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Efficacy and Safety of E/C/F/TAF (Genvoya®) in HIV-1/Hepatitis B Co-infected Adults

19 octobre 2018 mis à jour par: Gilead Sciences

A Phase 3b Open-label Study of the Efficacy and Safety of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Single-Tablet Regimen in HIV-1/Hepatitis B Co-infected Adults

This study will assess the efficacy, safety, and tolerability of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) fixed-dose combination (FDC) in human immunodeficiency virus (HIV)/hepatitis B virus (HBV) coinfected adults.

Participants will be enrolled into two cohorts:

  • Cohort 1: HIV/HBV coinfected adults who are HIV treatment-naive and HBV treatment-naive
  • Cohort 2: HIV/HBV coinfected adults who are HIV-suppressed

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Réel)

79

Phase

  • Phase 3

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5G 2N2
        • University Health Network/Toronto General Hospital
      • Toronto, Ontario, Canada, M5G1K2
        • Maple Leaf Research/Maple Leaf Medical Clinic
  • Japon
    • Tokyo
      • Shinjuku-ku, Tokyo, Japon, 1628655
        • Center Hospital of the National Center for Global Health and Medicine
  • États-Unis
    • Arizona
      • Phoenix, Arizona, États-Unis, 85012
        • Spectrum Medical Group
    • California
      • Beverly Hills, California, États-Unis, 90211
        • AHF Research Center
      • Los Angeles, California, États-Unis, 90036
        • Peter J. Ruane MD, Inc.
      • Los Angeles, California, États-Unis, 90069
        • Anthony Mills MD, Inc
    • District of Columbia
      • Washington, District of Columbia, États-Unis, 20009
        • Whitman Walker Health
    • Florida
      • Clearwater, Florida, États-Unis, 33765
        • Barry M. Rodwick MD
      • Fort Lauderdale, Florida, États-Unis, 33316
        • Gary J Richmond M.D.,P.A.
      • Fort Pierce, Florida, États-Unis, 34982
        • Midway Immunology and Research Center
      • Miami Beach, Florida, États-Unis, 33139
        • AIDS Health Foundation/WPA
      • Vero Beach, Florida, États-Unis, 32960
        • AIDS Research and Treatment Center of the Treasure Coast
      • West Palm Beach, Florida, États-Unis, 33401
        • Triple O Research Institute PA
    • Michigan
      • Berkley, Michigan, États-Unis, 48072
        • Be Well Medical Center PC
    • Missouri
      • Kansas City, Missouri, États-Unis, 64111
        • KC Care Clinic
      • Saint Louis, Missouri, États-Unis, 63139
        • Southampton Healthcare, Inc.
    • New Mexico
      • Santa Fe, New Mexico, États-Unis, 87505
        • Southwest CARE Center
    • Texas
      • Austin, Texas, États-Unis, 78705
        • Central Texas Clinical Research
      • Bellaire, Texas, États-Unis
        • St. Hope Foundation
      • Dallas, Texas, États-Unis, 75246
        • North Texas Infectious Diseases Consultants
      • Houston, Texas, États-Unis, 77004
        • Therapeutic Concepts
      • Houston, Texas, États-Unis, 77098
        • Gordon E. Crofoot MD PA
    • Washington
      • Seattle, Washington, États-Unis, 98104
        • Peter Shalit MD

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Key Inclusion Criteria:

  • Both Cohorts 1 and 2:

    • The ability to understand and sign a written informed consent form, which must be obtained prior to initiation of study procedures
    • HIV/HBV co-infected adult males and non-pregnant and non-lactating females

    • No evidence of hepatocellular carcinoma (HCC) or clinical or imaging evidence of cirrhosis (ascites, variceal bleeding, encephalopathy).

      --- Subjects should have documentation of an abdominal ultrasound in the 12 months prior to screening, or an abdominal ultrasound at screening, demonstrating the absence of cirrhosis and HCC.

    • Acute Hepatitis A virus (HAV) immunoglobulin M (IgM) negative
    • Hepatitis C virus (HCV) Ab negative, or HCV Ab positive with negative HCV RNA
    • Hepatitis D virus (HDV) Ab negative, or HDV Ab positive with negative HDV RNA
    • Estimated glomerular filtration rate (eGFR) ≥ 50 mL/min according to the Cockcroft-Gault formula
    • CD4+ count of > 200 cells/μL

    • Chronic HBV infection as defined by

      • HBsAg positive for ≥ 6 months Or
      • HBsAg positive at screening and either hepatitis B e antigen (HBeAg) or HBV DNA positive ≥ 6 months Or

      • At screening: positive total hepatitis B core antibody (HBcAb) and negative immunoglobulin M antibody to hepatitis B core antigen (HBcIgM) antibody, and

        • HBsAg positive, or
        • HBeAg positive, or
        • HBV DNA positive

  • Cohort 1 (HIV and HBV treatment naive) only:

    • No current or prior anti-HIV treatment, including antiretroviral medications received for prevention (PrEP), or post exposure prophylaxis (PEP)
    • No current or prior anti-HBV treatment
    • Plasma HIV-1 RNA level ≥ 500 copies/mL at screening
    • Screening HBV DNA ≥ 3 log10 IU/mL and < 9 log10 IU/mL

  • Cohort 2 (HIV suppressed) only:

    • Receiving current antiretroviral regimen for at least 4 consecutive months
    • No current or prior regimen containing 3 active anti-HBV agents (i.e. cannot be on tenofovir alafenamide (TDF)/emtricitabine (FTC)/Entecavir or TDF/lamivudine(3TC)/Entecavir)
    • Maintained plasma HIV-1 RNA < 50 copies/mL for 6 consecutive months prior to and at the time of the screening visit. Unconfirmed virologic evaluation of ≥ 50 copies/mL after previously reaching viral suppression (transient detectable viremia, or "blip") and prior to screening is acceptable
    • Documented positive HIV antibody test
    • Screening HBV DNA < 9 log10 IU/mL

Key Exclusion Criteria:

  • Females who are breastfeeding
  • Positive serum pregnancy test (female of childbearing potential)
  • Have an implanted defibrillator or pacemaker
  • Current alcohol or substance use
  • A history of malignancy within the past 5 years (prior to screening) or ongoing malignancy other than cutaneous Kaposi's sarcoma (KS), basal cell carcinoma, or resected, non-invasive carcinoma.
  • Received solid organ or bone marrow transplant
  • Any history of, or current evidence of, clinical hepatic decompensation (e.g., ascites, encephalopathy or variceal hemorrhage).
  • Significant bone disease (e.g., osteomalacia, chronic osteomyelitis, osteogenesis imperfecta, osteochondroses), or multiple bone fractures
  • Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to Day 1
  • Subjects on hemodialysis, other forms of renal replacement therapy, or on treatment for underlying kidney diseases (including prednisolone, and dexamethasone)
  • Any other clinical condition or prior therapy that, in the opinion of the Investigator, would make the subject unsuitable for the study or unable to comply with the dosing requirements
  • Investigational agents (unless approved by Gilead Sciences). Participation in any other clinical trial without prior approval from the sponsor is prohibited while participating in this trial

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: HIV treatment-naive and HBV treatment-naive
HIV/HBV coinfected participants who are HIV treatment-naive and HBV treatment-naive will receive E/C/F/TAF for 48 weeks.
Médicament: E/C/F/TAF
E/C/F/TAF (150/150/200/10 mg) FDC tablet administered orally once daily with food
Autres noms:
  • Genvoya®
Expérimental: HIV-suppressed
HIV/HBV coinfected participants who are HIV-suppressed will receive E/C/F/TAF for 48 weeks.
Médicament: E/C/F/TAF
E/C/F/TAF (150/150/200/10 mg) FDC tablet administered orally once daily with food
Autres noms:
  • Genvoya®

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants With Plasma HIV-1 RNA Level < 50 Copies/mL
Délai: Week 24
The percentage of participants achieving HIV-1 RNA < 50 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Week 24
Percentage of Participants With Plasma HBV DNA Levels < 29 IU/mL
Délai: Week 24
The percentage of participants with HBV DNA < 29 IU/mL at Week 24 was calculated using the missing = failure method.
Week 24

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants With Plasma HIV-1 RNA Level < 50 Copies/mL
Délai: Week 48
The percentage of participants achieving HIV-1 RNA < 50 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
Week 48
Percentage of Participants With Plasma HBV DNA Levels < 29 IU/mL
Délai: Week 48
The percentage of participants with HBV DNA < 29 IU/mL at Week 48 was calculated using the missing = failure method.
Week 48
Percentage of Participants With Normalized Alanine Aminotransferase (ALT) at Week 24
Délai: Baseline; Week 24
ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit.
Baseline; Week 24
Percentage of Participants With Normalized ALT at Week 48
Délai: Baseline; Week 48
ALT normalization was defined as an ALT value that changed from above the normal range at baseline to within the normal range at the given postbaseline visit.
Baseline; Week 48
Percentage of Participants With Seroconversion to Hepatitis B Surface Antibody (Anti-HBs) at Week 24
Délai: Baseline; Week 24
Seroconversion to antibody is defined as (1) antigen loss and (2) positive postbaseline antibody value. Missing = excluded method.
Baseline; Week 24
Percentage of Participants With Seroconversion to Anti-HBs at Week 48
Délai: Baseline; Week 48
Seroconversion to antibody is defined as (1) antigen loss and (2) positive postbaseline antibody value. Missing = excluded method.
Baseline; Week 48
Percentage of Participants With Seroconversion to Hepatitis B e Antibody (Anti-HBe) at Week 24
Délai: Baseline; Week 24
Seroconversion to antibody is defined as (1) antigen loss and (2) positive postbaseline antibody value. Missing = excluded method.
Baseline; Week 24
Percentage of Participants With Seroconversion to Anti-HBe at Week 48
Délai: Baseline; Week 48
Seroconversion to antibody is defined as (1) antigen loss and (2) positive postbaseline antibody value. Missing = excluded method.
Baseline; Week 48
Change From Baseline in FibroTest® Score at Week 24
Délai: Baseline; Week 24
The FibroTest® score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis.
Baseline; Week 24
Change From Baseline in FibroTest® Score at Week 48
Délai: Baseline; Week 48
The FibroTest® score is used to assess liver fibrosis. Scores range from 0.00 to 1.00, with higher scores indicating a greater degree of fibrosis.
Baseline; Week 48

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Gilead Sciences

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

25 février 2014

Achèvement primaire (Réel)

23 janvier 2015

Achèvement de l'étude (Réel)

26 octobre 2016

Dates d'inscription aux études

Première soumission

21 février 2014

Première soumission répondant aux critères de contrôle qualité

21 février 2014

Première publication (Estimation)

25 février 2014

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

16 novembre 2018

Dernière mise à jour soumise répondant aux critères de contrôle qualité

19 octobre 2018

Dernière vérification

1 octobre 2017

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • GS-US-292-1249

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

Oui

Description du régime IPD

Qualified external researchers may request IPD for this study after study completion. For more information, please visit our website at http://www.gilead.com/research/disclosure-and-transparency.

Délai de partage IPD

18 months after study completion

Critères d'accès au partage IPD

A secured external environment with username, password, and RSA code.

Type d'informations de prise en charge du partage d'IPD

  • Protocole d'étude
  • Plan d'analyse statistique (PAS)

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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