Dolutegravir and Clinical Outcomes Among ART-recipients in Brazil

NCT ID: NCT04326504

Last Updated: 2024-02-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

5000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-02-01

Study Completion Date

2025-02-28

Brief Summary

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Access to antiretroviral therapy (ART) in low-income and middle-income countries has been scaled-up effectively over recent years. Recently, the World Health Organization (WHO) guidelines changed to recommend the use of Dolutegravir (DTG) combined with two nucleoside reverse transcriptase inhibitors (NRTIs), tenofovir and lamivudine, for first-line ART; however, there is still a need for further data on the outcomes of DTG-based regimens for people with HIV-1.

This study aims to describe the outcomes of drug-naïve and experienced patients starting a dolutegravir (DTG)-based regimen in a large cohort of HIV - infected patients in Brazil and compare to outcomes obtained from a retrospective control group of subjects who initiated non-DTG-based ART.

Detailed Description

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CODE is a multicenter prospective observational study to describe and quantify the outcomes of patients starting DTG-based regimens. The investigators will follow ART-naïve patients starting DTG-based regimens (Group 1), patients on stable ART regimens switching to DTG (any reason) (Group 2), and ART-experienced patients switching to DTG-containing regimens due to virological failure (Group 3). In addition, for comparison purposes, the investigators will collect data on patients who started a non-DTG containing regimen (Group 4) in the period for 2014-2016 and did not switch to DTG-based regimens (Figure 1). Enrolled patients will be followed for 36 months.

Conditions

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HIV Infections Clinical Outcomes Adverse Drug Event Effect of Drugs

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients starting DTG-based regimens

ART-naïve patients, starting cART regimens based on DTG

No intervention

Intervention Type OTHER

This will be an observational study, no intervention will be performed

Switch cohort

Patients on stable ART regimens switching to DTG (any reason)

No intervention

Intervention Type OTHER

This will be an observational study, no intervention will be performed

Therapy failure

ART-experienced patients switching to DTG-containing regimens due to virological failure

No intervention

Intervention Type OTHER

This will be an observational study, no intervention will be performed

Non-DTG group

Patients who started a non-DTG containing regimen

No intervention

Intervention Type OTHER

This will be an observational study, no intervention will be performed

Interventions

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No intervention

This will be an observational study, no intervention will be performed

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* • Signed informed consent.

* HIV infection documented by plasma HIV RNA viral load, a rapid HIV test or any licensed ELISA test; and confirmed by another test using a different method, including but not limited to a rapid HIV test, Western Blot, HIV culture, HIV antigen, or HIV pro-viral DNA at any time prior to study entry.
* Age ≥ 15 years.
* For women of child-bearing potential, willingness to use effective contraceptives.
* Starting use of DTG-based regimen, or being initiated on a non-DTG based ART between 2014 - 2016.

Exclusion Criteria

* • Any previous use of ART (drug-naïve group only).

* Current imprisonment, or compulsory detention (involuntary incarceration). For treatment of a psychiatric or physical illness.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of New Mexico

OTHER

Sponsor Role collaborator

Instituto Infectologia Evandro Chagas, Rio de Janeiro

UNKNOWN

Sponsor Role collaborator

Fundação de Medicina Tropical de Manaus

UNKNOWN

Sponsor Role collaborator

Hospital de Clinicas de Porto Alegre

OTHER

Sponsor Role collaborator

Centro de Referência e Tratamento, CRT, São Paulo, SP

UNKNOWN

Sponsor Role collaborator

Hospital Partenon, Porto Alegre

UNKNOWN

Sponsor Role collaborator

Universidade Municipal de São Caetano do Sul

UNKNOWN

Sponsor Role collaborator

Universidade Federal do Rio Grande do Norte

OTHER

Sponsor Role collaborator

Hospital Universitário Cassiano Antônio de Moraes/HUCAM

UNKNOWN

Sponsor Role collaborator

Hospital das Clínicas da Faculdade de Medicina de Ribeirao Preto/USP

UNKNOWN

Sponsor Role collaborator

Faculdade de Medicina de Botucatu, Unesp

UNKNOWN

Sponsor Role collaborator

Sociedade Campineira de Educação e Instrução - Campinas

UNKNOWN

Sponsor Role collaborator

Fundação Universidade de Caxias do Sul - FUCS/RS

UNKNOWN

Sponsor Role collaborator

Fundação Bahiana de Infectologia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Fundação Bahiana de Infectologia/SEI

Salvador, Estado de Bahia, Brazil

Site Status RECRUITING

Fundação Bahiana de Infectologia

Salvador, Estado de Bahia, Brazil

Site Status RECRUITING

Centro de Referência e Treinamento

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Carlos Brites, MD, PhD

Role: CONTACT

557132838123

Estela Luz, RN, MPH

Role: CONTACT

557132838123

Facility Contacts

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Estela Luz, RN, MSci

Role: primary

Carlos Brites, MD, PhD

Role: primary

Valdez Madruga, MD

Role: primary

References

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Dutertre M, Cuzin L, Demonchy E, Pugliese P, Joly V, Valantin MA, Cotte L, Huleux T, Delobel P, Martin-Blondel G; Dat'AIDS Study Group. Initiation of Antiretroviral Therapy Containing Integrase Inhibitors Increases the Risk of IRIS Requiring Hospitalization. J Acquir Immune Defic Syndr. 2017 Sep 1;76(1):e23-e26. doi: 10.1097/QAI.0000000000001397. No abstract available.

Reference Type RESULT
PMID: 28418992 (View on PubMed)

de Boer MG, van den Berk GE, van Holten N, Oryszcyn JE, Dorama W, Moha DA, Brinkman K. Intolerance of dolutegravir-containing combination antiretroviral therapy regimens in real-life clinical practice. AIDS. 2016 Nov 28;30(18):2831-2834. doi: 10.1097/QAD.0000000000001279.

Reference Type RESULT
PMID: 27824625 (View on PubMed)

Ciccullo A, Baldin G, Cossu MV, Passerini M, Borghetti A, Capetti A, Di Giambenedetto S. Dolutegravir Plus Lamivudine as First-Line Regimen in a Multicenter Cohort of HIV-1-Infected Patients: Preliminary Data from Clinical Practice. AIDS Res Hum Retroviruses. 2020 Jan;36(1):4-5. doi: 10.1089/AID.2019.0147. Epub 2019 Sep 30. No abstract available.

Reference Type RESULT
PMID: 31476877 (View on PubMed)

Elzi L, Erb S, Furrer H, Cavassini M, Calmy A, Vernazza P, Gunthard H, Bernasconi E, Battegay M; Swiss HIV Cohort Study Group. Adverse events of raltegravir and dolutegravir. AIDS. 2017 Aug 24;31(13):1853-1858. doi: 10.1097/QAD.0000000000001590.

Reference Type RESULT
PMID: 28692533 (View on PubMed)

Hoffmann C, Welz T, Sabranski M, Kolb M, Wolf E, Stellbrink HJ, Wyen C. Higher rates of neuropsychiatric adverse events leading to dolutegravir discontinuation in women and older patients. HIV Med. 2017 Jan;18(1):56-63. doi: 10.1111/hiv.12468. Epub 2016 Nov 10.

Reference Type RESULT
PMID: 27860104 (View on PubMed)

Norwood J, Turner M, Bofill C, Rebeiro P, Shepherd B, Bebawy S, Hulgan T, Raffanti S, Haas DW, Sterling TR, Koethe JR. Brief Report: Weight Gain in Persons With HIV Switched From Efavirenz-Based to Integrase Strand Transfer Inhibitor-Based Regimens. J Acquir Immune Defic Syndr. 2017 Dec 15;76(5):527-531. doi: 10.1097/QAI.0000000000001525.

Reference Type RESULT
PMID: 28825943 (View on PubMed)

Taramasso L, Ricci E, Menzaghi B, Orofino G, Passerini S, Madeddu G, Martinelli CV, De Socio GV, Squillace N, Rusconi S, Bonfanti P, Di Biagio A; CISAI Study Group. Weight Gain: A Possible Side Effect of All Antiretrovirals. Open Forum Infect Dis. 2017 Nov 3;4(4):ofx239. doi: 10.1093/ofid/ofx239. eCollection 2017 Fall.

Reference Type RESULT
PMID: 29255735 (View on PubMed)

Zash R, Makhema J, Shapiro RL. Neural-Tube Defects with Dolutegravir Treatment from the Time of Conception. N Engl J Med. 2018 Sep 6;379(10):979-981. doi: 10.1056/NEJMc1807653. Epub 2018 Jul 24. No abstract available.

Reference Type RESULT
PMID: 30037297 (View on PubMed)

American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019 Jan;42(Suppl 1):S13-S28. doi: 10.2337/dc19-S002.

Reference Type RESULT
PMID: 30559228 (View on PubMed)

Cruz LN, Fleck MP, Oliveira MR, Camey SA, Hoffmann JF, Bagattini AM, Polanczyk CA. Health-related quality of life in Brazil: normative data for the SF-36 in a general population sample in the south of the country. Cien Saude Colet. 2013 Jul;18(7):1911-21. doi: 10.1590/s1413-81232013000700006.

Reference Type RESULT
PMID: 23827895 (View on PubMed)

Laguardia J, Campos MR, Travassos C, Najar AL, Anjos LA, Vasconcellos MM. Brazilian normative data for the Short Form 36 questionnaire, version 2. Rev Bras Epidemiol. 2013 Dec;16(4):889-97. doi: 10.1590/s1415-790x2013000400009. English, Portuguese.

Reference Type RESULT
PMID: 24896594 (View on PubMed)

Other Identifiers

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FBAI

Identifier Type: -

Identifier Source: org_study_id

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