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Safety and Efficacy of Switching From Regimens of ABC/3TC + a 3rd Agent to E/C/F/TAF Fixed-Dose Combination (FDC) in Virologically-Suppressed HIV 1 Infected Adults

Phase 3
Completed
Conditions
HIV-1 Infection
Interventions
Drug: ABC/3TC
Drug: Third Antiretroviral Agent
Registration Number
NCT02605954
Lead Sponsor
Gilead Sciences
Brief Summary

The primary objective of this study is to evaluate the efficacy of switching to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) fixed-dose combination (FDC) relative to continuing on a baseline regimen consisting of abacavir/lamivudine (ABC/3TC) plus a 3rd antiretroviral agent in HIV-1 infected participants.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
275
Inclusion Criteria

HIV-infected adult participants who meet the following criteria will be given the option to participate in the study:

  • Currently receiving ABC/3TC plus a third antiretroviral (ARV) agent for ≥ 6 consecutive months preceding the screening visit. For subjects with 3 or more ART regimens, a regimen history must be provided to the Sponsor for approval. Allowed third antiretroviral agents include LPV/r, ATV+RTV, ATV+COBI (or ATV/COBI FDC), DRV+RTV, DRV + COBI (or DRV/COBI FDC) FPV + RTV, SQV + RTV, ATV (no booster), EFV, RPV, NVP, ETR, RAL or DTG
  • Documented plasma HIV-1 RNA levels < 50 copies/mL for ≥ 6 months preceding the screening visit (measured at least twice using the same assay). In the preceding 6 months prior to screening, one episode of "blip" (HIV-1 RNA > 50 and < 400 copies/mL) is acceptable, only if HIV-1 RNA is < 50 copies/mL immediately before and after the "blip".
  • Plasma HIV-1 RNA < 50 copies/mL at screening visit
  • Individuals will have no evidence of previous virologic failure on a PI+RTV or integrase strand transfer inhibitor-based regimen (with or without resistance to either class of ARV).
  • All documented historical plasma genotype(s) must not show resistance to tenofovir disoproxil fumarate (TDF) or emtricitabine (FTC), including, but not limited to the presence of reverse transcriptase resistance mutants K65R, K70E, M184V/I, or thymidine analog associated mutations (TAMs) (TAMs are: M41L, D67N, K70R, L210W, T215Y/F, K219Q/E/N/R). If a historical genotype is not available or subject has 3 or more ART regimens, subject will have proviral genotype analysis prior to Day 1 to confirm absence of archived resistance to TDF or FTC.
  • Adequate renal function defined as having an estimated glomerular filtration rate of ≥ 30 mL/min as calculated by Cockcroft-Gault (eGFR-CG)

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

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
E/C/F/TAFE/C/F/TAFParticipants will switch to E/C/F/TAF FDC and receive treatment for 48 weeks.
ABC/3TC+3rd AgentThird Antiretroviral AgentParticipants will maintain prior regimen of ABC/3TC plus a third antiretroviral agent for 24 weeks followed by a delayed switch to E/C/F/TAF FDC. Note: the prior regimen is determined by the participant's clinician (prior to entry into the study) and will consist of one of the third antiretroviral agents listed.
ABC/3TC+3rd AgentABC/3TCParticipants will maintain prior regimen of ABC/3TC plus a third antiretroviral agent for 24 weeks followed by a delayed switch to E/C/F/TAF FDC. Note: the prior regimen is determined by the participant's clinician (prior to entry into the study) and will consist of one of the third antiretroviral agents listed.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Who Have HIV-1 RNA < 50 Copies/mL as Defined by the FDA Snapshot Algorithm at Week 24Week 24

The percentage of participants achieving HIV-1 RNA \< 50 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in CD4+ Cell Count at Week 48Baseline; Week 48
Percentage of Participants Who Have HIV-1 RNA < 50 Copies/mL as Defined by the FDA Snapshot Algorithm at Week 12Week 12

The percentage of participants achieving HIV-1 RNA \< 50 copies/mL at week 12 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Percentage of Participants Who Have HIV-1 RNA < 50 Copies/mL as Defined by the FDA Snapshot Algorithm at Week 48Week 48

The percentage of participants achieving HIV-1 RNA \< 50 copies/mL at week 48 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Change From Baseline in CD4+ Cell Count at Week 24Baseline; Week 24

Trial Locations

Locations (49)

Capital Medical Associates, P.C.

🇺🇸

Washington, District of Columbia, United States

Georgetown University

🇺🇸

Washington, District of Columbia, United States

Azienda Ospedale San Paolo

🇮🇹

Monza, Italy

Hopital Europeen Marseille

🇫🇷

Marseille, France

Tarrant County ID Associates

🇺🇸

Fort Worth, Texas, United States

ICH Study Center Hamburg

🇩🇪

Hamburg, Germany

ARNAS Garibaldi - Nesima

🇮🇹

Catania, Italy

Unit Infectious Diseases - University of Catania - ARNAS Garibaldi

🇮🇹

Catania, Italy

Azienda Ospedaliera San Gerardo

🇮🇹

Monza, Italy

Hopital Necker les Enfants Malades

🇫🇷

Paris, France

CHU - Groupe Saint-Andre

🇫🇷

Bordeaux, France

Epimed GmbH

🇩🇪

Berlin, Germany

Istituto Nazionale Malattie Infettive Lazzaro Spallanzani I.R.C.C.S.

🇮🇹

Roma, Italy

Universitatsklinikum Essen

🇩🇪

Essen, Germany

Hopital Henri Mondor

🇫🇷

Creteil, France

Azienda Ospedaliero Universitaria Policlinico di Modena

🇮🇹

Modena, Italy

C.H.U. de NICE

🇫🇷

Nice, France

Hopital Saint Louis

🇫🇷

PARIS cedex 10, France

Comprensorio Ospedaliero Amedeo di Savoia

🇮🇹

Torino, Italy

Dipartimento di Malattie Infettive e Tropicali

🇮🇹

Torino, Italy

C.H.U. de Nantes

🇫🇷

Nantes, France

Hopital Saint Antoine

🇫🇷

Paris cedex 12, France

Hospital General Universitario Gregorio Maranon

🇪🇸

Madrid, Spain

Azienda Ospedaliera Luigi Sacco

🇮🇹

Milano, Italy

Ospedale Civile S. Spirito AUSL

🇮🇹

Pescara, Italy

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Hospital Costa Del Sol

🇪🇸

Marbella, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Alvaro Cunqueiro

🇪🇸

Vigo, Spain

Steinhart Medical Associates dba The Kinder Medical Group

🇺🇸

Miami, Florida, United States

Spectrum Medical Group

🇺🇸

Phoenix, Arizona, United States

Unità Operativa Complessa di Malattie Infettive

🇮🇹

Pescara, Italy

CHU Hotel Dieu

🇫🇷

Paris Cedex 14, France

Centre Hospitalier Gustave Dron

🇫🇷

Tourcoing, France

Hospital Reg. Univ. Carlos Haya

🇪🇸

Málaga, Spain

Ruane Clinical Research Group

🇺🇸

Los Angeles, California, United States

Gary Richmond, MD, PA, Inc.

🇺🇸

Fort Lauderdale, Florida, United States

Midway Immunology & Research Center, LLC

🇺🇸

Fort Pierce, Florida, United States

Triple O Research Institute PA

🇺🇸

West Palm Beach, Florida, United States

The Positive Health Clinic, Allegheny Health Network

🇺🇸

Pittsburgh, Pennsylvania, United States

AIDS Arms, Inc./Trinity Health & Wellness Center

🇺🇸

Dallas, Texas, United States

Universitatsklinikum Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

Hospital Clínico Universitario de Valencia (Galindo)

🇪🇸

Valencia, Spain

Hospital General Universitario de Valencia (Abril)

🇪🇸

Valencia, Spain

Mortimer Market Centre

🇬🇧

London, United Kingdom

Central Texas Clinical Research

🇺🇸

Austin, Texas, United States

Hopital Lariboisiere

🇫🇷

Paris, France

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