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Switching From a Tenofovir Disoproxil Fumarate (TDF) Containing Regimen to Elvitegravir/Cobicistat/Emtricitabine/ Tenofovir Alafenamide (E/C/F/TAF) Fixed-Dose Combination (FDC) in Virologically-Suppressed, HIV-1 Infected Adults Aged ≥ 60 Years

Primary Purpose

HIV-1 Infection

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
E/C/F/TAF
TDF
FTC
FTC/TDF
3TC
Third agent
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1 Infection focused on measuring HIV 1 Infection, HIV, Virologically-Suppressed

Eligibility Criteria

60 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • Currently receiving a TDF and FTC or 3TC-containing 'backbone' (maximum 2 NRTIs) regimen plus a third agent for ≥ 6 consecutive months prior to screening visit. For individuals with 3 or more ART regimens, a regimen history must be provided for approval by the Sponsor.

Refer to assigned interventions for allowed third agents of the current regimen.

  • Documented plasma HIV-1 RNA levels < 50 copies/mL for ≥ 6 months preceding the screening visit (measured at least twice using the same assay). In the preceding 6 months prior to screening, one episode of "blip" (HIV-1 RNA > 50 and < 400 copies/mL) is acceptable, only if HIV-1 RNA is < 50 copies/mL immediately before and after the "blip".
  • Plasma HIV-1 RNA level < 50 copies/mL at screening visit
  • Adequate renal function
  • Estimated glomerular filtration rate ≥ 30 mL/min according to the Cockcroft-Gault formula (eGFRCG) and are on ARVs that are appropriately dose adjusted for renal function per package insert
  • All documented historical plasma genotype(s) must not show resistance to TDF or FTC, including, but not limited to the presence of reverse transcriptase resistance mutations K65R, K70E, M184V/I, or thymidine analog-associated mutations (TAMs) that include M41L, L210W, D67N, K70R, T215Y/F, K219Q/E/N/R. If historical plasma prior to first ART is not available or individual has 3 or more ART regimens, individuals will have proviral genotype analysis prior to Day 1 to confirm absence of archived resistance to TDF or FTC.
  • Study performed dual energy x-ray absorptiometry (DXA) scan and T-score received prior to Day 1

Key Exclusion Criteria:

  • Previous use of any approved or experimental integrase strand transfer inhibitor (INSTI) (for any length of time) if the current regimen contains a PI/r
  • Individuals will have no evidence of previous virologic failure on a PI/r or INSTI-based regimen (with or without resistance to either class of ARV)
  • A new AIDS-defining condition diagnosed within the 30 days prior to screening (except CD4+ cell count and/or percentage criteria)
  • Hepatitis C virus that would require therapy during the study
  • Individuals receiving ongoing treatment for bone disease (eg, osteoporosis), including bisphosphonates, denosumab, and strontium ranelate

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

Sites / Locations

  • CHU Saint-Pierre University Hospital
  • University Hospital Gent
  • CHU - Groupe Saint-Andre
  • CHU de Dijon
  • Hopital Europeen Marseille
  • C.H.U. de Nantes
  • C.H.U. de NICE
  • Hopital Saint Louis
  • Hopital Saint Antoine
  • CHU Hotel Dieu
  • Hopital Necker les Enfants Malades
  • Hopital Haut-Leveque
  • Service des Maladies Infectieuses et du Voyageur
  • Azienda Ospedaliera Papa Giovanni XXIII
  • Busto Arsizio Hospital
  • IRCCS A.O.U. San Martino
  • Azienda Ospedaliera Luigi Sacco
  • Azienda Ospedaliero Universitaria Policlinico di Modena
  • U.O. Malattie Infettive
  • Istituto Nazionale Malattie Infettive Lazzaro Spallanzani I.R.C.C.S.
  • Azienda Ospedaliero Universitaria di Sassari
  • Dipartimento di Malattie Infettive e Tropicali
  • Hospital Clinic de Barcelona
  • Hospital de la Santa Creu i Sant Pau
  • Hospital Universitari Germans Trias i Pujol
  • Hospital Vall d'Hebron
  • Hospital 12 de Octubre
  • Hospital General Universitario Gregorio Maranon
  • Hospital Universitario La Paz
  • Ramon Y Cajal University Hospital
  • Hospital Costa Del Sol
  • Hospital General Universitario de Valencia
  • Royal Victoria Hospital
  • Mortimer Market Centre
  • Newcastle Royal Victoria Infirmary

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

E/C/F/TAF

Remain current regimen

Arm Description

Participants will switch from tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) or 3TC plus a third agent to E/C/F/TAF and will receive treatment for 48 weeks.

Participants will remain on current TDF and FTC (or FTC/TDF) or 3TC plus continuing third agent.

Outcomes

Primary Outcome Measures

Percent Change From Baseline to Week 48 in Spine BMD
Percent Change From Baseline to Week 48 in Hip BMD

Secondary Outcome Measures

Percent Change From Baseline to Week 24 in Spine BMD
Percent Change From Baseline to Week 24 in Hip BMD
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 24 as Defined by the US FDA-Defined Snapshot Algorithm
The percentage of participants with HIV-1 RNA < 50 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 48 as Defined by the US FDA-Defined Snapshot Algorithm
The percentage of participants with HIV-1 RNA < 50 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Change From Baseline in CD4+ Cell Count at Week 24
Change in Baseline in CD4+ Cell Count at Week 48

Full Information

First Posted
November 23, 2015
Last Updated
February 18, 2020
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT02616783
Brief Title
Switching From a Tenofovir Disoproxil Fumarate (TDF) Containing Regimen to Elvitegravir/Cobicistat/Emtricitabine/ Tenofovir Alafenamide (E/C/F/TAF) Fixed-Dose Combination (FDC) in Virologically-Suppressed, HIV-1 Infected Adults Aged ≥ 60 Years
Official Title
A Phase 3b, Randomized, Open-Label Study to Evaluate Switching From a Tenofovir Disoproxil Fumarate (TDF) Containing Regimen to Elvitegravir/Cobicistat/Emtricitabine/ Tenofovir Alafenamide (E/C/F/TAF) Fixed-Dose Combination (FDC) in Virologically-Suppressed, HIV-1 Infected Subjects Aged ≥ 60 Years
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
December 22, 2015 (Actual)
Primary Completion Date
February 21, 2018 (Actual)
Study Completion Date
March 21, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to evaluate the safety of elvitegravir/cobicistat/emtricitabine/ tenofovir alafenamide (E/C/F/TAF) relative to unchanged current antiretroviral therapy (ART) by assessing spine and hip bone mineral density (BMD) measured at Week 48 in virologically-suppressed, HIV-1 infected participants aged ≥ 60 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1 Infection
Keywords
HIV 1 Infection, HIV, Virologically-Suppressed

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
167 (Actual)

8. Arms, Groups, and Interventions

Arm Title
E/C/F/TAF
Arm Type
Experimental
Arm Description
Participants will switch from tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) or 3TC plus a third agent to E/C/F/TAF and will receive treatment for 48 weeks.
Arm Title
Remain current regimen
Arm Type
Active Comparator
Arm Description
Participants will remain on current TDF and FTC (or FTC/TDF) or 3TC plus continuing third agent.
Intervention Type
Drug
Intervention Name(s)
E/C/F/TAF
Other Intervention Name(s)
Genvoya®
Intervention Description
150/150/200/10 mg FDC tablet administered orally once daily
Intervention Type
Drug
Intervention Name(s)
TDF
Other Intervention Name(s)
Viread®
Intervention Description
300 mg tablet administered orally once daily
Intervention Type
Drug
Intervention Name(s)
FTC
Other Intervention Name(s)
Emtriva®
Intervention Description
200 mg capsule administered orally once daily
Intervention Type
Drug
Intervention Name(s)
FTC/TDF
Other Intervention Name(s)
Truvada®
Intervention Description
200/300 mg tablet administered orally once daily
Intervention Type
Drug
Intervention Name(s)
3TC
Other Intervention Name(s)
Lamivudine, Epivir®
Intervention Description
Tablet administered orally
Intervention Type
Drug
Intervention Name(s)
Third agent
Intervention Description
Third agent may include one of the following regimens: lopinavir+ritonavir (LPV/r; Kaletra®), atazanavir (ATV; Reyataz®) + ritonavir (RTV; Norvir®), ATV + cobicistat (COBI;Tybost®) (or ATV/COBI FDC), DRV + RTV, darunavir (DRV; Prezista®) + COBI (or DRV/COBI FDC), fosamprenavir (FPV; Lexiva®) + RTV , saquinavir (SQV; Invirase®; Fortovase®) + RTV, efavirenz (EFV;Sustiva®), rilpivirine (RPV;Edurant®), nevirapine (NVP;Viramune®), etravirine (ETR;Intelence®), raltegravir (RAL; Isentress®), elvitegravir (EVG) + COBI, or dolutegravir (DTG;Tivicay®) Drug classes: Protease inhibitors (PI): LPV/r, ATV, RTV, ATV, DRV, FPV, and SQV Pharmacokinetic enhancer: COBI Non-nucleoside reverse transcriptase inhibitors (NNRTI): EFV, RPV, NVP, and ETR Integrase inhibitors: RAL and DTG
Primary Outcome Measure Information:
Title
Percent Change From Baseline to Week 48 in Spine BMD
Time Frame
Baseline; Week 48
Title
Percent Change From Baseline to Week 48 in Hip BMD
Time Frame
Baseline; Week 48
Secondary Outcome Measure Information:
Title
Percent Change From Baseline to Week 24 in Spine BMD
Time Frame
Baseline; Week 24
Title
Percent Change From Baseline to Week 24 in Hip BMD
Time Frame
Baseline; Week 24
Title
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 24 as Defined by the US FDA-Defined Snapshot Algorithm
Description
The percentage of participants with HIV-1 RNA < 50 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Time Frame
Week 24
Title
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 48 as Defined by the US FDA-Defined Snapshot Algorithm
Description
The percentage of participants with HIV-1 RNA < 50 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Time Frame
Week 48
Title
Change From Baseline in CD4+ Cell Count at Week 24
Time Frame
Baseline; Week 24
Title
Change in Baseline in CD4+ Cell Count at Week 48
Time Frame
Baseline; Week 48

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Currently receiving a TDF and FTC or 3TC-containing 'backbone' (maximum 2 NRTIs) regimen plus a third agent for ≥ 6 consecutive months prior to screening visit. For individuals with 3 or more ART regimens, a regimen history must be provided for approval by the Sponsor. Refer to assigned interventions for allowed third agents of the current regimen. Documented plasma HIV-1 RNA levels < 50 copies/mL for ≥ 6 months preceding the screening visit (measured at least twice using the same assay). In the preceding 6 months prior to screening, one episode of "blip" (HIV-1 RNA > 50 and < 400 copies/mL) is acceptable, only if HIV-1 RNA is < 50 copies/mL immediately before and after the "blip". Plasma HIV-1 RNA level < 50 copies/mL at screening visit Adequate renal function Estimated glomerular filtration rate ≥ 30 mL/min according to the Cockcroft-Gault formula (eGFRCG) and are on ARVs that are appropriately dose adjusted for renal function per package insert All documented historical plasma genotype(s) must not show resistance to TDF or FTC, including, but not limited to the presence of reverse transcriptase resistance mutations K65R, K70E, M184V/I, or thymidine analog-associated mutations (TAMs) that include M41L, L210W, D67N, K70R, T215Y/F, K219Q/E/N/R. If historical plasma prior to first ART is not available or individual has 3 or more ART regimens, individuals will have proviral genotype analysis prior to Day 1 to confirm absence of archived resistance to TDF or FTC. Study performed dual energy x-ray absorptiometry (DXA) scan and T-score received prior to Day 1 Key Exclusion Criteria: Previous use of any approved or experimental integrase strand transfer inhibitor (INSTI) (for any length of time) if the current regimen contains a PI/r Individuals will have no evidence of previous virologic failure on a PI/r or INSTI-based regimen (with or without resistance to either class of ARV) A new AIDS-defining condition diagnosed within the 30 days prior to screening (except CD4+ cell count and/or percentage criteria) Hepatitis C virus that would require therapy during the study Individuals receiving ongoing treatment for bone disease (eg, osteoporosis), including bisphosphonates, denosumab, and strontium ranelate Note: Other protocol defined Inclusion/ Exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilead Study Director
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
Facility Name
CHU Saint-Pierre University Hospital
City
Brussels
Country
Belgium
Facility Name
University Hospital Gent
City
Ghent
Country
Belgium
Facility Name
CHU - Groupe Saint-Andre
City
Bordeaux
Country
France
Facility Name
CHU de Dijon
City
Dijon
Country
France
Facility Name
Hopital Europeen Marseille
City
Marseille
Country
France
Facility Name
C.H.U. de Nantes
City
Nantes
Country
France
Facility Name
C.H.U. de NICE
City
Nice
Country
France
Facility Name
Hopital Saint Louis
City
Paris cedex 10
Country
France
Facility Name
Hopital Saint Antoine
City
Paris cedex 12
Country
France
Facility Name
CHU Hotel Dieu
City
Paris
Country
France
Facility Name
Hopital Necker les Enfants Malades
City
Paris
Country
France
Facility Name
Hopital Haut-Leveque
City
Pessac, Cedex
Country
France
Facility Name
Service des Maladies Infectieuses et du Voyageur
City
Tourcoing
Country
France
Facility Name
Azienda Ospedaliera Papa Giovanni XXIII
City
Bergamo
Country
Italy
Facility Name
Busto Arsizio Hospital
City
Busto Arsizio
Country
Italy
Facility Name
IRCCS A.O.U. San Martino
City
Genova
Country
Italy
Facility Name
Azienda Ospedaliera Luigi Sacco
City
Milano
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria Policlinico di Modena
City
Modena
Country
Italy
Facility Name
U.O. Malattie Infettive
City
Pescara
Country
Italy
Facility Name
Istituto Nazionale Malattie Infettive Lazzaro Spallanzani I.R.C.C.S.
City
Roma
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria di Sassari
City
Sassari
Country
Italy
Facility Name
Dipartimento di Malattie Infettive e Tropicali
City
Torino
Country
Italy
Facility Name
Hospital Clinic de Barcelona
City
Barcelona
Country
Spain
Facility Name
Hospital de la Santa Creu i Sant Pau
City
Barcelona
Country
Spain
Facility Name
Hospital Universitari Germans Trias i Pujol
City
Barcelona
Country
Spain
Facility Name
Hospital Vall d'Hebron
City
Barcelona
Country
Spain
Facility Name
Hospital 12 de Octubre
City
Madrid
Country
Spain
Facility Name
Hospital General Universitario Gregorio Maranon
City
Madrid
Country
Spain
Facility Name
Hospital Universitario La Paz
City
Madrid
Country
Spain
Facility Name
Ramon Y Cajal University Hospital
City
Madrid
Country
Spain
Facility Name
Hospital Costa Del Sol
City
Marbella
Country
Spain
Facility Name
Hospital General Universitario de Valencia
City
Valencia
Country
Spain
Facility Name
Royal Victoria Hospital
City
Belfast
Country
United Kingdom
Facility Name
Mortimer Market Centre
City
London
Country
United Kingdom
Facility Name
Newcastle Royal Victoria Infirmary
City
Newcastle Upon Tyne
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified external researchers may request IPD for this study after study completion. For more information, please visit our website at https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy.
IPD Sharing Time Frame
18 months after study completion
IPD Sharing Access Criteria
A secured external environment with username, password, and RSA code.
IPD Sharing URL
https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy
Citations:
PubMed Identifier
31578954
Citation
Maggiolo F, Rizzardini G, Raffi F, Pulido F, Mateo-Garcia MG, Molina JM, Ong E, Shao Y, Piontkowsky D, Das M, McNicholl I, Haubrich R. Bone mineral density in virologically suppressed people aged 60 years or older with HIV-1 switching from a regimen containing tenofovir disoproxil fumarate to an elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide single-tablet regimen: a multicentre, open-label, phase 3b, randomised trial. Lancet HIV. 2019 Oct;6(10):e655-e666. doi: 10.1016/S2352-3018(19)30195-X.
Results Reference
derived

Learn more about this trial

Switching From a Tenofovir Disoproxil Fumarate (TDF) Containing Regimen to Elvitegravir/Cobicistat/Emtricitabine/ Tenofovir Alafenamide (E/C/F/TAF) Fixed-Dose Combination (FDC) in Virologically-Suppressed, HIV-1 Infected Adults Aged ≥ 60 Years

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