- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT01721109
Pharmacokinetics, Safety, and Efficacy of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Disoproxil Fumarate Single Tablet Regimen (STR) in Adolescents
A Phase 2/3, Open-Label Study of the Pharmacokinetics, Safety, and Antiviral Activity of the Elvitegravir/ Cobicistat/Emtricitabine/Tenofovir Disoproxil Fumarate Single Tablet Regimen (STR) in HIV-1 Infected Antiretroviral Treatment-Naive Adolescents
The primary objectives of this study are to evaluate the steady-state pharmacokinetics (PK) and confirm the dose of the elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) single-tablet regimen (STR) (Part A) and to evaluate the safety and tolerability of EVG/COBI/FTC/TDF STR through Week 48 (Part B) in HIV-1 infected, antiretroviral (ARV) treatment-naive adolescents.
A total of 50 adolescent participants (12 to < 18 years of age) will be enrolled to receive EVG/COBI/FTC/TDF as follows:
- Part A: Twelve to 16 eligible participants will be enrolled to evaluate steady-state PK, and confirm the dose, with the intent to enroll at least 4 participants 12 to < 15 and at least 4 participants 15 to < 18 years of age.
- Part B: Following confirmation of EVG exposure in at least 12 participants from Part A, 34 to 38 participants in addition to those enrolled in Part A will be enrolled to evaluate the safety, tolerability, and antiviral activity of EVG/COBI/FTC/TDF STR.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
- Fas 3
Kontakter och platser
Studieorter
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California
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Oakland, California, Förenta staterna, 94609
- East Bay AIDS Center Medical Group
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Florida
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Tampa, Florida, Förenta staterna, 33606
- University of South Florida - Department of Pediatrics
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Illinois
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Chicago, Illinois, Förenta staterna, 60637
- University of Chicago
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New York
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Bronx, New York, Förenta staterna, 10467
- Montefiore Medical Center
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New York, New York, Förenta staterna, 10016
- New York University School of Medicine
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Pennsylvania
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Philadelphia, Pennsylvania, Förenta staterna, 19134
- St. Christopher's Hospital for Children
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Tennessee
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Memphis, Tennessee, Förenta staterna, 38105
- St. Jude Children's Research Hospital
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Cape Town, Sydafrika, 7925
- Desmond Tutu HIV Research Centre
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Dundee, Sydafrika, 3000
- Mpati Medical Center
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Johannesburg, Sydafrika, 2092
- Clinical HIV Research Unit
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Soweto, Sydafrika, 2013
- Perinatal HIV Research Unit
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Stellenbosch, Sydafrika, 7602
- University of Stellenbosch
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Gauteng
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Johannesburg, Gauteng, Sydafrika, 2112
- Rahima Moosa Mother and Child Hospital (Wits)
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Kwazulu-Natal
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Durban, Kwazulu-Natal, Sydafrika, 4001
- Dr Latiff Private Practice
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Bangkok, Thailand, 10330
- The HIV Netherlands Australia Thailand Research collaboration (HIV-NAT)
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Bangkok, Thailand, 10700
- Siriraj Hospital, Mahidol University
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Chon Buri, Thailand, 20110
- Queen Savang Vadhana Memorial Hospital
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Khon Kaen, Thailand, 40002
- Srinakarind Hospital
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Key Inclusion Criteria:
- 12 years to < 18 years of age at baseline
- Able to give written assent prior to any screening evaluations
- Parent or guardian able to give written informed consent prior to any screening evaluations and willing to comply with study requirements
- Plasma HIV-1 RNA levels of ≥ 1,000 copies/mL
- CD4+ cell count > 100 cells/µL
- Weight ≥ 35 kg (77 lbs)
- Screening genotype report must show sensitivity to FTC and TDF
- Able to swallow oral tablets
- Adequate renal function
- Clinically normal ECG
- Documented screening for active pulmonary tuberculosis per local standard of care within 6 months of a screening visit
- Hepatic transaminases ≤ 5 x upper limit of normal
- Total bilirubin ≤ 1.5 mg/dL, or normal direct bilirubin
- Individuals with a positive Hepatitis B surface antigen screening test can participate in the study, providing that alternate therapy (other than TDF) for chronic Hepatitis B infection is available as a part of local standard of care
- Adequate hematologic function
- Negative serum pregnancy test for all females
- Males and females of childbearing potential must agree to utilize highly effective contraception methods while on study treatment or agree to abstain from heterosexual intercourse throughout the study period and for 30 days following the last dose of study drug
- Males must agree to utilize a highly effective method of contraception during heterosexual intercourse throughout the study period and for 30 days following discontinuation of investigational medicinal product
- Must be willing and able to comply with all study requirements
- Life expectancy ≥ 1 year
Key Exclusion Criteria:
- A new AIDS-defining condition diagnosed within the 30 days prior to screening
- Prior treatment with any approved or investigational or experimental anti HIV-1 drug for any length of time (other than that given for prevention of mother-to-child transmission)
- Evidence of active pulmonary or extra-pulmonary tuberculosis disease within 3 months of the screening visit
- Anticipated to require rifamycin treatment for mycobacterial infection while participating in the study. Note: prophylactic Isoniazid (INH) therapy for latent tuberculosis (TB) treatment is allowed.
- Individuals experiencing decompensated cirrhosis
- Pregnant or lactating females
- Have any serious or active medical or psychiatric illness which would interfere with treatment, assessment, or compliance with the protocol. This would include uncontrolled renal, cardiac, hematological, hepatic, pulmonary, endocrine, central nervous, gastrointestinal, vascular, metabolic, immunodeficiency disorders, active infection, or malignancy that are clinically significant or requiring treatment within 30 days prior to the study dosing.
- Current alcohol or substance abuse that will potentially interfere with compliance
- Have history of significant drug sensitivity or drug allergy
- Known hypersensitivity to the study drugs, the metabolites or formulation excipients
- Have been treated with immunosuppressant therapies or chemotherapeutic agents within 3 months of study screening or expected to receive these agents during the study
- A history of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous carcinoma
- Have previously participated in an investigational trial involving administration of any investigational agent within 30 days prior to the study dosing
- Participation in any other clinical trial without prior approval from sponsor is prohibited while participating in this trial
- Receiving ongoing therapy with any disallowed medications, including drugs not to be used with EVG, COBI, FTC, TDF or individuals with any known allergies to the excipients of EVG/COBI/FTC/TDF STR tablets
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: EVG/COBI/FTC/TDF
Participants will receive treatment for 48 weeks and then had the option to enter an Extension Phase to receive EVG/COBI/FTC/TDF until 1) the age of 18, 2) EVG/COBI/FTC/TDF becomes commercially available in the country the participant is enrolled, or 3) Gilead elects to terminate the development of EVG/COBI/FTC/TDF in that country.
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150/150/200/300 mg STR administered orally once daily with food
Andra namn:
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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For Part A, Pharmacokinetic (PK) Parameter: AUCtau of EVG
Tidsram: Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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AUCtau is defined as concentration of drug over time (the area under the concentration verses time curve over the dosing interval).
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Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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Incidence of Treatment-Emergent Serious Adverse Events (SAEs) and All Treatment-Emergent Adverse Events (AEs)
Tidsram: Up to Week 48 plus 30 days
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Up to Week 48 plus 30 days
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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For Part A, PK Parameter: Ctau of EVG, FTC, Tenofovir (TFV), and COBI
Tidsram: Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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Ctau is defined as the observed drug concentration at the end of the dosing interval.
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Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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For Part A, PK Parameter: Cmax of EVG, FTC, TFV, and COBI
Tidsram: Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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Cmax is defined as the maximum concentration of drug.
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Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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For Part A, PK Parameter: AUCtau of FTC, TFV, and COBI
Tidsram: Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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AUCtau is defined as concentration of drug over time (the area under the concentration verses time curve over the dosing interval).
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Predose, 2, 4, 4.5, 5, 8, and 12 hours postdose on Day 10
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Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Weeks 24 and 48 as Defined by the FDA Snapshot Analysis
Tidsram: Weeks 24 and 48
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Weeks 24 and 48
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Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Weeks 24 and 48 as Defined by the FDA Snapshot Analysis
Tidsram: Weeks 24 and 48
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Weeks 24 and 48
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Change From Baseline in Plasma log10 HIV-1 RNA at Weeks 24 and 48
Tidsram: Baseline; Weeks 24 and 48
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Baseline; Weeks 24 and 48
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Ändring från baslinjen i CD4+-cellantal vid vecka 24 och 48
Tidsram: Baslinje; Vecka 24 och 48
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Baslinje; Vecka 24 och 48
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Change From Baseline in CD4 Percentage at Weeks 24 and 48
Tidsram: Baseline; Weeks 24 and 48
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Baseline; Weeks 24 and 48
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Samarbetspartners och utredare
Sponsor
Publikationer och användbara länkar
Allmänna publikationer
- Gaur A, Fourie J, Chokephaibulkit K, Bekker L-G, Yin X, Custodio J, Bennett S, Cheng A, Quirk E. Pharmacokinetics, Efficacy and Safety of an Integrase Inhibitor-Based Single-Tablet Regimen in HIV-Infected Treatment-Naïve Adolescents. 21st Conference on Retroviruses and Opportunistic Infections (CROI). March 2014. Boston, MA, USA
- Chokephaibulkit K, Gaur A, Fourie J, Bekker L-G, Shao Y, Custodio J, Bennett S, Cheng A, Quirk E. Safety and Efficacy of the Integrase Inhibitor-Based Stribild Single-Tablet Regimen in HIV-Infected Adolescents Through 24 Weeks of Treatment. 20th International AIDS Conference. July 2014. Melbourne, Australia
- Porter DP, Bennett S, Quirk E, Miller MD, White KL. Lack of Emergent Resistance in HIV-1-Infected Adolescents on Elvitegravir-Based STRs. 22nd Conference on Retroviruses and Opportunistic Infections (CROI). February 2015. Seattle, WA, USA
- Kizito H, Gaur A, Prasitsuebsai W, Rakhmanina N, Chokephaibulkit K, Fourie J, Bekker LG, Shao Y, Bennett S, Quirk E. Changes in renal laboratory markers and bone mineral density in treatment-naïve HIV-1-infected adolescents initiating INSTI-based single-tablet regimens containing tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF). 8th IAS Conference on HIV Pathogenesis, Treatment & Prevention. July 2015. Vancouver, Canada
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- RNA-virusinfektioner
- Virussjukdomar
- Infektioner
- Blodburna infektioner
- Smittsamma sjukdomar
- Sexuellt överförbara sjukdomar, virala
- Sexuellt överförbara sjukdomar
- Lentivirusinfektioner
- Retroviridae-infektioner
- Immunsystemets sjukdomar
- Långsamma virussjukdomar
- HIV-infektioner
- Förvärvat immunbristsyndrom
- Immunologiska bristsyndrom
- Anti-infektionsmedel
- Antivirala medel
- Anti-HIV-medel
- Antiretrovirala medel
- Elvitegravir, Cobicistat, Emtricitabin, Tenofovir Disoproxil Fumarate Läkemedelskombination
Andra studie-ID-nummer
- GS-US-236-0112
- 2015-000313-40 (EudraCT-nummer)
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Studerar en amerikansk FDA-reglerad produktprodukt
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Kliniska prövningar på EVG/COBI/FTC/TDF
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Gilead SciencesAvslutadHIV-infektioner | HIVKanada, Förenta staterna, Spanien, Puerto Rico, Frankrike, Schweiz, Australien, Tyskland, Storbritannien, Sverige, Brasilien, Österrike, Thailand, Nederländerna, Belgien, Dominikanska republiken, Portugal, Italien, Danmark, Mexiko
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Juan A. ArnaizOkänd
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Fundacion SEIMC-GESIDAAvslutad
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University of WashingtonEunice Kennedy Shriver National Institute of Child Health and Human Development... och andra samarbetspartnersAvslutadHypoöstrogenism | Bendemineralisering | Subklinisk njurskada | BenmikroarkitekturUganda
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Yale UniversityAvslutadHIV-infektionerFörenta staterna
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French National Agency for Research on AIDS and...Merck Sharp & Dohme LLCAvslutad
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Duke UniversityAvslutad
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Auritec PharmaceuticalsEunice Kennedy Shriver National Institute of Child Health and Human Development... och andra samarbetspartnersAvslutadProfylax för humant immunbristvirus (HIV).Förenta staterna
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ANRS, Emerging Infectious DiseasesUniversity of KwaZulu; Africa Centre For Health and Population StudiesAvslutad
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Gilead SciencesAvslutadHIV-infektioner | Förvärvat immunbristsyndromFörenta staterna, Puerto Rico