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The Effect of Biktarvy (B/F/TAF) on Whole-body Insulin Sensitivity, Lipid and Endocrine Profile in Healthy Volunteers

Primary Purpose

HIV-1-infection

Status
Recruiting
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
BIKTARVY 50Mg-200Mg-25Mg Tablet
Sponsored by
Chelsea and Westminster NHS Foundation Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV-1-infection focused on measuring HIV, Insulin, Biktarvy

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Willing and able to provide informed consent
  • Cis-Male and Cis-Female healthy subjects without underlying conditions
  • Cis-Male and Cis-Female subjects with recruitment stratified to include at least 6 female subjects and at least 6 subjects of black Africa origin
  • Subjects must have documented negative HIV serology by ELISA and P24 antigen and not receiving anti-HIV pre-exposure prophylaxis (PreP)
  • Subjects must be clinically well volunteers aged between 18 to 60 years with BMI <30 kg/m2 but >18 kg/m2
  • Healthy, as determined by the investigator or medically qualified designee based on a medical evaluation, including medical history, physical examination, laboratory tests, and cardiac evaluation (including ECG)
  • Non-fasting blood glucose, total cholesterol and triglycerides within normal limits
  • Subjects should have complete blood count (FBC) with normal differential and platelet count
  • A female, may be eligible to enter and participate in the study if she:

    • is of non-child-bearing potential defined as either post-menopausal (12 months of spontaneous amenorrhea and ≥45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or,
    • is of child-bearing potential with a negative pregnancy test at both Screening and Day 1 and agrees to use one of the following methods of contraception to avoid pregnancy:
    • Complete abstinence from penile-vaginal intercourse. Abstinence is acceptable only as true abstinence when this is in line with the preferred and usual lifestyle of the participant;
    • Any intrauterine device with published data showing that the expected failure rate is <1% per year (not all intrauterine devices meet this criterion, see Appendix 6] for an example listing of approved intrauterine devices);
    • Male partner sterilization confirmed prior to the female subject's entry into the study, and this male is the sole partner for that subject;
    • Approved hormonal contraception (see Appendix 6] for a listing of examples of approved hormonal contraception)*;
    • Any other method with published data showing that the expected failure rate is <1% per year
  • Men who have partners who are women of childbearing potential (WOCBP - definition in Appendix 6) must be using an adequate method of contraception to avoid pregnancy in their partner throughout the study and for a period of at least 4 weeks after the study;
  • Complete abstinence from penile-vaginal intercourse. Abstinence is acceptable only as true abstinence when this is in line with the preferred and usual lifestyle of the patient;
  • Double barrier method (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide);
  • Any intrauterine device (IUD) with published data showing that the expected failure rate is <1% per year (not all IUDs meet this criterion, see Appendix 4 for an example listing of approved IUDs) plus male condom;
  • Sterilisation confirmed prior to the subject's entry into the study
  • Approved hormonal contraception used by female partner (see protocol appendix 4 for a listing of examples of approved hormonal contraception) plus male condom;
  • Any other method with published data showing that the expected failure rate is <1% per year and not containing hormones plus male condom.
  • Any contraception method must be used consistently, in accordance with the approved product label and for at least four weeks after discontinuation of IMP (Appendix 6).

Any contraception method must be used consistently, in accordance with the approved product label and for at least 28 days prior to the first dose of study medication and 4 weeks after discontinuing the study medication.

Exclusion Criteria:

  • Subjects with a waist hip ratio > 0.97 or BMI > 30kg/m2 and BMI <18 kg/m2 will be excluded
  • Acute or chronic hepatitis B infection (determined by positive hepatitis B surface antigen result at the screening visit)
  • Acute or chronic hepatitis C infection (determined by positive hepatitis C antibody result at the screening visit)
  • Diabetes mellitus, other metabolic syndrome or disease process in the opinion of the investigator likely to cause marked disturbance in glucose and lipid homeostasis including hypertension. Subject with HbA1c >42 mmol/mol will be excluded.
  • History or presence of allergy to the B/F/TAF
  • ALT greater than or equal to 1.5 x ULN and total bilirubin greater than or equal to 1.5 x ULN excluded;
  • Pregnancy and breastfeeding women
  • Alcohol consumption >10 units/week
  • Clinically relevant drug use (positive urine drug screen) or history of alcohol or drug use considered by the Investigator to be sufficient to hinder compliance with treatment, follow-up procedures or evaluation of adverse events. Smoking is permitted, but tobacco intake should remain consistent throughout the study.
  • Unable to refrain from the use of prescription (e.g., dofetilide) or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives prior to the baseline visit and throughout the study until the follow-up period, unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise participant safety.
  • This includes on-going therapy with any of the following

    • Metabolically active medications
    • Any lipid-lowering medication
    • Hormonal agents (oestrogens or androgens)
    • Glucocorticoids including inhaled steroids except for 'as necessary' use
    • Beta-blockers
    • Thiazide diuretics and indapamide
    • Thyroid preparations
    • Psychotropic agents
    • Anabolic steroids
    • Megestrol acetate
    • Dofetilide (or pilsicainide)

Sites / Locations

  • Chelsea & Westminster Hospital NHS Foundation TrustRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm 1

Arm 2

Arm Description

Biktarvy - one tablet once daily, orally administered for the first 28 days of the study. No treatment for the last 44 days of the study.

No treatment for the first 28 days of the study. Biktarvy - one tablet once daily, orally administered for the last 28 days of the study (day 44-72).

Outcomes

Primary Outcome Measures

Change in insulin sensitivity in participants from baseline to end of study between two crossover groups
Change in insulin sensitivity will be determined by peripheral glucose uptake using a euglycaemic clamp.

Secondary Outcome Measures

Effect of Biktarvy on adipocytokines
Fasting adiponectin and leptin levels in blood.
Effect of Biktarvy on fasting ghrelin
Fasting ghrelin levels in blood.
Effect of Biktarvy on pituitary hormones
Pituitary hormone function tests to measure blood levels of the following: Adrenocorticotrophic hormone (ACTH) Thyroid-stimulating hormone (TSH) Luteinising hormone (LH) Follicle-stimulating hormone (FSH) Prolactin (PRL) Melanocyte-stimulating hormone (MSH) Cortisol Insulin-like growth factors (IGFs)
Effect of Biktarvy on lipid profile including lipid fractions
Lipid profile in serum samples to measure blood levels of: Fasting cholesterol Triglycerides High-density lipoproteins (HDL) Low-density lipoproteins (LDL)
Effect of Biktarvy on changes in indirect calorimetry
Indirect calorimetry by ventilated hood expires gas analysis will be used to determine energy expenditure during the course of the clamp procedures.
Effect of Biktarvy on changes in food intake
Changes measured food diaries completed 3 days prior to each trial visit.
Effect of Biktarvy on quality of sleep
Changes measured through the Pittsburgh Sleep Quality Index (PSQI). Questionnaire score ranges 0-21, with higher score indicating poorer sleep quality.

Full Information

First Posted
June 24, 2021
Last Updated
May 3, 2023
Sponsor
Chelsea and Westminster NHS Foundation Trust
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1. Study Identification

Unique Protocol Identification Number
NCT04950530
Brief Title
The Effect of Biktarvy (B/F/TAF) on Whole-body Insulin Sensitivity, Lipid and Endocrine Profile in Healthy Volunteers
Official Title
The Effect of Biktarvy (B/F/TAF) on Whole-body Insulin Sensitivity, Lipid and Endocrine Profile in Healthy Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 22, 2022 (Actual)
Primary Completion Date
October 30, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chelsea and Westminster NHS Foundation Trust

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
This study will investigate changes in insulin sensitivity, lipid metabolism and endocrine profile in HIV-negative subjects exposed to Biktarvy (B/F/TAF) compared to subject not exposed to B/F/TAF for 28 days.
Detailed Description
A randomised, crossover study investigating the difference in changes in insulin sensitivity (determined by peripheral glucose uptake using a euglycaemic clamp) with the administration of Biktarvy (B/F/TAF) compared to no B/F/TAF for 28 days in HIV seronegative healthy volunteers. Group 1: B/F/TAF tablet once daily for the first 28 days of the study. No treatment for the last 44 days of the study. Group 2: No treatment for the first 28 days of the study. B/F/TAF tablet once daily for the last 28 days of the study (day 44-72). Research bloods, endocrine profiles, weight and urine samples will be collected at baseline, as well as day 28, 44, and 72 to enable comparative analyses. Participants will be closely monitored whilst taking the study medications. Participants will exit the study 72 days post-randomisation, with a follow-up call 28 days after exiting.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV-1-infection
Keywords
HIV, Insulin, Biktarvy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Model Description
Subjects will be randomised to start on Biktarvy tablet once daily OR no treatment for the first 28 day dosing phase of the study then will cross over to the alternative for the second dosing phase, following a 2 week washout period (equivalent to 5+ B/F/TAF elimination half-lives).
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Biktarvy - one tablet once daily, orally administered for the first 28 days of the study. No treatment for the last 44 days of the study.
Arm Title
Arm 2
Arm Type
Experimental
Arm Description
No treatment for the first 28 days of the study. Biktarvy - one tablet once daily, orally administered for the last 28 days of the study (day 44-72).
Intervention Type
Drug
Intervention Name(s)
BIKTARVY 50Mg-200Mg-25Mg Tablet
Other Intervention Name(s)
BIC/FTC/TAF, Bictegravir
Intervention Description
A three-drug fixed dose combination tablet containing 50mg of bictegravir, 200mg of emtricitabine, and 25mg of tenofovir alafenamide taken once daily, orally
Primary Outcome Measure Information:
Title
Change in insulin sensitivity in participants from baseline to end of study between two crossover groups
Description
Change in insulin sensitivity will be determined by peripheral glucose uptake using a euglycaemic clamp.
Time Frame
Baseline, day 28, 44, and 72 for both groups
Secondary Outcome Measure Information:
Title
Effect of Biktarvy on adipocytokines
Description
Fasting adiponectin and leptin levels in blood.
Time Frame
Baseline, day 28, 44, and 72 for both groups
Title
Effect of Biktarvy on fasting ghrelin
Description
Fasting ghrelin levels in blood.
Time Frame
Baseline, day 28, 44, and 72 for both groups
Title
Effect of Biktarvy on pituitary hormones
Description
Pituitary hormone function tests to measure blood levels of the following: Adrenocorticotrophic hormone (ACTH) Thyroid-stimulating hormone (TSH) Luteinising hormone (LH) Follicle-stimulating hormone (FSH) Prolactin (PRL) Melanocyte-stimulating hormone (MSH) Cortisol Insulin-like growth factors (IGFs)
Time Frame
Baseline, day 28, 44, and 72 for both groups
Title
Effect of Biktarvy on lipid profile including lipid fractions
Description
Lipid profile in serum samples to measure blood levels of: Fasting cholesterol Triglycerides High-density lipoproteins (HDL) Low-density lipoproteins (LDL)
Time Frame
Baseline, day 28, 44, and 72 for both groups
Title
Effect of Biktarvy on changes in indirect calorimetry
Description
Indirect calorimetry by ventilated hood expires gas analysis will be used to determine energy expenditure during the course of the clamp procedures.
Time Frame
Baseline, day 28, 44, and 72 for both groups
Title
Effect of Biktarvy on changes in food intake
Description
Changes measured food diaries completed 3 days prior to each trial visit.
Time Frame
Baseline, day 28, 44, and 72 for both groups
Title
Effect of Biktarvy on quality of sleep
Description
Changes measured through the Pittsburgh Sleep Quality Index (PSQI). Questionnaire score ranges 0-21, with higher score indicating poorer sleep quality.
Time Frame
Baseline, day 28, 44, and 72 for both groups

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Willing and able to provide informed consent Cis-Male and Cis-Female healthy subjects without underlying conditions Cis-Male and Cis-Female subjects with recruitment stratified to include at least 6 female subjects and at least 6 subjects of black Africa origin Subjects must have documented negative HIV serology by ELISA and P24 antigen and not receiving anti-HIV pre-exposure prophylaxis (PreP) Subjects must be clinically well volunteers aged between 18 to 60 years with BMI <30 kg/m2 but >18 kg/m2 Healthy, as determined by the investigator or medically qualified designee based on a medical evaluation, including medical history, physical examination, laboratory tests, and cardiac evaluation (including ECG) Non-fasting blood glucose, total cholesterol and triglycerides within normal limits Subjects should have complete blood count (FBC) with normal differential and platelet count A female, may be eligible to enter and participate in the study if she: is of non-child-bearing potential defined as either post-menopausal (12 months of spontaneous amenorrhea and ≥45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or, is of child-bearing potential with a negative pregnancy test at both Screening and Day 1 and agrees to use one of the following methods of contraception to avoid pregnancy: Complete abstinence from penile-vaginal intercourse. Abstinence is acceptable only as true abstinence when this is in line with the preferred and usual lifestyle of the participant; Any intrauterine device with published data showing that the expected failure rate is <1% per year (not all intrauterine devices meet this criterion, see Appendix 6] for an example listing of approved intrauterine devices); Male partner sterilization confirmed prior to the female subject's entry into the study, and this male is the sole partner for that subject; Approved hormonal contraception (see Appendix 6] for a listing of examples of approved hormonal contraception)*; Any other method with published data showing that the expected failure rate is <1% per year Men who have partners who are women of childbearing potential (WOCBP - definition in Appendix 6) must be using an adequate method of contraception to avoid pregnancy in their partner throughout the study and for a period of at least 4 weeks after the study; Complete abstinence from penile-vaginal intercourse. Abstinence is acceptable only as true abstinence when this is in line with the preferred and usual lifestyle of the patient; Double barrier method (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide); Any intrauterine device (IUD) with published data showing that the expected failure rate is <1% per year (not all IUDs meet this criterion, see Appendix 4 for an example listing of approved IUDs) plus male condom; Sterilisation confirmed prior to the subject's entry into the study Approved hormonal contraception used by female partner (see protocol appendix 4 for a listing of examples of approved hormonal contraception) plus male condom; Any other method with published data showing that the expected failure rate is <1% per year and not containing hormones plus male condom. Any contraception method must be used consistently, in accordance with the approved product label and for at least four weeks after discontinuation of IMP (Appendix 6). Any contraception method must be used consistently, in accordance with the approved product label and for at least 28 days prior to the first dose of study medication and 4 weeks after discontinuing the study medication. Exclusion Criteria: Subjects with a waist hip ratio > 0.97 or BMI > 30kg/m2 and BMI <18 kg/m2 will be excluded Acute or chronic hepatitis B infection (determined by positive hepatitis B surface antigen result at the screening visit) Acute or chronic hepatitis C infection (determined by positive hepatitis C antibody result at the screening visit) Diabetes mellitus, other metabolic syndrome or disease process in the opinion of the investigator likely to cause marked disturbance in glucose and lipid homeostasis including hypertension. Subject with HbA1c >42 mmol/mol will be excluded. History or presence of allergy to the B/F/TAF ALT greater than or equal to 1.5 x ULN and total bilirubin greater than or equal to 1.5 x ULN excluded; Pregnancy and breastfeeding women Alcohol consumption >10 units/week Clinically relevant drug use (positive urine drug screen) or history of alcohol or drug use considered by the Investigator to be sufficient to hinder compliance with treatment, follow-up procedures or evaluation of adverse events. Smoking is permitted, but tobacco intake should remain consistent throughout the study. Unable to refrain from the use of prescription (e.g., dofetilide) or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives prior to the baseline visit and throughout the study until the follow-up period, unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise participant safety. This includes on-going therapy with any of the following Metabolically active medications Any lipid-lowering medication Hormonal agents (oestrogens or androgens) Glucocorticoids including inhaled steroids except for 'as necessary' use Beta-blockers Thiazide diuretics and indapamide Thyroid preparations Psychotropic agents Anabolic steroids Megestrol acetate Dofetilide (or pilsicainide)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Research Delivery Operations Manager
Phone
020 3315 6825
Email
chelwest.research@nhs.net
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ana Milinkovic
Organizational Affiliation
Chelsea and Westminster Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Chelsea & Westminster Hospital NHS Foundation Trust
City
London
ZIP/Postal Code
SW10 9NH
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Research Project Manager
Phone
02033158209
Email
chelwest.research@nhs.net
First Name & Middle Initial & Last Name & Degree
Research & Operations manager
Phone
02033152560
Email
damon.foster2@nhs.net
First Name & Middle Initial & Last Name & Degree
Marta Boffito

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Effect of Biktarvy (B/F/TAF) on Whole-body Insulin Sensitivity, Lipid and Endocrine Profile in Healthy Volunteers

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