ADORE: Efficacy of DORavirine in Adults Living With HIV Experiencing Virological Failure on First-line Efavirenz-based Antiretroviral Therapy With NNRTI Resistance
- Conditions
- HIV-1-infection
- Interventions
- Drug: Doravirine/Lamivudine/Tenofovir
- Registration Number
- NCT04429152
- Lead Sponsor
- Professor Francois Venter
- Brief Summary
This is a pilot study investigating the efficacy of Doravirine (DOR) in combination with Lamivudine (3TC) and Tenofovir Disoproxil Fumarate (TDF) administered over 48 weeks in adults living with HIV-1 experiencing virological failure on first-line Efavirenz-based antiretroviral therapy with non-nucleoside reverse transcriptase inhibitor resistance
- Detailed Description
This is a single-arm, phase 3 pilot study investigating the efficacy of Doravirine (DOR) in combination with Lamivudine (3TC) and Tenofovir Disoproxil Fumarate (TDF) administered over 48 weeks in adults living with HIV-1 experiencing virological failure on first-line Efavirenz-based antiretroviral therapy with non-nucleoside reverse transcriptase inhibitor resistance.
Approximately 25 male and female participants 18 years and older infected with HIV-1 and experiencing virological failure on efavirenz-based ART will be administered a once-daily, fixed-dose combination of doravirine 100 mg, lamivudine 300 mg, and tenofovir disoproxil fumarate 300 mg (DOR/3TC/TDF). The study includes screening and baseline visits, 4 study visits from Week 4 to Week 36, and an end of study visit at Week 48.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 25
- Adults living with HIV-1, 18 years and older
- Viral load 5000 - 60 000 copies/mL on first-line efavirenz-based antiretroviral therapy
- HIV genotype resistance test with first generation NNRTI resistance (e.g. K103N, Y181C, etc as listed in the protocol)
- CD4 > 200 cells/uL
- Creatinine clearance > 50 mL/min
- Body mass ≥ 35 kg.
- Resistance to TDF on genotype (K65R)
- "Significant resistance" to doravirine, denoted by a Stanford Score ≥ 15 on genotype
- Virologic failure on any other regimen
- Women who are pregnant at the time of the screening or enrolment visits
- Active tuberculosis and/or are on anti-tuberculous therapy at the time of the screening or enrolment visits
- Taking and cannot discontinue prohibited concomitant medications listed in protocol at least two weeks prior to the enrolment visit and for the duration of the study period.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Doravirine Doravirine/Lamivudine/Tenofovir Once-daily, fixed-dose combination of doravirine 100 mg, lamivudine 300 mg, and tenofovir disoproxil fumarate 300 mg (DOR/3TC/TDF).
- Primary Outcome Measures
Name Time Method Proportion of participants with undetectable plasma HIV-1 RNA levels (<50 copies/mL) at week 24 24 weeks The proportion of participants with undetectable plasma HIV-1 RNA levels at Week 24 will be recorded.
- Secondary Outcome Measures
Name Time Method Proportion of patients with undetectable plasma HIV-1 RNA levels (<50 copies/mL) at weeks 4, 12 and 48 At week 4, 12, 48 Evaluation of viral suppression by recording the proportion of patients with undetectable plasma HIV-1 RNA levels (\<50 copies/mL) at weeks 4, 12 and 48
Change from baseline in plasma CD4 levels at weeks 24 and 48 At week 24, 48 Evaluation of changes in CD4 count from baseline recorded at weeks 24 and 48.
Emergence of antiretroviral resistance mutations in participants with virological failure 48 weeks Evaluation of the number of antiretroviral resistance mutations that emerge in participants with virological failure
Trial Locations
- Locations (3)
Wits RHI Yeoville Clinic
🇿🇦Johannesburg, Gauteng, South Africa
Charlotte Maxeke Johannesburg Academic Hospital
🇿🇦Johannesburg, Gauteng, South Africa
Sunnyside Office Park
🇿🇦Johannesburg, Gauteng, South Africa