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    Summary
    EudraCT Number:2017-002946-62
    Sponsor's Protocol Code Number:207966
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2017-09-18
    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 number2017-002946-62
    A.3Full title of the trial
    A Phase IIIb, Randomized, Multicenter, Parallel-group, Non-inferiority, Open-label Study Evaluating the Efficacy, Safety, and Tolerability of Long-acting Cabotegravir Plus Long-acting Rilpivirine Administered Every 8 Weeks or Every 4 Weeks in HIV-1-infected Adults who are Virologically Suppressed
    Estudio Fase IIIb, aleatorizado, multicéntrico, abierto, de grupos paralelos, de no inferioridad que evalúa la eficacia, seguridad y tolerabilidad de cabotegravir de acción prolongada más rilpivirina de acción prolongada administrados cada 8 semanas o cada 4 semanas en adultos infectados por VIH-1 que presentan supresión virológica
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    207966 or "ATLAS-2M" is a study to compare two drugs called Cabotegravir and Rilpivirine when given as long acting injections either every 8 weeks or every 4 weeks in adults with HIV.
    2007966 o "ATLAS-2M" es un estudio que compara dos fármacos llamados cabotegravir y rilpivirina cuando se administran en inyecciones de acción prolongada cada 8 semanas o cada 4 semanas en adultos que tienen VIH
    A.3.2Name or abbreviated title of the trial where available
    Phase 3b study of Cabotegravir LA + Rilpivirine LA administered every 8 weeks or every 4 weeks, HIV
    A.4.1Sponsor's protocol code number207966
    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 supportViiV Healthcare UK (No.4) Limited
    B.4.2CountryUnited Kingdom
    B.4.1Name of organisation providing supportJanssen Sciences Ireland UC
    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 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 nameCabotegravir LA
    D.3.2Product code GSK1265744
    D.3.4Pharmaceutical form Suspension for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCabotegravir (free acid)
    D.3.9.1CAS number 1051375-10-0
    D.3.9.2Current sponsor codeGSK1265744
    D.3.9.3Other descriptive nameGSK1265744A (Free acid)
    D.3.9.4EV Substance CodeSUB127217
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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: 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 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 nameCabotegravir Tablets (CAB)
    D.3.2Product code GSK1265744
    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 INNCabotegravir Sodium (Na salt)
    D.3.9.1CAS number 1051375-13-3
    D.3.9.2Current sponsor codeGSK1265744
    D.3.9.3Other descriptive nameGSK1265744B (Sodium Salt)
    D.3.9.4EV Substance CodeSUB127217
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    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 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 N.V.
    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 nameEDURANT
    D.3.2Product code TMC278
    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 500287-72-9
    D.3.9.2Current sponsor codeR278474
    D.3.9.3Other descriptive nameRILPIVIRINE
    D.3.9.4EV Substance CodeSUB31456
    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: 4
    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 nameRilpivirine LA
    D.3.2Product code TMC278LA
    D.3.4Pharmaceutical form Suspension for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRilpivirine (free base)
    D.3.9.1CAS number JNJ-16150108
    D.3.9.3Other descriptive nameRilpivirine LA
    D.3.9.4EV Substance CodeSUB127218
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 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 20.0
    E.1.2Level LLT
    E.1.2Classification code 10003582
    E.1.2Term Asymptomatic human immunodeficiency virus type I infection
    E.1.2System Organ Class 100000020183
    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 CAB LA + RPV LA every 8 weeks (every two months) compared to CAB LA + RPV LA every 4 weeks (monthly) over 48 weeks in suppressed HIV-1 infected antiretroviral therapy (ART)-experienced participants
    Demostrar la no inferioridad de la actividad antiviral de CAB AP + RPV AP cada 8 semanas (cada dos meses) frente a CAB AP + RPV AP cada 4 semanas (mensualmente) durante 48 semanas en sujetos que hayan recibido un tratamiento antirretroviral (TAR) previo para la infección por VIH-1.
    E.2.2Secondary objectives of the trial
    -To demonstrate the antiviral and immunologic activity of CAB LA + RPV LA every 8 weeks compared to CAB LA + RPV LA every 4 weeks
    -To evaluate the safety and tolerability of CAB LA + RPV LA every 8 weeks compared to CAB LA + RPV LA every 4 weeks
    -To assess viral resistance in participants experiencing protocol-defined confirmed virologic failure
    -To characterize CAB and RPV concentrations and population pharmacokinetics and identify important determinants of variability
    -To assess patient reported health-related quality of life, treatment satisfaction, injection tolerability, and treatment acceptance.
    - Demostrar la actividad antiviral e inmunitaria de CAB AP + RPV AP cada 8 semanas frente a CAB AP + RPV AP cada 4 semanas.
    -Evaluar la seguridad y tolerabilidad de CAB AP + RPV AP cada 8 semanas frente a CAB AP + RPV AP cada 4 semanas.
    - Evaluar la resistencia viral en participantes que presentan fracaso virológico según la definición del protocolo.
    - Caracterizar las concentraciones de CAB y RPV y la farmacocinética poblacional e identificar importantes determinantes de la variabilidad.
    - Evaluar el grado de calidad de vida relacionado con la salud, la satisfacción con el tratamiento, la tolerabilidad de las inyecciones y la aceptación del tratamiento reportado por los pacientes.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Aged 18 years or older (or ≥19 where required by local regulatory agencies), at the time of signing the informed consent.
    2. A female participant is eligible to participate if she is not pregnant (as confirmed by a negative serum human chorionic gonadotropin (hCG) test at screen and a negative urine hCG test at Randomization), 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 [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) and estradiol levels consistent with menopause (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) from 30 days prior to the first dose of study medication, throughout the study, for at least 30 days after discontinuation of all oral study medications, and for at least 52 weeks after discontinuation of CAB LA and RPV LA.
    The investigator is responsible for ensuring that participants understand how to properly use these methods of contraception.
    3. Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.
    Eligible participants or their legal guardians (and next of kin when locally required), must sign a written Informed Consent Form before any protocol specified assessments are conducted. Enrolment of participants who are unable to provide direct informed consent is optional and will be based on local legal/regulatory requirements and site feasibility to conduct protocol procedures.
    4. Participants enrolled in France must be affiliated to, or a beneficiary of, a social security category.
    5. Must be on uninterrupted current regimen (either the initial or second ARV regimen) for at least 6 months prior to Screening. Any prior switch, defined as a change of a single drug or multiple drugs simultaneously, must have occurred due to tolerability/safety, access to medications, or convenience/simplification, and must NOT have been done for treatment failure (HIV-1 RNA ≥400 c/mL).
    Acceptable stable (initial or second) ARV 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 either the initial cART regimen or one historical within class switch is permitted due to safety/tolerability)
    The addition, removal, or switch of a drug(s) that has been used to treat HIV based on antiretroviral properties of the drug constitutes a change in ART with the following limited exceptions:
    Historical changes in formulations of ART drugs or booster drugs will not constitute a change in ART regimen if the data support similar exposures and efficacy, and the change must have been at least 3 months prior to Screening.
    Historical perinatal use of an NRTI when given in addition to an ongoing HAART will not be considered a change in ART regimen.
    A change in dosing scheme of the same drug from twice daily to once daily will not be considered a change in ART regimen if data support similar exposures and efficacy.
    6. 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;
    7. Plasma HIV-1 RNA <50 c/mL at Screening;
    8. Must have been on CAB LA 400 mg + RPV LA 600 mg Q4W or “Current ART” regimen through at minimum Week 52 of the ATLAS study as per ATLAS protocol dosing requirements and until Day 1 of the ATLAS-2M study. Any disruptions in dosing during ATLAS must be discussed with the Medical Monitor for a final determination of eligibility.
    9. Plasma HIV-1 RNA <50 c/mL at Screening
    1. Pacientes >=18 años de edad (o >=19 años si es requerido por las agencias reguladoras locales) en el momento de la firma del consentimiento informado.
    2. Una paciente es elegible para participar en el estudio si no está embarazada (según lo confirmado por un resultado negativo en la prueba de gonadotropina coriónica humana [hCG] en suero en la visita de Selección y una prueba de hCG en orina negativa en la aleatorización), no se encuentra en periodo de lactancia y se aplica, al menos, una de las siguientes condiciones:
    a. No se encuentra en edad fértil, que se define como:
    - Mujeres premenopáusicas que presentan una de las siguientes opciones:
    Ligadura de trompas documentada
    Procedimiento histeroscópico de oclusión de las trompas documentado con confirmación en el seguimiento de oclusión tubárica bilateral
    Histerectomía
    Ovariectomía bilateral documentada
    - Posmenopáusicas, definidas como 12 meses de amenorrea espontánea [en casos dudosos se confirma con una muestra sanguínea con determinaciones simultáneas de folitropina y niveles de estradiol coherentes con la menopausia]. Las mujeres que reciben una terapia de reemplazo hormonal (TRH) y cuyo estado menopáusico es dudoso deben utilizar uno de los métodos anticonceptivos de gran eficacia si desean seguir recibiendo TRH durante el estudio. En caso contrario, suspenderán el TRH para permitir la confirmación del estado posmenopáusico antes de su inclusión en el estudio.
    b. En edad fértil y accede a utilizar una de las opciones dispuestas en la Lista Modificada de Métodos Altamente Eficaces para Evitar el Embarazo en Mujeres en Edad Fértil (MEF) a partir de los 30 días anteriores a la primera dosis del fármaco del estudio, a lo largo del mismo y hasta 30 días después de la suspensión de todos los fármacos orales del estudio, así como durante, al menos, 52 sems. tras interrumpir la administración de CAB AP y RPV AP.
    El Investigador es responsable de garantizar que los pacientes conocen el uso adecuado de estos métodos anticonceptivos.
    3. Con capacidad para otorgar el consentimiento informado firmado, que incluye el cumplimiento con los requisitos y las restricciones dispuestas en el formulario de consentimiento y en este protocolo Los participantes elegibles, o sus tutores legales (y los parientes más cercanos si se requiere localmente), deben firmar el formulario de consentimiento informado antes de realizar cualquier evaluación específica del protocolo. La aleatorización de los participantes que no son capaces de dar consentimiento informado directo es opcional, en base a los requisitos legales/reguladores locales y la viabilidad del centro para realizar los procedimientos del protocolo.
    4. Los participantes incluidos en Francia deben estar afiliados o ser beneficiarios de una categoría de la Seguridad Social.
    5. Deben recibir el tratamiento actual de forma ininterrumpida (la inicial o la segunda terapia ARV) durante, al menos, 6 meses previos a la Selección. Cualquier modificación previa, que se define como el cambio de un único fármaco o diversos fármacos de manera simultánea, se debería haber realizado por problemas de tolerabilidad/seguridad, acceso a los fármacos o por comodidad/simplificación, y NO debería haberse efectuado debido a un fracaso terapéutico (ARN del VIH-1 ≥ 400 c/ml).
    Los tratamientos ARV estables aceptables (inicial o segundo) 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, permitiéndose un cambio previo por seguridad/tolerabilidad dentro de la misma clase)
    La adición, retirada o cambio de un fármaco(s) usado para el tratamiento del VIH por sus propiedades antirretrovirales constituye un cambio en el TAR con las siguientes excepciones:
    - Los cambios previos en las formulaciones de los fármacos o los potenciadores del TAR no constituyen un cambio en el TAR si los datos apoyan exposiciones y eficacia similares, y siempre que el cambio haya tenido lugar al menos 3 meses antes de la Selección.
    - El uso perinatal previo de un ITIN junto con un TAR de base no se considerará un cambio en el TAR.
    - Un cambio en el esquema posológico del mismo fármaco, de dos veces a una vez al día, no se considerará un cambio si los datos apoyan exposiciones y eficacia similares.
    6. Evidencia documentada de, al menos, dos determinaciones del ARN del VIH-1 en plasma <50 c/ml en los 12 meses previos a la visita de Selección: una en la ventana de 6 a 12 meses y la otra en los 6 meses previos a la visita de Selección.
    7. ARN del VIH-1 en plasma <50 c/ml en la Selección.
    8. Deberán haber estado en tratamiento con CAB AP 400 mg+RPV AP 600 mg c4semanas o el "TAR actual" hasta, como mínimo, la Semana 52 del estudio ATLAS conforme a los requisitos de posología del protocolo de ATLAS y hasta el Día 1 del estudio ATLAS-2M.
    9. ARN del VIH-1 en plasma <50 c/ml en la Selección.
    E.4Principal exclusion criteria
    1. Within 6 months prior to Screening, any plasma HIV-1 RNA measurement ≥ 50 c/mL
    2. Within the 6 to 12-month window prior to Screening, any plasma HIV-1 RNA
    measurement >200 c/mL, or 2 or more plasma HIV-1 RNA measurements ≥ 50 c/mL
    3. 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
    4. 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 ≥200 c/mL after initial suppression
    to <50 c/mL while on first line HIV therapy regimen)
    5. A history of use of any regimen consisting of only mono or dual HIV-1 therapy
    (even if only for peri-partum treatment). Participants who are currently
    participating in or anticipate to be selected for any other interventional study with the exception of the 201585 (ATLAS) study.
    6. During participation in ATLAS, consecutive (2 or more sequential) plasma HIV-1
    RNA measurements ≥ 50 c/mL
    7. During participation in ATLAS, any HIV-1 RNA measurement ≥ 200 c/mL
    8. More than two total measurements of plasma HIV-1 RNA ≥ 50 c/mL during
    participation in the ATLAS trial will require direct approval by the ATLAS-2M
    Medical Monitor and Study virologist for study participation.
    9. Women who are pregnant, breastfeeding or plan to become pregnant or breastfeed during the study
    10. Any evidence of a current Center for Disease Control and Prevention (CDC)
    Stage 3 disease [CDC, 2014], except cutaneous Kaposi’s sarcoma not requiring
    systemic therapy.
    11. Participants with moderate to severe hepatic impairment
    12. Any pre-existing physical or mental condition (including substance use disorder) which, in the opinion of the Investigator, may interfere with the participant’s ability to comply with the dosing schedule and/or protocol evaluations or which may compromise the safety of the participant
    13. Participants determined by the Investigator to have a high risk of seizures,
    including participants with an unstable or poorly controlled seizure disorder. A
    participant with a prior history of seizure may be considered for enrolment if the
    Investigator believes the risk of seizure recurrence is low. All cases of prior
    seizure history should be discussed with the Medical Monitor prior to enrolment
    14. All participants will be screened for syphilis (rapid plasma reagin [RPR]).
    Participants with untreated secondary (late latent) or tertiary syphilis infection,
    defined as a positive RPR and a positive treponemal test without clear
    documentation of treatment, are excluded. Participants with a false positive RPR
    (with negative treponemal test) or serofast RPR result (persistence of a reactive
    nontreponemal syphilis test despite history of adequate therapy and no evidence
    of re-exposure) may enroll after consultation with the Medical Monitor.
    Participants with primary syphilis or early latent secondary syphilis (acquired
    within the preceding year) who have a positive RPR test and have not been treated may be treated during the screening period and if completion of antibiotic treatment occurs during the screening period, may be allowed entry after consultation with the Medical Monitor. If antibiotic treatment cannot be
    completed before the screening window ends, subjects may be rescreened once
    following completion of antibiotic therapy for primary or early latent secondary
    syphilis.
    15. Participants who, in the investigator's judgment, pose a significant suicide risk.
    Participant’s recent history of suicidal behavior and/or suicidal ideation should be considered when evaluating for suicide risk
    16. The participant has a tattoo or other dermatological condition overlying the
    gluteus region which may interfere with interpretation of injection site reactions
    17. Evidence of Hepatitis B virus (HBV) infection based on the results of testing at
    Screening for Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody
    (anti-HBc), Hepatitis B surface antibody (anti-HBs) and HBV DNA as follows:
    a. •Participants positive for HBsAg are excluded;
    b. •Participants negative for anti-HBs but positive for anti-HBc (negative
    HBsAg status) and positive for HBV DNA are excluded
    Note: Participants 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.

    For a full list of exclusion criteria refer to Section 5.2 of the protocol
    1. Cualquier determinación del ARN del VIH-1 en plasma >=50 c/ml en los 6 meses previos a la Selección
    2. Cualquier determinación del ARN del VIH-1 en plasma >200 c/ml o 2 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
    3. 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
    4. 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 >=200 c/ml tras la supresión inicial a < 50 c/ml durante el tratamiento de primera línea del VIH)
    5. Antecedentes de uso de cualquier esquema de monoterapia o tratamiento dual para el VIH-1 (incluso aunque solo se trate de una terapia periparto). Sujetos que actualmente participan o cuya selección se prevé para cualquier otro estudio intervencional, a excepción del estudio 201585 (ATLAS).
    6. Durante la participación en ATLAS, determinaciones consecutivas (2 o más) de ARN del VIH-1 en plasma >=50 c/ml
    7. Durante la participación en ATLAS, cualquier determinación de ARN del VIH-1 en plasma >=200 c/ml
    8. Se necesitará la aprobación directa del Monitor Médico de ATLAS-2M y del virólogo del estudio para la participación en dicho estudio en caso de haber tenido más de dos determinaciones de ARN del VIH-1 en plasma >=50 c/ml durante la participación en el estudio ATLAS.
    9. Mujeres embarazadas, en periodo de lactancia o que planean quedarse embarazadas o amamantar durante el estudio
    10. Cualquier evidencia de una enfermedad de Estadio 3 activa según el Center for Disease Control and Prevention [CDC, 2014], salvo el sarcoma de Kaposi cutáneo que no requiera tratamiento sistémico
    11. Los participantes con insuficiencia hepática moderada a grave
    12. 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 participante
    13. Los participantes que, según el Investigador, presentan un riesgo elevado de convulsiones o crisis, incluyendo los sujetos con un trastorno epiléptico inestable o mal controlado. Un participante con antecedentes previos de crisis epilépticas puede considerarse para su inclusión si el Investigador considera que el riesgo de recurrencia de las crisis es bajo. Todos los casos con antecedentes de crisis previas deben debatirse con el Monitor Médico con anterioridad a la inclusión
    14. Se realizará una prueba de cribado para sífilis a todos los participantes (reagina plasmática rápida [RPR]). Se excluyen los participantes con infección por sífilis secundaria (latencia tardía) o terciaria sin tratar, conforme a lo definido por un resultado positivo de RPR y de prueba treponémica sin documentación clara del tratamiento. Los sujetos con resultado de RPR falso positivo (prueba treponémica negativa) o con un resultado de RPR serorresistente (prueba de persistencia de sífilis reactiva no treponémica pese a antecedentes de tratamiento adecuado y sin evidencia de re-exposición) pueden ser aleatorizados después de consultar al Monitor Médico. Los participantes con sífilis primaria o sífilis secundaria latente precoz (desarrollada durante el año anterior) que presentan una prueba RPR positiva y no han recibido tratamiento pueden ser tratados durante el periodo de selección y, si durante el mismo se completa el tratamiento antibiótico, pueden resultar incluidos tras consultar con el Monitor Médico. Si el tratamiento antibiótico no puede completarse antes de que finalice la ventana de selección, los sujetos pueden someterse a una nueva selección después de completar el tratamiento antibiótico para la sífilis primaria o secundaria latente precoz.
    15. Sujetos que, a criterio del Investigador, presentan un riesgo de suicidalidad significativo. Los antecedentes recientes de conducta suicida e/o ideas de suicidio del participante se deben considerar en la evaluación del riesgo de suicidio.
    16. El sujeto tiene un tatuaje u otra condición dermatológica sobre la zona glútea que puede interferir con la interpretación de las reacciones en el lugar de la inyección.

    Para una lista completa de los Criterios de Exclusión consulte la Sección 5.2 del Protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    Proportion of participants with plasma HIV-RNA greater than or equal to 50 copies/mL (Virologic Failure ) as per Food and Drug Administration (FDA)
    Snapshot algorithm at Week 48 (Intent-to- Treat Exposed [ITT-E] population)
    Porcentaje de participantes con ARN del VIH en plasma superior o igual a 50 c/ml (Fracaso Virológico) conforme al algoritmo Snapshot de la Food and Drug Administration (FDA) en la Semana 48 (población expuesta con intención de tratar [ITT-E])
    E.5.1.1Timepoint(s) of evaluation of this end point
    48 weeks
    48 semanas
    E.5.2Secondary end point(s)
    -Proportion of participants with plasma HIV-1 RNA <50 c/mL (c/mL) at Week 48 and Week 96 using the FDA Snapshot algorithm (Missing, Switch or Discontinuation = Failure, Intent-to-Treat Exposed [ITT-E] population)
    -Proportion of participants with protocol defined confirmed virologic failure (CVF) through Week 48 and Week 96
    -Proportion of participants with HIV-RNA greater than or equal to 50 c/mL as per FDA Snapshot algorithm at Week 96
    -Absolute values and changes from Baseline in viral load and CD4+ cell counts over time including Week 48 and Week 96
    -Incidence and severity of AEs and laboratory abnormalities over time
    including Week 48 and Week 96
    -Proportion of participants who discontinue treatment due to AEs over time including Week 48 and Week 96
    -Change from Baseline in laboratory parameters over time including Week 48 and Week 96
    -Incidence of treatment emergent genotypic and phenotypic resistance to CAB, RPV through Week 48 and Week 96
    -Plasma PK parameters for CAB LA and RPV LA (when evaluable, Ctrough, concentrations post dose [~Cmax], and area under the curve [AUC])
    -Demographic parameters including, but not limited to, age, sex, race, body weight, body mass index, and relevant laboratory parameters will be evaluated as potential predictors of inter- and intra-participant variability for pharmacokinetic parameters
    -Change from Baseline (Day 1) in HRQoL at Week 24, and Week 48 (or Withdrawal)
    -Change from baseline (Day 1) in total “treatment satisfaction” score, and individual item scores of the HIV Treatment Satisfaction Status Questionnaire (HIVTSQs) at Week 24, and 48, (or Withdrawal)
    -Change in treatment satisfaction over time using the HIV Treatment Satisfaction
    -Change Questionnaire HIVTSQc at Week 48 (or Withdrawal).
    -Change from Week 8 in Dimension scores (“Bother of ISRs”, “Leg movement”, “Sleep”, and “Injection Acceptance”) and individual item scores assessing pain during injection, anxiety before and after injection, willingness to be injected in the future and overall satisfaction with mode of administration over time will be assessed using the Perception of iNjection questionnaire (PIN) at Weeks 8, 24, and 48 (or Withdrawal)
    -Change from Baseline (Day 1) in treatment acceptance at Week 24 and Week 48 (or Withdrawal) will be assessed using the “General acceptance” dimension of the Chronic Treatment Acceptance (ACCEPT) questionnaire
    - Porcentaje de participantes con ARN del VIH-1 en plasma < 50 c/ml en las Semanas 48 y 96, utilizando el algoritmo Snapshot de la FDA (Pérdida, Cambio o Retirada = Fracaso, población expuesta con intención de tratar [ITT-E]).
    - Porcentaje de participantes con fracaso virológico confirmado (FVC) según la definición del protocolo hasta las Semanas 48 y 96.
    - Porcentaje de participantes con ARN del VIH superior o igual a 50 c/ml conforme al algoritmo Snapshot de la (FDA) en la Semana 96.
    - Valores absolutos y cambios frente al valor basal en la carga viral y el recuento linfocitario de CD4+ a lo largo del tiempo incluyendo las Semanas 48 y 96.
    - Incidencia y gravedad de AA y anomalías de laboratorio a lo largo del tiempo incluyendo las Semanas 48 y 96.
    - Porcentaje de participantes que interrumpen el tratamiento por la aparición de AA a lo largo del tiempo incluyendo las Semanas 48 y 96.
    - Cambios frente al valor basal en los parámetros analíticos a lo largo del tiempo incluyendo las Semanas 48 y 96.
    - Incidencia de resistencia fenotípica y genotípica relacionada con el tratamiento a CAB y RPV en las Semanas 48 y 96.
    - Parámetros FC en plasma para CAB AP y RPV AP (cuando sea evaluable, Cmin, concentraciones después de la dosis [~Cmáx] y área bajo la curva [AUC]).
    - Los parámetros demográficos incluyendo, aunque sin limitarse a, edad, sexo, raza, peso corporal, índice de masa corporal y parámetros analíticos relevantes se evaluarán como factores pronósticos potenciales de la variabilidad inter- e intra-participantes con respecto a los parámetros farmacocinéticos.
    - Cambio frente al valor basal (Día 1) en la CVRS en las Semanas 24 y 48 (o Retirada).
    - Cambio frente al valor basal (Día 1) en la puntuación de "satisfacción con el tratamiento" total y puntuación individual de cada elemento del Cuestionario de Satisfacción sobre el Tratamiento del VIH (HIVTSQs) en las Semanas 24 y 48 (o Retirada).
    - Cambio en la satisfacción con el tratamiento a lo largo del tiempo utilizando el Cuestionario de Satisfacción del Cambio, HIVTSQc, en la Semana 48 (o Retirada).
    - Cambio frente a Semana 8 en las puntuaciones de las dimensiones ("Molestias por RLI", "Movimiento de las piernas", "Sueño" y "Aceptación de la inyección") y puntuaciones individuales de cada ítem que evalúan el dolor durante la inyección, la ansiedad antes y después de la inyección, la disposición a recibir una inyección en el futuro y la satisfacción general con la vía de administración a lo largo del tiempo utilizando el cuestionario sobre la percepción de la inyección (PIN) en las Semanas 8, 24 y 48 (o Retirada).
    - Se evaluará el cambio frente al valor basal (Día 1) en la aceptación del tratamiento en las Semanas 24 y 48 (o Retirada) utilizando la dimensión "Aceptación general" del cuestionario sobre aceptación del tratamiento crónico (ACCEPT).
    E.5.2.1Timepoint(s) of evaluation of this end point
    Time points of evaluation are included within endpoint above.
    El momento de evaluación se incluye en cada variable secundaria en el apartado anterior.
    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 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 Yes
    E.8.2.3.1Comparator description
    CAB LA + RPV LA Q4W
    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 EEA37
    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
    Canada
    France
    Germany
    Italy
    Korea, Democratic People's Republic of
    Mexico
    Russian Federation
    South Africa
    Spain
    Sweden
    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
    LVLS
    Última visita del último paciente.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    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 years5
    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: 850
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 30
    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
    ICF document allows for thumbprint for illiterate individuals
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state150
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 250
    F.4.2.2In the whole clinical trial 850
    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)
    Refer to Protocol (section 6.12) for full text.

    The investigator is responsible for ensuring that consideration has been given to the post study care of the participant’s medical condition, whether or not GSK is providing specific post-study treatment. Participants who have successfully completed 100 weeks of treatment will continue to have access to both CAB LA and RPV LA in the Extension Phase until study treatment is either locally approved and commercially available,......is terminated.
    Ver Sección 6.12 del Protocolo para el texto completo.

    El investigador es responsable de garantizar que se ha valorado una asistencia médica 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. Todos los sujetos que completen con éxito las 100 semanas de tratamiento continuarán recibiendo CAB AP + RPV AP durante la Fase de Extensión hasta la autorización local disponibilidad en.....
    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 Decision2017-09-18
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-08-31
    P. End of Trial
    P.End of Trial StatusOngoing
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