A clinical study of people with HIV-1 who have not taken antiretroviral therapy, one group will start treatment with a combination of doravirine and Islatravir compared to a different group that will start treatment with bictegravir/emtricitabine/tenofovir alafenamide

2022-502099-22-00 Protocol MK-8591A-053 Therapeutic confirmatory (Phase III) Not authorised

Status Not authorised · 6 EU/EEA countries · 30 sites · Protocol MK-8591A-053

Overview

Sponsor-declared trial summary

Phase Therapeutic confirmatory (Phase III)
Status Not authorised
Participants planned 581
Countries 6
Sites 30

HIV-1 Infection

1. To evaluate the antiretroviral activity of DOR/ISL compared to BIC/FTC/TAF, as assessed by the percentage of participants with HIV-1 RNA <50 copies/mL at Week 48. 2. To evaluate the safety and tolerability of DOR/ISL compared with BIC/FTC/TAF as assessed by review of the accumulated safety data through Week 48.

Key facts

Sponsor
Merck Sharp & Dohme LLC
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Virus Diseases [C02]
Decision date (initial)
2023-04-29
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes
Funding sources
Merck Sharp & Dohme LLC

External identifiers

EU CT number
2022-502099-22-00
WHO UTN
U1111-1283-2516

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Pharmacogenomic, Pharmacokinetic, Safety, Therapy, Efficacy, Pharmacogenetic

1. To evaluate the antiretroviral activity of DOR/ISL compared to BIC/FTC/TAF, as assessed by the percentage of participants with HIV-1 RNA <50 copies/mL at Week 48.
2. To evaluate the safety and tolerability of DOR/ISL compared with BIC/FTC/TAF as assessed by review of the accumulated safety data through Week 48.

Secondary objectives 6

  1. To evaluate the antiretroviral activity of DOR/ISL compared with BIC/FTC/TAF, as assessed by the percentage of participants with HIV-1 RNA <50 copies/mL at Week 96
  2. To evaluate the antiretroviral activity of DOR/ISL compared with BIC/FTC/TAF, as assessed by the percentage of participants with HIV-1 RNA <200 copies/mL at Week 48 and Week 96
  3. To evaluate the immunologic effect of DOR/ISL compared with BIC/FTC/TAF, as assessed by the mean change from baseline in CD4+ T-cell count at Week 48 and Week 96
  4. To evaluate the development of viral drug resistance in participants who receive DOR/ISL and in those who receive BIC/FTC/TAF
  5. To evaluate the effect of DOR/ISL compared with BIC/FTC/TAF on weight, as assessed by the mean change from baseline to Week 48 and Week 96
  6. To evaluate the safety and tolerability of DOR/ISL compared with BIC/FTC/TAF as assessed by review of the accumulated safety data through study duration

Conditions and MedDRA coding

HIV-1 Infection

VersionLevelCodeTermSystem organ class
20.1 LLT 10068341 HIV-1 infection 10021881

Study design 1 period

#TitleAllocationBlindingRoles blindedArms
1 Overall trial
A Phase 3, Randomized, Active-Controlled, Double-Blind Clinical Study to Evaluate the Antiretroviral Activity, Safety, and Tolerability of Doravirine/Islatravir (DOR/ISL 100 mg/0.25 mg) Once-Daily in HIV-1 Infected Treatment-Naïve Participants
Randomised Controlled Double [{"id":6636,"code":1,"name":"Subject"},{"id":6637,"code":2,"name":"Investigator"}] Group 1: DOR/ISL (taken with matching placebo to BIC/FTC/TAF)
Group 2: BIC/FTC/TAF (taken with matching placebo to DOR/ISL)

Regulatory references

Scientific advice from competent authorities
European Medicines Agency

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 3

  1. Is an individual ≥18 years of age of any sex/gender who is HIV-1 positive with plasma HIV-1 RNA ≥500 copies/mL at screening
  2. Is naïve to antiretroviral therapy (ART) defined as having received no prior therapy with any antiretroviral agent following a diagnosis of HIV-1 infection
  3. Female is not a participant of childbearing potential (POCBP); or if a POCBP, is not pregnant or breastfeeding, and is willing to use an acceptable contraceptive method or abstain from heterosexual intercourse for study duration

Exclusion criteria 7

  1. Has HIV-2 infection
  2. Has hypersensitivity or other contraindication to any of the components of the study interventions as determined by the investigator
  3. Has a diagnosis of an active AIDS-defining opportunistic infection within 30 days prior to screening
  4. Has active hepatitis B infection (defined as hepatitis B surface antigen [HBsAg]-positive or HBV deoxyribonucleic acid [DNA]-positive).
  5. Has chronic hepatitis C virus (HCV) infection (detectable HCV ribonucleic acid [RNA])
  6. Has a history of malignancy ≤5 years prior to providing documented informed consent except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or cutaneous Kaposi’s sarcoma
  7. Has a history or current evidence of any condition (including active tuberculosis infection), therapy, laboratory abnormality, or other circumstance (including drug or alcohol use or dependence) that might, in the opinion of the investigator, confound the results of the study or interfere with the participant’s participation for the full duration of the study, such that it is not in the best interest of the participant to participate

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 3

  1. Percentage of participants with human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) ≥50 copies/mL at Week 48
  2. Percentage of participants experiencing ≥1 adverse event (AE) through Week 48
  3. Percentage of participants discontinuing from study treatment due to an AE through Week 48

Secondary endpoints 10

  1. Percentage of participants with HIV-1 RNA <50 copies/mL at Week 96
  2. Percentage of participants with HIV-1 RNA <200 copies/mL at Week 48
  3. Percentage of participants with HIV-1 RNA <200 copies/mL at Week 96
  4. Change from baseline in cluster of differentiation 4+ (CD4+) T-cells at Week 48
  5. Change from baseline in CD4+ T-cells at Week 96
  6. Incidence of viral drug resistance
  7. Change from baseline in body weight at Week 48
  8. Change from baseline in body weight at Week 96
  9. Percentage of participants experiencing ≥1 AE through Week 96
  10. Percentage of participants discontinuing from study treatment due to an AE through Week 48

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Doravirine

PRD9952827 · Product

Active substance
Doravirine
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
100.25 mg milligram(s)
Max total dose
67368 mg milligram(s)
Max treatment duration
96 Week(s)
Authorisation status
Not Authorised
MA holder
MERCK & CO. INC.
Paediatric formulation
No
Orphan designation
No

Comparator 2

Biktarvy 50 mg/200 mg/25 mg film-coated tablets

PRD6357592 · Product

Active substance
Emtricitabine
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
275 mg milligram(s)
Max total dose
184.80 g gram(s)
Max treatment duration
96 Week(s)
Authorisation status
Authorised
ATC code
J05AR20 — -
Marketing authorisation
EU/1/18/1289/002
MA holder
GILEAD SCIENCES IRELAND UC
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
epackaged into HDPE bottles, with induction seals and child-resistant plastic closures, with desiccant

Biktarvy 50 mg/200 mg/25 mg film-coated tablets

PRD6357588 · Product

Active substance
Emtricitabine
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
275 mg milligram(s)
Max total dose
184.80 g gram(s)
Max treatment duration
96 Week(s)
Authorisation status
Authorised
ATC code
J05AR20 — -
Marketing authorisation
EU/1/18/1289/001
MA holder
GILEAD SCIENCES IRELAND UC
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
epackaged into HDPE bottles, with induction seals and child-resistant plastic closures, with desiccant

Placebo 2

Placebo to bictegravir/ emtricitabine/ tenofovir alafenamide

N/A · Product

Other product name
N/A
Pharmaceutical form
N/A
ATC code
N/A — N/A
Marketing authorisation
N/A
MA holder
N/A
MA country
Iceland
Paediatric formulation
No

Placebo to doravirine/ islatravir

N/A · Product

Other product name
N/A
Pharmaceutical form
N/A
ATC code
N/A — N/A
Marketing authorisation
N/A
MA holder
N/A
MA country
Iceland
Paediatric formulation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Merck Sharp & Dohme LLC

Sponsor organisation
Merck Sharp & Dohme LLC
Address
126 East Lincoln Avenue
City
Rahway
Postcode
07065-4607
Country
United States

Scientific contact point

Organisation
Merck Sharp & Dohme LLC
Contact name
Mary Pisculli

Public contact point

Organisation
Merck Sharp & Dohme LLC
Contact name
Mary Pisculli

Third parties 5

OrganisationCity, countryDuties
Labcorp Central Laboratory Services S.a.r.l. Meyrin
ORG-100011524
Meyrin, Switzerland Laboratory analysis
Parexel International Corporation
ORG-100007310
Auburndale, United States Other
Bioclinica Inc.
ORG-100033079
Princeton, United States Other
Perceptive Eclinical Limited
ORG-100041144
Nottingham, United Kingdom Other
Signant Health Inc.
ORG-100040732
Blue Bell, United States Interactive response technologies (IRT)

Locations

6 EU/EEA countries · 30 investigational sites

By country

CountryMS statusPlanned subjectsSites
France Not authorised 30 7
Germany Not authorised 20 5
Italy Not authorised 15 3
Netherlands Not authorised 3 2
Poland Not authorised 10 2
Spain Not authorised 46 11
Rest of world
Israel, South Africa, Chile, Argentina, Puerto Rico, United Kingdom, Colombia, Turkey, Thailand, United States, Mexico, Malaysia, Japan
457

Investigational sites

France

7 sites · Not authorised
Assistance Publique Hopitaux De Paris
Hôpital Pitié Salpétrière _ Service des Maladies infectieuses et tropicales, 47 Boulevard De L Hopital, 75651, Paris Cedex 13
Assistance Publique Hopitaux De Paris
Hôpital Saint Louis _ Service des Maladies infectieuses et tropicales, 1 Avenue Claude Vellefaux, 75010, Paris
Assistance Publique Hopitaux De Paris
Hôpital Avicenne _ Service des Maladies infectieuses et tropicales, 125 Rue De Stalingrad, 93000, Bobigny
Centre Hospitalier De Tourcoing
Service Universitaire des Maladies Infectieuses et du Voyageur, 155 Rue Du President Coty, Bp 40619, Tourcoing Cedex
Assistance Publique Hopitaux De Paris
Hôpital Bichat _ Service des Maladies infectieuses et tropicales, 46 Rue Henri Huchard, 75877, Paris Cedex 18
Centre Hospitalier Universitaire De Nice
Hôpital Archet _ Service des Maladies infectieuses et tropicales, 151 Route De Saint Antoine, 06200, Nice
Assistance Publique Hopitaux De Paris
Hôpital Saint-Antoine _ Service des Maladies infectieuses et tropicales, 184 Rue Du Faubourg Saint Antoine, 75012, Paris

Germany

5 sites · Not authorised
Universitaetsklinikum Bonn AöR
Medizinische Klinik I - Klinisches Studienzentrum Immunologie, Venusberg-Campus 1, Venusberg, Bonn
Epimed Gesellschaft Fuer Epidemiologische Und Klinische Forschung In Der Medizin mbH
Epimed Gesellschaft fuer epidemiologische und klinische Forschung in der Medizin mbh, Budapester Strasse 15-19, Tiergarten, Berlin
ICH Study Center GmbH & Co. KG
ICH Study Center GmbH & Co. KG, Grindelallee 35, Rotherbaum, Hamburg
Klinikum Der Universitat Munchen AöR
Medizinische Klinik und Poliklinik IV Infektionsambulanz Poliklinik, Pettenkoferstrasse 8a, Ludwigsvorstadt-Isarvorstadt, Munich
Medical Center - University Of Freiburg
HIV-Zentrum Abteilung Infektiologie, Hugstetter Strasse 55, Stuehlinger, Freiburg Im Breisgau

Italy

3 sites · Not authorised
National Institute For Infectious Diseases Lazzaro Spallanzani
Viral Immunodeficiency, Via Portuense 292, 00149, Rome
ASST Fatebenefratelli Sacco
I Division Infectious disease, Via Giovanni Battista Grassi 74, 20157, Milan
Ospedale San Raffaele S.r.l.
Infectious disease Division, Via Stamira D'ancona 20, 20127, Milan

Netherlands

2 sites · Not authorised
Amsterdam UMC
Department Infectious deseases, De Boelelaan 1117, 1081 HV, Amsterdam
Amsterdam UMC
Department Infectious deseases, Meibergdreef 9, 1105 AZ, Amsterdam

Poland

2 sites · Not authorised
Wroclawskie Centrum Zdrowia SP ZOZ
Ośrodek Profilaktyczno-Leczniczy Chorób Zakaźnych i Terapii Uzależnień, Ul Wszystkich Swietych 2, 50-136, Wroclaw
Wojewodzki Szpital Zakazny W Warszawie samodzielny publiczny zaklad opieki zdrowotnej
Oddział X, Ul. Wolska 37, 01-201, Warsaw

Spain

11 sites · Not authorised
Hospital General Universitario De Elche
Enfermedades Infecciosas, Edificio 2, Camino De La Almazara 11, Elche
Hospital Universitario Virgen De La Victoria
Enfermedades Infecciosas, Calle Del Arroyo Teatinos S N, 29010, Malaga
Hospital General Universitario Gregorio Maranon
Enfermedades Infecciosas, Calle Del Doctor Esquerdo 46, 28009, Madrid
Hospital Universitario La Paz
Enfermedades Infecciosas, Paseo Castellana 261, 28046, Madrid
Hospital Clinic De Barcelona
Enfermedades Infecciosas, Calle Villarroel 170, 08036, Barcelona
Hospital Universitari Germans Trias I Pujol
Enfermedades Infecciosas, Carretera Canyet 1a Planta, 08916, Badalona
Bellvitge University Hospital
Enfermedades Infecciosas, Carretera De La Feixa Llarga S/n, Poligono Industrial De La Zona Ranca De Barcelona, L'hospitalet De Llobregat
Hospital Universitario Ramon Y Cajal
Enfermedades Infecciosas, Carretera Del Colmenar Viejo Km 9 100, Por El Pardo, Madrid
Hospital Universitario Fundacion Jimenez Diaz
Enfermedades Infecciosas, Avenida De Los Reyes Catolicos 2, 28040, Madrid
Hospital Universitario 12 De Octubre
Enfermedades Infecciosas, Bloque D, Avenida De Cordoba S/n, Madrid
Hospital Universitari Vall D Hebron
Enfermedades Infecciosas, Edificio Materno-Infantil, Passeig De La Vall D'hebron 119-129, Barcelona

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-01-05 Italy Not acceptable
2023-04-24
2023-04-26