Phase 2 Completed N=122 Treatment

Dolutegravir Plus Lamivudine Dual Therapy in Treatment Naïve HIV-1 Patients

HIV-1 Infection

Source: ClinicalTrials.gov NCT02582684 ↗

Enrolled (actual)

122

Serious AEs

2.5%

Results posted

Mar 2018

Primary outcomePrimary: Virologic Status at Week 24 — 108; 5; 7 Participants

Summary

This study was done to see if the combination of two anti-HIV medicines, dolutegravir (DTG, Tivicay) and lamivudine (3TC, Epivir) taken once a day, provide a safe, effective, and well-tolerated treatment for HIV. DTG is a type of HIV medicine called an integrase inhibitor; 3TC is a type of HIV medicine called a reverse transcriptase inhibitor. DTG works by blocking integrase and 3TC works by blocking reverse transcriptase, two HIV proteins (enzymes). This prevents HIV from multiplying and lowers the viral load (amount of HIV in the blood). Both DTG and 3TC are currently part of Food and Drug Administration (FDA) recommended regimens along with a third active drug. Since some HIV medicines have side effects and are costly, there is interest in whether HIV can be successfully controlled with fewer than three HIV drugs.

Outcome Measures

Outcome	Result	p-value
PRIMARY Virologic Status at Week 24	108; 5; 7	—
SECONDARY Virologic Status at Week 12	107; 7; 6	—
SECONDARY Virologic Status at Week 48	102; 6; 12	—
SECONDARY Virologic Failure	4; 116	—
SECONDARY Proportion of Participants With Plasma HIV-1 RNA < 50 Copies/mL - Missing = Failure	0.40; 0.68; 0.85; 0.89; 0.88; 0.90	—
SECONDARY Proportion of Participants With Plasma HIV-1 RNA < 200 Copies/mL - Missing = Failure	0.68; 0.90; 0.95; 0.93; 0.92; 0.95	—
SECONDARY Proportion of Participants With Plasma HIV-1 RNA <50 Copies/mL - Missing = Ignored	0.41; 0.70; 0.88; 0.94; 0.94; 0.94	—
SECONDARY Proportion of Participants With Plasma HIV-1 RNA <200 Copies/mL- ITT Missing = Ignored	0.71; 0.94; 0.98; 0.98; 0.98; 0.99	—
SECONDARY Proportion of Participants With Plasma HIV-1 RNA <50 Copies/mL- As Treated	0.41; 0.70; 0.88; 0.94; 0.94; 0.94	—
SECONDARY Proportion of Participants With Plasma HIV-1 RNA <200 Copies/mL- As Treated	0.71; 0.94; 0.98; 0.98; 0.98; 0.99	—
SECONDARY CD4+ Cell Count	387; 473; 520; 582; 579	—
SECONDARY Change in CD4+ Cell Count	78; 122; 167; 182	—
SECONDARY Number of HIV-1 Drug Resistance Mutation Occurrences in Participants	1; 1; 1	—
SECONDARY Fasting Lipids and Glucose	151; 154; 85; 86; 39; 46	—
SECONDARY Creatinine Clearance	126.0; 112.9; 112.0; 114.7; 115.5; 112.7	—
SECONDARY Number of Participants With Grade 3 of Higher Adverse Events	16	—

Eligibility Criteria

NOTE: Further information on the eligibility criteria can be found in the study protocol.

Inclusion Criteria

HIV-1 infection.
Plasma HIV-1 RNA ≥1000 copies/mL and <500,000 copies/mL obtained within 90 days prior to study entry.
No evidence of any RT, any integrase, or major protease resistance mutation (according to the 2014 IAS-USA drug resistance mutations list, available at https://www.iasusa.org/sites/default/files/tam/22-3-642.pdf) based on pre-ARV (antiretroviral) treatment genotype performed any time prior to study entry.
ARV treatment drug-naive (defined as no previous ARV treatment at any time prior to study entry, with the exception of successful post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP).
The following laboratory values obtained within 45 days prior to study entry:
ANC (absolute neutrophil count) ≥750/mm^3
Hemoglobin ≥10.0 g/dL
Platelets ≥ 50,000/mm^3
Calculated creatinine clearance (CrCl) ≥50 mL/min, as estimated by the Cockcroft-Gault equation
AST (aspartate aminotransferase) <5 x ULN (upper limit of normal)
ALT (alanine aminotransferase) <5x ULN
Total bilirubin <1.5 x ULN
Hepatitis B surface antigen negative within 45 days prior to study entry.
For women with reproductive potential, negative serum or urine pregnancy test at screening and within 48 hours prior to study entry.
If participating in sexual activity that could lead to pregnancy, female participants with reproductive potential must have agreed to use one form of contraceptive as listed in the protocol while receiving protocol-specified medications and for 30 days after stopping the medications.
Ability and willingness of participant or legal representative to provide informed consent.

Exclusion Criteria

Serious illness requiring systemic treatment and/or hospitalization.
Treatment within 30 days prior to study entry with immune modulators such as systemic steroids, interleukins, interferons, granulocyte colony-stimulating factor (G-CSF), erythropoietin, or any investigational therapy.
Pregnancy or breastfeeding.
Receipt of systemic cytotoxic chemotherapy or dofetilide.
Known allergy/sensitivity to any of the study drugs or their formulations.
Active drug or alcohol use or dependence that may interfere with adherence to study requirements, in the opinion of the site investigator.
Active hepatitis C virus (HCV) treatment or anticipated need for treatment within study period.
Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
Severe hepatic impairment (Class C) as determined by Child-Pugh classification.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02582684). 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.