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    The EU Clinical Trials Register currently displays   43857   clinical trials with a EudraCT protocol, of which   7284   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    Summary
    EudraCT Number:2016-000459-28
    Sponsor's Protocol Code Number:205543
    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:2016-07-15
    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 number2016-000459-28
    A.3Full title of the trial
    A Phase III, randomised, double-blind, multicentre, parallel-group, non-inferiority study evaluating the efficacy, safety, and tolerability of dolutegravir plus lamivudine compared to dolutegravir plus tenofovir/emtricitabine in HIV-1-infected treatment-naïve adults
    Estudio de fase III, aleatorizado, doble ciego, multicéntrico, con grupos paralelos, de ausencia de inferioridad, para evaluar la eficacia, seguridad y tolerabilidad de dolutegravir más lamivudina en comparación con dolutegravir más tenofovir/emtricitabina en adultos infectados por el VIH-1 no tratados previamente
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to evaluate the efficacy, safety, and tolerability of dolutegravir plus
    lamivudine compared to dolutegravir plus tenofovir/emtricitabine in HIV-
    1-infected patients that have not been treated yet.
    Estudio para evaluar la eficacia, seguridad y tolerabilidad de dolutegravir más lamivudina en comparación con dolutegravir más tenofovir/emtricitabina en pacientes infectados por el VIH-1 que no han sido tratados todavía.
    A.3.2Name or abbreviated title of the trial where available
    Gemini 2
    A.4.1Sponsor's protocol code number205543
    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 UK Limited
    B.1.3.4CountryUnited Kingdom
    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 supportViiV Healthcare UK Limited
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPPD
    B.5.2Functional name of contact pointAD PROJECT MGMT
    B.5.3 Address:
    B.5.3.1Street Address929 North Front Street
    B.5.3.2Town/ cityWilmington
    B.5.3.3Post code28401-3331
    B.5.3.4CountryUnited States
    B.5.4Telephone number900834223
    B.5.6E-mailRegistroEspanolDeEstudiosClinicos@druginfo.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 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,DTG
    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 nameDOLUTEGRAVIR
    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.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 Epivir
    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 nameLamivudine, 3TC
    D.3.2Product code GR109714
    D.3.4Pharmaceutical form Capsule
    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 INNLAMIVUDINE
    D.3.9.1CAS number 134678-17-4
    D.3.9.2Current sponsor codeGSK3515864
    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.3.11 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.2.1.1.1Trade name Truvada
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences International 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 nameTruvada
    D.3.4Pharmaceutical form Capsule
    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 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.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEMTRICITABINE
    D.3.9.1CAS number 143491-57-0
    D.3.9.4EV Substance CodeSUB01882MIG
    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.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 la inmunodeficiencia humana de tipo 1
    E.1.1.1Medical condition in easily understood language
    HIV - 1 infection
    Infección por el 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 19.0
    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 demonstrate non-inferior antiviral activity of DTG + 3TC versus DTG + TDF/FTC at 48 weeks in HIV-1-infected, ART-naïve subjects
    Demostrar la ausencia de inferioridad en cuanto a la actividad antiviral de DTG + 3TC en comparación con DTG + TDF/FTC a las 48 semanas en sujetos infectados por el VIH-1 sin TAR previo
    E.2.2Secondary objectives of the trial
    -To demonstrate the antiviral activity of DTG+3TC versus DTG+TDF/FTC at 24, 96 and 144 weeks;
    -To evaluate the antiviral activity, immunological effects,and incidence of disease progression (HIV-associated conditions, AIDS and death) of DTG+3TC compared to DTG+TDF/FTC over time;
    -To assess viral resistance in subjects meeting confirmed virologic withdrawal (CVW) criteria;
    -To evaluate the safety and tolerability of DTG+TDF/FTC over time;
    -To evaluate renal biomarkers (in urine and blood) and bone biomarkers(in blood)in subjects treated with DTG+3TC compared to DTG+TDF/FTC;
    -To evaluate the effects of DTG + 3TC on fasting lipids compared to DTG +TDF/FTC over time;
    -To evaluate the effect of patient demographics and baseline characteristics on response to DTG+3TC compared to DTG+TDF/FTC over time;
    -To assess change in health-related quality-of-life for subjects treated with DTG plus 3TC compared toDTG+TDF/FTC
    - Demostrar actividad antiviral de DTG + 3TC versus DTG + TDF/FTC a las 24, 96 y 144 semanas
    - Evaluar actividad antiviral, efectos inmunológicos e incidencia de progresión de enfermedad (VIH, SIDA y muerte) de DTG + 3TC en comparación con DTG + TDF/FTC a lo largo del tiempo.
    - Valorar aparición de resistencia en sujetos que cumplan criterios virológicos de retirada confirmados.
    - Evaluar seguridad y tolerabilidad de DTG + 3TC versus DTG + TDF/FTC a lo largo del tiempo.
    - Evaluar biomarcadores renales (orina y sangre) y óseos (sangre) en los sujetos tratados con DTG + 3TC versus DTG + TDF/FTC.
    - Evaluar el efecto de DTG + 3TC sobre los lípidos en ayunas en comparación con DTG + TDF/FTC a lo largo del tiempo.
    - Evaluar el efecto de características demográficas y basales del paciente sobre la respuesta a DTG + 3TC versus DTG + TDF/FTC a lo largo del tiempo.
    - Evaluar variaciones de calidad de vida relacionada con la salud de sujetos tratados con DTG más 3TC versus DTG + TDF/FTC.
    E.2.3Trial contains a sub-study No
    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).
    A subject will be eligible for inclusion in this study only if all of the following criteria apply:
    1. HIV-1 infected adults 18 years of age, (or older, if required by local regulations), at the time of signing the informed consent.
    2.Screening plasma HIV-1 RNA of 1000 c/mL to <= 100,000 c/mL. If an independent review of accumulated data from other clinical trials investigating the DTG plus 3TC dual regimen is supportive of the DTG plus 3TC treatment regimen, enrolment will be opened to subjects with Screening plasma HIV-1 RNA of 1000 c/mL to <= 500,000 c/mL;
    3.Antiretroviral-naïve (defined as <=10 days of prior therapy with any antiretroviral agent following a diagnosis of HIV-1 infection). Subjects who received HIV post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP) in the past are allowed as long as the last PEP/PrEP dose was > 1 year from HIV diagnosis or there is documented HIV seronegativity between the last prophylactic dose and the date of HIV diagnosis.
    4.Male or female.
    A female subject is eligible to participate if she is not pregnant as confirmed by a negative serum human chorionic gonadotrophin (hCG) test at Screening and negative urine test at Baseline), not lactating, and at least one of the following conditions applies:
    a.Non-reproductive potential defined as:
    •Pre-menopausal females with one of the following:
    •Documented tubal ligation
    •Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion
    •Hysterectomy
    •Documented Bilateral Oophorectomy
    •Postmenopausal defined as 12 months of spontaneous amenorrhea and ≥45 years of age [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) and oestradiol levels consistent with menopause is confirmatory (refer to laboratory reference ranges for confirmatory levels)]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrolment.
    b.Reproductive potential and agrees to follow one of the options listed in the Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) (see Appendix 9, Section 12.9.1) from 30 days prior to the first dose of study medication and until the last dose of study medication and completion of the Follow-up visit.
    The investigator is responsible for ensuring that subjects understand how to properly use these methods of contraception.
    All subjects participating in the study should also be counselled 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.
    5.Subject or the subject’s legal representative capable of giving signed informed consent as described in Section 10.2 which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.
    6.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 deberán:
    • ser capaces de comprender y cumplir los requisitos, instrucciones y restricciones del protocolo;
    • tener probabilidades de finalizar el estudio según lo previsto;
    • ser candidatos adecuados para participar en un ensayo clínico de investigación con medicación oral (por ejemplo, sin toxicomanía activa ni enfermedad orgánica importante aguda, o sin previsión de obligaciones laborales prolongadas en el extranjero).
    Solo podrán participar en este estudio los sujetos que cumplan todos los criterios siguientes:
    1. Pacientes infectados por el VIH-1 con edad mínima de 18 años (o más cuando así lo exijan las leyes locales) en el momento de firmar el documento de consentimiento informado
    2. ARN del VIH-1 de 1000 c/ml a 100.000 c/ml en la visita de selección. Si una revisión independiente de los datos acumulados de otros ensayos clínicos en los que se investigue la pauta doble de DTG y 3TC respalda el uso de este tratamiento, se abrirá el reclutamiento a los sujetos con un valor de ARN del VIH-1 de 1000 c/ml a <=500.000 c/ml en la visita de selección.
    3. Sin tratamiento antirretroviral previo (definido como no más de 10 días de tratamiento previo con un antirretroviral después del diagnóstico de infección por el VIH-1). Los sujetos que recibieron profilaxis previa o posterior a la exposición (PPrE o PPoE) al VIH en el pasado podrán participar siempre que la última dosis de la profilaxis se administrara más de un año antes del diagnóstico de la infección por el VIH o hubiera seronegatividad documentada entre la última dosis profiláctica y la fecha del diagnóstico de infección por el VIH.
    4. Varón o mujer.
    Las mujeres podrán participar siempre que no estén embarazadas (según lo confirmado por un resultado negativo en la prueba de la gonadotropina coriónica humana [hCG] en suero en la selección y un resultado negativo de la prueba en orina en el momento basal), no estén en período de lactancia y cumplan al menos una de las condiciones siguientes:
    a. No estar en edad fértil, lo que abarca:
    • Mujeres premenopáusicas con una de las condiciones siguientes:
    • Ligadura de trompas documentada.
    • Procedimiento documentado de ligadura de trompas histeroscópica con confirmación posterior de la oclusión bilateral de las trompas.
    • Histerectomía
    • Ovariectomía bilateral documentada
    • Mujeres posmenopáusicas, es decir, con 12 meses de amenorrea espontánea y edad ≥ 45 años [en los casos dudosos, una concentración de folitropina (FSH) y de estradiol en sangre compatible con el estado de menopausia será confirmatoria (para conocer los valores confirmatorios, consúltense los intervalos de referencia de cada laboratorio]). Las mujeres que estén recibiendo tratamiento hormonal sustitutivo (THS) y cuyo estado menopáusico sea dudoso tendrán que usar uno de los métodos anticonceptivos de elevada eficacia si desean continuar con el THS durante el estudio. De lo contrario, deberán suspender el THS para poder confirmar el estado posmenopáusico antes del reclutamiento para el estudio.
    b. Las mujeres que estén en edad fértil deberán aceptar el uso de una de las opciones que se citan en la lista modificada de métodos altamente eficaces para evitar embarazos en mujeres en edad fértil (MEF) (apéndice 9, sección 12.9.1) desde 30 días antes de la primera dosis de la medicación del estudio hasta la última dosis de la medicación del estudio y la realización de la visita de seguimiento.
    El investigador es responsable de garantizar que los sujetos conozcan el uso correcto de estos métodos anticonceptivos.
    Todos los sujetos que participen en el estudio deberán recibir asesoramiento sobre las prácticas sexuales más seguras, lo que incluye el uso y la relación beneficio/riesgo de métodos de barrera eficaces (p. ej., preservativo masculino), y sobre el riesgo de transmisión del VIH a la pareja no infectada.
    5. Sujeto o representante legal del sujeto con capacidad para otorgar el consentimiento informado firmado según se describe en la sección 10.2 lo que incluye el cumplimiento de los requisitos y restricciones que se recogen en el documento de consentimiento y en este protocolo.
    6. Sujetos inscritos en Francia: solo podrán participar en este estudio sujetos que estén afiliados o sea beneficiarios de la seguridad social.
    E.4Principal exclusion criteria
    A subject will not be eligible for inclusion in this study if any of the following criteria apply:
    1.Women who are breastfeeding or plan to become pregnant or breastfeed during the study; 2.Any evidence of an active Center for Disease Control and Prevention (CDC) Stage 3 disease [CDC, 2014], except cutaneous Kaposi’s sarcoma not requiring systemic therapy and historical or current CD4 cell counts less than 200 cells/mm3. 3.Subjects with severe hepatic impairment (Class C) as determined by Child-Pugh classification; 4.Unstable liver disease (as defined by the presence of 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); 5.Evidence of HBV infection based on the results of testing at Screening for HBV surface antigen (HBsAg), HBV core antibody (anti-HBc), HBV surface antibody (anti-HBs or HBsAb), and HBV DNA as follows:
    •Subjects positive for HBsAg are excluded;
    •Subjects negative for anti-HBs but positive for anti-HBc (negative HBsAg status) and positive for HBV DNA are excluded.
    NOTE: Subjects positive for anti-HBc (negative HBsAg status) and positive for anti-HBs (past and/or current evidence) are immune to HBV and are not excluded.
    6.Anticipated need for any HCV therapy during the first 48 weeks of the study and for HCV therapy based on interferon or any drugs that have a potential for adverse drug:drug interactions with study treatment throughout the entire study period;
    7.Untreated syphilis infection (positive rapid plasma reagin [RPR] at Screening without clear documentation of treatment). Subjects who are at least 14 days post completed treatment are eligible.
    8.History or presence of allergy or intolerance to the study drugs or their components or drugs of their class; 9.Ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma, or cervical, anal or penile intraepithelial neoplasia; other localised malignancies require agreement between the investigator and the Study Medical Monitor for inclusion of the subject. 10.Subjects who in the investigator’s judgment, poses a significant suicidality risk. Recent history of suicidal behaviour and/or suicidal ideation may be considered as evidence of serious suicide risk.
    EXCLUSIONARY TREATMENTS PRIOR TO SCREENING OR DAY 1
    11.Treatment with an HIV-1 immunotherapeutic vaccine within 90 days of Screening; 12.Treatment with any of the following agents within 28 days of Screening i.radiation therapy, ii.cytotoxic chemotherapeutic agents, iii.any systemic immune suppressant;
    13.Treatment with any agent, except recognised ART as allowed above (inclusion criterion 3.), with documented activity against HIV-1 in vitro within 28 days of first dose of study treatment; 14.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 study treatment. 15.Subjects enrolled in France: the subject has participated in any study using an investigational drug during the previous 60 days or 5 half-lives, or twice the duration of the biological effect of the experimental drug or vaccine, whichever is longer, prior to screening for the study or the subject will participate simultaneously in another clinical study.
    LABORATORY VALUES OR CLINICAL ASSESSMENTS AT SCREENING
    16.Any evidence of pre-existing viral resistance based on the presence of any major resistance-associated mutation [IAS-USA, 2014] in the Screening result or, if known, in any historical resistance test result. NOTE: retests of disqualifying Screening genotypes are not allowed. 17.Any verified Grade 4 laboratory abnormality. A single repeat test is allowed during the Screening period to verify a result. 18.Any acute laboratory abnormality at Screening, which, in the opinion of the Investigator, would preclude the subject’s participation in the study of an investigational compound.
    19.Alanine aminotransferase (ALT) >=5 times the upper limit of normal (ULN) or ALT >=3xULN and bilirubin >= 1.5xULN (with >35% direct bilirubin); 20.Creatinine clearance of <50 mL/min/1.73 m2 via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method.
    No podrán participar en este estudio sujetos que cumplan alguno de los criterios siguientes:
    1. Mujeres en período de lactancia o que tengan intención de quedarse embarazadas durante el estudio
    2. Cualquier dato que indique la presencia de una enfermedad activa de estadio 3 de los Centers for Disease Control and Prevention [CDC, 2014], excepto sarcoma de Kaposi cutáneo que no precise tratamiento sistémico y antecedentes de recuentos de linfocitos CD4+ < 200 células/mm3
    3. Sujetos con insuficiencia hepática grave (clase C) según clasificación de Child-Pugh (Apéndice 2, sección 12.2).
    4. Hepatopatía inestable (definida por presencia de ascitis, encefalopatía, coagulopatía, hipoalbuminemia, varices esofágicas o gástricas o ictericia persistente), cirrosis o anomalías biliares conocidas (a excepción de síndrome de Gilbert o colelitiasis asintomática)
    5. Datos de infección por VHB según resultados siguientes de análisis de antígeno de superficie (HBsAg), anticuerpos contra antígenos central del VHB (anti-HBc), anticuerpos contra antígeno de superficie del VHB (anti-HBs o HBsAb) y ADN del VHB efectuados en la fase de selección:
    • No podrán participar en el estudio los sujetos con resultado positivo para el HBsAg.
    • No podrán participar en el estudio los sujetos con resultado negativo para anti-HBs pero positivo para anti-HBc (estado negativo para HBsAg) y para ADN del VHB
    NOTA: Los sujetos que presentan resultado positivo para anti-HBc (estado negativo para HBsAg) y positivo para anti-HBs (dato antiguo o actual) son inmunes al VHB y podrán participar en el estudio
    6. Necesidad prevista de cualquier tratamiento durante las primeras 48 semanas del estudio y de tratamiento para la infección por el VHC con interferón o con cualquier fármaco que conlleve un riesgo de interacción farmacológica adversa con el tratamiento del estudio durante todo el período del estudio
    7. Sífilis no tratada (resultado positivo en prueba de reagina plasmática rápida [RPR] en período de selección sin documentación clara del tratamiento). Podrán participar los sujetos que hayan completado el tratamiento como mínimo 14 días antes
    8. Antecedentes o presencia de alergia o intolerancia a los fármacos del estudio, a sus componentes o a fármacos de su clase
    9. Proceso maligno en curso distinto del sarcoma de Kaposi cutáneo, carcinoma basocelular, carcinoma espinocelular cutáneo no invasivo extirpado o neoplasia intraepitelial cervical, anal o peniana; otros procesos malignos localizados exigen el acuerdo entre investigador y monitor médico del estudio para la inclusión del sujeto
    10. Sujetos que, a criterio del investigador, plantean riesgo de suicidio importante. Los antecedentes recientes de conducta o ideas suicidas, o ambas, pueden considerarse indicativos de riesgo grave de suicidio
    TRATAMIENTOS EXCLUYENTES ANTES DE LA SELECCIÓN O EL DÍA 1
    11. Tratamiento con una vacuna inmunoterapéutica contra el VIH-1 en los 90 días previos a la selección
    12. Tratamiento con cualquiera de los siguientes en los 28 días previos a la selección:
    i. Radioterapia
    ii. Quimioterapia citotóxica
    iii. Cualquier inmunodepresor sistémico
    13. Tratamiento con cualquier fármaco, excepto el TAR reconocido de los permitidos (criterio inclusión nº 3), con actividad documentada contra el VIH-1 in vitro en los 28 días previos a la primera dosis del tratamiento del estudio
    14. Exposición a un fármaco experimental o a una vacuna experimental en los 28 días, 5 semividas del fármaco ensayado o el doble de la duración del efecto biológico del fármaco ensayado, lo que sea más largo, antes de la primera dosis del tratamiento del estudio
    15. Sujetos inscritos en Francia: haber participado en un estudio con un fármaco experimental en los 60 días o 5 semividas, o el doble de la duración del efecto biológico del fármaco o vacuna experimental, lo que sea más prolongado, antes de la selección para el estudio o intención de participar simultáneamente en otro estudio clínico
    VALORES ANALÍTICOS O VALORACIONES CLÍNICAS EXCLUYENTES EN LA SELECCIÓN
    16. Cualquier dato de resistencia viral preexistente basado en la detección de cualquier mutación mayor asociada a resistencia [IAS-USA, 2014] en la selección o cualquier resultado conocido de resistencia en análisis anteriores. NOTA: no se permite repetir análisis de genotipos en la selección
    17. Cualquier anomalía analítica de grado 4 comprobada. Se permite repetir el análisis una sola vez durante el período de selección para verificar el resultado
    18. Cualquier anomalía analítica aguda en la selección que, en opinión del investigador, impida la participación del sujeto en el estudio de un compuesto en investigación
    19. Alanina aminotransferasa (ALT) ≥ 5 veces el límite superior de la normalidad (LSN) o ALT ≥ 3 veces el LSN y bilirrubina ≥ 1,5 veces el LSN (con bilirrubina directa > 35%)
    20. Aclaramiento de creatinina < 50 ml/min/1,73 m2 según el método de la Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of subjects with plasma HIV-1 RNA <50 copies/mL (c/mL) at Week 48 using the FDA Snapshot algorithm [Missing, Switch or Discontinuation = Failure (MSD=F)] for the intent-to-treat exposed (ITT-E) population
    Porcentaje de sujetos con una concentración plasmática de ARN del VIH-1 < 50 copias/ml (c/ml) en la semana 48 usando el algoritmo de Snapshot de la FDA (omisión, cambio o retirada es igual a fracaso [OCR=F]) en la población por intención de tratamiento expuesta (IT-E).
    E.5.1.1Timepoint(s) of evaluation of this end point
    At Week 48
    En la semana 48
    E.5.2Secondary end point(s)
    1)Proportion of subjects with plasma HIV-1 RNA <50 c/mL using the
    FDA Snapshot algorithm (MSD=F) for the ITT-E population
    2)Time to viral suppression (HIV-1 RNA <50 c/mL);
    3)Absolute values and changes from Baseline in CD4+ cell counts
    4)Incidence of disease progression (HIV-associated conditions, AIDS
    and death).
    5)Incidence of treatment-emergent genotypic and phenotypic resistance to DTG and 3TC or TDF/FTC in subjects meeting CVW criteria
    6)Incidence and severity of adverse events (AEs) and laboratory
    abnormalities;
    7)Proportion of subjects who discontinue treatment due to AEs
    8)Change from Baseline in renal and bone biomarkers
    9)Change from Baseline in fasting lipids;
    10)The incidence of Grade 2 or greater laboratory abnormalities in
    fasting LDL cholesterol
    11)Proportion of subjects by patient subgroup(s) (e.g. by age, gender,
    Baseline CD4+ cell count) with plasma HIV-1 RNA <50 c/mL using the
    Snapshot algorithm for the ITT-E population
    12)Change from Baseline in CD4+ cell counts by patient subgroups
    13)Change from Baseline in health related quality of life using EQ-5D-5L
    1) Porcentaje de sujetos con una concentración plasmática de ARN del VIH-1 < 50 c/ml usando el algoritmo de Snapshot de la FDA (OCR=F) en la población IT-E.
    2) Tiempo transcurrido hasta alcanzar la supresión virológica (ARN del VIH-1 < 50 c/ml);
    3)Valores absolutos y variaciones del recuento de linfocitos CD4+ desde el momento basal.
    4) Incidencia de progresión de la enfermedad (enfermedades relacionadas con el VIH, SIDA y muerte).
    5) Incidencia de la resistencia genotípica y fenotípica a DTG y 3TC o TDF/FTC aparecida con el tratamiento en sujetos que cumplan CVRC.
    6) Incidencia e intensidad de todos los acontecimientos adversos (AA) y las anomalías analíticas.
    7)Porcentaje de sujetos que suspendan el tratamiento por AA
    8) Variación de los biomarcadores renales y óseos desde el momento basal.
    9) Variación de los lípidos en ayunas con respecto al valor basal.
    10) Incidencia de anomalías analíticas de grado 2 o mayor en la concentración de colesterol LDL en ayunas.
    11) Porcentaje de sujetos por subgrupos de pacientes (p. ej., según la edad, el sexo o el recuento basal de linfocitos CD4+) que presenten una concentración plasmática de ARN del VIH-1 < 50 c/ml usando el algoritmo de Snapshot de la FDA en la población IT-E.
    12) Variación del recuento de linfocitos CD4+ desde el momento basal por subgrupos de pacientes
    13) Variación de la calidad de vida, determinada mediante el EQ-5D-5L, desde el momento basal
    E.5.2.1Timepoint(s) of evaluation of this end point
    1) Weeks 24, 96 and 144
    2)HIV-1 RNA <50 c/mL
    3)Weeks 24, 48, 96 and 144;
    4)During study when event occurred
    5)During study when event occurred
    6)During study when event occurred
    7)over 24, 48, 96 and 144 weeks
    8)Weeks 24, 48, 96 and 144
    9) Weeks 24, 48, 96, and 144;
    10) Weeks 24, 48, 96, and 144;
    11) at Weeks 24, 48, 96 and 144
    12) Weeks 24, 48, 96 and 144
    13)Weeks 4, 24, 48, 96, and 144 (or Withdrawal from the study)
    1) Semanas 24, 96 y 144
    2) ARN del VIH-1 < 50 copias/ml
    3) Semanas 24, 48, 96 y 144;
    4) Durante el estudio cuando suceda
    5) Durante el estudio cuando suceda
    6) Durante el estudio cuando suceda
    7) Durante 24, 48, 96 y 144 semanas
    8) Semanas 24, 48, 96 y 144
    9) Semanas 24, 48, 96, y144;
    10) Semanas 24, 48, 96 y 144;
    11) Semanas 24, 48, 96 y 144
    12) Semanas 24, 48, 96 y 144
    13) Semanas 4, 24, 48, 96, y 144 (o retirada 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 No
    E.6.7Pharmacodynamic No
    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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Doble ciego Semana 1 a 96. Abierto Semana 96 a 148
    Double blind Week 1 to 96. Open label week 96 to 148
    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 concerned13
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA63
    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
    Mexico
    Peru
    Poland
    Portugal
    Romania
    Russian Federation
    South Africa
    Spain
    Switzerland
    Taiwan
    Ukraine
    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
    El fin del estudio se define como la última visita 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 months1
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months1
    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: 693
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 7
    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 state130
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 300
    F.4.2.2In the whole clinical trial 700
    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)
    - continuing to receive DTG plus 3TC once daily (Continuation Phase), as detailed in the protocol (Section 6.8)
    or
    - receive antiretroviral medication as per SOC.
    - continuar recibiendo DTG + 3TC (fase de continuación), tal y como se detalla en el protocolo (sección 6.8)
    o
    - recibir medicación antirretroviral según la práctica clinica habitual
    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 Decision2016-07-20
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-07-07
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2022-06-29
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