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Safety and Efficacy Trial of a Dapivirine Vaginal Matrix Ring in Healthy HIV-Negative Women

Primary Purpose

HIV Infections

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Placebo Vaginal Ring
Dapivirine Vaginal Ring, 25 mg
Sponsored by
International Partnership for Microbicides, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for HIV Infections focused on measuring HIV Infections, Anti-HIV agents, HIV-1

Eligibility Criteria

18 Years - 45 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Women > 18 and < 45 years of age, at screening, who can provide informed consent;
  • Available for all visits and consent to follow all procedures scheduled for the trial;
  • Self-reported sexually active (defined as an average of at least one penetrative penile-vaginal coital act per month for the last 3 months prior to screening);
  • HIV-negative as determined by the HIV algorithm applied at screening and enrolment;
  • On a stable form of contraception as defined within section 5.4 and willing to continue on stable contraception for the duration of the clinical trial, unless post-menopausal or surgically sterilised;
  • Asymptomatic for genital infections at the time of enrolment (if a woman is diagnosed with any clinically significant curable STI, she must have initiated treatment at least 1 week prior to enrolment and have completed the full course of treatment);
  • Willing to provide adequate locator information for trial retention purposes and be reachable per local standard procedures (e.g., by home visit or telephone; or via family or close neighbour contacts); confidentiality to be maintained;
  • Willing to refrain from participation in another research trial using drugs, vaccines, medical devices, microbicides or oral pre-exposure prophylaxis investigational drugs for the duration of the IPM 027 trial.

Exclusion Criteria:

  • Currently pregnant or last pregnancy within 3 months prior to screening or intends to become pregnant during trial participation;
  • Currently breast-feeding;
  • Non-therapeutic injection drug use in the 12 months prior to screening;
  • Participated in another research trial using drugs, medical devices, microbicides or oral pre-exposure prophylaxis agents within 60 days prior to screening;
  • Previously participated or currently participating in any HIV vaccine trial;
  • Untreated, clinically significant urogenital infections , e.g., urinary tract, or other sexually transmitted infections, or other gynaecological symptoms within 1 week prior to enrolment;
  • Has a Grade 2 or higher pelvic examination finding, according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events; Addendum 1 Female Genital Grading Table for Use in Microbicide Studies;
  • History of significant urogenital or uterine prolapse, undiagnosed vaginal bleeding, diagnosed chronic and/or recurrent vulvovaginal candidiasis, urethral obstruction, incontinence or urge incontinence;
  • Any gynaecological surgery within 90 days prior to screening;
  • Any Grade 1 or higher baseline aspartate aminotransferase (AST), alanine transaminase (ALT), or platelet count, and any Grade 2 or higher baseline haematology, chemistry or urinalysis laboratory value according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events;
  • Any history of anaphylaxis or severe allergy resulting in angioedema; or a history of sensitivity/allergy to latex or a silicone elastomer;
  • Any history of diabetes mellitus and chronic use of oral corticosteroid therapy; and any uncontrolled serious chronic or progressive disease;
  • Cervical cytology at screening that requires cryotherapy, biopsy or treatment (other than for infection). Women with Grade 1 cervical cytology findings can be enrolled upon completion of the initial phase of evaluation if no current treatment is indicated (based on local standard of care for management of abnormal cervical cytology);
  • Any condition(s) that, in the opinion of the investigator, might put the participant at risk, or interfere with the trial objectives or the participant's adherence to trial requirements.

Sites / Locations

  • Qhakaza Mbokodo
  • Prevention of HIV / AIDS (PHIVA) Project
  • Ndlovu Medical Centre
  • Madibeng Centre for Research (MCR)
  • Desmond Tutu HIV Foundation, Guinea Fowl Road, Sunnydale, Fish Hoek
  • Maternal, Adolescent and Child Health (MatCH)
  • MRC/UVRI Uganda Research Unit on AIDS, Plot 51-59, Nakiwogo Road, PO BOX 49

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo Vaginal Ring

Dapivirine Vaginal Ring

Arm Description

Vaginal Ring containing 0.0 mg Dapivirine

Vaginal Ring containing 25mg of Dapivirine

Outcomes

Primary Outcome Measures

HIV-1 Seroconversion According to Comprehensive HIV Testing Algorithm.
HIV-1 seroconversion measured by rapid and specialised laboratory testing according to the comprehensive HIV testing algorithm.
All Adverse Events
Self-reports, physical examination, gynaecological assessments, including pelvic/speculum examination, laboratory tests and other indicated investigations. All AEs will be reported, regardless of grade or relatedness.

Secondary Outcome Measures

The Incidence Rate of HIV-2 Seroconversion.
Rapid and specialised laboratory testing according to the comprehensive HIV testing algorithm in Appendix C of protocol.
The Incidence of Curable STIs
The percentage of participants testing positive for any STI (gonorrhoea, chlamydia, trichomonas, syphilis) will be assessed.
Percentage of Participants With Pregnancy in Each Trial Arm Over the IP Use Period;
The percentage of participants with pregnancies in each treatment group. For each treatment group, the numerator will include the number of participants that had a positive urine pregnancy test during the trial period.
The Percentage of Women Who Report Adherence to the Use of the Vaginal Ring Inserted Once Every 4 Weeks Over the Trial Period;
Questionnaires and qualitative data regarding sexual behaviour and adherence to the use of a vaginal ring inserted once every 4 weeks over the trial period. Dapivirine residual levels in used rings and dapivirine plasma concentrations are two objective measures of adherence to DVR ring use,
The Percentage of Women Who Report the Use of the Vaginal Ring as Acceptable;
Questionnaires and qualitative data regarding the acceptability of use of a vaginal ring inserted once every 4 weeks over the trial period; Number of participants with positive response. Response of 'likely' or 'very likely' to the question: 'If in the future a vaginal ring was available that provided some protection against HIV, and it was similar to the one you used in this trial, how likely would you be to keep it inserted in your vagina every day?'
The Percentage of Participants With HIV-1 Drug Resistance Mutations Among Participants Who Acquire HIV-1.
The analysis of HIV-1 drug resistance will be primarily descriptive in nature, and will depend on the pattern of resistance mutations observed in the HIV-1 seroconverters. The proportion of HIV-1 seroconverters with at least one HIV-1 drug resistant mutation will be presented overall, and by treatment arm, with corresponding 95% CIs.

Full Information

First Posted
February 21, 2012
Last Updated
September 26, 2022
Sponsor
International Partnership for Microbicides, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01539226
Brief Title
Safety and Efficacy Trial of a Dapivirine Vaginal Matrix Ring in Healthy HIV-Negative Women
Official Title
A Multi-Centre, Randomised, Double-Blind, Placebo-Controlled Safety and Efficacy Trial of a Dapivirine Vaginal Matrix Ring in Healthy HIV-Negative Women
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
March 27, 2012 (Actual)
Primary Completion Date
December 13, 2016 (Actual)
Study Completion Date
December 13, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
International Partnership for Microbicides, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a double-blind, randomised, placebo-controlled study to assess the safety and efficacy of a silicone elastomer vaginal matrix ring.
Detailed Description
A multi center, randomized, double-blind, placebo=controlled safety and efficacy trial of a Dapivirine Vaginal Matrix Ring in healthy HIV-negative women.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
HIV Infections, Anti-HIV agents, HIV-1

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
1959 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo Vaginal Ring
Arm Type
Placebo Comparator
Arm Description
Vaginal Ring containing 0.0 mg Dapivirine
Arm Title
Dapivirine Vaginal Ring
Arm Type
Experimental
Arm Description
Vaginal Ring containing 25mg of Dapivirine
Intervention Type
Combination Product
Intervention Name(s)
Placebo Vaginal Ring
Intervention Description
Dapivirine Vaginal Ring containing 0.0 mg of dapivirine
Intervention Type
Combination Product
Intervention Name(s)
Dapivirine Vaginal Ring, 25 mg
Intervention Description
Dapivirine Vaginal Ring containing 25 mg of dapivirine
Primary Outcome Measure Information:
Title
HIV-1 Seroconversion According to Comprehensive HIV Testing Algorithm.
Description
HIV-1 seroconversion measured by rapid and specialised laboratory testing according to the comprehensive HIV testing algorithm.
Time Frame
24 months
Title
All Adverse Events
Description
Self-reports, physical examination, gynaecological assessments, including pelvic/speculum examination, laboratory tests and other indicated investigations. All AEs will be reported, regardless of grade or relatedness.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
The Incidence Rate of HIV-2 Seroconversion.
Description
Rapid and specialised laboratory testing according to the comprehensive HIV testing algorithm in Appendix C of protocol.
Time Frame
24 months
Title
The Incidence of Curable STIs
Description
The percentage of participants testing positive for any STI (gonorrhoea, chlamydia, trichomonas, syphilis) will be assessed.
Time Frame
24 months
Title
Percentage of Participants With Pregnancy in Each Trial Arm Over the IP Use Period;
Description
The percentage of participants with pregnancies in each treatment group. For each treatment group, the numerator will include the number of participants that had a positive urine pregnancy test during the trial period.
Time Frame
24 months
Title
The Percentage of Women Who Report Adherence to the Use of the Vaginal Ring Inserted Once Every 4 Weeks Over the Trial Period;
Description
Questionnaires and qualitative data regarding sexual behaviour and adherence to the use of a vaginal ring inserted once every 4 weeks over the trial period. Dapivirine residual levels in used rings and dapivirine plasma concentrations are two objective measures of adherence to DVR ring use,
Time Frame
24 months
Title
The Percentage of Women Who Report the Use of the Vaginal Ring as Acceptable;
Description
Questionnaires and qualitative data regarding the acceptability of use of a vaginal ring inserted once every 4 weeks over the trial period; Number of participants with positive response. Response of 'likely' or 'very likely' to the question: 'If in the future a vaginal ring was available that provided some protection against HIV, and it was similar to the one you used in this trial, how likely would you be to keep it inserted in your vagina every day?'
Time Frame
24 months
Title
The Percentage of Participants With HIV-1 Drug Resistance Mutations Among Participants Who Acquire HIV-1.
Description
The analysis of HIV-1 drug resistance will be primarily descriptive in nature, and will depend on the pattern of resistance mutations observed in the HIV-1 seroconverters. The proportion of HIV-1 seroconverters with at least one HIV-1 drug resistant mutation will be presented overall, and by treatment arm, with corresponding 95% CIs.
Time Frame
24 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Women > 18 and < 45 years of age, at screening, who can provide informed consent; Available for all visits and consent to follow all procedures scheduled for the trial; Self-reported sexually active (defined as an average of at least one penetrative penile-vaginal coital act per month for the last 3 months prior to screening); HIV-negative as determined by the HIV algorithm applied at screening and enrolment; On a stable form of contraception as defined within section 5.4 and willing to continue on stable contraception for the duration of the clinical trial, unless post-menopausal or surgically sterilised; Asymptomatic for genital infections at the time of enrolment (if a woman is diagnosed with any clinically significant curable STI, she must have initiated treatment at least 1 week prior to enrolment and have completed the full course of treatment); Willing to provide adequate locator information for trial retention purposes and be reachable per local standard procedures (e.g., by home visit or telephone; or via family or close neighbour contacts); confidentiality to be maintained; Willing to refrain from participation in another research trial using drugs, vaccines, medical devices, microbicides or oral pre-exposure prophylaxis investigational drugs for the duration of the IPM 027 trial. Exclusion Criteria: Currently pregnant or last pregnancy within 3 months prior to screening or intends to become pregnant during trial participation; Currently breast-feeding; Non-therapeutic injection drug use in the 12 months prior to screening; Participated in another research trial using drugs, medical devices, microbicides or oral pre-exposure prophylaxis agents within 60 days prior to screening; Previously participated or currently participating in any HIV vaccine trial; Untreated, clinically significant urogenital infections , e.g., urinary tract, or other sexually transmitted infections, or other gynaecological symptoms within 1 week prior to enrolment; Has a Grade 2 or higher pelvic examination finding, according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events; Addendum 1 Female Genital Grading Table for Use in Microbicide Studies; History of significant urogenital or uterine prolapse, undiagnosed vaginal bleeding, diagnosed chronic and/or recurrent vulvovaginal candidiasis, urethral obstruction, incontinence or urge incontinence; Any gynaecological surgery within 90 days prior to screening; Any Grade 1 or higher baseline aspartate aminotransferase (AST), alanine transaminase (ALT), or platelet count, and any Grade 2 or higher baseline haematology, chemistry or urinalysis laboratory value according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events; Any history of anaphylaxis or severe allergy resulting in angioedema; or a history of sensitivity/allergy to latex or a silicone elastomer; Any history of diabetes mellitus and chronic use of oral corticosteroid therapy; and any uncontrolled serious chronic or progressive disease; Cervical cytology at screening that requires cryotherapy, biopsy or treatment (other than for infection). Women with Grade 1 cervical cytology findings can be enrolled upon completion of the initial phase of evaluation if no current treatment is indicated (based on local standard of care for management of abnormal cervical cytology); Any condition(s) that, in the opinion of the investigator, might put the participant at risk, or interfere with the trial objectives or the participant's adherence to trial requirements.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Annalene Nel
Organizational Affiliation
IPM
Official's Role
Study Director
Facility Information:
Facility Name
Qhakaza Mbokodo
City
Ladysmith
State/Province
Kwazulu Natal
Country
South Africa
Facility Name
Prevention of HIV / AIDS (PHIVA) Project
City
Pinetown
State/Province
KwaZulu Natal
ZIP/Postal Code
3610
Country
South Africa
Facility Name
Ndlovu Medical Centre
City
Elandsdoorn
State/Province
Limpopo
ZIP/Postal Code
0485
Country
South Africa
Facility Name
Madibeng Centre for Research (MCR)
City
Brits
ZIP/Postal Code
0250
Country
South Africa
Facility Name
Desmond Tutu HIV Foundation, Guinea Fowl Road, Sunnydale, Fish Hoek
City
Cape Town
ZIP/Postal Code
7975
Country
South Africa
Facility Name
Maternal, Adolescent and Child Health (MatCH)
City
Plessislaer
ZIP/Postal Code
3216
Country
South Africa
Facility Name
MRC/UVRI Uganda Research Unit on AIDS, Plot 51-59, Nakiwogo Road, PO BOX 49
City
Masaka
Country
Uganda

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33542153
Citation
Kusemererwa S, Abaasa A, Kabarambi A, Onyango M, Mugisha JO. Assessment of risk compensation following use of the dapivirine vaginal ring in southwestern Uganda. Sex Transm Infect. 2022 Feb;98(1):32-37. doi: 10.1136/sextrans-2020-054718. Epub 2021 Feb 4.
Results Reference
derived
PubMed Identifier
29855975
Citation
Kusemererwa S, Abaasa A, Onyango M, Nel AM, Isaacs M, Asiki G. Contraceptive Preference Among Women at Risk of HIV Acquisition in a Preparatory Screening Study for a Phase III Microbicide Trial in South Western Uganda. AIDS Behav. 2018 Jul;22(Suppl 1):131-138. doi: 10.1007/s10461-018-2177-3.
Results Reference
derived
PubMed Identifier
27959766
Citation
Nel A, van Niekerk N, Kapiga S, Bekker LG, Gama C, Gill K, Kamali A, Kotze P, Louw C, Mabude Z, Miti N, Kusemererwa S, Tempelman H, Carstens H, Devlin B, Isaacs M, Malherbe M, Mans W, Nuttall J, Russell M, Ntshele S, Smit M, Solai L, Spence P, Steytler J, Windle K, Borremans M, Resseler S, Van Roey J, Parys W, Vangeneugden T, Van Baelen B, Rosenberg Z; Ring Study Team. Safety and Efficacy of a Dapivirine Vaginal Ring for HIV Prevention in Women. N Engl J Med. 2016 Dec 1;375(22):2133-2143. doi: 10.1056/NEJMoa1602046.
Results Reference
derived

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Safety and Efficacy Trial of a Dapivirine Vaginal Matrix Ring in Healthy HIV-Negative Women

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