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Not yet recruitingNCT07881809Updated Oct 19, 2026

A Clinical Study of Ixazomib to Reactivate HIV and Reduce HIV Reservoir Size

A Phase 2 interventional study of Ixazomib 4 mg and Placebo in HIV (Human Immunodeficiency Virus), sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Not yet recruiting at 20 sites in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-10-19.

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

Updated Oct 19, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
45
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

This study tests whether a medicine called ixazomib is safe for people living with HIV, and whether it can wake up HIV that is hiding in the body so the immune system and treatment can reach it.

HIV can stay hidden inside cells even when antiretroviral therapy (ART) keeps the virus under control. These hidden cells are called the HIV reservoir, and they are the reason HIV is not cured by ART alone. Laboratory research suggests ixazomib may reactivate hidden HIV and also help kill the cells that carry it. Ixazomib is already approved to treat a cancer called multiple myeloma and has been given to a smaller group of people with HIV in an earlier study.

About 45 adults with HIV that is well controlled on ART will take part. Participants are assigned by chance to take either ixazomib or a placebo - a capsule with no active medicine - one capsule by mouth once a week for a total of 25 doses. Two out of every three participants receive ixazomib and one out of three receives placebo. Neither participants nor the study staff know which one a participant is taking.

Everyone continues their own HIV treatment throughout the study.

Participation lasts about 7 months: 24 weeks of weekly capsules and 4 more weeks of follow-up after the last dose. Participants come to the clinic for about 14 visits, and take their capsule 24 to 36 hours before each visit so blood samples can show the effect of the dose.

The main purposes of the study are to evaluate whether ixazomib is safe and tolerable, and to measure whether it increases the very small amounts of HIV in the blood compared with placebo. The study also measures the size of the HIV reservoir and how the immune system responds.

Read the detailed description

A5420 is a phase 2, double-blinded, randomized, placebo-controlled trial of ixazomib in adults with HIV-1 who are virologically suppressed on antiretroviral therapy. Forty-five participants will be randomized 2:1 to ixazomib 4 mg or matching placebo, taken orally once weekly for a total of 25 doses over 24 weeks, while continuing their own suppressive ART. Randomization is stratified by sex (male/female) using permuted blocks to balance enrollment across arms. Participants are evaluated at screening, entry (week 0), and weeks 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24, with a post-treatment evaluation at week 28 following a 4-week washout, for approximately 14 visits over roughly 7 months.

Study treatment is administered as a single 4 mg capsule taken with water on an empty stomach, at least 1 hour before or 2 hours after food, on the same day and at approximately the same time each week. Capsules are not broken, chewed, or opened. Doses preceding a clinic visit are taken 24 to 36 hours before that visit so that plasma and cell-associated virologic measurements capture the post-dose interval.

02

Conditions studied

  • HIV (Human Immunodeficiency Virus)

Keywords

  • HIV
  • AIDS
  • Antiretroviral Therapy
03

In context

Acquired Immunodeficiency Syndrome

2,099 studies on the registry are indexed under Acquired Immunodeficiency Syndrome; 273 are open to participants now.

This study's planned enrollment of 45 is below the median of 104 across 1,590 interventional studies indexed under Acquired Immunodeficiency Syndrome.

Browse Acquired Immunodeficiency Syndrome studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,445 studies on the registry; 182 are open to participants now.

Of its 402 completed or terminated interventional studies of FDA-regulated products, 300 (75%) have results posted.

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

04

Who can participate

Ages eligible
18 Years to 70 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

  1. Documented HIV-1 infection.
  2. Plasma HIV-1 RNA of 50 copies/mL or lower, for at least 48 weeks prior to study entry while on antiretroviral therapy. One blip above 50 but below 200 copies/mL in the preceding 48 weeks is permitted provided at least two other measurements in that period were 50 copies/mL or lower.
  3. Plasma HIV-1 RNA below the lower limit of quantification within 30 days prior to study entry.
  4. Receiving antiretroviral therapy for less than 10 years.
  5. On antiretroviral therapy for at least 48 weeks prior to study entry, with no interruption of more than 7 consecutive days in the 90 days prior to entry, and no change in regimen within 90 days prior to entry.
  6. CD4+ T cell count of at least 500 cells/mm\^3 within 30 days prior to study entry.
  7. Laboratory values within 30 days prior to study entry: absolute neutrophil count at least 1,000/mm\^3; hemoglobin at least 10 g/dL (female participants) or at least 11 g/dL (male participants); platelet count at least 75,000/mm\^3; estimated glomerular filtration rate at least 30 mL/min/1.73m\^2; bilirubin no more than 1.5 times the upper limit of normal, or no more than 3 times the upper limit of normal if the isolated elevation is attributable to a participant medication or Gilbert syndrome, or direct bilirubin within the normal range.
  8. For participants who can become pregnant, a negative serum or urine pregnancy test within 24 hours prior to study entry.
  9. For participants who can become pregnant, agreement to use two methods of contraception from 10 days prior to study entry through 90 days after the last dose of study treatment. Egg donation is prohibited over the same period.
  10. For participants whose sexual activity could result in a partner becoming pregnant, agreement to use condoms from 10 days prior to study entry through 90 days after the last dose of study treatment. Sperm donation is prohibited over the same period.
  11. Negative hepatitis B surface antigen within 30 days prior to study entry.
  12. Negative hepatitis C antibody, or if positive, a negative HCV RNA PCR, within 30 days prior to study entry.

Exclusion criteria

Exclusion Criteria:

  1. Untreated, active AIDS-defining illness.
  2. Receiving an HIV protease inhibitor or efavirenz as part of the antiretroviral regimen.
  3. Current pregnancy or breastfeeding.
  4. Receipt of an investigational HIV vaccine or HIV-specific monoclonal antibody, or participation in a trial of any investigational product, within 180 days prior to study entry, or expected participation in such a study during this study.
  5. Any current clinically significant acute or chronic medical condition other than HIV infection that in the investigator's opinion would preclude participation.
  6. Any history of peripheral neuropathy, or peripheral neuropathy detected during screening.
  7. History of an HIV-associated malignancy, including Kaposi sarcoma or lymphoma of any type, treated with systemic chemotherapy or immunotherapy.
  8. Active or recent non-HIV-associated malignancy requiring systemic chemotherapy or surgery within 36 months prior to study entry, or for whom such therapy is expected within the following 12 months. Surgical removal of minor localized skin cancers is not exclusionary.
  9. Use of prohibited medications within 30 days prior to study entry or planned use during study participation.
  10. Known allergy, sensitivity, or hypersensitivity to ixazomib or its formulation.
  11. Active drug or alcohol use or dependence that, in the investigator's opinion, would interfere with adherence to study requirements.
  12. Acute or serious illness requiring systemic treatment or hospitalization within 30 days prior to study entry.
  13. Anticipated change in antiretroviral regimen during the 24 weeks following study entry.
  14. Current uncontrolled cardiovascular symptoms, including uncontrolled hypertension (systolic blood pressure above 140 mmHg or diastolic blood pressure above 90 mmHg), uncontrolled cardiac arrhythmia, symptomatic congestive heart failure, unstable angina, or myocardial infarction within 24 weeks prior to study entry.
  15. Any serious medical or psychiatric illness that in the investigator's opinion could interfere with completion of protocol treatment.
  16. Known gastrointestinal disease or procedure that could interfere with oral absorption or tolerance of ixazomib, including difficulty swallowing.
  17. Previous treatment with ixazomib.
  18. Known resistance to two or more classes of antiretrovirals.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
45 participants (estimated)

Study arms

  • Experimental
    Ixazomib

    Ixazomib 4 mg orally once weekly for a total of 25 doses over 24 weeks.

    Drug: Ixazomib 4 mg

  • Placebo comparator
    Placebo

    Placebo for Ixazomib orally once weekly for a total of 25 doses over 24 weeks.

    Drug: Placebo

Interventions

  • One Ixazomib 4 mg capsule should be taken by mouth with a full glass of water on an empty stomach at least 1 hour before or 2 hours after food once a week on the same day and approximately the same time each week

    Also known as: Ninlaro, MLN9708

  • DrugPlacebo

    One Placebo for Ixazomib capsule should be taken by mouth with a full glass of water on an empty stomach at least 1 hour before or 2 hours after food once a week on the same day and approximately the same time each week

06

What researchers measure

Primary outcomes

  1. Proportion of Ixazomib-Treated Participants With at Least One Grade 3 or Higher Adverse Event Related to Study Treatment.

    Time frame: Entry (Week 0) to Week 28

  2. Frequency of Ixazomib-Treated Participants Who Prematurely Discontinue Study Treatment for Reasons That Are Deemed Related to Study Treatment.

    Time frame: Entry (Week 0) to Week 24

  3. Post-Dose Plasma HIV-1 RNA Levels Measured by Multireplicate Single-Copy Assay (SCA)

    Time frame: Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24

Secondary outcomes

  1. Intact Proviral DNA Levels Measured by the Intact Proviral DNA Assay (IPDA)

    Time frame: Screening, Entry (Week 0), and Weeks 4, 24, and 28

  2. Plasma HIV-1 RNA Levels Measured by Multireplicate Single-Copy Assay (SCA)

    Time frame: Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24

  3. Cell-Associated HIV RNA Levels

    Time frame: Screening, Entry (Week 0), and Weeks 1, 2, 3, 4, 6, 10, 12, 16, 20, and 24

  4. Cell-Associated HIV RNA/DNA Ratio

    Time frame: Screening, Entry (Week 0), and Weeks 4, 24, and 28

07

Study locations

20 sites
  • Alabama CRS (Site #31788)
    Birmingham, Alabama 35222, United States
  • University of California, Los Angeles CARE Center CRS (Site #601)
    Los Angeles, California 90035, United States
  • UCSD Antiviral Research Center CRS (Site #701)
    San Diego, California 92103, United States
  • University of California, San Francisco HIV/AIDS CRS (Site #801)
    San Francisco, California 94110, United States
  • University of Colorado Hospital CRS (Site #6101)
    Aurora, Colorado 80045, United States
  • Whitman-Walker Institute, Inc. CRS (Site #31791)
    Washington D.C., District of Columbia 20009, United States
  • The Ponce de Leon Center CRS (Site #5802)
    Atlanta, Georgia 30308-2012, United States
  • Northwestern University CRS (Site #2701)
    Chicago, Illinois 60611, United States
  • Massachusetts General Hospital CRS (MGH CRS) (Site #101)
    Boston, Massachusetts 02114, United States
  • Columbia Physicians & Surgeons (P&S) CRS (Site #30329)
    New York, New York 10032, United States
  • University of Rochester Adult HIV Therapeutic Strategies Network CRS (Site #31787)
    Rochester, New York 14642, United States
  • Chapel Hill CRS (Site #3201)
    Chapel Hill, North Carolina 27599-7215, United States
  • Cincinnati Clinical Research Site (Site #2401)
    Cincinnati, Ohio 45267-0405, United States
  • Case Clinical Research Site (Site #2501)
    Cleveland, Ohio 44106, United States
  • Ohio State University CRS (Site #2301)
    Columbus, Ohio 43210-1282, United States
  • Penn Therapeutics CRS (Site #6201)
    Philadelphia, Pennsylvania 19104, United States
  • University of Pittsburgh CRS (Site #1001)
    Pittsburgh, Pennsylvania 15213, United States
  • Vanderbilt Therapeutics (VT) CRS (Site #3652)
    Nashville, Tennessee 37204, United States
  • Houston Advancing Research Team CRS (Site #31473)
    Houston, Texas 77030, United States
  • University of Washington Positive Research CRS (Site #1401)
    Seattle, Washington 98104, United States
    • Rachel Bender Ignacio · Contact · rbi13@uw.edu · 206-744-4876
08

References and documents

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 Advancing Clinical Therapeutics Globally (ACTG) by NIH

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

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Oct 19, 2026
Show all 1 update
  1. Oct 19, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07881809
Collaborators
Takeda
Responsible party
Sponsor
First posted
Oct 19, 2026
Start date
Nov 23, 2026 (estimated)
Primary completion
Oct 8, 2027 (estimated)
Completion
Nov 5, 2027 (estimated)
Last update
Oct 19, 2026

Oversight

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

Not currently enrolling

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Studies of the drug tested here: Ixazomib

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