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PASO-DOBLE: DTG/3TC vs. BIC/FTC/TAF Maintenance Therapy in People Living With HIV:

Sponsor
Fundacion SEIMC-GESIDA (Other)
Overall Status
Recruiting
CT.gov ID
NCT04884139
Collaborator
ViiV Healthcare (Industry)
550
Enrollment
29
Locations
2
Arms
41.6
Anticipated Duration (Months)
19
Patients Per Site
0.5
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The hypothesize that DTG/3TC will be non-inferior to BIC/FTC/TAF with a 4% margin in virologically suppressed HIV-infected patients. The study will allow claiming for Superiority. Assuming that both DTG and BIC may lead to similar weight gains (approximately 1 kg after 48 weeks) in virologically suppressed HIV-infected patients and that TAF may induce a further weight gain (approximately 1 kg after 48 weeks), also hypothesize that switching to BIC/FTC/TAF may lead to greater weight gain than switching to DTG/3TC over 48 weeks.

This trial is a Phase IV, open-label, randomized multicentre clinical trial evaluating the efficacy of DTG/3TC versus BIC/FTC/TAF for the maintenance of virological suppression in HIV patients.

Condition or Disease Intervention/Treatment Phase
  • Drug: Dolutegravir/Lamivudine as a single pill
  • Drug: Bictegravir/Emtricitabine/Tenofovir alfenamide as a single pill.
 Phase 4

Detailed Description

Participants will be randomly assigned in a 1:1 ratio to receive DTG/3TC or BIC/FTC/TAF. Randomization will be stratified by sex and TAF use at baseline. At least 33% of the patients included will be women.

The investigatora will also endeavour to recruit as many non-Caucasian participants as possible.

Patients with TAF-containing regimens at baseline will be limited to 25% or less of the total number of participants. Three sub-studies will be performed: Omics sub-study ; Senescence sub-study; Fat biopsies sub-study.

Omics sub-study: Assess the mechanistic pathways involved on weight changes associated with switching to BIC/FTC/TAF vs. DTG/3TC.

Senescence sub-study: Assess the potential effects on the telomere length, epigenetic age and oxidative stress markers of switching to BIC/FTC/TAF vs. DTG/3TC.

Fat biopsies sub-study: To assess potential effects of switching to BIC/FTC/TAF vs.

DTG/3TC on expression of marker genes of mitochondrial function, adipogenesis, and inflammation in subcutaneous fat tissue. Assays on adipose tissue gene expression will be complemented by analysis in serum of adipokines representative of adipose tissue function (leptin, adiponectin), and inflammation biomarkers (TNFalpha, MCP-1, IL-6, IL- 8, IL-10, IL-18).

Study Design

Study Type:
Interventional
Anticipated Enrollment :
550 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
DTG/3TC vs. BIC/FTC/TAF Maintenance Therapy in People Living With HIV: an Open-label Randomized Clinical Trial
Actual Study Start Date :
Jul 14, 2021
Anticipated Primary Completion Date :
Jan 1, 2025
Anticipated Study Completion Date :
Jan 1, 2025

Arms and Interventions

Arm Intervention/Treatment
Experimental: Dovato arm

DTG/3TC

Drug: Dolutegravir/Lamivudine as a single pill
- Dose: Dolutegravir 50mg/ Lamivudine 300 mg -Route of adminstration: oral -Schedule of administration: once a day for 96 weeks.
Active Comparator: Biktarvy arm

BIC/FTC/TAF

Drug: Bictegravir/Emtricitabine/Tenofovir alfenamide as a single pill.
Dose: Bictegravir 50 mg/Emtricitabine 200 mg /Tenofovir alafenamide 25 mg Route of adminstration: oral Schedule of administration: once a day for 96 weeks.

Outcome Measures

Primary Outcome Measures

  1. Proportion of patients with plasma HIV-1 RNA ≥50 copies/mL [Week 48]

Secondary Outcome Measures

  1. Proportion of patients with plasma HIV-1 RNA ≥50 copies/mL [week 96]

  2. Proportion of patients with plasma HIV-1 RNA <50 copies/mL [Week 48 and week 96]

  3. Absolute weight [Basal, week 48 y week 96]

  4. BMI change [Basal, week 48 y week 96]

  5. Proportion of patients with weight change >5% [Basal, week 48 y week 96]

  6. Absolute values in CD4+ cells count [Basal, week 48 y week 96]

  7. Changes in CD4+ cells count [Basal, week 48 y week 96]

  8. Absolute values CD4:CD8 ratio [Basal, week 48 y week 96]

  9. Changes CD4:CD8 ratio [Basal, week 48 y week 96]

  10. Change in total and regional (trunk and extremities) fat by DXA [Basal, week 48 y week 96]

  11. Change in total and regional (trunk and extremities) fat-free mass by DXA [Basal, week 48 y week 96]

  12. Change in lumbar and hip bone mineral density (BMD) by DXA [Basal, week 48 y week 96]

  13. Change trabecular bone score (TBS) by DXA [Basal, week 48 y week 96]

  14. Change in subcutaneous and visceral fat (CT) [Basal, week 48 y week 96]

  15. Change in fasting glucose cholesterol, triglycerides), and FIB-4 score [Basal, week 48 y week 96]

  16. Change insulin cholesterol, triglycerides), and FIB-4 score [Basal, week 48 y week 96]

  17. Change in HOMA-IR cholesterol, triglycerides), and FIB-4 score [Basal, week 48 y week 96]

  18. Change in HbA1c cholesterol, triglycerides), and FIB-4 score [Basal, week 48 y week 96]

  19. Change in plasma lipids (total, HDL, and LDL) cholesterol, triglycerides), and FIB-4 score [Basal, week 48 y week 96]

  20. Changes in estimated glomerular filtration rate (CKD-EPI) [Basal, week 48 y week 96]

  21. Changes in urinary protein/creatinine [Basal, week 48 y week 96]

  22. Change in blood pressure [Basal, week 48 y week 96]

    Systolic and Diastolic Blood Pressure

  23. Change in sleep quality (Pittsburg Sleep Quality Index) [From basal, until week 96 , in each visit]

    Pittsburg Sleep Quality Index

  24. Change in anxiety and depression (HAD) quality of life (HIV Symptom Index questionnaire / Symptom Distress Module (HIV-SI/SDM [From basal, until week 96 , in each visit]

    Anxiety and depression (HAD) questionnaire

  25. Change in quality of life (HIV Symptom Index questionnaire / Symptom Distress Module (HIV-SI/SDM) [From basal, until week 96 , in each visit]

    Quality of life (HIV-SI/SDM) questionnaire

  26. Incidence and severity of adverse events (clinical and laboratory) [From basal, until week 96 , in each visit]

  27. Incidence of adverse events leading to treatment discontinuation. [From basal, until week 96 , in each visit]

  28. Incidence of genotypic resistance mutations in participants with virological failure [Week 48 and week 96]

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:

  1. Understanding the study information provided and being capable of giving written informed consent.

  2. Confirmed HIV infection.

  3. ≥18 years of age on the day of screening.

  4. HIV RNA <50 copies/mL for at least 24 weeks before screening.

  5. Receiving any regimen for HIV containing more than 1 pill a day or any single tablet regimen containing at least one of the following: cobicistat-boosting, efavirenz, or tenofovir disoproxyl fumarate, for at least 24 weeks before screeningPatients with TAF are expected from cobiscitat-boosting single tablet regimens containing darunavir or elvitegravir and from more-than-1-pill-a-day regimens containing TAF/FTC; their participation will be limited to ≤25%. Patients will be stratified according to the presence or not of TAF in their regimens.

  6. No evidence of previous viral failure.

  7. No known or suspected resistance to study drugs.

  8. Females of childbearing potential, must be using highly effective methods of contraception from study inclusion and for at least 4 weeks after last study visit; all female volunteers must be willing to undergo urine pregnancy testing at the time points specified in the schedules of events.

  9. Clinical stability: Participants who are healthy (other than HIV infection) as determined by the Investigator or medically qualified designee based on a medical evaluation including medical history, laboratory tests, and cardiac monitoring.

Exclusion Criteria:

  1. Is pregnant or lactating at the screening visit or at any time during the study or is planning on becoming pregnant over the duration of the study.

  2. Evidence of Hepatitis B virus infection based on at least one positive result of testing at Screening for Hepatitis B surface antigen (HBsAg) and Hepatitis B core antibody (anti- HBc).

  3. Previous or current therapy with dolutegravir or bictegravir.

  4. History of allergy to study drugs or their components.

  5. Liver disease as defined by ALT >= 5x ULN or ALT >=3xULN and Bili >=1.5xULN (with >35% direct bilirubin).

  6. Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), cirrhosis, known biliary abnormalities (apart from hyperbilirubinemia or jaundice due to Gilbert's syndrome or asymptomatic gallstones);

  7. Subjects with severe hepatic impairment (Class C) as determined by Child-Pugh classification and/or anticipated need for Hep C treatment.

  8. Kidney disease as defined by CKD-EPI <50ml/min.

  9. Any recently (<=6 months) diagnosed clinical condition or recently (<=6 months) initiated concomitant therapy (see Section 6.5) that may primarily affect weight or body composition. E.g., including but not limited to endocrine disorders, osteoporosis or medications to treat these clinical conditions, with the exception of controlled diabetes mellitus.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Hospital Fundación Alcorcón Alcorcón Madrid Spain 28922
2 H. de Elche Alicante Spain
3 H. de Torrecárdenas Almería Spain
4 H. Clinic Barcelona Spain 08036
5 H. de Bellvitge Barcelona Spain
6 H. de Igualada Barcelona Spain
7 H. del Mar Barcelona Spain
8 H. San Joan de Deu Barcelona Spain
9 H. Sant Creu y Sant Pau Barcelona Spain
10 H. Vall de Hebron Barcelona Spain
11 CHUAC Coruña Spain
12 H. Universitario de Guadalajara Guadalajara Spain 19002
13 H. Juan Ramón Jimenez Huelva Spain
14 H. Infanta Leonor Madrid Spain
15 H. La Princesa Madrid Spain
16 H. Príncipe de asturias Madrid Spain
17 H. Univ. La Paz Madrid Spain
18 H. Univ. Puerta de Hierro Madrid Spain
19 H. Costa del Sol Marbella Spain
20 H. Reina Sofía Murcia Spain
21 H. Central de Asturias Oviedo Spain
22 H. Son Espases Palma De Mallorca Spain
23 H. Son Llatzer Palma De Mallorca Spain
24 H. de Valme Sevilla Spain
25 H. Joan XXIII Tarragona Spain
26 H. Clínico Univ. de Valencia Valencia Spain
27 H Clinico Univ. de Valladolid Valladolid Spain
28 H. Alvaro Cunquerio Vigo Spain
29 H. Clinico Univ. Lozano Bleza Zaragoza Spain

Sponsors and Collaborators

  • Fundacion SEIMC-GESIDA
  • ViiV Healthcare

Investigators

  • Principal Investigator: Esteban Martinez, MD, H. Clinc de Barcelona

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Fundacion SEIMC-GESIDA
ClinicalTrials.gov Identifier:
NCT04884139
Other Study ID Numbers:
  • GESIDA11720
First Posted:
May 12, 2021
Last Update Posted:
Jun 24, 2022
Last Verified:
Jun 1, 2022
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Additional relevant MeSH terms:
Tenofovir
Lamivudine
Emtricitabine
Dolutegravir

Study Results

No Results Posted as of Jun 24, 2022