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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01818596
Registration number
NCT01818596
Ethics application status
Date submitted
22/03/2013
Date registered
26/03/2013
Titles & IDs
Public title
Open-label Safety Study of E/C/F/TAF (Genvoya®) in HIV-1 Positive Patients With Mild to Moderate Renal Impairment
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Scientific title
A Phase 3 Open-label Safety Study of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Single-Tablet Regimen in HIV-1 Positive Patients With Mild to Moderate Renal Impairment
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Secondary ID [1]
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2013-000516-25
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Secondary ID [2]
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GS-US-292-0112
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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
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HIV Infections
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Condition category
Condition code
Infection
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Acquired immune deficiency syndrome (AIDS / HIV)
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Renal and Urogenital
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - E/C/F/TAF
Experimental: E/C/F/TAF - Participants will receive E/C/F/TAF for 144 weeks. Following Week 144, in countries where E/C/F/TAF is not available (except for the United Kingdom), participants will be given the option to continue in the study and receive E/C/F/TAF for another 48 weeks, or until the product becomes available through an access program, or until Gilead Sciences elects to discontinue the study in that country, whichever comes first.
Treatment: Drugs: E/C/F/TAF
E/C/F/TAF (150/150/200/10 mg) FDC tablet administered orally once daily with food
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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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Change From Baseline in the Estimated Glomerular Filtration Rate Calculated by the Cockcroft-Gault Formula (eGFR_CG) at Week 24
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Assessment method [1]
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eGFR is a measurement of the kidney's ability to filter blood.
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Timepoint [1]
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Baseline; Week 24
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Primary outcome [2]
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Change From Baseline in eGFR Calculated by the Chronic Kidney Disease Epidemiology Collaboration Method Based on Cystatin C (eGFR_CKD-EPI,cysC) at Week 24
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Assessment method [2]
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eGFR is a measurement of the kidney's ability to filter blood. The eGFR_CKD-EPI,cysC method is adjusted for age and sex.
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Timepoint [2]
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Baseline; Week 24
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Primary outcome [3]
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Change From Baseline in eGFR Calculated by the CKD-EPI Method Based on Serum Creatinine (eGFR_CKD-EPI,Creatinine) at Week 24
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Assessment method [3]
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eGFR is a measurement of the kidney's ability to filter blood. The eGFR_CKD-EPI,creatinine method is adjusted for age, race, and sex.
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Timepoint [3]
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Baseline; Week 24
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Secondary outcome [1]
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Change From Baseline in Actual GFR (aGFR) of E/C/F/TAF for Participants Enrolled in the PK/PD Substudy
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Assessment method [1]
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aGFR was directly measured using iohexol plasma clearance (CLiohexol).
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Timepoint [1]
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Baseline; Week 2, 4, or 8; Week 24
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Secondary outcome [2]
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Percent Change From Baseline in C-type Collagen Sequence (CTX) at Weeks 24 and 48
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Assessment method [2]
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CTX is a biomarker of bone turnover.
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Timepoint [2]
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Baseline; Weeks 24 and 48
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Secondary outcome [3]
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Percent Change From Baseline in Procollagen Type 1 N-terminal Propeptide (P1NP) at Weeks 24 and 48
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Assessment method [3]
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P1NP is a biomarker of bone turnover.
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Timepoint [3]
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Baseline; Weeks 24 and 48
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Secondary outcome [4]
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Percent Change From Baseline in Retinol Binding Protein (RBP) to Creatinine Ratio (µg/g) at Weeks 24, 48, 96, and 144
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Assessment method [4]
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Urine RBP is a renal biomarker which is used to evaluate drug-induced kidney injury.
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Timepoint [4]
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Baseline; Weeks 24, 48, 96, and 144
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Secondary outcome [5]
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Percent Change From Baseline in Urine Beta-2-microglobulin to Creatinine Ratio (µg/g) at Weeks 24, 48, 96, and 144
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Assessment method [5]
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Urine beta-2-microglobulin is a renal biomarker which is used to evaluate drug-induced kidney injury.
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Timepoint [5]
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Baseline; Weeks 24, 48, 96, and 144
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Secondary outcome [6]
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Percentage of Participants Experiencing Adverse Events or Graded Laboratory Abnormalities
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Assessment method [6]
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Adverse events (AEs) and graded laboratory abnormalities occurring during the E/C/F/TAF treatment period were summarized across the participant population. A participant was counted once if they had a qualifying event.
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Timepoint [6]
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Baseline up to Week 240 plus 30 days
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Secondary outcome [7]
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Percentage of Participants Achieving HIV-1 RNA < 50 Copies/mL at Weeks 24, 48, 96, and 144
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Assessment method [7]
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The percentage of participants achieving HIV-1 RNA \< 50 Copies/mL at Weeks 24, 48, 96, and 144 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.
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Timepoint [7]
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Weeks 24, 48, 96, and 144
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Secondary outcome [8]
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Pharmacokinetic (PK) Parameter: Cmax of TAF
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Assessment method [8]
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Cmax is defined as the maximum concentration of drug. Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [8]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [9]
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PK Parameter: Tmax of TAF
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Assessment method [9]
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Tmax is defined as the time of Cmax. Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [9]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [10]
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PK Parameter: Clast of TAF
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Assessment method [10]
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Clast is defined as the last observable concentration of drug. Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [10]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [11]
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PK Parameter: Tlast of TAF
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Assessment method [11]
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Tlast is defined as the time of Clast. Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [11]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [12]
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PK Parameter: ?z of TAF
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Assessment method [12]
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?z is defined as the terminal elimination rate constant. Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [12]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [13]
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PK Parameter: AUCtau of TAF
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Assessment method [13]
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AUCtau is defined as the concentration of drug over time (area under the plasma concentration versus time curve over the dosing interval). Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [13]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [14]
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PK Parameter: t1/2 of TAF
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Assessment method [14]
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t1/2 is defined as the estimate of the terminal elimination half-life of the drug. Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [14]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [15]
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PK Parameter: AUCtau of Tenofovir Diphosphate (TFV-DP) in Peripheral Blood Mononuclear Cell (PBMC) for Participants Enrolled in PK/PD Sub-study
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Assessment method [15]
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TFV-DP is an active phosphorylated metabolite of tenofovir alafenamide. AUCtau is defined as the concentration of drug over time (area under the plasma concentration versus time curve over the dosing interval). Blood draws for this outcome may have been at the Week 2, 4, or 8 visit.
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Timepoint [15]
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Predose, and 5 minutes, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 8, and 24 hours postdose
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Secondary outcome [16]
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Change From Baseline in the eGFR_CG at Weeks 48, 96, and 144
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Assessment method [16]
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eGFR is a measurement of the kidney's ability to filter blood.
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Timepoint [16]
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Baseline; Weeks 48, 96, and 144
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Secondary outcome [17]
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Change From Baseline in eGFR_CKD-EPI,cysC at Weeks 48, 96, and 144
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Assessment method [17]
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eGFR is a measurement of the kidney's ability to filter blood. The eGFR_CKD-EPI,cysC method is adjusted for age and sex.
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Timepoint [17]
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Baseline; Weeks 48, 96, and 144
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Secondary outcome [18]
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Change From Baseline in eGFR_CKD-EPI,Creatinine at Weeks 48, 96, and 144
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Assessment method [18]
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eGFR is a measurement of the kidney's ability to filter blood. The eGFR_CKD-EPI,creatinine method is adjusted for age, race, and sex.
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Timepoint [18]
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Baseline; Weeks 48, 96, and 144
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Eligibility
Key inclusion criteria
Key
Cohort 1 (treatment-experienced switch)
* Must not have a history of known resistance to elvitegravir (EVG), tenofovir disoproxil fumarate (TDF), or emtricitabine (FTC)
* Plasma HIV-1 RNA concentrations (at least two measurements) at undetectable levels (according to the local assay being used) in the 6 months preceding the screening visit and have HIV-1 RNA < 50 copies/mL at screening
* Estimated glomerular filtration rate (GFR) 30-69 mL/min according to the Cockcroft-Gault formula for creatinine clearance, using actual weight
* May be currently enrolled in Gilead studies GS-US-236-0102, GS-US-236-0103, and GS-US-216-0114, but will be eligible to enroll only after the Week 144 visit for that study is complete; or currently receiving Stribild® (STB) or atazanavir (ATV)/cobicistat (COBI) + Truvada (TVD) in Gilead studies GS-US-236-0104 or GS-US-216-0105, but will be eligible to enroll only after the Week 48 visit for that study is complete.
Cohort 2 (treatment-naive)
* Plasma HIV-1 RNA levels = 1,000 copies/mL at screening
* Screening genotype report provided by Gilead Sciences must show sensitivity to EVG, FTC, and TDF
* No prior use of any approved or investigational antiretroviral drug for any length of time, except the use for pre-exposure prophylaxis (PrEP), or post-exposure prophylaxis (PEP), up to 6 months prior to screening
* Estimated GFR 30-69 mL/min according to the Cockcroft Gault formula for creatinine clearance, using actual weight
All Cohorts:
All individuals must meet all of the following inclusion criteria to be eligible for participation in this study:
* The ability to understand and sign a written informed consent form, which must be obtained prior to initiation of study procedures
* CD4+ count of = 50 cells/µL
* Stable renal function: serum creatinine measurements to be taken at least once (within three months of screening)
* Cause of underlying chronic kidney disease (eg hypertension, diabetes) stable, without change in medical management, for 3 months prior to baseline
* Normal electrocardiogram (ECG)
* Hepatic transaminases (AST and ALT) = 5 x upper limit of normal (ULN)
* Total bilirubin = 1.5 mg/dL, or normal direct bilirubin
* Adequate hematologic function
* Serum amylase = 5 x ULN
* Females of childbearing potential must agree to utilize highly effective contraception methods (two separate forms of contraception, one of which must be an effective barrier method, or be non-heterosexually active, practice sexual abstinence) from screening throughout the duration of study treatment and for 30 days following the last dose of study drug
* Females who utilize hormonal contraceptive as one of their birth control methods must have used the same method for at least three months prior to study dosing
* Males must agree to utilize a highly effective method of contraception during heterosexual intercourse throughout the study period and for 30 days following discontinuation of investigational medicinal product. A highly effective method of contraception is defined as two separate forms of contraception, one of which must be an effective barrier method, or males must be non-heterosexually active, or practice sexual abstinence
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Minimum age
18
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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
* A new AIDS-defining condition (excluding CD4 cell count and percentage criteria) diagnosed within the 30 days prior to screening,with the exception of the first two bullet points
* Hepatitis C virus (HCV) antibody positive. Individuals who are HCV positive, but have a documented negative HCV RNA, are eligible
* Hepatitis B surface antigen (HBVsAg) positive
* Individuals receiving drug treatment for Hepatitis C, or individuals who are anticipated to receive treatment for Hepatitis C during the course of the study
* Individuals experiencing decompensated cirrhosis (eg, ascites, encephalopathy, etc.)
* Females who are breastfeeding
* Positive serum pregnancy test
* Have an implanted defibrillator or pacemaker
* Current alcohol or substance use judged by the Investigator to potentially interfere with study compliance
* A history of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous carcinoma
* Active, serious infections (other than HIV-1 infection) requiring parenteral antibiotic or antifungal therapy within 30 days prior to baseline
* Individuals on hemodialysis, other forms of renal replacement therapy, or on treatment for underlying kidney diseases (including prednisolone and dexamethasone)
* Individuals receiving ongoing therapy with any medications not to be used with EVG, COBI, FTC, or TAF or individuals with any known allergies to the excipients of E/C/F/TAF
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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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
27/03/2013
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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
18/07/2018
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Sample size
Target
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Accrual to date
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Final
252
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Holdsworth House Medical Practice - Darlinghurst
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Recruitment hospital [2]
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Clinical Research Infectious Diseases Department- Alfred Hospital - Melbourne
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Recruitment hospital [3]
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Prahran Market Clinic - Prahran
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Recruitment postcode(s) [1]
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2010 - Darlinghurst
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Recruitment postcode(s) [2]
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3004 - Melbourne
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Recruitment postcode(s) [3]
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3181 - Prahran
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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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Colorado
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United States of America
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District of Columbia
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Country [6]
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United States of America
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Florida
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Country [7]
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0
United States of America
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Georgia
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Country [8]
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0
United States of America
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Indiana
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0
United States of America
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Massachusetts
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Country [10]
0
0
United States of America
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Michigan
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0
0
United States of America
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Minnesota
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0
0
United States of America
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Missouri
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United States of America
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New Jersey
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United States of America
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New Mexico
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United States of America
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New York
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0
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United States of America
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Ohio
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0
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United States of America
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Pennsylvania
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0
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United States of America
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Texas
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0
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United States of America
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State/province [19]
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Washington
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Country [20]
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Dominican Republic
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State/province [20]
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Santo Domingo
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France
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State/province [21]
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Lyon
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France
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Paris
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Mexico
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State/province [23]
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Jalisco
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Country [24]
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Netherlands
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Utrecht
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Spain
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State/province [25]
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Barcelona
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Spain
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State/province [26]
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Madrid
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Thailand
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State/province [27]
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Bangkok
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Country [28]
0
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Thailand
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State/province [28]
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Khon Kaen
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Country [29]
0
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United Kingdom
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State/province [29]
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Brighton
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0
0
United Kingdom
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State/province [30]
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London
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Country [31]
0
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United Kingdom
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State/province [31]
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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 primary objective of this study is to evaluate the effect of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) fixed-dose combination (FDC) tablet on renal parameters at Week 24 in treatment-naive and treatment-experienced HIV-positive, adults with mild to moderate renal impairment.
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Trial website
https://clinicaltrials.gov/study/NCT01818596
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Trial related presentations / publications
Pozniak A, Arribas JR, Gathe J, Gupta SK, Post FA, Bloch M, Avihingsanon A, Crofoot G, Benson P, Lichtenstein K, Ramgopal M, Chetchotisakd P, Custodio JM, Abram ME, Wei X, Cheng A, McCallister S, SenGupta D, Fordyce MW; GS-US-292-0112 Study Team. Switching to Tenofovir Alafenamide, Coformulated With Elvitegravir, Cobicistat, and Emtricitabine, in HIV-Infected Patients With Renal Impairment: 48-Week Results From a Single-Arm, Multicenter, Open-Label Phase 3 Study. J Acquir Immune Defic Syndr. 2016 Apr 15;71(5):530-7. doi: 10.1097/QAI.0000000000000908. Post FA, Tebas P, Clarke A, Cotte L, Short WR, Abram ME, Jiang S, Cheng A, Das M, Fordyce MW. Brief Report: Switching to Tenofovir Alafenamide, Coformulated With Elvitegravir, Cobicistat, and Emtricitabine, in HIV-Infected Adults With Renal Impairment: 96-Week Results From a Single-Arm, Multicenter, Open-Label Phase 3 Study. J Acquir Immune Defic Syndr. 2017 Feb 1;74(2):180-184. doi: 10.1097/QAI.0000000000001186.
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Public notes
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Contacts
Principal investigator
Name
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Gilead Study Director
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Address
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Gilead Sciences
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Country
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0
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Phone
0
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Fax
0
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Email
0
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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)?
Yes
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What data in particular will be shared?
Qualified external researchers may request IPD for this study after study completion. For more information, please visit our website at https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP)
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When will data be available (start and end dates)?
18 months after study completion
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Available to whom?
A secured external environment with username, password, and RSA code.
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: https://www.gilead.com/science-and-medicine/research/clinical-trials-transparency-and-data-sharing-policy
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Pozniak A, Arribas JR, Gathe J, Gupta SK, Post FA,...
[
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Journal
Post FA, Tebas P, Clarke A, Cotte L, Short WR, Abr...
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Results are available at
https://clinicaltrials.gov/study/NCT01818596