Phase 2
N=195
Safety and Acceptability Study of Oral Emtricitabine/Tenofovir Disoproxil Fumarate Tablet and Rectally-Applied Tenofovir Reduced-Glycerin 1% Gel
HIV
Bottom Line
View on ClinicalTrials.gov: NCT01687218 ↗Enrolled (actual)
195
Serious AEs
0.5%
Results posted
Feb 2017
Primary outcome: Primary: Safety: Grade 2 or Higher Adverse Events — 64; 61; 56 participants — p=0.88
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Oral FTC/TDF (Daily Emtricitabine/Tenofovir Disoproxil fumarate Tablet) (Drug); Rectal Daily TFV RG 1% gel (Rectally applied Tenofovir Reduced Glycerin 1% Gel) (Drug); Rectal RAI-associated TFV RG 1% gel (Receptive Anal Intercourse Associated rectally applied Tenofovir Reduced Glycerin 1% Gel) (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- Male
- Sponsor
- CONRAD
- Primary completion
- May 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Safety: Grade 2 or Higher Adverse Events |
64; 61; 56 | 0.88 |
| PRIMARY Acceptability: Participant Self-report of Liking the Product. H1-Overall How do You Feel About the Product You Used Recently? |
16; 47; 38; 163; 134; 145 | <0.0001 sig |
| PRIMARY Acceptability: Participant Self-report of Ease of Use. I1-Overall How Easy or Difficult Was it to Use the Product? |
14; 24; 18; 169; 160; 165 | 0.08 |
| PRIMARY Acceptability: Participant Self-report of Likelihood of Product Use if Shown to be Effective. N1-If This Product Provides Some Protection How Likely Would You be to Take it? |
24; 52; 31; 159; 132; 145 | 0.0004 sig |
| SECONDARY Pharmacokinetics: Tenofovir (TFV) Concentrations (log10 ng/mL) in Blood Plasma |
1.85; 0.42; -0.01; 1.77; 0.37; -0.02 | <0.001 sig |
| SECONDARY Pharmacokinetics: End Period Tenofovir (TFV) Concentrations (log10 ng/mg) in Rectal Tissue |
0.18; 0.84; 0.02 | <0.001 sig |
| SECONDARY Pharmacokinetics: Tenofovir (TFV) Concentrations (log10 ng/mg) in Rectal Sponge |
-1.53; -1.65; -1.29; 0.71; 0.97; -0.03 | 0.004 sig |
| SECONDARY Pharmacokinetics: Emtricitabine (FTC) Concentrations (log10 ng/mL) in Blood Plasma |
2.34; -0.35; -0.37; 2.25; -0.37; -0.33 | <0.001 sig |
| SECONDARY Pharmacokinetics: End Period Emtricitabine (FTC) Concentrations (log10 ng/mg) in Rectal Tissue |
-0.35; -1.26; -1.26 | <0.001 sig |
| SECONDARY Pharmacokinetics: Emtricitabine (FTC) Concentrations (log10 ng/mg) in Rectal Sponge |
-1.75; -1.76; -1.57; 0.31; -1.76; -1.67 | <0.001 sig |
| SECONDARY Pharmacokinetics: End Period Tenofovir-Diphosphate (TFV-DP) Concentrations (log10 ng/mg) in Rectal Tissue |
1.52; 2.06; 1.54 | <0.001 sig |
| SECONDARY Adherence: Percentage of Prescribed Doses Taken Orally or Administered Rectally in an 8-week Period |
12; 31; 13; 173; 153; 170 | 0.0005 sig |
Summary
MTN-017 is a Phase 2, multi-site, randomized, six-sequence, two three-period, open label crossover study, examining the effects of oral Truvada and reduced glycerin 1% tenofovir gel. The study population will be sexually active, HIV-uninfected males who are 18 years of age or older, who report a history of receptive anal intercourse in the past 3 months. Each of the study product regimens offers different advantages to participants seeking an effective HIV prevention agent. How these relative advantages will compare in terms of safety, acceptability, systemic and local absorption, and adherence will be examined within this study.
Eligibility Criteria
Inclusion Criteria
- Male or transgender female > age of 18 at Screening
- Able and willing to provide written informed consent
- HIV-1 uninfected at Screening and Enrollment
- Able and willing to provide adequate locator information, as defined in site SOP
- Available to return for all study visits, barring unforeseen circumstances and willing to comply with study participation requirements
- In general good health at Screening and Enrollment, as determined by the site IoR or designee
- Per participant report, a history of consensual RAI at least once in the past 3 months
- Per participant report at Screening and Enrollment, agrees not to engage in receptive or insertive sexual activity with another study participant for the duration of study participation.
- Willing to use study-provided condoms for the duration of the study for penetrative intercourse
- Willing to not take part in other research studies involving drugs, medical devices, vaccines or genital products for the duration of study participation (including the time between Screening and Enrollment)
- Men and transgender females who agree to take part in the PK, PD and Mucosal Immunology Subset, must also agree to abstain from:
- Inserting anything into the rectum, including abstaining from RAI for 72 hours after the collection of biopsies
- Taking non-steroidal anti-inflammatory drugs (NSAIDs), aspirin and/or other drugs that are associated with increased likelihood of bleeding following mucosal biopsy collection for 72 hours prior to and following the collection of biopsies.
Exclusion Criteria
- At Screening, participant-reported symptoms, and/or clinical or laboratory diagnosis of active anorectal or reproductive tract infection requiring treatment per current World Health Organization (WHO) guidelines or symptomatic urinary tract infection (UTI). Infections requiring treatment include symptomatic Chlamydia trachomatis (CT) infection, Neisseria gonorrhea (GC), syphilis, active herpes simplex virus (HSV) lesions, anogenital sores or ulcers, or symptomatic genital warts.
Note: HSV-1 or HSV-2 seropositive diagnosis with no active lesions is allowed, since treatment is not required.
In cases of non-anorectal GC/CT identified at screening, one re-screening 2 months after the screening visit will be allowed
- History of inflammatory bowel disease as reported by participant history
- At Screening:
- Positive for hepatitis B surface antigen
- Positive for hepatitis C antibody
- Hemoglobin 15,000 cells/mm3
- Calculated creatinine clearance less than 60 mL/min by the Cockcroft-Gault formula where creatinine clearance in mL/min = (140 - age in years) x (weight in kg) x (1 for male)/72 x (serum creatinine in mg/dL)
- Serum creatinine > 1.3 x the site laboratory upper limit of normal (ULN)
- Alanine transaminase (ALT) and/or aspartate aminotransferase (AST) > 2.5× the site laboratory ULN
- PK, PD and Immunological Subset only: International normalized ratio (INR) > 1.5× the site laboratory ULN or partial thromboplastin time (PTT) > 1.25× the site laboratory ULN
- Known allergy to methylparaben and/or propylparaben
- Known allergy to any of the study products.
- Per participant report, use of the following medications and/or products within 12 weeks prior to screening, and/or anticipated use or unwillingness to abstain from use throughout study participation:
- Any investigational products
- Systemic immunomodulatory medications
- Use of Heparin, including Lovenox®
- Warfarin
- Plavix® (clopidogrel bisulfate)
- Rectally-administered medications or products, containing N-9 or corticosteroids
- By participant report, use of post-exposure prophylaxis (PEP) for HIV exposure within the 12 weeks prior to screening or anticipated use during study participation.
- Symptoms suggestive of acute HIV seroconversion at Screening and Enrollment
- Has any other condition that, in the opinion of the Investigator of Record (IoR)/designee, would preclude informed
Data sourced from ClinicalTrials.gov (NCT01687218). 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.