Study Assessing Dolutegravir in HIV-1 Infected Subjects With Virus Resistant to Raltegravir and/or Elivitegravir (VIKING-4)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
Shionogi
GlaxoSmithKline
Information provided by (Responsible Party):
ViiV Healthcare
ClinicalTrials.gov Identifier:
NCT01568892
First received: March 29, 2012
Last updated: May 9, 2013
Last verified: April 2013
  Purpose

Study ING116529 is a multicenter, randomized, study with an initial 7 day placebo- controlled, functional monotherapy phase to quantify the antiviral activity attributable to dolutegravir (DTG) in HIV-1 infected, ART-experienced adults who are experiencing virological failure on an Integrase inhibitor containing regimen (current RAL or ELV failures), with evidence of genotypic resistance to RAL or ELV at study entry. Thirty subjects will be randomized (1:1) to receive either DTG 50mg BID (Arm A) or Placebo (Arm B) with the current failing regimen for 7 days (RAL or ELV should be discontinued prior to dosing with DTG). At Day 8, subjects from both arms will enter an open label phase and receive open label DTG 50mg BID with an optimized background regimen containing at least one fully active drug.


Condition Intervention Phase
Infection, Human Immunodeficiency Virus
Drug: dolutegravir 50 mg twice daily
Drug: dolutegravir placebo twice daily
Drug: Open-label dolutegravir 50mg twice daily
Phase 3

Access to an investigational treatment associated with this study is available outside the clinical trial.   More info ...

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase III Randomized, Double-blind Trial Investigating the Activity of Dolutegravir 50 mg BID vs Placebo Over 7 Days in HIV-1-infected Subjects With RAL/ELV Resistance, Followed by an Open-label Phase With an Optimized Background Regimen

Resource links provided by NLM:


Further study details as provided by ViiV Healthcare:

Primary Outcome Measures:
  • Mean change from baseline in plasma HIV-1 RNA (log10 copies/mL) at Day 8 [ Time Frame: Day 8 ] [ Designated as safety issue: No ]
    Mean change from baseline in plasma HIV-1 RNA (log10 copies/mL) at Day 8 analysis will use a last observation carried forward with discontinuation equals baseline (LOCFDB) dataset.


Secondary Outcome Measures:
  • Proportion of subjects with HIV-1 RNA <50c/mL and <400c/mL [ Time Frame: Week 24, 48 and beyond ] [ Designated as safety issue: No ]
    To assess the antiviral activity of DTG over time when administered with optimized background regimen (OBR) consisting of at least one fully active agent from Day 8

  • Absolute value and change from baseline in CD4+ and CD8+ cell counts [ Time Frame: Week 24, 48 and beyond ] [ Designated as safety issue: No ]
  • Incidence of HIV-1 disease progression [ Time Frame: Week 24, 48 and beyond ] [ Designated as safety issue: No ]
  • Number of subjects with clinical and laboratory adverse events and severity of such events overtime [ Time Frame: Week 24, 48 and beyond ] [ Designated as safety issue: No ]
  • Pharmacokinetic parameters of DTG as measured by Area Under the Curve, maximum and minimum concentrations of DTG [ Time Frame: Day 8, Day 28 and Week 24 ] [ Designated as safety issue: No ]
  • Incidence of treatment emergent viral resistance to DTG, raltegravir and other on study ARTs in subjects experiencing virologic failure [ Time Frame: throughout the study at time of virologic failure ] [ Designated as safety issue: No ]

Enrollment: 30
Study Start Date: April 2012
Estimated Study Completion Date: June 2015
Primary Completion Date: October 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: dolutegravir 50mg twice daily
Active dolutegravir plus failing background regimen (Day 1 to Day 7)
Drug: dolutegravir 50 mg twice daily
Active dolutegravir plus failing background regimen (Day 1 to Day 7)
Other Name: GSK1349572
Experimental: dolutegravir placebo twice daily
Dolutegravir placebo plus failing background regimen (Day 1 to Day 7)
Drug: dolutegravir placebo twice daily
Dolutegravir placebo plus failing background regimen (Day 1 to Day 7)
Other Name: GSK1349572 Placebo
Experimental: Open-label dolutegravir 50mg twice daily
Open label dolutegravir plus optimized background regimen (From Day 8)
Drug: Open-label dolutegravir 50mg twice daily
Open label dolutegravir plus optimized background regimen (from Day 8)
Other Name: GSK1349572

Detailed Description:

Study ING116529 is a multicenter, randomized, study with an initial 7 day placebo-controlled, functional monotherapy phase to assess the antiviral activity and safety of a dolutegravir (DTG, GSK1349572) containing regimen in HIV-1 infected, ART-experienced adults with virological failure on an integrase inhibitor (INI) containing regimen.

Subjects must have evidence of genotypic resistance to raltegravir [RAL] or elvitegravir [ELV] at Screening and documented current or historical genotypic or phenotypic resistance to at least two other antiretroviral therapy drug classes.

The study is designed to provide an accurate measure of the intrinsic antiviral activity of DTG 50mg twice daily versus placebo both administered with the current failing regimen in a randomised double-blind phase to Day 8. This will be followed by an open label phase with all subjects receiving DTG 50mg twice daily with an optimized background regimen (containing at least one fully active drug) until subjects no longer derive clinical benefit or until DTG is locally available. Thirty subjects will be randomized (1:1) to receive either DTG 50mg BID (Arm A) or Placebo (Arm B) with the current failing regimen for 7 days (RAL or ELV should be discontinued prior to dosing at Day 1). At Day 8, subjects from both arms will enter an open label phase and receive open label DTG 50mg BID with an optimized background regimen containing at least one fully active drug The primary analysis will be conducted after the last subject enrolled has completed the randomised, double-blind phase at Day 8. Additional analyses may be performed prior to study closure when all ongoing subjects transition to locally available commercial DTG.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Screening plasma HIV-1 RNA ≥1000 copies/mL
  • ART-experienced, INI-experienced, DTG naïve
  • Current virological failure on raltegravir (RAL) or elvitegravir (ELV) regimen
  • The subject's HIV-1 shows genotypic resistance to RAL or ELV at Screening
  • Subject has been on stable ART for at least one month prior to Screening and through Day 1(with exceptions for ETV, EFV and NVP that can be interrupted within 14 days of Day 1, see Exclusion Criterion)
  • Documented resistance to at least one drug from each of two or more of any approved classes of ART other than integrase inhibitors
  • Be able to receive at least one fully active drug as part of the OBR from Day 8
  • Women capable of becoming pregnant must use appropriate contraception during the study (as defined by the protocol)
  • Willing and able to understand and provide signed and dated written informed consent prior to Screening.

Exclusion Criteria:

  • Women who are pregnant or breast feeding
  • An active AIDS-defining condition at Screening (except cutaneous Kaposi's sarcoma not requiring systemic therapy or CD4+ <200c/mm3)
  • Moderate to severe hepatic impairment as defined by Child-Pugh classification
  • Anticipated need for HCV therapy during the first 24 weeks of the study
  • Recent history (less than or equal to 3 months) of any upper or lower gastrointestinal bleed, with the exception of anal or rectal bleeding
  • Allergy or intolerance to the study drugs or their components or drugs of their class
  • Malignancy within the past 6 months
  • Treatment with an HIV-1 therapeutic vaccine within 90 days of Screening
  • Treatment with radiation therapy, cytotoxic chemotherapeutic agents or any immunomodulator within 28 days of Screening
  • Treatment with any agent, other than licensed ART, with documented in vitro/vivo activity against HIV-1 within 28 days of first dose of investigational product (with the exception of entecavir if required for Hep B treatment)
  • Treatment with etravirine, efavirenz, or nevirapine within 14 days of Day 1(etravirine may be used if coadministered with lopinavir/ritonavir or darunavir/ritonavir)
  • Treatment with tipranivir/ritonavir, fosamprenavir, or fosamprenavir/ritonavir within 28 days prior to Screening
  • Exposure to an experimental drug or vaccine within either 28 days, 5 half-lives of the test agent, or twice the duration of the biological effect of the test agent, which ever is longer, prior to the first dose of IP.
  • Any acute or verified Grade 4 laboratory abnormality (with the exception of Grade 4 lipids) at Screening
  • ALT> 5 times the upper limit of normal (ULN) at Screening
  • ALT ≥ 3X ULN and bilirubin > 1.5 X ULN (with 35% direct bilirubin) at Screening
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01568892

Locations
United States, California
GSK Investigational Site
Bakersfield, California, United States, 93301
GSK Investigational Site
Beverly Hills, California, United States, 90211
GSK Investigational Site
Los Angeles, California, United States, 90069
United States, Connecticut
GSK Investigational Site
Norwalk, Connecticut, United States, 06850
United States, District of Columbia
GSK Investigational Site
Washington, District of Columbia, United States, 20007
GSK Investigational Site
Washington, District of Columbia, United States, 20009
United States, Florida
GSK Investigational Site
Fort Lauderdale, Florida, United States, 33316
GSK Investigational Site
Fort Pierce, Florida, United States, 34982
GSK Investigational Site
Orlando, Florida, United States, 32803
United States, Georgia
GSK Investigational Site
Savannah, Georgia, United States, 31401
United States, Massachusetts
GSK Investigational Site
Boston, Massachusetts, United States, 02115
United States, New York
GSK Investigational Site
Bronx, New York, United States, 10467
GSK Investigational Site
Buffalo, New York, United States, 14215
GSK Investigational Site
New York, New York, United States, 10011
United States, North Carolina
GSK Investigational Site
Durham, North Carolina, United States, 27710
United States, Pennsylvania
GSK Investigational Site
Philadelphia, Pennsylvania, United States, 19140
United States, Texas
GSK Investigational Site
Dallas, Texas, United States, 75246
United States, Virginia
GSK Investigational Site
Annandale, Virginia, United States, 22003
Sponsors and Collaborators
ViiV Healthcare
Shionogi
GlaxoSmithKline
Investigators
Study Director: GSK Clinical Trials ViiV Healthcare
  More Information

No publications provided

Responsible Party: ViiV Healthcare
ClinicalTrials.gov Identifier: NCT01568892     History of Changes
Other Study ID Numbers: 116529
Study First Received: March 29, 2012
Last Updated: May 9, 2013
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by ViiV Healthcare:
ART-experienced
GSK1349572
Integrase inhibitor resistance
Dolutegravir

Additional relevant MeSH terms:
Acquired Immunodeficiency Syndrome
HIV Infections
Immunologic Deficiency Syndromes
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Slow Virus Diseases
Immune System Diseases

ClinicalTrials.gov processed this record on May 19, 2013