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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02500446
Registration number
NCT02500446
Ethics application status
Date submitted
30/06/2015
Date registered
16/07/2015
Titles & IDs
Public title
Dolutegravir Impact on Residual Replication
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Scientific title
Dolutegravir Impact on Residual Replication: Dolutegravir Intensification Study
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Secondary ID [1]
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DIORR_20150306
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Universal Trial Number (UTN)
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Trial acronym
DIORR
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
HIV
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - dolutegravir
Other interventions - Placebo
Active comparator: Intensification - Oral dolutegravir 50 mg once daily for 8 weeks added to their current ART regimen.
Placebo comparator: Placebo - Oral placebo once daily for 8 weeks added to their current ART regimen.
Treatment: Drugs: dolutegravir
Each film-coated tablet contains dolutegravir sodium equivalent to 50 mg dolutegravir.
Other interventions: Placebo
A film-coated tablet identical in appearance to the active drug tablet but not containing any dolutegravir or any other active ingredient
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Other interventions
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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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Level of residual HIV replication in circulating CD4+ T cells
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Assessment method [1]
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Change in the level of 2-LTR circles as measured by polymerase chain reaction (PCR) in the dolutegravir arm versus the placebo arm after 7 days of treatment
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Timepoint [1]
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day 7 of treatment
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Secondary outcome [1]
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Level of Human Leukocyte Antigen D-related (HLA-DR)
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Assessment method [1]
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Change in level of Human Leukocyte Antigen D-related (HLA-DR), a marker of T cell activation from baseline within and across study arms.
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Timepoint [1]
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time points to day 84 (28 days after treatment)
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Secondary outcome [2]
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Level of Programmed cell death-1 receptor (PD-1)
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Assessment method [2]
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Change in level of Programmed cell death-1 receptor (PD-1), a marker of T cell activation from baseline within and across study arms.
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Timepoint [2]
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time points to day 84 (28 days after treatment)
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Secondary outcome [3]
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Level of Cluster of Differentiation 38 (CD-38)
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Assessment method [3]
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Change in level of Cluster of Differentiation 38 (CD-38), a marker of T cell activation, from baseline within and across study arms.
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Timepoint [3]
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time points to day 84 (28 days after treatment)
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Secondary outcome [4]
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Level of residual HIV replication in circulating CD4+ T cells in a protease inhibitor -containing regimen
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Assessment method [4]
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Change in the level of 2-LTR circles as measured by polymerase chain reaction (PCR) in the dolutegravir arm versus the placebo arm in those participants on regimen which includes a protease inhibitor
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Timepoint [4]
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time points up to day 84 (28 days after treatment)
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Eligibility
Key inclusion criteria
* Documented HIV-1 infection
* Minimum age 18 years
* Receiving combination ART (at least 3 agents) for at least 3 years. Twenty of the 40 study participants will be on a PI-based ART regimen.
* HIV-1 plasma RNA <50 copies/mL for >3 years and <20 copies/mL at screening.
* Two CD4+ T cell counts >350 cells/µL in the 24 months prior to screening
* Able to give informed consent
* A female, may be eligible to enter and participate in the study if she:
* Is of non-child-bearing potential OR
* Is of child-bearing potential with a negative pregnancy test at both Screening and Day 1 and agrees to use one of the study protocol-specified methods of contraception to avoid pregnancy:
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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
* Known hypersensitivity to DTG or to any of the excipients
* Current use of dofetilide, pilsicainide or metformin
* Current use of etravirine except when etravirine is co-administered with atazanavir/ritonavir, lopinavir/ritonavir or darunavir/ritonavir
* Current or prior use of any integrase inhibitor
* Previous use of histone deacetylase inhibitors or other latency reversing agents
* Any significant acute medical illness requiring hospitalization within preceding 8 weeks
* Significant renal disease (eGFR <50 milliliters per min)
* Hepatitis C co-infection (Individuals with prior hepatitis C infection that is now cleared are eligible for enrolment)
* Subjects with severe hepatic impairment (Class C) as determined by Child-Pugh classification
* Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones)
* Receipt of immunomodulating agents (excluding immunization) or systemic chemotherapeutic agents within 28 days prior to study entry
* Patients who intend to modify their ART regimen within the study period
* Current or recent gastrointestinal disease or surgery that may impact the absorption of the investigational drug
* Active alcohol or substance use that in the opinion of the investigator will prevent adequate compliance with study procedures
* Currently pregnant, breastfeeding or unwilling to use barrier contraception
* Women of Child Bearing Potential (WOCBP) unwilling or unable to use an acceptable method of contraception to avoid pregnancy as specified in the inclusion criteria
* Unable or unwilling to adhere to protocol procedures
* The following laboratory values within 3 weeks before starting the investigational drug (lab tests may be repeated to obtain acceptable values before failure at screening is concluded)
* Hepatic transaminases (AST or ALT) =3 x upper limit of normal (ULN)
* Serum total bilirubin =1.5 x ULN
* eGFR <50 mL/min
* Haemoglobin <11.0 g/dL
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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 assessing the outcomes
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 4
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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
28/09/2015
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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
30/09/2017
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Sample size
Target
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Melbourne Sexual Health Centre - Carlton
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Recruitment hospital [2]
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Alfred Hospital - Prahran
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Recruitment postcode(s) [1]
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3053 - Carlton
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Recruitment postcode(s) [2]
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3010 - Prahran
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Funding & Sponsors
Primary sponsor type
Other
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Name
University of Melbourne
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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The Alfred
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Address [1]
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Country [1]
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Other collaborator category [2]
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Commercial sector/industry
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Name [2]
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ViiV Healthcare
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
Several studies have suggested that despite suppressive combination antiretroviral therapy (ART) in people who are HIV-positive, in some individuals there may be on-going viral replication. Clarifying the extent of on-going viral replication on ART is important for the development of HIV-1 curative strategies and for reducing HIV-1 associated immune activation. The investigators hypothesize that treatment intensification with dolutegravir will inhibit residual virus replication in HIV-1 infected patients on ART. The primary objective of this study is to determine the effects of dolutegravir intensification on residual virus replication in circulating cluster of differentiation 4 (CD4+) T cells.
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Trial website
https://clinicaltrials.gov/study/NCT02500446
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Trial related presentations / publications
Rasmussen TA, McMahon JH, Chang JJ, Audsley J, Rhodes A, Tennakoon S, Dantanarayana A, Spelman T, Schmidt T, Kent SJ, Morcilla V, Palmer S, Elliott JH, Lewin SR. The effect of antiretroviral intensification with dolutegravir on residual virus replication in HIV-infected individuals: a randomised, placebo-controlled, double-blind trial. Lancet HIV. 2018 May;5(5):e221-e230. doi: 10.1016/S2352-3018(18)30040-7. Epub 2018 Apr 8.
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Public notes
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Contacts
Principal investigator
Name
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Sharon Lewin
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Address
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Doherty Institute for Immunity and Infection
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No plan to share individual participant data
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT02500446