- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00540449
TMC278-TiDP6-C209: A Clinical Trial in Treatment Naive HIV-1 Patients Comparing TMC278 to Efavirenz in Combination With Tenofovir + Emtricitabine.
March 1, 2016 updated by: Tibotec Pharmaceuticals, Ireland
A Phase III, Randomized, Double-blind Trial of TMC278 25 mg q.d. Versus Efavirenz 600mg q.d. in Combination With a Fixed Background Regimen Consisting of Tenofovir Disoproxil Fumarate and Emtricitabine in Antiretroviral-naive HIV-1 Infected Subjects.
The purpose of this trial is to compare the effectiveness, safety and tolerability of TMC278 given at a dose of 25 mg once daily versus efavirenz (EFV) at a dose of 600 mg once daily, when combined with a fixed background regimen consisting of emtricitabine (FTC) + tenofovir disoproxil fumarate (TDF), in HIV-1 infected patients who have not yet taken any anti-HIV drugs.
The following evaluations will be done: antiviral activity, immunologic changes, and viral geno-/phenotype evolution, relationship of Pharmacokinetics (PK) and PK/Pharmacodynamics, medical resource utilization and treatment adherence.
Study Overview
Status
Completed
Intervention / Treatment
Detailed Description
Over the past decade, anti-human immunodeficiency virus (HIV) drugs have been introduced sequentially for use in the clinic.
Currently, patients are routinely being treated with 3 or 4 drug combinations including nucleoside/tide analogue reverse transcriptase inhibitors (NRTIs/NtRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and/or fusion inhibitors.
New potent antiretroviral (ARV) compounds that work in people whose HIV-1 virus is resistant to available drugs are urgently needed.
This is a Phase III, randomized (study medication is assigned by chance), double-blind (neither the study physician nor the patient knows the name of the study assigned medication), double-dummy, active-controlled trial to compare the effectiveness, safety, and ability to tolerate TMC278 versus efavirenz (EFV).
The study will last for 104 weeks which includes a screening period of 4 weeks, a 96-week treatment period, followed by a 4 week follow-up period.
Patients will be randomly assigned to TMC278 or to efavirenz, either of these treatments will be in combination with two other anti-HIV drugs (2 NRTIs: emtricitabine (FTC) + tenofovir (TDF)).
TDF/FTC will be administered as a fixed dose combination if available.
The hypothesis to be provided in this study is that the investigational drug TMC278 will perform just like efavirenz (EFV) in terms of antiviral effectiveness (i.e., suppressing of the plasma viral load to a level < 50 HIV-1 RNA (ribonucleic acid) copies/mL) in ARV-naïve HIV-infected patients.
During the trial, patients' health will be monitored by physical examination, interview to assess health and well being, and laboratory testing on blood and urine samples.
Experimental Group: One tablet of TMC278 25 mg once daily plus one tablet of placebo once daily that looks just like efavirenz (EFV) plus tenofovir/emtricitabine; Control Group: One tablet of Placebo once daily that looks just like TMC278 plus EFV 600 mg once daily plus tenofovir/emtricitabine.
Study Type
Interventional
Enrollment (Actual)
694
Phase
- Phase 3
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Buenos Aires, Argentina
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Cordoba, Argentina
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Guernica, Argentina
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Darlinghurst, Australia
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Melbourne, Australia
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Perth, Australia
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Surry Hills, Australia
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Innsbruck, Austria
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Vienna, Austria
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Wien, Austria
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Curitiba, Brazil
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Nova Iguacu, Brazil
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Rio De Janeiro, Brazil
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Salvador, Brazil
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Sao Paulo, Brazil
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Ontario
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Ottawa, Ontario, Canada
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Toronto, Ontario, Canada
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Quebec
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Montreal, Quebec, Canada
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Copenhagen, Denmark
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Hvidovre N/A, Denmark
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Odense N/A, Denmark
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Loire, France
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Lyon, France
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Paris, France
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Paris Cedex 10, France
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Paris Cedex 12, France
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Tourcoing, France
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Villejuif Cedex, France
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Ciudad De Mexico, Mexico
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Zapopan, Mexico
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Rotterdam, Netherlands
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Amadora, Portugal
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Lisboa, Portugal
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Portimao, Portugal
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Porto, Portugal
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San Juan, Puerto Rico
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Bucuresti, Romania
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Iasi, Romania
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Timisoara, Romania
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Krasnodar, Russian Federation
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St Petersburg, Russian Federation
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Bloemfontein, South Africa
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Cape Town, South Africa
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Durban N/A, South Africa
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Houghton, Johannesburg, South Africa
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Johannesburg, South Africa
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Pretoria N/A, South Africa
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Alicante, Spain
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Barcelona, Spain
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Madrid, Spain
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Göteborg, Sweden
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Malmö, Sweden
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Stockholm, Sweden
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Kaohsiung, Taiwan
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Kaohsiung County, Taiwan
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Tainan, Taiwan
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Taipei, Taiwan
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Bangkok, Thailand
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Chiang Mai, Thailand
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Khon Kaen, Thailand
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Birmingham, United Kingdom
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Brighton, United Kingdom
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London, United Kingdom
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Alabama
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Birmingham, Alabama, United States
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Arizona
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Phoenix, Arizona, United States
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California
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Beverly Hills, California, United States
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Los Angeles, California, United States
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Newport Beach, California, United States
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Sacramento, California, United States
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District of Columbia
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Washington, District of Columbia, United States
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Florida
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Fort Lauderdale, Florida, United States
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Miami, Florida, United States
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Tampa, Florida, United States
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Vero Beach, Florida, United States
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West Palm Beach, Florida, United States
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Georgia
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Macon, Georgia, United States
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Illinois
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Chicago, Illinois, United States
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Maryland
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Baltimore, Maryland, United States
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New Jersey
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Newark, New Jersey, United States
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New York
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Albany, New York, United States
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Buffalo, New York, United States
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New York, New York, United States
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North Carolina
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Chapel Hill, North Carolina, United States
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Durham, North Carolina, United States
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Winston Salem, North Carolina, United States
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Ohio
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Akron, Ohio, United States
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Cincinnati, Ohio, United States
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Columbus, Ohio, United States
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Oregon
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Portland, Oregon, United States
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Pennsylvania
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Philadelphia, Pennsylvania, United States
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South Carolina
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Columbia, South Carolina, United States
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Texas
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Austin, Texas, United States
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Dallas, Texas, United States
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Washington
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Seattle, Washington, United States
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Wisconsin
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Milwaukee, Wisconsin, United States
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 99 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patient with documented HIV-1 infection
- Patient has never been treated with a therapeutic HIV vaccine or an ARV drug prior to screening
- Patient's HIV-1 plasma viral load at screening is > 5,000 HIV-1 RNA copies/mL (assayed by RNA PCR standard specimen procedure)
- Patient's virus is sensitive to TDF and FTC
- Patient agrees not to start ART (antiretroviral treatment) before the baseline visit
Exclusion Criteria:
- Previous use of ANY ARV drug for ANY length of time
- Any documented evidence of NNRTI resistance associated mutations in patient's HIV
- Category C AIDS defining illness, except: stable Kaposi Sarcoma, wasting syndrome if not progressive
- Pneumocystis carinii pneumonia (PCP) that is considered not cured
- Active TB
- Allergy or hypersensitivity to study or background ARTs
- Specific grade 3 or 4 toxicity
- Kidney impairment: calculated creatinine clearance <50 ml/min
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: Efavirenz
Efavirenz 600mg once daily for 96 weeks
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600mg once daily for 96 weeks
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Experimental: TMC278
TMC278 25 mg tablet once daily for 96 weeks
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25 mg tablet once daily for 96 weeks
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Number of Participants With Virological Response (Intent-to-Treat - Time to Loss of Virologic Response [TLOVR], <50 Copies/ml) at Week 48
Time Frame: Week 48
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Virological response is defined as confirmed plasma viral load less than (<) 50 human immunodeficiency virus-1 (HIV-1) (ribonucleic acid [RNA]) copies/milliliter (ml) at Week 48.
The TLOVR algorithm was used to derive response.
Response needed to be confirmed at 2 consecutive visits and participants who permanently discontinued were considered nonresponders after discontinuation.
Resuppression after confirmed virologic failure was considered as failure.
Virologic Failure includes participants who were rebounder (confirmed viral load >= 50 copies/ml after being responder) or who were never suppressed (no confirmed viral load <50 copies/ml).
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Week 48
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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The Number of Participants With Virological Response (Intent-to-Treat - Snapshot, <50 Copies/ml) at Week 48
Time Frame: Week 48
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The analysis is based on the last observed viral load (VL) data within the Week 48 window.
Virologic response is defined as a VL<50 copies/ml (observed case).
Missing VL was considered as non-response.
Virologic Failure includes subjects who had VL>=50 copies/ml in the Wk48 window, subjects who discontinued early due to lack or loss of efficacy, subjects who discontinued for reasons other than an adverse event, death or lack or loss of efficacy and at the time of discontinuation had a VL>=50 copies/ml and subjects who had a switch in background regimen that was not permitted by the protocol.
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Week 48
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Number of Participants With Virological Response (Intent-to-Treat - Time to Loss of Virologic Response [TLOVR], <50 Copies/ml) at Week 96
Time Frame: Week 96
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Week 96
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The Number of Participants With Virological Response (Intent-to-Treat - Snapshot, <50 Copies/ml) at Week 96
Time Frame: Week 96
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Week 96
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Number of Participants With Virological Response (Observed, <50 Copies/ml) at Last On-Treatment Visit (Post-Week 96).
Time Frame: Variable, ranging from 3 months up to maximum 15 months for TMC278 and 12 months for Efavirenz after the 96-week visit
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Virological response is defined as (observed) plasma viral load less than 50 human immunodeficiency virus-type 1 (HIV-1) ribonucleic acid (RNA) copies per ml at the last on-treatment visit (post-Week 96).
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Variable, ranging from 3 months up to maximum 15 months for TMC278 and 12 months for Efavirenz after the 96-week visit
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Number of Participants With Virological Response (Intent-to-Treat - Time to Loss of Virologic Response [TLOVR], <400 Copies/ml) at Week 48
Time Frame: Week 48
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Week 48
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Number of Participants With Virological Response (Intent-to-Treat - Time to Loss of Virologic Response [TLOVR], <400 Copies/ml) at Week 96
Time Frame: Week 96
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Week 96
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Mean Change From Baseline to Week 48 and Week 96 in Absolute and Relative CD4+ Cell Counts (Using Imputed Data)
Time Frame: Baseline, Week 48, and Week 96
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Change from baseline in CD4+ cell count was imputed in case of missing values: in case of premature discontinuation, data were imputed with the baseline value after discontinuation (i.e.
change=0, Non-Completer [NC] = Failure); otherwise last observation carried forward was applied.
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Baseline, Week 48, and Week 96
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Number of Participants With Virologic Failure for the Resistance Determination by Emerging Resistance Associated Mutations: First Available On-Treatment Genotypic Data After Failure
Time Frame: Week 96
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Virologic failure for the resistance determinations was defined as lack of virologic response (never having had 2 consecutive plasma viral load <50 copies/mL) and plasma viral load increase of >=0.5 log 10 copies/mL above nadir (i.e., never suppressed), or confirmed loss of virologic response (2 consecutive plasma viral load >=50 copies/mL after having had 2 consecutive plasma viral load <50 copies/mL; i.e., rebounder), or discontinued with a last observed on-treatment plasma viral load >=50 copies/mL after having had 2 consecutive plasma viral load <50 copies/mL.
For this study, treatment-emergent reverse transcriptase (RT) resistance associated mutations (RAMs) occurring in at least 2 virologic failures (for at least one treatment group) for the following lists are presented: i) Extended list of Non-nucleoside reverse transcriptase inhibitor (NNRTI RAMs) ii) IAS-USA list of Nucleoside/tide reverse transcriptase inhibitor (N[t]RTI RAMs).
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Week 96
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Rimsky L, Van Eygen V, Hoogstoel A, Stevens M, Boven K, Picchio G, Vingerhoets J. 96-Week resistance analyses of rilpivirine in treatment-naive, HIV-1-infected adults from the ECHO and THRIVE Phase III trials. Antivir Ther. 2013;18(8):967-77. doi: 10.3851/IMP2636. Epub 2013 May 28.
- Nelson M, Amaya G, Clumeck N, Arns da Cunha C, Jayaweera D, Junod P, Li T, Tebas P, Stevens M, Buelens A, Vanveggel S, Boven K; ECHO and THRIVE Study Groups. Efficacy and safety of rilpivirine in treatment-naive, HIV-1-infected patients with hepatitis B virus/hepatitis C virus coinfection enrolled in the Phase III randomized, double-blind ECHO and THRIVE trials. J Antimicrob Chemother. 2012 Aug;67(8):2020-8. doi: 10.1093/jac/dks130. Epub 2012 Apr 24.
- Molina JM, Cahn P, Grinsztejn B, Lazzarin A, Mills A, Saag M, Supparatpinyo K, Walmsley S, Crauwels H, Rimsky LT, Vanveggel S, Boven K; ECHO study group. Rilpivirine versus efavirenz with tenofovir and emtricitabine in treatment-naive adults infected with HIV-1 (ECHO): a phase 3 randomised double-blind active-controlled trial. Lancet. 2011 Jul 16;378(9787):238-46. doi: 10.1016/S0140-6736(11)60936-7.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
May 1, 2008
Primary Completion (Actual)
February 1, 2010
Study Completion (Actual)
December 1, 2011
Study Registration Dates
First Submitted
October 4, 2007
First Submitted That Met QC Criteria
October 4, 2007
First Posted (Estimate)
October 8, 2007
Study Record Updates
Last Update Posted (Estimate)
March 29, 2016
Last Update Submitted That Met QC Criteria
March 1, 2016
Last Verified
February 1, 2016
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- RNA Virus Infections
- Virus Diseases
- Infections
- Blood-Borne Infections
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Sexually Transmitted Diseases
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- Immune System Diseases
- Slow Virus Diseases
- HIV Infections
- Acquired Immunodeficiency Syndrome
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Reverse Transcriptase Inhibitors
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Anti-HIV Agents
- Anti-Retroviral Agents
- Cytochrome P-450 Enzyme Inhibitors
- Cytochrome P-450 Enzyme Inducers
- Cytochrome P-450 CYP3A Inducers
- Cytochrome P-450 CYP2B6 Inducers
- Cytochrome P-450 CYP2C9 Inhibitors
- Cytochrome P-450 CYP2C19 Inhibitors
- Efavirenz
- Rilpivirine
Other Study ID Numbers
- CR002689
- TMC278-TIDP6-C209 (Other Identifier: Tibotec Pharmaceuticals, Ireland)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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