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    Summary
    EudraCT Number:2020-002623-11
    Sponsor's Protocol Code Number:213500
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-25
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2020-002623-11
    A.3Full title of the trial
    A Phase IIIb, Randomized, Multicenter, Active-controlled, Parallel-group, Non-inferiority, Open-label Study Evaluating the Efficacy, Safety, and Tolerability of Switching to Long-acting Cabotegravir Plus Long-acting Rilpivirine administered every two months from a Bictegravir/emtricitabine/tenofovir alafenamide Single Tablet Regimen in HIV-1 Infected Adults who are Virologically Suppressed
    Studio di non-inferiorità, di fase IIIb, randomizzato, in aperto, con controllo attivo, multicentrico, a gruppi paralleli, volto a valutare efficacia, sicurezza e tollerabilità del passaggio a cabotegravir a lunga durata d’azione e rilpivirina a lunga durata d’azione somministrati ogni due mesi da un regime a singola compressa a base di Bictegravir/emtricitabina/tenofovir alafenamide in adulti con infezione da HIV-1 in soppressione virologica
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    CARLA vs. Biktarvy in treatment-experienced, suppressed participants
    CARLA verso Biktarvy in pazienti con esperienza di trattamento, in soppressione virologica
    A.3.2Name or abbreviated title of the trial where available
    PH3b, CAB LA+RPV LA vs BIK, IM Every 2Months, Non-inferiority, Efficacy&Safety in Participants HIV-1
    Studio di fase IIIb di non inferiorità su sicurezza, efficacia di CAB LA + RPV LA rispetto a BIK, IM
    A.4.1Sponsor's protocol code number213500
    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 (No.3) Limited
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline Research & Development Ltd
    B.5.2Functional name of contact pointGSK Clinical Support HelpDesk
    B.5.3 Address:
    B.5.3.1Street Address980 Great West Road
    B.5.3.2Town/ cityBrentford, Middlesex
    B.5.3.3Post codeTW8 9GS
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number004408007839733
    B.5.5Fax number0000000
    B.5.6E-mailGSKClinicalSupportHD@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 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 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 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 (RILPIVIRINE)
    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 INNRILPIVIRINA
    D.3.9.1CAS number 500287-72-9
    D.3.9.2Current sponsor codeR314585
    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 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 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 nameGSK1265744
    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 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 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 500287-72-9
    D.3.9.2Current sponsor codeR278474
    D.3.9.3Other descriptive nameRilpilvirine 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 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 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 Biktarvy
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences Ireland UC
    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 nameBiktarvy Tablets (BIK)
    D.3.2Product code [na]
    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 INNBICTEGRAVIR
    D.3.9.1CAS number 1611493-60-7
    D.3.9.2Current sponsor codena
    D.3.9.4EV Substance CodeSUB182699
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNEMTRICITABINE
    D.3.9.1CAS number 143491-57-0
    D.3.9.2Current sponsor codena
    D.3.9.3Other descriptive nameFTC
    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.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTENOFOVIR ALAFENAMIDE
    D.3.9.1CAS number 379270-37-8
    D.3.9.2Current sponsor codena
    D.3.9.3Other descriptive nameTAF
    D.3.9.4EV Substance CodeSUB121761
    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 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
    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 dell'immunodeficienza umana di tipo 1 (HIV-1)
    E.1.1.1Medical condition in easily understood language
    HIV-1 Infection
    Virus HIV-1
    E.1.1.2Therapeutic area Diseases [C] - Virus Diseases [C02]
    MedDRA Classification
    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 two months compared to a BIK single tablet regimen administered once daily over 12 months in suppressed HIV-1 infected antiretroviral therapy (ART)-experienced participants
    Dimostrare la non-inferiorità dell’attività antivirale di CAB LA + RPV LA ogni due mesi rispetto a un regime a singola compressa di BIK somministrata una volta al giorno nel corso di 12 mesi nei partecipanti con infezione da HIV-1 soppresso già trattati con antiretrovirali (ART)
    E.2.2Secondary objectives of the trial
    To demonstrate the antiviral and immunologic activity of CAB LA + RPV LA every 2 months compared to a BIK single tablet regimen administered once daily.
    To assess viral resistance in participants experiencing protocol-defined confirmed virologic failure.
    To evaluate renal (in urine and blood) and bone (in blood) biomarkers in participants treated with CAB LA + RPV LA compared to BIK.
    To evaluate Metabolic Syndrome for participants treated with CAB + RPV and BIK.
    To evaluate insulin resistance in participants treated with CAB LA + RPV LA compared to BIK.
    To assess preference for CAB LA + RPV LA administered every 2 months compared to a BIK single tablet regimen administered once daily.
    To assess patient reported treatment satisfaction, and injection tolerability.
    Dimostrare l’attività antivirale e immunologica di CAB LA + RPV LA ogni 2 mesi rispetto al regime a singola compressa a base di BIK somministrato una volta al giorno
    Valutare la resistenza virale nei partecipanti che manifestano un fallimento virologico confermato secondo la definizione del protocollo
    Valutare i biomarcatori renali (nel sangue e nelle urine) e ossei (nel sangue) nei soggetti trattati con CAB LA + RPV LA rispetto a BIK
    Valutare la sindrome metabolica nei soggetti trattati con CAB LA + RPV LA e BIK
    Valutare la resistenza insulinica nei soggetti trattati con CAB LA + RPV LA rispetto a BIK
    Valutare la preferenza tra CAB LA + RPV LA somministrato ogni 2 mesi rispetto al regime a singola compressa a base di BIK somministrato una volta al giorno
    Valutare la soddisfazione relativa al trattamento riferita dal paziente e la tollerabilità all’iniezione
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Be able to understand and comply with protocol requirements, instructions, and restrictions; Understand the long-term commitment to the study and be likely to complete the study as planned; Be considered appropriate candidates for participation in an investigative clinical trial with oral and intramuscularly injectable medications .
    Aged 18 years or older (or =19 where required by local regulatory agencies), at the time of signing the informed consent.
    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 properly use these methods of contraception.
    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.
    Participants enrolled in France must be affiliated to, or a beneficiary of, a social security category.
    Must be on the uninterrupted current regimen of BIK for at least 6 months prior to Screening with an undetectable HIV-1 viral load for at least 6 months prior to Screening. Only a single prior INI regimen is allowed if BIK is a second line regimen 6 months prior to screening. Any prior change in regimen, 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).
    Only a single prior INI regimen is permitted with the following limited exceptions:
    •A change from TDF to TAF will not be considered a regimen change.
    •Historical perinatal use of an NRTI when given in addition to an ongoing HAART will not be considered a change in ART regimen.
    •The past use of ARVs in the context of PEP or PrEP while the patient was HIV negative will be allowed. Such cases will be evaluated on a case by case basis and may require documentation of HIV negative serology during time of PEP or PrEP
    •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.
    A change in formulation from multiple class regimens to single treatment regimens (of the same medications) would not be considered a change in ART regimen.
    Documented evidence of plasma HIV-1 RNA measurements <50 c/mL in the 6 months prior to Screening.
    Plasma HIV-1 RNA <50 c/mL at Screening.
    Comprendere e rispettare i requisiti, istruzioni e restrizioni del protocollo; Comprendere l’impegno dello studio ed essere in grado di completare lo studio come programmato; Essere considerato idoneo alla partecipazione a uno studio su farmaci orali e intramuscolare; Età =18 anni, al momento della firma del consenso informato(ICF); Le partecipanti sono idonee allo studio se non in gravidanza (come confermato da un test hCG su siero in fase di screening e da un test della hCG sulle urine alla randomizzazione), non sono in fase di allattamento e soddisfano almeno 1 delle condizioni seguenti: a. Donne non potenzialmente fertili definite come: Donne in premenopausa con una delle seguenti situazioni; Legatura delle tube documentata; Occlusione tubarica per via isteroscopica documentata con follow-up di conferma; Isterectomia; Ovariectomia bilaterale documentata; Postmenopausa definita come 1 anno di amenorrea spontanea (nei casi dubbi è possibile confermare con la documentazione su campione ematico di un livello di ormone FSH e di estradiolo nei parametri per la menopausa [intervalli di riferimento del laboratorio]). Le donne in terapia ormonale sostitutiva (HRT) per le quali non è stata accertata la menopausa e che proseguono la terapia durante lo studio, dovranno utilizzare uno dei metodi di contraccezione altamente efficaci. In alternativa, prima dell’arruolamento, dovranno interrompere l’HRT per verificare l’eventuale stato di postmenopausa. b. Donne potenzialmente fertili che accettano una delle opzioni previste nell’elenco modificato dei metodi altamente efficaci per evitare la gravidanza (FRP) a partire da 30 giorni precedenti la prima dose di farmaco, fino ad almeno 30 giorni dopo l’interruzione di tutti i farmaci orali in studio e almeno 52 settimane dopo l’interruzione di CAB LA e RPV LA.Lo sperimentatore deve assicurarsi che le partecipanti comprendano come utilizzare questi contraccettivi.3. Soggetti in grado di fornire e firmare il consenso informato. Gli idonei o i loro tutori (e il parente più stretto) devono firmare un ICF scritto prima che venga eseguita qualsiasi valutazione. L’arruolamento di partecipanti non in grado di fornire un ICF è facoltativo e basato su requisiti legali/regolatori locali e sulla possibilità di condurre le visite del protocollo al centro. 4. Se arruolati in Francia devono appartenere a una categoria di sicurezza sociale. 5. Devono seguire un attuale regime ininterrotto di BIK ed avere una carica virale dell’HIV-1 non rilevabile per almeno 6 mesi prima dello screening. È consentito un solo regime con INI precedente se BIK è un regime di seconda linea 6 mesi prima dello screening. Eventuali precedenti variazioni nel regime, di un singolo farmaco o di più farmaci simultaneamente, devono essersi verificate tollerabilità/sicurezza, accesso ai farmaci o comodità/semplificazione, e NON devono essere dovute a fallimento terapeutico (HIV-1 RNA =400 c/ml).È consentito un solo regime con INI precedente, con le seguenti eccezioni: Un passaggio da TDF a TAF non sarà ritenuto una modifica di regime; L’utilizzo storico perinatale di un NRTI in aggiunta a un HAART attuale non sarà ritenuto una modifica del regime ART. ;L’uso passato di ARV nel contesto di PEP o PrEP quando il paziente risultava negativo all’HIV sarà accettato. Tali eccezioni saranno valutate caso per caso e potrebbe richiedere documentazione della sierologia HIV-negativa nel periodo di PEP o PrEP. ;Una variazione della posologia dello stesso farmaco da due volte a una volta al giorno non sarà considerata una modifica del regime ART se hanno esposizioni ed efficacia analoghi.; Una modifica nella formulazione da regimi con diverse classi a regimi con un singolo trattamento (dello stesso farmaco) non sarà considerata una modifica del regime ART. 6. Evidenza documentata di livelli plasmatici di HIV-1 RNA <50 c/mL nei 6 mesi prima dello screening. 7. Livelli plasmatici di HIV-1 RNA <50 c/mL allo screening.
    E.4Principal exclusion criteria
    Within 6 months prior to Screening, any plasma HIV-1 RNA measurement =50 c/mL.
    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. NOTE: This statement does not apply to study participants who started treatment within the 6 to 12-month window prior to screening.
    History of prior treatment failure to any DHHS recommended ART regimen.
    History of drug holiday >1 month for any reason prior to Screening visit, except where all ART was stopped due to tolerability and/or safety concerns.
    Any change 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).
    Participants who are currently participating in or anticipate being selected for any other interventional study.
    Women who are pregnant, breastfeeding or plan to become pregnant or breastfeed during the study.
    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, and CD4+ counts <200 cells/µL are not exclusionary.
    Participants with moderate to severe hepatic impairment.
    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.
    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.
    All participants will be screened for syphilis.
    •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. 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.
    The participant has a tattoo, gluteal implant/enhancements or other dermatological condition overlying the gluteus region which may interfere with interpretation of injection site reactions.
    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), whether negative or 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.
    Asymptomatic individuals with chronic hepatitis C virus (HCV) infection will not be excluded, however Investigators must carefully assess if therapy specific for HCV infection is required; participants who require or qualify for immediate HCV treatment are excluded (see Section 5.3.1 for those co-infected participants who post entry into SOLAR decide treatment for HCV infection is warranted or desired either by the participant or by the treating physician.
    Participants with HCV co-infection will be allowed entry into this study if: a.Liver enzymes meet entry criteria
    For further points refer Protocol
    Nei 6 mesi precedenti lo screening, livelli plasmatici di HIV-1 RNA ¿50 c/mL. Dai 6 ai 12 mesi precedenti lo screening livelli HIV-1 RNA >200 c/mL, o 2 o più misurazioni dei livelli di HIV-1 RNA ¿50 c/mL. NOTA: Non vale per i partecipanti allo studio che hanno iniziato il trattamento tra 6 e 12 mesi prima dello screening. Anamnesi di precedente fallimento del trattamento a qualsiasi regime ART raccomandato da DHHS. Anamnesi di interruzioni del trattamento >1 mese per motivi prima dello screening, fatta eccezione per l’interruzione di ART causata da problemi di tollerabilità e/o sicurezza. Variazione a un regime di seconda linea, di uno o più farmaci contemporaneamente, dovuto a fallimento virologico (livelli di HIV-1 RNA ¿200 c/mL dopo l'iniziale soppressione a <50 c/mL con il regime anti-HIV di prima linea). Partecipazione in corso o possibile per la partecipazione ad altri studi. Patologie che comportano l’esclusione - per tutti i partecipanti Donne in gravidanza, in allattamento o durante il corso dello studio. Patologia attiva allo stadio 3 secondo i criteri CDC, a eccezione del sarcoma di Kaposi che non necessita di una terapia sistemica e della conta di CD4+ <200 cellule/¿L. Partecipanti con insufficienza epatica medio/grave. Condizioni fisiche/mentali preesistenti che possono interferire con il rispettare il calendario di somministrazione e/o le valutazioni previste dal protocollo o che possano mettere a rischio la sicurezza del partecipante. Chi presentano un elevato rischio di convulsioni, incluse le crisi epilettiche scarsamente controllate. Casi di convulsioni precedenti possono essere arruolati se viene valutato un basso rischio di recidiva. I casi di convulsioni pregresse devono essere discussi con il Medical Monitor prima dell’arruolamento.12. I partecipanti saranno sottoposti a test per la sifilide. • I partecipanti con infezione secondaria o terziaria da sifilide non trattata, positivi alla RPR e al test del Treponema, senza chiara documentazione, sono esclusi. • I partecipanti con un test per la RPR falso positivo (test del Treponema neg) o con una condizione di “serofast” possono essere arruolati previa consultazione con il Medical Monitor. • I partecipanti con una sifilide primaria o una sifilide secondaria che presentano un test RPR positivo e non trattati possono essere trattati durante il periodo di screening e, se il trattamento antibiotico viene completato durante il periodo di screening, potranno entrare nello studio previa consultazione con il Medical Monitor. I soggetti potranno fare un nuovo screening dopo il completamento della terapia antibiotica per la sifilide. Partecipanti che presentano un rischio di suicidio. Per il rischio di suicidio si deve considerare un’anamnesi di ideazione e/o comportamenti suicidari recenti. Partecipanti con tatuaggi, gluteoplastica o altre condizioni dermatologiche che potrebbero interferire con l’interpretazione delle reazioni nel sito di iniezione 15. Infezione da HBV in base ai test per la ricerca dell’antigene (HbsAg, anti-HBc, anti-HBs) e di HBV DNA allo screening: a. sono esclusi i soggetti positivi all’HBsAg; b. sono esclusi i partecipanti negativi agli anti-HBs, ma positivi agli anti-HBc (HBsAg-negativi), che siano negativi o positivi all’HBV-DNA. Nota: i partecipanti positivi agli anti-HBc (HBsAg-negativi) e positivi agli anti-HBs sono immuni all’HBV e non sono esclusi. I soggetti asintomatici con infezione cronica da HCV non saranno esclusi; tuttavia, si deve valutare una terapia specifica per l’infezione da HCV; i partecipanti per i quali si prevede un trattamento per l’HCV immediato devono essere esclusi (si veda la Sezione 5.3.1 del prot. Emend.) per i partecipanti con coinfezione i quali, dopo l’ingresso in SOLAR, iniziano a trattare l’infezione da HCV.I partecipanti con infezione concomitante da HCV potranno partecipare allo studio se: a. Gli enzimi epatici soddisfano i criteri di ammissione. Per altri punti consultare il Protocollo
    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 as per Food and Drug Administration (FDA) Snapshot algorithm at Month 12 (OLI and BIK)/Month 11 (D2I) (Intent-to-Treat Exposed [ITT-E] population)
    Percentuale di partecipanti con livelli plasmatici di HIV-RNA superiori o uguali a 50 copie/ml secondo l’algoritmo Snapshot della FDA (Food and Drug Administration) al Mese 12 (OLI e BIK)/Mese 5 e Mese 11 (D2I) (popolazione Intent-To-Treat esposta [ITT-E])
    E.5.1.1Timepoint(s) of evaluation of this end point
    12 months
    12 mesi
    E.5.2Secondary end point(s)
    Proportion of participants with plasma HIV-1 RNA <50 c/mL (c/mL) at Month 6 and Month 12 (OLI and BIK)/Month 5 and Month 11 (D2I) using the FDA Snapshot algorithm (Intent-to-Treat Exposed [ITT-E] population).

    Proportion of participants with protocol-defined confirmed virologic failure (CVF) through Month 6 and Month 12 (OLI and BIK)/Month 5 and Month 11 (D2I) .

    Proportion of participants with HIV-RNA greater than or equal to 50 c/mL as per FDA Snapshot algorithm at Month 6, Month 12 (OLI and BIK)/Month 5 and Month 11 (D2I) .

    Absolute values and changes from Baseline in viral load and CD4+ cell count over time including Month 6 and Month 12 (OLI and BIK)/Month 5 and Month 11 (D2I).

    Incidence of treatment emergent genotypic and phenotypic resistance to CAB, RPV, BIC, FTC, and TAF through Month 6 and Month 12 (OLI and BIK)/Month 5 and Month 11 (D2I).

    Change from Baseline (Day 1) in renal and bone biomarkers at Months 6 and 12 (OLI and BIK)/Month 5 and Month 11 (D2I).

    Change from Baseline in proportions of participants with Metabolic syndrome at Months 6 and 12 (OLI and BIK)/Month 5 and Month 11 (D2I) in each arm.

    Change from Baseline in incident metabolic syndrome at Months 6 and 12 (OLI and BIK)/Month 5 and Month 11 (D2I).

    Change from Baseline (Day 1) in homeostasis model of assessment-insulin resistance (HOMA-IR) at Months 6 and 12 (OLI and BIK)/Month 5 and Month 11 (D2I).

    Preference for CAB LA + RPV LA every 2 months compared to a BIK single tablet regimen will be assessed using a preference questionnaire at Month 12 (OLI and BIK)/Month 11 (D2I) (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 Month 6, and Month 12 (OLI and BIK)/Month 5 and Month 11 (D2I), (or Withdrawal).

    Change in treatment satisfaction over time using the HIV Treatment Satisfaction Change Questionnaire HIVTSQc total score and individual item scores at Month 12 (OLI and BIK)/Month 11 (D2I) (or Withdrawal).

    Change from Month 2 in Dimension scores (“Acceptance of ISRs”, “Bother of ISRs”, “Leg movement”, “Sleep 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 Months 2, 6, and 12 (OLI)/Months 1, 5, 11 (D2I) (or Withdrawal).
    Percentuale di partecipanti con livelli plasmatici di HIV-1 RNA <50 copie/mL (c/mL) al Mese 6 e al Mese 12 (OLI e BIK)/Mese 5 e Mese 11 (D2I), calcolati tramite l’algoritmo Snapshot della FDA (popolazione esposta intent-to-treat [ITT-E])
    Percentuale di partecipanti con fallimento virologico confermato (CVF), secondo la definizione del protocollo, al Mese 6 e al Mese 12 (OLI e BIK)/Mese 5 e Mese 11 (D2I).
    Percentuale di partecipanti con un HIV-RNA superiore o uguale a 50 c/mL secondo l’algoritmo Snapshot della FDA al Mese 6 e al Mese 12 (OLI e BIK)/Mese 5 e Mese 11 (D2I)
    Valori assoluti e variazioni rispetto al basale di carica virale e conta di cellule CD4+ nel tempo, inclusi il Mese 6 e il Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I)
    Incidenza delle resistenze genotipiche e fenotipiche a CAB, RPV, BIC, FTC e TAF emerse durante il trattamento al Mese 6 e al Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I)
    Variazione rispetto al basale (Giorno 1) dei biomarcatori renali e ossei ai Mese 6 e al Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I)
    Variazione rispetto al basale delle percentuali di soggetti con sindrome metabolica ai Mese 6 e Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I)
    Variazione rispetto al basale nella sindrome metabolica incidente ai Mese 6 e Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I)
    Variazione rispetto al basale (Giorno 1) dell’HOMA-IR (homeostasis model of assessment-insulin resistance) ai Mese 6 e Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I)
    La preferenza per CAB LA + RPV LA ogni 2 mesi rispetto al regime a singola compressa a base di BIK sarà valutata tramite un questionario sulla preferenza al Mese 12 (OLI e BIK)/Mese 11 (D2I) (o al ritiro)
    Variazione dal basale (Giorno 1) del punteggio totale relativo alla soddisfazione e dei punteggi dei singoli item del questionario HIVTSQs (HIV Treatment Satisfaction Status Questionnaire) al Mese 6 e al Mese 12 (OLI e BIK)/ Mese 5 e Mese 11 (D2I) (o al ritiro)
    Variazione della soddisfazione relativa al trattamento per l’HIV nel corso del tempo in base al punteggio totale e ai punteggi dei singoli item del questionario HIVTSQc (HIV Treatment Satisfaction Change Questionnaire) al Mese 12 (OLI e BIK)/ Mese 11 (D2I) (o al ritiro)
    La variazione dal Mese 2 dei punteggi dimensionali (“accettazione delle ISR”, “fastidio delle ISR”, “movimento delle gambe”, “sonno”) e dei punteggi dei singoli item relativi a dolore durante l’iniezione, ansia prima e dopo l’iniezione, propensione a sottoporsi a un’iniezione in futuro e grado di soddisfazione generale relativo alla modalità di somministrazione nel corso del tempo sarà valutata tramite il questionario sulla percezione dell’iniezione (PIN) ai Mesi 2, 6, 12(OLI)/Mesi 1, 5, 11 (D2I) (o al ritiro)
    E.5.2.1Timepoint(s) of evaluation of this end point
    12 months
    12 mesi
    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 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 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
    BIC 50 mg + FTC 200 mg + TAF 25 mg oral, somministrato 1 volta al giorno per 12 mesi
    E.8.2.4Number of treatment arms in the trial3
    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 concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA61
    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
    Japan
    United States
    Switzerland
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LSLV
    Ultima visita dell'ultimo paziente (LSLV)
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months3
    E.8.9.1In the Member State concerned days27
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months3
    E.8.9.2In all countries concerned by the trial days27
    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: 654
    F.1.3Elderly (>=65 years) No
    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 state36
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 209
    F.4.2.2In the whole clinical trial 654
    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)
    All eligible participants who transition into the Extension Phase will continue study treatment until CAB LA and RPV LA are either locally approved and commercially available.
    Tutti i partecipanti eleggibili che passeranno alla fase di estensione continueranno il trattamento di studio finchè Cabotegravir LA è Rilpivirina LA saranno localmente approvate e disponibili in commercio
    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 Decision2020-11-02
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-09-23
    P. End of Trial
    P.End of Trial StatusOngoing
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