Phase 3 Open-Label Study to Evaluate Switching From Optimized Stable Antiretroviral Regimens Containing Darunavir to Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide (E/C/F/TAF) Fixed Dose Combination (FDC) Plus Darunavir (DRV) in Treatment Experienced HIV-1 Positive Adults
HIV-1, HIV Infections, Acquired Immunodeficiency Syndrome
About this trial
This is an interventional treatment trial for HIV-1 focused on measuring HIV-1, HIV, Treatment-Experienced
Eligibility Criteria
Key Inclusion Criteria:
- Ability to understand and sign a written informed consent form
- History of at least two prior antiretroviral regimens, and history of resistance to at least two different classes of antiretroviral agents
- Plasma HIV-1 RNA levels < 50 copies/mL at screening. Virologically suppressed on the current antiretroviral regimen containing darunavir 600 mg twice a day or 800 mg once daily continuously for ≥ 4 months preceding the screening visit and have maintained documented undetectable plasma HIV-1 RNA levels (< 50 copies/mL) and must have documentation of genotype/phenotype prior to current regimen which shows no darunavir associated resistance mutation.
- Currently receiving raltegravir, elvitegravir, or dolutegravir (50 mg once daily, but not twice daily), or have never received integrase inhibitor, or have documentation of genotype/phenotype within 12 months prior to current regimen which must show no evidence of resistance to integrase inhibitors
- Normal ECG
- Estimated glomerular filtration rate (eGFR) ≥ 50 mL/min according to the Cockcroft Gault formula for creatinine clearance
- Hepatic transaminases (AST and ALT) ≤ 5 × upper limit of normal (ULN)
- Total bilirubin ≤ 1.5 mg/dL, or normal direct bilirubin
- Adequate hematologic function (absolute neutrophil count ≥ 1,000/mm^3; platelets ≥ 50,000/mm^3; hemoglobin ≥ 8.5 g/dL)
- Serum amylase ≤ 5 × ULN (individuals with serum amylase > 5 × ULN will remain eligible if serum lipase is ≤ 5 × ULN)
A female individual is eligible to enter the study if it is confirmed that she is:
- Not pregnant or nursing
- Of non-childbearing potential (i.e., women who have had a hysterectomy, have had both ovaries removed or medically documented ovarian failure, or are postmenopausal women > 54 years of age with cessation (for ≥ 12 months) of previously occurring menses), or
- Of childbearing potential and agrees to utilize highly effective contraception methods or be non-heterosexually active or practice sexual abstinence from screening throughout the duration of study treatment and for 30 days following the last study drug dose.
- Female individuals who utilize hormonal contraceptive as one of their birth control methods must have used the same method for at least three months prior to study dosing.
- Male individuals must agree to utilize a highly effective method of contraception during heterosexual intercourse or be non-heterosexually active, or practice sexual abstinence from first dose throughout the study period and for 30 days following the last study drug dose.
- Male individuals must agree to refrain from sperm donation from first dose until at least 30 days after the last study drug dose.
Key Exclusion Criteria:
- A new AIDS-defining condition diagnosed within the 30 days prior to screening (except CD4 cell count and/or percentage criteria)
- Hepatitis B surface antigen (HBsAg) positive
- Individuals receiving drug treatment for Hepatitis C, or individuals who are anticipated to receive treatment for Hepatitis C during the course of the study.
- Must not have Q151M, T69ins, or > 3 thymidine analogue mutations (TAMS) present on documented historic genotype report
- Individuals experiencing decompensated cirrhosis
- Females who are breastfeeding
- Positive serum pregnancy test
- Have an implanted defibrillator or pacemaker
- Current alcohol or substance use that may interfere with individual's study compliance
- A history of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma (KS), basal cell carcinoma, or resected, non-invasive cutaneous squamous carcinoma.
- Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to Day 1 visit
- Any other clinical condition or prior therapy that would make the individual unsuitable for the study or unable to comply with dosing requirements
- Participation in any other clinical trial (including observational trials) without prior approval from the sponsor is prohibited while participating in this trial
- Individuals receiving ongoing therapy with any of the disallowed medications, including drugs not to be used with elvitegravir, cobicistat, emtricitabine, TAF, or DRV; or individuals with any known allergies to the study drugs.
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Sites / Locations
- Pueblo Family Physicians, Ltd.
- Pacific Oaks Medical Group
- Kaiser Permanente
- Long Beach Education and Research Consultants
- Peter J Ruane, MD, Inc.
- Kaiser Permanente Medical Group
- Kaiser San Francisco Division of Research
- Dupont Circle Physician's Group
- Midland Florida Clinical Research Center, LLC
- Therafirst Medical Center
- Gary J.Richmond, MD, P.A.
- Midway Immunology and Research Center
- Orlando Immunology Center
- Valuhealthmd/Idocf
- Infectious Diseases Associates of NW FL
- Hillsborough County Health Department
- St. Joseph's Comprehensive Research Institute
- AIDS Research and Treatment Center of the Treasure Coast
- Triple O Research Institute PA
- Atlanta ID Group
- AIDS Research Consortium of Atlanta
- Mercer University, Mercer Medicine
- The Ruth M. Rothstein CORE Center
- Howard Brown Health Center
- Johns Hopkins University
- Brigham and Women's Hospital
- Harvard Medical School
- Baystate Infectious Diseases Clinical Research
- Henry Ford Health System
- Abbott Northwestern Hospital
- The Kansas City Free Health Clinic/ KC Care Clinic
- Central West Clinical Research
- South Jersey Infectious Disease
- Southwest CARE Center
- Albany Medical College
- New York Hospital Queens
- Beth Israel Medical Center
- Weill Medical College
- University of Rochester
- Carolinas Medical Center--Myer's Park
- Duke University Health System
- East Carolina University The Brody School of Medicine, Infectious Diseases
- Wake Forest University Health Sciences
- Summa Health System CARE Center
- The Ohio State University Medical Center
- University Of Pennsylvania
- Philadelphia FIGHT
- Thomas Jefferson University
- The Miriam Hospital
- North Texas infectious Diseases Consultants, PA
- Therapeutic Concepts, PA
- Gordon E. Crofoot MD PA
- DCOL Center for Clinical Research
- University of Utah
- Clinical Alliance for Research & Education - Infectious Diseases (CARE-ID)
- Peter Shalit, MD
- Southern Alberta Clinic
- Vancouver ID Research & Care Centre Society
- Wrha - Health Sciences Centre Winnipeg
- Ottawa Hospital - General Campus
- Maple Leaf Research
- Clinique médicale L'actuel
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Cohort 1
Cohort 2, Treatment Group 1
Cohort 2, Treatment Group 2
Participants will receive E/C/F/TAF FDC + DRV once daily with food for 48 weeks. Based on safety and efficacy data from Cohort 1 at Week 4, the participants will be randomized into Cohort 2. The participants in Cohort 1 will continue receiving E/C/F/TAF FDC + DRV through 48 weeks.
Participants will be randomized to receive E/C/F/TAF FDC+DRV once daily with food for 48 weeks.
Participants will be randomized to continue on their baseline DRV-containing ARV regimen for 48 weeks.