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Pre-Exposure Prophylaxis Study of Lenacapavir in Cisgender Men, Transgender Women, Transgender Men, and Gender Nonbinary People at Risk for HIV Infection (PURPOSE 2)

11 september 2026 uppdaterad av: Gilead Sciences

En fas 3, dubbelblind, multicenter, randomiserad studie för att utvärdera effektiviteten och säkerheten av subkutan två gånger årligen långverkande lenacapavir för hiv-pre-exponeringsprofylax hos cisgender män, transpersoner, transpersoner och icke-binära personer ≥ 16 år av Ålder som har sex med manliga partner och som är i riskzonen för hiv-infektion

The goal of this study is to evaluate the efficacy of the study drugs, lenacapavir (LEN) in preventing HIV infection, in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV-1 infection.

The primary objective of this study is to evaluate the efficacy of LEN for HIV-1 pre-exposure prophylaxis (PrEP) in participants ≥ 16 years of age who have condomless receptive anal sex with partners assigned male at birth at risk of HIV-1 infection.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Faktisk)

3292

Fas

  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Buenos Aires, Argentina, 1072
        • Hospital General de Agudos JM Ramos Mejia
      • Buenos Aires, Argentina, B7600
        • Instituto de Investigaciones Clinicas Mar del Plata
      • Buenos Aires, Argentina, 1202
        • Fundacion Huesped
      • Belo Horizonte - MG, Brasilien, 30130-100
        • Unidade de Pesquisa Clinica em Vacinas (UPqVac) da Faculdade de Medicina da Universidade
      • Canela-Salvador, Brasilien, 40110-060
        • Fundação Bahiana de Infectologia
      • Manauas, Brasilien, 69040-000
        • Fundação de Medicina Tropical Doutor Heitor Vieira Dourado / Fundação Medicina Tropical do Amazonas - FMT/IMT/AM
      • Nova Iguaçu, Brasilien, 26030-380
        • Hospital General de Nova Iguaçu - HGNI
      • Porto Alegre, Brasilien, RS 91350 200
        • Grupo Hospitalar Conceição/ Hospital Nossa Senhora da Conceição S.A.
      • Rio de Janeiro, Brasilien, 21040-360
        • Instituto Nacional de Infectologia Evandro Chagas / Fundação Oswaldo Cruz - INI FIOCRUZ
      • São Paulo, Brasilien, 01246-903
        • Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
      • São Paulo, Brasilien, 04121-000
        • Centro de Referência e Treinamento DST/AIDS
      • São Paulo, Brasilien, 06519-332
        • Center for Management and Research. SPDM-Paulista Association for the Development of Medicine-Hospital São Paulo/Federal
    • Alabama
      • Birmingham, Alabama, Förenta staterna, 35233
        • UAB Sexual Health Research Clinic
    • California
      • Loma Linda, California, Förenta staterna, 92354
        • Loma Linda University Clinical Trial Center Clinic
      • Los Angeles, California, Förenta staterna, 90069
        • Mills Clinical Research
      • Los Angeles, California, Förenta staterna, 90036
        • Ruane Clinical Research Group Inc.
      • Los Angeles, California, Förenta staterna, 90038
        • UCLA CBAM Vine Street Clinic
      • Los Angeles, California, Förenta staterna, 90059
        • Charles R. Drew University of Medicine and Science (CDU) - Clinical Translational Research Center (CTRC)
      • Los Angeles, California, Förenta staterna, 90502
        • The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
      • Palm Springs, California, Förenta staterna, 92262
        • BIOS Clinical Research
      • San Diego, California, Förenta staterna, 92103
        • UCSD Anti Viral Research Center
      • San Francisco, California, Förenta staterna, 94102
        • Optimus Medical Group
      • San Francisco, California, Förenta staterna, 94102
        • Bridge HIV at the San Francisco Department of Public Health
    • Colorado
      • Aurora, Colorado, Förenta staterna, 80045
        • University of Colorado Clinical and Translational Research Centers (CTRC)
    • Connecticut
      • New Haven, Connecticut, Förenta staterna, 06510
        • Yale University, School of Medicine
    • District of Columbia
      • Washington D.C., District of Columbia, Förenta staterna, 20009
        • Whitman-Walker Institute Inc.
      • Washington D.C., District of Columbia, Förenta staterna, 20017
        • Washington Health Institute
    • Florida
      • Fort Lauderdale, Florida, Förenta staterna, 33308
        • Therafirst Medical Center
      • Fort Lauderdale, Florida, Förenta staterna, 33316
        • Gary Richmond, MD, PA
      • Ft. Pierce, Florida, Förenta staterna, 34982
        • Midway Immunology & Research Center, LLC
      • Jacksonville, Florida, Förenta staterna, 32207
        • CAN Community Health Clinic
      • Miami, Florida, Förenta staterna, 33136
        • University of Miami Miller School of Medicine Division of Infectious Disease Research - Converge Miami
      • Miami Gardens, Florida, Förenta staterna, 33055
        • CAN Community Health
      • Orlando, Florida, Förenta staterna, 32803
        • Orlando Immunology Center
      • Sarasota, Florida, Förenta staterna, 34237
        • CAN Community Health
    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30303
        • Emory University
      • Atlanta, Georgia, Förenta staterna, 30308
        • Emory University Hospital Midtown Infectious Disease Clinic
      • Atlanta, Georgia, Förenta staterna, 30030
        • The Hope Clinic at Emory University
    • Illinois
      • Chicago, Illinois, Förenta staterna, 60613
        • Howard Brown Health Center
      • Chicago, Illinois, Förenta staterna, 60612
        • RMR Core Center
      • Chicago, Illinois, Förenta staterna, 60612
        • University of Illinois at Chicago, Department of Medicine, Division of Infectious Diseases, Project WISH
    • Indiana
      • Indianapolis, Indiana, Förenta staterna, 46202
        • Indiana University Infectious Diseases Research
    • Kentucky
      • Lexington, Kentucky, Förenta staterna, 40503
        • Baptist Health Lexington
      • Louisville, Kentucky, Förenta staterna, 40241
        • Norton Infectious Disease Specialists
    • Louisiana
      • New Orleans, Louisiana, Förenta staterna, 70119
        • LSU-CrescentCare Sexual Health Center- New Orleans Community Health Center
    • Maryland
      • Baltimore, Maryland, Förenta staterna, 21287
        • Johns Hopkins University School of Medicine
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02215
        • The Fenway Institute
    • Michigan
      • Berkley, Michigan, Förenta staterna, 48072
        • Be Well Medical Center
      • Detroit, Michigan, Förenta staterna, 48202
        • Henry Ford Hospital
    • Mississippi
      • Jackson, Mississippi, Förenta staterna, 39202
        • Open Arms Healthcare Center
    • Missouri
      • Kansas City, Missouri, Förenta staterna, 64111
        • KC CARE Health Center
    • New Jersey
      • Newark, New Jersey, Förenta staterna, 07102
        • St. Michael's Medical Center
      • Somers Point, New Jersey, Förenta staterna, 08244
        • South Jersey Infectious Disease
    • New York
      • New York, New York, Förenta staterna, 10029
        • Icahn School of Medicine at Mount Sinai- Mount Sinai Downtown
    • North Carolina
      • Chapel Hill, North Carolina, Förenta staterna, 27514
        • NC TraCS Institute - CTRC; University of North Carolina at Chapel Hill
      • Greensboro, North Carolina, Förenta staterna, 27401
        • Cone Health/Regional Center for Infectious Disease Research Center
      • Winston-Salem, North Carolina, Förenta staterna, 27103
        • Wake Forest University Health Sciences
    • Ohio
      • Cincinnati, Ohio, Förenta staterna, 45267
        • University of Cincinnati
      • Columbus, Ohio, Förenta staterna, 43210
        • The Ohio State University Wexner Medical Center
    • Pennsylvania
      • Philadelphia, Pennsylvania, Förenta staterna, 19104
        • Penn Prevention Unit
      • Philadelphia, Pennsylvania, Förenta staterna, 19107
        • Philadelphia FIGHT Community Health Centers, Jonathan Lax Treatment Center
    • South Carolina
      • Charleston, South Carolina, Förenta staterna, 29425
        • Medical University of South Carolina, Infectious Disease Clinic
      • Columbia, South Carolina, Förenta staterna, 29203
        • Prisma Health-Midlands Clinical Research Unit
      • Greenville, South Carolina, Förenta staterna, 29605
        • Prisma Health Internal Medicine Clinic
    • Tennessee
      • Memphis, Tennessee, Förenta staterna, 38105
        • St Jude Children's Research Hospital
      • Memphis, Tennessee, Förenta staterna, 38103
        • Methodist University Hospital/University of Tennessee Health Science Center, Clinical Research Center
      • Nashville, Tennessee, Förenta staterna, 37208
        • Meharry Medical College Clinical and Transitional Research Center
    • Texas
      • Austin, Texas, Förenta staterna, 78705
        • Central Texas Clinical Research
      • El Paso, Texas, Förenta staterna, 79915
        • Centro San Vincente
      • Houston, Texas, Förenta staterna, 77098
        • The Crofoot Research Center, INC
      • Houston, Texas, Förenta staterna, 77009
        • UT Health Science Center at Houston
    • Washington
      • Seattle, Washington, Förenta staterna, 98104
        • Ofiice of Dr. Peter Shalit, MD
      • Guadalajara C.P., Mexiko, 44160
        • Centro de Investigacion Farmaceutica Especializada de Occidente S.C.
      • Barranco, Peru, 15063
        • Asociacion Civil Impacta Salud y Educacion - Sede Barranco
      • Callao, Peru, 7006
        • Instituto de Medicina Tropical "Daniel Alcides Carrion", Facultad de Medicina Humana, UNMSM
      • Iquitos, Peru
        • Asociacion Civil Selva Amazonica
      • Lima, Peru, 15001
        • Via Libre
      • Lima, Peru, 15088
        • Asociacion Civil Impacta Salud y Educacion - Sede San Miguel
    • PR
      • San Juan, PR, Puerto Rico, 00717
        • Ararat Research Center
      • San Juan, PR, Puerto Rico, 00909
        • Centro Ararat- San Juan
      • Cape Town, Sydafrika, 7925
        • Desmond Tutu Health Foundation
      • Johannesburg, Sydafrika, 2038
        • Wits Reproductive Health and HIV Institute (Wits RHI)
      • Pretoria, Sydafrika, 87
        • The Aurum Institute: Pretoria Clinical Research Centre
      • Soshanguvhe, Sydafrika, 0152
        • Setshaba Research Centre
      • Tembisa, Sydafrika, 1632
        • The Aurum Institute Tembisa CRC, Clinic 4
      • Vincent, Sydafrika, 5217
        • FPD-DTHF Ndevana Commuity Research Site
      • Bangkok, Thailand, 10330
        • King Chulalongkorn Memorial Hospital
      • Bangkok, Thailand, 10400
        • Ramathibodi Hospital, Mahidol University
      • Bangkok, Thailand, 10330
        • Institute of HIV Research and Innovation
      • Bangkok, Thailand, 10330
        • The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS research Centre
      • Chiang Mai, Thailand, 50200
        • Research Institute for Health Sciences, Chiang Mai University
      • Khon Kaen, Thailand, 40002
        • Srinagarind Hospital, Khon Kaen University
      • Nonthaburi, Thailand, 11000
        • Bamrasnaradura Infectious Disease Institute

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

16 år och äldre (Barn, Vuxen, Äldre vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Key Inclusion Criteria:

Incidence Phase

  • CGM, TGW, TGM, and GNB who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV infection.

  • HIV-1 status unknown at screening and no prior HIV-1 testing within the last 3 months.

  • Sexually active with ≥ 1 partner assigned male at birth (condomless receptive anal sex) in the last 12 months and 1 of the following:

    • Condomless receptive anal sex with ≥ 2 partners in the last 12 weeks.
    • History of syphilis, rectal gonorrhea, or rectal chlamydia in the last 24 weeks.
    • Self-reported use of stimulants with sex in the last 12 weeks.

Randomized Phase

  • Negative local rapid fourth generation HIV-1/2 Ab/Ag, central fourth generation HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT).
  • Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min at screening according to the Cockcroft-Gault formula for creatinine clearance (CLcr).

Key Exclusion Criteria:

Incidence Phase

  • Prior use of HIV PrEP (including F/TDF or F/TAF) or HIV postexposure prophylaxis (PEP) in the past 12 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir).
  • Prior recipient of an HIV vaccine or HIV broadly neutralizing antibody formulation.

Randomized Phase

  • Acute viral hepatitis A, B or C or evidence of chronic hepatitis B or C infection.
  • Severe hepatic impairment or a history of or current clinical decompensated liver cirrhosis.

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Randomized Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF

Participants will receive the following for up to approximately 52 weeks:

  • Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks
  • Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily
  • Oral LEN 600 mg on Days 1 and 2

Participants will receive oral LEN if SC injections are not available.

Tablets administered orally without regard to food

Andra namn:
  • GS-6207

Administered via SC injections

Andra namn:
  • GS-6207; Yeztugo

Tablets administered orally

Experimentell: Randomized Blinded Phase: Placebo LEN + F/TDF

Participants will receive the following for up to approximately 52 weeks:

  • SC LEN placebo every 26 weeks
  • Oral F/TDF 200/300 mg once daily
  • PTM Oral LEN on Days 1 and 2

Participants will receive oral LEN placebo if SC injections are not available.

Tablets administered orally

Andra namn:
  • Truvada®

Administered via SC injections

Tablets administered orally

Experimentell: LEN Open-Label Extension (OLE) Phase

Participants will be offered entry into LEN OLE Phase, following completion of primary analysis, if LEN demonstrates acceptable safety and efficacy in the Randomized Blinded Phase.

Participants randomized to LEN will continue to receive SC LEN 927 mg, every 26 weeks (± 7 days), and have study visits every 13 weeks (± 7 days).

Participants randomized to F/TDF will switch to SC LEN 927 mg on OLE Day 1, Week 26 and every 26 weeks thereafter. Participants will also receive oral LEN 600 mg on OLE Days 1 and 2.

All participants in LEN OLE Phase will complete the phase, once LEN becomes available or the sponsor decides to discontinue the study, whichever happens first.

After completing LEN OLE Phase or study discontinuation, participants will transition to local PrEP, including LEN or other options. If a participant exits early, they will complete an early study drug discontinuation (ESDD), be referred to local PrEP services if needed, and have a 30-day follow-up visit.

Tablets administered orally without regard to food

Andra namn:
  • GS-6207

Administered via SC injections

Andra namn:
  • GS-6207; Yeztugo
Experimentell: Pharmacokinetic (PK) Tail Phase

Participants who prematurely discontinue study drug during the Randomized Blinded Phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase will transition to the PK Tail Phase. Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks to cover the PK tail and complete visits every 13 weeks (+/- 7 days).

Upon unblinding, participants who were randomized to F/TDF in the Randomized Blinded Phase who decline to participate in the LEN OLE Phase will complete the ESDD visit, transition to local HIV prevention services, and return for a 30-day follow-up visit.

Tablets administered orally

Andra namn:
  • Truvada®

F/TAF tablets administered orally once daily

Andra namn:
  • Descovy

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Incidence Phase: Recent Infection Testing Algorithm (RITA) Estimate of the Background Human Immunodeficiency-1 Virus Infection Incidence Rate (bHIV) Per 100 Person Years (PY)
Tidsram: Incidence Phase Screening Visit (Day 1)

bHIV per 100 PY in the Incidence Phase was calculated using RITA. The RITA incorporated HIV-1 testing results and recency assay testing results to estimate the bHIV. Recency assay testing was performed for participants in the All Screened Set found to have HIV-1 infection at the Incidence Phase Screening Visit as defined below. Participants were considered to have recent HIV-1 infection if the normalized optical density (ODn) was below 1.5 threshold using the Sedia limiting antigen avidity enzyme immunoassay (LAg-EIA) and the HIV-1 RNA (viral load) was > 75 copies/mL of blood.

HIV-1 infection was defined as participants having at least one of the following central lab results at the Incidence Phase screening visit:

  • Positive HIV-1/2 differentiation Ab, OR
  • Positive HIV-1 ribonucleic acid (RNA) qualitative test, OR
  • HIV-1 RNA quantitative test ≥200 copies/mL.
Incidence Phase Screening Visit (Day 1)
Randomized Blinded Phase: HIV-1 Incidence Reported Per 100 PY for LEN Compared to Background HIV (bHIV, Participants in All Screened Set)
Tidsram: Up to 149 weeks

HIV-1 incidence per 100 PY for LEN was calculated as the number of participants who acquired HIV-1 divided by the total of a) for participants not diagnosed with HIV-1, sum of all duration of follow-up time in years, while at risk of HIV-1 infection (where a year is 365.25 days) and b) for participants diagnosed with HIV-1, sum of all duration of follow-up time up to confirmed HIV-1 diagnoses. HIV-1 diagnosis was determined by an HIV adjudication committee who reviewed potential HIV-1 infection events in the randomized participants. The committee, in a blinded, consistent, and unbiased manner, determined whether HIV test results confirmed HIV-1 infection and determined the date of diagnosis for each case, defined as the date of the earliest study visit with evidence of HIV infection considering both prospective HIV testing and back-testing of archived samples. bHIV incidence per 100 PY in All Screened Set was estimated as described in outcome measure#1.

Up to 149 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Randomized Blinded Phase: HIV-1 Incidence Reported Per 100 PY for LEN Compared to F/TDF
Tidsram: Up to 149 weeks

HIV-1 incidence per 100 PY was calculated as the number of participants who acquired HIV-1 divided by the total of a) for participants not diagnosed with HIV-1, sum of all duration of follow-up time in years, while at risk of HIV-1 infection (where a year is 365.25 days) and b) for participants diagnosed with HIV-1, sum of all duration of follow-up time up to confirmed HIV-1 diagnoses. HIV-1 diagnosis was determined by an HIV adjudication committee who reviewed potential HIV-1 infection events in the randomized participants. The committee, in a blinded, consistent, and unbiased manner, determined whether HIV test results confirmed HIV-1 infection and determined the date of diagnosis for each case, defined as the date of the earliest study visit with evidence of HIV infection considering both prospective HIV testing and back-testing of archived samples.

Up to 149 weeks
Randomized Blinded Phase: HIV-1 Incidence Among Participants Adherent to LEN
Tidsram: Up to 149 weeks

A participant was defined as adherent to LEN if they have received all per-protocol administrations of LEN within 28 weeks since the previous administration. The incidence of HIV-1 infection per 100 PY calculation is defined in outcome measure #2.

Up to 149 weeks
Randomized Blinded Phase: Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs)
Tidsram: First dose date up to 184 weeks

An adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a study drug that did not necessarily have a causal relationship with the treatment. TEAEs were defined as 1 or both of the following: Any AEs leading to premature discontinuation of study drug, or any AEs with an onset date on or after the study drug start date and no later than the last exposure date after permanent discontinuation of the study drug.

First dose date up to 184 weeks
Randomized Blinded Phase: Percentage of Participants Experiencing Grade 3 or Higher Laboratory Abnormalities
Tidsram: First dose date up to 184 weeks

Treatment-emergent laboratory abnormalities were defined as values that increased at least 1 toxicity grade from baseline at any post-baseline visit, up to and including the last exposure date for participants who permanently discontinued study drug, or the last available date in the database snapshot for participants who were still on treatment at the time of an analysis. The division of acquired immunodeficiency syndrome toxicity grading scale, Version 2.1 was used to assign toxicity grades (0 to 4) to laboratory results for analysis. Grade 0 included all values that do not meet the criteria for an abnormality of at least Grade 1. Grade 1 mild, Grade 2 moderate, Grade 3 severe, and Grade 4 potentially life-threatening. Percentages were rounded off.

First dose date up to 184 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Utredare

  • Studierektor: Gilead Study Director, Gilead Sciences

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

28 juni 2021

Primärt slutförande (Faktisk)

21 augusti 2024

Avslutad studie (Beräknad)

1 augusti 2028

Studieregistreringsdatum

Först inskickad

28 maj 2021

Först inskickad som uppfyllde QC-kriterierna

11 juni 2021

Första postat (Faktisk)

14 juni 2021

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 oktober 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

11 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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