Pharmacokinetics, Safety, and Efficacy of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Disoproxil Fumarate Single Tablet Regimen (STR) in Adolescents

Phase 2

Completed

• Conditions: Acquired Immunodeficiency Syndrome; HIV Infections
• Interventions: Drug: EVG/COBI/FTC/TDF

• Registration Number: NCT01721109
• Lead Sponsor: Gilead Sciences

Brief Summary

The primary objectives of this study are to evaluate the steady-state pharmacokinetics (PK) and confirm the dose of the elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) single-tablet regimen (STR) (Part A) and to evaluate the safety and tolerability of EVG/COBI/FTC/TDF STR through Week 48 (Part B) in HIV-1 infected, antiretroviral (ARV) treatment-naive adolescents.

A total of 50 adolescent participants (12 to \< 18 years of age) will be enrolled to receive EVG/COBI/FTC/TDF as follows:

* Part A: Twelve to 16 eligible participants will be enrolled to evaluate steady-state PK, and confirm the dose, with the intent to enroll at least 4 participants 12 to \< 15 and at least 4 participants 15 to \< 18 years of age.

* Part B: Following confirmation of EVG exposure in at least 12 participants from Part A, 34 to 38 participants in addition to those enrolled in Part A will be enrolled to evaluate the safety, tolerability, and antiviral activity of EVG/COBI/FTC/TDF STR.

Detailed Description

Not available

Basic Information
|
Recruitment & Eligibility
|
Study & Design
|
Trial Locations

Study Timeline

• Study First Submitted: 2012-11-01
• Study First Submitted QC: 2012-11-01
• Study First Posted: 2012-11-04
• Study Start: 2012-12-06
• Primary Completion: 2015-10-22
• Disposition First Submitted: 2016-08-17
• Disposition First Submitted QC: 2016-08-18
• Disposition First Posted: 2016-08-19
• Results First Submitted: 2017-02-24
• Results First Submitted QC: 2017-02-24
• Results First Posted: 2017-04-10
• Study Completion: 2018-01-29
• Status Verified: 2018-07
• Last Update Submitted: 2018-07-20
• Last Update Posted: 2018-08-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• 12 years to < 18 years of age at baseline
• Able to give written assent prior to any screening evaluations
• Parent or guardian able to give written informed consent prior to any screening evaluations and willing to comply with study requirements
• Plasma HIV-1 RNA levels of ≥ 1,000 copies/mL
• CD4+ cell count > 100 cells/µL
• Weight ≥ 35 kg (77 lbs)
• Screening genotype report must show sensitivity to FTC and TDF
• Able to swallow oral tablets
• Adequate renal function
• Clinically normal ECG
• Documented screening for active pulmonary tuberculosis per local standard of care within 6 months of a screening visit
• Hepatic transaminases ≤ 5 x upper limit of normal
• Total bilirubin ≤ 1.5 mg/dL, or normal direct bilirubin
• Individuals with a positive Hepatitis B surface antigen screening test can participate in the study, providing that alternate therapy (other than TDF) for chronic Hepatitis B infection is available as a part of local standard of care
• Adequate hematologic function
• Negative serum pregnancy test for all females
• Males and females of childbearing potential must agree to utilize highly effective contraception methods while on study treatment or agree to abstain from heterosexual intercourse throughout the study period and for 30 days following the last dose of study drug
• Males must agree to utilize a highly effective method of contraception during heterosexual intercourse throughout the study period and for 30 days following discontinuation of investigational medicinal product
• Must be willing and able to comply with all study requirements
• Life expectancy ≥ 1 year

Key

Read More

Exclusion Criteria

• A new AIDS-defining condition diagnosed within the 30 days prior to screening
• Prior treatment with any approved or investigational or experimental anti HIV-1 drug for any length of time (other than that given for prevention of mother-to-child transmission)
• Evidence of active pulmonary or extra-pulmonary tuberculosis disease within 3 months of the screening visit
• Anticipated to require rifamycin treatment for mycobacterial infection while participating in the study. Note: prophylactic Isoniazid (INH) therapy for latent tuberculosis (TB) treatment is allowed.
• Individuals experiencing decompensated cirrhosis
• Pregnant or lactating females
• Have any serious or active medical or psychiatric illness which would interfere with treatment, assessment, or compliance with the protocol. This would include uncontrolled renal, cardiac, hematological, hepatic, pulmonary, endocrine, central nervous, gastrointestinal, vascular, metabolic, immunodeficiency disorders, active infection, or malignancy that are clinically significant or requiring treatment within 30 days prior to the study dosing.
• Current alcohol or substance abuse that will potentially interfere with compliance
• Have history of significant drug sensitivity or drug allergy
• Known hypersensitivity to the study drugs, the metabolites or formulation excipients
• Have been treated with immunosuppressant therapies or chemotherapeutic agents within 3 months of study screening or expected to receive these agents during the study
• A history of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous carcinoma
• Have previously participated in an investigational trial involving administration of any investigational agent within 30 days prior to the study dosing
• Participation in any other clinical trial without prior approval from sponsor is prohibited while participating in this trial
• Receiving ongoing therapy with any disallowed medications, including drugs not to be used with EVG, COBI, FTC, TDF or individuals with any known allergies to the excipients of EVG/COBI/FTC/TDF STR tablets

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

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
EVG/COBI/FTC/TDF	EVG/COBI/FTC/TDF	Participants will receive treatment for 48 weeks and then had the option to enter an Extension Phase to receive EVG/COBI/FTC/TDF until 1) the age of 18, 2) EVG/COBI/FTC/TDF becomes commercially available in the country the participant is enrolled, or 3) Gilead elects to terminate the development of EVG/COBI/FTC/TDF in that country.

Primary Outcome Measures

Name	Time	Method
Incidence of Treatment-Emergent Serious Adverse Events (SAEs) and All Treatment-Emergent Adverse Events (AEs)	Up to Week 48 plus 30 days
For Part A, Pharmacokinetic (PK) Parameter: AUCtau of EVG	Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10	AUCtau is defined as concentration of drug over time (the area under the concentration verses time curve over the dosing interval).

Secondary Outcome Measures

Name	Time	Method
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Weeks 24 and 48 as Defined by the FDA Snapshot Analysis	Weeks 24 and 48
Change From Baseline in CD4+ Cell Count at Weeks 24 and 48	Baseline; Weeks 24 and 48
Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Weeks 24 and 48 as Defined by the FDA Snapshot Analysis	Weeks 24 and 48
Change From Baseline in Plasma log10 HIV-1 RNA at Weeks 24 and 48	Baseline; Weeks 24 and 48
For Part A, PK Parameter: Cmax of EVG, FTC, TFV, and COBI	Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10	Cmax is defined as the maximum concentration of drug.
For Part A, PK Parameter: AUCtau of FTC, TFV, and COBI	Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10	AUCtau is defined as concentration of drug over time (the area under the concentration verses time curve over the dosing interval).
For Part A, PK Parameter: Ctau of EVG, FTC, Tenofovir (TFV), and COBI	Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10	Ctau is defined as the observed drug concentration at the end of the dosing interval.
Change From Baseline in CD4 Percentage at Weeks 24 and 48	Baseline; Weeks 24 and 48

Trial Locations

Locations (18)

St. Christopher's Hospital for Children; 🇺🇸 Philadelphia, Pennsylvania, United States

University of South Florida - Department of Pediatrics; 🇺🇸 Tampa, Florida, United States

East Bay AIDS Center Medical Group; 🇺🇸 Oakland, California, United States

University of Chicago; 🇺🇸 Chicago, Illinois, United States

New York University School of Medicine; 🇺🇸 New York, New York, United States

Rahima Moosa Mother and Child Hospital (Wits); 🇿🇦 Johannesburg, Gauteng, South Africa

St. Jude Children's Research Hospital; 🇺🇸 Memphis, Tennessee, United States

Desmond Tutu HIV Research Centre; 🇿🇦 Cape Town, South Africa

Dr Latiff Private Practice; 🇿🇦 Durban, Kwazulu-Natal, South Africa

Clinical HIV Research Unit; 🇿🇦 Johannesburg, South Africa

The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT); 🇹🇭 Bangkok, Thailand

Perinatal HIV Research Unit; 🇿🇦 Soweto, South Africa

Queen Savang Vadhana Memorial Hospital; 🇹🇭 Chon Buri, Thailand

Srinakarind Hospital; 🇹🇭 Khon Kaen, Thailand

Siriraj Hospital, Mahidol University; 🇹🇭 Bangkok, Thailand

Mpati Medical Center; 🇿🇦 Dundee, South Africa

University of Stellenbosch; 🇿🇦 Stellenbosch, South Africa

Montefiore Medical Center; 🇺🇸 Bronx, New York, United States