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Emtricitabine/Tenofovir Alafenamide (F/TAF) in HIV-1 Infected Children and Adolescents Virologically Suppressed on a 2-NRTI-Containing Regimen

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02285114
Recruitment Status : Active, not recruiting
First Posted : November 6, 2014
Last Update Posted : June 11, 2020
Sponsor:
Information provided by (Responsible Party):
Gilead Sciences

Brief Summary:
This study will evaluate the pharmacokinetics (PK), safety, and efficacy of emtricitabine/tenofovir alafenamide (F/TAF) in HIV-1 infected children and adolescents virologically suppressed (defined as having < 50 copies/mL of HIV-1 RNA for a period of at least 6 months) while on a stable 2-nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) containing regimen.

Condition or disease Intervention/treatment Phase
HIV-1 Drug: F/TAF Drug: 3rd ARV agent Phase 2 Phase 3

Detailed Description:

Cohorts 2, 3, and 4 will be on a boosted protease inhibitor (PI) or any other 3rd ARV agent and will switch their current 2-NRTI-containing regimen to open-label F/TAF while continuing their boosted PI or 3rd agent through 48 weeks. A minimum of 10 participants each in Groups 1 and 2 of Cohort 2, and Cohorts 3 and 4, who are on boosted-ATV as their 3rd ARV agent will be enrolled. Participants in Cohort 2, Group 1 receive boosted PI agents only. Cohorts 2, 3, and 4 will be enrolled by cohort into a two-part study (Parts A and B).

After completion of 48 weeks, all participants will be given the option to participate in an extension phase of the study. Gilead will provide F/TAF until a) The participant turns 18 years old and F/TAF is commercially available for use in adults in the country in which the participant is enrolled or b), F/TAF becomes commercially available for pediatric use in the country in which the participant is enrolled or c), Gilead Sciences elects to terminate development of F/TAF in the applicable country.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 41 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 2/3, Open-Label, Multi-Cohort Switch Study to Evaluate Emtricitabine/Tenofovir Alafenamide (F/TAF) in HIV-1 Infected Children and Adolescents Virologically Suppressed on a 2-NRTI-Containing Regimen
Actual Study Start Date : January 20, 2015
Actual Primary Completion Date : November 4, 2019
Estimated Study Completion Date : June 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: HIV/AIDS

Arm Intervention/treatment
Experimental: F/TAF+3rd ARV agent (Cohort 1)
Participants between 12 to < 18 years of age will switch their current 2-NRTI containing regimen to F/TAF while continuing on their 3rd ARV agent for 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: F/TAF+3rd ARV agent (Cohort 2, Group 1, Part A)
Participants between 6 to < 12 years of age must be on a boosted protease inhibitor (PI) as their 3rd ARV agent and will switch their current 2-NRTI regimen to F/TAF while continuing on their boosted PI for 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: F/TAF+3rd ARV agent (Cohort 2, Group 2, Part A)
Participants between 2 to < 12 years of age must be on a boosted protease inhibitor (PI) or other protocol specified 3rd ARV agent and will switch their current 2-NRTI containing regimen to F/TAF while continuing their 3rd ARV agent for 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: FTC/TAF+3rd ARV agent (Cohort 3, Part A)
Participants between 2 to < 6 years of age will receive F/TAF plus a 3rd ARV agent through 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: FTC/TAF+3rd ARV agent (Cohort 4, Part A)
Participants between 1 month to < 2 years of age will receive F/TAF plus a 3rd ARV agent through 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: F/TAF+3rd ARV agent (Cohort 2, Group 1, Part B)
Screening will be initiated for Part B following confirmation of TAF dose in Part A. Approximately 10 additional total participants will be enrolled across all Part B cohorts and will receive F/TAF while continuing their 3rd ARV agent through 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: F/TAF+3rd ARV agent (Cohort 2, Group 2, Part B)
Screening will be initiated for Part B following confirmation of TAF dose in Part A. Approximately 10 additional total participants will be enrolled across all Part B cohorts and will receive F/TAF while continuing their 3rd ARV agent through 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: FTC/TAF+3rd ARV agent (Cohort 3, Part B)
Screening will be initiated for Part B following confirmation of TAF dose in Part A. Approximately 10 additional total participants will be enrolled across all Part B cohorts and will receive F/TAF while continuing their 3rd ARV agent through 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).

Experimental: FTC/TAF+3rd ARV agent (Cohort 4, Part B)
Screening will be initiated for Part B following confirmation of TAF dose in Part A. Approximately 10 additional total participants will be enrolled across all Part B cohorts and will receive F/TAF while continuing their 3rd ARV agent through 48 weeks.
Drug: F/TAF
F/TAF tablets administered orally once daily
Other Name: Descovy®

Drug: 3rd ARV agent
A 3rd antiretroviral (ARV) agent of the participant's pre-existing regimen may include one of the following: boosted atazanavir (ATV), boosted lopinavir (LPV), boosted darunavir (DRV), efavirenz (EFV), nevirapine (NVP), raltegravir (RAL), or dolutegravir (DTG). Cohort 2, Group 1 will receive only boosted PIs (ATV, LPV or DRV).




Primary Outcome Measures :
  1. PK parameter of tenofovir alafenamide (TAF) as measured by AUClast [ Time Frame: Predose and postdose on Week 2 ]
  2. Incidence of treatment-emergent serious adverse events (SAEs) and all treatment-emergent adverse events (AEs) [ Time Frame: Up to 48 weeks plus 30 days ]
    Incidence of SAEs and AEs will be summarized.


Secondary Outcome Measures :
  1. PK profiles of TAF, emtricitabine (FTC), and tenofovir (TFV) [ Time Frame: Predose and postdose on Weeks 4 and 12 ]

    This endpoint will measure the plasma PK profiles of TAF, FTC, and TFV. The following parameters will be measured, as applicable:

    • TAF: Cmax, Clast, Cl/F, and Vz /F
    • FTC and TFV: TAF, AUCtau, Cmax, and Ctau

  2. Percentage of participants with HIV 1 RNA < 50 copies/mL as defined by the FDA snapshot algorithm [ Time Frame: Week 24; Week 48 ]
  3. Change from baseline in CD4+ cell count (cells/μL) and CD4+ percentage [ Time Frame: Week 24; Week 48 ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   1 Month to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • HIV-1 infected male and female adolescents and children aged 1 month to < 18 years at baseline/Day 1 (according to requirements of the enrolling cohort)
  • Must be able to give written assent prior to any screening evaluations
  • Parent or guardian able to give written informed consent prior to any screening evaluations and willing to comply with study requirements
  • Body weight at screening as follows:

    • Cohort 1: ≥ 35 kg
    • Cohort 2, Group 1: ≥ 25 kg
    • Cohort 2, Group 2: 17 kg to < 25 kg
    • Cohort 3: to be updated per a protocol amendment
    • Cohort 4: to be updated per a protocol amendment
  • Currently on a stable 2-NRTI containing regimen that includes a 3rd ARV agent for ≥ 6 consecutive months prior to screening
  • Plasma HIV-1 RNA levels < 50 copies/mL for ≥ 6 consecutive months preceding the screening visit
  • No opportunistic infection within 30 days of study entry (at baseline/Day 1)
  • A negative serum β-human chorionic gonadotropin (HCG) pregnancy test is required for females of childbearing potential only

Key Exclusion Criteria:

  • An acquired immunodeficiency syndrome (AIDS) - indicator condition with onset within 30 days prior to screening
  • Life expectancy of < 2 years
  • Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to baseline/Day 1
  • Evidence of active pulmonary or extra-pulmonary tuberculosis disease within 3 months of the screening visit
  • Active hepatitis C virus (HCV) infection defined as positive for HCV antibody and having detectable HCV RNA
  • Positive hepatitis B surface antigen or other evidence of active hepatitis B virus (HBV) infection.
  • Have any serious or active medical or psychiatric illness which, in the opinion of the Investigator, would interfere with treatment, assessment, or compliance with the protocol.
  • Pregnant or lactating females
  • Have history of significant drug sensitivity or drug allergy
  • Have previously participated in an investigational trial involving administration of any investigational agent, other than tenofovir, within 30 days prior to the study dosing

NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02285114


Locations
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United States, California
University of California Los Angeles
Los Angeles, California, United States, 90095
United States, Colorado
Children's Hospital Colorado
Aurora, Colorado, United States, 80045
United States, Pennsylvania
St. Christopher's Hospital for Children
Philadelphia, Pennsylvania, United States, 19134
United States, Washington
Seattle Children's Hospital
Seattle, Washington, United States, 98105-0371
Panama
Hospital del Nino
Panama City, Panama, 0816-00383
South Africa
Rahima Moosa Mother and Child Hospital
Johannesburg, Gauteng, South Africa, 2112
KIDCRU, Ward J8, Tygerberg Children's Hospital
Cape Town, South Africa, 7505
Be Part Yoluntu Centre
Cape Town, South Africa, 7646
Sponsors and Collaborators
Gilead Sciences
Investigators
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Study Director: Gilead Study Director Gilead Sciences
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Responsible Party: Gilead Sciences
ClinicalTrials.gov Identifier: NCT02285114    
Other Study ID Numbers: GS-US-311-1269
2015-001339-19 ( EudraCT Number )
First Posted: November 6, 2014    Key Record Dates
Last Update Posted: June 11, 2020
Last Verified: June 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Gilead Sciences:
HIV
emtricitabine
FTC
tenofovir
TDF
TAF
antiretroviral
pharmacokinetic
PK
adolescents
children
pediatric
Gilead