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Study to Compare an Oral Weekly Islatravir/Lenacapavir Regimen With Bictegravir/Emtricitabine/Tenofovir Alafenamide in Virologically Suppressed People With HIV-1

Phase 3
Recruiting
Conditions
HIV-1-infection
Interventions
Drug: ISL/LEN
Drug: B/F/TAF
Drug: PTM B/F/TAF
Drug: PTM ISL/LEN
Registration Number
NCT06630286
Lead Sponsor
Gilead Sciences
Brief Summary

The goal of this clinical study is to learn about the safety and efficacy of switching to once weekly tablet of islatravir/lenacapavir (ISL/LEN) regimen versus continuing standard treatment of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with human immunodeficiency virus (PWH) who are virologically suppressed (HIV-1 RNA levels \< 50 copies/mL) on B/F/TAF for ≥ 6 months prior to screening.

The primary objective is to evaluate the efficacy of switching to oral weekly ISL/LEN tablet regimen versus continuing B/F/TAF in virologically suppressed PWH at Week 48.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
600
Inclusion Criteria
  • HIV-1 RNA < 50 copies/mL for ≥ 6 months before screening, as documented by:

    1. One HIV-1 RNA < 50 copies/mL immediately preceding the 24 week period prior to screening.
    2. Within 24 weeks prior to screening, if HIV-1 RNA results are available, all levels must be < 50 copies/mL.
    3. During the 6 to 12 months period prior to screening, transient detectable viremia ≥ 50 copies/mL is acceptable ("blip"), as long as it is not confirmed on 2 consecutive visits.
  • Plasma HIV-1 RNA levels < 50 copies/mL at screening.

  • Individuals are receiving B/F/TAF for ≥ 6 months prior to screening and willing to continue until Day 1.

  • Individuals assigned female at birth and of childbearing potential who engage in heterosexual intercourse must agree to use protocol-specified methods of contraception.

Key

Exclusion Criteria
  • Prior virologic failure.

  • Prior use of, or exposure to ISL or LEN.

  • Active, serious infections requiring parenteral therapy within 30 days before randomization.

  • Active tuberculosis infection.

  • Acute hepatitis within 30 days before randomization.

  • Hepatitis B virus (HBV) infection as determined below at the screening visit:

    1. Positive HBV surface antigen OR
    2. Positive HBV core antibody and negative HBV surface antibody. Note: individuals found to be susceptible to HBV infection (eg negative hepatitis B surface antibody at the screening visit, regardless of prior HBV vaccination history) should be recommended to receive HBV vaccination.
  • Active hepatitis C virus (HCV) coinfection, defined as detectable HCV RNA. Note: individuals with prior/inactive HCV infection (defined as undetectable HCV RNA) may be enrolled.

  • Any of the following laboratory values at screening:

    1. Creatinine clearance (CLcr) ≤ 30 mL/min according to the Cockcroft-Gault formula
    2. Alanine aminotransferase > 5 x upper limit of normal (ULN)
    3. Direct bilirubin > 1.5 x ULN
    4. Platelets < 50,000/μL
    5. Hemoglobin < 8.0 g/dL

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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Blinded Phase: ISL/LEN + Placebo-to-Match (PTM) B/F/TAFISL/LENParticipants will receive an initial dose of ISL/LEN (Dose A), followed by once weekly ISL/LEN (Dose B) from Day 8 onwards up to Week 96. Participants will also receive PTM B/F/TAF once daily from Day 1 up to Week 96.
Blinded Phase: ISL/LEN + Placebo-to-Match (PTM) B/F/TAFPTM B/F/TAFParticipants will receive an initial dose of ISL/LEN (Dose A), followed by once weekly ISL/LEN (Dose B) from Day 8 onwards up to Week 96. Participants will also receive PTM B/F/TAF once daily from Day 1 up to Week 96.
Blinded Phase: PTM ISL/LEN + B/F/TAFB/F/TAFParticipants will receive an initial dose of PTM ISL/LEN (Dose A), followed by once weekly PTM ISL/LEN (Dose B) from Day 8 onwards up to Week 96. Participants will also receive B/F/TAF (50/200/25 mg) once daily up from Day 1 up to Week 96.
Blinded Phase: PTM ISL/LEN + B/F/TAFPTM ISL/LENParticipants will receive an initial dose of PTM ISL/LEN (Dose A), followed by once weekly PTM ISL/LEN (Dose B) from Day 8 onwards up to Week 96. Participants will also receive B/F/TAF (50/200/25 mg) once daily up from Day 1 up to Week 96.
Open- Label Extension (OLE) PhaseISL/LENAfter the end of Blinded Phase at Week 96, if safety and efficacy of ISL/LEN are demonstrated following review of unblinded data, all participants will be given an option to enter the open-label extension phase to receive ISL/LEN in an extension phase until ISL/LEN becomes available or until the sponsor elects to discontinue the study, whichever occurs first. Participants receiving ISL/LEN and PTM B/F/TAF during the blinded phase will continue to take ISL/LEN weekly. Participants receiving B/F/TAF and PTM ISL/LEN during the blinded phase will take an initial dose of ISL/LEN (Dose A), followed by once weekly ISL/LEN (Dose B) from Day 8 onwards.
Primary Outcome Measures
NameTimeMethod
Proportion of Participants with HIV-1 RNA ≥ 50 Copies/mL at Week 48 as Determined by the United States (US) Food and Drug Administration (FDA)-Defined Snapshot AlgorithmWeek 48
Secondary Outcome Measures
NameTimeMethod
Proportion of Participants With HIV-1 RNA ≥ 50 Copies/mL at Week 96 as Determined by the US FDA-Defined Snapshot AlgorithmWeek 96
Proportion of Participants with HIV-1 RNA < 50 Copies/mL at Weeks 48 as Determined by the US FDA-Defined Snapshot AlgorithmWeek 48
Proportion of Participants with HIV-1 RNA < 50 Copies/mL at Weeks 96 as Determined by the US FDA-Defined Snapshot AlgorithmWeek 96
Change From Baseline in Cluster of Differentiation 4 (CD4) T-Cell Count at Weeks 48Week 48
Change From Baseline in CD4 T-Cell Count at Weeks 96Week 96
Proportion of Participants Discontinuing ISL/LEN due to Treatment-Emergent Adverse Events (TEAEs)Day 1 up to Week 48

Trial Locations

Locations (103)

EPIMED GmbHGesellschaft fur klinische und epidemiologische Forschung in Berlin

🇩🇪

Berlin, Germany

University Hospital Bonn, Medizinische und Poliklink I, Immunologische Studienambulanz

🇩🇪

Bonn, Germany

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Pueblo Family Physicians

🇺🇸

Phoenix, Arizona, United States

Kaiser Permanente Southern California

🇺🇸

Los Angeles, California, United States

Ruane Clinical Research Group, Inc

🇺🇸

Los Angeles, California, United States

Mills Clinical Research

🇺🇸

Los Angeles, California, United States

BIOS Clinical Research

🇺🇸

Palm Springs, California, United States

Optimus Medical Group

🇺🇸

San Francisco, California, United States

Vivent Health

🇺🇸

Denver, Colorado, United States

University of Colorado- Anschutz Medical Campus - PPDS

🇺🇸

Denver, Colorado, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

Georgetown University

🇺🇸

Washington, District of Columbia, United States

Whitman-Walker Health

🇺🇸

Washington, District of Columbia, United States

CAN Community Health

🇺🇸

Sarasota, Florida, United States

Midway Immunology and Research Center

🇺🇸

Fort Pierce, Florida, United States

Midland Research Group, Inc.

🇺🇸

Oakland Park, Florida, United States

Orlando Immunology Center

🇺🇸

Orlando, Florida, United States

AHF (AIDS Healthcare Foundation) - Pensacola Research

🇺🇸

Pensacola, Florida, United States

St. Josephs Comprehensive Research Institute

🇺🇸

Tampa, Florida, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Infectious Disease Specialists of Atlanta

🇺🇸

Decatur, Georgia, United States

Chiba University Hospital

🇯🇵

Chiba, Japan

Mercer University

🇺🇸

Macon, Georgia, United States

Chatham CARE Center

🇺🇸

Savannah, Georgia, United States

Howard Brown Health

🇺🇸

Chicago, Illinois, United States

Indiana University School of Medicine

🇺🇸

Indianapolis, Indiana, United States

The Brigham and Women's Hospital, Inc.

🇺🇸

Boston, Massachusetts, United States

Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Community Research Initiative

🇺🇸

Boston, Massachusetts, United States

Be Well Medical Center

🇺🇸

Berkley, Michigan, United States

Trinity Health

🇺🇸

Grand Rapids, Michigan, United States

KC CARE Health Center

🇺🇸

Kansas City, Missouri, United States

ID CARE

🇺🇸

Hillsborough, New Jersey, United States

Saint Michael's Medical Center

🇺🇸

Newark, New Jersey, United States

South Jersey Infectious Disease

🇺🇸

Somers Point, New Jersey, United States

AXCES Research Group - Albuquerque

🇺🇸

Santa Fe, New Mexico, United States

Jacobi Medical Center

🇺🇸

Bronx, New York, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

Brooklyn Clinical Research Center

🇺🇸

Brooklyn, New York, United States

New York Presbyterian Hospital

🇺🇸

Flushing, New York, United States

CTRC University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Atrium Health Infectious Disease Kenilworth

🇺🇸

Charlotte, North Carolina, United States

Duke University

🇺🇸

Durham, North Carolina, United States

Brody School of Medicine at East Carolina University Adult Specialty Care

🇺🇸

Greenville, North Carolina, United States

Rosedale Health and Wellness

🇺🇸

Huntersville, North Carolina, United States

University of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

MetroHealth Medical Center

🇺🇸

Cleveland, Ohio, United States

Ohio State University

🇺🇸

Columbus, Ohio, United States

Prisma Health/USC

🇺🇸

Columbia, South Carolina, United States

Central Texas Clinical Research

🇺🇸

Austin, Texas, United States

North Texas Infectious Diseases Consultants

🇺🇸

Dallas, Texas, United States

AXCES Research Group, LLC

🇺🇸

Salt Lake City, Utah, United States

Texas Centers for Infectious Disease Associates

🇺🇸

Fort Worth, Texas, United States

The Crofoot Research Center, INC.

🇺🇸

Houston, Texas, United States

DCOL Center for Clinical Research

🇺🇸

Longview, Texas, United States

Clinical Alliance for Research & Education - Infectious Diseases, LLC (CARE-ID)

🇺🇸

Annandale, Virginia, United States

Peter Shalit MD

🇺🇸

Seattle, Washington, United States

MultiCare Institute for Research & Innovation

🇺🇸

Spokane, Washington, United States

University of Wisconsin-Madison

🇺🇸

Madison, Wisconsin, United States

Fundacion Huesped

🇦🇷

Buenos Aires, Argentina

Helios Salud S.A.

🇦🇷

Buenos Aires, Argentina

East Sydney Doctors

🇦🇺

Darlinghurst, New South Wales, Australia

St Vincent's Hospital

🇦🇺

Darlinghurst, New South Wales, Australia

Taylor Square Private Clinic

🇦🇺

Surry Hills, New South Wales, Australia

Monash Health

🇦🇺

Clayton, Victoria, Australia

Prahran Market Private Clinic

🇦🇺

South Yarra, Victoria, Australia

Clinique de médecine Urbaine du Quartier Latin

🇨🇦

Montreal, Canada

McGill University Health Centr

🇨🇦

Montreal, Canada

Spectrum Health

🇨🇦

Vancouver, Canada

CHU Bordeaux - Hopital Saint André

🇫🇷

Bourdeaux, France

AP-HP-Hopital Bicétre

🇫🇷

Le Kremlin Bicetre, France

Assistance Publique Hopitaux de Marseille - Hopital Sainte Marguerite

🇫🇷

Marseile, France

CHU Nice - Hopital Archet I

🇫🇷

Nice, France

University of the Ryukyus Hospital

🇯🇵

Okinawa, Japan

University of Puerto Rico School of Medicine

🇵🇷

San Juan, Puerto Rico

Inselspital

🇨🇭

Bern, Switzerland

Universitatsmedizin Essen, Universitatsklinikum Essen, Klinik Dermatologie, Venerologie und Allergologie,, HPSTD-Ambulanz

🇩🇪

Essen, Germany

Tokyo Medical University Hospital

🇯🇵

Tokyo, Japan

Centre Hospitalier Universitaire Vaudois

🇨🇭

Lausanne, Switzerland

Universitaetsspital Zuerich

🇨🇭

Zurich, Switzerland

ICH Study Center GmbH & Co.KG

🇩🇪

Hamburg, Germany

Uniklinik Kéin, Innere Medizin |, Klinisches Studienzentrum Infektiologle, Clinical Trials Unit for Infectious Diseases(CTU-ID), ISZ Geb. 80

🇩🇪

Köln, Germany

National Center for Global Health and Medicine

🇯🇵

Tokyo, Japan

Clinical Research Puerto Rico

🇵🇷

San Juan, Puerto Rico

Hospital Universitario Regional de Malaga

🇪🇸

Málaga, Spain

National Hospital Organization Nagoya Medical Center

🇯🇵

Nagoya, Japan

National Hospital Organization Osaka National Hospital

🇯🇵

Osaka Fu, Japan

Osaka City General Hospital

🇯🇵

Osaka-City, Japan

Hospital Universitario Vall d' Hebron

🇪🇸

Barcelona, Spain

Hospital Clinic Barcelona

🇪🇸

Barcelona, Spain

Complexo Hospitalario Universitario da Coruna

🇪🇸

La Coruña, Spain

Kaohsuing Medical University Hospital

🇨🇳

Kaohsiung, Taiwan

Kaohsuing Veterans General Hospital

🇨🇳

Kaohsiung, Taiwan

Far Eastern Memorial Hospital

🇨🇳

New Taipei City, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei City, Taiwan

Taoyuan General Hospital

🇨🇳

Taoyuan City, Taiwan

Hawthorn House, Birmingham Heartlands Hospital (University Hospitals Birmingham NHS Foundation Trust)

🇬🇧

Birmingham, United Kingdom

Clinical Research Facility (University Hospitals Sussex NHS Foundation Trust)

🇬🇧

Brighton, United Kingdom

Grahame Hayton Unit, Ambrose King Centre, Royal London Hospital (Barts Health NHS Trust)

🇬🇧

London, United Kingdom

Royal Free Hospital (Royal Free London NHS Foundation Trust)

🇬🇧

London, United Kingdom

Clinical Research Facility, 1st Floor, St Stephen's Centre, Chelsea and Westminster Hospital (Chelsea and Westminster Hospital NHS Foundation Trust)

🇬🇧

London, United Kingdom

Mortimer Market Centre (Central and North West London NHS Foundation Trust)

🇬🇧

London, United Kingdom

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