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HIV PreventionPhase 1NCT01813162

In Vivo Drug Interaction Pharmacokinetic Study of Tenofovir 1% Gel and Three Commonly Used Vaginal Products

A Phase 1 study testing Tenofovir 1% gel and Vaginal product in people with HIV Prevention, run by CONRAD at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is determine if the local release characteristics and systemic exposure to tenofovir (TFV) 1% gel and a given commonly used vaginal product are impacted by concomitant use Read more about this study

Who is it for?
Ages 18 to 50 years, women onlyHealthy volunteers can take part
Conditions the study is for
HIV Prevention
What is being tested?
Tenofovir 1% gel and Vaginal product
Could I receive a placebo?
No, everyone receives an active treatment
How many people
101 participants
Where
2 sitesUnited States
Study dates
Dec 2013to Dec 2014
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Age 18-50 years, inclusive
  • General good health (by volunteer history and per investigator discretion)
  • History of and currently regular menstrual cycles
  • Willing to abstain from the use of vaginal products, other than the TFV gel and her assigned study vaginal product for the duration of the study.
  • Willing to abstain from sex and other vaginal activity during each crossover period starting 72 hours prior to initiating product use, for the duration of use, and until the sixth day following sample collection
  • At low risk for pregnancy due to surgical sterilization of participant and/or her sexual partner, use of copper IUD or male condom, abstinence, or same sex relationship
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  • Vaginal and cervical anatomy that, in the opinion of the investigator, lends itself to easy genital tract sample collection
  • History of Pap smears and follow-up consistent with ACOG practice guidelines
  • Negative urine pregnancy test
  • Willing to give voluntary consent, sign an informed consent form and comply with study procedures as required by the protocol

Who cannot join

  • History of hysterectomy
  • Currently pregnant/within 2 calendar months from the last pregnancy outcome.
  • Use of Depo-Provera in the last 120 days or any hormonal contraceptives in the last month
  • Currently breastfeeding or having breastfed an infant in the last 2 months, or planning to breastfeed during the course of the study
  • History of sensitivity/allergy to any component of:
  • TFV 1% gel; or
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  • topical anesthetic, or allergy to both silver nitrate and Monsel's solution.
  • Contraindication to any of 3 vaginal products (antifungal cream, antimicrobial gel, or the combination contraceptive vaginal ring) to which participants may be randomized
  • In the last 6 months, diagnosed with or treated for any STI or pelvic inflammatory disease, by self report.
  • Symptomatic BV
  • Positive test for Trichomonas vaginalis at Visit 1
  • Positive test for Neisseria gonorrhea or Chlamydia trachomatis
  • Positive test for HIV
  • Positive test for Hepatitis B surface antigen (HBsAg)
  • Known bleeding disorder that could lead to prolonged or continuous bleeding with biopsy
  • Chronic or acute vulvar or vaginal symptoms
  • Known current drug or alcohol abuse which could impact study compliance
  • Grade 2 or higher laboratory abnormality, per the August 2009 update of the DAIDS Table for Grading the Severity of Adverse Events
  • Systemic use in the last 2 weeks or anticipated use during the study of any of the following: corticosteroids, antibiotics, anticoagulants or other drugs known to prolong bleeding and or clotting, antifungals, antivirals (e.g., acyclovir or valacyclovir) or antiretrovirals (e.g., Viread®).
  • Participation in any other drug or device interventional investigational trial (device, drug, or vaginal trial) within 30 days of this study or planned participation in any other investigational trial during the study
  • History of gynecological procedures (including genital piercing) on the external genitalia, vagina or cervix within the last 14 days
  • Abnormal finding on laboratory or physical examination or a social or medical condition which, in the opinion of the investigator, would make participation in the study unsafe or would complicate interpretation of data

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Dept of OBGYN and Reproductive Sciences, UCSF

    San Francisco, California

  • Bronx-Lebanon Hospital Center

    The Bronx, New York

Other trials in United States

About this study

The purpose of the study is determine if the local release characteristics and systemic exposure to tenofovir (TFV) 1% gel and a given commonly used vaginal product are impacted by concomitant use

Read the detailed description

This study consists of three separate crossover studies, each evaluating if local release characteristics and systemic exposure to TFV 1% gel and a given vaginal product are impacted by concomitant use. Vaginal products to be assessed are: antifungal cream, antimicrobial gel, and the combination contraceptive vaginal ring (IVR). There will be no comparison between vaginal product groups.

Participants will be randomized to vaginal product. Participants in the cream and gel cohorts will be randomized to the order of treatment conditions (TFV gel alone, vaginal product alone, and TFV gel and vaginal product concomitantly). Participants in the IVR cohort will use TFV gel alone during the first crossover period; the order of the remaining treatment conditions (IVR alone, TFV and IVR concomitantly) for crossover periods 2 and 3 will be randomly assigned.

Each participant will attend a total of at least 7 visits. At the first visit, volunteers will be consented and will undergo procedures to assess whether they are eligible to continue in the study. If eligible, they will undergo 3 crossover treatment periods. Within each crossover treatment period there will be 2 visits, which will be scheduled to occur within the same menstrual cycle; the first visit will be in the follicular phase of the menstrual cycle such that product use is initiated on cycle day 9 to 18 and the second visit will be on cycle day 16 to 24.

At the start of crossover period 1, after it has been confirmed that the participant meets all of the inclusion criteria and none of the exclusion criteria, she will be randomized to a vaginal product cohort and to a sequence of the treatment conditions for the 3 crossover periods. Crossover periods 2 and 3 will be scheduled in the subsequent menstrual cycles, with the first visit of each crossover period occurring approximately 2 weeks after the completion of the previous crossover period.

Product usage during the 3 crossover periods is as follows:

  • Treatment Condition (vaginal product alone): The participant will be instructed to use her assigned product for 5 to 21 days, depending on the dosing instructions for the particular product cohort to which she has been assigned . The second visit of the crossover period will occur after product use is complete. For participants using antifungal cream or antimicrobial gel, blood specimens will be collected approximately 6 hours after the last gel or cream use. In the IVR cohort, blood specimens will be collected after 21 days of use at 0/4, 6, 10, and 24 hours. The 0/4 hour collection time point is the time of the first plasma draw. It is meant to mimic the 4 hour post-TFV gel insertion collection time point described below for the TFV gel alone and the vaginal product/TFV gel treatment conditions. No biopsies will be collected during the vaginal product treatment condition for all cohorts.
  • Treatment Condition (TFV gel alone): The participant will be instructed to use TFV gel for 7 days, inserted twice a day with each dose approximately 12 hours apart. The second visit of the crossover period will occur after product use is complete. Blood specimens will be collected approximately 4 hours after the last dose of TFV gel. In the IVR cohort, participants will have blood specimens collected 4, 6, 10 and 24 hours after the last dose of TFV gel. Vaginal biopsy will be scheduled to take place approximately 6 hours after the last dose of TFV gel for all cohorts.
  • Treatment Condition (vaginal product and TFV gel): The participant will be instructed to use her assigned product for 5 to 21 days, depending on the dosing instructions for the particular product cohort to which she has been assigned. TFV gel will be used for 7 days, inserted twice a day with each dose approximately 12 hours apart; the morning insertion of TFV gel will occur approximately two hours after insertion of the vaginal product (for the gel and cream cohorts). The second visit of the crossover period will occur after product use is complete. In the gel and or cream cohorts, blood specimens will be collected approximately 4 hours after the last TFV gel use. In the IVR cohort, blood specimens will be collected 4, 6, 10 and 24 hours after the last dose of TFV gel. Vaginal biopsy will be scheduled to take place approximately 6 hours after the last dose of TFV gel for all cohorts.

Each participant will be contacted by phone approximately 1-2 weeks after completion of crossover period 3 to confirm that there have been no additional adverse experiences. If necessary, she may be seen in an unscheduled visit for follow-up. She will then be exited from the study.

Conditions
HIV Prevention
Being tested
Tenofovir 1% gel, Vaginal product

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tenofovir 1% gelDrug

  • Vaginal productDrug

    Also called Terconazole 0.4%, Metronidazole gel, Contraceptive IVR

Study groups in NCT01813162
Study groupRoleWhat they receive
Tenofovir 1% gelActive comparatorParticipants will vaginally insert 1 applicator of TFV gel twice a day for 7 days, with each dose inserted approximately 12 hours after the previous dose (for a total of 13 doses). Each applicator contains 4.4 gm of TFV 1% gel.
Receives: Drug: Tenofovir 1% gel
Vaginal product aloneActive comparatorParticipants will use their assigned vaginal product for 5 to 21 days depending on the dosing instructions for the particular product: 1. Terconazole 0.4% vaginal cream: once a day for seven days. 1 applicator (5 gm) of terconazole cream contains 20 mg terconazole. 2. Metronidazole gel: once a day for 5 days. 1 applicator (5 gm)of metronidazole gel contains 37.5 mg metronidazole. 3. Contraceptive IVR: insert ring and leave in place for 21 days; return to clinic for removal on day 21. The IVR contains two active components, etonogestrel (progestin) and ethinyl estradiol (estrogen).
Receives: Drug: Vaginal product
Vaginal product and Tenofovir 1% gelExperimentalTenofovir gel: Participants will vaginally insert 1 applicator of TFV gel twice a day for 7 days, with each dose inserted approximately 12 hours after the previous dose (for a total of 13 doses). Each applicator contains 4.4 gm of TFV 1% gel. In addition, Participants will use their assigned vaginal product for 5 to 21 days depending on the dosing instructions for the particular product: 1. Terconazole 0.4% vaginal cream: once a day for seven days. 1 applicator (5 gm) of terconazole cream contains 20 mg terconazole. 2. Metronidazole gel: once a day for 5 days. 1 applicator (5 gm)of metronidazole gel contains 37.5 mg metronidazole. 3. Contraceptive IVR: insert ring and leave in place for 21 days; return to clinic for removal on day 21. The IVR contains two active components, etonogestrel (progestin) and ethinyl estradiol (estrogen). Use of TFV gel will begin on day 15 of IVR use.
Receives: Drug: Tenofovir 1% gel; Drug: Vaginal product

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. TFV concentrations in plasma and genital tissue and TFV-DP concentrations in genital tissue

    Vaginal product alone: Participant will use assigned product per dosing instructions (antifungal cream: 7 days; antimicrobial gel: 5 days; IVR: 21 days). In cream or gel cohorts, blood will be drawn 6 hrs after last use. In contraceptive ring cohort, blood will be drawn after 21 days of use at 0/4,6,10\&24 hrs.

    TFV gel alone: Participant will use TFV gel for 7 days, inserted 2X a day. In cream/gel cohorts blood will be drawn 4 hrs after last TFV gel use. In contraceptive ring cohort blood will be drawn 4,6,10\&24 hrs after last TFV gel use. Vaginal biopsy will occur 6 hrs after last TFV gel use for all.

    Vaginal product \& TFV gel: Participant will use assigned product per dosing instructions. TFV gel will be used for 7 days, 2X a day. In gel/cream cohorts blood will be drawn 4 hrs after last TFV gel use. In contraceptive ring cohort blood will be drawn 4,6,10\&24 hrs after last dose of TFV gel. Vaginal biopsy will occur 6 hrs after the last dose of TFV gel for all.

    Measured: Assessments will be after product use (see description)

Secondary outcomes (2)
  1. Vaginal product concentration in plasma

    Vaginal product alone: Participant will use assigned product per dosing instructions (antifungal cream: 7 days; antimicrobial gel: 5 days; IVR: 21 days). In cream or gel cohorts, blood will be drawn 6 hrs after last use. In contraceptive ring cohort, blood will be drawn after 21 days of use at 0/4,6,10\&24 hrs.

    TFV gel alone: Participant will use TFV gel for 7 days, inserted 2X a day. In cream/gel cohorts blood will be drawn 4 hrs after last TFV gel use. In contraceptive ring cohort blood will be drawn 4,6,10\&24 hrs after last TFV gel use.

    Vaginal product \& TFV gel: Participant will use assigned product per dosing instructions. TFV gel will be used for 7 days, 2X a day. In gel/cream cohorts blood will be drawn 4 hrs after last TFV gel use. In contraceptive ring cohort blood will be drawn 4,6,10\&24 hrs after last dose of TFV gel.

    Measured: Assessments will be after product use (see description)

  2. Genitourinary adverse events (AEs)

    Vaginal product alone: Participant will use assigned product per dosing instructions (antifungal cream: 7 days; antimicrobial gel: 5 days; IVR: 21 days). Genitourinary AEs will be assessed by participant report and exam after completion of dosing.

    TFV gel alone: Participant will use TFV gel for 7 days, inserted 2X a day. Genitourinary AEs will be assessed by participant report and exam after completion of dosing.

    Vaginal product \& TFV gel: Participant will use assigned product per dosing instructions. TFV gel will be used for 7 days, 2X a day. Genitourinary AEs will be assessed by participant report and exam after completion of dosing.

    Measured: Assessments will be after product use (see description)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2013 (estimated)
  2. Study startDec 2013
  3. Primary completionDec 2014
  4. Study completionDec 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
101 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01813162
Sponsor's protocol ID
A11-118
Status last verified
May 2015
First submitted
11 Mar 2013
Last updated
22 May 2015
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Tenofovir 1% gel and Vaginal product in people with HIV Prevention, run by CONRAD at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 May 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

TFV concentrations in plasma and genital tissue and TFV-DP concentrations in genital tissue (time frame: Assessments will be after product use (see description)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2015; AzTrials last refreshed its copy on 8 Nov 2026.

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