Phase 3
N=681
A Study to Evaluate Efficacy and Safety of Cabotegravir (CAB) Long Acting (LA) Plus (+) Rilpivirine (RPV) LA Versus BIKTARVY® (BIK) in Participants With Human Immunodeficiency Virus (HIV)-1 Who Are Virologically Suppressed
HIV Infections
Bottom Line
View on ClinicalTrials.gov: NCT04542070 ↗Enrolled (actual)
681
Serious AEs
5.0%
Results posted
Sep 2023
Primary outcome: Primary: Percentage of Participants With Plasma Human Immunodeficiency Viruses (HIV)-1 Ribonucleic Acid (RNA) Greater Than or Equal to (>=) 50 Copies Per Milliliter (c/mL) at Month 12/11 - ITT-E Population — 1.3; 0.4 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Cabotegravir Tablets (Drug); Cabotegravir Injectable Suspension (CAB LA) (Drug); Rilpivirine Tablets (Drug); Rilpivirine Injectable Suspension (RPV LA) (Drug); BIKTARVY Tablets (BIK) (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- ViiV Healthcare
- Primary completion
- Jul 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Plasma Human Immunodeficiency Viruses (HIV)-1 Ribonucleic Acid (RNA) Greater Than or Equal to (>=) 50 Copies Per Milliliter (c/mL) at Month 12/11 - ITT-E Population |
1.3; 0.4 | — |
| PRIMARY Percentage of Participants With Plasma HIV-1 RNA Greater >=50 Copies Per Milliliter (c/mL) at Month 12/11 - mITT-E Population |
1.1; 0.4 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA Less Than (<)50 c/mL at Month 12/11 - ITT-E Population |
89.4; 93.0 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA <50 c/mL at Month 12/11 -mITT-E Population |
90.2; 92.8 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA <50 c/mL at Month 6/5 - ITT-E Population |
92.7; 97.8 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA <50 c/mL at Month 6/5 - mITT-E Population |
93.5; 97.8 | — |
| SECONDARY Number of Participants With Protocol-defined Confirmed Virologic Failure (CVF) Through Month 6/5 and 12/11 |
1; 0; 2; 0 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA Greater Than or Equal to (>=) 50 c/mL at Month 6/5 |
0.4; 0 | — |
| SECONDARY Absolute Values of HIV Viral Load |
1.5993; 1.5947; 1.6002; 1.5910; 1.6019; 1.5911 | — |
| SECONDARY Change From Baseline in HIV Viral Load |
1.5993; 1.5947; 0.0015; -0.0039; 0.0029; -0.0041 | — |
| SECONDARY Absolute Values of Cluster of Differentiation 4 Plus (CD4+) Cell Count |
670.9; 679.4; 689.1; 673.7; 711.9; 717.3 | — |
| SECONDARY Change From Baseline in CD4+ Cell Count |
670.9; 679.4; 20.4; -3.1; 35.2; 32.2 | — |
| SECONDARY Number of Participants With Treatment-emergent Phenotypic Resistance Through Month 12/11 |
2; 0; 2; 0 | — |
| SECONDARY Number of Participants With Treatment-emergent Phenotypic Resistance Through Month 6/5 |
1; 0; 1; 0 | — |
| SECONDARY Number of Participants With Treatment-emergent Genotypic Resistance Through Month 12/11 |
1; 0; 1; 0; 1; 0 | — |
| SECONDARY Number of Participants With Treatment-emergent Genotypic Resistance Through Month 6/5 |
1; 0; 1; 0 | — |
| SECONDARY Change From Baseline in Bone Biomarkers: Specific Alkaline Phosphatase, Procollagen Type 1 N-Terminal Propeptide, Type 1 Collagen Cross-linked C-telopeptide, Osteocalcin (Micrograms Per Liter (ug/L)) |
12.7; 12.9; 0.3; 0.2; 0.1; 0.5 | — |
| SECONDARY Change From Baseline in Bone Biomarkers: Serum 25-hydroxyvitamin D (Nanomoles Per Liter (Nmol/L)) |
61.0; 59.9; 2.8; 6.0; -2.3; -3.1 | — |
| SECONDARY Change From Baseline in Renal Biomarkers: Specific Serum Beta-2 Microglobulin, Cystatin c, Retinol Binding Protein, Urine Beta-2 Microglobulin (Milligrams Per Liter [mg/L]) |
1.8; 1.8; 0.0; 0.0; 0.0; 0.0 | — |
| SECONDARY Change From Baseline in Renal Biomarkers: Urine Phosphate (Millimoles Per Liter (mmol/L)) |
20.0; 18.4; -1.0; 0.4; 0.1; -0.6 | — |
| SECONDARY Change From Baseline in Renal Biomarker: Urine Retinol Binding Protein 4 (Microgram Per Liter (ug/L)) |
114.2; 100.0; 0.8; 5.7; -0.6; -1.2 | — |
| SECONDARY Change From Baseline in Renal Biomarker: Urine Retinol Binding Protein/Creatinine (Milligram Per Mole (mg/Mol)) |
8.6; 8.0; 0.8; -0.8; -0.5; 0.0 | — |
| SECONDARY Change From Baseline in Renal Biomarker: Urine Beta-2 Microglobulin/ Creatinine (Grams Per Mole (g/Mol)) |
0.0; 0.0; 0.0; 0.0; 0.0; 0.0 | — |
| SECONDARY Change From Baseline in Percentage of Participants With Metabolic Syndrome at Month 12/11 |
9; 9; 5; 7; 2; 1 | — |
| SECONDARY Change From Baseline in Percentage of Participants With Metabolic Syndrome at Month 6/5 |
9; 11; 7; 6; 1; 0 | — |
| SECONDARY Change From Baseline in Homeostasis Model of Assessment-insulin Resistance (HOMA-IR) |
2.8; 3.1; 0.3; -0.1; 0.2; -0.4 | — |
| SECONDARY Percentage of Participants With Treatment Preference as Assessed Using Preference Questionnaire at Month 12/11 - Q2M |
87; 92; 7; 4; 6; 5 | — |
| SECONDARY Change From Baseline in Total Treatment Satisfaction Score Using HIV Treatment Satisfaction Status Questionnaire (HIVTSQs) |
57.88; 58.38; 3.99; -0.66; 4.21; -1.93 | — |
| SECONDARY Change From Baseline in Individual Item Scores Using HIVTSQs |
5.5; 5.6; 0.1; -0.2; 0.2; -0.3 | — |
| SECONDARY HIV Treatment Satisfaction Change Questionnaire (HIVTSQc) Total Score at Month 12/11 |
26.97; 16.89 | — |
| SECONDARY Individual Item Scores of HIVTSQc at Month 12/11 |
2.56; 1.60; 2.47; 1.88; 2.10; 1.63 | — |
| SECONDARY Change From Month 2/1 in Dimension Scores Using Perception of Injection (PIN) Questionnaire - Q2M |
1.58; 1.60; 0.01; -0.03; 0.08; -0.04 | — |
| SECONDARY Change From Month 2/1 in Individual Item Scores Using PIN Questionnaire- Q2M |
1.9; 1.9; -0.14; -0.22; -0.28; -0.22 | — |
Summary
This study is designed to assess the antiviral activity and safety of a two-drug regimen of CAB LA + RPV LA compared with maintenance of BIK. BIKTARVY is a registered trademark of Gilead Sciences.
Eligibility Criteria
Inclusion Criteria
- Participants aged 18 years or older (or >=19 where required by local regulatory agencies), at the time of signing the informed consent.
- A female participant is eligible to participate if she is not pregnant (as confirmed by a negative serum human chorionic gonadotropin (hCG) test at screen and a negative urine hCG test at Randomization), not lactating, and at least one of the following conditions applies.
- Non-reproductive potential defined as:
- Pre-menopausal females with one of the following:
- Documented tubal ligation.
- Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion.
- Hysterectomy.
- Documented Bilateral Oophorectomy
- Postmenopausal defined as 12 months of spontaneous amenorrhea (in questionable cases a blood sample with simultaneous follicle stimulating hormone [FSH] and estradiol levels consistent with menopause). Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment.
- Reproductive potential and agrees to follow one of the options listed in the Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) from 30 days prior to the first dose of study medication, throughout the study, for at least 30 days after discontinuation of all oral study medications, and for at least 52 weeks after discontinuation of CAB LA and RPV LA.
- Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the consent form and in this protocol. Eligible participants or their legal guardians (and next of kin when locally required), must sign a written Informed Consent Form before any protocol-specified assessments are conducted. Enrollment of participants who are unable to provide direct informed consent is optional and will be based on local legal/regulatory requirements and site feasibility to conduct protocol procedures.
- Participants enrolled in France must be affiliated to, or a beneficiary of, a social security category.
- Must be on the uninterrupted current regimen of BIK for at least 6 months prior to Screening with an undetectable HIV-1 viral load for at least 6 months prior to Screening. BIK must be the participant's first or second regimen. If BIK is the second regimen, the first regimen must be an integrase inhibitor (INI) regimen. Only a single prior Integrase inhibitor (INI) regimen is allowed if BIK is a second line regimen >=6 months prior to screening. Any history of non-integrase strand transfer inhibitor regimens (that is. non-nucleoside reverse transcriptase inhibitor, protease inhibitor, C-C chemokine receptor 5 and other entry inhibitors) are not permitted. Any prior change in regimen, defined as a change of a single drug or multiple drugs simultaneously, must have occurred due to tolerability/safety, access to medications, or convenience/simplification, and must not have been done for treatment failure (HIV-1 RNA >=400 c/mL).
The following are limited exceptions:
- A change from Tenofovir disoproxil fumarate (TDF) to TAF will not be considered a regimen change.
- Historical perinatal use of Nucleoside reverse transcriptase inhibitor (NRTI) when given in addition to an ongoing Highly active antiretroviral therapy (HAART) will not be considered a change in ART therapy regimen.
- The past use of ARVs in the context of Post Exposure Prophylaxis (PEP) or Pre-Exposure Prophylaxis (PrEP) while the participant was HIV negative will be allowed. Such cases will be evaluated on a case by case basis with the Medical Monitor, and may require documentation of HIV negative serology during time of PEP or PrEP.
- A change in dosing scheme of the same drug from twice d
Data sourced from ClinicalTrials.gov (NCT04542070). 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.