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Phase 2 N=108 Randomized Triple-blind Treatment

Standard Versus Double Dose Dolutegravir in Patients With HIV-associated Tuberculosis

HIV Infections · Tuberculosis

Enrolled (actual)
108
Serious AEs
4.6%
Results posted
Sep 2023
Primary outcome: Primary: Virological Suppression at 24 Weeks — 43; 44 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Placebo (Other); Dolutegravir 50 mg (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
University of Cape Town
Primary completion
Jan 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Virological Suppression at 24 Weeks
43; 44
SECONDARY
Virological Suppression at 12 Weeks (Modified ITT)
42; 46
SECONDARY
Virological Suppression at 24 Weeks (Per Protocol)
43; 44
SECONDARY
Virological Suppression at 48 Weeks (Modified ITT)
34; 35
SECONDARY
Virological Suppression at 48 Weeks (Per Protocol)
34; 35
SECONDARY
CD4 Change at 24 Weeks
111; 101
SECONDARY
Dolutegravir Trough Concentrations
32; 34
SECONDARY
Grade 3 or 4 Adverse Events
11; 10
SECONDARY
Change in Sleep Assessment From Baseline - Any Treatment Emergent Insomnia After Baseline Assessed at 4 Weekly Intervals Until Week 24 and Then Again at Week 48
10; 4
SECONDARY
Change in Mental Health Assessment From Baseline Through Week 48
2; 4
SECONDARY
Serious Adverse Events
0; 5
SECONDARY
Adverse Events Requiring Discontinuation of an ART Drug
0; 0
SECONDARY
Antiretroviral Resistance Mutations Testing by Genotypic Resistance Assay in Participants With Virologic Failure
3; 3
SECONDARY
Primary Outcome Differences Among ART-naïve Versus First-line Interruption Status
36; 36; 7; 8

Summary

The investigators propose to conduct a phase 2 randomised (1:1) double-blind placebo-controlled trial of the dolutegravir-lamivudine-tenofovir fixed dose combination tablet daily with an additional 50 mg dose of dolutegravir/matching placebo taken 12 hours later in ART-naïve or fisrt-line interrupted HIV-infected patients on rifampicin-based anti-tuberculosis therapy. The hypothesis is that virologic outcomes with standard dose dolutegravir-based ART will be acceptable in patients on rifampicin-based anti-tuberculosis therapy.

Eligibility Criteria

Inclusion Criteria

  • HIV-1 infection as documented by screening plasma HIV-1 RNA >1000 c/mL
  • ART-naïve (short-term antiretroviral use for prevention of mother-to-child transmission will be allowed) or
  • ART treatment interrupters on ART 100 cells/µL
  • Women of child-bearing potential willing to use adequate contraception (defined as either an intrauterine contraceptive device or hormonal contraception as per national guidelines)

Exclusion Criteria

  • Pregnant/breastfeeding
  • Estimated glomerular filtration rate (eGFR) 3 times upper limit of normal (ULN)
  • Allergy or intolerance to one of the drugs in regimen
  • Concomitant medication known to significantly reduce or increase dolutegravir exposure (except rifampicin)
  • Active psychiatric disease or substance abuse
  • On treatment for active AIDS-defining condition other than tuberculosis (participants on maintenance therapy may be enrolled)
  • Malignancy
  • Any other clinical condition that in the opinion of an investigator puts the patient at increased risk of participating in the study.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03851588). 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.

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