Study of Lenacapavir for HIV Pre-Exposure Prophylaxis in People Who Are at Risk for HIV Infection (PURPOSE 2)
Pre-Exposure Prophylaxis of HIV Infection
About this trial
This is an interventional treatment trial for Pre-Exposure Prophylaxis of HIV Infection
Eligibility Criteria
Key Inclusion Criteria:
Incidence Phase
- CGM, TGW, TGM, and GNB who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV infection.
- HIV-1 status unknown at screening and no prior HIV-1 testing within the last 3 months
Sexually active with ≥ 1 partner assigned male at birth (condomless receptive anal sex) in the last 12 months and 1 of the following:
- Condomless receptive anal sex with ≥ 2 partners in the last 12 weeks
- History of syphilis, rectal gonorrhea, or rectal chlamydia in the last 24 weeks
- Self-reported use of stimulants with sex in the last 12 weeks
Randomized Phase
- Negative local rapid fourth generation HIV-1/2 Ab/Ag, central fourth generation HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT)
- Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min at screening according to the Cockcroft-Gault formula for creatinine clearance (CLcr)
Key Exclusion Criteria:
Incidence Phase
- Prior use of oral PrEP (including F/TDF or F/TAF) in the past 12 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir)
- Prior recipient of an HIV vaccine or HIV broadly neutralizing antibody formulation
Randomized Phase
- Acute viral hepatitis A, B or C or evidence of chronic hepatitis B or C infection
- Severe hepatic impairment or a history of or current clinical decompensated liver cirrhosis
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Sites / Locations
- UAB Sexual Health Research ClinicRecruiting
- Valleywise Community Health Center - McDowellRecruiting
- Loma Linda University Clinical Trial Center ClinicRecruiting
- Ruane Clinical Research Group Inc.Recruiting
- UCLA CBAM Vine Street ClinicRecruiting
- Charles R. Drew University of Medicine and Science (CDU) - Clinical Translational Research Center (CTRC)Recruiting
- Mills Clinical ResearchRecruiting
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical CenterRecruiting
- Kaiser PermanenteRecruiting
- BIOS Clinical ResearchRecruiting
- One Community HealthRecruiting
- Kaiser-Permanente Medical CenterRecruiting
- UCSD Anti Viral Research CenterRecruiting
- Bridge HIV at the San Francisco Department of Public HealthRecruiting
- Optimus Medical GroupRecruiting
- San Francisco AIDS Foundation
- Kaiser PermanenteRecruiting
- University of Colorado Clinical and Translational Research Centers (CTRC)Recruiting
- Yale University, School of MedicineRecruiting
- Whitman-Walker Institute Inc.Recruiting
- Washington Health Institute
- CAN Community Health Clinic
- Therafirst Medical CenterRecruiting
- Gary Richmond, MD, PA
- Midway Immunology & Research Center, LLCRecruiting
- CAN Community Health Clinic
- CAN Community HealthRecruiting
- University of Miami Miller School of Medicine Division of Infectious Disease Research - Converge MiamiRecruiting
- Orlando Immunology CenterRecruiting
- CAN Community HealthRecruiting
- Triple O Research InstituteRecruiting
- The Hope Clinic at Emory UniversityRecruiting
- Emory UniversityRecruiting
- Emory University Hospital Midtown Infectious Disease ClinicRecruiting
- Mercer University, Department of Internal MedicineRecruiting
- RMR Core Center
- University of Illinois at Chicago, Department of Medicine, Division of Infectious Diseases, Project WISHRecruiting
- Howard Brown Health CenterRecruiting
- Indiana University Infectious Diseases ResearchRecruiting
- Baptist Health LexingtonRecruiting
- Norton Infectious Disease SpecialistsRecruiting
- LSU-CrescentCare Sexual Health Center- New Orleans Community Health CenterRecruiting
- Johns Hopkins University School of MedicineRecruiting
- The Fenway InstituteRecruiting
- Be Well Medical CenterRecruiting
- Henry Ford HospitalRecruiting
- Open Arms Healthcare CenterRecruiting
- KC CARE Health CenterRecruiting
- Huntridge Family Clinic
- St. Michael's Medical CenterRecruiting
- South Jersey Infectious DiseaseRecruiting
- Icahn School of Medicine at Mount Sinai- Mount Sinai DowntownRecruiting
- NC TraCS Institute - CTRC; University of North Carolina at Chapel HillRecruiting
- Cone Health/Regional Center for Infectious Disease Research CenterRecruiting
- Wake Forest University Health SciencesRecruiting
- University of CincinnatiRecruiting
- MetroHealth System
- The Ohio State University Wexner Medical CenterRecruiting
- Penn Prevention UnitRecruiting
- Philadelphia FIGHT Community Health Centers, Jonathan Lax Treatment CenterRecruiting
- Medical University of South Carolina, Infectious Disease ClinicRecruiting
- Prisma Health-Midlands Clinical Research UnitRecruiting
- Prisma Health Internal Medicine ClinicRecruiting
- Methodist University Hospital/University of Tennessee Health Science Center, Clinical Research CenterRecruiting
- St Jude Children's Research HospitalRecruiting
- Meharry Medical College Clinical and Transitional Research CenterRecruiting
- Central Texas Clinical ResearchRecruiting
- UT Southwestern Medical CenterRecruiting
- Centro San VincenteRecruiting
- UT Health Science Center at Houston
- The Crofoot Research Center, INCRecruiting
- Ofiice of Dr. Peter Shalit, MDRecruiting
- Hospital General de Agudos JM Ramos MejiaRecruiting
- Fundacion HuespedRecruiting
- Instituto de Investigaciones Clinicas Mar del PlataRecruiting
- Unidade de Pesquisa Clinica em Vacinas (UPqVac) da Faculdade de Medicina da UniversidadeRecruiting
- Fundação Bahiana de InfectologiaRecruiting
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado / Fundação Medicina Tropical do Amazonas - FMT/IMT/AMRecruiting
- Hospital General de Nova Iguaçu - HGNIRecruiting
- Grupo Hospitalar Conceição/ Hospital Nossa Senhora da Conceição S.A.Recruiting
- Instituto Nacional de Infectologia Evandro Chagas / Fundação Oswaldo Cruz - INI FIOCRUZRecruiting
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloRecruiting
- Centro de Referência e Treinamento DST/AIDSRecruiting
- Center for Management and Research. SPDM-Paulista Association for the Development of Medicine-Hospital São Paulo/FederalRecruiting
- Asociacion Civil Impacta Salud y Educacion - Sede BarrancoRecruiting
- Instituto de Medicina Tropical "Daniel Alcides Carrion", Facultad de Medicina Humana, UNMSMRecruiting
- Asociacion Civil Selva AmazonicaRecruiting
- Via LibreRecruiting
- Asociacion Civil Impacta Salud y Educacion - Sede San MiguelRecruiting
- Ararat Research CenterRecruiting
- Centro Ararat- San JuanRecruiting
- Maternal Infant Studies Center (CEMI)Recruiting
- Desmond Tutu Health FoundationRecruiting
- Wits Reproductive Health and HIV Institute (Wits RHI)Recruiting
- The Aurum Institute: Pretoria Clinical Research CentreRecruiting
- Setshaba Research CentreRecruiting
- The Aurum Institute Tembisa CRC, Clinic 4Recruiting
- FPD-DTHF Ndevana Commuity Research SiteRecruiting
- Institute of HIV Research and InnovationRecruiting
- King Chulalongkorn Memorial HospitalRecruiting
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS research CentreRecruiting
- Ramathibodi Hospital, Mahidol UniversityRecruiting
- Research Institute for Health Sciences, Chiang Mai UniversityRecruiting
- Srinagarind Hospital, Khon Kaen UniversityRecruiting
- Bamrasnaradura Infectious Disease InstituteRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF
Blinded Phase: Placebo LEN + F/TDF
LEN Open-Label Extension (OLE) Phase
PK Tail Phase
Participants will receive the following for at least 52 weeks: Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily Oral LEN 600 mg on Days 1 and 2 Participants will receive oral LEN if SC injections are not available
Participants will receive the following for at least 52 weeks: SC LEN placebo every 26 weeks Oral F/TDF 200/300 mg once daily PTM Oral LEN on Days 1 and 2 Participants will receive oral LEN placebo if SC injections are not available
After completion of the Blinded phase, participants will be offered entry into the LEN OLE Phase. Participants randomized to LEN will continue to receive SC LEN 927 mg every 26 weeks for a total of 2 doses. Participants randomized to F/TDF will receive SC LEN 927 mg on OLE Day 1, OLE Week 26, and will also receive oral LEN 600 mg on OLE Days 1 and 2.
At the completion of the LEN OLE phase, participants will transition into the PK Tail phase. Additionally, participants that prematurely discontinue the study drug during blinded phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase are also eligible to transition to the PK Tail Phase. Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks beginning 26 weeks after the last injection of LEN.