- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03067285
A Phase IV, Open-label, Randomised, Pilot Clinical Trial Designed to Evaluate the Potential Neurotoxicity of Dolutegravir/Lamivudine/Abacavir in Neurosymptomatic HIV Patients and Its Reversibility After Switching to Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide. DREAM Study (DREAM)
February 3, 2020 updated by: Fundacion SEIMC-GESIDA
A phase IV, multicentre, randomised, open-label, pilot clinical trial designed to evaluate HIV-infected, aviremic patients who receive treatment with the combination of DTG/3TC/ABC and who have neuropsychiatric adverse effects that, in the opinion of the investigators, may be related to taking DTG/3TC/ABC, if they improve after switching antiretroviral therapy to the combination of ELV/COBI/FTC/TAF.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
we estimate that 64 participants will need to be enrolled in the study to demonstrate symptomatic improvement after switching antiretroviral therapy from DTG/3TC/ABC to ELV/COBI/FTC/TAF.
Study Type
Interventional
Enrollment (Actual)
39
Phase
- Phase 4
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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Madrid, Spain
- Hospital Ramón y Cajal
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Madrid, Spain
- Hospital Universitario La Paz
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Madrid, Spain
- Hospital Fundación Jimenez Diaz
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Madrid, Spain
- Hospital Univ. Infanta Leonor
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Madrid, Spain
- Hospital Univ. La Princesa
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-
Madrid
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Majadahonda, Madrid, Spain
- Hospital Puerta de Hierro
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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
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patient > 18 years of age diagnosed with HIV using normal serology techniques.
- Current antiretroviral therapy with DTG/3TC/ABC.
- HIV viral load < 50 copies/mL for at least 12 weeks prior to signing the consent form [(]confirmed by two assays at least 12 weeks apart with viremia < 50 copies/mL between both). If the patient has a recent routine blood test available (≤ 4 weeks) that includes determining HIV viral load, these results may be used for the screening visit. If this test is not available, or the test is more than four weeks old, viral load will be determined on the day of screening in order to confirm that the patient meets this criterion.
Appearance or worsening of the following symptoms compared to when DTG/3TC/ABC was started:
- Symptoms of anxiety or depression
- Insomnia or other sleep disturbances
- Headache
- Cognitive complaints (attention, concentration or memory)
- Alterations in behaviour (irritability, aggressiveness or agitation)
- Dizziness of neurological or neurologically-mediated origin
Exclusion Criteria:
- Determination of at least one HIV viral load ≥ 50 copies/mL in the last 12 weeks.
- Allergy, intolerance or existence of resistance mutations to any of the components of ELV/COBI/FTC/TAF
- History of active CNS infections
- Active psychosis, major depression with psychotic symptoms or autolytic ideation
- Dementia or mental retardation
- Drug use with a diagnosis of abuse or dependence according to DSM-5 criteria
- Illnesses that may interfere with the study procedures
- Claustrophobia
- Presence of magnetisable devices in the body
- Inability to complete any of the study procedures
- Pregnant or nursing women, as well as women of childbearing age who do not agree to use an adequate birth control method.
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: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Arm 1
Patients who postpone switching from DTG/3TC/ABC to ELV/COBI/FTC/TAF four weeks:
|
Patients continuing on treatment with DTG/3TC/ABC after the randomization for 4 weeks, and then switch to ELV/COBI/FTC/TAF for 24 weeks
|
Experimental: Arm 2
Patients who switch from DTG/3TC/ABC to ELV/COBI/FTC/TAF during the baseline visit
|
Treatment with ELV/COBI/FTC/TAF during 24 weeks since randomized.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To compare changes in the severity of neuropsychiatric symptoms potentially associated with the use of DTG/3TC/ABC, perceived by patients randomised to begin isolated symptomatic treatment or treatment associated with switching antiretroviral therapy.
Time Frame: Week 4
|
To compare, between the two arms of the study, changes in the percentage and in the severity of neuropsychiatric symptoms compiled using the ACTG adverse effects scale. anxiety and depression scale. |
Week 4
|
To compare changes in the severity of neuropsychiatric symptoms potentially associated with the use of DTG/3TC/ABC, perceived by patients randomised to begin isolated symptomatic treatment or treatment associated with switching antiretroviral therapy.
Time Frame: Week 4
|
To compare, between the two arms of the study, changes in the percentage and in the severity of neuropsychiatric symptoms compiled using the pittsburgh sleep quality index.
|
Week 4
|
To compare changes in the severity of neuropsychiatric symptoms potentially associated with the use of DTG/3TC/ABC, perceived by patients randomised to begin isolated symptomatic treatment or treatment associated with switching antiretroviral therapy.
Time Frame: Week 4
|
To compare, between the two arms of the study, changes in the percentage and in the severity of neuropsychiatric symptoms compiled using the depression scale.
|
Week 4
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To evaluate changes in the severity of neuropsychiatric symptoms potentially associated with the use of DTG/3TC/ABC after switching to ELV/COBI/FTC/TAF
Time Frame: Week 4
|
To evaluate the change in the percentage and in the severity of neuropsychiatric symptoms compiled using the ACTG adverse effects scale.
|
Week 4
|
To evaluate changes in the severity of neuropsychiatric symptoms potentially associated with the use of DTG/3TC/ABC after switching to ELV/COBI/FTC/TAF
Time Frame: Week 4
|
To evaluate the change in the percentage and in the severity of neuropsychiatric symptoms compiled using the pittsburgh sleep quality index
|
Week 4
|
To evaluate changes in the severity of neuropsychiatric symptoms potentially associated with the use of DTG/3TC/ABC after switching to ELV/COBI/FTC/TAF
Time Frame: Week 4
|
To evaluate the change in the percentage and in the severity of neuropsychiatric symptoms compiled using the hospital anxiety and depression scale.
|
Week 4
|
To evaluate changes in neurocognitive function and volumetric, spectroscopic, tractographic and cerebral perfusion markers, acquired by Magnetic Resonance Imaging, after switching from DTG/3TC/ABC to ELV/COBI/FTC/TAF
Time Frame: Week 24 after the switching
|
To evaluate the change in global neurocognitive function (global deficit score) and cognitive domains (T-scores) in the volumes of the different structures of the brain using MRI volumetric techniques; the change in levels of neuronal integrity estimated by determining N-acetylaspartate levels in the structures of the frontal lobe and the basal ganglia using spectroscopy.
|
Week 24 after the switching
|
To evaluate changes in neurocognitive function and volumetric, spectroscopic, tractographic and cerebral perfusion markers, acquired by Magnetic Resonance Imaging, after switching from DTG/3TC/ABC to ELV/COBI/FTC/TAF
Time Frame: Week 24 after the switching
|
To evaluate the change in global neurocognitive function (global deficit score) and cognitive domains (T-scores) in the volumes of the different structures of the brain using MRI volumetric techniques; the change in the levels of white matter integrity estimated using the diffusion tensor imaging MRI technique.
|
Week 24 after the switching
|
To evaluate changes in neurocognitive function and volumetric, spectroscopic, tractographic and cerebral perfusion markers, acquired by Magnetic Resonance Imaging, after switching from DTG/3TC/ABC to ELV/COBI/FTC/TAF
Time Frame: Week 24 after the switching
|
To evaluate the change in global neurocognitive function (global deficit score) and cognitive domains (T-scores) in the volumes of the different structures of the brain using MRI volumetric techniques; the change in the levels of brain inflammation estimated by determining the levels of choline and myo-inositol in the structures of the frontal lobe and basal ganglia using spectroscopy.
|
Week 24 after the switching
|
Percentages of virologic failure
Time Frame: Week 24 after the switching
|
To evaluate the percentages of virologic failure after switching antiretroviral therapy from DTG/3TC/ABC to ELV/COBI/FTC/TAF
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Week 24 after the switching
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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 (Actual)
September 8, 2017
Primary Completion (Actual)
April 23, 2019
Study Completion (Actual)
April 23, 2019
Study Registration Dates
First Submitted
February 14, 2017
First Submitted That Met QC Criteria
February 24, 2017
First Posted (Actual)
March 1, 2017
Study Record Updates
Last Update Posted (Actual)
February 5, 2020
Last Update Submitted That Met QC Criteria
February 3, 2020
Last Verified
August 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Chemically-Induced Disorders
- Nervous System Diseases
- 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
- Poisoning
- HIV Infections
- Neurotoxicity Syndromes
Other Study ID Numbers
- GESIDA 9016
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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