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Switch From Dual Regimens Based on Dolutegravir Plus a Reverse Transcriptase Inhibitor to E/C/F/TAF in Virologically Suppressed, HIV-1 Infected Patients (Be-OnE)

Open Label, Randomized (1:1) Clinical Trial to Evaluate Switching From Dual Regimens Based on Dolutegravir Plus a Reverse Transcriptase Inhibitor to Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in Virologically Suppressed, HIV-1 Infected Patients (Be-OnE Study).

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03493568
Acronym
Be-OnE
Enrollment
100
Registered
2018-04-10
Start date
2017-02-06
Completion date
2020-07-31
Last updated
2024-02-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

HIV-1-infection

Brief summary

Research hypothesis: Switching from dual regimens based on dolutegravir plus a RTI to a single tablet regimen of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), lowers the exposure to Residual Viremia (and hence the risk of viral rebound), without increasing treatment toxicity.

Detailed description

Study design Randomized, single-center, open-label, 96-week superiority study. Patients with HIV-RNA \<50 copies/mL while receiving DTG plus one RTI will be randomized 1:1 to continue the ongoing treatment or to switch to E/C/F/TAF. Randomization list will be a computer-generated list (with equal block sizes) and will be incorporated within an electronic clinical report form (eCRF). Patients will be evaluated at screening, baseline, week 4, 8, 16, 24, 32, 40, 48, 60, 72, 84, 96 or premature discontinuation. At each visit the following evaluations will be performed: 1. clinical assessment. 2. routine laboratory tests (hematological tests and clinical chemistry). Additional blood samples will be collected at specified visits for storage and further determinations (e.g. RV by a single-copy assay). During follow-up, at different timepoints, patients will additionally undergo HIV-DNA quantification in PBMCs (BL, 48 and 96 weeks) and quality of life (QOL) and adherence assessement (BL, 48 and 96 weeks). Viral load will be assessed by Abbott Real time PCR (Abbott RealTime HIV-1) Residual viremia (RV) will be defined as any detectable HIV-RNA value below 50 copies/mL Virologic failure will be defined as a confirmed rebound in plasma HIV-RNA levels ≥ 50 copies/mL Subjects who meet a protocol-defined virologic failure during follow-up will be discontinued from the study. At virologic failure subjects will perform genotypic HIV resistance testing and a determination in plasma of elvitegravir or DTG Cthrough. HIV-DNA will be extracted from 1x106 peripheral blood mononuclear cells (PBMCs) by using Qiagen DNA extraction kit and quantified by Real Time PCR (ABI Prism 7900).

Interventions

switch to Genvoya 150Mg-150Mg-200Mg-10Mg Tablet in patients virologically suppressed HIV-1 infected patients.

DRUGDolutegravir 50 mg plus one RTI

Continuing Dolutegravir 50 mg (1 pill every 24 hours) plus one RTI (at label dose)

Sponsors

Gilead Sciences
CollaboratorINDUSTRY
IRCCS San Raffaele
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

Treatments 1. Genvoya 150Mg-150Mg-200Mg-10Mg Tablet ( 1 pill every 24 hours) 2. Dolutegravir 50 mg (1 pill every 24 hours) plus one Reverse Trascriptase Inhibitor (at label dose)

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

1. Age \>18 years 2. Willing and able to provide informed consent 3. On a stable (at least 3 months) antiretroviral therapy with DTG 50 mg QD plus one RTI 4. HIV-RNA \<50 copies/mL since at least 6 months

Exclusion criteria

1. Active AIDS-defining condition (except Kaposi's sarcoma non requiring systemic chemotherapy) 2. Serious illness requiring systemic treatment and/or hospitalization 3. Current use of immunomodulant or immunosuppressive drugs 4. Need (or will likely need) of treatment with antacids 5. Use of drugs contraindicated with study drugs, according to technical sheets 6. Previous suboptimal therapies with NRTIs or presence of TAMs (type 1 or 2) in previous resistance tests (patients with the 184I/V mutation alone are allowed to enter the study) 7. Resistance or previous virological failure to InSTIs 8. Detectable HCV-RNA 9. Documented allergy to COBI or EVG or FTC or tenofovir. 10. Absolute neutrophil count (ANC) \<500/µL 11. Haemoglobin \<8.0 g/dL 12. Platelet count \<50,000/µL 13. eGFR \<30 mL/min/1.73m2 by CKD-EPI equation 14. Alanine aminotransferase (ALT) more than 5 times the upper limit of normal (ULN) 15. Presence of Child Pugh Class B or C liver cirrhosis. 16. Pregnancy or breastfeeding 17. Woman of childbearing potential who does not agree to adopt highly effective contraception.

Design outcomes

Primary

MeasureTime frameDescription
Residual Viremia48 weeksTo investigate RV through 48 weeks in virologically suppressed patients randomized to continue treatment with DTG plus a single RTI or to switch to E/C/F/TAF.

Secondary

MeasureTime frameDescription
viral reservoir48 weeksTo investigate changes in viral reservoir (HIV-DNA)
QOL48 weeksTo investigate changes in the quality of life (administration of questionnaire ISSQoL uses five- point Likert scales 1 never 2 rarely 3 sometimes 4 often 5 always)
virological rebound48 weeksTo investigate the occurrence of virological rebound above 50 HIV-RNA copies/mL;
Virological failure96 weeksproportion of patient in virological rebound
Adherence.96 weeksTo investigate changes in adherence (administration of questionnaire uses scale ranges from 0 to 100 )
Adherence48 weeksTo investigate changes in adherence (administration of questionnaire uses scale ranges from 0 to 100)

Countries

Italy

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026