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TerminatedNCT04272242Updated Sep 19, 2024Results posted

Drug-Drug Interactions Between Rifapentine and Dolutegravir in HIV/LTBI Co-Infected Individuals

A Phase 2 interventional study of Dolutegravir (DTG) and Isoniazid (INH) in HIV Infection and LTBI, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Terminated at 10 sites in 7 countries. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 2, Interventional, and Treatment

Why this study was terminated
Opening of Arm 2 was dependent upon assessment of DTG pharmacokinetics (PK) data from participants in Arm 1. Arm 1 is complete and results are reported. Arm 2 was not conducted based on the Arm 1 PK assessment.
Phase
Phase 2
Study type
Interventional
Enrollment
37
Allocation
Non-randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study evaluated the potential drug-drug interactions between dolutegravir (DTG) and steady state rifapentine (RPT) when RPT was given with isoniazid (INH) daily for 4 weeks (1HP) as part of treatment for latent TB infection (LTBI) in HIV-1 and LTBI co-infected individuals.

Read the detailed description

The purpose of this study was to evaluate the potential drug-drug interactions between dolutegravir (DTG) and steady state rifapentine (RPT) when RPT was given with isoniazid (INH) daily for 4 weeks (1HP) as part of treatment for latent TB infection (LTBI) in HIV-1 and LTBI co-infected individuals.

Participants received study-provided INH and RPT once daily for 4 weeks (1HP). During the 1HP treatment, DTG was administered twice daily in Arm 1. Arm 2 planned to administer DTG once daily.

At study entry, all participants were required to be on DTG-based antiretroviral (ARV) treatment with 2 nucleoside reverse transcriptase inhibitors (NRTIs) (tenofovir alafenamide [TAF] was prohibited) during the study. In Arm 1, DTG 50 mg was administered twice daily; the morning dose from non-study ARV supply and the evening dose from study supply.

Participants were also required to receive pyridoxine (vitamin B6) with each dose of INH based on the current local, national, or international dosing guidelines. NRTI therapy and pyridoxine (vitamin B6) was not provided by the study.

The majority of Arm 1 participants were on study for 6 weeks (a 4-week on-study treatment period and a 2-week follow-up period). Arm 1 participants could be on study for up to 11 weeks if the on-study treatment duration was extended or if participants needed additional follow-up visits to measure viral load.

The study began enrollment with Arm 1. Opening of Arm 2 was dependent upon assessment of DTG pharmacokinetics (PK) data from participants in Arm 1.

Arm 1 is complete and results are reported. Arm 2 was not conducted based on the Arm 1 PK assessment.

02

Conditions studied

  • HIV Infection
  • LTBI

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Keywords

  • LTBI
  • HIV and LTBI Co-Infection
  • Rifapentine
  • Dolutegravir Interaction
03

In context

HIV Infections

4,734 studies on the registry are indexed under HIV Infections; 244 are open to participants now.

This study's enrollment of 37 is below the median of 80 across 3,489 interventional studies indexed under HIV Infections.

Browse HIV Infections studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,446 studies on the registry; 179 are open to participants now.

Of its 405 completed or terminated interventional studies of FDA-regulated products, 302 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Ability and willingness of participant or legal guardian/representative to provide .
  • Weight ≥40 kg and a (BMI) of greater than 18.5 kg/m\^2.
  • Documentation of -1 infection status, as below:

    • HIV-1 infection, documented by any licensed rapid HIV test or HIV-1 E/CIA test kit at any time prior to entry and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 antigen or plasma HIV-1 RNA viral load. Two or more HIV-1 RNA viral loads of >1,000 copies/mL are also acceptable as documentation of HIV-1 infection.
    • Note A: The term "licensed" refers to a US Food and Drug Administration (FDA)-approved kit, which is required for all new drug (IND) studies, or for sites that are located in countries other than the United States, a kit that has been certified or licensed by an oversight body within that country and validated internally. Non-US sites are encouraged to use US FDA-approved methods for IND studies.
    • Note B: World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) guidelines mandate that confirmation of the initial test result must use a test that is different from the one used for the initial assessment. A reactive initial rapid test should be confirmed by either another type of rapid assay or an E/CIA that is based on a different antigen preparation and/or different test principle (e.g., indirect versus competitive), or a Western blot or a plasma HIV-1 RNA viral load.
  • HIV-1 plasma viral load \<50 copies/mL obtained within 30 days prior to study entry by any US laboratory that has a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent, or at any network-approved non-US laboratory that is Virology Quality Assessment (VQA) certified.
  • At US sites: Evidence of LTBI by tuberculin skin test (TST) reactivity ≥5 mm, or a positive interferon gamma release assay (IGRA) at any time prior to study entry.

    • At non-US sites: Indication for LTBI treatment according to WHO latent TB guidelines (Note: TST/IGRA results not required).
  • On a stable once daily DTG (50 mg) based ART with once daily 2 NRTIs and

    • with at least 28 total days of DTG and NRTI dosing prior to study entry
    • with no gaps in self-reported DTG and NRTI adherence of more than 3 consecutive days in the 28 days prior to study entry
    • with no intention to change ART for the duration of the study
    • NOTE A: Participants who switch from another ART regimen to DTG to meet eligibility requirements for this study will be eligible to enroll as long as the ART is switched at least 28 days prior to study entry.
  • Chest radiograph or chest computed tomography (CT) scan performed within 30 days prior to study entry without evidence of active TB.

    • NOTE: An existing chest X-ray or CT scan from within 30 days prior to entry can be used as qualifying chest imaging. If chest imaging will be performed for study evaluation (i.e., Screening), then chest X-ray should be performed. A CT scan will be used only if an existing scan is already available and will not be performed as part of study.
  • The following laboratory values obtained within 30 days prior to study entry by any US laboratory that has a CLIA certification or its equivalent, or at any network approved non-US laboratory that operates in accordance with Good Clinical Laboratory Practice (GCLP) and participates in appropriate external quality assurance programs.

    • (ANC) >750 cells/mm\^3
    • ≥7.4 g/dL
    • count ≥50,000/mm\^3
    • (AST) (serum glutamic oxaloacetic transaminase [SGOT]) \<2.5 X the (ULN)
    • Alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) \<2.5 X ULN
    • Total ≤1.5 x ULN
    • Creatinine \<1.3× ULN
  • For females of , negative serum or urine pregnancy test at Screening within 30 days prior to entry and within 48 hours prior to entry by any US clinic or laboratory that has a CLIA certification or its equivalent, or is using a point of care (POC)/CLIA-waived test, or at any network-approved non-US laboratory or clinic that operates in accordance with GCLP and participates in appropriate external quality assurance programs.

    • NOTE A: If screening visit occurs within 48 hours prior to entry, only one test will occur prior to entry.
    • NOTE B: Urine test must have a sensitivity of 15-25 mIU/mL.
  • Female participants of reproductive potential must agree not to participate in the conception process (i.e., active attempt to become pregnant, in vitro fertilization), and if participating in sexual activity that could lead to pregnancy, must agree to use one reliable nonhormonal method of , as listed below, while on study treatment and through study completion.
  • Acceptable forms of contraception include:

    • Intrauterine device (IUD) or intrauterine system
    • Cervical cap with spermicide
    • Diaphragm with spermicide
    • Condoms (male or female)
    • NOTE A: Hormonal methods may be used, however, one of the other acceptable forms of contraception listed above must also be used through the duration of the study because of potential interactions with RPT.
    • NOTE B: Participant-reported history is acceptable documentation of menopause (i.e., at least 1 year amenorrheic), hysterectomy, or bilateral oophorectomy or bilateral tubal ligation; these candidates are considered not of reproductive potential and are eligible without the required use of contraception.

Exclusion criteria

Exclusion Criteria:

  • Breastfeeding, pregnancy, or plans to become pregnant.
  • Known allergy/sensitivity or any to components of the study drugs, or their formulations.
  • Presence of any confirmed or probable active TB based on criteria listed in the current AIDS Clinical Trials Group (ACTG) Diagnosis Appendix at screening.
  • History of rifamycin-monoresistant, INH-monoresistant, multi-drug resistant (MDR) or extensively-drug resistant (XDR) TB at any time prior to study entry
  • Known exposure to rifamycin-monoresistant, INH-monoresistant, MDR- or XDR-TB (e.g., household member of a person with rifamycin-monoresistant, INH monoresistant, MDR- or XDR-TB) at any time prior to study entry by participant self report or medical records.
  • History of peripheral neuropathy Grade ≥2 according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, July 2017, which can be found on the DAIDS RSC website at https://rsc.niaid.nih.gov/clinical-research-sites/daids-adverse-event-grading-tables.
  • Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
  • Acute or serious illness requiring systemic treatment and/or hospitalization within 7 days prior to study entry.
  • Known cirrhosis, a history of decompensated liver disease (ascites, hepatic encephalopathy, or esophageal varices) or current Class B or C hepatic impairment.

    • Note: Refer to the study protocol for Child Pugh scoring and classification table.
  • Initiated, discontinued, or changed doses of drugs that are P-glycoprotein (PGP) inducers, that are P-glycoprotein (PGP) inhibitors,or that are known to have drug interactions with DTG, within 30 days prior to study entry.

    • Note: Refer to the list of prohibited and precautionary medications in the study protocol.
  • Known porphyria at any time prior to study entry.
  • Receipt of any other antiretroviral therapy other than DTG and 2 NRTI within 28 days prior to study entry.
  • Receipt of TAF within 28 days prior to study entry.
  • Documented resistance that may confer reduced susceptibility to DTG, at any time prior to study entry. This includes the following INSTI mutations: Q148 substitutions, T66A, L74I/M, E138A/K/T, G140S/A/C, Y143R/C/H, E157Q, G163S/E/K/Q, G193E/R, or N155H.
  • Clinically suspected INSTI resistance, at any time prior to study entry, as evidenced by prior receipt of INSTI containing ART, during which time two or more -1 RNA levels of >200 copies/mL were observed after having attained virologic suppression to \<200 copies/mL and without known interruption.
  • Consumption of >3 alcohol beverages on any day within 30 days prior to entry.
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
37 participants (actual)

Study arms

  • Experimental
    Arm 1: DTG + INH + RPT

    Participants received 50 mg of DTG orally twice daily (\~12 hours apart). Participants received 300 mg of INH and 600 mg of RPT orally each morning for 4 weeks. Participants also received 25 or 50 mg of pyridoxine (vitamin B6) with each dose of INH. Participants remained on DTG-based ARV treatment with 2 NRTIs (excluding TAF) during the study. Participants took non-study supply of DTG for morning doses, and study-supplied DTG for evening doses.

    Drug: Dolutegravir (DTG) · Drug: Isoniazid (INH) · Drug: Rifapentine (RPT) · Drug: Antiretroviral Therapy (ART) · Dietary Supplement: Pyridoxine (Vitamin B6)

  • Experimental
    Arm 2: DTG + INH + RPT

    Participants were to receive 50 mg of DTG orally each morning and 300 mg of INH and 600 mg of RPT orally each morning for 4 weeks. Participants were also to have received 25 or 50 mg of pyridoxine (vitamin B6) with each dose of INH. Participants were to remain on once-daily DTG-based ARV treatment with 2 NRTIs (excluding TAF) during the study with DTG supplied from non-study ARV supply. It was decided to not move forward with Arm 2 of the study based on the Arm 1 PK assessment and no participants were enrolled in Arm 2.

    Drug: Dolutegravir (DTG) · Drug: Isoniazid (INH) · Drug: Rifapentine (RPT) · Drug: Antiretroviral Therapy (ART) · Dietary Supplement: Pyridoxine (Vitamin B6)

Interventions

  • Administered orally

  • Administered orally

  • Administered orally

  • DrugAntiretroviral Therapy (ART)

    Participants remained on DTG-based ARV treatment with 2 NRTIs (excluding TAF) during the study. NRTIs were not provided by the study. Arm 1 participants took non-study supply of DTG for morning doses, and study-supplied DTG for evening doses. For Arm 2 participants, DTG was to have come from non-study ARV supply.

  • Dietary supplementPyridoxine (Vitamin B6)

    Participants received 25 or 50 mg of pyridoxine (vitamin B6) with each dose of INH, based on the current local, national, or international dosing guidelines. Pyridoxine was not provided by the study.

06

What researchers measure

Primary outcomes

  1. DTG PK Parameter Maximum Plasma Concentration (Cmax) Determined Based on DTG Levels From Individual Participants in Arm 1 by Visit Day

    This evaluates the effect of RPT on the DTG PK parameter Cmax obtained from participants enrolled in Arm 1 at day 0 (DTG QD) and day 28 (DTG BID with 1HP). Cmax defines the model-predicted maximum concentration observed over the 12- or 24- hours of the DTG dosing interval.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at days 0 and 28

  2. DTG PK Parameter Area Under the Concentration Time Curve (AUC0-24) Calculated Based on Intensive PK Samples Obtained From Individual Participants Enrolled in Arm 1 by Visit Day

    This evaluates the effect of RPT on the DTG PK parameter AUC 0-24h obtained from participants enrolled in Arm 1 at day 0 (DTG QD) and day 28 (DTG BID with 1HP). AUC 0-24h defines area under the concentration-time curve over the period of 24 hours post-dose estimated based on the fitted model. For Arm 1, Day 28 (BID dosing), participant-specific AUC0-24h was estimated by summing participant-specific estimated AUC values for the 0-12 hour dosing interval (AUC0-12).

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at days 0 and 28

  3. DTG PK Parameter Minimum Plasma Concentration (Cmin) Determined Based on DTG Levels From Individual Participants in Arm 1 by Visit Day

    This evaluates the effect of RPT on the DTG PK parameter Cmin obtained from participants enrolled in Arm 1 at day 0 (DTG QD) and day 28 (DTG BID with 1HP). Cmin defines the model-predicted minimum concentration observed over the 12- or 24- hour DTG dosing interval.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at days 0 and 28

  4. DTG PK Parameter Ctrough Determined Based on DTG Levels From Individual Participants in Arm 1 at Day 28

    This evaluates the effect of RPT on the DTG PK parameter Ctrough obtained from participants enrolled in Arm 1 at day 28 (DTG BID with 1HP). Ctrough defines the observed non-model based minimum concentration observed over the 12- hour DTG dosing interval.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at day 28

  5. DTG PK Parameter Maximum Plasma Concentration (Cmax) Determined Based on DTG Levels From Individual Participants in Arm 2 by Visit Day

    This evaluates the effect of RPT on the DTG PK parameter Cmax obtained from participants enrolled in Arm 2 at day 0 (DTG QD) and day 28 (DTG QD with 1HP). Cmax defines the model-predicted maximum concentration observed over the 24- hours of the DTG dosing interval.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

  6. DTG PK Parameter Area Under the Concentration Time Curve (AUC0-24) Calculated Based on Intensive PK Samples Obtained From Individual Participants Enrolled in Arm 2 by Visit Day

    This evaluates the effect of RPT on the DTG PK parameter AUC 0-24h obtained from participants enrolled in Arm 2 at day 0 (DTG QD) and day 28 (DTG QD with 1HP). AUC 0-24h defines area under the concentration-time curve over the period of 24 hours post-dose estimated based on the fitted model.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

  7. DTG PK Parameter Minimum Plasma Concentration (Cmin) Determined Based on DTG Levels From Individual Participants in Arm 2 by Visit Day

    This evaluates the effect of RPT on the DTG PK parameter Cmin obtained from participants enrolled in Arm 2 at day 0 (DTG QD) and day 28 (DTG QD with 1HP). Cmin defines the model-predicted minimum concentration observed over the 24- hour DTG dosing interval.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

  8. DTG PK Parameter Ctrough Determined Based on DTG Levels From Individual Participants in Arm 2 at Day 28

    This evaluates the effect of RPT on the DTG PK parameter Ctrough obtained from participants enrolled in Arm 2 at day 28 (DTG QD with 1HP). Ctrough defines the observed non-model based minimum concentration observed over the 24- hour DTG dosing interval.

    Time frame: Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

Secondary outcomes

  1. Percentage of Participants in Arm 1 With an Occurrence of Grade 2 or Higher Adverse Event

    Arm 1 participants with an occurrence of an adverse event (laboratory value, sign/symptom, diagnosis) of grade 2 or higher on a scale of 1 to 5 where 5 is the most severe. Severity graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Participants were counted once at the highest grade.

    Time frame: From initiation of study treatment to day 28

  2. Percentage of Participants in Arm 1 Who Completed the Study

    Percentage of participants in Arm 1 who completed the study

    Time frame: From initiation of study to day 28

  3. Percentage of Participants in Arm 1 Who Completed Study Drug Treatment

    Percentage of participants in Arm 1 who completed study drug treatment (DTG+1HP)

    Time frame: From initiation of study treatment to day 28

  4. Percentage of Participants in Arm 1 With HIV-1 RNA Levels >50 Copies/mL

    This evaluates the short-term impact on virologic suppression of DTG based ART when coadministered with 1HP by measuring the percentage of participants with plasma HIV-1 RNA levels \>50 copies/mL at study day 28 (after 4 weeks of DTG+1HP) and study day 42 (14 days after completing study treatment).

    Time frame: Measured at Days 28 and 42

  5. Percentage of Participants in Arm 2 With an Occurrence of Grade 2 or Higher Adverse Event

    Arm 2 participants with an occurrence of an adverse event (laboratory value, sign/symptom, diagnosis) of grade 2 or higher on a scale of 1 to 5 where 5 is the most severe. Severity graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Participants will be counted once at the highest grade.

    Time frame: From initiation of study treatment to day 28

  6. Percentage of Participants in Arm 2 Who Completed the Study

    Percentage of participants in Arm 2 who completed the study.

    Time frame: From initiation of study to day 28

  7. Percentage of Participants in Arm 2 Who Completed Study Drug Treatment

    Percentage of participants in Arm 2 who completed study drug treatment (DTG+1HP).

    Time frame: From initiation of study treatment to day 28

  8. Percentage of Participants in Arm 2 With HIV-1 RNA Levels >50 Copies/mL

    This evaluates the short-term impact on virologic suppression of DTG based ART when coadministered with 1HP by measuring the percentage of participants with plasma HIV-1 RNA levels \>50 copies/mL at study day 28 (after 4 weeks of DTG+1HP) and study day 42 (14 days after completing study treatment).

    Time frame: Measured at Days 28 and 42

07

Results

Posted Aug 9, 2024

Participant flow

Participants in Arm 1 were enrolled from February 2021 to November 2021 at 9 selected US and non-US ACTG clinical research sites. It was decided to not move forward with Arm 2 of the study and no participants were enrolled in Arm 2. Results are for Arm 1 only.

Participant flow — Overall Study
MilestoneArm 1: DTG + INH + RPT
Started37
Completed32
Not completed5
Withdrew: Withdrawal by subject3
Withdrew: Lost to follow-up1
Withdrew: Adverse event1

Outcome measures

PrimaryDTG PK Parameter Maximum Plasma Concentration (Cmax) Determined Based on DTG Levels From Individual Participants in Arm 1 by Visit Day

This evaluates the effect of RPT on the DTG PK parameter Cmax obtained from participants enrolled in Arm 1 at day 0 (DTG QD) and day 28 (DTG BID with 1HP). Cmax defines the model-predicted maximum concentration observed over the 12- or 24- hours of the DTG dosing interval.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at days 0 and 28
Reported as:
Median · ng/mL
DTG PK Parameter Maximum Plasma Concentration (Cmax) Determined Based on DTG Levels From Individual Participants in Arm 1 by Visit Day
ng/mLArm 1: DTG + INH + RPT
Day 04180.8 (3920.6 to 5196.4)
Day 283913.5 (3475.7 to 4743.1)
Statistical analysis
  • Arm 1: DTG + INH + RPT · Geometric mean ratio: 0.92 · 90% CI 0.91 to 0.93The numerator represents Day 28 and the denominator represents Entry.
PrimaryDTG PK Parameter Area Under the Concentration Time Curve (AUC0-24) Calculated Based on Intensive PK Samples Obtained From Individual Participants Enrolled in Arm 1 by Visit Day

This evaluates the effect of RPT on the DTG PK parameter AUC 0-24h obtained from participants enrolled in Arm 1 at day 0 (DTG QD) and day 28 (DTG BID with 1HP). AUC 0-24h defines area under the concentration-time curve over the period of 24 hours post-dose estimated based on the fitted model. For Arm 1, Day 28 (BID dosing), participant-specific AUC0-24h was estimated by summing participant-specific estimated AUC values for the 0-12 hour dosing interval (AUC0-12).

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at days 0 and 28
Reported as:
Median · h*ng/mL
DTG PK Parameter Area Under the Concentration Time Curve (AUC0-24) Calculated Based on Intensive PK Samples Obtained From Individual Participants Enrolled in Arm 1 by Visit Day
h*ng/mLArm 1: DTG + INH + RPT
Day 068079.5 (59139.5 to 85561.0)
Day 2865261.3 (56748.6 to 81999.4)
Statistical analysis
  • Arm 1: DTG + INH + RPT · Geometric mean ratio: 0.96 · 90% CI 0.96 to 0.96The numerator represents Day 28 and the denominator represents Entry.
PrimaryDTG PK Parameter Minimum Plasma Concentration (Cmin) Determined Based on DTG Levels From Individual Participants in Arm 1 by Visit Day

This evaluates the effect of RPT on the DTG PK parameter Cmin obtained from participants enrolled in Arm 1 at day 0 (DTG QD) and day 28 (DTG BID with 1HP). Cmin defines the model-predicted minimum concentration observed over the 12- or 24- hour DTG dosing interval.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at days 0 and 28
Reported as:
Median · ng/mL
DTG PK Parameter Minimum Plasma Concentration (Cmin) Determined Based on DTG Levels From Individual Participants in Arm 1 by Visit Day
ng/mLArm 1: DTG + INH + RPT
Day 01726.1 (1267.9 to 2395.6)
Day 281717.5 (1206.6 to 2502.7)
Statistical analysis
  • Arm 1: DTG + INH + RPT · Geometric mean ratio: 0.99 · 90% CI 0.97 to 1.00The numerator represents Day 28 and the denominator represents Entry.
PrimaryDTG PK Parameter Ctrough Determined Based on DTG Levels From Individual Participants in Arm 1 at Day 28

This evaluates the effect of RPT on the DTG PK parameter Ctrough obtained from participants enrolled in Arm 1 at day 28 (DTG BID with 1HP). Ctrough defines the observed non-model based minimum concentration observed over the 12- hour DTG dosing interval.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 13h, 14h, 23h and 24h post-dose at day 28
Reported as:
Median · ng/mL
DTG PK Parameter Ctrough Determined Based on DTG Levels From Individual Participants in Arm 1 at Day 28
ng/mLArm 1: DTG + INH + RPT
DTG PK Parameter Ctrough Determined Based on DTG Levels From Individual Participants in Arm 1 at Day 281987.0 (1331.0 to 2377.5)
PrimaryDTG PK Parameter Maximum Plasma Concentration (Cmax) Determined Based on DTG Levels From Individual Participants in Arm 2 by Visit Day

This evaluates the effect of RPT on the DTG PK parameter Cmax obtained from participants enrolled in Arm 2 at day 0 (DTG QD) and day 28 (DTG QD with 1HP). Cmax defines the model-predicted maximum concentration observed over the 24- hours of the DTG dosing interval.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

No measurements were reported for this outcome.

PrimaryDTG PK Parameter Area Under the Concentration Time Curve (AUC0-24) Calculated Based on Intensive PK Samples Obtained From Individual Participants Enrolled in Arm 2 by Visit Day

This evaluates the effect of RPT on the DTG PK parameter AUC 0-24h obtained from participants enrolled in Arm 2 at day 0 (DTG QD) and day 28 (DTG QD with 1HP). AUC 0-24h defines area under the concentration-time curve over the period of 24 hours post-dose estimated based on the fitted model.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

No measurements were reported for this outcome.

PrimaryDTG PK Parameter Minimum Plasma Concentration (Cmin) Determined Based on DTG Levels From Individual Participants in Arm 2 by Visit Day

This evaluates the effect of RPT on the DTG PK parameter Cmin obtained from participants enrolled in Arm 2 at day 0 (DTG QD) and day 28 (DTG QD with 1HP). Cmin defines the model-predicted minimum concentration observed over the 24- hour DTG dosing interval.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

No measurements were reported for this outcome.

PrimaryDTG PK Parameter Ctrough Determined Based on DTG Levels From Individual Participants in Arm 2 at Day 28

This evaluates the effect of RPT on the DTG PK parameter Ctrough obtained from participants enrolled in Arm 2 at day 28 (DTG QD with 1HP). Ctrough defines the observed non-model based minimum concentration observed over the 24- hour DTG dosing interval.

Time frame:
Intensive DTG PK samples at pre-dose, 1h, 2h, 4h, 8h, 12h, 23h and 24h post-dose at days 0 and 28

No measurements were reported for this outcome.

SecondaryPercentage of Participants in Arm 1 With an Occurrence of Grade 2 or Higher Adverse Event

Arm 1 participants with an occurrence of an adverse event (laboratory value, sign/symptom, diagnosis) of grade 2 or higher on a scale of 1 to 5 where 5 is the most severe. Severity graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Participants were counted once at the highest grade.

Time frame:
From initiation of study treatment to day 28
Reported as:
Number · Percentage of participants
Percentage of Participants in Arm 1 With an Occurrence of Grade 2 or Higher Adverse Event
Percentage of participantsArm 1: DTG + INH + RPT
Grade 2 Adverse Event36 (21 to 54)
Grade 3 Adverse Event6 (1 to 19)
SecondaryPercentage of Participants in Arm 1 Who Completed the Study

Percentage of participants in Arm 1 who completed the study

Time frame:
From initiation of study to day 28
Reported as:
Number · Percentage of participants
Percentage of Participants in Arm 1 Who Completed the Study
Percentage of participantsArm 1: DTG + INH + RPT
Percentage of Participants in Arm 1 Who Completed the Study89 (74 to 97)
SecondaryPercentage of Participants in Arm 1 Who Completed Study Drug Treatment

Percentage of participants in Arm 1 who completed study drug treatment (DTG+1HP)

Time frame:
From initiation of study treatment to day 28
Reported as:
Number · Percentage of participants
Percentage of Participants in Arm 1 Who Completed Study Drug Treatment
Percentage of participantsArm 1: DTG + INH + RPT
Percentage of Participants in Arm 1 Who Completed Study Drug Treatment92 (78 to 98)
SecondaryPercentage of Participants in Arm 1 With HIV-1 RNA Levels >50 Copies/mL

This evaluates the short-term impact on virologic suppression of DTG based ART when coadministered with 1HP by measuring the percentage of participants with plasma HIV-1 RNA levels \>50 copies/mL at study day 28 (after 4 weeks of DTG+1HP) and study day 42 (14 days after completing study treatment).

Time frame:
Measured at Days 28 and 42
Reported as:
Number · percentage of participants
Percentage of Participants in Arm 1 With HIV-1 RNA Levels >50 Copies/mL
percentage of participantsArm 1: DTG + INH + RPT
Percentage with HIV-1 RNA >50 copies/mL at day 283
Percentage with HIV-1 RNA >50 copies/mL at day 420
SecondaryPercentage of Participants in Arm 2 With an Occurrence of Grade 2 or Higher Adverse Event

Arm 2 participants with an occurrence of an adverse event (laboratory value, sign/symptom, diagnosis) of grade 2 or higher on a scale of 1 to 5 where 5 is the most severe. Severity graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Participants will be counted once at the highest grade.

Time frame:
From initiation of study treatment to day 28

No measurements were reported for this outcome.

SecondaryPercentage of Participants in Arm 2 Who Completed the Study

Percentage of participants in Arm 2 who completed the study.

Time frame:
From initiation of study to day 28

No measurements were reported for this outcome.

SecondaryPercentage of Participants in Arm 2 Who Completed Study Drug Treatment

Percentage of participants in Arm 2 who completed study drug treatment (DTG+1HP).

Time frame:
From initiation of study treatment to day 28

No measurements were reported for this outcome.

SecondaryPercentage of Participants in Arm 2 With HIV-1 RNA Levels >50 Copies/mL

This evaluates the short-term impact on virologic suppression of DTG based ART when coadministered with 1HP by measuring the percentage of participants with plasma HIV-1 RNA levels \>50 copies/mL at study day 28 (after 4 weeks of DTG+1HP) and study day 42 (14 days after completing study treatment).

Time frame:
Measured at Days 28 and 42

No measurements were reported for this outcome.

Adverse events

Collected over From start of study treatment to study completion at Day 49 or premature study discontinuation.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Arm 1: DTG + INH + RPT0/36 (0%)0/36 (0%)15/36 (41.7%)
Most frequent other events
Showing 10 of 17
Most frequent other events
EventArm 1: DTG + INH + RPT
NeutropeniaBlood and lymphatic system disorders3/36
Blood creatinine increasedInvestigations3/36
HeadacheNervous system disorders3/36
LeukopeniaBlood and lymphatic system disorders1/36
Conjunctivitis allergicEye disorders1/36
PyrexiaGeneral disorders1/36
COVID-19Infections and infestations1/36
OrchitisInfections and infestations1/36
Alanine aminotransferase increasedInvestigations1/36
Aspartate aminotransferase increasedInvestigations1/36

Baseline characteristics

All participants who enrolled to the study

Age, Continuous
Age, Continuous(years)Arm 1: DTG + INH + RPT
Median41.0 (35.0 to 48.0)
Sex: Female, Male
Sex: Female, Male(Participants)Arm 1: DTG + INH + RPT
Female14
Male23
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Arm 1: DTG + INH + RPT
Hispanic or Latino3
Not Hispanic or Latino34
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Arm 1: DTG + INH + RPT
American Indian or Alaska Native0
Asian9
Native Hawaiian or Other Pacific Islander0
Black or African American25
White3
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(Participants)Arm 1: DTG + INH + RPT
Haiti3
United States4
Malawi4
Botswana3
South Africa7
Zimbabwe8
Thailand8
HIV-1 RNA below 50 copies/mL
HIV-1 RNA below 50 copies/mL(Participants)Arm 1: DTG + INH + RPT
Below 50 copies/mL36
50 copies/mL or Greater1
08

Study locations

10 sites
  • University of California HIV/AIDS CRS
    San Francisco, California 94110, United States
  • Houston AIDS Research Team CRS
    Houston, Texas 77030, United States
  • Gaborone CRS
    Gaborone, South-East District, Botswana
  • GHESKIO Institute of Infectious Diseases and Reproductive Health (GHESKIO - IMIS) CRS
    Port-au-Prince, HT-6110, Haiti
  • Les Centres GHESKIO Clinical Research Site (GHESKIO-INLR) CRS
    Port-au-Prince, HT-6110, Haiti
  • Malawi CRS
    Lilongwe, Central Malawi, Malawi
  • University of Cape Town Lung Institute (UCTLI) CRS
    Cape Town, 7700, South Africa
  • South African Tuberculosis Vaccine Initiative (SATVI) CRS
    Cape Town, 7705, South Africa
  • Thai Red Cross AIDS Research Centre (TRC-ARC) CRS
    Pathum Wan, Bangkok 10330, Thailand
  • Milton Park CRS
    Milton Park, Harare, Zimbabwe
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References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — Individual participant data that underlie results in the publication, after deidentification.

Supporting information: Study protocol, Statistical analysis plan

Time frame: Beginning 3 months following publication and available throughout period of funding of the AIDS Clinical Trials Group by NIH.

Access criteria: With whom? Researchers who provide a methodologically sound proposal for use of the data that is approved by the AIDS Clinical Trials Group. For what types of analyses? To achieve aims in the proposal approved by the AIDS Clinical Trials Group. By what mechanism will data be made available? Researchers may submit a request for access to data using the AIDS Clinical Trials Group "Data Request" form at: https://submit.mis.s-3.net/ Researchers of approved proposals will need to sign an AIDS Clinical Trials Group Data Use Agreement before receiving the data.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04272242
Collaborators
ViiV Healthcare
Responsible party
Sponsor
First posted
Feb 17, 2020
Start date
Feb 27, 2021
Primary completion
Dec 15, 2021
Completion
Dec 27, 2021
Results posted
Aug 9, 2024
Last update
Sep 19, 2024

Study contacts

Anthony Podany, PharmD
study chair · University of Nebraska

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Sep 2024. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Dolutegravir · Rifapentine

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