879004822

drkeyurshah@yahoo.com 
Dr Srinivasa M  Mysore Medical College  Department of General Medicine, Ground floor Administrative Block, Irwin Road, Mysore-570001, Karnataka, India Mysore KARNATAKA
Mysore
KARNATAKA 
08212420142

drsrinivasam@gmail.com 
Dr Rajiv Ranjan Dutta  Paras Hospitals  Department of Medicine,C-1 Block, Sushant Lok- Phase –I, Sector-43, Gurgaon, Haryana-122 002, India
Gurgaon
HARYANA 
9811742549

rrduttas@gmail.com 
Dr Prakash Kurmi  Shivam Hospital & Diagnostic Centre,   Groumd Floor, Director cabin,C/4 Satyanarayan Society, Gor’s Kuva, Near JashodanagarCross Road, Maninagar, East, Ahmedabad- 380 008
Ahmadabad
GUJARAT 
9825047692

dr_prakashkurmi@yahoo.co.in 
Dr M N Lakshmikanth Reddy  Surakshaka Diabetic Centre Pvt. Ltd.,   Department of General Medicine, OPD-I, Ground floor MIG- 218, KPHB Main Road, Kukatpally, Hayderabad- 500 072, AP, India
Hyderabad
ANDHRA PRADESH 
04040061930

mnlkreddy@gmail.com 
Dr Alap Mehta  Unique hospital multispeciality & Research Institute  Department of Medicine, Ground Floor,Opp. Kiran Motor, Nr. Cana, Civil Hospital Char Rasta- Sosyo Circle Lane, Off. Ring Road, Surat- 395 002, Gujarat, India
Surat
GUJARAT 
9925809158

dralapmehta@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 9  
Name of Committee  Approval Status 
Ethics Committee, BAPS Pramukh Swami Hospital, Adajan Cross Road, Nr. Country Club, Adajan, Surat- 395 009, Gujarat, India  Approved 
Ethics Committee, Medilink Institutional Ethics Committee, Basement Medilink Hospital, Nr. Shyamal Cross Road, 132 Ft. Ring Road, Satellite, Ahmedabad- 380 015, Gujarat, India  Approved 
Ethics Committee, Unique hospital,- multispeciality & Research Institute, Opp. Kiran Motor, Nr. Cana, Civil Hospital Char Rasta- Sosyo Circle Lane, Off. Ring Road, Surat- 395 002, Gujarat, India  Not Applicable 
Institutional Ethics Committee Paras Hospital C-I, Sushant Lok , Phase- I,Sector-43 Gurgaon-122 002, India  Not Applicable 
Institutional Ethics committee, Mysore Medical college and Research Institute and Associated Hospitals, Mysore  Approved 
Manipal University Ethics Committee, 7th Floor, Kasturba Hospital, Attavar, Magalore-575 001, Karnataka, India  Approved 
Mavens Institutional Ethics Committee, 1st Floor, Mavens, N-37, Lane Opposite Reliance Fresh, Vaishali Nagar, Ajmer-305 001, Rajasthan, India  Not Applicable 
Shivam Ethics Committee, Institutional Ethics Committee, Shivam medical Hospital, C/4 Satyanarayan Society, Gor’s Kuva, Near JashodanagarCross Road, Maninagar, East, Ahmedabad- 380 008  Approved 
Surakshaka Institutional Ethics Committee, MIG- 218, KPHB Main Road, Kukatpally, Hayderabad- 500 072, AP, India  Not Applicable 
 
Regulatory Clearance Status from DCGI
Modification(s)  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  HIV-I Infected patients,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Nevirapine Tab.  Nevirapine Extended Release Tablet 400 mg of Apotex Inc.. Oral, Once daily for 11 Days 
Comparator Agent  Viramune® XR  Viramune® XR Extended-Release Tablet 400 mg of Boehringer Ingelheim Pty Limited., Australia, Oral, Once daily for 11 Days 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  Subjects participating in the study must have:
1. Able to understand and willing to sign the informed consent form
2. Male and Non pregnant, non-lactating female subjects 18-65 years of age with documented HIV-I infection
3. BMI 18-30 kg/m2
4. Already receiving stable Nevirapine based regimen at least since 12 weeks either immediate release or extended release in combination with:
a. Zidovudine and Lamivudine or
b. Tenofovir and Lamivudine as separately prescribed components and to be kept constant throughout the study
5. An HIV viral load < 50 copies/mL at screening
6. A CD4+ T cell count > 50 cell/mm3
7. Willingness of study participants to comply with the all the study requirements
8. Willingness of study participants to not plan a child during the study
Clinically acceptable screening laboratory values that indicate adequate baseline organ function
 
 
ExclusionCriteria 
Details  1. History of allergy or hypersensitivity reactions to Nevirapine or the ingredients of the formulation
2. Current treatment with an HIV protease inhibitor
3. Clinically significant cardiac, liver or kidney disease
4. Having moderate to severe renal dysfunction or serum creatinine > 3 X ULN
5. Females who are pregnant or breast feeding or planning to become pregnant or subjects not willing to take appropriate measures to prevent pregnancy during the study
6. ALT or AST ≥ 3 X ULN, Bilirubin > 2 X ULN
7. Any contraindication to use of Nevirapine
8. Past history or currently suffering from tuberculosis
9. Relevant history or current condition, illness that might interfere with drug absorption, distribution, metabolism or excretion
10. Use of concomitant medication (other than the stable background antiretroviral HIV therapy) that may interfere with the pharmacokinetics of Nevirapine and/or the background antiretroviral HIV therapy
11. Consumption of grapefruit, grapefruit-like or grapefruit containing products within 7 days of drug administration.
12. Use of enzyme-modifying drugs within 30 days prior to receiving the first dose of study medication (listed in Appendix-II). They can be allowed depending on Principal Investigator’s discretion in consultation with Medical monitor, if they are kept constant in the last 30 days and are expected to remain constant during the study period.
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   An Open list of random numbers 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
Cmax,ss, AUCtau, Tmax,ss, Cmin,ss, Cav,ss, Ctauss and % Fluctuation for Nevirapine  1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 16, 18, 20 and 24 hours post
dose. 
 
Secondary Outcome  
Outcome  TimePoints 
NIL  NIL 
 
Target Sample Size   Total Sample Size="30"
Sample Size from India="30" 
Final Enrollment numbers achieved (Total)= ""
Final Enrollment numbers achieved (India)="" 
Phase of Trial   N/A 
Date of First Enrollment (India)   24/06/2015 
Date of Study Completion (India) Date Missing 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="0"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details   Not Yet 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Brief Summary  

The sponsor has developed the test formulation. This study is being conducted to compare the bioavailability and characterize the Pharmacokinetic profile of the sponsor’s

formulatons (Nevirapine Extended Release 400 mg tablets) with reference formulation (Viramune® XR Extended Release 400 mg tablets) in HIV-I Infected patients under fasting conditions, stabilized on Nevirapine based regimen either immediate release or prolonged release to assess the bioequivalence. The most  adverse reactions associated with nevirapine are rash, fever, nausea,headache, fatigue, somnolence, vomiting, diarrhoea, abdominal pain and myalgia. Cases of anaemia and neutropenia may be associated with VIRAMUNE therapy. Arthralgia has been reported as a stand-alone event in rare instances in patients receiving VIRAMUNE containing regimens. etc., regulatory authorities are recommending that studies should be conducted on HIV-I infected patients.

 Since the formaulation being studied is a extended release formaulation, a multiple dose, stady state study is being conducted as per applicable regulatory guidance. The study is being conducted on  patients who are on a stable dose of Nevirapine based regimen, and the patient cannot be deprived of the Nevirapine treatment during the washout period of the study. Hence, the study has been planned to be a continuous administration of the test and reference formulation without any intervening washout period.

Objective: To evaluate the pharmacokinetic bioequivalence of the test and reference products and to monitor safety of the patients. The total number of patients to enroll is around 30 from India.

 
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