Phase 3
Completed N=484
Dolutegravir Compared to Darunavir/Ritonavir , Each in Combination With Dual Nucleoside Reverse Transcriptase Inhibitors (NRTIs) in ART-naive Subjects
Infection, Human Immunodeficiency Virus
Source: ClinicalTrials.gov NCT01449929 ↗
Enrolled (actual)
484
Serious AEs
10.1%
Results posted
Mar 2014
Primary outcomePrimary: Percentage of Participants With Plasma Human Immunodeficiency Virus-1 (HIV-1) Ribonucleic Acid (RNA) <50 Copies/Milliliter (c/mL) at Week 48 — 90; 83 Percentage of participants — p=0.025
Summary
This study will be conducted in approximately 468 HIV-1 infected antiretroviral therapy (ART)-naïve subjects. Subjects will be randomized 1:1 to receive dolutegravir (DTG) 50 mg once daily (approximately 234 subjects) or darunavir/ritonavir (DRV/r) 800 mg/100 mg once daily (approximately 234 subjects), each in combination with fixed-dose dual nucleoside reverse transriptase inhibitor (NRTI) therapy (either abacavir/lamivudine (ABC/3TC) or tenofovir/emtricitabine (TDF/FTC). Subjects will be stratified by screening HIV-1 RNA and background NRTI selection. The primary analysis will take place after the last subject completes 48 weeks on therapy; an additional analysis will be conducted after the last subject completes Week 96 on study.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Plasma Human Immunodeficiency Virus-1 (HIV-1) Ribonucleic Acid (RNA) <50 Copies/Milliliter (c/mL) at Week 48 |
90; 83 | 0.025 sig |
| SECONDARY Time to Virologic Suppression (<50 Copies/mL) Through Week 48 |
28.0; 85.0 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA <400 c/mL at Week 48 |
92; 87 | — |
| SECONDARY Change From Baseline in Plasma HIV-1 RNA (log10 c/mL) at Weeks 4, 8, 12, 16, 24, 36 and 48 |
-2.80; -2.01; -2.86; -2.40; -2.88; -2.61 | — |
| SECONDARY Change From Baseline in CD4+ and CD8+ Cell Counts |
80.1; 75.6; 126.9; 118.8; 135.2; 131.8 | — |
| SECONDARY Number of Participants With HIV-1 Associated Disease Progression With the Indicated Shift to CDC Class C, or New CDC Class C or Death at Week 48 |
0; 0 | — |
| SECONDARY Change From Baseline in Fasting Low-density Lipoprotein (LDL) Cholesterol Through Week 48 |
0.07; 0.37 | — |
| SECONDARY Percentage of Participants With Grade 2 or Higher Abnormalities in Fasting LDL Cholesterol Through Week 48 |
2; 7 | — |
| SECONDARY Number of Participants With the Indicated Grade 3 and Grade 4 Maximum Post-Baseline Chemistry and Hematology Laboratory Toxicities |
2; 1; 1; 3; 6; 3 | — |
| SECONDARY Number of Participants (Par.) With Detectable Virus That Has Genotypic or Phenotypic Evidence of Treatment-emergent Resistance to DTG, DRV+RTV and Other On-study ART at Time of Protocol Defined Virology Failure (PDVF) |
0; 0 | — |
| SECONDARY Change From Baseline in Acquired Immune Deficiency Syndrome (AIDS) Clinical Trials Group (ACTG) Symptom Distress Module (SDM) Bother Score at Week 4, Week 24, and Week 48 |
-3.20; -2.19; -2.71; -1.65; -2.46; -0.77 | — |
| SECONDARY Change From Baseline in European Quality of Life -5 Dimensions (EQ-5D) Utility Scores at Week 24 and Week 48 |
0.00; 0.02; 0.01; 0.01 | — |
| SECONDARY Change From Baseline in EQ-5D Thermometer Scores at Week 24 and Week 48 |
4.95; 5.96; 5.78; 6.95 | — |
| SECONDARY Human Immunodeficiency Virus Treatment Satisfaction Questionnaire (HIVTSQ) Total Score at Week 4, Week 24, and Week 48 |
54.1; 52.4; 56.1; 54.3; 56.1; 54.5 | — |
| SECONDARY Human Immunodeficiency Virus Treatment Satisfaction Questionnaire (HIVTSQ) Lifestyle/Ease Sub Score at Week 4, Week 24, and Week 48 |
26.7; 25.8; 27.5; 26.6; 27.6; 26.6 | — |
| SECONDARY Human Immunodeficiency Virus Treatment Satisfaction Questionnaire (HIVTSQ) Convenience Score at Week 4, Week 24, and Week 48 |
5.6; 5.2; 5.6; 5.4; 5.7; 5.4 | — |
Eligibility Criteria
Inclusion Criteria
- HIV-1 infected adults greater than or equal to 18 years of age. Females are eligible to enter and participate in the study if she is (1) non-childbearing potential, (2) child bearing potential with negative pregnancy test at screening and Day 1 and agrees to use protocol-specified methods of birth control while on study.
- HIV-1 infection with a screening plasma HIV-1 RNA greater than or equal to 1000copies/mL
- Antiretroviral-naïve (less than or equal to 10 days of prior therapy with any antiretroviral agent following a diagnosis of HIV-1 infection)
- Signed and dated written informed consent is obtained from the subject or the subject's legal representative prior to screening
Exclusion Criteria
- Women who are pregnant or breastfeeding
- Any evidence of an active Centers for Disease and Prevention Control (CDC) Category C disease [CDC, 1993], except cutaneous Kaposi's sarcoma not requiring systemic therapy
- Subjects with moderate to severe hepatic impairment (Class B or C) as determined by Child-Pugh classification
- Anticipated need for Hepatitis C virus (HCV) therapy during the study
- History or presence of allergy or intolerance to the study drugs or their components or drugs of their class
- History of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma; other localized malignancies require agreement between the investigator and the Study medical monitor for inclusion of the subject
- Treatment with an HIV-1 immunotherapeutic vaccine within 90 days of Screening
- Treatment with any of the following agents within 28 days of Screening: radiation therapy; cytotoxic chemotherapeutic agents; any immunomodulators
- Treatment with any agent, except recognized ART as allowed above, with documented activity against HIV-1 in vitro within 28 days of first dose of investigational product
- Exposure to an experimental drug or experimental vaccine within either 28 days, 5 half-lives of the test agent, or twice the duration of the biological effect of the test agent, whichever is longer, prior to the first dose of investigational product
- Any evidence of primary viral resistance based on the presence of any major resistance-associated mutation [IAS-USA, 2010] in the Screening result or, if known, any historical resistance test result
- Any verified Grade 4 laboratory abnormality. Any acute laboratory abnormality at Screening, which, in the opinion of the Investigator, would preclude the subject's participation in the study of an investigational compound is exclusionary
- Alanine aminotransferase (ALT) greater than 5 times the upper limit of normal
- ALT greater than 3 times the upper limit of normal and bilirubin greater than or equal to 1.5 times the upper limit of normal (with greater than 35% direct bilirubin)
- Subject has creatinine clearance of less than 50 mL/min via Cockroft-Gault method
- Recent history (less than or equal to 3 months) of any upper or lower gastrointestinal bleed, with the exception of anal or rectal bleeding
Data sourced from ClinicalTrials.gov (NCT01449929). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.