- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03270969
A Pharmacokinetic Evaluation of Tenofovir/Emtricitabine as HIV Pre-Exposure Prophylaxis in Transgender Women
September 13, 2023 updated by: University of Nebraska
Pharmacokinetics of Tenofovir Disoproxil Fumarate/Emtricitabine for HIV Pre-exposure Prophylaxis in Transgender Women Receiving Feminizing Hormone Therapy
Human immunodeficiency virus (HIV) persists worldwide as an immense health burden among vulnerable populations.
HIV pre-exposure prophylaxis (PrEP) has offered the promise of limiting the global burden of HIV.
The objective of this proposal is to conduct a pharmacokinetic (PK) study in transgender women to describe the pharmacokinetics of tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) as PrEP within this population.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
PrEP is a critical component of comprehensive transgender medical care.
The proposed open-label, intensive PK study will inform the pharmacologic impact of combining PrEP and concurrent feminizing hormone regimens.
The investigators hypothesize transgender women will achieve similar PrEP concentrations compared to the historical controls, and that hormone concentrations (estrogen and testosterone) will not be affected.
The aims of this study are to (1) to determine if concurrent use of TDF/FTC as PrEP in combination with feminizing hormones alters the PK of tenofovir (TFV) and FTC and (2) to determine if concurrent use of PrEP with feminizing hormones alters serum estradiol and testosterone concentrations.
To achieve these aims, this study will enroll transgender women who are receiving either oral/sublingual or transdermal estradiol with spironolactone.
Using intensive PK sampling, plasma and intracellular TDF/FTC concentrations will be measured after 14 days of oral TDF/FTC.
Study Type
Interventional
Enrollment (Actual)
15
Phase
- Phase 1
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
-
-
Nebraska
-
Omaha, Nebraska, United States, 68198
- University of Nebraska Medical Center
-
-
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
19 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Evidence of a personally signed and dated informed consent document indicating that the participant has been informed of all pertinent aspects of the study.
- Participants who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
- Self identify as a transgender woman.
- Receiving estradiol (oral/sublingual tablets or transdermal patches) with oral spironolactone for at least 3 months prior to study entry.
- Serum estradiol level >100 pg/mL.
- Non-reactive 4th or 5th generation screening test for HIV.
- Adults (19 years or older).
- Able to read and speak English to ensure appropriate ability to obtain informed consent.
Exclusion Criteria:
- Participants will not be included in the study if one, or more, of the following criteria are met:
- Use of drugs known to be contraindicated with TDF, FTC, estradiol, or spironolactone within 30 days of study entry. The study team will review all concomitant medications at screening based on the US Department of Health and Human Services drug interaction table and the drug product labeling.
- Use of injectable estradiol (valerate or cypionate).
- Presence of any active condition or clinically significant disease that, in the investigator's opinion, would compromise the subject's safety or outcome of the study, including qualifying for non-occupational post-HIV exposure prophylaxis.
- Signs or symptoms of acute HIV infection within the last 30 days.
- Laboratory values obtained within 30 days prior to study entry:
- Creatinine clearance (CrCl) less than 60 mL/min as estimated by the Cockcroft-Gault equation.
- Positive hepatitis B surface antigen and/or hepatitis C antibody.
- Alanine transaminase (ALT), Aspartate transaminase (AST) or alkaline phosphatase > 5x the upper limit of normal (ULN).
- Hemoglobin <10 g/dL.
- Platelets <50,000/mm3.
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: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: TDF/FTC
Tenofovir Disoproxil Fumarate/Emtricitabine group HIV-uninfected transgender women receiving feminizing hormone therapy plus tenofovir disoproxil fumarate/emtricitabine
|
Participants will receive daily TDF/FTC for 14 days
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
TFV plasma exposure
Time Frame: 14 days
|
Intensive PK sampling compared to historical controls
|
14 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
FTC plasma exposure
Time Frame: 14 days
|
Intensive PK sampling compared to historical controls
|
14 days
|
Tenofovir-diphosphate (TFV-DP) intracellular concentrations
Time Frame: 14 days
|
Peripheral blood mononuclear cells (PBMC) concentrations compared to historical control
|
14 days
|
Emtricitabine-triphosphate (FTC-TP) intracellular concentrations
Time Frame: 14 days
|
Peripheral blood mononuclear cells (PBMC) concentrations compared to historical control
|
14 days
|
TFV maximum plasma concentration (Cmax)
Time Frame: 14 days
|
Cmax of TFV compared to historical control
|
14 days
|
FTC maximum plasma concentration (Cmax)
Time Frame: 14 days
|
Cmax of FTC compared to historical control
|
14 days
|
Estradiol serum concentrations
Time Frame: 14 days
|
Before and after intervention
|
14 days
|
Testosterone serum concentrations
Time Frame: 14 days
|
Before and after intervention
|
14 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Kimberly Scarsi, PharmD, MS, University of Nebraska
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.
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)
January 5, 2018
Primary Completion (Actual)
September 10, 2018
Study Completion (Actual)
September 10, 2018
Study Registration Dates
First Submitted
August 23, 2017
First Submitted That Met QC Criteria
August 30, 2017
First Posted (Actual)
September 1, 2017
Study Record Updates
Last Update Posted (Actual)
September 15, 2023
Last Update Submitted That Met QC Criteria
September 13, 2023
Last Verified
September 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0491-17-FB
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
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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