Efficacy of Doravirine + Dolutegravir Dual Therapy in the Context of Antiretroviral Therapy Switch

NCT ID: NCT04892654

Last Updated: 2023-10-25

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

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-17

Study Completion Date

2027-11-30

Brief Summary

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Combination antiretroviral therapy (cART) HIV treatments are associated with increased quality of life, and a normalisation of life expectancy in people living with HIV. However, long-term use of cART can lead to side-effects through exposure to drug-related toxicity.

For this reason researchers are interested in looking at alternative therapies that might expose patients to fewer and less severe side effects while providing the same quality of care as antiretroviral therapies most often used to treat HIV.

The purpose of this study is to investigate if the study drug combination that is being tested (doravirine + dolutegravir) is safe compared with other triple cART regimens.

Detailed Description

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A randomised, open label study to assess the efficacy of switching from suppressive triple cART to doravirine + dolutegravir dual cART in people living with HIV (PLWH) with an undetectable viral load

A computer-based software will randomise participants 2:1 to either the (1) experimental arm (early switch group) to take two-pill regimen for 96 weeks, or (2) control arm (delayed switch group) where participants continue their current triple cART regimen for 48 weeks, then switch to the two-pill regimen for another 48 weeks.

Viral load will be measured at each study visit to determine the percentage of participants in each treatment arm with undetectable plasma HIV RNA levels at week 48.

Additional research urine and bloods will be taken, as well as questionnaires completed at baseline and every 24 weeks to further investigate safety, tolerability, and quality of life from switch of suppressive triple cART to doravirine + dolutegravir dual cART.

Conditions

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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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Immediate Switch

Two-pill regimen, doravirine (100 mg) + dolutegravir (50 mg) tablets taken orally once daily for 96 weeks.

Group Type EXPERIMENTAL

Doravirine

Intervention Type DRUG

Antiretroviral, Non-nucleoside Reverse Transcriptase Inhibitor

Dolutegravir

Intervention Type DRUG

Antiretroviral, Integrase strand transfer inhibitors

Delayed Switch

Participants will continue their current triple cART regimen for 48 weeks. Patients will then be switched to two-pill regimen, doravirine (100 mg) + dolutegravir (50 mg) tablets taken orally once daily for 48 weeks.

Group Type OTHER

Doravirine

Intervention Type DRUG

Antiretroviral, Non-nucleoside Reverse Transcriptase Inhibitor

Dolutegravir

Intervention Type DRUG

Antiretroviral, Integrase strand transfer inhibitors

Triple cART regimen

Intervention Type OTHER

Participant standard triple cART regimen

Interventions

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Doravirine

Antiretroviral, Non-nucleoside Reverse Transcriptase Inhibitor

Intervention Type DRUG

Dolutegravir

Antiretroviral, Integrase strand transfer inhibitors

Intervention Type DRUG

Triple cART regimen

Participant standard triple cART regimen

Intervention Type OTHER

Other Intervention Names

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Pifeltro Tivicay

Eligibility Criteria

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Inclusion Criteria

* HIV-1 infected, 18 years or older
* On stable \& suppressive triple cART for at least 6 months
* No evidence of resistance to DOR or DTG
* No laboratory abnormalities, medical/psychiatric conditions or alcohol/drug use considered a barrier to participation by investigators
* Women who are pre-menopausal and sexually active should be on one of the following methods of contraception:

* Implant
* Depot injection
* Intra-uterine device or system
* Oral hormonal contraception

Exclusion Criteria

* History of virological failure on an NNRTI in absence of a post-failure genotypic resistance test proving absence of resistance to DOR
* History of virological failure on an INSTI in absence of a post-failure genotypic resistance test proving absence of resistance to DTG (INSTI mutations that will lead to the need of administering DTG twice-daily are considered as resistance to DTG - and the subject will be considered NOT eligible)
* Concomitant medication contra-indicated with DTG or DOR
* Haemoglobin \<9 g/dL
* Platelets \<80,000/mm3
* Creatinine clearance \<30 mL/min
* AST or ALT ≥5N
* Acute Hepatitis A infection.
* Concomitant DAA for anti-HCV therapy
* Known acute or chronic viral hepatitis B or C.

* Individuals testing positive for HBcAb, but negative HBsAg/HBeAg, may be included on the trial.
* Individuals with positive anti-HCV results, but with HCV RNA not detected may be included on the trial.
* Pregnant or breastfeeding women
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chelsea and Westminster NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marta Boffito, MD PhD FRCP

Role: PRINCIPAL_INVESTIGATOR

Chelsea and Westminster NHS Foundation Trust

Locations

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Mortimer Market Centre

London, , United Kingdom

Site Status RECRUITING

Chelsea & Westminster Hospital NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Imperial College Healthcare NHS Trust

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Research Regulatory Compliance Manager

Role: CONTACT

020 3315 6825

Facility Contacts

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Rubina Choudhry

Role: primary

Research Regulatory Compliance Manager

Role: primary

02033158209

Role: backup

020 3315 6825

Tara Tamang

Role: primary

Other Identifiers

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2020-003928-17

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

CW004

Identifier Type: -

Identifier Source: org_study_id

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