- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne 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.
Przegląd badań
Status
Warunki
Szczegółowy opis
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 studiów
Zapisy (Szacowany)
Faza
- Faza 4
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: María Inés Figueroa, MD
- Numer telefonu: +541149817777
- E-mail: maria.figueroa@huesped.org.ar
Kopia zapasowa kontaktu do badania
- Nazwa: Emanuel Dell'Isola, Mr.
- Numer telefonu: +541149817777
- E-mail: emanuel.dellisola@huesped.org.ar
Lokalizacje studiów
-
-
Buenos Aires
-
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentyna, C1155AHD
- Rekrutacyjny
- Hospital General de Agudos Dr. Cosme Argerich
-
Kontakt:
- Diego Cecchini, MD
- Numer telefonu: +54911 54976263
- E-mail: diegocec@gmail.com
-
Główny śledczy:
- Diego Cecchini, MD
-
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentyna, C1188AAF
- Rekrutacyjny
- Sanatorio Güemes
-
Kontakt:
- Verónica Lacal, MD
- Numer telefonu: +54 9 11 58296259
- E-mail: verolacal@gmail.com
-
Kontakt:
- Sebastián Nuñez, MD
- Numer telefonu: 8384 / 8365 +54 11 4959-8200
- E-mail: snunez@fsg.edu.ar
-
Główny śledczy:
- Verónica Lacal, MD
-
Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentyna, C1425AGP
- Rekrutacyjny
- Hospital de Agudos J.A. Fernandez
-
Kontakt:
- María José Rolón, MD
- Numer telefonu: +54 011 48082627
- E-mail: fernandez_infectologia@buenosaires.gob.ar
-
Kontakt:
- José MD, Barletta
- Numer telefonu: +54 011 48082627
- E-mail: fernandez_infectologia@buenosaires.gob.ar
-
Główny śledczy:
- María José Rolón, MD
-
El Palomar, Buenos Aires, Argentyna, B1684
- Jeszcze nie rekrutacja
- Hospital Nacional Profesor Alejandro Posadas
-
Kontakt:
- Mariana Golikow, MD
- Numer telefonu: +54 9 11 3803-1126
- E-mail: marugolikow@gmail.com
-
Główny śledczy:
- Mariana Golikow, MD
-
Isidro Casanova, Buenos Aires, Argentyna, B1765
- Jeszcze nie rekrutacja
- Hospital de Agudos Paroissien
-
Kontakt:
- Pablo Garnica, MD
- Numer telefonu: +54 9 15-5958-4516
- E-mail: andrespablo451@hotmail.com
-
Kontakt:
- Eduardo Warley, MD
- Numer telefonu: +54 011 1541897181
- E-mail: eduwarley@yahoo.com.ar
-
Główny śledczy:
- Pablo Garnica, MD
-
-
-
-
-
São Paulo, Brazylia, 04037-030
- Jeszcze nie rekrutacja
- RDSS - Ricardo Sobhie Diaz & Cia Solucoes Cientificas Ltda - Ricardo Diaz Scientific Solution
-
Kontakt:
- Ricardo Sobhie Diaz, MD
- Numer telefonu: +55(21)99799-4412
- E-mail: daniele.lunacunha@ricardodiaz.com.br
-
Główny śledczy:
- Ricardo Sobhie Diaz, MD
-
-
Estado de Bahia
-
Salvador, Estado de Bahia, Brazylia, 40110-160
- Jeszcze nie rekrutacja
- Fundação Bahiana de Infectologia
-
Kontakt:
- Carlos Brites, MD
- Numer telefonu: +55 71 99232-9552
- E-mail: crbrites@gmail.com
-
Kontakt:
- Anne Kettley Lacerda de L. Gonzaga, RN
- Numer telefonu: +55 (71) 3646-3561
- E-mail: annegonzaga.fbai@outlook.com
-
Główny śledczy:
- Carlos Brites, MD
-
-
Pernambuco
-
Curitiba, Pernambuco, Brazylia, 80430-000
- Jeszcze nie rekrutacja
- Complexo do Hospital de Clínicas da UFPR/Ebserh
-
Kontakt:
- Monica Maria Gomes da Silva, MD
- Numer telefonu: 41-999951285
- E-mail: monica.gomez@ufpr.br
-
Główny śledczy:
- Monica Maria Gomes da Silva, MD
-
-
Rio Grande do Norte
-
Natal, Rio Grande do Norte, Brazylia, 59075-070
- Jeszcze nie rekrutacja
- Universidade Federal do Rio Grande do Norte
-
Kontakt:
- Monica Bay, MD
- Numer telefonu: +55 84 994141921
- E-mail: monicabay@gmail.com
-
Główny śledczy:
- Monica Bay, MD
-
-
Rio de Janeiro
-
Nova Iguaçu, Rio de Janeiro, Brazylia, 26030-380
- Jeszcze nie rekrutacja
- Hospital Geral de Nova Iguaçu
-
Kontakt:
- Aline Santos Ramalho Teixeira Benevenuto, MD
- Numer telefonu: 295 +55 21 35132812
- E-mail: alineramalhopesquisa@gmail.com
-
Główny śledczy:
- Aline Santos Ramalho Teixeira Benevenuto, MD
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dziecko
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
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.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Eksperymentalny: Experimental
Dolutegravir plus Lamivudine DOVATO: Dolutegravir 50mg/lamivudine 300 mg, FDC, 1 coformulated tablet QD
|
1 pill QD
Inne nazwy:
|
|
Aktywny komparator: Active Comparator
TDF/XTC or TAF/FTC plus Dolutegravir (XTC stands for lamivudine OR emtricitabine)
|
1 pill of each QD
Inne nazwy:
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
To evaluate the virological response to Dolutegravir/Lamivudine in pregnant women with HIV who are starting antiretroviral therapy and vertical transmission in exposed neonates
Ramy czasowe: 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
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
- To evaluate the incidence of adverse maternal events.
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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.
Ramy czasowe: 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.
Ramy czasowe: 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.
Ramy czasowe: 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.
Ramy czasowe: 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
Ramy czasowe: 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
|
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
- To explore the non-inferiority of DTG+3TC therapy compared to DTG+TDF/XTC or DTG+TAF/FTC treatment.
Ramy czasowe: 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.
Ramy czasowe: 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
|
Współpracownicy i badacze
Sponsor
Współpracownicy
Śledczy
- Główny śledczy: Pedro Enrinque Cahn, MD, Fundación Huésped
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- FH-94
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- SOK ROŚLINNY
- ICF
- CSR
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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