Clinical trial • Phase II • Infectious Disease

LENACAPAVIR for Human Immunodeficiency Virus (HIV-1) infection

Phase II trial of LENACAPAVIR for Human Immunodeficiency Virus (HIV-1) infection.

Overview

Trial Therapeutic Area
Infectious Disease
Trial Disease
Human Immunodeficiency Virus (HIV-1) infection
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
07-05-2024
First CTIS Authorization Date
21-08-2024

Trial design

Randomised, open-label, comparator arm: tenofovir disoproxidil and emtricitabine (emtricitabine + tenofovir disoproxil fumarate); dose and schedule not specified in ctis record. active/test products include sunlenca 464 mg solution for injection (lenacapavir) subcutaneous administered twice yearly (long-acting) and sunlenca 300 mg film-coated tablets (lenacapavir) oral (schedule not specified).-controlled Phase II trial across 6 sites in France.

Randomised
Yes
Open Label
Yes
Comparator
Comparator arm: TENOFOVIR DISOPROXIDIL AND EMTRICITABINE (emtricitabine + tenofovir disoproxil fumarate); dose and schedule not specified in CTIS record. Active/test products include Sunlenca 464 mg solution for injection (lenacapavir) subcutaneous administered twice yearly (long-acting) and Sunlenca 300 mg film-coated tablets (lenacapavir) oral (schedule not specified).
Target Sample Size
150
Trial Duration For Participant
364

Eligibility

Recruits 150 The study indicates vulnerable population selection (isVulnerablePopulationSelected=true). All participants must be able to comprehend and provide a signed written informed consent obtained prior to initiation of study procedures. Participants are adults ("At least 18 years of age at screening"); no procedures for assent of minors are provided. Consent documents (ICFs and summaries) are available in multiple languages (see recruitment/documents) to support informed consent..

Pregnancy Exclusion
Participants of childbearing potential who are pregnant or lactating at screening or on Day 1. Participants of childbearing potential must have a negative pregnancy test at screening and on Day 1 (see “Definition of Childbearing Potential” in Appendix 11.4 of the Protocol).
Vulnerable Population
The study indicates vulnerable population selection (isVulnerablePopulationSelected=true). All participants must be able to comprehend and provide a signed written informed consent obtained prior to initiation of study procedures. Participants are adults ("At least 18 years of age at screening"); no procedures for assent of minors are provided. Consent documents (ICFs and summaries) are available in multiple languages (see recruitment/documents) to support informed consent.

Inclusion criteria

  • {"criterion_text":"- Able to comprehend and provide a signed written informed consent, which must be obtained prior to initiation of study procedures.\n- Cisgender men who have sex with men, transgender women, transgender men, cisgender women, and nonbinary people\n- At least 18 years of age at screening\n- Increased likelihood of HIV acquisition as indicated by at least one of the following: a) Condomless sex with ≥ 2 partners in the past 6 months b) Diagnosis of a bacterial sexually transmitted infection (STI) in the past 12 months c) Engagement in sex work or transactional sex in the past 12 months d) Use of ≥ 2 courses of nonoccupational HIV postexposure prophylaxis (nPEP) in the past 12 months e) Condomless sex with a partner living with HIV who has unknown or unsuppressed viral load (≥ 200 copies/mL) in the past 12 months\n- Negative local rapid HIV-1/2 antibody (Ab)/antigen (Ag) test, central HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT) at screening\n- Estimated glomerular filtration rate (eGFR) at least 60 mL/min at screening according to the Cockcroft-Gault formula for creatinine clearance (CLcr): (140 - age in years) × (weight in kg) x [0.85 if female] = CLcr (mL/min) 72 × (serum creatinine in mg/dL)\n- Body weight at least 35 kg\n- Willing and able to follow study procedures\n- Participants of childbearing potential who are receiving teratogenic medications, including testosterone, who engage in frontal (vaginal) intercourse must not intend to become pregnant during the study and must agree to utilize protocol-specified method(s) of contraception as described in Appendix 11.4. of the Protocol."}

Exclusion criteria

  • {"criterion_text":"- Coenrollment in any other clinical study (including observational) without prior approval from the sponsor is prohibited while participating in this study.\n- Have a history of osteoporosis or bone fragility fractures.\n- Current alcohol or substance abuse judged by the investigator to be problematic such that it potentially interferes with participant study adherence.\n- Grade 3 or Grade 4 proteinuria or glycosuria at screening that is unexplained or not clinically manageable.Grade 3 or Grade 4 proteinuria or glycosuria at screening that is unexplained or not clinically manageable.\n- Participants of childbearing potential who are pregnant or lactating at screening or on Day 1. Participants of childbearing potential must have a negative pregnancy test at screening and on Day 1 (see “Definition of Childbearing Potential” in Appendix 11.4 of the Protocol).\n- Any other clinical condition, laboratory abnormalities, or psychosocial condition or prior therapy that, in the opinion of the Investigator, would make the participant unsuitable for the study or unable to comply with dosing requirements.\n- Known hypersensitivity to the study drug, the metabolites, or formulation excipient.\n- Current use of PrEP, defined as self-report of the use of PrEP in the preceding 4 weeks. PrEP should not be discontinued to facilitate study participation.\n- Current use of nPEP, unless the prescribed course will be completed prior to randomization.\n- Past or current participation in HIV vaccine or HIV broadly neutralizing Ab study unless participant provides documentation of receipt of placebo (ie, not active product).\n- Acute viral hepatitis A, B, or C or evidence of chronic hepatitis B or C infection a) If a participant has a negative hepatitis B surface antigen (HBsAg), negative hepatitis B surface antibody (HBsAb), and positive hepatitis B core antibody (HBcAb), hepatitis B virus (HBV) DNA testing will be completed. If the HBV DNA result is positive, the participant is a screen failure. Participants found to be susceptible to HBV infection will be offered HBV vaccination. b) If the hepatitis C virus (HCV) Ab result is positive, then HCV RNA will be evaluated. Participants found to be positive for HCV at screening must not have active infection or must have completed treatment and achieved a sustained virologic response.\n- Severe hepatic impairment or a history of or current clinical decompensated liver cirrhosis (eg, ascites, encephalopathy, variceal bleeding).\n- Have a suspected or known active, serious infection(s) (eg, active tuberculosis, etc).\n- Need for continued use of any contraindicated concomitant medications."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- On-time LEN injection at Day 1/baseline and Week 26 and on-time follow-up visit at Week 52","definition_or_measurement_approach":"On-time administration and visit scheduling at Day 1/baseline, Week 26 and Week 52 to assess persistence of LEN injections."}
  • {"endpoint_text":"- Dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations consistent with ≥ 4 doses/week (≥ 700 fmol/punch) at Weeks 13, 26, 39, and 52","definition_or_measurement_approach":"Measurement of TFV-DP concentrations in DBS; threshold ≥700 fmol/punch interpreted as consistent with ≥4 doses/week measured at Weeks 13, 26, 39 and 52."}

Secondary endpoints

  • {"endpoint_text":"- Treatment-emergent adverse events and treatment emergent laboratory abnormalities","definition_or_measurement_approach":"Safety monitoring of adverse events and laboratory tests per protocol-defined schedules and criteria."}
  • {"endpoint_text":"- Questionnaire outcomes related to general acceptability of LEN and F/TDF","definition_or_measurement_approach":"Participant-completed questionnaires assessing acceptability of LEN and F/TDF (questionnaire instruments provided in study documents)."}
  • {"endpoint_text":"- LEN plasma concentrations at Weeks 26 and 52","definition_or_measurement_approach":"Measurement of lenacapavir plasma concentrations at scheduled Week 26 and Week 52 visits."}

Recruitment

Digital Remote Recruitment
Yes
Planned Sample Size
150
Recruitment Window Months
58
Consent Approach
Signed written informed consent must be obtained prior to initiation of study procedures; participants must be able to comprehend and provide consent. Consent materials (ICFs, summaries, flipcharts) are provided in multiple languages (documents include French and translations indicated for Portuguese, Italian, Arabic, Spanish, Urdu and English-language protocol synopsis). No assent procedures for minors are indicated (study includes adults ≥18 years).

Methods

  • Recruitment arrangements document (K1_GS-US-528-6727_Recruitment-Arrangements_FR_French_Public) — public-facing recruitment planning for French public
  • Flyers and posters (K2_GS-US-528-6727_Flyer-and-Poster_FR_French_Public) — printed materials for public recruitment in France
  • Refer-a-friend referral cards and instructions (K2_GS-US-528-6727_Refer-a-friend-referral-card) — peer referral materials in multiple languages for French public
  • Social media advertisements (K2_GS-US-528-6727_Social-Medial-Advertisementst_FR_Frenc_Public) — digital/social media channel recruitment targeted to the French public

Geography

Total Number Of Sites
6
Total Number Of Participants
112

France

Earliest CTIS Part Ii Submission Date
29-07-2024
Latest Decision Or Authorization Date
14-04-2026
Processing Time Days
624
Number Of Sites
6
Number Of Participants
112

Sites

Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service des Maladies Infectieuses et Tropicales
Contact Person Name
Hugues Cordel
Contact Person Email
hugues.cordel@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service des Maladies Infectieuses et Tropicales
Contact Person Name
Jean-Michel Molina
Contact Person Email
jean-michel.molina@aphp.fr
Site Name
Centre Hospitalier Universitaire De Nice
Contact Person Name
Eric Cua
Contact Person Email
cua.e@chu-nice.fr
Site Name
Hopital Europeen Marseille
Department Name
Service interne et maladies infectieuses
Contact Person Name
Patrick Philibert
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service des Maladies Infectieuses et Tropicales
Contact Person Name
Karine Lacombe
Contact Person Email
karine.lacombe2@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service des Maladies Infectieuses et Tropicales
Contact Person Name
Jade Ghosn
Contact Person Email
jade.ghosn@aphp.fr

Sponsor

Primary sponsor

Full Name
Gilead Sciences Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
PPD Global Limited
Responsibilities
Operational/clinical vendor duties (sponsorDuties codes: 1,12,13,2,5)
Name
Medidata Solutions Inc.
Responsibilities
Clinical data systems / eClinical services (sponsorDuties code: 7)

Third parties

  • {"country":"United Kingdom","full_name":"PPD Global Limited","duties_or_roles":"codes: 1,12,13,2,5","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"codes: 7","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Labcorp","duties_or_roles":"HIV-1/HIV-2 Qualitative RNA","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"The University Of Colorado Denver Anschutz Medical Campus","duties_or_roles":"Dried Blood Spot (DBS) analysis","organisation_type":"Educational Institution"}
  • {"country":"Germany","full_name":"Seq-it GmbH & Co. KG","duties_or_roles":"HIV resistance, Genotyping","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Labcorp Early Development Laboratories Inc.","duties_or_roles":"Sample Management- Anytime plasma PK","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Canfield Scientific Inc.","duties_or_roles":"Medical Image Analysis/Review - x-ray, MRI, ultrasound, etc","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"University Of Colorado Foundation","duties_or_roles":"Dried Blood Spot (DBS) analysis","organisation_type":"Educational Institution"}
  • {"country":"Switzerland","full_name":"Labcorp Central Laboratory Services SARL","duties_or_roles":"Lab analytes as per table 19 of the protocol under Clinical Chemistry, Hematology, and Urinalysis, Serum pregnancy, HIV 1/2 AB/AG, HBV/HCV, HIV viral load, STIs, CD4","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Sunlenca 464 mg solution for injection
Active Substance
LENACAPAVIR
Modality
Small molecule
Routes Of Administration
SUBCUTANEOUS USE
Route
Subcutaneous
Authorisation Status
EU/1/22/1671/002
Starting Dose
464 mg
Frequency
Twice yearly
Investigational Product Name
Sunlenca 300 mg film-coated tablets
Active Substance
LENACAPAVIR
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Authorisation Status
EU/1/22/1671/001
Starting Dose
300 mg
Investigational Product Name
TENOFOVIR DISOPROXIL AND EMTRICITABINE
Active Substance
EMTRICITABINE, TENOFOVIR DISOPROXIL FUMARATE
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Authorisation Status
-
Combination Treatment
Yes

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