- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07616739
Dolutegravir/Lamivudine in Treatment-Naïve Pregnant Women (PREDUAL)
Evaluating the Efficacy and Safety of Dolutegravir/Lamivudine (DTG/3TC) in ART-Naïve Pregnant Women
Protocol Number: FH-94
Study Objetives:
Primary:
- To evaluate the virological response to Dolutegravir/Lamivudine in naive pregnant women with HIV who are starting antiretroviral therapy and vertical transmission in exposed neonates.
Secondary:
- To evaluate the incidence of maternal adverse events.
- To evaluate perinatal outcomes at delivery.
- To evaluate maximum virological suppression at delivery.
- To evaluate the incidence of changes in body weight exceeding what is expected for gestation.
- To evaluate the immune response based on changes in CD4, CD8, and CD4/CD8 ratio values during pregnancy.
- Assess baseline resistance and the development of resistance to virological failure to integrase inhibitors and INTRs during treatment with DTG+3TC or DTG+TDF/XTC or DTG+TAF/FTC.
- To evaluate the incidence of HIV infection in children that breastfeed.
- To evaluate safety outcomes and virological response of DTG+3TC compared to DTG+TDF/XTC or DTG+TAF/FTC.
Exploratory:
- To explore the non-inferiority of DTG+3TC therapy compared to DTG+TDF/XTC or DTG+TAF/FTC treatment.
- To evaluate the frequency of antiretroviral therapy withdrawal or modification before delivery.
Přehled studie
Postavení
Podmínky
Detailní popis
Primary endpoints:
- Proportion of pregnant women who achieve an HIV-1 plasma viral load <200 copies/mL at delivery after starting DTG+3TC (Intention-to-Treat Exposed analysis).
- Proportion of children born without HIV infection at 6 weeks & 6 months of age, defined by the negative result of negative virological tests (PCR) performed at birth (delivery visit and up to 72 hours after delivery), at 6 weeks, and at 6 months
Secondary endpoints:
- Frequency of grade 2 or higher maternal adverse events, by type and severity, from baseline to 6 months postpartum.
- Frequency of spontaneous abortion, preterm delivery, congenital malformations at birth or identified and reported during the first 6 month of life, or intrauterine fetal death.
- Proportion of pregnant women with plasma viral load below 50 copies/mL at delivery.
- Average total weight gain and BMI during pregnancy, compared with recommendations based on pre-pregnancy BMI.
- Changes in CD4 lymphocyte count and CD4/CD8 ratio between baseline and delivery visit values.
- Frequency and type of mutations according to the International AIDS Society (IAS-USA drug resistance mutations, 2025) mutation guidelines panel at the baseline visit and in case of virological failure at any time during the study.
- Proportion of HIV infection among breastfed children.
- Frequency of grade 2 or higher maternal adverse events, by type and severity, between the two arms. Frequency of pregnant women with plasma viral load <200 copies/mL in the two arms at delivery visit.
Exploratory endpoints:
- Difference in the proportion of pregnant women who achieve an HIV-1 plasma viral load of less than 50 copies/mL at delivery between the DTG+3TC and DTG+TDF/XTC or DTG+TAF/FTC groups, to explore the non-inferiority of the dual regimen.
- Proportion of participants requiring a change in antiretroviral regimen (due to lack of efficacy, adverse events, medical decision, or other reasons) before delivery.
Patient Population: HIV-1-infected Pregnant Women aged >16 years (>15 years for Brazil's sites) who are naïve to antiretroviral therapy Study design: Phase IV. Randomized, non-comparative, open-label, multicenter study.
Regimens: Dolutegravir 50 mg /lamivudine 300 mg QD FDC. Dolutegravir 50 mg QD plus tenofovir 300 mg/emtricitabine 200mg or plus tenofovir 300 mg/ lamivudine 300 mg or tenofovir alafenamide 25 mg/emtricitabine 200 mg.
Duration: 14 months approximately months (depending on gestational age at entry).
Sample size: 210 subjects
Typ studie
Zápis (Odhadovaný)
Fáze
- Fáze 4
Kontakty a umístění
Studijní kontakt
- Jméno: María Inés Figueroa, MD
- Telefonní číslo: +541149817777
- E-mail: maria.figueroa@huesped.org.ar
Studijní záloha kontaktů
- Jméno: Emanuel Dell'Isola, Mr.
- Telefonní číslo: +541149817777
- E-mail: emanuel.dellisola@huesped.org.ar
Studijní místa
-
-
Buenos Aires
-
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, C1155AHD
- Hospital General de Agudos Dr. Cosme Argerich
-
Kontakt:
- Diego Cecchini, MD
- Telefonní číslo: +54911 54976263
- E-mail: diegocec@gmail.com
-
Vrchní vyšetřovatel:
- Diego Cecchini, MD
-
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, C1188AAF
- Sanatorio Güemes
-
Kontakt:
- Verónica Lacal, MD
- Telefonní číslo: +54 9 11 58296259
- E-mail: verolacal@gmail.com
-
Kontakt:
- Sebastián Nuñez, MD
- Telefonní číslo: 8384 / 8365 +54 11 4959-8200
- E-mail: snunez@fsg.edu.ar
-
Vrchní vyšetřovatel:
- Verónica Lacal, MD
-
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, C1425AGP
- Hospital de Agudos J.A. Fernandez
-
Kontakt:
- María José Rolón, MD
- Telefonní číslo: +54 011 48082627
- E-mail: fernandez_infectologia@buenosaires.gob.ar
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Kontakt:
- José MD, Barletta
- Telefonní číslo: +54 011 48082627
- E-mail: fernandez_infectologia@buenosaires.gob.ar
-
Vrchní vyšetřovatel:
- María José Rolón, MD
-
El Palomar, Buenos Aires, Argentina, B1684
- Hospital Nacional Profesor Alejandro Posadas
-
Kontakt:
- Mariana Golikow, MD
- Telefonní číslo: +54 9 11 3803-1126
- E-mail: marugolikow@gmail.com
-
Vrchní vyšetřovatel:
- Mariana Golikow, MD
-
Isidro Casanova, Buenos Aires, Argentina, B1765
- Hospital de Agudos Paroissien
-
Kontakt:
- Pablo Garnica, MD
- Telefonní číslo: +54 9 15-5958-4516
- E-mail: andrespablo451@hotmail.com
-
Kontakt:
- Eduardo Warley, MD
- Telefonní číslo: +54 011 1541897181
- E-mail: eduwarley@yahoo.com.ar
-
Vrchní vyšetřovatel:
- Pablo Garnica, MD
-
-
-
-
Estado de Bahia
-
Salvador, Estado de Bahia, Brazílie, 40110-160
- Fundação Bahiana de Infectologia
-
Kontakt:
- Carlos Brites, MD
- Telefonní číslo: +55 71 99232-9552
- E-mail: crbrites@gmail.com
-
Kontakt:
- Anne Kettley Lacerda de L. Gonzaga, RN
- Telefonní číslo: +55 (71) 3646-3561
- E-mail: annegonzaga.fbai@outlook.com
-
Vrchní vyšetřovatel:
- Carlos Brites, MD
-
-
Pernambuco
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Curitiba, Pernambuco, Brazílie, 80430-000
- Complexo do Hospital de Clínicas da UFPR/Ebserh
-
Kontakt:
- Monica Maria Gomes da Silva, MD
- Telefonní číslo: 41-999951285
- E-mail: monica.gomez@ufpr.br
-
Vrchní vyšetřovatel:
- Monica Maria Gomes da Silva, MD
-
-
Rio Grande do Norte
-
Natal, Rio Grande do Norte, Brazílie, 59075-070
- Universidade Federal do Rio Grande do Norte
-
Kontakt:
- Monica Bay, MD
- Telefonní číslo: +55 84 994141921
- E-mail: monicabay@gmail.com
-
Vrchní vyšetřovatel:
- Monica Bay, MD
-
-
Rio de Janeiro
-
Nova Iguaçu, Rio de Janeiro, Brazílie, 26030-380
- Hospital Geral de Nova Iguaçu
-
Kontakt:
- Aline Santos Ramalho Teixeira Benevenuto, MD
- Telefonní číslo: 295 +55 21 35132812
- E-mail: alineramalhopesquisa@gmail.com
-
Vrchní vyšetřovatel:
- Aline Santos Ramalho Teixeira Benevenuto, MD
-
-
São Paulo
-
São Paulo, São Paulo, Brazílie, 04037-030
- RDSS - Ricardo Sobhie Diaz & Cia Solucoes Cientificas Ltda - Ricardo Diaz Scientific Solution
-
Kontakt:
- Ricardo Sobhie Diaz, MD
- Telefonní číslo: +55(21)99799-4412
- E-mail: daniele.lunacunha@ricardodiaz.com.br
-
Vrchní vyšetřovatel:
- Ricardo Sobhie Diaz, MD
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dítě
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
All persons who are eligible must meet all of the following:
- Confirmed HIV-1 infection: All tests must use blood, serum, or plasma samples. Documentation may be obtained from medical records. HIV-1 positive is defined as having HIV-1 RNA in plasma ≥ 1000 copies/mL, plus one antibody test or two positive HIV antibody tests (two different rapid tests or one rapid test and one positive ELISA/EIE test). If any of these diagnostic test results are not available, they will be performed at the SCR visit. In all cases, an HIV viral load test will be performed.
- Not exposed to prior antiretroviral therapy (ART): No prior antiretroviral therapy, including exposure to PrEP and/or PEP in the last 6 months.
- Ability to sign the informed consent form.
- Plasma HIV-1 RNA ≥1000 copies/mL. Viral load from the last 30 days may be valid. . Age ≥ 16 years or older in Argentina, ≥ 15 years or older in Brazil. The participant must be of the age required in their country of residence to give legal informed consent. Otherwise, informed consent must be signed by a parent or legal guardian, according to country guidelines, in addition to the participant.
6. Pregnant at any gestational age up to 32 weeks at the time of the screening visit: Viable pregnancy with a gestational age ≤32 weeks, defined according to menstrual history and/or ultrasound. Note: If the menstrual history is unknown or if there is a discrepancy between the menstrual history and the ultrasound, the gestational age will be determined based on the best technology available at each center.
7. The participant intends to continue with the pregnancy.
Exclusion Criteria:
All eligible individuals must NOT meet any of the following criteria:
- Documented resistance to 3TC (presence of the M184V/I mutation) or DTG (defined as the presence of G118R, Q148 H/K/R, or R263K).
- Active hepatitis C infection. 3. Active hepatitis B (HBsAg positive or detectable HBV viral load in cases with isolated positive HBV anti-core).
- Hemoglobin <8 g/dL.
- Fetal abnormalities detected on ultrasound
- Concomitant medications required with possible drug interactions specified in section 5.10.
- ALT >=5 times the ULN, or ALT >=3xULN and bilirubin >=1.5xULN (with >35% direct bilirubin). Participants with severe hepatic impairment (Class C) as determined by Child-Pugh classification
- Presence of severe preeclampsia or other pregnancy-related events, in current or previous pregnancies, such as renal or hepatic abnormalities (grade 2 or higher proteinuria, elevated serum creatinine, CrCl <50 mL/min, total bilirubin, ALT, or AST).
- Active opportunistic infection at screening: active severe opportunistic infections and/or severe bacterial infection, including active tuberculosis or severe disease or unstable clinical condition within 14 days prior to study entry.
- Any patient or disease-related condition that, in the investigator's opinion, would prevent the patient from adhering to study medication or complying with study visits or procedures.
- Problematic drug and/or alcohol use, which in the opinion of the site investigator could interfere with therapeutic compliance with study requirements.
- Known allergy or sensitivity to any of the study medications or their formulations.
- Vomiting or any other reason generating inability to swallow medications due to a pre-existing active disorder that prevents proper swallowing and absorption of study medications.
- Creatinine Clearance of <30 mL/min . If a creatinine value was obtained within 30 days prior to the screening visit, it may be used to calculate the CrCl.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: Experimental
Dolutegravir plus Lamivudine DOVATO: Dolutegravir 50mg/lamivudine 300 mg, FDC, 1 coformulated tablet QD
|
1 pill QD
Ostatní jména:
|
|
Aktivní komparátor: Active Comparator
TDF/XTC or TAF/FTC plus Dolutegravir (XTC stands for lamivudine OR emtricitabine)
|
1 pill of each QD
Ostatní jména:
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
To evaluate the virological response to Dolutegravir/Lamivudine in pregnant women with HIV who are starting antiretroviral therapy and vertical transmission in exposed neonates
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Endpoints:
|
From enrollment to the end of treatment at 6 months after delivery
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
- To evaluate the incidence of adverse maternal events.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Frequency of grade 2 or higher maternal adverse events, by type and severity, from baseline to 6 months postpartum
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- To evaluate perinatal outcomes at delivery
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Frequency of spontaneous abortion, preterm delivery, congenital malformations at birth or identified and reported during the first 6 month of life, or intrauterine fetal death.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- To evaluate maximum virological suppression at delivery
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Proportion of pregnant women with plasma viral load below 50 copies/mL at delivery.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- To evaluate the incidence of changes in body weight exceeding what is expected for gestation
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Average total weight gain and BMI during pregnancy, compared with recommendations based on pre-pregnancy BMI.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- To evaluate the immune response based on changes in CD4, CD8, and CD4/CD8 ratio values during pregnancy.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Changes in CD4 lymphocyte count and CD4/CD8 ratio between baseline and delivery visit values.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- Assess baseline resistance and the development of resistance to virological failure to integrase inhibitors and INTRs during treatment with DTG+3TC, DTG+TDF/XTC or DTG+TAF/FTC.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Frequency and type of mutations according to the International AIDS Society (IAS-USA drug resistance mutations, 2025) mutation guidelines panel at the baseline visit and in case of virological failure at any time during the study.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- To evaluate the incidence of HIV infection in children that breastfeed.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Proportion of HIV infection among breastfed children
|
From enrollment to the end of treatment at 6 months after delivery
|
|
To evaluate safety outcomes and virological response of DTG+3TC compared to DTG+TDF/XTC or DTG+TAF/FTC. Part 1 of 2.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Frequency of grade 2 or higher maternal adverse events, by type and severity, between the two arms.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
To evaluate safety outcomes and virological response of DTG+3TC compared to DTG+TDF/XTC or DTG+TAF/FTC. Part 2 of 2
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Frequency of pregnant women with plasma viral load <200 copies/mL in the two arms at delivery visit
|
From enrollment to the end of treatment at 6 months after delivery
|
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
- To explore the non-inferiority of DTG+3TC therapy compared to DTG+TDF/XTC or DTG+TAF/FTC treatment.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Difference in the proportion of pregnant women who achieve an HIV-1 plasma viral load of less than 50 copies/mL at delivery between the DTG+3TC and DTG+TDF/XTC or DTG+TAF/FTC groups, to explore the non-inferiority of the dual regimen.
|
From enrollment to the end of treatment at 6 months after delivery
|
|
- To evaluate the frequency of antiretroviral therapy withdrawal or modification before delivery.
Časové okno: From enrollment to the end of treatment at 6 months after delivery
|
Proportion of participants requiring a change in antiretroviral regimen (due to lack of efficacy, adverse events, medical decision, or other reasons) before delivery
|
From enrollment to the end of treatment at 6 months after delivery
|
Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Pedro Enrinque Cahn, MD, Fundacion Huesped
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
- FH-94
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Časový rámec sdílení IPD
Kritéria přístupu pro sdílení IPD
Typ podpůrných informací pro sdílení IPD
- PROTOKOL STUDY
- MÍZA
- ICF
- CSR
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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