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HIV-1-infectionPhase 3MODERATONCT04022967

ANRS 12372 MODERATO Study

A Phase 3 study testing dolutegravir, atazanavir boosted with ritonavir and tenofovir + lamivudine +efavirenz or dolutegravir + lamivudine + tenofovir in people with HIV-1-infection, run by ANRS, Emerging Infectious Diseases at 5 sites in 3 countries.

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

MODERATO is a phase III, open-label, randomized, multicenter, non-inferiority trial conducted in West and Central Africa (Cameroon, Côte d'Ivoire, Burkina Faso). HIV-1 infected adults receiving first line ART with TDF+XTC+EFV or DTG+XTC+TDF virologically suppressed will be recruited and followed during 100 weeks. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
HIV-1-infection
What is being tested?
dolutegravir, atazanavir boosted with ritonavir and tenofovir + lamivudine +efavirenz or dolutegravir + lamivudine + tenofovir
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
480 participants
Where
5 sitesin 3 countries
Study dates
17 Nov 2020to 30 Dec 2024
Phase
Phase 3
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • HIV-1 infection
  • Age of legal majority
  • CD4 > 200 cells/mm3 at pre-inclusion
  • Start first-line ART with non-nucleotide reverse transcriptase inhibitors including TDF+XTC+EFV for at least two years without a past history of virological failure, OR
  • Be on TDF+XTC+EFV for at least two years then DTG+XTC+TDF without a past history of virological failure, OR
  • Be on DTG+XTC+TDF (1st line regimen) for at least two years without a past history of virological failure
Show all 10Show fewer
  • Absence of past history of virological failure (viral load above the threshold corresponding to the test used); two blips between 50 and 200 copies/ml are allowed.
  • At least 2 consecutive HIV-1 RNA < 50 copies/ml within past 2 years, including HIV-1 RNA at pre-inclusion
  • Women with pregnancy potential are required to use an effective contraceptive method throughout the study follow up.
  • Signed informed consent

Who cannot join

  • HIV-2 infection or HIV-1+2 infection
  • CD4 nadir <100 cells/mm3
  • Chronic Hepatitis B (HBs Ag positive in the pre-inclusion balance)
  • Ongoing active Tuberculosis
  • Ongoing severe opportunistic infection
  • Ongoing chemotherapy or immunotherapy
Show all 14Show fewer
  • Grade > 2 hemoglobin, neutrophil or platelet disorder
  • ALT≥ 3 times the upper limit of normal value
  • Creatinine clearance < 50 ml/min (CKD-EPI)
  • Allergy to a trial drugs or drug component
  • Ongoing pregnancy or Refusal of contraception
  • Patient at risk of non-compliance
  • Ongoing treatment with a drug that should not be associated with one of the drugs used in the study (cf appendix E page 77)
  • Any symptoms or biological findings suggestive of a systemic disorder (renal, hepatic, cardiovascular, pulmonary) or other medical conditions that may interfere with the interpretation of test results or jeopardize the health of patients

Trial locations and contacts

5 sites in 3 countries.

5 sites in 3 countries

Burkina Faso2 sites
  • Hôpital de jour, Service des maladies infectieuses, CHU Sourô Sanou

    Bobo-Dioulasso

  • Service de médecine interne, CHU Yalgado Ouédraogo

    Ouagadougou

Other trials in Burkina Faso

Côte d’Ivoire2 sites
  • Centre de Prise en Charge et de Formation (CePReF), Association ACONDA

    Abidjan

  • Service des Maladies Infectieuses et Tropicales (SMIT), CHU de Treichville

    Abidjan

Other trials in Côte d’Ivoire

Cameroon1 site
  • Service des Maladies Infectieuses, Hôpital du jour, Hôpital Central

    Yaoundé

Other trials in Cameroon

About this study

Official title: Randomized, Non-inferiority Trial Comparing a Dual Maintenance Therapy Strategy With Dolutegravir + Lamivudine (DTG/3TC) or Atazanavir/Ritonavir + Lamivudine (ATV/r+3TC) Versus the Standard WHO First Line Triple Therapy Tenofovir + Lamivudine + Efavirenz (TDF+3TC+EFV) or Dolutegravir + Lamivudine + Tenofovir (DTG+3TC+TDF) in West and Central African HIV-1 Infected Patients

MODERATO is a phase III, open-label, randomized, multicenter, non-inferiority trial conducted in West and Central Africa (Cameroon, Côte d'Ivoire, Burkina Faso).

HIV-1 infected adults receiving first line ART with TDF+XTC+EFV or DTG+XTC+TDF virologically suppressed will be recruited and followed during 100 weeks.

The objective is to assess the non-inferiority of a strategy consisting of switching to a dual maintenance therapy (DTG+3TC or ATV/r+3TC), comparing to WHO standard first line regimen (TDF+3TC+EFV or DTG+3TC+TDF), in terms of virological success at 96 weeks

Read the detailed description

In HIV-1 infected adults receiving first line ART with TDF+XTC+EFV or DTG+XTC+TDF virologically suppressed (viral load < detection limit of the technique used) for at least two years: to assess the non-inferiority of a strategy consisting of switching to a dual maintenance therapy (DTG+ 3TC or ATV/r+3TC), comparing to WHO standard first line regimen (TDF+3TC+EFV or DTG+3TC+TDF), in terms of virological success at 96 weeks, in Cameroon, Côte d'Ivoire and Burkina Faso.

This is a trial including two strategies (dual maintenance therapy and triple reference therapy) and three ART regimens (DTG+3TC and ATV/r+3TC used in the maintenance strategy and TDF+3TC+EFV/ DTG+3TC+TDF used in the reference strategy).

The primary analysis will compare the two strategies. Secondary analyses will compare the three ART regimens two by two.

In order to make these secondary analyses possible, participants will be randomly assigned, at inclusion, to each of the three ART regimens (arm 1: DTG+3TC; arm 2: ATV/r+3TC; arm 3: TDF+3TC+EFV / DTG+3TC+TDF). The maintenance strategy will include arm 1 and 2. The reference strategy will include arm 3

Number of participants : 480 (160 in each ART regimen, ie 320 in the dual maintenance therapy strategy and 160 in the triple therapy reference strategy)

The primary endpoint is treatment success, as defined by using the FDA snapshot algorithm : patients who are still continuing the assigned strategy and whose last available plasma HIV-1 RNA in the the window analysis (90 to 102 weeks) is <50 copies/ml at the end of the window analysis (90 to 102 weeks)

Conditions
HIV-1-infection
Being tested
dolutegravir, atazanavir boosted with ritonavir, tenofovir + lamivudine +efavirenz or dolutegravir + lamivudine + tenofovir, Lamivudine
Keywords
Africa, Antiretroviral Treatment, HIV-1, Adults, Dual maintenance therapy, Dolutegravir, Atazanavir

What participants receive

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

  • dolutegravirDrug

    One daily tablet (50mg) during 96 weeks

  • atazanavir boosted with ritonavirDrug

    One daily tablet with atazanavir (300 mg) boosted with ritonavir (100 mg) during 96 weeks

  • tenofovir + lamivudine +efavirenz or dolutegravir + lamivudine + tenofovirDrug

    One daily tablet with tenofovir 245 mg + lamivudine (300 mg) + efavirenz (400 mg) during 96 weeks OR One daily tablet with dolutegravir 50 mg + lamivudine (300 mg) + tenofovir (300 mg) during 96 weeks

  • LamivudineDrug

    One daily tablet (300mg) during 96 weeks

Study groups in NCT04022967
Study groupRoleWhat they receive
Arm 1 : Dual maintenance therapy DTG+3TCExperimentalNot described
Receives: Drug: dolutegravir; Drug: Lamivudine
Arm 2 : Dual maintenance therapy ATV/r+3TCExperimentalNot described
Receives: Drug: atazanavir boosted with ritonavir; Drug: Lamivudine
Arm 3 : Reference triple therapy TDF+3TC+EFV or DTG+3TC+TDFActive comparatorNot described
Receives: Drug: tenofovir + lamivudine +efavirenz or dolutegravir + lamivudine + tenofovir

What is being measured

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

  1. The treatment success, as defined by using the FDA snapshot algorithm

    Success : The proportion of patients who are still continuing the assigned strategy and whose last available plasma HIV-1 RNA in the the window analysis is <50 copies/ml at the end of the window analysis.

    Failure : patients who have discontinued the assigned strategy or whose last available plasma HIV-1 RNA in the window analysis (90 to 102 weeks) is ≥ 50 copies/ml or with no available HIV-1 RNA in the window analysis

    Measured: 90 to 102 weeks

Secondary outcomes (22)
  1. Failure combined endpoint

    Percentage of participants who reach the following combined endpoint : "new drug-resistant resistance mutations observed", "decline of at least 20% in creatinine clearance" and "occurrence of at least one grade 3-4 neuropsychiatric disorder"

    Measured: Between Day 0 and Week 96

  2. Plasma HIV-1 RNA

    Evolution of plasma HIV-1 RNA

    Measured: Between Day 0 and Week 96

  3. Virological success

    Evolution of the percentage of participants with virological success (VL< 50 copies/Ml)

    Measured: Between Day 0 and Week 96

  4. CD4 lymphocyte

    Evolution of CD4 lymphocyte absolute count and percentage

    Measured: Between Day 0 and Week 96

  5. Virological failure and new resistance mutations

    Percentage of participants with virological failure and new resistance mutations

    Measured: Week 48 and Week 96

  6. New HIV-1 drug resistance mutations

    Profile of new HIV-1 drug resistance mutations observed in participants with virological failure

    Measured: Week 48 and Week 96

  7. WHO stage 3-4 morbidity

    Incidence of WHO stage 3-4 morbidity ( AIDS events and non AIDS severe morbidity)

    Measured: Between Day 0 and Week 96

  8. ANRS grade 3-4 overall morbidity

    Incidence of ANRS grade 3-4 overall morbidity (toxicity)

    Measured: Between Day 0 and Week 96

  9. ANRS grade 3-4 renal morbidity

    Incidence of ANRS grade 3-4 renal morbidity

    Measured: Between Day 0 and Week 96

  10. ANRS grade 3-4 neurologic morbidity

    Incidence of ANRS grade 3-4 neurologic morbidity

    Measured: Between Day 0 and Week 96

  11. ANRS grade 3-4 hepatic morbidity

    Incidence of ANRS grade 3-4 hepatic morbidity

    Measured: Between Day 0 and Week 96

  12. Creatinine clearance

    Evolution of creatinine clearance

    Measured: Between Day 0 and Week 96

  13. Grade 1,2,3 or 4 renal disorders

    Evolution of the percentage of patients with grade 1,2,3 or 4 renal disorders

    Measured: Between Day 0 and Week 96

  14. Grade 1,2,3 or 4 hepatic liver disorders or abnormalities

    Evolution of the percentage of patients with grade 1,2,3 or 4 hepatic liver disorders or abnormalities

    Measured: Between Day 0 and Week 96

  15. Grade 1,2,3 or 4 CNS disorders

    Evolution of the percentage of patients with grade 1,2,3 or 4 CNS disorders

    Measured: Between Day 0 and Week 96

  16. Bone mineral density

    Evolution of bone mineral density measured using CT bone density scan

    Measured: Between Day 0 and Week 96

  17. Adherence to treatment using a self-questionnaire

    Evolution of adherence to treatments measured using a self-questionnaire

    Measured: Between Day 0 and Week 96

  18. Life quality

    Evolution of quality of life measured using the ProQOL questionnaire

    Measured: Between Day 0 and Week 96

  19. Symptoms

    Evolution of symptoms using the "symptoms experienced" questionnaire

    Measured: Between Day 0 and Week 96

  20. ARV drug plasma concentrations in participants with treatment failure

    ARV drug plasma concentrations in participants with treatment failure

    Measured: Between Day 0 and Week 96

  21. Switched back to triple therapy

    Percentage of patients on dual therapy who switched back to triple therapy

    Measured: Between Day 0 and Week 96

  22. Cost-effectiveness of the 3 ARV strategies

    Cost-effectiveness of the 3 ARV strategies

    Measured: Week 96

Timeline

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

  1. First posted17 Jul 2019
  2. Study start17 Nov 2020
  3. Primary completion30 Dec 2024
  4. Study completion30 Dec 2024

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
480 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04022967
Sponsor's protocol ID
ANRS 12372 MODERATO
Acronym
MODERATO
Status last verified
Oct 2026
First submitted
12 Jul 2019
Last updated
16 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing dolutegravir, atazanavir boosted with ritonavir and tenofovir + lamivudine +efavirenz or dolutegravir + lamivudine + tenofovir in people with HIV-1-infection, run by ANRS, Emerging Infectious Diseases at 5 sites in 3 countries.

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 14 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 16 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Burkina Faso, Côte d’Ivoire, Cameroon. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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?

The treatment success, as defined by using the FDA snapshot algorithm (time frame: 90 to 102 weeks). 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 16 Oct 2026.

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