A Phase IIIb Study of the Safety, Efficacy, and Tolerability of Switching to a Fixed-dose Combination of Abacavir/Dolutegravir/ Lamivudine From Current Antiretroviral Regimen

Last updated: November 7, 2016
Sponsor: ViiV Healthcare
Overall Status: Completed

Phase

3

Condition

Hiv Infections

Hiv/aids

Aids And Aids Related Infections

Treatment

N/A

Clinical Study ID

NCT02105987
201147
  • Ages > 18
  • All Genders

Study Summary

This study is a 48-week, Phase IIIb, randomly assigned, open-label, active-controlled, multicenter, parallel group, non-inferiority study. This study is designed to demonstrate the non-inferior antiviral activity of switching to the Abacavir (ABC) 600 milligrams (mg)/Dolutegravir(DTG) 50 mg/Lamivudine (3TC) 300 mg fixed-dose combination (FDC) compared with continuing the subject's current suppressive regimen through 24 weeks. The study will be conducted in approximately 538 Human Immunodeficiency Virus -1 (HIV-1) infected individuals who are on stable suppressive combination antiretroviral therapy (cART) with 2 Nucleoside reverse transcriptase inhibitors (NRTIs) plus either a protease inhibitor (PI), an non-nucleoside reverse transcriptase inhibitor (NNRTI), or an integrase inhibitor (INI). Eligible subjects will be randomly assigned 1:1 to continue their current regimen (approximately 269 subjects) or be switched to ABC/DTG/3TC FDC (approximately 269 subjects) once daily for 24 weeks. At Week 24, individuals originally randomly assigned to continue their current regimen will switch to ABC/DTG/3TC FDC and be followed for an additional 24 weeks. Individuals initially randomly assigned to ABC/DTG/3TC FDC will continue on that treatment arm for an additional 24 weeks. A pharmacokinetic (PK) substudy will be conducted at a small number of sites (approximately 10) to evaluate predose DTG concentrations as well as residual drug concentrations of efavirenz (EFV), nevaripine (NVP), amprenavir (APV) and tipranavir (TPV) in a subgroup of subjects who switch from EFV, NVP, fosamprenavir/ritonavir (FPV/r) or tipranavir/ritonavir (TPV/r).

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Be able to understand and comply with protocol requirements, instructions, andrestrictions;

  • Be likely to complete the study as planned;

  • Be considered appropriate candidates for participation in an investigative clinicaltrial with oral medication (e.g., no active substance abuse, acute major organdisease, or planned long-term work assignments out of the country, etc.).

  • Signed and dated written informed consent is obtained from the subject or thesubject's legal representative prior to screening

  • HIV-1 infected men or women >=18 years of age;

  • A female may be eligible to enter and participate in the study if she: a. Is ofnon-childbearing potential either defined as post-menopausal (12 months of spontaneousamenorrhea and >=45 years of age) or physically incapable of becoming pregnant withdocumented tubal ligation, hysterectomy, or bilateral oophorectomy or,

  • A female may be eligible to enter and participate in the study if she: b. Is ofchildbearing potential with a negative pregnancy test at both Screening and Day 1 andagrees to use one of the following methods of contraception to avoid pregnancy:Complete abstinence from intercourse from 2 weeks prior to administration of studydrug, throughout the study, and for at least 2 weeks after discontinuation of allstudy drugs; Double barrier method (e.g., male condom/spermicide, malecondom/diaphragm, diaphragm/spermicide); Any intrauterine device (IUD) with publisheddata showing that the expected failure rate is <1% per year ; Male partnersterilization prior to the female subject's entry into the study and this male is thesole partner for that subject; Approved hormonal contraception for subjects randomlyassigned to the ABC/DTG/3TC arm or approved hormonal contraception plus a barriermethod for subjects assigned to continued antiretroviral therapy arm; Any other methodwith published data showing that the expected failure rate is <1% per year.

  • Any contraception method must be used consistently, in accordance with the approvedproduct label and for at least 2 weeks after discontinuation of study drug. Achildbearing potential female subject who starts the study using complete abstinenceas her contraceptive method and decides to become sexually active must use the doublebarrier method either as a bridge to an approved hormonal contraception (if possible)or as a method of choice to be maintained from that moment onwards.

  • All subjects participating in the study should be counselled on safer sexual practicesincluding the use of effective barrier methods (e.g., male condom/spermicide).

  • Within the last year, 2 consecutive plasma HIV-1 Ribonucleic acid (RNA) measurements <50 copies/millilitres (c/mL) and plasma HIV-1 RNA<50 c/mL at Screening (<75 bDeoxyribonucleic acid [bDNA] is considered equal to <50 c/mL); Subjects who present atinitial screening with a viral load between 50 to 200 c/mL can be retested once withinthe screening period.

  • Must be on current regimen (whether first or second line Combination antiretroviraltherapy [cART]) for at least 6 months prior to Screening;

  • Acceptable stable cART regimens prior to Screening include: • Boosted PI (orAtazanavir [ATV]) unboosted) + 2 NRTIs, NNRTI + 2 NRTIs, • INI + 2 NRTIs. For subjectson an INI, their INI at Screening must be RAL or Elvitegravir (EVG)

  • Any switch to a second line regimen, defined as change of a single drug or multipledrugs simultaneously, must have occurred due to tolerability and/or safety concerns.

  • Subject must have achieved plasma HIV-1 RNA level <50 c/mL within 6 months of start ofinitial cART regimen with no plasma HIV-1 RNA level >200 c/mL following initialsuppression;

  • Documentation that the subject is negative for the human leukocyte antigen (HLA)B*5701 allele;

Exclusion

Exclusion Criteria: Exclusionary Medical Conditions

  • Women who are breastfeeding;

  • Any evidence of an active (Centers for Disease Control and Prevention [CDC] CategoryC) disease. Exceptions include cutaneous Kaposi's sarcoma not requiring systemictherapy and historic CD4+ cell counts of <200 cells/cubic millimeter (mm).

  • Subjects with any degree of hepatic impairment;

  • Subjects positive for hepatitis B virus surface antigen (+HBsAg) at Screening or withan anticipated need for hepatitis C virus (HCV) therapy during the study;

  • History or presence of allergy to the study drugs or their components or drugs oftheir class;

  • Ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, orresected, non-invasive cutaneous squamous cell carcinoma, or cervical intraepithelialneoplasia; other localized malignancies require agreement between the investigator andthe study medical monitor for inclusion of the subject;

  • Subjects who, in the investigator's judgment, pose a significant suicidality risk.Recent history of suicidal behavior and/or suicidal ideation may be considered asevidence of serious suicide risk; Exclusionary Treatments Prior to Screening or Day 1

  • Treatment with an HIV-1 immunotherapeutic vaccine within 90 days of Screening;

  • Treatment with any of the following agents within 28 days of Screening: radiationtherapy, cytotoxic chemotherapeutic agents, any immunomodulators that alter immuneresponses;

  • Exposure to an experimental drug or experimental vaccine within either 28 days, 5half-lives of the test agent, or twice the duration of the biological effect of thetest agent, whichever is longer, prior to the first dose of study drug;

  • A history of use of only mono or dual NRTI therapy prior to starting cART;

  • Use of etravirine at time of switch;

  • Use of DTG at time of switch;

  • Subjects receiving any prohibited medication listed in the protocol and who areunwilling or unable to switch to an alternate medication Exclusionary Laboratory Values or Clinical Assessments at Screening

  • Evidence of primary viral resistance based on the presence of anyresistance-associated major PI or any NRTI, NNRTI, or INI mutation in any priorresistance genotype assay result;

  • Any verified Grade 4 laboratory abnormality, with the exception of Grade 4triglyceride abnormalities. A single repeat test is allowed during the screeningperiod to verify a result;

  • Any acute laboratory abnormality at Screening, which, in the opinion of theinvestigator, would preclude the subject's participation in the study of aninvestigational compound;

  • Alanine aminotransferase (ALT) >=5 times the upper limit of normal (ULN), or ALT >=3 ×ULN and bilirubin >=1.5 × ULN (with >35% direct bilirubin);

  • Subject has CrCl of <50 mL/min using Modification of Diet in Renal Disease (MDRD);

  • QTc (Bazett) >=450 msec or QTc (Bazett) >=480 msec for subjects with bundle branchblock. The QTc is the QT interval corrected for heart rate according to Bazett'sformula (QTcB). The QTc should be based on a single QTc value electrocardiogram (ECG)obtained.

  • Eligibility of subjects for study participation will be decided by the investigatorsafter taking into consideration various country specific guidelines, andnotwithstanding the above mentioned minimum inclusion and exclusion criteria.

Study Design

Total Participants: 555
Study Start date:
April 01, 2014
Estimated Completion Date:
December 31, 2015

Connect with a study center

  • GSK Investigational Site

    Calgary, Alberta T2R 0X7
    Canada

    Site Not Available

  • GSK Investigational Site

    Vancouver, British Columbia V6Z 2C7
    Canada

    Site Not Available

  • GSK Investigational Site

    Victoria, British Columbia V8W 1M8
    Canada

    Site Not Available

  • GSK Investigational Site

    Winnipeg, Manitoba R3A 1R9
    Canada

    Site Not Available

  • GSK Investigational Site

    Toronto, Ontario M5G 1K2
    Canada

    Site Not Available

  • GSK Investigational Site

    Montreal, Quebec H2L 5B1
    Canada

    Site Not Available

  • GSK Investigational Site

    Ponce, 00717-1567
    Puerto Rico

    Site Not Available

  • GSK Investigational Site

    Rio Piedras, 00935
    Puerto Rico

    Site Not Available

  • GSK Investigational Site

    San Juan, 00909
    Puerto Rico

    Site Not Available

  • GSK Investigational Site

    Phoenix, Arizona 85015
    United States

    Site Not Available

  • GSK Investigational Site

    Bakersfield, California 93301
    United States

    Site Not Available

  • GSK Investigational Site

    Beverly Hills, California 90211
    United States

    Site Not Available

  • GSK Investigational Site

    Long Beach, California 90813
    United States

    Site Not Available

  • GSK Investigational Site

    Los Angeles, California 90028
    United States

    Site Not Available

  • GSK Investigational Site

    Newport Beach, California 92663
    United States

    Site Not Available

  • GSK Investigational Site

    Oakland, California 94602
    United States

    Site Not Available

  • GSK Investigational Site

    Sacramento, California 95825
    United States

    Site Not Available

  • GSK Investigational Site

    San Diego, California 92103
    United States

    Site Not Available

  • GSK Investigational Site

    San Francisco, California 94118
    United States

    Site Not Available

  • GSK Investigational Site

    San Leandro, California 94577
    United States

    Site Not Available

  • GSK Investigational Site

    Torrance, California 90502
    United States

    Site Not Available

  • GSK Investigational Site

    Denver, Colorado 80205-5422
    United States

    Site Not Available

  • GSK Investigational Site

    Norwalk, Connecticut 06850
    United States

    Site Not Available

  • GSK Investigational Site

    Washington, District of Columbia 20036
    United States

    Site Not Available

  • GSK Investigational Site

    Fort Lauderdale, Florida 33316
    United States

    Site Not Available

  • GSK Investigational Site

    Fort Pierce, Florida 34982
    United States

    Site Not Available

  • GSK Investigational Site

    Jacksonville, Florida 32209
    United States

    Site Not Available

  • GSK Investigational Site

    Miami, Florida 33136
    United States

    Site Not Available

  • GSK Investigational Site

    Orlando, Florida 32803
    United States

    Site Not Available

  • GSK Investigational Site

    Pensacola, Florida 32504
    United States

    Site Not Available

  • GSK Investigational Site

    Tampa, Florida 33614
    United States

    Site Not Available

  • GSK Investigational Site

    Vero Beach, Florida 32960-6571
    United States

    Site Not Available

  • GSK Investigational Site

    West Palm Beach, Florida 33401
    United States

    Site Not Available

  • GSK Investigational Site

    Atlanta, Georgia 30339
    United States

    Site Not Available

  • GSK Investigational Site

    Augusta, Georgia 30912-3130
    United States

    Site Not Available

  • GSK Investigational Site

    Decatur, Georgia 30033
    United States

    Site Not Available

  • GSK Investigational Site

    Savannah, Georgia 31405
    United States

    Site Not Available

  • GSK Investigational Site

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • GSK Investigational Site

    Chicago, Illinois 60612
    United States

    Site Not Available

  • GSK Investigational Site

    Indianapolis, Indiana 46202
    United States

    Site Not Available

  • GSK Investigational Site

    Iowa City, Iowa 52242
    United States

    Site Not Available

  • GSK Investigational Site

    New Orleans, Louisiana 70121
    United States

    Site Not Available

  • GSK Investigational Site

    Springfield, Massachusetts 01105
    United States

    Site Not Available

  • GSK Investigational Site

    Ann Arbor, Michigan 48109
    United States

    Site Not Available

  • GSK Investigational Site

    Berkley, Michigan 48072
    United States

    Site Not Available

  • GSK Investigational Site

    Minneapolis, Minnesota 55415
    United States

    Site Not Available

  • GSK Investigational Site

    Kansas City, Missouri 64111
    United States

    Site Not Available

  • GSK Investigational Site

    Saint Louis, Missouri 63108
    United States

    Site Not Available

  • GSK Investigational Site

    St. Louis, Missouri 63110
    United States

    Site Not Available

  • GSK Investigational Site

    Las Vegas, Nevada 89031
    United States

    Site Not Available

  • GSK Investigational Site

    Camden, New Jersey 08103
    United States

    Site Not Available

  • GSK Investigational Site

    Hillsborough, New Jersey 08844
    United States

    Site Not Available

  • GSK Investigational Site

    Newark, New Jersey 07102
    United States

    Site Not Available

  • GSK Investigational Site

    Santa Fe, New Mexico 87505
    United States

    Site Not Available

  • GSK Investigational Site

    Bronx, New York 10467
    United States

    Site Not Available

  • GSK Investigational Site

    Buffalo, New York 14215
    United States

    Site Not Available

  • GSK Investigational Site

    Manhasset, New York 11030
    United States

    Site Not Available

  • GSK Investigational Site

    New York, New York 10001
    United States

    Site Not Available

  • GSK Investigational Site

    Valhalla, New York 10595
    United States

    Site Not Available

  • GSK Investigational Site

    Charlotte, North Carolina 28207
    United States

    Site Not Available

  • GSK Investigational Site

    Greensboro, North Carolina 27401
    United States

    Site Not Available

  • GSK Investigational Site

    Akron, Ohio 44304
    United States

    Site Not Available

  • GSK Investigational Site

    Cincinnati, Ohio 45267-0405
    United States

    Site Not Available

  • GSK Investigational Site

    Tulsa, Oklahoma 74127
    United States

    Site Not Available

  • GSK Investigational Site

    Allentown, Pennsylvania 18102
    United States

    Site Not Available

  • GSK Investigational Site

    Philadelphia, Pennsylvania 19107
    United States

    Site Not Available

  • GSK Investigational Site

    Pittsburgh, Pennsylvania 15212
    United States

    Site Not Available

  • GSK Investigational Site

    Charleston, South Carolina 29425
    United States

    Site Not Available

  • GSK Investigational Site

    Austin, Texas 78705
    United States

    Site Not Available

  • GSK Investigational Site

    Bellaire, Texas 77401
    United States

    Site Not Available

  • GSK Investigational Site

    Dallas, Texas 75246
    United States

    Site Not Available

  • GSK Investigational Site

    Fort Worth, Texas 76104
    United States

    Site Not Available

  • GSK Investigational Site

    Houston, Texas 77098
    United States

    Site Not Available

  • GSK Investigational Site

    Longview, Texas 75605
    United States

    Site Not Available

  • GSK Investigational Site

    Annandale, Virginia 22003
    United States

    Site Not Available

  • GSK Investigational Site

    Lynchburg, Virginia 24501
    United States

    Site Not Available

  • GSK Investigational Site

    Seattle, Washington 98104
    United States

    Site Not Available

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