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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00708162
Registration number
NCT00708162
Ethics application status
Date submitted
30/06/2008
Date registered
2/07/2008
Date last updated
30/05/2016
Titles & IDs
Public title
Multicenter, Randomized, Double-Blind, Double-Dummy, Phase 3 Study of the Safety and Efficacy of Elvitegravir Versus Raltegravir
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Scientific title
A Multicenter, Randomized, Double-Blind, Double-Dummy, Phase 3 Study of the Safety and Efficacy of Ritonavir-Boosted Elvitegravir (EVG/r) Versus Raltegravir (RAL) Each Administered With a Background Regimen in HIV-1 Infected, Antiretroviral Treatment-Experienced Adults
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Secondary ID [1]
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0
2007-004225-26
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Secondary ID [2]
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GS-US-183-0145
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
HIV Infection
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0
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Condition category
Condition code
Infection
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0
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Acquired immune deficiency syndrome (AIDS / HIV)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Elvitegravir
Treatment: Drugs - Raltegravir
Treatment: Drugs - EVG placebo
Treatment: Drugs - RAL placebo
Treatment: Drugs - Background regimen
Experimental: Elvitegravir - EVG 85 mg or 150 mg + RAL placebo + background regimen in the Randomized Phase, followed by EVG 85 mg or 150 mg + background regimen in the Open-Label Phase.
Participants receiving lopinavir/ritonavir (LPV/r) or atazanavir/ritonavir (ATV/r) as part of their background regimen will receive EVG 85 mg; all other participants will receive EVG 150 mg.
Active comparator: Raltegravir - RAL 800 mg (400 mg twice daily) + EVG placebo + background regimen in the Randomized Phase, followed by EVG 85 mg or 150 mg + background regimen in the Open-Label Phase.
Participants receiving LPV/r or ATV/r as part of their background regimen in the Open-Label Phase will receive EVG 85 mg; all other participants will receive EVG 150 mg.
Treatment: Drugs: Elvitegravir
Elvitegravir (EVG) tablet administered orally once daily with food
Treatment: Drugs: Raltegravir
Raltegravir tablet administered orally twice daily according to prescribing information
Treatment: Drugs: EVG placebo
Placebo to match elvitegravir administered orally once daily
Treatment: Drugs: RAL placebo
RAL placebo administered orally twice daily.
Treatment: Drugs: Background regimen
Background Regimen (administered according to prescribing information) contains 1 fully-active ritonavir-boosted protease inhibitor (PI/r) plus 1 or 2 additional agents. The ritonavir-boosted PIs include either ATV, darunavir, fosamprenavir, LPV (Kaletra®), or tipranavir; the additional agents include abacavir (ABC), Combivir® (lamivudine (LAM)/zidovudine (ZDV) coformulated), didanosine, emtricitabine (FTC), enfuvirtide, Epzicom® (ABC/LAM coformulated), etravirine, LAM, maraviroc, tenofovir disoproxil fumarate (TDF), Truvada®, (FTC/TDF coformulated), and/or ZDV.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Participants Achieving and Maintaining Confirmed HIV-1 RNA < 50 Copies/mL at Week 48
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Assessment method [1]
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The percentage of participants achieving and maintaining confirmed HIV-1 RNA \< 50 copies/mL at Week 48 was analyzed using the FDA-defined Time to Loss of Virologic Response (TLOVR) algorithm, which takes into account a patient's longitudinal viral load up to the predefined time point by considering patterns of suppression and rebounding.
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Timepoint [1]
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Week 48
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Secondary outcome [1]
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Percentage of Participants Achieving and Maintaining Confirmed HIV-1 RNA < 50 Copies/mL at Week 96
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Assessment method [1]
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The percentage of participants achieving and maintaining confirmed HIV-1 RNA \< 50 copies/mL at Week 96 was analyzed using the FDA-defined TLOVR algorithm, which takes into account a patient's longitudinal viral load up to the predefined time point by considering patterns of suppression and rebounding.
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Timepoint [1]
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Week 96
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Secondary outcome [2]
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Percentage of Participants Achieving and Maintaining Confirmed HIV-1 RNA < 400 Copies/mL at Week 48
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Assessment method [2]
0
0
The percentage of participants achieving and maintaining confirmed HIV-1 RNA \< 400 copies/mL at Week 48 was analyzed using the FDA-defined TLOVR algorithm, which takes into account a patient's longitudinal viral load up to the predefined time point by considering patterns of suppression and rebounding.
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Timepoint [2]
0
0
Week 48
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Secondary outcome [3]
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0
Percentage of Participants Achieving and Maintaining Confirmed HIV-1 RNA < 400 Copies/mL at Week 96
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Assessment method [3]
0
0
The percentage of participants achieving and maintaining confirmed HIV-1 RNA \< 400 copies/mL at Week 96 was analyzed using the FDA-defined TLOVR algorithm, which takes into account a patient's longitudinal viral load up to the predefined time point by considering patterns of suppression and rebounding.
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Timepoint [3]
0
0
Week 96
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Secondary outcome [4]
0
0
Virologic Response at Week 48 (HIV-1 RNA < 50 Copies/mL)
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Assessment method [4]
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Virologic response at Week 48 (percentage of participants with HIV-1 RNA \< 50 copies/mL) was analyzed using the FDA-defined Snapshot algorithm, which defines a patient's virologic response status using the viral load along with study drug discontinuation status at the predefined time point within an allowed window of time.
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Timepoint [4]
0
0
Week 48
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Secondary outcome [5]
0
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Virologic Response at Week 96 (HIV-1 RNA < 50 Copies/mL)
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Assessment method [5]
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Virologic response at Week 96 (percentage of participants with HIV-1 RNA \< 50 copies/mL) was analyzed using the FDA-defined Snapshot algorithm, which defines a patient's virologic response status using the viral load along with study drug discontinuation status at the predefined time point within an allowed window of time.
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Timepoint [5]
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0
Week 96
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Secondary outcome [6]
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Percentage of Participants With Pure Virologic Failure (HIV-1 RNA Cutoff at 50 Copies/mL) up to Week 48
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Assessment method [6]
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The percentage of participants with pure virologic failure (HIV-1 RNA cutoff at 50 copies/mL) up to Week 48 was estimated using the Kaplan-Meier method in the time to event analysis.
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Timepoint [6]
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Baseline to Week 48
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Secondary outcome [7]
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0
Percentage of Participants With Pure Virologic Failure (HIV-1 RNA Cutoff at 50 Copies/mL) up to Week 96
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Assessment method [7]
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The percentage of participants with pure virologic failure (HIV-1 RNA cutoff at 50 copies/mL) up to Week 96 was estimated using the Kaplan-Meier method in the time to event analysis.
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Timepoint [7]
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0
Baseline to Week 96
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Secondary outcome [8]
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Percentage of Participants With Pure Virologic Failure (HIV-1 RNA Cutoff at 400 Copies/mL) up to Week 48
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Assessment method [8]
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The percentage of participants with pure virologic failure (HIV-1 RNA cutoff at 400 copies/mL) up to Week 48 was estimated using the Kaplan-Meier method in the time to event analysis.
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Timepoint [8]
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Baseline to Week 48
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Secondary outcome [9]
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Percentage of Participants With Pure Virologic Failure (HIV-1 RNA Cutoff at 400 Copies/mL) up to Week 96
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Assessment method [9]
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The percentage of participants with pure virologic failure (HIV-1 RNA cutoff at 400 copies/mL) up to Week 96 was estimated using the Kaplan-Meier method in the time to event analysis.
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Timepoint [9]
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0
Baseline to Week 96
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Secondary outcome [10]
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0
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 48
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Assessment method [10]
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The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 48 was analyzed using the missing = failure method, where participants with missing data were considered as having failed to meet the criteria for evaluation.
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Timepoint [10]
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0
Week 48
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Secondary outcome [11]
0
0
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 96
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Assessment method [11]
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0
The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 96 was analyzed using the missing = failure method.
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Timepoint [11]
0
0
Week 96
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Secondary outcome [12]
0
0
Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Week 48
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Assessment method [12]
0
0
The percentage of participants with HIV-1 RNA \< 400 copies/mL at Week 48 was analyzed using the missing = failure method.
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Timepoint [12]
0
0
Week 48
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Secondary outcome [13]
0
0
Percentage of Participants With HIV-1 RNA < 400 Copies/mL at Week 96
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Assessment method [13]
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The percentage of participants with HIV-1 RNA \< 400 copies/mL at Week 96 was analyzed using the missing = failure method.
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Timepoint [13]
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Week 96
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Secondary outcome [14]
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Change From Baseline in HIV-1 RNA at Week 48
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Assessment method [14]
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The change from baseline in log10 HIV-1 RNA (copies/mL) at Week 48 was analyzed.
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Timepoint [14]
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Baseline to Week 48
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Secondary outcome [15]
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Change From Baseline in HIV-1 RNA at Week 96
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Assessment method [15]
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The change from baseline in log10 HIV-1 RNA (copies/mL) at Week 96 was analyzed.
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Timepoint [15]
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Baseline to Week 96
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Secondary outcome [16]
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Change From Baseline in CD4 Cell Count at Week 48
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Assessment method [16]
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The change from baseline in CD4 cell count (cells/mm\^3) at Week 48 was analyzed.
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Timepoint [16]
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Baseline to Week 48
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Secondary outcome [17]
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0
Change From Baseline in CD4 Cell Count at Week 96
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Assessment method [17]
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The change from baseline in CD4 cell count (cells/mm\^3) at Week 96 was analyzed.
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Timepoint [17]
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0
Baseline to Week 96
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Eligibility
Key inclusion criteria
* Plasma HIV-1 RNA levels = 1,000 copies/mL at screening
* Documented resistance or at least six months experience prior to screening with two or more different classes of antiretroviral agents
* Stable antiretroviral regimen for at least 30 days prior to screening: however, participants may discontinue the antiretroviral regimen after screening and remain off therapy until baseline at the discretion of the investigator
* Eligible to receive one of the fully-active ritonavir-boosted-PIs, and an allowed second agent
* Normal ECG
* Adequate renal function (estimated glomerular filtration rate according to the Cockcroft-Gault formula = 60 mL/min)
* Hepatic transaminases = 5 × upper limit of normal
* Total bilirubin = 1.5 mg/dL, or normal direct bilirubin
* Adequate hematologic function (absolute neutrophil count = 1,000/mm^3; platelets = 50,000/mm^3; hemoglobin = 8.5 g/dL)
* Serum amylase < 1.5 × the upper limit of the normal range
* Negative serum pregnancy test (females of childbearing potential only)
* Males and females of childbearing potential must agree to use highly effective contraception methods
* Age = 18 years
* Life expectancy = 1 year
* Ability to understand and sign a written informed consent form
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* New AIDS-defining condition diagnosed within the 30 days prior to screening
* Prior treatment with any HIV-1 integrase inhibitor
* Participants experiencing ascites
* Participants experiencing encephalopathy
* Females who are breastfeeding
* Positive serum pregnancy test at any time during the study (female of childbearing potential)
* Participants receiving ongoing therapy with any disallowed medication
* Current alcohol or substance use judged by the investigator to potentially interfere with study compliance
* Malignancy other than cutaneous Kaposi's sarcoma or basal cell carcinoma
* Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to baseline
* Participation in any other clinical trial (except for the etravirine or maraviroc expanded access program), without prior approval from sponsor
* Any other clinical condition or prior therapy that would make participants unsuitable for the study
* Known hypersensitivity to study drug, metabolites or formulation excipients
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/07/2008
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/04/2015
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Sample size
Target
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Accrual to date
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Final
724
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [2]
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Ground Zero Medical Centre - Darlinghurst
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Recruitment hospital [3]
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Holdsworth House Medical Practice - Darlinghurst
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Recruitment hospital [4]
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St. Vincent's Hospital, Sydney - Darlinghurst
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Recruitment hospital [5]
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St George Hospital - Kogarah
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Recruitment hospital [6]
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East Sidney Doctors - Sidney
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Recruitment hospital [7]
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Albion Street Centre - Sydney
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Recruitment hospital [8]
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Westmead Hospital - Wentworthville
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2010 - Darlinghurst
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Recruitment postcode(s) [3]
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2217 - Kogarah
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Recruitment postcode(s) [4]
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2010 - Sidney
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Recruitment postcode(s) [5]
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2010 - Sydney
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Recruitment postcode(s) [6]
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2145 - Wentworthville
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Arizona
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United States of America
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Arkansas
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United States of America
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California
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United States of America
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Connecticut
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United States of America
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State/province [5]
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District of Columbia
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United States of America
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Florida
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United States of America
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State/province [7]
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Georgia
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United States of America
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State/province [8]
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Hawaii
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United States of America
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Illinois
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United States of America
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Kentucky
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United States of America
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Maryland
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United States of America
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Massachusetts
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Michigan
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Missouri
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New Jersey
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New Mexico
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New York
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North Carolina
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Ohio
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Pennsylvania
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Virginia
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Washington
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Belgium
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Antwerp
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Belgium
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Brussels
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Belgium
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Charleroi
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Belgium
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Liege
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Canada
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British Columbia
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Canada
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Nova Scotia
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Canada
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Ontario
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Canada
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Quebec
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Canada
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Winnipeg
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France
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Le Kremlin Bicetre
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France
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Montpellier
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France
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Nantes
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France
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Nice
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France
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Paris
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France
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Pessac
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France
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Toulouse
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Germany
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Bonn
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Germany
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Dusseldorf
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Germany
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Essen
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Germany
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Frankfurt
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Germany
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Hamburg
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Germany
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Kiel
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Germany
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Koln
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Germany
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Munich
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Italy
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Bergamo
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Italy
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Brescia
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Italy
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Milan
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Italy
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Rome
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Mexico
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D.f.
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Mexico
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Guanajuato
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Mexico
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Jalisco
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Mexico
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San Luis Potsi
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Netherlands
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Rotterdam
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Portugal
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Amadora
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Portugal
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Lisbon
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Portugal
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Porto
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Puerto Rico
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Ponce
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Puerto Rico
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San Juan
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Spain
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Alicante
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Spain
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Barcelona
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Spain
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Cordoba
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Spain
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Elche
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Spain
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Granada
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0
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Spain
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Madrid
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Spain
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Malaga
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0
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Spain
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Santa Cruz de Tenerife
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Spain
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Sevilla
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Spain
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Vigo
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Switzerland
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Zurich
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0
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United Kingdom
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Edinburgh
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United Kingdom
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London
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United Kingdom
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State/province [75]
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Manchester
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Gilead Sciences
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to compare the safety, tolerability and efficacy of a regimen containing once-daily elvitegravir (EVG) versus twice-daily raltegravir (RAL) added to a background regimen (1 fully-active ritonavir (RTV)-boosted protease inhibitor (PI) plus 1 or 2 additional antiretroviral (ARV) agents) in HIV-1 infected, ARV treatment-experienced adults who have documented resistance, or at least six months experience prior to screening with two or more different classes of ARV agents. Participants will be randomized in a 1:1 ratio to receive EVG plus background regimen (Elvitegravir group), or raltegravir plus background regimen (Raltegravir group). Due to known drug interactions, participants in the Elvitegravir group receiving RTV-boosted atazanavir (ATV) or RTV-boosted lopinavir (LPV) as part of their background regimen will receive elvitegravir at a lower dose (85 mg).
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Trial website
https://clinicaltrials.gov/study/NCT00708162
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Trial related presentations / publications
Molina JM, Lamarca A, Andrade-Villanueva J, Clotet B, Clumeck N, Liu YP, Zhong L, Margot N, Cheng AK, Chuck SL; Study 145 Team. Efficacy and safety of once daily elvitegravir versus twice daily raltegravir in treatment-experienced patients with HIV-1 receiving a ritonavir-boosted protease inhibitor: randomised, double-blind, phase 3, non-inferiority study. Lancet Infect Dis. 2012 Jan;12(1):27-35. doi: 10.1016/S1473-3099(11)70249-3. Epub 2011 Oct 18.
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Public notes
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Contacts
Principal investigator
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Javier Szwarcberg, MD, MPH
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Gilead Sciences
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Results publications and other study-related documents
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Journal
Molina JM, Lamarca A, Andrade-Villanueva J, Clotet...
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Results are available at
https://clinicaltrials.gov/study/NCT00708162
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