Efficacy of Dolutegravir Plus Lamivudine in HIV-1-infected Treatment-naïve Adults Without a Baseline Genotyping Test

NCT ID: NCT04549467

Last Updated: 2024-02-21

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

244 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-17

Study Completion Date

2023-09-30

Brief Summary

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The purpose of this study is to evaluate the efficacy of DTG + 3TC versus DTG + TDF/FTC over 48 weeks in HIV-1 naive patients in a real life setting with no baseline HIV genotypic resistance testing available.

Detailed Description

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This is a 48-week, Phase IV, randomized, open-label, to assess the non-inferior antiviral activity (VL \< 50 c/ml) of 2DR DTG+3TC versus 3DR TDF/FTC + DTG over 48 weeks in HIV1 naïve adult patients without baseline GT available at Day 1 visit. Subjects will be stratified by screening HIV-1 RNA (≤100,000 c/mL or \>100,000 c/mL) and Screening CD4+ cell count (≤ or \>200 cells/mm3).

The study will comprise:

* a 28-day Screening Phase (which may be extended to 35 days to allow receipt of all Screening assessment results).
* an Open-label Randomized Phase (Day 1 to Week 48).

Approximately 200 HIV-1 naïve adult patients will be randomized 1:1 to receive 2DR DTG+3TC versus 3DR TDF/FTC + DTG for 48 weeks.

Conditions

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Hiv HIV-1-infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dolutegravir + lamivudine

Dolutegravir 50 mg, 1 tablet QD plus lamivudine 300 mg, 1 tablet QD

Group Type EXPERIMENTAL

Lamivudine 300 MG

Intervention Type DRUG

Experimental arm

Dolutegravir + emtricitabine/tenofovir (FTC/TDF)

Dolutegravir 50 mg, 1 tablet QD plus FTC/TDF 200/300 mg, 1 coformulated tablet QD

Group Type ACTIVE_COMPARATOR

Emtricitabine / Tenofovir Disoproxil Pill

Intervention Type DRUG

Active Comparator

Interventions

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Lamivudine 300 MG

Experimental arm

Intervention Type DRUG

Emtricitabine / Tenofovir Disoproxil Pill

Active Comparator

Intervention Type DRUG

Other Intervention Names

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3TC dolutegravir truvada dolutegravir

Eligibility Criteria

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Inclusion Criteria

1. Subject should be antiretroviral naïve (defined as \<=10 days of prior therapy with any antiretroviral agent following a diagnosis of HIV 1 infection).
2. Age ≥ 18 years
3. Screening plasma HIV-1 RNA ≥1000 c/mL
4. CD4 cell count nadir: any value
5. Effective contraception for women of childbearing potential.
6. Informed consent form signed by patient and investigator

Exclusion Criteria

1. History of suicide ideation, intention or action.
2. Evidence of HBV infection based on the results of testing at Screening\* for HBV surface antigen (HBsAg), HBV core antibody (anti-HBc), HBV surface antibody (antiHBs or HBsAb), and HBV DNA as follows: Subjects positive for HBsAg are excluded; Subjects negative for anti-HBs and HBsAg but positive for anti-HBc and positive for HBV DNA are excluded.
3. Anticipated need for any HCV therapy during the first 48 weeks of the study.
4. Acute symptomatic HIV Infection.
5. Any active Opportunistic Infection (category C, CDC 2014).
6. Current pregnancy or breastfeeding.
7. No effective contraception for the women of childbearing.
8. Any verified Grade 4 laboratory abnormality. A single repeat test is allowed during the Screening period to verify a result.
9. ALT (Alanine Aminotransferase) ≥ 5 x upper limit of normal value (ULN) or AST (Aspartate Aminotransferase) ≥ 3 x ULN and bilirubinemia ≥ 1.5 x ULN (with 35% direct bilirubinemia).
10. Unstable liver disease (ascitis, encephalopathy, coagulopathy, hypoalbuminemia, oesophageal or gastric varices or persistent jaundice).
11. Creatinine clearance of \<50 mL/min/1.73 m2 (Cockroft-Gault method).
12. History or presence of allergy to the trial drugs or their components.
13. Severe hepatic insufficiency (Child Pugh Class C).
14. Any available historical resistance test result.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ViiV Healthcare

INDUSTRY

Sponsor Role collaborator

Fundacion IDEAA

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ezequiel Cordova, MD

Role: PRINCIPAL_INVESTIGATOR

Fundacion IDEAA

Locations

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Fundacion IDEAA

Buenos Aires, , Argentina

Site Status

Countries

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Argentina

References

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Cordova E, Hernandez Rendon J, Mingrone V, Martin P, Arevalo Calderon G, Seleme S, Ballivian J, Porteiro N. Efficacy of dolutegravir plus lamivudine in treatment-naive people living with HIV without baseline drug-resistance testing available (D2ARLING): 48-week results of a phase 4, randomised, open-label, non-inferiority trial. Lancet HIV. 2025 Feb;12(2):e95-e104. doi: 10.1016/S2352-3018(24)00294-7. Epub 2025 Jan 15.

Reference Type DERIVED
PMID: 39826566 (View on PubMed)

Related Links

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http://fundacionideaa.com.ar/

Fundacion IDEAA web page

Other Identifiers

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IDEAA 002

Identifier Type: -

Identifier Source: org_study_id

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