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NCT04513626RecruitingPhase 2

HIV-1 Infected Patients, Phase II Trial, Dual Combination Doravirine/Raltegravir Open Label

A Randomized Comparative Phase II Trial Evaluating the Capacity of the Dual Combination Doravirine/Raltegravir to Maintain Virological Success in HIV-1 Infected Patients With an HIV-RNA Plasma Viremia Below 50 Copies/mL Under a Current Antiretroviral Regimen

Source: ClinicalTrials.gov · Last updated 10 Jan 2025 · Not updated for over 12 months - ask the site whether it is still open

Brief summary (registry, in English)

The objective of antiretroviral therapy (ART) is the maintenance of HIV viral suppression, the optimal condition to prevent disease progression, to optimize immune restoration, to prevent the development of viral resistance and to reduce viral transmission. Antiretroviral therapy has to be maintained long life over decades in the absence of strategies for HIV cure. This is why the long-term cumulative toxicity of ARV drugs is a major issue. Indeed as a consequence of potent ART strategies, in 2011 over 88% of patients on ART in the French Hospital database (ANRS CO4 FHDH) achieved viral suppression with HIV-RNA plasma viral load \< 50 copies/mL and nearly 60% had CD4 \> 500/mm3. As a consequence of massive reduction of mortality and morbidity related to HIV, infected patients are aging with 40% of patients over 50 years of age in the ANRS CO4 FHDH. The current standard-of-care for antiretroviral therapy consists in a triple drug combination with two nucleoside reverse transcriptase inhibitors (NRTIs) plus either a non-nucleoside reverse transcriptase inhibitor (NNRTI), a protease inhibitor (PI), or an integrase inhibitor (INSTI). NRTIs and PIs have been associated to cumulative long-term toxicity such as bone and renal disorders related to tenofovir and increased cardio-vascular risk with PIs. In general population, aging is associated with well-known comorbidities such as bone demineralization, increased incidence of cardio or cerebrovascular disease, diabetes, renal dysfunction. HIV infected patients are at a greater risk for such abnormalities. Another crucial concern is the high probability of drug-drug interactions in HIV-infected patients, between ART and comedications. Alternative strategies are needed, which must address the following questions: how to maintain the control of HIV viral replication while minimizing the occurrence of long-term clinical and metabolic complications, and minimizing the risk of drug-drug interactions? This study is an open label, randomized, switch study over 96 weeks in which virally suppressed patients on a stable combined ART regimen will be randomized (2:1) to an immediate switch to doravirine/raltegravir (immediate switch group) or to the maintaining of their current ART followed by a switch to doravirine/raltegravir at W48 (delayed switch group). Patients will be followed during 96 weeks.

Status (registry)
Recruiting
Phase (registry)
Phase 2
Study type
Interventional
Enrollment
150 (estimated)
First submitted
12 Aug 2020
Start date
15 Sept 2020
Primary completion date
30 Oct 2025
Lead sponsor
Centre de Recherches et d'Etude sur la Pathologie Tropicale et le Sida
Diseases
HIV
NCT number
NCT04513626
EU CT number
2024-513941-35-00
EudraCT number
2019-004195-19

What you commit to

  • Study type: Interventional · Phase 2
  • Planned participants: 150
  • From 15 Sept 2020 to the primary completion date, 30 Oct 2025
  • 6 sites in 3 countries
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Concomitant DAA for anti-HCV therapy
  • Any severe concomitant illness
  • Any drug with potential drug-drug interaction with doravirine
  • Concomitant treatment using interferon, interleukins or any other immune-therapy or chemotherapy
  • Concomitant prophylactic or curative treatment for an opportunistic infection
  • Subjects participating in another clinical trial evaluating different therapies and including an exclusion period that is still in force during the screening phase

Other illness

  • Absence of RT and INI HIV sequence available (past genotypes or failure of amplification of DNA at screening)
  • HBV co-infection
  • All conditions (use of alcohol, drugs, etc.) judged by the investigator to possibly interfere with trial protocol compliance, adherence and/or trial treatment tolerance

Lab values

  • Hemoglobin \<9 g/dL
  • Platelets \<80,000/mm3
  • Creatinine clearance \<60 mL/min (MDRD)
  • AST or ALT ≥5N

Other

  • Subjects under "sauvegarde de justice" (judicial protection due to temporarily and slightly diminished mental or physical faculties), or under legal guardianship
  • Pregnant women or breastfeeding women

Who the study is looking for

  • Age ≥ 18 years
  • Patients with HIV-1 documented infection
  • CD4 ≥ 200/mm3
  • On stable combined ART regimen with at least 2 drugs for at least 6 months
  • HIV-RNA plasma VL ≤ 50 copies/mL during the last 12 months prior to screening visit (W-6/W-4), documented by at least 2 time-points with no more than one blip (defined as one HIV-RNA plasma VL between 51 and 200 copies/mL followed by one HIV-RNA plasma VL ≤ 50 copies/mL)
  • Naive to doravirine
  • Absence of resistance to doravirine\* and/or raltegravir\*\*(see list mutations below)
    • on all HIV-genotypes with available RT and integrase gene sequences allowing resistance interpretation in case of previous virological failure
    • or on DNA genotype performed at screening if HIV genotype is not available in case of prior virological failure.
  • Signed informed consent form.
  • Patient affiliated to a social insurance regimen. For French patients only: subject enrolled in or a beneficiary of a Social Security programme (State Medical Aid or AME is not a Social Security programme).
    • Mutations associated to doravirine resistance are: V106A/M, Y188L, G190E/S, M230L, F227C, at least 2 among: A98G, L100I, K101E, V106I, E138K, Y181C/V, G190A or H221Y
    • Mutations associated to raltegravir resistance are: T66A/K, E92Q, G118R, F121Y, G140A/S Y143A/C/G/H/R/S, Q148E/G/H/K/R, V151L, N155H/S/T, E157Q, S230R, R263K, L74 F/I + V75I.

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (6)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Hospital Clinic and University of Barcelona
Coordinator of this site? Confirm its status
barcelonaSpainNot yet recruiting
Hospital de la Santa Creu i Sant Pau
Coordinator of this site? Confirm its status
BarcelonaSpainNot yet recruiting
Bellvitge University Hospital
Coordinator of this site? Confirm its status
BarcelonaSpainNot yet recruiting
Centre De Recherches Et D'Etudes Sur La Pathologie Tropicale Et Le Sida
Coordinator of this site? Confirm its status
Paris Cedex 13FranceNot yet recruiting
IRCCS San Raffaele Scientific Institute
Coordinator of this site? Confirm its status
MilanItalyNot yet recruiting
National Institute For Infectious Diseases Lazzaro Spallanzani
Coordinator of this site? Confirm its status
RomeItalyNot yet recruiting

This page is information, not medical advice. Discuss any trial with your doctor.