A Clinical Trial to Evaluate the Efficacy and Safety of Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide as a First-line Treatment in Naïve Patients With HIV-1 Infection With Severe Immunosuppression (GENIS)
Primary Purpose
HIV Infections, Severe Immunosuppression
Status
Completed
Phase
Phase 4
Locations
Spain
Study Type
Interventional
Intervention
Genvoya®
Sponsored by

About this trial
This is an interventional treatment trial for HIV Infections
Eligibility Criteria
Inclusion Criteria:
- Patients able to give their written consent to participate in the study after having received information about the design, the purposes of the study, the possible risks that may arise from it and the possibility of withdrawing from it at any time. moment
- Adult patients (age ≥18 years) of both sexes
- Patients with HIV-1 infection with severe immunosuppression, defined by a concentration of CD4 + lymphocytes <200 cells / μL
- Patients who are allowed to perform a genotypic resistance test to inhibitors of intregrase, emtricitabine or tenofovir
- Creatinine clearance ≥ 30 ml / min before the start of treatment
- Alanine transaminase (ALT) / Aspartate transaminase (AST) levels not higher than five times normal levels, total bilirubin with normal values, neutrophils> 1000 cells / μL,> 50000 platelets / μL,> Hb level of 85 g / L and serum amylase levels <1 , 5 times higher normal limit before the start of treatment
Exclusion Criteria:
- Patient who undergoes a concomitant treatment not allowed. Patient with documented intolerance or hypersensitivity to the study medication, or who is contraindicated to use it, attending a technical file
- Patient receiving therapies with interferon, interleukin 2, cytotoxic chemotherapy or immunosuppressants at the baseline visit.
- Patients with neoplasms, an exception of skin cancer and anus cancer in situ (stage 0)
- Patient with any medical or psychological, sociological or geographical alteration, toxic habit (drugs, alcohol) that, a criterion of the researcher, may interfere in the fulfillment of the study by the patient. These conditions will be discussed with the patient before their inclusion in the trial
- Patients with any medical or psychological alteration that, a criterion of the investigator, an involuntary factor of the patient's ability to understand and complement the questionnaires and scales used in the study
- Patient in a treatment with any type of drug / product under investigation or who is participating in a clinical trial that uses a product under investigation, with the exception of studies in which the study treatment was completed more than 12 weeks ago
- Pregnant women, in breastfeeding period or with a positive pregnancy test in the selection period; women of childbearing age and sexually active who are not willing to use an adequate contraceptive method during the study and up to 3 months after the administration of the last dose of study treatment. Some women in adulthood have undergone permanent infertility procedures or amenorrheic procedures for less than 12 months
- Patients with severe hepatic impairment (Child-Pugh Class C).
Sites / Locations
- Hospital Costa del Sol
- H. Ramón y Cajal
- H. Clínico San Carlos
- H. Doce de Octubre
- Hospital Infanta Leonor
- Hospital virgen del Rocío
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Arm 1
Arm Description
Naive HIV patients with severe immunosuppression.
Outcomes
Primary Outcome Measures
Percentage of patients with undetectable plasma viral load
study the effectiveness of the combination of TAF/FTC/EVG-cb
Secondary Outcome Measures
Proportion of patients with virological failure
Proportion of patients with Plasma viral load of HIV-1 RNA ≥50 copies / mL in the last measurement while the patient receives the treatment in the window period, patients who interrupt the treatment prematurely due to lack / loss of efficacy in which the last viral load was ≥50 copies / mL or in which the antiretroviral treatment was modified before 48 weeks.
Proportion of patients with virological failure
Proportion of patients who interrupt the treatment prematurely due to absence or loss of efficacy
Proportion of patients with virological failure
Proportion of patients who interrupt the treatment prematurely by others reasons (other than an adverse event, death or loss of effectiveness) and whose last viral load at the time of abandonment was ≥50 copies / mL.
Time to virological suppression
viral load <50 copies / mL
Proportion of patients with virological failure while receiving antiretroviral treatment (ART), having previously been suppressed .
virological failure defined by protocol as viral load> 1000 copies / mL at week 24 or 2 consecutive viral loads> 50 copies / mL (at least 2 weeks apart)
Time to virological failure
Viral load ≥50 copias/mL
Incidence of genotypic resistance in patients with virological failure
Changes in viral load
plasma concentration of HIV RNA
Change in the CD4+ lymphocyte count
Proportion of patients who have a CD4+ lymphocyte count > 200 cells / μL
Mean time to reach a CD4 + lymphocyte count> 200 cells / μL
Full Information
NCT ID
NCT03693508
First Posted
October 1, 2018
Last Updated
August 6, 2020
Sponsor
Fundacion SEIMC-GESIDA
Collaborators
Merck Sharp & Dohme LLC
1. Study Identification
Unique Protocol Identification Number
NCT03693508
Brief Title
A Clinical Trial to Evaluate the Efficacy and Safety of Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide as a First-line Treatment in Naïve Patients With HIV-1 Infection With Severe Immunosuppression
Acronym
GENIS
Official Title
Phase IV, Open, Multicentre, Single-arm Study to Evaluate the Efficacy and Safety of Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide as a First-line Treatment in Naïve Patients With HIV-1 Infection With Severe Immunosuppression.
Study Type
Interventional
2. Study Status
Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
April 13, 2018 (Actual)
Primary Completion Date
May 28, 2020 (Actual)
Study Completion Date
May 28, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fundacion SEIMC-GESIDA
Collaborators
Merck Sharp & Dohme LLC
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Phase IV, open, multicentre and single-arm study. 50 HIV infection naive patients with severe immunosuppression will be recruited to evaluate the efficacy and safety of elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide as a first-line treatment.
Detailed Description
The patients included in the study will be treated during 48 weeks and will have to perform the selection/basal visit, week 4 visit, week 8 visit, week 12 visit, week 24 visit, week 48 visit and follow up visit.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections, Severe Immunosuppression
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Model Description
Single arm, phase 4 study. The naive patients will be treated with elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide as a first-line treatment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Naive HIV patients with severe immunosuppression.
Intervention Type
Drug
Intervention Name(s)
Genvoya®
Other Intervention Name(s)
TAF/FTC/EVG-cb
Intervention Description
Patents treated with elvitegravir (EVG) 150mg / cobicistat (COBI) 150mg / emtricitabine (FTC) 200mg / tenofovir (TAF) 10mg once a day as the first line treatment.
Primary Outcome Measure Information:
Title
Percentage of patients with undetectable plasma viral load
Description
study the effectiveness of the combination of TAF/FTC/EVG-cb
Time Frame
Week 48
Secondary Outcome Measure Information:
Title
Proportion of patients with virological failure
Description
Proportion of patients with Plasma viral load of HIV-1 RNA ≥50 copies / mL in the last measurement while the patient receives the treatment in the window period, patients who interrupt the treatment prematurely due to lack / loss of efficacy in which the last viral load was ≥50 copies / mL or in which the antiretroviral treatment was modified before 48 weeks.
Time Frame
From basal until week 48
Title
Proportion of patients with virological failure
Description
Proportion of patients who interrupt the treatment prematurely due to absence or loss of efficacy
Time Frame
From basal visit until week 48
Title
Proportion of patients with virological failure
Description
Proportion of patients who interrupt the treatment prematurely by others reasons (other than an adverse event, death or loss of effectiveness) and whose last viral load at the time of abandonment was ≥50 copies / mL.
Time Frame
From basal visit until week 48
Title
Time to virological suppression
Description
viral load <50 copies / mL
Time Frame
From basal until week 48
Title
Proportion of patients with virological failure while receiving antiretroviral treatment (ART), having previously been suppressed .
Description
virological failure defined by protocol as viral load> 1000 copies / mL at week 24 or 2 consecutive viral loads> 50 copies / mL (at least 2 weeks apart)
Time Frame
From basal until week 48
Title
Time to virological failure
Description
Viral load ≥50 copias/mL
Time Frame
From basal until week 48
Title
Incidence of genotypic resistance in patients with virological failure
Time Frame
From basal until week 48
Title
Changes in viral load
Description
plasma concentration of HIV RNA
Time Frame
Weeks 4, 8, 12, 24, 36 and 48
Title
Change in the CD4+ lymphocyte count
Time Frame
Week 48
Title
Proportion of patients who have a CD4+ lymphocyte count > 200 cells / μL
Time Frame
Week 48
Title
Mean time to reach a CD4 + lymphocyte count> 200 cells / μL
Time Frame
From basal until week 48
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients able to give their written consent to participate in the study after having received information about the design, the purposes of the study, the possible risks that may arise from it and the possibility of withdrawing from it at any time. moment
Adult patients (age ≥18 years) of both sexes
Patients with HIV-1 infection with severe immunosuppression, defined by a concentration of CD4 + lymphocytes <200 cells / μL
Patients who are allowed to perform a genotypic resistance test to inhibitors of intregrase, emtricitabine or tenofovir
Creatinine clearance ≥ 30 ml / min before the start of treatment
Alanine transaminase (ALT) / Aspartate transaminase (AST) levels not higher than five times normal levels, total bilirubin with normal values, neutrophils> 1000 cells / μL,> 50000 platelets / μL,> Hb level of 85 g / L and serum amylase levels <1 , 5 times higher normal limit before the start of treatment
Exclusion Criteria:
Patient who undergoes a concomitant treatment not allowed. Patient with documented intolerance or hypersensitivity to the study medication, or who is contraindicated to use it, attending a technical file
Patient receiving therapies with interferon, interleukin 2, cytotoxic chemotherapy or immunosuppressants at the baseline visit.
Patients with neoplasms, an exception of skin cancer and anus cancer in situ (stage 0)
Patient with any medical or psychological, sociological or geographical alteration, toxic habit (drugs, alcohol) that, a criterion of the researcher, may interfere in the fulfillment of the study by the patient. These conditions will be discussed with the patient before their inclusion in the trial
Patients with any medical or psychological alteration that, a criterion of the investigator, an involuntary factor of the patient's ability to understand and complement the questionnaires and scales used in the study
Patient in a treatment with any type of drug / product under investigation or who is participating in a clinical trial that uses a product under investigation, with the exception of studies in which the study treatment was completed more than 12 weeks ago
Pregnant women, in breastfeeding period or with a positive pregnancy test in the selection period; women of childbearing age and sexually active who are not willing to use an adequate contraceptive method during the study and up to 3 months after the administration of the last dose of study treatment. Some women in adulthood have undergone permanent infertility procedures or amenorrheic procedures for less than 12 months
Patients with severe hepatic impairment (Child-Pugh Class C).
Facility Information:
Facility Name
Hospital Costa del Sol
City
Marbella
State/Province
Malaga
Country
Spain
Facility Name
H. Ramón y Cajal
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Facility Name
H. Clínico San Carlos
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
H. Doce de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Hospital Infanta Leonor
City
Madrid
Country
Spain
Facility Name
Hospital virgen del Rocío
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Clinical Trial to Evaluate the Efficacy and Safety of Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide as a First-line Treatment in Naïve Patients With HIV-1 Infection With Severe Immunosuppression
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