MedPath

Study to Evaluate the Safety and Efficacy of a Single Tablet Regimen of Emtricitabine/Rilpivirine/Tenofovir Disoproxil Fumarate Compared With a Single Tablet Regimen of Efavirenz/Emtricitabine/Tenofovir Disoproxil Fumarate in HIV-1 Infected, Antiretroviral Treatment-Naive Adults

Phase 3
Completed
Conditions
HIV-1 Infection
Interventions
Drug: FTC/RPV/TDF
Drug: EFV/FTC/TDF
Registration Number
NCT01309243
Lead Sponsor
Gilead Sciences
Brief Summary

The purpose of the study was to evaluate the safety and efficacy of the emtricitabine (FTC)/rilpivirine (RPV)/tenofovir disoproxil fumarate (TDF) single-tablet regimen (STR) compared with the efavirenz (EFV)/FTC/TDF STR in HIV-1 infected adults who had not previously received treatment with antiretroviral medications.

Participants were randomized in a 1:1 ratio to receive one of the study treatments. Randomization was stratified by HIV-1 RNA level (≤ 100,000 copies/mL or \> 100,000 copies/mL) at screening. A treatment duration of 96 weeks was planned, with the option for subjects in FTC/RPV/TDF STR arm to receive treatment following the Week 96 visit until FTC/RPV/TDF STR is commercially available or until Gilead Sciences elects to terminate development in that country.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
799
Inclusion Criteria
  • Ability to understand and sign a written informed consent form
  • Plasma HIV-1 RNA levels ≥ 2,500 copies/mL at screening
  • No prior use of any approved or experimental anti-HIV drug for any length of time
  • Screening genotype report showing sensitivity to EFV, FTC, TDF, and lack of the RPV mutations K101E/P, E138A/G/K/Q/R, Y181C/I/V, and H221Y
  • Normal ECG
  • Hepatic transaminases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) ≤ 5 x the upper limit of the normal range (ULN)
  • Total bilirubin ≤ 1.5 mg/dL, or normal direct bilirubin
  • Adequate hematologic function
  • Serum amylase ≤ 5 x ULN (participants with serum amylase > 5 x ULN remained eligible if serum lipase was ≤ 5 x ULN)
  • Adequate renal function
  • Males and Females of childbearing potential must have agreed to utilize highly effective contraception methods (two separate forms of contraception, one of which must be an effective barrier method, or be non-heterosexually active, practice sexual abstinence or have a vasectomized partner) from screening throughout the duration of study period and for 12 weeks following the last dose of study drug.
  • Adult (≥ 18 years) males or non-pregnant females
Exclusion Criteria
  • A new AIDS-defining condition diagnosed within the 30 days prior to screening
  • Females who were breastfeeding
  • Positive serum pregnancy test (female of childbearing potential)
  • Proven or suspected acute hepatitis in the 30 days prior to study entry
  • Subjects receiving drug treatment for hepatitis C, or subjects who were anticipated to receive treatment for hepatitis C during the course of the study
  • Subjects experiencing decompensated cirrhosis
  • Had an implanted defibrillator or pacemaker
  • Current alcohol or substance abuse
  • 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
  • Active, serious infections requiring parenteral antibiotic or antifungal therapy within 30 days prior to baseline
  • Receiving ongoing therapy or anticipated to need to initiate drugs or herbal/natural supplements during the study that are contraindicated or not recommended for use, including drugs not to be used with FTC, EFV, RPV, or TDF; or subjects with known allergies to the excipients of the FTC/RPV/TDF or EFV/FTC/TDF single-tablet regimens
  • Participation in any other clinical trial without prior approval from the sponsor was prohibited while participating in this trial.
  • Had been treated with immunosuppressant therapies or chemotherapeutic agents within 3 months of study screening, or expected to receive these agents or systemic steroids for immunosuppression during the study (eg, corticosteroids, immunoglobulins, and other immune-based or cytokine-based therapies)
  • Had any other clinical condition or prior therapy that, in the opinion of the Investigator, would have made the participant unsuitable for the study or unable to comply with the dosing requirements

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
FTC/RPV/TDFFTC/RPV/TDF-
EFV/FTC/TDFEFV/FTC/TDF-
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 48Week 48

The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 48 was analyzed using the US FDA snapshot algorithm.

The snapshot algorithm defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Fasting High-density Lipoprotein (HDL) Cholesterol at Week 48Baseline to Week 48
Development of HIV-1 Drug Resistance Through Week 96, Participants With Viral ResistanceBaseline to Week 96

Resistance Analysis Set: participants with either suboptimal virologic response or virologic rebound were considered to have virologic failure and were analyzed. Suboptimal virologic response was assessed at Week 8 and was defined as having HIV-1 RNA ≥ 50 copies/mL and \< 1-log10 reduction from baseline at the Week 8 visit, which was confirmed at the subsequent visit. Virologic rebound was defined as having 2 consecutive visits with HIV-1 RNA ≥ 400 copies/mL after achieving HIV-1 RNA \< 50 copies/mL, or as having 2 consecutive visits with \> 1 log10 increase in HIV-1 RNA from their nadir. In addition, subjects who were on study drugs, had not been analyzed previously, and who had HIV-1 RNA ≥ 400 copies/mL at Week 48, Week 96, or their last visit (at or after Week 8) were also analyzed for resistance at their last visit. Subsequent to the first resistance testing, subjects experiencing repeated confirmed virologic failure were assessed for resistance retesting on a case-by-case basis.

Change From Baseline in Fasting Low-density Lipoprotein (LDL) Cholesterol at Week 48Baseline to Week 48
Development of HIV-1 Drug Resistance Through Week 96, All ParticipantsBaseline to Week 96

Participants who experienced either suboptimal virologic response or virologic rebound were considered to have virologic failure and were analyzed for resistance. Suboptimal virologic response was assessed at Week 8 and was defined as having HIV-1 RNA ≥ 50 copies/mL and \< 1-log10 reduction from baseline at the Week 8 visit, which was confirmed at the subsequent visit. Virologic rebound was defined as having 2 consecutive visits with HIV-1 RNA ≥ 400 copies/mL after achieving HIV-1 RNA \< 50 copies/mL, or as having 2 consecutive visits with \> 1 log10 increase in HIV-1 RNA from their nadir. In addition, subjects who were on study drugs, had not been analyzed previously, and who had HIV-1 RNA ≥ 400 copies/mL at Week 48, Week 96, or their last visit (at or after Week 8) were also analyzed for resistance at their last visit. Subsequent to the first resistance testing, subjects experiencing repeated confirmed virologic failure were assessed for resistance retesting on a case-by-case basis.

Change From Baseline in Fasting Triglycerides at Week 48Baseline to Week 48
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 96Baseline to Week 96

The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 96 was analyzed using the US FDA snapshot algorithm.

Change From Baseline in CD4 Cell Count at Week 48Baseline to Week 48
Change From Baseline in CD4 Cell Count at Week 96Baseline to Week 96
Change From Baseline in Fasting Total Cholesterol at Week 48Baseline to Week 48

Trial Locations

Locations (150)

Universitätsklinikum Innsbruck Universitätsklinik für Dermatologie und Venerologie

🇦🇹

Innsbruck, Austria

University of California, Davis

🇺🇸

Sacramento, California, United States

Johns Hopkins Rockland Physicians Practice and Research Group at Greenspring Station

🇺🇸

Lutherville, Maryland, United States

Capital Medical Associates, PC

🇺🇸

Washington, District of Columbia, United States

Whitman-Walker Clinic

🇺🇸

Washington, District of Columbia, United States

Orlando Immunology Center

🇺🇸

Orlando, Florida, United States

South Jersey Infectious Disease

🇺🇸

Somers Point, New Jersey, United States

Cliniques Universitaires Saint-Luc - UCL

🇧🇪

Brussels, Belgium

University Hospitals Leuven

🇧🇪

Leuven, Belgium

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

Clinique médicale L' Actuel

🇨🇦

Montréal, Quebec, Canada

Onze Lieve Vrouwe Gasthuis

🇳🇱

Amsterdam, Netherlands

Jeffrey Goodman Special Care Clinic/Los Angeles Gay and Lesbian Center

🇺🇸

Los Angeles, California, United States

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Oasis Clinic

🇺🇸

Los Angeles, California, United States

Anthony Mills MD Inc

🇺🇸

Los Angeles, California, United States

Orange Coast Medical Group

🇺🇸

Newport Beach, California, United States

North Shore University Hospital--Division of Infectious Diseases

🇺🇸

Manhasset, New York, United States

University of South Carolina

🇺🇸

Columbia, South Carolina, United States

AHF Research Center

🇺🇸

Beverly Hills, California, United States

Kaiser Permanente Medical Center

🇺🇸

Los Angeles, California, United States

Clinical and Translational Research Center - UNC Hospitals

🇺🇸

Chapel Hill, North Carolina, United States

Southwest Care Center

🇺🇸

Sante Fe, New Mexico, United States

AHF Health Positive - Tampa Bay

🇺🇸

Safety Harbor, Florida, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

St Vincent's Hospital, Sydney

🇦🇺

Darlinghurst, Australia

Be Well Medical Center

🇺🇸

Berkley, Michigan, United States

Beth Israel Medical Center

🇺🇸

New York, New York, United States

Gordon E. Crofoot MD PA

🇺🇸

Houston, Texas, United States

Ricky K. Hsu, Md, Pc

🇺🇸

New York, New York, United States

Taylor Square Private Clinic

🇦🇺

Darlinghurst, Australia

Clinical Research - Infectious Diseases Unit Alfred Hospital

🇦🇺

Melbourne, Australia

Emory University

🇺🇸

Atlanta, Georgia, United States

Infectious Disease Specialists of America

🇺🇸

Decatur, Georgia, United States

Howard Brown Health Center

🇺🇸

Chicago, Illinois, United States

Southampton Healthcare

🇺🇸

St. Louis, Missouri, United States

Peter Shalit, M.D.

🇺🇸

Seattle, Washington, United States

Midway Immunology and Research Center

🇺🇸

Fort Pierce, Florida, United States

Broward General Medical Center

🇺🇸

Ft. Lauderdale, Florida, United States

Claudia T Martorell, MD., LLC dba The Research Institute

🇺🇸

Springfield, Massachusetts, United States

Gary J. Richmond, M.D., P.A.

🇺🇸

Fort Lauderdale, Florida, United States

Central Texas Clinical Research

🇺🇸

Austin, Texas, United States

Mercer University School of Medicine

🇺🇸

Macon, Georgia, United States

Greiger Clinic

🇺🇸

Mount Vernon, New York, United States

Northside Clinic

🇦🇺

North Fitzroy, Australia

Central West Clinical Research, Inc.

🇺🇸

St. Louis, Missouri, United States

Saint Michael's Medical Center

🇺🇸

Newark, New Jersey, United States

Upstate Infectious Disease Associates

🇺🇸

Albany, New York, United States

Summa Health System Care Center

🇺🇸

Akron, Ohio, United States

Garcia Family Health Group

🇺🇸

Harlingen, Texas, United States

CARE-ID

🇺🇸

Annandale, Virginia, United States

Prahran Market Clinic

🇦🇺

Prahran, Australia

CHUV

🇨🇭

Lausanne, Switzerland

AIDS Research Consortium of Atlanta

🇺🇸

Atlanta, Georgia, United States

Atlanta ID Group

🇺🇸

Atlanta, Georgia, United States

Valuhealthmd,Llc / Idocf

🇺🇸

Orlando, Florida, United States

Carolinas Medical Center

🇺🇸

Charlotte, North Carolina, United States

Wohlfeiler, Piperato and Associates, LLC

🇺🇸

Miami Beach, Florida, United States

Infectious Disease Associates of NW FL

🇺🇸

Pensacola, Florida, United States

Rosedale Infectious Diseases

🇺🇸

Huntersville, North Carolina, United States

Medical Faculty Associates

🇺🇸

Washington, District of Columbia, United States

New York Hospital Queens

🇺🇸

Flushing, New York, United States

Southwest Infectious Disease Associates, Inc.

🇺🇸

Dallas, Texas, United States

Maple Leaf Research Maple Leaf Medical Clinic

🇨🇦

Toronto, Ontario, Canada

Department of Dermatology, Allergy, and Infectious Disease University Vienna Medical School

🇦🇹

Vienna, Austria

University Hospital Zurich

🇨🇭

Zurich, Switzerland

Rockwood Pulmonary and Critical Care

🇺🇸

Spokane, Washington, United States

Holdsworth House Medical Practice

🇦🇺

Darlinghurst, New South Wales, Australia

Hopital Bichat Claude Bernard

🇫🇷

Paris, France

ICH Study Center

🇩🇪

Hamburg, Germany

Ridu, Wgh

🇬🇧

Edinburgh, United Kingdom

Hôpital de la Croix-Rousse

🇫🇷

Lyon, France

Unidad HIV. Hospital 12 de Octubre

🇪🇸

Madrid, Spain

Guys and St Thomas' NHS trust

🇬🇧

London, United Kingdom

Hospital Universitari de Bellvitge

🇪🇸

Cataluña, Spain

Royal Free NHS Trust,

🇬🇧

London, United Kingdom

LKH Medical University Graz West, Department of Internal Medicine

🇦🇹

Graz, Austria

Institute of Tropical Medicine

🇧🇪

Antwerp, Belgium

Hospital de Santa Maria - CHLN, EPE

🇵🇹

Lisbon, Portugal

Hospital de Joaquim urbano

🇵🇹

Porto, Portugal

Centre Hospitalier de Tourcoing

🇫🇷

Tourcoing, France

Albion Street Centre

🇦🇺

Surry Hills, Australia

East Sydney Doctors

🇦🇺

Sydney, Australia

Hospital Universitario de Elche, Unidad de Enfermedades Infecciosas

🇪🇸

Elche, Spain

Division of HIV/AIDS, St. Paul's Hospital

🇨🇦

Vancouver, British Columbia, Canada

HOSPITAL SAINT LOUIS - Services des Maladies Infectieuses

🇫🇷

Paris, France

Clinical Research Puerto Rico

🇵🇷

San Juan, Puerto Rico

IRCCS Ospedale San Raffaele Centro San Luigi, Unità Operativa di Malattie Infettive

🇮🇹

Milan, Italy

Hopital Raymond Poincare

🇫🇷

Garches, France

CHU Nice - Archet 1

🇫🇷

Nice, France

North Manchester General Hospital

🇬🇧

Manchester, United Kingdom

Royal Sussex County Hospital

🇬🇧

Brighton, United Kingdom

Hopital Saint Antoine- Service Maladies infectieuses

🇫🇷

Paris, France

Hospital La Paz

🇪🇸

Madrid, Spain

EPIMED GmbH

🇩🇪

Berlin, Germany

Department of Dermatology University Hospital Essen

🇩🇪

Essen, Germany

Medizinische Universitätsklinik I der Friedrich-Wilhelms Universität Bonn

🇩🇪

Bonn, Germany

Clinical Research, Grahame Hayton Unit Ambrose King Centre, The Royal London Hospital

🇬🇧

London, United Kingdom

The Ottawa Hospital, General Campus

🇨🇦

Ottawa, Ontario, Canada

McGill University Health Center, Montreal Chest Institute

🇨🇦

Montreal, Quebec, Canada

Erasmus MC

🇳🇱

Rotterdam, Netherlands

Hospital Universitario 12 Octubre

🇪🇸

Madrid, Spain

Chu Hotel Dieu

🇫🇷

Nantes, France

Vancouver ID Research and Care Centre Society

🇨🇦

Vancouver, British Columbia, Canada

Hospital General Universitario Alicante

🇪🇸

Alicante, Spain

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

Serviço de Doenças Infecciosas, Hospital S. Joao

🇵🇹

Porto, Portugal

University Health Network/Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

Universitätsklinik für Infektiologie

🇨🇭

Bern, Switzerland

Hôpital Pitié Salpêtrière - Service des Maladies Infectieuses

🇫🇷

Paris cedex 13, France

Private Practice Gute & Locher & Lutz, Infektiologikum

🇩🇪

Frankfurt am Main, Germany

MUC Research GmbH

🇩🇪

München, Germany

Universitätsklinikum Eppendorf Ambulanzzentrum des UKE GmbH, Infekiologie

🇩🇪

Hamburg, Germany

Division of Infectious Disease, Department of Medicine, University Hospital Freiburg

🇩🇪

Freiburg, Germany

The Kinder Medical Group

🇺🇸

Miami, Florida, United States

Hennepin County Medical Center

🇺🇸

Minneapolis, Minnesota, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Clint Spencer Clinic

🇺🇸

Honolulu, Hawaii, United States

Foundation "IRCCS Policlinico San Matteo Hospital"

🇮🇹

Pavia, Italy

Ospedali Riuniti

🇮🇹

Bergamo, Italy

I Div Infectious Diseases, Luigi Sacco Hospital

🇮🇹

Milano, Italy

San Gerardo Hospital - Uo Malattie Infettive

🇮🇹

Monza, Italy

National Institute for Infectious Diseases "L. Spallanzani" IRCCS

🇮🇹

Rome, Italy

Hopital Tenon Service des Maladies infectieuses et tropicales

🇫🇷

Paris, France

Spectrum Medical Group

🇺🇸

Phoenix, Arizona, United States

Apex Research LLC

🇺🇸

Denver, Colorado, United States

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

St. Joseph's Hospital d/b/a Comprehensive Research Institute

🇺🇸

Tampa, Florida, United States

Northstar Medical Center

🇺🇸

Chicago, Illinois, United States

Trinity Health and Wellness Center

🇺🇸

Dallas, Texas, United States

Therapeutic Concepts, P.A.

🇺🇸

Houston, Texas, United States

Tarrant County Infectious Disease Associates

🇺🇸

Fort Worth, Texas, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Living Hope Education and Research Consultants

🇺🇸

Long Beach, California, United States

Lightsource Medical

🇺🇸

Los Angeles, California, United States

Stanford University

🇺🇸

Palo Alto, California, United States

East Bay AIDS Center

🇺🇸

Oakland, California, United States

La Playa Medical Group and Clinical Research

🇺🇸

San Diego, California, United States

Metropolis Medical/Dr.Fritz

🇺🇸

San Francisco, California, United States

Kaiser Permanente Medical Center, San Francisco

🇺🇸

San Francisco, California, United States

Dupont Circle Physician's Group

🇺🇸

Washington, District of Columbia, United States

Community Research Initiative of New England

🇺🇸

Boston, Massachusetts, United States

Kaiser Permanente Medical Group

🇺🇸

Sacramento, California, United States

Hospital of the University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Philadelphia FIGHT

🇺🇸

Philadelphia, Pennsylvania, United States

The Brody School of Medicine at East Carolina University

🇺🇸

Greenville, North Carolina, United States

DCOL Center for Clinical Research

🇺🇸

Longview, Texas, United States

Chelsea and Westminster Hospital

🇬🇧

London, United Kingdom

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

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