The TILT Study: A pilot trial of antiretroviral Therapy Interruption with and without use of interLeukin-Two

ISRCTN ISRCTN85996946
DOI https://doi.org/10.1186/ISRCTN85996946
Secondary identifying numbers G0000198
Submission date
18/10/2000
Registration date
18/10/2000
Last edited
30/07/2009
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr M Youle
Scientific

Department of Thoracic Medicine
Royal Free Hospital
Pond Street
London
NW3 2QG
United Kingdom

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific title
Study acronymTILT
Study objectivesPrimary: To gain experience in antiretroviral therapy interruptions in patients with viral suppression and increased CD4 count, with and without use of Interleukin-2 (IL-2). In particular, to test the ability to maintain the CD4 count at a level above 150/mm3 during interruption, to evaluate the length of time off therapy that can be safely achieved and to evaluate the ability to "re-suppress" viral load if and when antiretroviral therapy is restarted. This information will be used to guide the design of a larger trial.

Secondary: To obtain preliminary data comparing the three strategies with regard to:
1. CD4 count decline to less than 150/mm to the power of three or new Acquired Immume Deficiency Symdrome (AIDS) disease or death
2. Virological failure of therapy (viral load greater than 1000 after having been on antiretroviral therapy for over 16 weeks) by two years
3. Changes in levels of lactates, lipids and bicarbonates
4. Quality of life using the Medical Outcomes Study health status questionnaire for HIV (MOS-HIV)
Ethics approval(s)Not provided at time of registration
Health condition(s) or problem(s) studiedHuman Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS)
InterventionAn open, randomised, three arm, controlled trial to study interruption of antiretroviral therapy with or without IL-2 therapy, in individuals with HIV-1 infection and nadir CD4 cell counts greater than 100 x 10^6/1, current CD4 count greater than 300 x 10^6/1 and currently receiving antiretrovirals and with a viral load less than 50 copies/ml for greater than three months.

Participants will be randomly allocated 1:1:1 ratio to either:

1. Continue with antiretroviral therapy. If drugs need to be switched for any reason, this should be done without a complete interruption, or
2. Interrupt antiretroviral therapy. Restart with the same regimen when the clinician and patient feel this is warranted. Treatment should certainly be restarted before the CD4 count falls below 200/mm^3. Further treatment interruptions should be considered when viral load is less than 50 for 12 weeks or more and if CD4 count is more than or equal to 300/mm^3, or
3. Give two cycles of IL-2, eight weeks apart, while still on antiretroviral therapy. Then interrupt antiretroviral therapy. Use new cycles of IL-2 and/or reintroduction of antiretroviral therapy if the clinician and patient feel that this is warranted.
New cycles of IL-2 and/or antiretroviral therapy should certainly be given before the CD4 count falls below 200/mm^3.

Last patient will complete follow up in July 2006.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)interLeukin-Two
Primary outcome measure1. CD4 decline to les than 100 or new AIDS disease after death
2. Virological failure of therapy at two years after baseline
3. Virological failure of therapy at any time during the two year period after randomisation
4. Changes in levels of total cholesterol
5. Changes in severity of lipodystrophy/ quality of life
6. Incidence of grade three or four adverse
Secondary outcome measuresNot provided at time of registration
Overall study start date20/02/2001
Completion date31/08/2006

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants90 - Closed to recruitment - in follow-up
Key inclusion criteria1. HIV seropositive
2. Adult (18 years or older) HIV-infected therapy naïve patients
3. On Highly Active Anti-retroviral Therapy (HAART) (more than or equal to three ARTs of any of the three main classes) with viral load less than 50 copies/mL for 12 weeks or more
4. CD4 count nadir more than 50/mm^3
5. CD4 lymphocyte count more than or equal to 300/mm^3
6. Signed informed consent obtained
Key exclusion criteria1. Patients on hydroxyurea or interferons or any immunomodulating agent besides IL-2
2. Age less than 16
3. Prior IL-2 therapy
4. Use of any approved or experimental antiretroviral drug within four months prior to study therapy
5. Concurrent malignancy other than mucocutaneos Kaposi sarcoma or malignancy treated within the past five years
6. Any concurrent or history of AIDS defining illness
7. Use of systemic corticosteroids, chemotherapy or experimental cytotoxic drugs within four weeks prior to study therapy
8. Use of any agent approved or experimental with clinically significant immunomodulatory effects
9. Any Central Nervous System (CNS) abnormality that requires treatment with anti-seizure medication
10. Patients with current or historical Crohn's disease, psoriasis or other autoimmune/inflammatory diseases with potential life threatening complications
11. Pregnant or lactating women
12. Use of recreational drugs/alcohol that in the opinion of the investigator would affect patient safety and/or compliance
13. Patients with any serious psychiatric, medical and/or cognitive disturbance or illness that in the opinion of the investigator may affect safety, compliance or ability to provide written informed consent
Date of first enrolment20/02/2001
Date of final enrolment31/08/2006

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Department of Thoracic Medicine
London
NW3 2QG
United Kingdom

Sponsor information

Medical Research Council (MRC) (UK)
Research council

20 Park Crescent
London
W1B 1AL
United Kingdom

Phone +44 (0)20 7636 5422
Email clinical.trial@headoffice.mrc.ac.uk
Website http://www.mrc.ac.uk

Funders

Funder type

Research council

Medical Research Council (MRC) (UK)
Government organisation / National government
Alternative name(s)
Medical Research Council (United Kingdom), UK Medical Research Council, MRC
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 30/03/2008 Yes No