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    Summary
    EudraCT Number:2014-005148-16
    Sponsor's Protocol Code Number:201637
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-04-14
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2014-005148-16
    A.3Full title of the trial
    A Phase III, randomized, multicenter, parallel-group, noninferiority study evaluating the efficacy, safety, and tolerability of switching to dolutegravir plus rilpivirine from current INI-, NNRTI-, or PI-based antiretroviral regimen in HIV-1-infected adults who are virologically suppressed.
    Estudio Fase III aleatorizado, multicéntrico, de grupos paralelos, de no inferioridad, para evaluar la eficacia, seguridad y tolerabilidad del cambio de una terapia antirretroviral basada en INI, ITINN o IP a dolutegravir más rilpivirina en pacientes adultos infectados por el VIH-1 con supresión de la carga viral.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase III, randomized, multicenter, parallel-group, noninferiority study evaluating the efficacy, safety, and tolerability of switching to dolutegravir plus rilpivirine from current INI-, NNRTI-, or PI-based antiretroviral regimen in HIV-1-infected adults who are virologically suppressed
    Estudio Fase III aleatorizado, multicéntrico, de grupos paralelos, de no inferioridad, para evaluar la eficacia, seguridad y tolerabilidad del cambio de una terapia antirretroviral basada en INI, ITINN o IP a dolutegravir más rilpivirina en pacientes adultos infectados por el VIH-1 con supresión de la carga viral.
    A.3.2Name or abbreviated title of the trial where available
    SWORD-2
    A.4.1Sponsor's protocol code number201637
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorViiV Healthcare, S.L.
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportGlaxoSmithKline Research & Development Ltd.
    B.4.2CountryUnited Kingdom
    B.4.1Name of organisation providing supportViiV Healthcare UK (No.3) Limited
    B.4.2CountryUnited Kingdom
    B.4.1Name of organisation providing supportJanssen Sciences Ireland UC (formerly Janssen Research and Development Ireland Limited)
    B.4.2CountryIreland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline
    B.5.2Functional name of contact pointCentro de Información
    B.5.3 Address:
    B.5.3.1Street AddressC/Severo Ochoa, 2 (P.T.M.)
    B.5.3.2Town/ cityTres Cantos (Madrid)
    B.5.3.3Post code28760
    B.5.3.4CountrySpain
    B.5.4Telephone number902202700
    B.5.5Fax number918070476
    B.5.6E-mailes-ci@gsk.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name EDURANT
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International NV
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namerilpivirine
    D.3.2Product code EDURANT
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRILPIVIRINE HYDROCHLORIDE
    D.3.9.1CAS number 700361-47-3
    D.3.9.3Other descriptive nameR314585, TMC278, JNJ-16150108-AAC
    D.3.9.4EV Substance CodeSUB31460
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Tivicay
    D.2.1.1.2Name of the Marketing Authorisation holderViiV Healthcare UK Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDolutegravir
    D.3.2Product code GSK1349572
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDolutegravir
    D.3.9.1CAS number 1051375-19-9
    D.3.9.2Current sponsor codeGSK1349572
    D.3.9.3Other descriptive nameSodium (4R,9aS)-5-Hydroxy-4-methyl-6,10-dioxo-3,4,6,9,9a,10-hexahydro-2H-1-oxa-4a,8a-diaza-anthracene-7-carboxylic acid 2,4-difluoro-benzylamide
    D.3.9.4EV Substance CodeSUB31300
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Human immunodeficiency virus type 1 (HIV-1)
    Virus de la inmunodeficiencia humana tipo 1 (VIH-1)
    E.1.1.1Medical condition in easily understood language
    Human immunodeficiency virus type 1 (HIV-1)
    Virus de la inmunodeficiencia humana tipo 1 (VIH-1)
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 17.1
    E.1.2Level LLT
    E.1.2Classification code 10003582
    E.1.2Term Asymptomatic human immunodeficiency virus type I infection
    E.1.2System Organ Class 100000004862
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To demonstrate the non-inferior antiviral activity of switching to
    dolutegravir (DTG) plus rilpivirine (RPV) once daily compared to
    continuation of current antiretroviral regimen (CAR) over 48 weeks in
    HIV-1 infected antiretroviral therapy (ART)-experienced subjects.
    Demostrar la no inferioridad de la actividad antiviral del cambio a
    dolutegravir (DTG) más rilpivirina (RPV) una vez al día en comparación
    con el tratamiento antirretroviral actual (TARA) durante 48 semanas en
    sujetos infectados por VIH-1 que reciben tratamiento antirretroviral
    (TAR).
    E.2.2Secondary objectives of the trial
    - To evaluate the immunological activity of DTG + RPV once daily
    compared to continuation of CAR.
    - To evaluate the antiviral activity of DTG + RPV once daily compared to
    continuation of CAR.
    - To evaluate the safety and tolerability of DTG + RPV once daily
    compared to continuation of CAR over time.
    - To evaluate renal (in urine and blood), bone (in blood), and
    cardiovascular biomarkers (in blood) in subjects treated with DTG + RPV
    compared to continuation of CAR.
    - To evaluate the effects of DTG + RPV once daily on fasting lipids over
    time compared to continuation of CAR.
    - To assess viral resistance in subjects meeting Virologic Withdrawal
    Criteria.
    - To evaluate DTG and RPV trough concentrations.
    - To evaluate the DTG and RPV trough concentrations over time during
    the initial post-switch period in the first 20 subjects in the NNRTI Subset
    who switch from EFV or NVP to DTG + RPV.
    REFER TO PROTOCOL (page 18, section3) FOR COMPLETE LIST
    SECONDARY OBJECTIVES.
    - Evaluar la actividad inmunológica de DTG + RPV una vez al día en
    comparación con el TARA
    - Evaluar la actividad antiviral de DTG + RPV una vez al día en
    comparación con el TARA
    - Evaluar la seguridad y tolerabilidad de DTG + RPV una vez al día en
    comparación con la continuación del TARA a lo largo del tiempo
    - Evaluar los biomarcadores renales (en orina y sangre), óseos (en
    sangre) y cardiovasculares (en sangre) en sujetos tratados con DTG +
    RPV en comparación con la continuación del TARA
    - Evaluar los efectos de DTG + RPV una vez al día en los lípidos en
    ayunas a lo largo del tiempo en comparación con la continuación del
    TARA
    - Evaluar la resistencia viral en sujetos que cumplan los criterios de
    Retirada por Confirmación Virológica
    - Evaluar las concentraciones mínimas de DTG y RPV .
    Ver Sección 3 del Protocolo para una lista completa de los Objetivos
    Secundarios.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Title: Genetic Research, 26-FEB-2015, version 01 (2014N208737_01)
    The objectives of the genetic research are to investigate a relationship
    between genetic variants and:
    - Response to medicine, including DTG + RPV or any concomitant
    medicines;
    - HIV-1 susceptibility, severity and progression and related conditions.
    Title: An evaluation of bone mineral density in HIV-1-infected adult
    subjects switching from a tenofovir-containing antiretroviral therapy
    regimen to a dolutegravir plus rilpivirine regimen
    11-MAR-2015, Version 0 (2014N221875_00)
    Primary Objective: To evaluate the change in BMD assessed by areal
    density in total hip at 48 weeks following switch of subjects from an ART
    regimen containing TDF to DTG + RPV once daily compared to continued
    therapy with the TDF-containing regimen
    E.3Principal inclusion criteria
    Eligible subjects must:
    - be able to understand and comply with protocol requirements,
    instructions, and restrictions;
    - be likely to complete the study as planned;
    - be considered appropriate candidates for participation in an
    investigative clinical trial with oral medication (e.g., no active substance
    abuse, acute major organ disease, or planned long-term work
    assignments out of the country, etc.).
    Subjects eligible for enrollment in the study must meet all of the
    following criteria:
    1. HIV-1 infected men or women ?18 years of age;
    2. Must be on uninterrupted current regimen (either the initial or second
    cART regimen) for at least 6 months prior to Screening Any prior switch
    to a second cART regimen, defined as a change of a single drug or
    multiple drugs simultaneously, must have occurred due to tolerability
    and/or safety concerns or access to medications, or
    convenience/simplification.
    Acceptable stable cART regimens prior to Screening include 2 NRTIs
    plus:
    - INI (either the initial or second cART regimen)
    - NNRTI (either the initial or second cART regimen)
    - Boosted PI (or atazanavir [ATV] unboosted) (must be initial cART
    regimen; one within class switch permitted for tolerability);
    3. Documented evidence of at least two plasma HIV-1 RNA
    measurements <50 c/mL in the 12 months prior to Screening: one
    within the 6 to 12 month window, and one within 6 months prior to
    Screening;
    4. Plasma HIV-1 RNA <50 c/mL at Screening;
    5. A female, may be eligible to enter and participate in the study if she:
    a. is of non-child-bearing potential either defined as post-menopausal
    (12 months of spontaneous amenorrhea and ?45 years of age) or
    physically incapable of becoming pregnant with documented tubal
    ligation, hysterectomy or bilateral oophorectomy or,
    b. is of child-bearing potential with a negative pregnancy test at both
    Screening and Day 1 and agrees to use one of the following methods of
    contraception to avoid pregnancy:
    - Complete abstinence from intercourse from 2 weeks prior to
    administration of IP, throughout the study, and for at least 2 weeks after
    discontinuation of all study medications;
    - Male condom/spermicide, male
    condom/diaphragm,diaphragm/spermicide;
    - Any intrauterine device (IUD) with published data showing that the
    expected failure rate is <1% per year (not all IUDs meet this criterion,
    see the SPM for a listing describing criteria of approved IUDs);
    - Male partner sterilization prior to the female subject's entry into the
    study and this male is the sole partner for that subject;
    - Approved hormonal contraception for subjects randomly assigned to
    DTG + RPV arm or approved hormonal contraception plus a barrier
    method for subjects assigned to CAR (see the SPM for a listing of
    examples of approved hormonal contraception);
    - Any other method with published data showing that the expected
    failure rate is <1% per year.
    Any contraception method must be used consistently, in accordance with
    the approved product label during treatment with IP and for at least 2
    weeks after discontinuation of study drug. All subjects participating in
    the study should be counseled on safer sexual practices including the
    use and benefit/risk of effective barrier methods (e.g., male condom)
    and on the risk of HIV transmission to an uninfected partner.
    6. Subject is willing and able to understand requirements of study
    participation and provide signed and dated written informed consent
    prior to Screening.
    7. For subjects enrolled in France: a subject will be eligible for inclusion
    in this study only if either affiliated to or a beneficiary of a social security
    category.
    Los sujetos elegibles deben:
    - ser capaces de comprender y cumplir con los requisitos, instrucciones y
    restricciones del protocolo;
    - tener las probabilidades de completar el estudio según lo previsto;
    - ser considerados como candidatos apropiados para participar en un
    ensayo clínico de investigación con fármacos orales (p. ej. sin abuso de
    sustancias activas, enfermedad orgánica importante aguda o
    asignaciones laborales planificadas a largo plazo fuera del país, etc.).
    Los sujetos elegibles para su inclusión en el estudio deben cumplir todos
    los criterios que se enumeran a continuación:
    1. Mujeres o varones infectados por VIH-1 ? 18 años de edad;
    2. Deben haber recibido el tratamiento actual de forma ininterrumpida
    (el inicial o el segundo TARc) durante, al menos, 6 meses previos a la
    Selección; Cualquier modificación previa al segundo TARc, definido como
    el cambio de un único fármaco o diversos fármacos de manera simultánea, se debe realizar por problemas de tolerabilidad y/o
    seguridad o acceso a los fármacos o por comodidad/simplificación.
    Los TARc estables aceptables antes de la Selección incluyen 2 ITIN más:
    - IIn (el inicial o el segundo TARc)
    - ITINN (el inicial o el segundo TARc)
    - IP potenciado (o atazanavir [ATV] no potenciado) (debe ser el TARc
    inicial; uno en el cambio de clase permitido por tolerabilidad)
    3. Evidencia documentada de, al menos, dos determinaciones del ARN
    del VIH-1 en plasma < 50 c/ml en los 12 meses antes de la Selección:
    una en la ventana de 6 a 12 meses y otra en los 6 meses previos a la
    Selección;
    4. ARN del VIH-1 en plasma < 50 c/ml en la Selección;
    5. Una mujer es elegible para formar parte del estudio si:
    a. no está en edad fértil por encontrarse en periodo posmenopáusico (12
    meses de amenorrea espontánea y ? 45 años de edad) o son físicamente
    incapaces de quedarse embarazada con ligadura de trompas,
    histerectomía u ooforectomía bilateral documentadas o bien;
    b. está en edad fértil y presenta prueba de embarazo negativa durante la
    Selección y el Día 1 y acepta utilizar los métodos anticonceptivos
    apropiados que se citan a continuación para evitar el embarazo:
    - Abstinencia completa de relaciones sexuales desde dos semanas antes
    de la administración del PEI, a lo largo del estudio y hasta, al menos, dos
    semanas después de la interrupción de todos los fármacos del estudio.
    - Condón masculino/espermicida, preservativo masculino/diafragma,
    diafragma/espermicida.
    - Cualquier dispositivo intrauterino (DIU) con datos publicados que
    demuestren que la tasa de fracasos prevista es < 1% al año (no todos
    los DIU satisfacen este criterio, véase en el MPE para un listado en el que
    se describen los criterios de los DIU autorizados).
    - Esterilización de la pareja masculina antes de la inclusión de la
    paciente en el estudio y dicho varón es la única pareja del sujeto.
    - Anticonceptivos hormonales autorizados para sujetos aleatorizados al
    brazo con DTG + RPV o anticonceptivos hormonales autorizados y un
    método de barrera para sujetos asignados a recibir el TARA (véase el
    MPE para una lista de ejemplos de anticonceptivos hormonales
    autorizados).
    - Cualquier otro método con datos publicados que respalden que la tasa
    de fracasos prevista es < 1% al año.
    Cualquier método anticonceptivo se debe utilizar de manera constante,
    conforme a lo dispuesto en la ficha técnica del producto durante el
    tratamiento con el PEI y, al menos, dos semanas tras la interrupción del
    fármaco del estudio.
    Todos los sujetos que participan en el estudio deben recibir
    asesoramiento con respecto a prácticas sexuales más seguras tales
    como el uso y los beneficios/riesgos de métodos de barrera eficaces (p.
    ej. preservativo masculino) y sobre el riesgo de la transmisión del VIH a
    la pareja no infectada.
    6. El sujeto está dispuesto y es capaz de comprender los requisitos de la
    participación en el estudio y proporciona el consentimiento informado
    escrito con firma y fecha antes de la Selección.
    7. Sujetos incluidos en Francia: únicamente los sujetos afiliados o
    beneficiarios de una categoría de la Seguridad Social se considerarán
    elegibles para la inclusión en este estudio.
    E.4Principal exclusion criteria
    A subject will not be eligible for inclusion in this study if any of the
    following criteria apply:
    Exclusionary Criteria prior to Screening or Day 1
    1. Within 6 months prior to Screening and after confirmed suppression to <50 c/mL on current ART regimen, any plasma HIV-1 RNA measurement
    50 c/mL;
    2. Within the 6 to 12 month window prior to Screening and after
    confirmed suppression to <50 c/mL, any plasma HIV-1 RNA
    measurement >200 c/mL;
    3. Within the 6 to 12 month window prior to Screening and after
    confirmed suppression to <50 c/mL, 2 or more plasma HIV-1 RNA
    measurements 50 c/mL;
    4. Any drug holiday during the window between initiating first HIV ART
    and 6 months prior to Screening, except for brief periods (less than 1
    month) where all ART was stopped due to tolerability and/or safety
    concerns;
    5. Any switch to a second line regimen, defined as change of a single
    drug or multiple drugs simultaneously, due to virologic failure to therapy
    (defined as a confirmed plasma HIV-1 RNA measurement > or = 400
    c/mL after initial suppression to <50 c/mL while on first line HIV
    therapy regimen);
    Exclusionary medical conditions
    6. Women who are pregnant, breastfeeding or plan to become pregnant
    or breastfeed during the study;
    7. Any evidence of an active Centers for Disease Control and Prevention
    (CDC) Category C disease. Exceptions include cutaneous Kaposi's
    sarcoma not requiring systemic therapy and historic CD4+ lymphocyte
    counts of <200 cells/mm3;
    8. Subjects with severe hepatic impairment (Class C) as determined by
    Child-Pugh Classification C Appendix 2 of study Protocol, p98);
    9. Unstable liver disease (as defined by the presence of any of the
    following: ascites, encephalopathy, coagulopathy, hypoalbuminaemia,
    oesophageal or gastric varices, or persistent jaundice), cirrhosis, known
    biliary abnormalities (with the exception of Gilbert's syndrome or
    asymptomatic gallstones);
    10. Evidence of Hepatitis B virus (HBV) infection based on the results of
    testing for Hepatitis B surface antigen (HBsAg), Hepatitis B core
    antibody (anti-HBc), and antibodies against Hepatitis B surface antigen
    (anti-HBsAg) as follows:
    - Subjects positive for HBsAg are excluded;
    - Subjects positive for anti-HBc (negative HBsAg status) and negative for
    anti-HBsAg are excluded.
    11. Subjects with an anticipated need for any Hepatitis C virus (HCV)
    therapy during the Early Switch Phase and for interferon-based therapy
    for HCV throughout the entire study period;
    A subject will not be eligible for inclusion in this study if any of the
    following criteria apply:
    12. History or presence of allergy to the study drugs or their components
    or drugs of their class;
    13. Ongoing malignancy other than cutaneous Kaposi's sarcoma, basal
    cell carcinoma, or resected, non-invasive cutaneous squamous cell
    carcinoma, or cervical intraepithelial neoplasia; other localized
    malignancies require agreement between the investigator and the
    Studymedical monitor for inclusion of the subject prior to randomization;
    14. Subjects who in the investigator's judgment pose a significant
    suicidality risk. Subject's history of suicidal behavior and/or suicidal
    ideation should be considered when evaluating for suicide risk;
    15. Any pre-existing physical or mental condition (including substance
    abuse disorder) which, in the opinion of the Investigator, may interfere
    with the subject's ability to comply with the dosing schedule and/or
    protocol evaluations or which may compromise the safety of the subject;
    16. Any condition which, in the opinion of the Investigator, may interfere
    with the absorption, distribution, metabolism or excretion of the study
    drugs or render the subject unable to take oral medication;
    Exclusionary Treatments prior to Screening or Day 1 17. Use of medications which are associated with Torsades de Pointes.
    (See SPM for a list of relevant medications);
    18. Treatment with an HIV-1 immunotherapeutic vaccine within 90 days
    of Screening;
    19. Treatment with any of the following agents within 28 days of
    Screening: radiation therapy; cytotoxic chemotherapeutic agents; any
    immunomodulators that alter immune responses (a list of examples is
    provided in the SPM);
    20. Exposure to an experimental drug or experimental vaccine within
    either 28 days, 5 half-lives of the test agent, or twice the duration of the
    biological effect of the test agent, whichever is longer, prior to the first
    dose of investigational product (IP);
    **Please refer to study Protocol 201636, for continuing list of the
    Exclusion Criteria**
    Criterios excluyentes previos a la Selección o Día 1
    1. Cualquier determinación del ARN del VIH-1 en plasma ?50 c/ml en
    los 6 meses previos a la Selección y después de supresión confirmada a
    <50 c/ml con el TAR actual.
    2. Cualquier determinación del ARN del VIH-1 en plasma >200 c/ml en
    la ventana de 6 a 12 meses anterior a la Selección y después de
    supresión confirmada a <50 c/ml.
    3. Dos o más determinaciones del ARN del VIH-1 en plasma ?50 c/ml en
    la ventana de 6 a 12 meses anterior a la Selección y después de
    supresión confirmada a <50 c/ml.
    4. Cualquier descanso farmacológico durante la ventana entre el inicio
    del primer TAR del VIH y 6 meses antes de la Selección, excepto durante
    periodos breves (menos de 1 mes) en los que todos los TAR se
    suspendieron por problemas de tolerabilidad y/o seguridad.
    5. Cualquier cambio a un tratamiento de segunda línea, definido como la modificación de un único fármaco o varios fármacos de manera
    simultánea, debido al fracaso virológico al tratamiento (que se define
    como una determinación del ARN del VIH-1 en plasma confirmada ? 400 c/ml tras la supresión inicial a <50 c/ml durante el tratamiento de
    primera línea del VIH).
    Criterios médicos excluyentes
    6. Mujeres embarazadas, en periodo de lactancia o que planean quedarse embarazadas durante el estudio.
    7. Evidencia de una enfermedad de categoría C activa según los Centers
    for Disease Control and Prevention (CDC). Las excepciones son el
    sarcoma de Kaposi cutáneo que no requiera tratamiento sistémico y un
    recuento de linfocitos CD4+ <200 células/mm3 en el pasado.
    8. Sujetos con insuficiencia hepática grave (Categoría C) según lo
    determinado por la clasificación de Child-Pugh (Apéndice 2).
    9. Hepatopatía inestable (según se define por la presencia de cualquiera
    de las siguientes afecciones: ascitis, encefalopatía, coagulopatía,
    hipoalbuminemia, varices esofágicas o gástricas o ictericia persistente)
    cirrosis, anomalías biliares conocidas (con la excepción del síndrome de
    Gilbert o cálculos biliares asintomáticos).
    10. Evidencia de infección por el virus de la hepatitis B (VHB) en base a
    los resultados del análisis para antígeno de superficie del virus de la
    hepatitis B (HBsAg), anticuerpo nuclear del virus de la hepatitis B
    (antiHBc) y anticuerpos frente al antígeno de superficie del virus de la
    hepatitis B (antiHBsAg) como se describe a continuación:
    - Se excluyen sujetos con resultado positivo para HBsAg.
    - Se excluyen sujetos con resultado positivo para antiHBc (estado de
    HBsAg negativo) y negativo para antiHBsAg.
    11. Los pacientes con una necesidad anticipada de tratamiento para el
    virus de la hepatitis C (VHC) durante la Fase de Cambio Temprano y un
    tratamiento con interferón para VHC a lo largo de todo el periodo del
    estudio.
    12. Antecedentes o presencia de alergia a los fármacos del estudio o sus componentes u otros fármacos de su clase.
    13. Neoplasia maligna en curso distinta del sarcoma de Kaposi cutáneo,
    carcinoma de células basales, carcinoma de células escamosas de la piel
    no invasivo resecado o neoplasia intraepitelial cervical; otras neoplasias
    malignas localizadas requieren el acuerdo entre el investigador y el
    Monitor Médico del estudio para la inclusión del sujeto antes de la
    aleatorización.
    14. Sujetos que, a criterio del investigador, presenten un riesgo de
    suicidalidad significativo. Los antecedentes de conducta suicida y/o
    ideas de suicidio del paciente se deben considerar en la evaluación del
    riesgo de suicidio.
    15. Cualquier condición física o mental previa (como trastorno de abuso
    de sustancias) que, según la opinión del Investigador, pueda interferir
    con la capacidad del sujeto de cumplir con la pauta posológica y/o las
    evaluaciones del protocolo o que pueda comprometer la seguridad del
    sujeto.
    16. Cualquier afección que, según la opinión del Investigador, pueda
    interferir con la absorción, distribución, metabolismo o excreción del
    tratamiento del estudio o incapacite al sujeto a recibir el fármaco por vía oral.
    Tratamientos Excluyentes previos a la Visita de Selección o al Día 1
    17. Uso de fármacos asociados a Torsades de Pointes (véase una lista de
    fármacos relevantes en el MPE).
    18. Tratamiento con una vacuna inmunoterapéutica para el VIH-1 en los 90 días desde la Visita de Selección.
    19. Tratamiento con cualquiera de los siguientes medicamentos en los
    28 días desde la Visita de Selección: radioterapia; agentes
    quimioterapéuticos citotóxicos; cualquier agente inmunomodulador que
    modifica las respuestas inmunitarias.
    20. Exposición a un fármaco o vacuna experimental en un margen de 28
    días, 5 semividas del medicamento de estudio o el doble de la duración
    del efecto biológico del medicamento de estudio, lo que sea más
    prolongado, antes de recibir la primera dosis del producto en fase de
    investigación;
    Ver el Apartado 5.2 del Protocolo para una lista completa de los Criterios de Exclusión.
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of subjects with plasma HIV-1 RNA <50 copies per milliliter
    (c/mL) at Week 48 using the Snapshot algorithm for the Intent-to-treat
    exposed (ITT-E) population.
    Porcentaje de sujetos con ARN del VIH-1 en plasma < 50 copias por
    mililitro (c/ml) en la Semana 48 utilizando el algoritmo Snapshot para la
    población por intención de tratar expuesta (ITT-E).
    E.5.1.1Timepoint(s) of evaluation of this end point
    48 weeks
    48 semanas
    E.5.2Secondary end point(s)
    Change from Baseline in CD4+ lymphocyte count at Weeks 24 and 48;
    Proportion of subjects with plasma HIV-1 RNA <50 c/mL at Week 24,
    using the Snapshot algorithm for the ITT-E Population;
    Incidence and severity of adverse events (AEs) and laboratory
    abnormalities over 48 weeks;
    Proportion of subjects who discontinue treatment due to AEs over 48 weeks;
    Change from Baseline in renal, bone, and cardiovascular biomarkers at
    Week 48;
    Change from Baseline in fasting lipids at Weeks 24 and 48;
    Incidence of observed genotypic and resistance to CAR and to DTG or
    RPV for subjects meeting Virologic Withdrawal Criteria;
    Pre-dose concentrations of DTG and RPV at Weeks 4, 24, 48, 56, 76, 100,
    or Withdrawal in subjects switching to DTG + RPV
    Pre-dose concentrations of DTG and RPV at Weeks 2, 4 and 8 in the first
    20 subjects in the NNRTI Subset who switch from EFV or NVP to DTG
    +RPV
    By Baseline third agent treatment class:
    Proportion of subjects with plasma HIV-1 RNA <50 c/mL at Week 48
    using the Snapshot algorithm for the ITT-E Population;
    Changes from Baseline in CD4+ lymphocyte counts at Week 48;
    Incidence and severity of AEs and laboratory abnormalities over 48
    weeks;
    Proportion of subjects who discontinue treatment due to AEs over 48
    weeks;
    Incidence of observed genotypic and phenotypic resistance to current
    antiretroviral regimen and to DTG or RPV for subjects meeting Virologic
    Withdrawal Criteria;
    Change from Baseline in fasting lipids at Weeks 24 and 48;
    Between and within treatment group comparisons will be assessed on
    change from Baseline in pre-specified treatment symptoms (using the
    HIV Symptom Index) at Weeks 4, 24, 48, 56, 76, 100 and 148 (or
    Withdrawal from the study);
    Between and within treatment group comparisons will be assessed on
    change from Baseline treatment satisfaction (using the HIV TSQ) at
    Weeks 4, 24, 48, 56, 76, 100 and 148 (or Withdrawal from the study)
    - Cambio frente al valor basal en el recuento linfocitario de CD4+ en las
    Semanas 24 y 48
    - Porcentaje de sujetos con ARN del VIH-1 en plasma < 50 c/ml en la
    Semana 24, utilizando el algoritmo Snapshot para la población ITT-E
    - Incidencia y gravedad de los acontecimientos adversos (AA) y
    anomalías de laboratorio durante 48 semanas
    - Porcentaje de sujetos que interrumpen el tratamiento por la aparición
    de AA durante 48 semanas
    - Cambio frente al valor basal en los biomarcadores renales, óseos y
    cardiovasculares en la Semana 48
    - Cambio frente al valor basal de los valores de lípidos en ayunas en las
    Semanas 24 y 48
    - Incidencia observada de resistencia genotípica y fenotípica a TARA y a
    DTG o RPV en sujetos que cumplan los criterios de Retirada por
    Confirmación Virológica
    - Concentraciones predosis de DTG y RPV en las Semanas 4, 24, 48, 56,
    76, 100 o Retirada en sujetos que cambian a DTG + RPV
    - Concentraciones predosis de DTG y RPV en las Semanas 2, 4 y 8 en los
    primeros 20 sujetos del subgrupo con ITINN que cambian de EFV o NVP
    a DTG + RPV
    - En función de la clase de tratamiento con un tercer agente al inicio:
    - Porcentaje de sujetos con ARN del VIH-1 en plasma < 50 c/ml en la
    Semana 48, utilizando el algoritmo Snapshot para la población ITT-E
    - Cambios frente al valor basal en el recuento linfocitario de CD4+ en la
    Semana 48
    - Incidencia y gravedad de los AA y anomalías de laboratorio durante 48
    semanas
    - Porcentaje de sujetos que interrumpen el tratamiento por la aparición
    de AA durante 48 semanas
    - Incidencia observada de resistencia genotípica y fenotípica al
    tratamiento antirretroviral actual y a DTG o RPV en sujetos que cumplan el criterio de Retirada por Confirmación Virológica
    - Cambio frente al valor basal de los valores de lípidos en ayunas en las
    Semanas 24 y 48
    - Se evaluarán las comparaciones entre grupos terapéuticos y dentro del
    propio grupo con respecto al cambio frente al valor basal de los síntomas
    del tratamiento previamente especificado (utilizando el Cuestionario
    sobre las molestias de los Síntomas) en las Semanas 4, 24, 48, 56, 76,
    100 y 148 (o Retirada del estudio)
    - Se evaluarán las comparaciones ente grupos terapéuticos y dentro del
    propio grupo con respecto al cambio frente al valor basal de la
    satisfacción con el tratamiento (utilizando el HIVTSQ) en las Semanas 4,
    24, 48, 56, 76, 100 y 148 (o Retirada del estudio)
    E.5.2.1Timepoint(s) of evaluation of this end point
    Please see field E.5.2 above for timepoints
    Ver Sección E.5.2 para los tiempos de evaluación.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    current antiretroviral regimen (CAR)
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned14
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA43
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    Belgium
    Canada
    France
    Germany
    Italy
    Netherlands
    Russian Federation
    Spain
    Taiwan
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of the study is defined as the last subject's last visit/Contact.
    Última visita/contacto del último paciente.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 466
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 10
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state120
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 229
    F.4.2.2In the whole clinical trial 476
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    The investigator is responsible for ensuring that consideration has been given to the poststudy care of the subject's medical condition whether or not GSK is providing specific post-study treatment.
    Subjects who have successfully completed 148 weeks of treatment will be given the opportunity to continue to receive DTG + RPV until one of the following occurs:
    Please refer to the protocol (page 47, section 6.7) for the criteria.
    El investigador es responsable de garantizar que se ha valorado una asistencia médica proporcionada con respecto a la patología médica del sujeto tras finalizar el estudio, sin importar si GSK proporciona un tratamiento específico después de completar el estudio.
    Los sujetos que han completado satisfactoriamente las 148 semanas de tratamiento tendrán la oportunidad de continuar recibiendo DTG + RPV hasta que se produzca una de las siguientes condiciones:
    Ver Apartado 6.7 del Protocolo.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2015-05-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-04-09
    P. End of Trial
    P.End of Trial StatusCompleted
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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