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    Summary
    EudraCT Number:2014-005550-18
    Sponsor's Protocol Code Number:MK-1439A-024
    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:2015-07-09
    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 number2014-005550-18
    A.3Full title of the trial
    A Phase III Multicenter, Open-Label, Randomized Study to Evaluate a Switch to MK-1439A in HIV-1-Infected Subjects Virologically Suppressed on a Regimen of a Ritonavir-boosted Protease Inhibitor and Two Nucleoside Reverse Transcriptase Inhibitors (NRTIs).
    Estudio Fase III, Multicéntrico, Abierto, Randomizado, para Evaluar el Cambio a MK 1439A en Pacientes con Supresión Virológica Infectados por el VIH 1 en un Régimen de un Inhibidor de Proteasa Potenciado con Ritonavir y dos Inhibidores de la Transcriptasa Inversa Análogos de Nucleósido (NRTIs)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Switch to MK-1439A (once a day) from a Ritonavir-boosted Protease Inhibitor regimen in HIV-1 infected subjects
    Cambio a MK-1439A (una vez al día) en Pacientes Infectados por el VIH 1 en un Régimen de un Inhibidor de Proteasa Potenciado con Ritonavir
    A.3.2Name or abbreviated title of the trial where available
    Switch to MK-1439A from Ritonavir-boosted Protease Inhibitor regimen in HIV-1 infected subjects
    Cambio a MK-1439A en Pacientes Infectados por el VIH 1 en un Régimen de un Inhibido
    A.4.1Sponsor's protocol code numberMK-1439A-024
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02397096
    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 SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.1.3.4CountryUnited States
    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 supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme de España S.A.
    B.5.2Functional name of contact pointInvestigación Clínica
    B.5.3 Address:
    B.5.3.1Street AddressC/ Josefa Valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28027
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913210600
    B.5.5Fax number+34913210590
    B.5.6E-mailensayos_clinicos@merck.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 No
    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 name1439A
    D.3.2Product code MK-1439A
    D.3.4Pharmaceutical form Film-coated 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 INNdoravirine
    D.3.9.3Other descriptive nameMK-1439
    D.3.9.4EV Substance CodeSUB107739
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLAMIVUDINE
    D.3.9.1CAS number 134678-17-4
    D.3.9.4EV Substance CodeSUB08392MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTENOFOVIR DISOPROXIL FUMARATE
    D.3.9.1CAS number 202138-50-9
    D.3.9.4EV Substance CodeSUB12607MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    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 RoleComparator
    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.2.1.2Country 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.3.4Pharmaceutical 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 INNRITONAVIR
    D.3.9.1CAS number 155213-67-5
    D.3.9.3Other descriptive nameRitonavir
    D.3.9.4EV Substance CodeSUB10342MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLOPINAVIR
    D.3.9.1CAS number 192725-17-0
    D.3.9.3Other descriptive nameLopinavir
    D.3.9.4EV Substance CodeSUB02970MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    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: 3
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.2Country 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.3.4Pharmaceutical 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 INNRITONAVIR
    D.3.9.1CAS number 155213-67-5
    D.3.9.3Other descriptive nameRitonavir
    D.3.9.4EV Substance CodeSUB10342MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    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: 4
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.2Country 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.3.4Pharmaceutical 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 INNDARUNAVIR
    D.3.9.1CAS number 206361-99-1
    D.3.9.3Other descriptive nameDarunavir
    D.3.9.4EV Substance CodeSUB25394
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number600
    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: 5
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.2Country 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.3.4Pharmaceutical form Capsule, hard
    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 INNATAZANAVIR
    D.3.9.1CAS number 198904-31-3
    D.3.9.3Other descriptive nameatazanavir
    D.3.9.4EV Substance CodeSUB16398MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    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-1 infection
    Virus de inmunodeficiencia humana de tipo 1 (VIH 1) con supresión virológica
    E.1.1.1Medical condition in easily understood language
    HIV infection
    infección por VIH
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.0
    E.1.2Level LLT
    E.1.2Classification code 10068341
    E.1.2Term HIV-1 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 evaluate the non-inferior antiretroviral activity of an immediate switch to MK-1439A on Study Day 1 compared with continuation of a ritonavir-boosted PI based-regimen for 24 weeks, as measured by the proportion of subjects maintaining HIV-1 RNA <50 copies/mL by the Abbott RealTime HIV-1 Assay at Study Week 48 in the Immediate Switch Group and at Study Week 24 in the Delayed Switch Group.
    Evaluar la no inferioridad de la actividad antirretroviral de un cambio inmediato de tratamiento a MK 1439A el día 1 del estudio, comparado con la continuación de un régimen a base de IP potenciado con ritonavir durante 24 semanas, determinada por la proporción de sujetos que mantienen títulos de ARN del VIH 1 <50 copias/ml según la prueba Abbott RealTime HIV 1 en la semana 48 del estudio en el grupo de cambio inmediato, y en la semana 24 del estudio en el grupo de cambio aplazado.
    E.2.2Secondary objectives of the trial
    1. To evaluate the effect on fasting LDL-C of an immediate switch to MK-
    1439A on Study Day 1 compared with continuation of a ritonavir-boosted, PI-based
    regimen for 24 weeks, as measured by mean change from baseline at Study Week 24 in each treatment group.
    2. To evaluate the effect on fasting non-HDL-C of an immediate switch to
    MK-1439A on Study Day 1 compared with continuation of a ritonavir-boosted, PIbased regimen for 24 weeks, as measured by mean change from baseline at Study Week 24 in each treatment group.
    3. To evaluate the non-inferior antiretroviral activity of an immediate switch
    to MK-1439A on Study Day 1 compared with continuation of a ritonavir-boosted PIbased regimen for 24 weeks
    (Read rest in the protocol)
    1. Evaluar el efecto que tiene sobre el C LDL en ayunas el cambio inmediato de tratamiento a MK 1439A el día 1 del estudio, comparado con la continuación de un régimen a base de un IP potenciado con ritonavir durante 24 semanas, determinado por la variación media con respecto al valor basal en la semana 24 del estudio en cada grupo de tratamiento.
    2. Evaluar el efecto que tiene sobre el C no HDL en ayunas el cambio inmediato de tratamiento a MK 1439A el día 1 del estudio, comparado con la continuación de un régimen a base de un IP potenciado con ritonavir durante 24 semanas, determinado por la variación media con respecto al valor basal en la semana 24 del estudio en cada grupo de tratamiento.
    3. Evaluar la no inferioridad de la actividad antirretroviral de un cambio inmediato de tratamiento a MK 1439A el día 1 del estudio, comparado con la continuación de un régimen a base de IP potenciado con ritonavir durante 24 semanas
    (Leer resto en el protocolo)
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Merck will conduct Future Biomedical Research on DNA (blood) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time.
    Merck llevará a cabo investigaciones biomédicas futuras con las muestras obtenidas específicamente con estos fines durante este ensayo clínico.Estas investigaciones tendrán por objeto el análisis de biomarcadores para abordar aspectos nuevos que no se describen en otras partes del protocolo (como parte del ensayo principal) y solo se llevarán a cabo en muestras de los sujetos que hayan otorgado el consentimiento correspondiente. El objetivo de la obtención de muestras para investigaciones biomédicas futuras consiste en estudiar e
    identificar biomarcadores que proporcionen información a los científicos
    sobre las enfermedades y sus tratamientos. El objetivo último es utilizar
    tal información para desarrollar vacunas y fármacos más seguros y
    eficaces o para garantizar que los pacientes reciban la dosis correcta del
    fármaco o la vacuna adecuados en el momento preciso.
    E.3Principal inclusion criteria
    1. be at least 18 years of age on the day of signing the informed consent.
    2. understand the study procedures and voluntarily agree to participate by giving written informed consent (or have a legal representative provide written informed consent) for the trial. The subject or his/her legal representative may also provide consent for Future Biomedical Research. However, the subject may participate in the main trial without participating in Future Biomedical Research.
    3. have plasma HIV-1 RNA levels BLoQ (<40 copies/mL by the Abbott RealTime HIV-1 Assay as determined by the central laboratory) at the screening visit.
    4. have been receiving antiretroviral therapy with atazanavir/ritonavir, darunavir/ritonavir or lopinavir/ritonavir in combination with 2 NRTIs (and no other ART) continuously with HIV-1 RNA at undetectable levels for ? 6 months prior to the screening visit (as measured at ? 2 time points) and have no history of prior virologic failure.
    5. be receiving his/her first or second PI-based antiretroviral regimen
    6. have no history of using any approved or experimental NNRTI for any length of time.
    7. have had a genotype prior to starting his/her initial antiretroviral regimen and have no known resistance to any of the study agents (MK-1439, TDF, or lamivudine).
    8. be on either no lipid lowering therapy or on a stable dose of lipid lowering therapy at the time of enrollment
    9. have the following laboratory values at screening within 30 days prior to the
    treatment phase of this study:
    a) Alkaline phosphatase ? 3.0 x upper limit of normal (ULN)
    b) AST (SGOT) and ALT (SGPT) ? 5.0 x ULN
    c) Hemoglobin ?9.0 g/dL (if female) or ?10.0 g/dL (if male).
    10. have a calculated creatinine clearance at the time of screening ? 50 mL/min, based on the Cockcroft-Gault equation which is as follows:
    For Men:
    Clcr (mL/min) = (140-age) x weight (in kg)
    72 x serum creatinine (mg/dL)
    For Women:
    Clcr (mL/min) = (140-age) x weight (in kg)
    72 x serum creatinine (mg/dL)
    X 0.85
    11. in the opinion of the investigator, be considered clinically stable with no signs or symptoms of active infection at the time of entry into the study (i.e., clinical status and all chronic medications should be unchanged for at least 2 weeks prior to the start of treatment in this study).
    12. be highly unlikely to become pregnant or to impregnate a partner since the subject falls into at least one of the following categories:
    a. The subject is a male who is not of reproductive potential, defined as a male who has azoospermia (whether due to having had a vasectomy or due to an underlying medical condition).
    b. The subject is a female who is not of reproductive potential, defined as a female who either: (1) is postmenopausal (defined as at least 12 months with no menses in women ? 45 years of age); (2) has had a hysterectomy and/or bilateral oophorectomy, bilateral salpingectomy, or bilateral tubal ligation/occlusion at least 6 weeks prior to screening; OR (3) has a congenital or acquired condition that prevents childbearing.
    c. The subject is a female or a male who is of reproductive potential and agrees to avoid becoming pregnant or impregnating a partner while receiving study drug and for 14 days after the last dose of study drug by complying with one of the following: (1) practice abstinence* from heterosexual activity OR (2) use (or have their partner use) acceptable contraception during heterosexual activity.
    Acceptable methods of contraception are:
    Single method (one of the following is acceptable):
    - intrauterine device (IUD)
    - vasectomy of a female subject´s male partner
    - contraceptive rod? implanted into the skin (not acceptable for the subjects
    in the Delayed Switch Group until they switch to MK-1439A at Study
    Week 24)
    Combination method (requires use of two of the following):
    - diaphragm with spermicide (cannot be used in conjunction with cervical
    cap/spermicide)
    - cervical cap with spermicide (nulliparous women only)
    - contraceptive sponge (nulliparous women only)
    - male condom or female condom (cannot be used together)
    - hormonal contraceptive?: oral contraceptive pill (estrogen/progestin pill or
    progestin-only pill), contraceptive skin patch, vaginal contraceptive ring,
    or subcutaneous contraceptive injection (not acceptable for the subjects in
    the Delayed Switch Group until they switch to MK-1439A at Study Week
    24)
    1. Tener al menos 18 años el día de la firma del consentimiento informado.
    2. Comprender los procedimientos del estudio y aceptar voluntariamente participar otorgando el consentimiento informado por escrito para el ensayo (o tener un representante legal que otorgue el consentimiento informado por escrito). El sujeto, o su representante legal, también podrá otorgar su consentimiento para investigaciones biomédicas futuras. No obstante, podrá participar en el ensayo principal sin necesidad de participar en la investigación biomédica futura.
    3.Tener concentraciones plasmáticas de ARN del VIH 1 por debajo del LIdC (<40 copias/ml, determinadas con la prueba Abbott RealTime HIV 1 en el laboratorio central) en la visita de selección.
    4. Estar recibiendo tratamiento antirretroviral con atazanavir/ritonavir, darunavir/ritonavir o lopinavir/ritonavir en combinación con 2 NRTI (y ningún otro TAR) de manera continuada, presentar títulos indetectables de ARN del VIH 1 durante ? 6 meses antes de la visita de selección (determinados en ? 2 momentos de evaluación) y carecer de antecedentes de fracaso virológico previo.
    5. Estar recibiendo el primero o segundo régimen antirretroviral basado en un IP.
    6. No tener antecedentes de uso de ningún NNRTI aprobado o experimental durante ningún período de tiempo.
    7. Haber sido objeto de un estudio genotípico antes de comenzar el régimen antirretroviral inicial y carecer de resistencias conocidas a cualquiera de los fármacos del estudio (MK 1439, TDF o lamivudina).
    8. Estar sin tratamiento hipolipemiante o con una dosis estable de hipolipemiantes en el momento de la inclusión.
    9.Tener los valores analíticos siguientes en el momento de la selección dentro de los 30 días previos al inicio de la fase de tratamiento de este estudio:
    a) Fosfatasa alcalina ? 3,0 veces el límite superior de la normalidad (LSN).
    b) AST (SGOT) y ALT (SGPT) ? 5,0 veces el LSN
    c) Hemoglobina ? 9,0 g/dl (mujeres) o ? 10,0 g/dl (varones).
    10. Presentar un aclaramiento de creatinina calculado en el momento de la selección ? 50 ml/min, de acuerdo con la ecuación de Cockcroft Gault, que es como sigue:
    En varones: Clcr (ml/min) = (140 edad) x peso (kg)
    72 x creatinina sérica (mg/dl)

    En mujeres: Clcr (ml/min) = (140 edad) x peso (kg) X 0,85
    72 x creatinina sérica (mg/dl)
    11. En opinión del investigador, el sujeto está clínicamente estable, sin signos o síntomas de infección activa, en el momento de entrada en el estudio (es decir, el estado clínico y los medicamentos crónicos no deberán haber cambiado, como mínimo, en las 2 semanas previas al comienzo del tratamiento en este estudio).
    12. Tener muy escasa probabilidad de quedarse embarazada o de dejar embarazada a su pareja porque el sujeto pertenece al menos a una de las siguientes categorías:
    a) El sujeto es un varón sin capacidad reproductiva, lo que se define como azoospermia (ya sea por haberse sometido a vasectomía o por un trastorno médico subyacente).
    b) La participante es una mujer sin capacidad reproductiva, lo que se define como una mujer que: (1) es posmenopáusica (es decir, ausencia de menstruación durante como mínimo 12 meses en las mujeres de edad ? 45 años); (2) se ha sometido a una histerectomía o a una ovariectomía bilateral, a una salpingectomía bilateral o a una ligadura/oclusión de trompas bilateral al menos 6 semanas antes de la selección; O (3) presenta un trastorno congénito o adquirido que impide la concepción.
    c) La participante es una mujer en edad fértil y se compromete a no quedarse embarazada mientras reciba el tratamiento del estudio y durante 14 días después de recibir la última dosis del fármaco del estudio cumpliendo uno de estos requisitos: (1) practicar la abstinencia* de relaciones heterosexuales O (2) utilizar (o hacer que su pareja utilice) anticonceptivos aceptables durante las relaciones heterosexuales. Son métodos anticonceptivos aceptables los siguientes
    Método único (se admite el uso de uno de los siguientes):
    - dispositivo intrauterino (DIU)
    - vasectomía de la pareja masculina
    - implante anticonceptivo? bajo la piel (no es aceptable en las pacientes del grupo de cambio aplazado hasta que cambien a MK-1439A en la semana 24 del estudio)
    Método combinado (es obligatorio usar dos de los siguientes):
    - diafragma con espermicida (no se puede emplear junto con capuchón cervical/espermicida)
    - capuchón cervical con espermicida (solo en las mujeres nulíparas)
    - esponja anticonceptiva (solo en las mujeres nulíparas)
    - preservativo masculino o femenino (no se pueden utilizar a la vez)
    - anticonceptivos hormonales?: píldora anticonceptiva (píldora de estrógeno/progestágeno o píldora solo de progestágeno), parche cutáneo anticonceptivo, anillo vaginal anticonceptivo o inyección anticonceptiva subcutánea (no son aceptables en las pacientes del grupo de cambio aplazado hasta que cambien a MK-1439A en la semana 24 del estudio).
    E.4Principal exclusion criteria
    1. has a history or current evidence of any condition, therapy, laboratory abnormality or other circumstance that might confound the results of the study or interfere with the subject´s participation for the full duration of the study, such that it is not in the best interest of the subject to participate.
    2. is, at the time of signing informed consent, a user of recreational or illicit drugs or has had a recent history of drug or alcohol abuse or dependence. The nature and potential clinical context of the subject's illicit drug use, in relation to their exclusion from this trial, will be at the discretion of the Investigator.
    3. has been treated for a viral infection other than HIV-1, such as hepatitis B, with an agent that is active against HIV-1 including, but not limited to, adefovir, emtricitabine, entecavir, lamivudine or tenofovir.
    Note: Subjects may be enrolled if treatment occurred prior to the diagnosis of HIV or in the context of a complete regimen for HIV
    4. has documented or known resistance to study drugs including MK-1439, lamivudine, and/or tenofovir, as defined below:
    a. Resistance to MK-1439 for the purpose of this study is considered to include the following NNRTI mutations (as single mutations or components of double or triple mutations): L100I, K101E, K101P, K103S, V106A, V106I, V106M, V108I, E138A, E138G, E138K, E138Q, E138R, V179L, Y181I, Y181V, Y188C, Y188H, Y188L, G190S, H221Y, L234I, P225H, F227C, F227L, F227V, M230L, M230I.
    b. Resistance to lamivudine and tenofovir includes the following mutations: K65R, M41L, T69S (insertion complex), Q151M, M184I, M184V, L210W, T215F, T215Y, K219E, K219Q, D67N, K70R and K70E.
    5. has participated in a study with an investigational compound/device within 30 days prior to signing informed consent or anticipates participating in such a study involving an investigational compound/device during the course of this study.
    6. has used systemic immunosuppressive therapy or immune modulators within 30 days prior to treatment in this study or is anticipated to need them during the course of the study.
    7. requires or is anticipated to require any of the prohibited medications noted in the protocol
    8. has significant hypersensitivity or other contraindication to any of the components of the study drugs as determined by the investigator.
    9. has a current (active) diagnosis of acute hepatitis due to any cause.
    10. has evidence of decompensated liver disease manifested by the presence of or a history of ascites, esophageal or gastric variceal bleeding, hepatic encephalopathy or other signs or symptoms of advanced liver diseases
    or
    has liver cirrhosis and a Child-Pugh Class C score or Pugh-Turcotte (CPT) score > 9
    11. is pregnant, breastfeeding, or expecting to conceive.
    12. is female and is expecting to donate eggs (at any time during the study) or is male and is expecting to donate sperm (at any time during the study).
    13. is or has an immediate family member (e.g., spouse, parent/legal guardian, sibling or child) who is investigational site or sponsor staff directly involved with this trial.
    1. Tiene antecedentes o signos presentes de cualquier proceso, tratamiento, anomalía analítica u otra circunstancia que podría confundir los resultados del estudio o interferir en la participación del sujeto durante todo el estudio, por lo que no le conviene participar.
    2. En el momento de firmar el consentimiento informado, consume drogas activamente o tiene antecedentes recientes de abuso o dependencia de drogas o alcohol. La naturaleza y el posible contexto clínico del consumo de drogas del sujeto, en relación con su exclusión de este estudio, se dejará a criterio del investigador.
    3. Ha sido tratado por una infección viral distinta del VIH 1, como hepatitis B, con un fármaco que es activo contra el VIH 1, entre otros, adefovir, emtricitabina, entecavir, lamivudina o tenofovir.
    Nota: Los sujetos pueden incluirse si el tratamiento se produce antes del diagnóstico del VIH o si han recibido un régimen completo para el VIH.
    4. Tener resistencia documentada o conocida a los fármacos del estudio, incluidos MK 1439, lamivudina y/o tenofovir, como se define a continuación:
    a. Se considera que la resistencia a MK 1439, para los fines de este estudio, incluye las siguientes mutaciones de resistencia a los NNRTI (ya sean mutaciones aisladas o componentes de mutaciones dobles o triples): L100I, K101E, K101P, K103S, V106A, V106I, V106M, V108I, E138A, E138G, E138K, E138Q, E138R, V179L, Y181I, Y181V, Y188C, Y188H, Y188L, G190S, H221Y, L234I, P225H, F227C, F227L, F227V, M230L, M230I.
    b. La resistencia a lamivudina y tenofovir incluye las siguientes mutaciones: K65R, M41L, T69S (complejo de inserción), Q151M, M184I, M184V, L210W, T215F, T215Y, K219E, K219Q, D67N, K70R y K70E.
    5. Ha participado en un estudio con un compuesto/producto sanitario en investigación en los 30 días previos a la firma del consentimiento informado o prevé participar en el mismo durante este estudio.
    6. Ha recibido inmunomoduladores o tratamiento inmunodepresor sistémico en los 30 días previos al tratamiento de este estudio o se prevé que los necesite durante el estudio.
    7. Requiere, o se prevé que requiera, cualquiera de los medicamentos prohibidos indicados en el protocolo (consúltese la sección 5.5).
    8. Presenta hipersensibilidad significativa o cualquier otra contraindicación a alguno de los componentes de los fármacos del estudio, según la valoración del investigador.
    9. Se le ha diagnosticado de hepatitis aguda activa de cualquier etiología.
    10. Presenta indicios de hepatopatía descompensada, manifestada por la presencia o los antecedentes de ascitis, hemorragia por varices esofágicas o gástricas, encefalopatía hepática u otros signos o síntomas de hepatopatía avanzada
    o
    presenta cirrosis hepática y una puntuación de clase C de Child-Pugh o una puntuación de Pugh-Turcotte (CPT) >9

    11. Está embarazada o amamantando o espera concebir (en cualquier momento del estudio).
    12. Es una mujer que tiene previsto donar óvulos en cualquier momento del estudio o es un varón que tiene previsto donar semen en cualquier momento del estudio.
    13. Sean o tengan un familiar directo (por ejemplo, cónyuge, padre/madre o tutor legal, hermano o hijo) que forme parte del personal del centro del estudio o del promotor implicado directamente en este estudio.
    E.5 End points
    E.5.1Primary end point(s)
    The primary efficacy hypothesis of this study compares the proportion of subjects maintaining HIV-1 RNA <50 copies/mL at Study Week 48 in the Immediate Switch Group with the proportion of subjects maintaining HIV-1 RNA <50 copies/mL at Study Week 24 in the Delayed Switch Group.
    La hipótesis principal se evaluará atendiendo a la proporción de sujetos que mantienen títulos de ARN del VIH 1 <50 copias/ml HIV 1 en la semana 48 del estudio en el grupo de cambio inmediato, y en la semana 24 del estudio en el grupo de cambio aplazado.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Study Week 48 in the Immediate Switch Group and Study Week 24 in the Delayed Switch Group
    En la semana 48 del estudio en el grupo de cambio inmediato, y en la semana 24 del estudio en el grupo de cambio aplazado.
    E.5.2Secondary end point(s)
    Secondary and exploratory measurements for efficacy include the proportion of subjects maintaining HIV-1 RNA <40 copies/ mL, change from baseline in CD4 cell counts, time to loss of virologic response (TLVOR), and viral resistance for subjects who meet the virologic failure criteria and whose virus can be amplified.
    Evaluate PK of MK-1439 and the PK-PD association
    Las determinaciones secundarias y exploratorias de la eficacia son la proporción de sujetos que mantienen títulos de ARN del VIH 1 <40 copias/ml (LIdC), la variación del recuento de linfocitos CD4 respecto al valor basal, el tiempo hasta la desaparición de la respuesta virológica (TDRV), y la resistencia viral en aquellos sujetos que satisfacen los criterios de fracaso virológico y en los que es posible la amplificación viral.
    Evaluar la FK de MK 1439A y la asociación FK-FD
    E.5.2.1Timepoint(s) of evaluation of this end point
    Study Week 48
    En la semana 48 del estudio
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    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 No
    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 concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA54
    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
    Austria
    Belgium
    Brazil
    Canada
    Chile
    Colombia
    Denmark
    France
    Germany
    Guatemala
    Israel
    Italy
    Korea, Republic of
    Mexico
    New Zealand
    Peru
    Poland
    Puerto Rico
    Russian Federation
    South Africa
    Spain
    Switzerland
    Taiwan
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee No
    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
    Last subject´s last study-related phone call or visit.
    última llamada telefónica o visita relacionada con el estudio del último sujeto
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    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 years2
    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: 655
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 5
    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 Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Only if legal representative can provide written informed consent
    Sólo si el representante legal puede dar su consentimiento informado por escrito
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state32
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 255
    F.4.2.2In the whole clinical trial 660
    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)
    If development of MK-1439A is continuing, there will be a mechanism for study participants to continue treatment with MK-1439A after completing the study and without interruption, until it becomes locally available in the market. Subjects eligible for this mechanism will be those who have completed the last scheduled study visit, are considered by the investigator to have derived benefit from study participation, and for whom further treatment with MK1439A is considered clinically appropriate.
    Si el desarrollo de MK 1439A continúa está previsto que los pacien en el estud puedan tener la posibilidad de continuar el tratamiento con MK 1439A después de completar el estud, y sin interrupción, hasta que esté disponible en el mercado. Los pacien elegibles para esta fase serán los que hayan completado la ultim vist estud , el inves considere que puedan beneficiarse de la participación en el estud y para los que se considere que un tratamiento posterior con MK 1439A es clínicamente apropiado.
    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 Decision2015-08-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-07-16
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2023-09-05
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