A Phase 4 interventional study of Triumeq in HIV, sponsored by St Stephens Aids Trust. Completed at 1 site in United Kingdom. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2018-02-28.
Sponsored by St Stephens Aids Trust · Phase 4, Interventional, and Treatment
The purpose of this study is to identify the effects that ageing may have on the drug levels, the safety and the efficacy of Dolutegravir.
These effects will be measured in people who are aged 60 or over and taking antiretroviral therapy for HIV infection.
Dolutegravir is a newly licenced anti HIV medication, which belongs to a class of drugs called Integrase Inhibitors. It is taken with two other wellknown agents, Abacavir and Lamivudine, as part of a one tablet once a day regimen, called Triumeq. There is little data available on Dolutegravir in the context of older age. The HIV population is ageing and the investigators know that older age can significantly change the effects and side effects of medications, including that of antiretrovirals.
The investigators aim to investigate the treatment outcomes in older people taking Dolutegravir including the tolerability, efficacy and safety of the drug.
The study will also assess the quality of life (wellbeing of individuals) and cognition (mental abilities) of people aged 60 or over, taking Dolutegravir. The results from this study may inform treatment choices and monitoring in this population in the future.
The duration of involvement in the study will be 6 months with an additional screening visit and a checkup visit 10 days after end of study visit.
Protocol Number: SSAT 064
EudraCT Number: 2014-004970-40
Name of Investigational Product:Triumeq®
Name of active ingredients:Abacavir/lamivudine/dolutegravir
Study title: An open label study to investigate the safety and efficacy of abacavir/lamivudine/dolutegravir and the pharmacokinetic profile of dolutegravir in HIV-infected patients of 60 years of age and older
Objectives:
Primary:
Secondary:
Study design:Multi -centre, 180 days (excluding screening and follow up), open label, prospective, one phase pharmacokinetic/pharmacodynamic study
Indication:HIV-1 infection
Methodology:HIV-1 infected subjects will be recruited from four different HIV clinics. Eligible subjects currently receiving stable antiretroviral therapy with an undetectable plasma HIV RNA and with no evidence of previous HIV resistance mutations on genotypic resistance testing, will switch their treatment to abacavir/lamivudine/dolutegravir and undergo a 24 hour pharmacokinetic assessment at day 28 (+/- 1). Monitoring of adverse events (not at screening), viral load, quality of life and sleep quality, will occur at screening and on days 1, 28, 90, and 180. Cognitive function will be tested at screening, baseline and day 180. A sleep diary will be completed between day 1 and day 28.
Planned sample size:A sample size of 40 patients would provide at least 80% power to detect changes in dolutegravir exposure in older people.
Up to 45 subjects may be screened to have 40 patients completing the study.
Summary of eligibility criteria:HIV-1 infected subjects currently receiving stable antiretroviral therapy with undetectable plasma HIV RNA and no evidence of previous HIV- resistance mutations on genotypic resistance testing, 60 years old or older (approximately 30% between 60 and 64 and approximately 70% above the age of 65)
Number of study centres: 4 centres:
Chelsea and Westminster Hospital, London Royal Sussex County Hospital, Brighton St. Mary's Hospital Clinical Trials Centre, London Mortimer Market Centre, UCL, London
Duration of treatment: 180 (+/- 7) days
Dose and route of administration: All study drugs will be administered orally to subjects with the following schedule: Abacavir/lamivudine/dolutegravir one pill once daily
Criteria for evaluation:
Pharmacokinetic parameters of dolutegravir will be evaluated on blood drawn on day 28 (+/- 1) at 0 (pre-dose), 1, 2, 3, 4, 8, 12 and 24 hours post dose.
Monitoring of adverse events (not at screening), viral load, quality of life and sleep quality will occur at screening and days 1, 28, 90, and 180. Cognitive function will be tested at screening, baseline and day 180.
Primary Endpoint:
Secondary Endpoints:
Male subjects who are heterosexually active must be willing to use appropriate and consistent dual method contraception during heterosexual intercourse with women of child bearing potential, from screening through to one month post completion of the study. The following combined contraceptive methods are acceptable (please see appendix 3):
Double barrier method:
Male Condom + one of the following:
Footnotes:
If a female partner has had a total hysterectomy (surgical removal of the womb) or bilateral tubal ligation/clip (surgical sterilization), then she cannot get pregnant and the above section does not apply. If the male subject has had a vasectomy at least 1 month prior to starting the study, he does not need to use any other birth control.
Exclusion Criteria:
HIV-1 infected subjects currently receiving stable antiretroviral therapy switch their treatment to abacavir/lamivudine/dolutegravir (Triumeq).
Drug: Triumeq
Subjects will take the last dose of their current antiretroviral combination at its usual time on the day before the baseline visit (day 1) and will switch on day 1 to Abacavir/lamivudine/dolutegravir 600mg/300mg/50mg (Triumeq) fixed dose combination once daily between day 1 and day 180.
Also known as: abacavir/lamivudine/dolutegravir
Steady state plasma concentrations of dolutegravir when administered to HIV-infected individuals over the age of 60/65 years.
Time frame: Day 28
Safety on abacavir/lamivudine/dolutegravir once daily in HIV-infected subjects of 60 years or greater - measured by Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events.
Time frame: Up to day 190
Tolerability on abacavir/lamivudine/dolutegravir once daily in HIV-infected subjects of 60 years or greater- measured by Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events.
Time frame: Up to day 190
Maintenance of HIV viral load control on abacavir/lamivudine/dolutegravir once daily in HIV-infected subjects of 60 years or greater.
Time frame: Up to day 190
Quality of life on abacavir/lamivudine/dolutegravir once daily in HIV-infected subjects of 60 years or greater.- Measured by questionnaire
Time frame: Up to day 190
Sleep Quality on abacavir/lamivudine/dolutegravir once daily in HIV-infected subjects of 60 years or greater - Measured by questionnaire
Time frame: Up to day 190
Measurement of the metabolic profile in patients over the age of 60 with HIV infection who switch antiretroviral regime (metabonomics)
Time frame: Up to day 180
Cerebral function via cognitive testing before and after a switch in antiretroviral therapy to a dolutegravir containing regimen
Time frame: Up to day 180
Relationship between genetic polymorphisms and exposure to dolutegravir as measured by Peak plasma concentration (Cmax)
The results of genetic polymorphisms testing indicating the presence or absence of certain polymorphisms coding for enzymes and transporters responsible for the metabolism of dolutegravir will be correlated with the PK parameter Peak plasma concentration (Cmax). This, for instance, can tell us if the presence of certain alleles makes an individual more likely to metabolise or clear dolutegravir faster or slower.
Time frame: Day 1
Relationship between genetic polymorphisms and exposure to dolutegravir as measured by trough concentration (Ctrough)
The results of genetic polymorphisms testing indicating the presence or absence of certain polymorphisms coding for enzymes and transporters responsible for the metabolism of dolutegravir will be correlated with the PK parameter trough concentration (Ctrough). This, for instance, can tell us if the presence of certain alleles makes an individual more likely to metabolise or clear dolutegravir faster or slower.
Time frame: Day 1
Relationship between genetic polymorphisms and exposure to dolutegravir as measured by Area under the plasma concentration versus time curve (AUC)
The results of genetic polymorphisms testing indicating the presence or absence of certain polymorphisms coding for enzymes and transporters responsible for the metabolism of dolutegravir will be correlated with the PK parameter Area under the plasma concentration versus time curve (AUC). This, for instance, can tell us if the presence of certain alleles makes an individual more likely to metabolise or clear dolutegravir faster or slower.
Time frame: Day 1
This study is completed, as verified in Feb 2018. You cannot join it, but the record below documents what was studied.
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St Stephens Aids Trust