Phase 3
Completed N=553
A Phase IIIb Study of the Safety, Efficacy, and Tolerability of Switching to a Fixed-dose Combination of Abacavir/Dolutegravir/ Lamivudine From Current Antiretroviral Regimen
Infection, Human Immunodeficiency Virus
Source: ClinicalTrials.gov NCT02105987 ↗
Enrolled (actual)
553
Serious AEs
2.9%
Results posted
Feb 2016
Primary outcomePrimary: Number of Participants With Plasma HIV-1 Ribonucleic Acid (RNA) <50 Copies Per Milliliter (c/mL) at Week 24 Using the Snapshot Algorithm — 233; 245 Participants
Summary
This study is a 48-week, Phase IIIb, randomly assigned, open-label, active-controlled, multicenter, parallel group, non-inferiority study. This study is designed to demonstrate the non-inferior antiviral activity of switching to the Abacavir (ABC) 600 milligrams (mg)/Dolutegravir(DTG) 50 mg/Lamivudine (3TC) 300 mg fixed-dose combination (FDC) compared with continuing the subject's current suppressive regimen through 24 weeks. The study will be conducted in approximately 538 Human Immunodeficiency Virus -1 (HIV-1) infected individuals who are on stable suppressive combination antiretroviral therapy (cART) with 2 Nucleoside reverse transcriptase inhibitors (NRTIs) plus either a protease inhibitor (PI), an non-nucleoside reverse transcriptase inhibitor (NNRTI), or an integrase inhibitor (INI). Eligible subjects will be randomly assigned 1:1 to continue their current regimen (approximately 269 subjects) or be switched to ABC/DTG/3TC FDC (approximately 269 subjects) once daily for 24 weeks. At Week 24, individuals originally randomly assigned to continue their current regimen will switch to ABC/DTG/3TC FDC and be followed for an additional 24 weeks. Individuals initially randomly assigned to ABC/DTG/3TC FDC will continue on that treatment arm for an additional 24 weeks. A pharmacokinetic (PK) substudy will be conducted at a small number of sites (approximately 10) to evaluate predose DTG concentrations as well as residual drug concentrations of efavirenz (EFV), nevaripine (NVP), amprenavir (APV) and tipranavir (TPV) in a subgroup of subjects who switch from EFV, NVP, fosamprenavir/ritonavir (FPV/r) or tipranavir/ritonavir (TPV/r).
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Plasma HIV-1 Ribonucleic Acid (RNA) <50 Copies Per Milliliter (c/mL) at Week 24 Using the Snapshot Algorithm |
233; 245 | — |
| SECONDARY Change From Baseline in Cluster of Differentiation 4+ (CD4+) Cell Counts at Week 24 |
50.0; 11.0 | — |
| SECONDARY Number of Participants in the Virologic Non-response Category From the Snapshot Analysis at Week 24 |
3; 4 | — |
| SECONDARY Number of Participants With Incidence and Severity of Adverse Events (AEs) and Serious Adverse Events (SAEs) up to 24 Weeks |
183; 129; 6; 5 | — |
| SECONDARY Number of Participants With Maximum Post-Baseline Emergent Chemistry Toxicities up to 24 Weeks |
98; 108; 73; 71; 21; 25 | — |
| SECONDARY Number of Participants With Maximum Post-Baseline Emergent Hematology Toxicities up to 24 Weeks |
19; 15; 3; 6; 0; 2 | — |
| SECONDARY Number of Participants With AEs Leading to Withdrawal Over 24 Weeks |
11; 0 | — |
| SECONDARY Change From Baseline in Fasting Lipids (Cholesterol, LDL Cholesterol, HDL Cholesterol, and Triglycerides) at Week 24 |
0.10; -0.01; 0.10; 0.02; 0.00; -0.03 | 0.096 |
| SECONDARY Change From Baseline in Fasting Lipids (Total Cholesterol/HDL Cholesterol Ratio) at Week 24 |
0.10; 0.00 | 0.175 |
| SECONDARY Change From Baseline in Treatment Satisfaction at Week 4 and Week 24 |
3.2; 0.8; 1.3; 0.2; 1.8; 0.6 | <0.001 sig |
| SECONDARY Change From Baseline in Creatinine at Week 24 |
7.63; 1.12 | <0.001 sig |
| SECONDARY Change From Baseline in Glomerular Filtration Rate (GFR) From Creatinine Adjusted Using CKD-EPI Equation at Week 24 |
-8.05; -1.18 | <0.001 sig |
| SECONDARY Change From Baseline in GFR From Creatinine Adjusted Using MDRD Enzymatic Equation at Week 24 |
-0.16; -0.02 | <0.001 sig |
| SECONDARY Change From Baseline in Urea at Week 24 |
-0.03; 0.07 | 0.375 |
| SECONDARY Change From Baseline in Urine Albumin/Creatinine Ratio at Week 24 |
0.11; -0.07 | 0.749 |
| SECONDARY Percent Change From Baseline in Bone Marker Analytes at Week 24 |
0.84; 0.98; 0.87; 0.96; 0.88; 0.96 | <0.001 sig |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analytes at Week 24 |
0.67; 1.04; 0.86; 0.80; 0.76; 0.82 | <0.001 sig |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analyte, C-reactive Protein at Week 24 |
1.25; 1.25 | 0.999 |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analyte, D-Dimer at Week 24 |
1.00; 1.00 | 0.981 |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analyte, Homostat Model Assess of Insulin Resistance at Week 24 |
0.97; 1.00 | 0.640 |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analyte, Insulin at Week 24 |
0.97; 0.99 | 0.645 |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analyte, Soluble CD163 at Week 24 |
1.09; 1.08 | 0.577 |
| SECONDARY Percent Change From Baseline in Cardiovascular Marker Analyte, Glucose at Week 24 |
1.02; 1.01 | 0.687 |
| SECONDARY Number of Participants With Incidence of Genotypic and Phenotypic Resistance Meeting Confirmed Virologic Withdrawal Criteria Over 24 Weeks |
— | — |
Eligibility Criteria
Inclusion Criteria
- Be able to understand and comply with protocol requirements, instructions, and restrictions;
- Be likely to complete the study as planned;
- Be considered appropriate candidates for participation in an investigative clinical trial with oral medication (e.g., no active substance abuse, acute major organ disease, or planned long-term work assignments out of the country, etc.).
- Signed and dated written informed consent is obtained from the subject or the subject's legal representative prior to screening
- HIV-1 infected men or women >=18 years of age;
- A female may be eligible to enter and participate in the study if she: a. Is of non-childbearing potential either defined as post-menopausal (12 months of spontaneous amenorrhea and >=45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy, or bilateral oophorectomy or,
- A female may be eligible to enter and participate in the study if she: b. Is of childbearing potential with a negative pregnancy test at both Screening and Day 1 and agrees to use one of the following methods of contraception to avoid pregnancy: Complete abstinence from intercourse from 2 weeks prior to administration of study drug, throughout the study, and for at least 2 weeks after discontinuation of all study drugs; Double barrier method (e.g., male condom/spermicide, male condom/diaphragm, diaphragm/spermicide); Any intrauterine device (IUD) with published data showing that the expected failure rate is 200 c/mL following initial suppression;
- Documentation that the subject is negative for the human leukocyte antigen (HLA) B*5701 allele;
Exclusion Criteria
Exclusionary Medical Conditions
- Women who are breastfeeding;
- Any evidence of an active (Centers for Disease Control and Prevention [CDC] Category C) disease. Exceptions include cutaneous Kaposi's sarcoma not requiring systemic therapy and historic CD4+ cell counts of =5 times the upper limit of normal (ULN), or ALT >=3 × ULN and bilirubin >=1.5 × ULN (with >35% direct bilirubin);
- Subject has CrCl of =450 msec or QTc (Bazett) >=480 msec for subjects with bundle branch block. The QTc is the QT interval corrected for heart rate according to Bazett's formula (QTcB). The QTc should be based on a single QTc value electrocardiogram (ECG) obtained.
- Eligibility of subjects for study participation will be decided by the investigators after taking into consideration various country specific guidelines, and notwithstanding the above mentioned minimum inclusion and exclusion criteria.
Data sourced from ClinicalTrials.gov (NCT02105987). 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.