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Sawant Sangeeta
Miranda Cowen, Nicola Kaganson, Andrew Nunn, Sheena Mccormack, Robert Neurath, Charles Lacey
MRC/DFID Microbicide Development programme (MDP)
Background
Cellulose acetate phthalate (CAP) is a widely used pharmaceutical excipients that has been shown to block HIV-1 infection. In vitro studies confirmed that interaction between HIV-1 and CAP led to rapid virus adsorption onto CAP, gp41 six-helix bundle formation, virus disintegration and shedding of envelope glycoprotein with rapid loss of infectivity. In vivo experiments using animal models confirmed CAP is non- toxic, non-mutagenic and non-teratogenic. A new gel formulation for use as a vaginal microbicide has been developed.
Methods
A phase 1 vaginal microbicide safety study has been approved by the local research ethics committee. 60 women will be recruited. The study will be conducted in 2 parts. Informed consent will be obtained from women who meet the entry criteria. Part A will study 10 HIV-ve volunteers using CAP once a day for 14 days and will include a post-first dose Colposcopic assessment. The DSMC will review safety data from part A before proceeding to part B. Then 40 HIV-ve (randomised to gel, n=30 or observation, n=10) and 10 HIV+ve women (all will receive gel) will be recruited in Part B of the study. Outcome parameters will include local vaginal, clinical and laboratory adverse events.
Results
Enrolling 50 women in CAP arm enables to estimate the incidence of clinically significant adverse events. Thus if one person experiences such an event the 95% CI for the estimate will be 0.05% -10.6%
Discussion
Our study will provide the first human CAP vaginal microbicide safety data.
Dr Sangeeta Sawant
Clinical Trials Centre, Winston Churchill Wing, St Marys Hospital Campus, Imperial College London, Norfolk Place, London W2 1PG
(Telephone) 020 7886 6738 (Fax) 020 7886 6123 (E-mail) ssawant@imperial.ac.uk
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