This study has been designed to compare efficacy of dolutegravir plus tenofovir alafenamide as a double-drug regimen with the standard triple-drug redimen in HIV positive patients with undetectable viral load.
Design
This is an open-label randomized clinical trial. Eighty HIV positive patients will be assigned to the interّّvention or the control group according to the simple randomization method.
Settings and conduct
Patients who referred to the HIV clinic of Imam Khomeini Hospital Complex ( affiliated with Tehran University of Medical Sciences) for their treatment follow-up will be evaluated for the inclusion criteria of the study. Eligible patients will be included in study after that sign the consent form.
Participants/Inclusion and exclusion criteria
Inclusion criteria are:
-Adults older than 18 years old
-HIV positive patients with undetectable viral load for at least 2 years
-HIV positive patients with CD4 cells count >200 for at least 2 years
-Patients who are on first line antiretroviral therapy for at least 2 years
-No any mutation against INSTI or NRTI drugs
-Adequate adherence to treatment
-No any AIDS-related event (opportunistic infection or cancer)
Exclusion criteria are:
-Pregnant or lactating women
-Concomitant viral co-infections including hepatitis B or C
-Existing any co-morbidity that requiring treatment which may have significant interactions with ART
-Renal or hepatic diseases
Intervention groups
Intervention group : Standard ART regimen (triple-drug regimen) will be changed to dual regimen including dolutegravir plus tenofovir alafenamide ( DTG plus TAF )
Control group: The patients' standard regimen (triple-drug regimen) will be continued.
Duration of intervention and follow-up in the both groups is 48 weeks.
Main outcome variables
HIV viral load
CD4 cells count
Adverse drug reactions
Adherence to treatment
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20191005044984N1
Registration date:2019-12-21, 1398/09/30
Registration timing:registered_while_recruiting
Last update:2019-12-21, 1398/09/30
Update count:0
Registration date
2019-12-21, 1398/09/30
Registrant information
Name
Golbarg Alavian
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 21 6658 1598
Email address
golbarg.alavian@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2019-11-22, 1398/09/01
Expected recruitment end date
2020-02-19, 1398/11/30
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparing efficacy of dolutegravir plus tenofovir alafenamide as dual-drug regimen with the standard triple-drug regimen in HIV positive patients
Public title
Dolutegravir plus tenofovir alafenamide as a double-drug regimen in HIV positive patients
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Adults older than 18 years old
HIV positive patients with undetectable viral load for at least 2 years
HIV positive patients with CD4 cells count >200 for at least 2 years
Patients who are on first line antiretroviral therapy for at least 2 years
No any mutation against INSTI or NRTI drugs
Adequate adherence to treatment
No any AIDS-related event (opportunistic infection or cancer)
Exclusion criteria:
Pregnancy and lactation
Concomitant viral co-infections including hepatitis B or C
Existing any co-morbidity that requiring treatment which may have significant interactions with ART
Renal or hepatic diseases
Age
From 18 years old
Gender
Both
Phase
3
Groups that have been masked
No information
Sample size
Target sample size:
80
Randomization (investigator's opinion)
Randomized
Randomization description
Eligible patients will be assigned to the intervention or the control group using simple randomization method. The random numbers will be created by a computer program. The random numbers will be sent to satellite pharmacy of the HIV clinic. Eligible patients will be introduced to this department and treatment regimen will be assigned accordingly.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics Committee of Tehran University Of Medical Scienses
Street address
Ghods Ave.
City
Tehran
Province
Tehran
Postal code
۱۴۱۹۷۳۳۱۴۱
Approval date
2019-09-30, 1398/07/08
Ethics committee reference number
IR.TUMS.TIPS.REC.1398.087
Health conditions studied
1
Description of health condition studied
Virologically Undetectable HIV Patients
ICD-10 code
ICD-10 code description
Primary outcomes
1
Description
Virological response: Maintain HIV-RNA viral load <50 copies / ml in response to the ART regimen during the study course
Timepoint
Control group: At baseline and weeks 24 and 48 Intervention group: At baseline and weeks 8, 24 and 48
Method of measurement
LightCycler® 96 Real-Time PCR, Roche, with a limit of 40 copies / ml
2
Description
Immunological response: Increase or maintenance of CD4 cells count > 200 cells/mm3 during the study period
Timepoint
Control group: At baseline and weeks 24 and 48 Intervention group: At baseline and weeks 8, 24 and 48
Method of measurement
Flowcytometry
3
Description
Adverse reactions : Any new sign or symptom caused by the regimens
Timepoint
Control group: At baseline and weeks 24 and 48 Intervention group: At baseline and weeks 8, 24 and 48
Method of measurement
Interview and patient' report
4
Description
Adherence to treatment
Timepoint
Control group: At baseline and weeks 24 and 48 Intervention group: At baseline and weeks 8, 24 and 48
Method of measurement
Interview and pill count methods
Secondary outcomes
empty
Intervention groups
1
Description
Intervention group: The patients' previous standard triple-drug regimen will be changed to the dual-drug regimen including dolutegravir tablet, 50 mg daily plus tenofovir alafenamide tablet, 25 mg daily. This change will be continued for 48 weeks. Patients will be followed during the study period.
Category
Treatment - Drugs
2
Description
Control group: The patients' previous standard triple-drug regimen will be continued. Patients will be followed for 48 weeks.
Category
Treatment - Drugs
Recruitment centers
1
Recruitment center
Name of recruitment center
HIV Clinic affiliated to Imam Khomeini Hospital Complex
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, 16 Azar Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1417614411
Phone
+98 21 6658 1598
Email
Khalilih@tums.ac.ir
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document
Results of the study will be published. The study protocol and statistical analysis will be included in the manuscript.
When the data will become available and for how long
One year after finishing the study, data will be published and will be available in databases.
To whom data/document is available
After permission form the sponsor, data of the study will be available for academic researchers, physicians and scientific institutes.
Under which criteria data/document could be used
Other researchers are permitted to included the results in their systematic reviews and meta analysis.
From where data/document is obtainable
Contact scientific responsible person for the clinical trial as needed.
What processes are involved for a request to access data/document
After receiving the query, dependent on the requested data, the scientific responsible person of the study will response to the query in coordinate with the sponsor within 2 weeks.