An Efficacy, Safety, and Tolerability Study Comparing Dolutegravir Plus Lamivudine With Dolutegravir Plus Tenofovir/Emtricitabine in Treatment naïve HIV Infected Subjects (Gemini 1)



Status:Active, not recruiting
Conditions:HIV / AIDS, HIV / AIDS, HIV / AIDS
Therapuetic Areas:Immunology / Infectious Diseases
Healthy:No
Age Range:18 - Any
Updated:10/7/2018
Start Date:July 21, 2016
End Date:March 3, 2020

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A Phase III, Randomised, Double Blind, Multicentre, Parallel Group, Non Inferiority Study Evaluating the Efficacy, Safety, and Tolerability of Dolutegravir Plus Lamivudine Compared to Dolutegravir Plus Tenofovir/Emtricitabine in Human Immunodeficiency Virus 1 Infected Treatment naïve Adults

This study will compare safety, efficacy, and tolerability of a two drug regimen of
dolutegravir (DTG) plus (+) lamivudine (3TC) administered once daily with DTG plus two
nucleoside reverse transcriptase inhibitors (Tenofovir [TDF]/Emtricitabine [FTC] fixed dose
combination [FDC]) administered once daily in human immunodeficiency virus (HIV) 1 infected
adult subjects that have not previously received antiretroviral therapy. The study is
designed to demonstrate the non-inferior antiviral activity of DTG plus 3TC regimen to that
of DTG plus TDF/FTC FDC and will characterise the long term antiviral activity, tolerability
and safety of DTG plus 3TC through Week 148. Approximately, 700 subjects will be randomised
1:1 to receive DTG + 3TC or DTG + TDF/FTC FDC. Subjects will be stratified by screening HIV 1
ribonucleotide nucleic acid (RNA) levels and by screening CD4+ (cluster of differentiation 4)
cell count.


Inclusion Criteria:

- Must be an HIV 1 infected adult >=18 years of age (or older, if required by local
regulations) at the time of signing the informed consent

- An eligible female subject should not be pregnant (as confirmed by a negative serum
human chorionic gonadotrophin (hCG) test at Screening and negative urine test at
Baseline), not lactating, and at least one of the following conditions applies

- Non reproductive premenopausal women are those that have undergone documented
tubal ligation or documented hysteroscopic tubal occlusion procedure with follow
up confirmation of bilateral tubal occlusion or documented bilateral oophorectomy
or hysterectomy

- Non reproductive premenopausal women are those with 12 months of spontaneous
amenorrhea and >=45 years of age

- Women with reproductive potential agree to follow one of the protocol-defined
methods for avoiding pregnancy

- Should have screening plasma HIV 1 RNA levels of 1000 c/mL to <=100,000 c/mL. If an
independent review of accumulated data from other clinical trials investigating the
DTG plus 3TC dual regimen is supportive of the DTG plus 3TC treatment regimen,
enrolment will be opened to subjects with Screening plasma HIV 1 RNA of 1000 c/mL to
<=500,000 c/mL

- Subject should be antiretroviral naïve (defined as <=10 days of prior therapy with any
antiretroviral agent following a diagnosis of HIV 1 infection). Subjects who received
HIV post exposure prophylaxis (PEP) or pre exposure prophylaxis (PrEP) in the past are
allowed as long as the last PEP/PrEP dose was >1 year from HIV diagnosis or there is
documented HIV seronegativity between the last prophylactic dose and the date of HIV
diagnosis

- Subject or the subject's legal representative capable of giving signed informed
consent which includes compliance with the requirements and restrictions listed in the
consent form and the protocol

- Subjects enrolled in France: a subject will be eligible for inclusion in this study
only if either affiliated to or a beneficiary of a social security category

Exclusion Criteria

- Women who are breastfeeding or plan to become pregnant or breastfeed during the study

- Any evidence of an active centers for disease control and prevention (CDC) Stage 3
disease (CDC, 2014), except cutaneous Kaposi's sarcoma not requiring systemic therapy
and historical or current CD4 cell counts less than 200 cells/mm^3

- Subjects with severe hepatic impairment (Class C) as determined by Child Pugh
classification

- Unstable liver disease (as defined by the presence of ascites, encephalopathy,
coagulopathy, hypoalbuminaemia, oesophageal or gastric varices, or persistent
jaundice), cirrhosis, known biliary abnormalities (with the exception of Gilbert's
syndrome or asymptomatic gallstones

- Evidence of hepatitis B virus (HBV) infection or HBV surface antibody (anti-HBs or
HBsAb) based on:

Subjects positive for HBV surface antigen (HBsAg) at screening will be excluded Subjects
negative for HBV core antibody (anti HBs) but positive for anti HBc (negative HBsAg status)
and positive for HBV deoxyribose nucleic acid (DNA) will be excluded; however, subjects
positive for anti HBc (negative HBsAg status) and positive for anti HBs (past and/or
current evidence) are immune to HBV and will not be excluded

- Anticipated need for any hepatitis B virus (HCV) therapy during the first 48 weeks of
the study and for HCV therapy based on interferon or any drugs that have a potential
for adverse drug:drug interactions with study treatment throughout the entire study
period

- Untreated syphilis infection positive RPR at Screening without clear documentation of
treatment. Subjects who are at least 14 days post completed treatment are eligible

- History or presence of allergy or intolerance to the study drugs or their components
or drugs of their class

- Ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or
resected, non invasive cutaneous squamous cell carcinoma, or cervical, anal or penile
intraepithelial neoplasia; other localised malignancies require agreement between the
investigator and the Study Medical Monitor for inclusion of the subject

- Subjects who in the Investigator's judgment, poses a significant suicidality risk.
Recent history of suicidal behaviour and/or suicidal ideation may be considered as
evidence of serious suicide risk

- Treatment with an HIV 1 immunotherapeutic vaccine within 90 days of Screening

- Treatment with any of the following agents within 28 days of Screening:

- Radiation therapy,

- Cytotoxic chemotherapeutic agents,

- Any systemic immune suppressant

- Treatment with any agent, except recognised ART as allowed above, with documented
activity against HIV 1 in vitro within 28 days of first dose of study treatment

- Exposure to an experimental drug or experimental vaccine within either 28 days, 5 half
lives of the test agent, or twice the duration of the biological effect of the test
agent, whichever is longer, prior to the first dose of study treatment

- Subjects enrolled in France: the subject has participated in any study using an
investigational drug during the previous 60 days or 5 half lives, or twice the
duration of the biological effect of the experimental drug or vaccine, whichever is
longer, prior to screening for the study or the subject will participate
simultaneously in another clinical study

- Any evidence of pre existing viral resistance based on the presence of any major
resistance associated mutation in the Screening result or, if known, in any historical
resistance test result

- Any verified Grade 4 laboratory abnormality. A single repeat test is allowed during
the Screening period to verify a result

- Any acute laboratory abnormality at Screening, which, in the opinion of the
Investigator, would preclude the subject's participation in the study of an
investigational compound

- Alanine aminotransferase (ALT) >=5 times the upper limit of normal (ULN) or ALT
>=3xULN and bilirubin >=1.5xULN (with >35% direct bilirubin)

- Creatinine clearance of <50 mL/min per 1.73 m^2 via the chronic kidney disease
epidemiology collaboration (CKD EPI) method
We found this trial at
16
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Ciudad Autonoma de Buenos Aires, Buenos Aires
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Allentown, Pennsylvania 18102
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Bellaire, Texas 77401
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Berkley, Michigan 48072
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Chapel Hill, North Carolina 27599
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Decatur, Georgia 30033
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Fort Pierce, Florida 34982
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Indianapolis, Indiana 46202
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Indianapolis, IN
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Kansas City, Missouri 64128
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Orlando, Florida 32806
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Phoenix, Arizona 85012
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Providence, Rhode Island 02903
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Providence, RI
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Saint Louis, Missouri 63110
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Saint Louis, MO
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Springfield, Massachusetts 01199
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Springfield, MA
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Washington, District of Columbia 20007
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Washington,
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West Palm Beach, Florida 33409
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West Palm Beach, FL
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