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Pharmacokinetic Study of Dapivirine Gel Administered Rectally to HIV-1 Seronegative Adults

Primary Purpose

HIV Infections

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Dapivirine gel
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infections

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Men and transgender women who are 18 years or older at Screening, verified per site standard operating procedure (SOP)
  • Able and willing to provide written informed consent
  • HIV-1/2 uninfected at Screening and Enrollment, per applicable algorithm in Appendix II of the study protocol and willing to receive HIV test results
  • Able and willing to provide adequate locator information, as defined in site SOP
  • Available to return for all study visits and willing to comply with study participation requirements
  • In general good health at Screening and Enrollment, as determined by the site Investigator of Record (IoR) or designee
  • At Screening, history of consensual receptive anal intercourse (RAI) at least once in the past year per participant report
  • Willing not to take part in other research studies involving drugs, medical devices, genital or rectal products, or vaccines for the duration of study participation (including the time between Screening and Enrollment)
  • Willing to abstain from RAI, receptive oral anal stimulation (i.e., rimming), rectal stimulation via fingers, as well as the insertion of any non-study products into the rectum for 72 hours before and after each study visit

Exclusion Criteria:

  • At Screening:

    • Hemoglobin Grade 1 or higher*
    • Platelet count Grade 1 or higher*
    • White blood count Grade 2 or higher*
    • Aspartate aminotransferase (AST) or alanine transaminase (ALT) Grade 1 or higher*
    • Serum creatinine greater than 1.3 times the site laboratory upper limit of normal (ULN)
    • International normalized ratio (INR) greater than 1.5 times the site laboratory ULN
    • Positive for hepatitis C antibody
    • Positive for hepatitis B surface antigen
    • History of inflammatory bowel disease by participant report
    • (*As per the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events Corrected Version 2.1, July 2017)
    • Note: Otherwise eligible participants with an exclusionary test result (other than HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV)) can be re-tested during the screening process. If a participant is re-tested and a non-exclusionary result is documented within 30 days of providing informed consent for screening, the participant may be enrolled.
  • Known adverse reaction to latex or polyurethane (ever)
  • Anticipated use of and/or unwillingness to abstain from the following medications during study participation:

    • Anticoagulant medications
    • Aspirin (greater than 81 mg/day)
    • Non-steroidal anti-inflammatory drugs (NSAIDS)
    • Any other drugs that are associated with increased likelihood of bleeding
    • Rectally-administered medications or products containing nonoxynol-9 (N-9) or corticosteroids
    • CYP3A inducer(s) and/or inhibitor(s) as specified in the MTN-033 Study Specific Procedures (SSP) Manual
    • Hormone-replacement therapy in tablet, patch, injectable or gel form
  • Known adverse reaction to any of the components of the study product, applicator or coital simulation device
  • Use of pre-exposure prophylaxis (PrEP) for HIV prevention within 1 month prior to Enrollment, and/or anticipated use and/or unwillingness to abstain from PrEP during trial participation
  • Use of post-exposure prophylaxis (PEP) for potential HIV exposure within the 6 months prior to Enrollment
  • Use of systemic immunomodulatory medications within the 6 months prior to Enrollment, and/or anticipated use during trial participation
  • RAI without a condom and/or penile-vaginal intercourse with a partner who is known to be HIV-positive in the 6 months prior to Enrollment
  • Non-therapeutic injection drug use in the 12 months prior to Enrollment
  • Participation in research studies involving drugs, medical devices, genital or rectal products, or vaccines within 30 days of the Enrollment Visit
  • Per participant report at Screening, treatment of an anogenital sexually transmitted infection (STI) (after diagnosis) within the past 3 months
  • At Screening, participant-reported symptoms, and/or clinical or laboratory diagnosis of active anorectal or reproductive tract infection (RTI) requiring treatment per current CDC guidelines (http://www.cdc.gov/std/treatment) or symptomatic urinary tract infection (UTI). Infections requiring treatment include symptomatic Neisseria gonorrhea (GC), Chlamydia trachomatis (CT) infection, syphilis, active herpes simplex virus (HSV) lesions, anogenital sores or ulcers, or symptomatic genital warts, chancroid, trichomoniasis.

    • Note: Otherwise eligible participants with an exclusionary UTI may be re-tested during the screening process.
  • At Enrollment, active anorectal infection or RTI requiring treatment per current CDC guidelines (http://www.cdc.gov/std/treatment) or symptomatic UTI. Infections requiring treatment include symptomatic GC, CT, syphilis, active HSV lesions, anogenital sores or ulcers, symptomatic genital warts, trichomoniasis, chancroid.

    • Note: HSV-1 or HSV-2 seropositive diagnosis with no active lesions is permitted since treatment is not required.
  • Has any other condition that, in the opinion of the IoR/designee, would preclude informed consent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving study objectives.

Sites / Locations

  • University of Pittsburgh CRS

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Sequence A: Dapivirine gel

Sequence B: Dapivirine gel

Arm Description

Participants will receive 2.5 g of dapivirine gel administered rectally via an applicator, followed by a 2- to 4-week washout period. Participants will then receive a second dose of up to 10 g of dapivirine gel administered rectally via a coital simulation device.

Participants will receive up to 10 g of dapivirine gel administered rectally via a coital simulation device, followed by a 2- to 4-week washout period. Participants will then receive a second dose of 2.5 g of dapivirine gel administered rectally via an applicator.

Outcomes

Primary Outcome Measures

Measurement of dapivirine concentrations in rectal fluid
As assessed by pharmacokinetic sampling and analysis
Measurement of dapivirine concentrations in plasma
As assessed by pharmacokinetic sampling and analysis
Measurement of dapivirine concentrations in rectal mucosal tissue homogenates
As assessed by pharmacokinetic sampling and analysis

Secondary Outcome Measures

Frequency of Grade 2 or higher adverse events (AEs)
As defined by the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017 and/or Addenda 2 and 3 (Male Genital [Dated November 2007] and Rectal [Clarification Dated May 2012] Grading Tables for Use in Microbicide Studies)

Full Information

First Posted
January 2, 2018
Last Updated
October 15, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03393468
Brief Title
Pharmacokinetic Study of Dapivirine Gel Administered Rectally to HIV-1 Seronegative Adults
Official Title
An Open Label Randomized Phase 1 Pharmacokinetic Study of Dapivirine Gel Administered Rectally to HIV-1 Seronegative Adults
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
May 10, 2018 (Actual)
Primary Completion Date
December 3, 2018 (Actual)
Study Completion Date
December 3, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the pharmacokinetics of dapivirine gel administered rectally to HIV-1 seronegative adults.
Detailed Description
This study will evaluate the pharmacokinetics (PK) of dapivirine gel administered rectally to HIV-1 seronegative adults. Participants will be randomly assigned to two groups: Sequence A or Sequence B. Participants in Sequence A will receive 2.5 g of dapivirine gel administered rectally via an applicator, followed by a 2- to 4-week washout period. Participants will then receive a second dose of up to 10 g of dapivirine gel administered rectally via a coital simulation device. Participants in Sequence B will receive up to 10 g of dapivirine gel administered rectally via a coital simulation device, followed by a 2- to 4-week washout period. Participants will then receive a second dose of 2.5 g of dapivirine gel administered rectally via an applicator. Participants will be in the study for approximately 1 month and will attend 7 study visits. Study visits may include behavioral assessments, physical examinations, blood and urine collection, throat and anorectal sample collection, and PK sampling.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sequence A: Dapivirine gel
Arm Type
Experimental
Arm Description
Participants will receive 2.5 g of dapivirine gel administered rectally via an applicator, followed by a 2- to 4-week washout period. Participants will then receive a second dose of up to 10 g of dapivirine gel administered rectally via a coital simulation device.
Arm Title
Sequence B: Dapivirine gel
Arm Type
Experimental
Arm Description
Participants will receive up to 10 g of dapivirine gel administered rectally via a coital simulation device, followed by a 2- to 4-week washout period. Participants will then receive a second dose of 2.5 g of dapivirine gel administered rectally via an applicator.
Intervention Type
Drug
Intervention Name(s)
Dapivirine gel
Intervention Description
Dapivirine gel (0.05%); administered rectally
Primary Outcome Measure Information:
Title
Measurement of dapivirine concentrations in rectal fluid
Description
As assessed by pharmacokinetic sampling and analysis
Time Frame
Measured through approximately 1 month
Title
Measurement of dapivirine concentrations in plasma
Description
As assessed by pharmacokinetic sampling and analysis
Time Frame
Measured through approximately 1 month
Title
Measurement of dapivirine concentrations in rectal mucosal tissue homogenates
Description
As assessed by pharmacokinetic sampling and analysis
Time Frame
Measured through approximately 1 month
Secondary Outcome Measure Information:
Title
Frequency of Grade 2 or higher adverse events (AEs)
Description
As defined by the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017 and/or Addenda 2 and 3 (Male Genital [Dated November 2007] and Rectal [Clarification Dated May 2012] Grading Tables for Use in Microbicide Studies)
Time Frame
Measured through approximately 1 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Men and transgender women who are 18 years or older at Screening, verified per site standard operating procedure (SOP) Able and willing to provide written informed consent HIV-1/2 uninfected at Screening and Enrollment, per applicable algorithm in Appendix II of the study protocol and willing to receive HIV test results Able and willing to provide adequate locator information, as defined in site SOP Available to return for all study visits and willing to comply with study participation requirements In general good health at Screening and Enrollment, as determined by the site Investigator of Record (IoR) or designee At Screening, history of consensual receptive anal intercourse (RAI) at least once in the past year per participant report Willing not to take part in other research studies involving drugs, medical devices, genital or rectal products, or vaccines for the duration of study participation (including the time between Screening and Enrollment) Willing to abstain from RAI, receptive oral anal stimulation (i.e., rimming), rectal stimulation via fingers, as well as the insertion of any non-study products into the rectum for 72 hours before and after each study visit Exclusion Criteria: At Screening: Hemoglobin Grade 1 or higher* Platelet count Grade 1 or higher* White blood count Grade 2 or higher* Aspartate aminotransferase (AST) or alanine transaminase (ALT) Grade 1 or higher* Serum creatinine greater than 1.3 times the site laboratory upper limit of normal (ULN) International normalized ratio (INR) greater than 1.5 times the site laboratory ULN Positive for hepatitis C antibody Positive for hepatitis B surface antigen History of inflammatory bowel disease by participant report (*As per the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events Corrected Version 2.1, July 2017) Note: Otherwise eligible participants with an exclusionary test result (other than HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV)) can be re-tested during the screening process. If a participant is re-tested and a non-exclusionary result is documented within 30 days of providing informed consent for screening, the participant may be enrolled. Known adverse reaction to latex or polyurethane (ever) Anticipated use of and/or unwillingness to abstain from the following medications during study participation: Anticoagulant medications Aspirin (greater than 81 mg/day) Non-steroidal anti-inflammatory drugs (NSAIDS) Any other drugs that are associated with increased likelihood of bleeding Rectally-administered medications or products containing nonoxynol-9 (N-9) or corticosteroids CYP3A inducer(s) and/or inhibitor(s) as specified in the MTN-033 Study Specific Procedures (SSP) Manual Hormone-replacement therapy in tablet, patch, injectable or gel form Known adverse reaction to any of the components of the study product, applicator or coital simulation device Use of pre-exposure prophylaxis (PrEP) for HIV prevention within 1 month prior to Enrollment, and/or anticipated use and/or unwillingness to abstain from PrEP during trial participation Use of post-exposure prophylaxis (PEP) for potential HIV exposure within the 6 months prior to Enrollment Use of systemic immunomodulatory medications within the 6 months prior to Enrollment, and/or anticipated use during trial participation RAI without a condom and/or penile-vaginal intercourse with a partner who is known to be HIV-positive in the 6 months prior to Enrollment Non-therapeutic injection drug use in the 12 months prior to Enrollment Participation in research studies involving drugs, medical devices, genital or rectal products, or vaccines within 30 days of the Enrollment Visit Per participant report at Screening, treatment of an anogenital sexually transmitted infection (STI) (after diagnosis) within the past 3 months At Screening, participant-reported symptoms, and/or clinical or laboratory diagnosis of active anorectal or reproductive tract infection (RTI) requiring treatment per current CDC guidelines (http://www.cdc.gov/std/treatment) or symptomatic urinary tract infection (UTI). Infections requiring treatment include symptomatic Neisseria gonorrhea (GC), Chlamydia trachomatis (CT) infection, syphilis, active herpes simplex virus (HSV) lesions, anogenital sores or ulcers, or symptomatic genital warts, chancroid, trichomoniasis. Note: Otherwise eligible participants with an exclusionary UTI may be re-tested during the screening process. At Enrollment, active anorectal infection or RTI requiring treatment per current CDC guidelines (http://www.cdc.gov/std/treatment) or symptomatic UTI. Infections requiring treatment include symptomatic GC, CT, syphilis, active HSV lesions, anogenital sores or ulcers, symptomatic genital warts, trichomoniasis, chancroid. Note: HSV-1 or HSV-2 seropositive diagnosis with no active lesions is permitted since treatment is not required. Has any other condition that, in the opinion of the IoR/designee, would preclude informed consent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving study objectives.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ken Ho, MD
Organizational Affiliation
University of Pittsburgh
Official's Role
Study Chair
Facility Information:
Facility Name
University of Pittsburgh CRS
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States

12. IPD Sharing Statement

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Pharmacokinetic Study of Dapivirine Gel Administered Rectally to HIV-1 Seronegative Adults

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