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Phase 4 Completed N=72 Randomized Treatment

Renal Effect of Stribild or Other Tenofovir DF-containing Regimens Compared to Ritonavir-boosted Atazanavir Plus Abacavir/Lamivudine in Antiretroviral Treatment-naive HIV-1 Infected Adults

Source: ClinicalTrials.gov NCT02246998 ↗
Enrolled (actual)
72
Serious AEs
7.6%
Results posted
Jan 2018
Primary outcomePrimary: Actual Glomerular Filtration Rate (aGFR) Using Iohexol Plasma Clearance (CLiohexol) at Week 24 — 103.6; 104.9; 111.1; 101.0 mL/min
◆ Published Evidence
No publication linked

No peer-reviewed publication reporting this trial's results has been linked yet. This can indicate results are unpublished — a known publication-bias signal. We re-check periodically.

Summary

The primary objective of this study is to assess glomerular function before and during administration of stribild (STB; elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF)) or a regimen containing TDF without cobicistat (COBI) as ritonavir (RTV)-boosted atazanavir (ATV/r) plus truvada (TVD; FTC/TDF) or atripla (ATR; efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF)) compared to a regimen containing neither TDF nor COBI as ATV/r plus abacavir/lamivudine (ABC/3TC) via determination of actual glomerular filtration rate (aGFR) using iohexol (a probe GFR marker) plasma clearance and estimated (calculated) glomerular filtration rate (eGFR).

Outcome Measures

OutcomeResultp-value
PRIMARY
Actual Glomerular Filtration Rate (aGFR) Using Iohexol Plasma Clearance (CLiohexol) at Week 24
103.6; 104.9; 111.1; 101.0
PRIMARY
Estimated GFR (eGFR) Calculated by Cockcroft-Gault Formula at Week 24
116.9; 122.4; 120.0; 123.0
PRIMARY
Estimated GFR Calculated by Modification of Diet in Renal Disease (MDRD) Formula at Week 24
99.3; 110.2; 109.2; 104.9
SECONDARY
Percentage of Participants Experiencing Treatment-Emergent Graded Laboratory Abnormality: Urine Glucose (by Dipstick)
0; 0; 0; 0; 0; 0
SECONDARY
Percentage of Participants Experiencing Treatment-Emergent Graded Laboratory Abnormality: Serum Glucose (Fasting)
11.8; 12.5; 20.0; 0; 0; 0
SECONDARY
Percentage Change From Baseline in Urine Albumin to Creatinine Ratio (mg/g) at Week 24
0.0; -18.3; 50.0; -16.7
SECONDARY
Percentage Change From Baseline in Urine Protein to Creatinine Ratio (mg/g) at Week 24
5.7; 17.5; -10.5; 7.1
SECONDARY
Percentage Change From Baseline in Urine β2-microglobulin to Creatinine Ratio (µg/g) at Week 24
-5.1; 197.3; -1.1; -22.7
SECONDARY
Percentage Change From Baseline in Urine Retinol Binding Protein (RBP) to Creatinine Ratio (µg/g) at Week 24
38.1; 52.2; 52.1; 4.8
SECONDARY
Pharmacokinetic (PK) Parameter: Cmax for COBI
1189.1; 1017.8; 1197.3; 1123.4
SECONDARY
PK Parameter: Tmax for COBI
3.3; 3.1; 3.1; 3.0
SECONDARY
PK Parameter: Clast for COBI
85.0; 54.5; 214.0; 162.7
SECONDARY
PK Parameter: Tlast for COBI
24.0; 24.0; 24.0; 24.0
SECONDARY
PK Parameter: Ctau for COBI
59.7; 26.0; 198.3; 82.7
SECONDARY
PK Parameter: λz for COBI
0.179; 0.192; 0.206; 0.211
SECONDARY
PK Parameter: AUCtau for COBI
9225.8; 8127.4; 10684.8; 8391.3
SECONDARY
PK Parameter: t1/2 for COBI
3.80; 4.09; 3.42; 3.24
SECONDARY
PK Parameter: Cmax for RTV
1260.0; 1352.1; 1142.3; 1326.2; 1144.8; 1557.6
SECONDARY
PK Parameter: Tmax for RTV
4.0; 4.0; 4.0; 4.0; 4.1; 4.0
SECONDARY
PK Parameter: Clast for RTV
59.5; 61.0; 71.0; 85.5; 69.2; 99.1
SECONDARY
PK Parameter: Tlast for RTV
24.0; 24.0; 24.0; 24.0; 24.0; 24.0
SECONDARY
PK Parameter: Ctau for RTV
59.5; 61.0; 71.0; 85.5; 69.2; 99.1
SECONDARY
PK Parameter: AUCtau for RTV
8259.6; 9649.1; 8362.0; 9702.2; 8102.6; 11148.0
SECONDARY
PK Parameter: λz for RTV
0.156; 0.151; 0.144; 0.142; 0.138; 0.131
SECONDARY
PK Parameter: t1/2 for RTV
4.56; 4.53; 4.85; 4.68; 5.39; 5.57
SECONDARY
PK Parameter: Cmax for TFV
371.2; 301.6; 298.3; 379.8; 343.0; 325.5
SECONDARY
PK Parameter: Tmax for TFV
2.0; 3.0; 1.1; 2.0; 3.0; 1.0
SECONDARY
PK Parameter: Clast for TFV
81.1; 73.1; 55.4; 80.9; 78.2; 53.4
SECONDARY
PK Parameter: Tlast for TFV
24.0; 24.0; 24.0; 24.0; 24.0; 24.0
SECONDARY
PK Parameter: Ctau for TFV
74.6; 73.1; 55.4; 75.8; 78.2; 48.8
SECONDARY
PK Parameter: λz for TFV
0.045; 0.048; 0.037; 0.051; 0.048; 0.041
SECONDARY
PK Parameter: AUCtau for TFV
3370.2; 3151.2; 2244.8; 3549.7; 3361.9; 2250.8
SECONDARY
PK Parameter: t1/2 for TFV
15.73; 14.10; 20.65; 14.40; 15.82; 18.81
SECONDARY
PK Parameter: AUCinf for Iohexol
511.2; 486.8; 706.9; 695.2; 521.8; 496.2
SECONDARY
Percentage of Participants With HIV-1 RNA < 50 Copies/mL Week 24 as Determined by Snapshot Algorithm
88.2; 81.3; 81.3; 88.2
SECONDARY
Change From Baseline in Cluster of Differentiation 4 Positive (CD4+) Cell Count at Week 24
139.63; 217.60; 204.33; 237.29
SECONDARY
Percentage of Participants Experiencing Adverse Events (AEs)
70.6; 87.5; 87.5; 88.2; 5.9; 12.5
SECONDARY
Percentage of Participants Experiencing Treatment Emergent (TE) Grade 3 or 4 Laboratory Abnormalities
5.9; 25.0; 12.5; 52.9; 0; 6.3

Eligibility Criteria

Key Inclusion Criteria

  • Treatment naïve
  • Plasma HIV-1 RNA levels ≥ 5, 000 copies/mL at Screening
  • CD4 cell count > 200 cells/µL
  • Screening genotype report provided by the site must show sensitivity to FTC, TDF, EFV, ABC, 3TC, ATV and absence of study drug resistance mutations that include K65R, K70E and M184V in RT
  • Estimated GFR ≥ 70 mL/min
  • Hepatic transaminases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) ≤ 5 × upper limit of normal (ULN)
  • Total bilirubin ≤ 1.5 mg/dL (≤ 26 umol/L), or normal direct bilirubin
  • Adequate hematologic function (absolute neutrophil count ≥ 1,000/mm^3; platelets ≥ 50,000/mm^3; hemoglobin ≥ 8.5 g/dL)
  • Serum amylase ≤ 5 × ULN (individuals with serum amylase > 5 × ULN will remain eligible if serum lipase is ≤ 5 × ULN)
  • Normal electrocardiogram (ECG) or not clinically significant if abnormal ECG
  • Not pregnant or non-lactating females of non-childbearing potential. Or females with childbearing potential who agree to utilize highly effective contraception methods or be non-heterosexually active or practice sexual abstinence from screening throughout the duration of study treatment and for 90 days if taking EFV/FTC/TDF or for 30 days for all other study drugs following the last study drug dose
  • Males who agree to utilize a highly effective method of contraception during heterosexual intercourse or be non-heterosexually active, or practice sexual abstinence from first dose throughout the study period and for 90 days if taking EFV/FTC/TDF or for 30 days for all other study drugs following the last study drug dose. Males who agree to refrain from sperm donation from first dose until at least 90 days if taking EFV/FTC/TDF or for 30 days for all other study drugs following the last study drug dose
  • Body mass index (BMI) of 19 ≤ BMI ≤ 30 kg/m^2 and body weight ≥ 40 kg
  • Life expectancy ≥ 1 year

Key Exclusion Criteria

  • HLA-B*5701 allele positive
  • A new AIDS-defining condition diagnosed within the 30 days prior to screening
  • Hepatitis B surface antigen (HBsAg) positive
  • Hepatitis C virus (HCV) antibody positive and HCV RNA detectable
  • Individuals experiencing decompensated cirrhosis
  • Females who are breastfeeding
  • Positive serum pregnancy test
  • Have an implanted defibrillator or pacemaker
  • Current alcohol or substance that could potentially interfere with study compliance
  • A history of malignancy within the past 5 years (prior to screening) or ongoing malignancy other than cutaneous Kaposi's sarcoma (KS), basal cell carcinoma, or resected, non-invasive cutaneous squamous carcinoma. Individuals with cutaneous KS are eligible, but must not have received any systemic therapy for KS within 30 days of Day 1 Visit and must not be anticipated to require systemic therapy during the study
  • Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to Day 1 Visit

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02246998). 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.

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