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    Summary
    EudraCT Number:2019-000588-26
    Sponsor's Protocol Code Number:MK-8591A-019
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-06-14
    Trial 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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2019-000588-26
    A.3Full title of the trial
    A Phase 3, Randomized, Clinical Study in HIV-1-Infected Heavily Treatment-Experienced Participants Evaluating the Antiretroviral Activity of Blinded Islatravir (ISL), Doravirine (DOR), and Doravirine/Islatravir (DOR/ISL), Each Compared to Placebo, and the Antiretroviral Activity, Safety, and Tolerability of Open-Label DOR/ISL
    Studio Clinico di fase 3, randomizzato, in pazienti multitrattati affetti da HIV-1,  per valutare l’attività antiretrovirale di Islatravir (ISL), Doravirina (DOR) e Doravirina/Islatravir (DOR/ISL) in cieco, ciascuno comparato al placebo, e l’attività antiretrovirale, la sicurezza e la tollerabilità di DOR/ISL in aperto
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Doravirine/Islatravir in heavily treatment-experienced participants
    Doravirina/Islatravir in pazienti multitrattati
    A.3.2Name or abbreviated title of the trial where available
    DOR/ISL in heavily treatment-experienced participants
    DOR/ISL in pazienti multitrattati
    A.4.1Sponsor's protocol code numberMK-8591A-019
    A.5.4Other Identifiers
    Name:INDNumber:134,036
    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. UNA SUSSIDIARIA DI 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 organisationMSD Italia Srl
    B.5.2Functional name of contact pointDivisione Ricerca Clinica
    B.5.3 Address:
    B.5.3.1Street AddressVia Vitorchiano, 151
    B.5.3.2Town/ cityRoma
    B.5.3.3Post code00189
    B.5.3.4CountryItaly
    B.5.4Telephone number0039090636191371
    B.5.5Fax number00390636380371
    B.5.6E-mailgcto.italy@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 nameIslatravir
    D.3.2Product code [MK-8591]
    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 INNMK-8591
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB130009
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number750
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Doravirine (Pifeltro)
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme BV - EU/1/18/1332/001
    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 name-
    D.3.2Product code [-]
    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 INNDoravirina
    D.3.9.2Current sponsor codeMK-1439
    D.3.9.4EV Substance CodeSUB177834
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Doravirine
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme Corp.
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    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 name-
    D.3.2Product code [-]
    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 INNDoravirina
    D.3.9.2Current sponsor codeMK-1439
    D.3.9.4EV Substance CodeSUB177834
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    D.2.1.1.1Trade name Doravirina
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme Corp.
    D.2.1.2Country which granted the Marketing AuthorisationCanada
    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 name-
    D.3.2Product code [-]
    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 INNDoravirina
    D.3.9.2Current sponsor codeMK-1439
    D.3.9.4EV Substance CodeSUB177834
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 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 nameDoravirine/Islatravir
    D.3.2Product code [MK-8591A]
    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 INNDORAVIRINA
    D.3.9.2Current sponsor codeMK-1439
    D.3.9.4EV Substance CodeSUB177834
    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 INNMK-8591
    D.3.9.2Current sponsor code-
    D.3.9.3Other descriptive nameMK-8591
    D.3.9.4EV Substance CodeSUB130009
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number750
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 3
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 4
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    HIV-1 infection
    Infezione da HIV-1
    E.1.1.1Medical condition in easily understood language
    HIV-1 infection
    Infezione da HIV-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 20.1
    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
    1.To evaluate the antiretroviral activity of doravirine/islatravir (DOR/ISL) compared to placebo, each given in combination with failing antiretroviral therapy (ART) as assessed by the percentage of participants achieving >=0.5 log10 decrease in HIV-1 RNA from study baseline (Day 1) to Day 8 (Part 1)
    2.To evaluate the safety and tolerability of DOR/ISL as assessed by review of the accumulated safety data through Week 25 and Week 49
    1. Valutare l'attività antiretrovirale di doravirina/islatravir (DOR/ISL) a confronto con il placebo, ciascuno in combinazione con la terapia ART fallimentare, in termini di percentuale di partecipanti che raggiungono una riduzione >=0,5 log10 dell'HIV-1 RNA a partire dal basale dello studio (Giorno 1) fino al Giorno 8 (Parte 1)
    2. Valutare la sicurezza e la tollerabilità di DOR / ISL esaminando i dati sulla sicurezza accumulati fino alla settimana 25 e alla settimana 49
    E.2.2Secondary objectives of the trial
    1.To evaluate the safety and tolerability of DOR/ISL through Week 97
    2.To assess antiretroviral activity of DOR, ISL+failing antiretroviral therapy (ART) based on % of participants with =0.5 and =1.0 log10 decrease in HIV-1 RNA
    3.To assess antiretroviral activity of DOR, ISL + failing ART based on % of participants with >=0.5 log10 decrease in HIV-1 RNA; mean change in HIV-1 RNA; and % of participants with >=1.0 log10 decrease in HIV-1 RNA
    4.To assess antiretroviral activity of DOR, ISL, optimized background therapy (OBT) based on % of participants achieving >=0.5 log10 and >=1.0 log10 decrease in HIV-1 RNA; mean change in HIV-1 RNA; % of participants with HIV-1 RNA <50 and <200 copies/mL; and % of participants with HIV-1 RNA <40 copies/mL
    5.To assess development of viral drug resistance to DOR, ISL, OBT
    6.To assess the role of baseline antiviral resistance on virologic outcomes
    7.To assess the change in CD4+ T-cell counts
    1.Valutare la sicurezza e la tollerabilità di DOR / ISL fino alla settimana 97
    2. Valutare l'att. antiretr. di DOR, ISL+terapia ART fallimentare, in termini di percentuale di part. che raggiungono una riduz >=0,5 e >=1,0 log10 dell'HIV
    3. Val. l'att. antiretr. di DOR e ISL,+terapia ART fallimentare, in termini di perc. di part. che ragg. una rid. >= 0,5 log10 dell'HIV-1 RNA; var. media dell'HIV-1 RNA; perc. di part. che ragg. una rid. >=1,0 log10 dell'HIV-1 RNA
    4. Val. l'att. antiretr. di DOR/ISL + OBT in base alla perc. di part. che ragg. una rid. >=0,5 e >=1,0 log10 dell'HIV-1 RNA;var. media dell'HIV-1 RNA;perc. di part. che ragg. HIV-1 RNA <50 e <200 copie/ml;perc. di part. che ragg. HIV-1 RNA <40 copie/ml
    5. Val. lo svil. della farmacores. virale a DOR, ISL o componenti di OBT
    6. Valutare l'impatto della resistenza antivirale al basale dello studio sull'esito virologico
    7. Valutare la variazione della conta di cellule T CD4+
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Is HIV-1 positive with plasma HIV-1 RNA = 500 copies/mL at the Screening Visit and confirmed upon repeat testing (Visit 2 [or Visit 3 if required]) during the Run-in period.
    In addition, the log change in HIV-1 RNA must meet 1 of the following criteria at a confirmation visit:
    - < 0.5 log10 decline in HIV-1 RNA from the Screening Visit (Visit 1) to the Confirmation visit (Visit 2)
    OR
    - If = 0.5 log10 decline in HIV-1 RNA at Visit 2, another confirmation test is required (Visit 3). In this case, there must be < 0.3 log10 decline in HIV-1 RNA from Visit 2
    2. Has been receiving the same baseline ART for =3 months prior to signing the Informed Consent Form/Assent Form.
    3. Has at least triple-class resistance (NRTI, NNRTI, and resistance to at least 1 other class [ie, resistance to at least 1 drug in each class]) based on resistance testing at the Screening Visit.
    4. Has =1 fully active antiretroviral remaining that can be effectively combined to form a viable regimen based on resistance, tolerability, safety, drug access, or acceptability to participant.
    5. Is male or female, adult (>=18 years of age) or pediatric participants (weighing >=35 kg, and <18 years of age), at the time of signing the informed consent/assent (the Screening Visit).
    6. A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
    - Is not a woman of childbearing potential (WOCBP)
    OR
    - Is a WOCBP and using an acceptable contraceptive method, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis), during the intervention period and for at least 6 weeks, corresponding to the time needed to eliminate any study intervention(s) (eg, 5 terminal half-lives) after the last dose of study intervention. The investigator should evaluate the potential for contraceptive method failure (ie, noncompliance, recently initiated) in relationship to the first dose of study intervention.
    - A WOCBP must have a negative highly sensitive pregnancy test ([urine or serum] as required by local regulations) within 24 hours before the first dose of study intervention.
    - If a urine test cannot be confirmed as negative (eg, an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
    - The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
    7. The participant (or legally acceptable representative) has provided documented written informed consent/assent for the study. The participant may also provide consent/assent for future biomedical research. However, the participant may participate in the main study without participating in future biomedical research.
    1. È HIV-1 positivo/a con HIV-1 RNA plasmatico =500 copie/ml alla visita di screening e valore confermato con la ripetizione del test (Visita 2 [o Visita 3 se necessario]) durante il periodo di preparazione.
    Inoltre, la variazione del log dell'HIV-1 RNA deve soddisfare 1 dei seguenti criteri a una visita di conferma:
    - Riduzione <0,5 log10 dell'HIV-1 RNA dalla visita di screening (Visita 1) alla visita di conferma (Visita 2)
    OPPURE
    - Una riduzione >=0,5 log10 dell'HIV-1 RNA alla Visita 2 richiede un altro test di conferma (Visita 3). In questo caso, deve essere presente una riduzione <0,3 log10 dell'HIV-1 RNA dalla Visita 2
    2. Ha ricevuto la stessa terapia ART basale per >=3 mesi prima di firmare il modulo di consenso/assenso informato.
    3. Mostra almeno una resistenza a tre classi (NRTI, NNRTI e resistenza ad almeno un'altra classe [ovvero, resistenza ad almeno 1 farmaco in ciascuna classe]) in base ai test di resistenza alla visita di screening.
    4. Presenta <=1 attività antiretrovirale completamente attiva che può essere efficacemente combinata per realizzare un possibile regime basato su resistenza, tollerabilità, sicurezza, accesso al farmaco o accettabilità del paziente.
    5. È di sesso maschile o femminile, adulto (>= 18 anni) o minorenne (peso >=35 Kg, <18 anni) al momento della firma del consenso/assenso informato (alla visita di screening).
    6. Una partecipante è ritenuta idonea allo studio se non è in gravidanza o nel periodo di allattamento al seno e soddisfa almeno una delle seguenti condizioni:
    - Non è una donna in età fertile
    OPPURE
    - È una donna in età fertile e utilizza un metodo contraccettivo accettabile oppure pratica l'astinenza dai rapporti eterosessuali come propria scelta di stile di vita (astinenza continuativa e a lungo termine), durante il periodo di intervento e per almeno 6 mesi, corrispondente al periodo necessario per eliminare eventuali interventi dello studio (ad esempio, 5 emivite terminali) dopo l'ultima dose dell'intervento dello studio. Lo sperimentatore dovrebbe valutare il potenziale fallimento del metodo contraccettivo (ovvero, mancata compliance, recente avvio) rispetto alla prima dose dell'intervento dello studio.
    - Una donna in età fertile deve ottenere un risultato negativo da un test di gravidanza altamente sensibile ([analisi delle urine o esame del sangue] come richiesto dalle normative locali) entro 24 ore prima della prima dose dell'intervento dello studio.
    - Se non è possibile confermare un risultato negativo con l'analisi delle urine (ad esempio, il risultato è ambiguo), è necessario eseguire un test di gravidanza con l'esame del sangue. In questi casi, la partecipante deve essere esclusa dallo studio se il risultato del test di gravidanza con l'esame del sangue è positivo.
    - Lo sperimentatore ha la responsabilità di prendere in esame la storia clinica, i cicli mestruali e la recente attività sessuale della partecipante per ridurre il rischio di includere nello studio una donna con una gravidanza allo stato iniziale non rilevata.
    7. Il/La partecipante (o Suo/a rappresentate legalmente accettabile) ha fornito un consenso/assenso informato scritto per lo studio. Il/La partecipante può anche fornire il consenso/assenso per future ricerche biomediche. Tuttavia, il/la partecipante può prendere parte allo studio principale senza partecipare alle ricerche biomediche future.
    E.4Principal exclusion criteria
    1. Has HIV-2 infection.
    2. Has hypersensitivity or other contraindication to any of the components of the study interventions as determined by the investigator.
    3. Has HBV co-infection (defined as HBsAg-positive or HBV DNA positive) and is not currently being treated for HBV.
    4. Has a history or current evidence of any condition (including active TB co-infection), therapy, laboratory abnormality or other circumstance (including drug or alcohol abuse or dependence) that might, in the opinion of the investigator, confound the results of the study or interfere with study participation for the full study duration.
    5. Is taking or is anticipated to require any of the prohibited therapies from the Screening Visit and throughout the study treatment period.
    6. Is taking DOR as part of his/her current failing antiretroviral regimen.
    7. Is taking EFV, etravirine, or nevirapine.
    8. Is currently participating in or has participated in an interventional clinical study with an investigational compound or device from the Screening Visit through the study treatment period.
    9. Has exclusionary laboratory values (based on central laboratory results) at the Screening Visit
    10. Is female and is expecting to conceive or donate eggs at any time during the study.
    1. Ha un'infezione da HIV-2.
    2. Ha un'ipersensibilità o altre controindicazioni rispetto a uno qualsiasi dei componenti degli interventi dello studio in base a quanto stabilito dallo sperimentatore.
    3. Ha una co-infezione da HBV (definita HBsAg-positiva o HBV DNA positiva) ed è attualmente in trattamento per HBV.
    4. Ha una storia o evidenza attuale di qualsiasi condizione (inclusa una co-infezione da tubercolosi attiva), terapia, valori di laboratorio anormali o altre circostanze (inclusi abuso o dipendenza da alcol o sostanze d'abuso) che potrebbero, secondo il parere dello sperimentatore, contraddire i risultati dello studio o interferire con la partecipazione allo studio per l'intera durata dello studio.
    5. Sta assumendo o si prevede che necessiterà di una qualsiasi delle terapie vietate descritte a partire dalla visita di screening e per tutto il periodo di trattamento dello studio.
    6. Sta assumendo DOR come parte del suo attuale regime antiretrovirale senza successo.
    7. Sta assumendo EFV, etravirina o nevirapina.
    8. Sta partecipando o ha partecipato a uno studio clinico interventistico con un composto o dispositivo sperimentale a partire dalla visita di screening per tutto il periodo di trattamento dello studio.
    9. Presenta valori di laboratorio considerati criteri di esclusione (in base ai risultati del laboratorio centrale) alla visita di screening
    10. Le partecipanti donne sono in attesa di concepire o donare ovuli in un momento qualsiasi durante lo studio.
    E.5 End points
    E.5.1Primary end point(s)
    1. Percentage of participants receiving DOR/ISL with >=0.5 log10 decrease from baseline in HIV-1 RNA compared to placebo treatment
    2. Percentage of participants with >=1 adverse events (AEs)
    3. Percentage of participants withdrawing from study treatment due to AE(s)
    1. Percentuale di partecipanti che raggiungono una riduzione >=0,5 log10 dell'HIV-1 RNA a partire dal basale dello studio nel gruppo DOR/ISL rispetto al placebo
    2. Percentuale di partecipanti che hanno presentato >=1 eventi avversi
    3. Percentuale di partecipanti che hanno interrotto il trattamento dello studio a causa degli eventi avversi
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Day 1 (baseline) to Day 8
    2. Up to 49 weeks
    3. Up to 49 weeks
    1. Giorno 1 (Basale) fino al Giorno 8
    2. Fino a 49 Settimane
    3. Fino a 49 Settimane
    E.5.2Secondary end point(s)
    1. % of participants with =1 adverse events (AEs)
    2. % of participants withdrawing from study therapy due to AEs
    3. % of participants receiving DOR or ISL (given with ART) with =0.5 log10 decrease in HIV-1 RNA compared to placebo treatment
    4. Mean change from baseline in HIV-1 RNA following treatment with DOR/ISL (given with ART) , DOR, or ISL compared to placebo treatment
    5. % of participants receiving DOR/ISL (given with ART), DOR, or ISL with =1.0 log10 decrease from baseline in HIV-1 RNA compared
    to placebo treatment
    6. % of participants receiving DOR/ISL (given with ART) with = 0.5 log10 decrease from baseline in HIV-1 RNA compared to DOR or ISL
    treatment
    7. Mean change from baseline in HIV-1 RNA following treatment with DOR/ISL (given with ART) compared to DOR or ISL treatment
    8. % of participants receiving DOR/ISL (given with ART) with =1.0 log10 decrease from baseline in HIV-1 RNA compared to DOR or ISL
    treatment
    9. % of participants receiving DOR/ISL (given with ART) + OBT with =0.5 log10 decrease from baseline in HIV-1 RNA compared to DOR
    or ISL treatment
    10.% of participants receiving DOR/ISL (given with ART) + OBT with =0.5 log10 decrease from baseline in HIV-1 RNA compared to DOR
    or I SL treatment
    11. % of participants receiving DOR/ISL (given with ART) + OBT with =0.5 log10 decrease from baseline in HIV-1 RNA compared to DOR
    or ISL treatment
    12. % of participants receiving DOR/ISL (given with ART) + OBT with =1.0 log10 decrease from baseline in HIV-1 RNA compared to DOR
    or ISL treatment
    13. % of participants receiving DOR/ISL (given with ART) + OBT with =1.0 log10 decrease from baseline in HIV-1 RNA compared to DOR
    or ISL treatment
    14. % of participants receiving DOR/ISL (given with ART) + OBT with =0.5 log10 decrease from baseline in HIV-1 RNA compared to DOR
    or ISL treatment
    15. Mean change from baseline in HIV-1 RNA following treatment with DOR/ISL (given with ART) + OBT
    16. Mean change from baseline in HIV-1 RNA following treatment with DOR/ISL (given with ART) + OBT
    17. Mean change from baseline in HIV-1 RNA following treatment with DOR/ISL (given with ART) + OBT
    18. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <200 copies mL
    19. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <200 copies mL
    20. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <200 copies mL
    21. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <50 copies mL
    22. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <50 copies mL
    23. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <50 copies mL
    24. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <40 copies mL
    25. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <40 copies mL
    26. % of participants receiving DOR/ISL (given with ART) + OBT with HIV-1 RNA <40 copies mL
    27. Prevalence of viral drug resistance to DOR
    28. Prevalence of viral drug resistance to DOR
    29. Prevalence of viral drug resistance to ISL
    30. Prevalence of viral drug resistance to ISL
    31. Prevalence of viral drug resistance to OBT components
    32. Prevalence of viral drug resistance to OBT components
    33. Role of baseline antiviral resistance on viral resistance-associated substitutions (RAS)
    34. Role of baseline antiviral resistance on viral RAS
    35. Role of baseline antiviral resistance on viral RAS
    36. Role of baseline antiviral resistance on HIV-1 RNA
    37. Role of baseline antiviral resistance on HIV-1 RNA
    38. Role of baseline antiviral resistance on HIV-1 RNA
    39. Change from baseline in cluster of differentiation+ (CD4+) cell counts
    40. Change from baseline in CD4+ cell counts
    41. Change from baseline in CD4+ cell counts
    42. Change from baseline in CD4+ cell counts
    43. Change from baseline in CD4+ cell counts
    44. Change from baseline in CD4+ cell counts
    1. % di partecipanti con >=1 eventi avversi (AEs)
    2. % di partecipanti che discontinuano dalla terapia dello studio a causa di AEs
    3. % di partecipanti che ricevono DOR o ISL (+ART) con una riduz >=0,5 log10 dell'HIV-1 RNA rispetto al trattamcon placebo
    4. Variaz media rispetto al basale dell'HIV-1 RNA in seguito al trattamcon DOR/ISL (+ART), DOR o ISL rispetto al trattamcon placebo
    5. % di partecipanti che ricevono DOR/ISL (+ART), DOR o ISL con una riduz >=1,0 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon placebo
    6. % di partecipanti che ricevono DOR/ISL (+ART) con una riduz >=0,5 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon placebo
    7. Variaz media rispetto al basale dell'HIV-1 RNA in seguito al trattamcon DOR/ISL (+ART), rispetto al trattamcon DOR o ISL
    8. % di partecipanti che ricevono DOR/ISL (+ART) con una riduz >=1,0 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL
    9. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con una riduz >=0,5 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL
    10. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con una riduz >=0,5 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL.
    11. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con una riduz >=0,5 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL
    12. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con una riduz >=1,0 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL
    13. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con una riduz >=1,0 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL
    14. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con una riduz >=0,5 log10 rispetto al basale dell'HIV-1 RNA rispetto al trattamcon DOR o ISL
    15. Variaz media rispetto al basale dell'HIV-1 RNA in seguito al trattamcon DOR/ISL (+ART) + OBT
    16. Variaz media rispetto al basale dell'HIV-1 RNA in seguito al trattamcon DOR/ISL (+ART) + OBT
    17. Variaz media rispetto al basale dell'HIV-1 RNA in seguito al trattamcon DOR/ISL (+ART) + OBT
    18. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <200 copie/ml
    19. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <200 copie/ml
    20. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <200 copie/ml
    21. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <50 copie/ml
    22. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <50 copie/ml
    23. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <50 copie/ml
    24. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <40 copie/ml
    25. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <40 copie/ml
    26. % di partecipanti che ricevono DOR/ISL (+ART) +OBT con HIV-1 RNA <40 copie/ml
    27. Prevalenza della resistenza virale a DOR
    28. Prevalenza della resistenza virale a DOR
    29. Prevalenza della resistenza virale a ISL
    30. Prevalenza della resistenza virale a ISL
    31. Prevalenza della resistenza virale ai componenti OBT
    32. Prevalenza della resistenza virale ai componenti OBT
    33. Ruolo della resistenza antivirale al basale nelle sostituzioni associate alla
    resistenza virale (RAS)
    34. Ruolo della resistenza antivirale al basale nelle RAS
    35. Ruolo della resistenza antivirale al basale nelle RAS
    36. Ruolo della resistenza antivirale al basale su HIV-1 RNA
    37. Ruolo della resistenza antivirale al basale su HIV-1 RNA
    38. Ruolo della resistenza antivirale al basale su HIV-1 RNA
    39. Variaz rispetto al basale nella conta delle cell del cluster di differenziazione+ (CD4+)
    40. Variaz rispetto al basale nella conta delle cell CD4+
    41. Variaz rispetto al basale nella conta delle cell CD4+
    42. Variaz rispetto al basale nella conta delle cell CD4+
    43. Variaz rispetto al basale nella conta delle cell CD4+
    44. Variaz rispetto al basale nella conta delle cell CD4+
    E.5.2.1Timepoint(s) of evaluation of this end point
    1.Up to 97 wks
    2.Up to 97 wks
    3.D 1(BL) to D 8
    4.D 1(BL) to D 8
    5.D 1(BL) to D 8
    6.D 1(BL) to D 8
    7.D 1(BL) to D 8
    8.D 1(BL) to D 8
    9.D 8(BL) to W 25
    10.D 1(BL) to W 49
    11.D 1(BL) to W 97
    12.D 8(BL) to W 25
    13.D 1(BL) to W 49
    14.D 1(BL) to W 97
    15.D 8(BL) to W 25
    16.D 1(BL) to W 49
    17.D 1(BL) to W 97
    18.D 8(BL) to W 25
    19.D 1(BL) to W 49
    20.D 1(BL) to W 97
    21.D 8(BL) to W 25
    22.D 1(BL) to W 49
    23.D 1(BL) to W 97
    24.D 8(BL) to W 25
    25.D 1(BL) to W 49
    26.D 1(BL) to W 97
    27.W 25
    28.W 49
    29.W 25
    30.W 49
    31.W 25
    32.W 49
    33.D 1(BL) to W 25
    34.D 1(BL) to W 49
    35.D 1(BL) to W 97
    36.D 1(BL) to W 25
    37.D 1(BL) to W 49
    38.D 1(BL) to W 97
    39.D 1(BL) to W 25
    40.D 1(BL) to W 49
    41.D 1(BL) to W 97
    42.D 8(BL) to W 25
    43.D 8(BL) to W 49
    44.D 8(BL) to W 97
    1.Fino a 97 Settimane: Endpoint 2ario #1
    2.Fino a 97 Settimane: Endpoint 2ario #2
    3.G1 (Basale) fino a G8: Endpoint 2ari #3,4,5,6,7,8
    4.G8 (Bas) fino S25: Endpoint 2ari #9,12,15,18,21,24,42
    5.G8 (Bas) fino S49: Endpoint 2ario #43
    6.G8 (Bas) fino S97: Endpoint 2ario #44
    7.G1 (Bas) fino S25: Endpoint 2ari #33,36,39
    8.G1 (Bas) fino S49: Endpoint 2ari #10,13,16,19,22,25,34,37,40
    9.G1 (Bas) fino S97: Endpoint 2ari #11,14,17,20,23,26,35,38,41
    10.S25: Endpoint 2ario #27
    11.S49: Endpoint 2ario #28
    12.S25: Endpoint 2ario #29
    13.S49: Endpoint 2ario #30
    14.S25: Endpoint 2ario #31
    15.S49: Endpoint 2ario #32
    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 Yes
    E.6.12Pharmacoeconomic Yes
    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
    Nella parte 2: singolo gruppo in aperto
    Open single group in Part 2
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial5
    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 concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA57
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Canada
    Chile
    Colombia
    Japan
    Korea, Republic of
    Mexico
    Peru
    Russian Federation
    South Africa
    Ukraine
    United States
    France
    Germany
    Italy
    Portugal
    Spain
    United Kingdom
    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
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    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) Yes
    F.1.1.5.1Number of subjects for this age range: 1
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 9
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 80
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 10
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state11
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 55
    F.4.2.2In the whole clinical trial 100
    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)
    At the end of Week 97, provided development of DOR/ISL continues, all eligible participants will be given the option to continue receiving study intervention without interruption. Eligible participants are those who have completed the last scheduled study visit and are considered by the investigator to derive clinical benefit from continued administration of DOR/ISL.
    Al termine della Settimana 97, se lo sviluppo clinico di DOR/ISL dovesse continuare, tutti i partecipanti idonei avranno la possibilità di continuare a ricevere il trattamento di studio senza interruzioni. I partecipanti idonei sono coloro che hanno completato l’ultima visita di studio programmata e lo sperimentatore ritiene che traggano beneficio clinico dalla somministrazione continua di DOR / ISL.
    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 Decision2020-04-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-02-05
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2023-11-01
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