HIV InfectionPhase 3NCT04223791
Switch to Doravirine/Islatravir (DOR/ISL) in Human Immunodeficiency Virus 1 (HIV-1) Participants Treated With Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF) (MK-8591A-018)
A Phase 3 study testing DOR/ISL and BIC/FTC/TAF in people with HIV Infection, run by Merck Sharp & Dohme LLC at 89 sites in 11 countries.
Trial summary
This study will evaluate the safety and efficacy of a switch to Doravirine/Islatravir (DOR/ISL) (MK-8591A) (a fixed dose combination of doravirine 100 mg and islatravir 0.75 mg) in participants living with human immunodeficiency virus-1 (HIV-1) virologically suppressed on a regimen of… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- HIV Infection
- What is being tested?
- DOR/ISL and BIC/FTC/TAF
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 643 participants
- Where
- 89 sitesin 11 countries
- Study dates
- 18 Feb 2020to 27 Feb 2025
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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
- Is HIV-1 positive with plasma Human Immunodeficiency Virus 1 (HIV-1) RNA <50 copies/mL at screening.
- Has been receiving bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) therapy with documented viral suppression (HIV-1 RNA <50 copies/mL) for ≥3 months prior to signing informed consent and has no history of prior virologic treatment failure on any past or current regimen.
- Females are eligible to participate if not pregnant or breastfeeding, and at least one of the following conditions applies: Is not a woman of childbearing potential (WOCBP); is a WOCBP and using an acceptable contraceptive method, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle; a WOCBP must have a negative highly sensitive pregnancy test ([urine or serum] as required by local regulations) within 24 hours before the first dose of study intervention; if a urine test cannot be confirmed as negative (e.g. an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
Who cannot join
- Has HIV-2 infection.
- Has an active diagnosis of hepatitis due to any cause, including active Hepatitis B Virus (HBV) co-infection.
- Has a history of malignancy ≤5 years prior to signing informed consent except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or cutaneous Kaposi's sarcoma.
- Is taking or is anticipated to require systemic immunosuppressive therapy, immune modulators, or any prohibited therapies.
- Is currently participating in or has participated in a clinical study with an investigational compound or device from 45 days prior to Day 1 through the study treatment period.
- Has a documented or known virologic resistance to doravirine (DOR).
- expects to conceive or donate eggs at any time during the study.
Trial locations and contacts
89 sites in 11 countries.
89 sites in 11 countries
United States28 sites
Augusta University ( Site 2752)
Augusta, Georgia, 30912
Pacific Oaks Medical Group ( Site 2765)
Beverly Hills, California, 90211
North Texas ID Consultants, PA ( Site 2707)
Dallas, Texas, 75246
Infectious Disease Specialists Of Atlanta PC ( Site 2719)
Decatur, Georgia, 30033
TheraFirst Medical Center ( Site 2742)
Fort Lauderdale, Florida, 33308
Midway Immunology and Research ( Site 2759)
Ft. Pierce, Florida, 34982
ID Care ( Site 2751)
Hillsborough, New Jersey, 08844
The Crofoot Research Center, Inc. ( Site 2715)
Houston, Texas, 77098
Kansas City CARE Clinic ( Site 2718)
Kansas City, Missouri, 64111
DCOL Center for Clinical Research ( Site 2769)
Longview, Texas, 75605
Men's Health Foundation ( Site 2749)
Los Angeles, California, 80069
Kaiser Permanente Los Angeles Medical Center ( Site 2775)
Los Angeles, California, 90027
Mercer University ( Site 2738)
Macon, Georgia, 31201
The Kinder Medical Group ( Site 2739)
Miami, Florida, 33133
AHF South Beach ( Site 2780)
Miami Beach, Florida, 33140
Hennepin County Medical Center ( Site 2733)
Minneapolis, Minnesota, 55415
Icahn School of Medicine at Mount Sinai ( Site 2700)
New York, New York, 10029
Orlando Immunology Center ( Site 2734)
Orlando, Florida, 32803
Eisenhower Medical Center ( Site 2744)
Palm Springs, California, 92264
Pueblo Family Physicians ( Site 2717)
Phoenix, Arizona, 85015
University of California, Davis, Division of ID Research ( Site 2702)
Sacramento, California, 95811
Zuckerberg San Francisco General Hospital UCSF ( Site 2743)
San Francisco, California, 94110
Chatham County Health Department ( Site 2731)
Savannah, Georgia, 31401
Dr. Peter Shalit, MD ( Site 2770)
Seattle, Washington, 98104
Multicare Health System ( Site 2713)
Spokane, Washington, 99204
Montefiore Einstein Center ( Site 2730)
The Bronx, New York, 10467
Whitman-Walker Clinic ( Site 2728)
Washington D.C., District of Columbia, 20009
Triple O Research Institute, P.A. ( Site 2755)
West Palm Beach, Florida, 33407
France12 sites
Hopital Edouard Herriot ( Site 3126)
Lyon, Ain, 69003
Hopital Europeen Marseille ( Site 3117)
Marseille, Bouches-du-Rhone, 13003
CHU de Montpellier - Hopital Saint-Eloi ( Site 3121)
Montpellier, Herault, 34295
CHU Hotel Dieu Nantes ( Site 3120)
Nantes, Loire-Atlantique, 44093
CHU de Nice Hopital Archet 1 ( Site 3103)
Nice, Alpes-Maritimes, 06202
Centre Hospitalier Regional du Orleans ( Site 3108)
Orléans, Loiret, 45000
Hopital Saint-Antoine ( Site 3113)
Paris, 75012
Hopital Pitie Salpetriere ( Site 3111)
Paris, 75013
Hopital Tenon ( Site 3118)
Paris, 75020
Hopital Foch ( Site 3129)
Suresnes, Hauts-de-Seine, 92151
Centre Hospitalier de Tourcoing ( Site 3100)
Tourcoing, Nord, 59208
CHU de Nancy Hopital Brabois Adultes ( Site 3128)
Vandœuvre-lès-Nancy, Meurthe-et-Moselle, 54511
Germany11 sites
ZIBP-Zentrum fur Infektiologie Berlin Prenzlauer Berg GmbH ( Site 3003)
Berlin, 10439
EPIMED GmbH ( Site 3008)
Berlin, 12167
Universitaetsklinikum Bonn ( Site 3000)
Bonn, North Rhine-Westphalia, 53127
Universitaetsklinikum Essen ( Site 3007)
Essen, North Rhine-Westphalia, 45122
Infektiologikum ( Site 3001)
Frankfurt am Main, Hesse, 60596
ICH Study Center GmbH & Co.KG ( Site 3009)
Hamburg, 20146
Universitaetsklinikum Hamburg- Eppendorf (UKE) ( Site 3010)
Hamburg, 20246
Medizinische Hochschule Hannover ( Site 3012)
Hanover, Lower Saxony, 30625
MVZ Karlsplatz Dr.med.Hans Jaeger ( Site 3002)
Munich, Bavaria, 80335
Klinikum der LMU München ( Site 3004)
Munich, Bavaria, 80336
Klinikum rechts der Isar der Technischen Universitat ( Site 3005)
Munich, Bavaria, 81675
Spain10 sites
Hospital Universitari Germans Trias i Pujol ( Site 3601)
Badalona, Barcelona [Barcelona], 08916
Hospital Universitari Vall d Hebron ( Site 3602)
Barcelona, Barcelona [Barcelona], 08035
Hospital Clinic i Provincial ( Site 3600)
Barcelona, 08036
Hospital Universitari de Bellvitge ( Site 3612)
LHospitalet de Llobregat, Barcelona [Barcelona], 08907
Hospital General Universitario Gregorio Maranon ( Site 3603)
Madrid, 28007
Hospital Universitario Infanta Leonor ( Site 3606)
Madrid, 28031
Hospital Universitario Ramon y Cajal ( Site 3611)
Madrid, 28034
Hospital 12 de Octubre de Madrid ( Site 3605)
Madrid, 28041
Hospital Universitario La Paz ( Site 3604)
Madrid, 28046
Hospital Universitario Virgen de la Victoria ( Site 3609)
Málaga, 29010
Australia7 sites
Holdsworth House Medical Practice - Brisbane ( Site 3810)
Brisbane, Queensland, 4006
St Vincent's Hospital ( Site 3807)
Darlinghurst, New South Wales, 2010
Taylor Square Private Clinic ( Site 3804)
Darlinghurst, New South Wales, 2010
Royal Brisbane and Womens Hospital- Infectious Diseases Unit ( Site 3812)
Herston, Queensland, 4029
The Alfred Hospital ( Site 3802)
Melbourne, Victoria, 3004
Prahran Market Clinic (PMC) ( Site 3806)
Melbourne, Victoria, 3181
Holdsworth House Medical Practice ( Site 3800)
Sydney, New South Wales, 2010
Italy5 sites
Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico ( Site 3501)
Milan, Lombardy, 20122
Universita' Vita Salute. Ospedale San Raffaele ( Site 3502)
Milan, 20127
Azienda Ospedaliera San Paolo ( Site 3503)
Milan, 20142
ASST Fatebenefratelli-Ospedale Sacco ( Site 3500)
Milan, 20157
A.O.R.N. dei Colli - Ospedale Cotugno ( Site 3507)
Naples, 80131
Austria4 sites
LKH Graz West ( Site 3401)
Graz, Styria, 8020
Medical University Vienna ( Site 3402)
Vienna, State of Vienna, 1090
Sozialmedizinisches Zentrum Sued - Kaiser-Franz-Josef-Spital ( Site 3400)
Vienna, State of Vienna, 1100
Social Medical Center - Otto Wagner Hospital ( Site 3404)
Vienna, State of Vienna, 1145
Canada4 sites
Hamilton Health Sciences ( Site 2803)
Hamilton, Ontario, L8L 2X2
Clinique de Medecine Urbaine du Quartier Latin ( Site 2804)
Montreal, Quebec, H2L 4E9
Clinique Medicale L Actuel ( Site 2814)
Montreal, Quebec, H2L 4P9
Vancouver ID Research and Care Centre Society ( Site 2800)
Vancouver, British Columbia, V6Z 2C7
Puerto Rico4 sites
CAIMED Center - Ponce School of Medicine ( Site 2903)
Ponce, 00716
Puerto Rico CONCRA ( Site 2904)
Rio Piedras, 00925
Clinical Research Puerto Rico Inc ( Site 2900)
San Juan, 00909
Hope Clinical Research, Inc. ( Site 2902)
San Juan, 00909
Japan3 sites
National Hospital Organization Nagoya Medical Center ( Site 7203)
Nagoya, Aichi-ken, 460-0001
National Hospital Organization Osaka National Hospital ( Site 7202)
Osaka, 540-0006
Center Hospital of the National Center for Global Health and Medicine ( Site 7201)
Tokyo, 162-8655
Finland1 site
Helsinki University Hospital ( Site 3200)
Helsinki, Uusimaa, 00029
About this study
Official title: A Phase 3, Randomized, Active-Controlled, Double-Blind Clinical Study to Evaluate a Switch to Doravirine/Islatravir (DOR/ISL) Once-Daily in Participants With HIV-1 Virologically Suppressed on Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF)
This study will evaluate the safety and efficacy of a switch to Doravirine/Islatravir (DOR/ISL) (MK-8591A) (a fixed dose combination of doravirine 100 mg and islatravir 0.75 mg) in participants living with human immunodeficiency virus-1 (HIV-1) virologically suppressed on a regimen of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). The primary hypothesis is that a switch to DOR/ISL (MK-8591A) will be non-inferior to continued treatment with BIC/FTC/TAF as assessed by the proportion of participants with HIV-1 ribonucleic acid (RNA) ≥50 copies/mL at Week 48. Participants who benefit from their assigned intervention (as determined by investigator) will be able to continue treatment through a 24-week study extension.
- Conditions
- HIV Infection
- Being tested
- DOR/ISL, BIC/FTC/TAF, Placebo to BIC/FTC/TAF, Placebo to FDC DOR/ISL
- Medical subject headings
- HIV Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DOR/ISLDrug
Also called MK-8591A
100 mg DOR/ 0.75 ISL FDC single tablet taken orally once daily
BIC/FTC/TAFDrug
50 mg BIC, 200 mg FTC, and 25 mg TAF combined in a single tablet, taken orally once daily
Placebo to BIC/FTC/TAFDrug
Placebo to BIC/FTC/TAF in a single tablet taken orally, once daily
Placebo to FDC DOR/ISLDrug
Also called Placebo to MK-8591A
Placebo to FDC DOR/ISL in a single tablet taken orally, once daily
| Study group | Role | What they receive |
|---|---|---|
| DOR/ISL | Experimental | Participants with Human Immunodeficiency Virus-1 (HIV-1) that have been virologically suppressed for ≥3 consecutive months with no history of treatment failure who were previously treated with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) received a once daily (QD) fixed dose combination (FDC) of 100 mg doravirine (DOR)/0.75 mg islatravir (ISL) for 144 weeks; and a placebo to BIC/FTC/TAF for 96 weeks. At Week 144, participants who consent to enter the optional open-label study extension will continue to receive QD FDC of DOR/ISL (100 mg/0.75 mg) for an additional 24 weeks, up to Week 168. Receives: Drug: DOR/ISL; Drug: Placebo to BIC/FTC/TAF |
| BIC/FTC/TAF | Active comparator | Participants with Human Immunodeficiency Virus-1 (HIV-1) that have been virologically suppressed for ≥3 consecutive months with no history of treatment failure who were previously treated with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) received once daily (QD) 50 mg bictegravir (BIC), 200 mg emtricitabine (FTC), 25 mg tenofovir alafenamide (TAF) for 144 weeks, and placebo to fixed dose combination (FDC) DOR/ISL for 96 weeks. At Week 144, participants who consent to enter the optional open-label study extension will continue to receive QD BIC/FTC/TAF (50 mg/200 mg/25 mg) for an additional 24 weeks, up to Week 168. Receives: Drug: BIC/FTC/TAF; Drug: Placebo to FDC DOR/ISL |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With Human Immunodeficiency Virus 1 Ribonucleic Acid (HIV-1 RNA) ≥50 Copies/mL at Week 48
The Abbott RealTime polymerase chain reaction (PCR) assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the primary outcome measure, the percentage of participants with HIV-1 RNA ≥50 copies/mL at Week 48, is presented using the Food and Drug Administration (FDA) Snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Measured: Week 48
Percentage of Participants With One or More Adverse Events (AEs) up to Week 48
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who experienced an AE up to week 48 is presented.
Measured: Up to 48 weeks
Percentage of Participants Who Discontinued Study Intervention Due to an AE up to Week 48
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who discontinued study intervention due to an AE up to week 48 is presented.
Measured: Up to 48 weeks
Secondary outcomes (19)
Percentage of Participants With HIV-1 RNA ≥50 Copies/mL at Week 96
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, percentage of participants with HIV-1 RNA ≥50 copies/mL at Week 96, is presented using the Food and Drug Administration (FDA) Snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Measured: Week 96
Percentage of Participants With HIV-1 RNA ≥50 Copies/mL at Week 144
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, percentage of participants with HIV-1 RNA ≥50 copies/mL at Week 144, is presented using the FDA snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Measured: Week 144
Percentage of Participants With HIV-1 RNA <50 Copies/mL at Week 48
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, the percentage of participants with HIV-1 RNA <50 copies/mL at Week 48, is presented using the FDA snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Measured: Week 48
Percentage of Participants With HIV-1 RNA <40 Copies/mL at Week 48
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, the percentage of participants with HIV-1 RNA <40 copies/mL at Week 48, is presented using the FDA snapshot missing data approach.
Measured: Week 48
Percentage of Participants With HIV-1 RNA <50 Copies/mL at Week 96
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, the percentage of participants with HIV-1 RNA <50 copies/mL at Week 96, is presented using the FDA snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Measured: Week 96
Percentage of Participants With HIV-1 RNA <40 Copies/mL at Week 96
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, the percentage of participants with HIV-1 RNA <40 copies/mL at Week 96, is presented using the FDA snapshot missing data approach.
Measured: Week 96
Percentage of Participants With HIV-1 RNA <50 Copies/mL at Week 144
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, the percentage of participants with HIV-1 RNA <50 copies/mL at Week 144 is presented using the FDA snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Measured: Week 144
Percentage of Participants With HIV-1 RNA <40 Copies/mL at Week 144
The Abbott RealTime PCR assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the secondary outcome measure, percentage of participants with HIV-1 RNA <40 copies/mL at Week 144, is presented using the FDA snapshot missing data approach.
Measured: Week 144
Mean Change From Baseline in Cluster of Differentiation-positive (CD4+) T-cell Count at Week 48
Plasma CD4+ T-cell count was measured in cells/mm^3 for baseline and 48 weeks by a central laboratory. Baseline measurement of CD4+ T-cell count is defined as the day 1 value for each participant. The mean change from baseline in CD4+ T-cell count at week 48 using the data as observed (DAO) approach is presented. A negative value indicates a mean decrease in CD4+ T-cell count from baseline and a positive value indicates a mean increase in CD4+ T-cell count from baseline.
Measured: Baseline and Week 48
Mean Change From Baseline in CD4+ T-cell Count at Week 96
Plasma CD4+ T-cell count was measured in cells/mm^3 for baseline and 96 weeks by a central laboratory. Baseline measurement of CD4+ T-cell count is defined as the day 1 value for each participant. The mean change from baseline in CD4+ T-cell count at week 96 using the data as observed (DAO) approach is presented. A negative value indicates a mean decrease in CD4+ T-cell count from baseline and a positive value indicates a mean increase in CD4+ T-cell count from baseline.
Measured: Baseline and Week 96
Mean Change From Baseline in CD4+ T-cell Count at Week 144
Plasma CD4+ T-cell count was measured in cells/mm^3 for baseline and 144 weeks by a central laboratory. Baseline measurement of CD4+ T-cell count is defined as the day 1 value for each participant. The mean change from baseline in CD4+ T-cell count at week 144 using the data as observed (DAO) approach is presented. A negative value indicates a mean decrease in CD4+ T-cell count from baseline and a positive value indicates a mean increase in CD4+ T-cell count from baseline.
Measured: Baseline and Week 144
Number of Participants With Viral Drug Resistance-associated Substitutions at Week 48
Viral drug resistance is defined as participants with confirmed HIV-1 RNA ≥400 copies/mL having genotypic or phenotypic evidence of resistance to the study drug administered. The number of participants who demonstrate drug resistance is presented.
Measured: Week 48
Number of Participants With Evidence of Viral Drug Resistance-associated Substitutions at Week 96
Viral drug resistance is defined as participants with confirmed HIV-1 RNA ≥400 copies/mL and/or genotypic or phenotypic analysis of data showing evidence of resistance to the study drug administered. The number of participants who demonstrate drug resistance at week 96 is presented.
Measured: Week 96
Number of Participants With Evidence of Viral Drug Resistance-associated Substitutions at Week 144
Viral drug resistance is defined as participants with confirmed HIV-1 RNA ≥400 copies/mL and/or genotypic or phenotypic analysis of data showing evidence of resistance to the study drug administered. The number of participants who demonstrate drug resistance at week 144 is presented.
Measured: Week 144
Change From Baseline in Body Weight at Week 48
Body weight was measured and recorded at baseline and week 48. Participants removed their shoes and wore a single layer of clothing at each measurement. The mean change from baseline in body weight at week 48 is presented.
Measured: Baseline and Week 48
Change From Baseline in Body Weight at Week 96
Body weight was measured and recorded at baseline and week 96. Participants removed their shoes and wore a single layer of clothing at each measurement. The mean change from baseline in body weight at week 96 is presented.
Measured: Baseline and Week 96
Change From Baseline in Body Weight at Week 144
Body weight was measured and recorded at baseline and week 144. Participants removed their shoes and wore a single layer of clothing at each measurement. The mean change from baseline in body weight at week 144 is presented.
Measured: Baseline and Week 144
Percentage of Participants With One or More AEs
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who experienced at least one or more AEs is presented. Per protocol, pregnancy-related AEs collected for enrolled participants are reported separately and are presented in the AE module.
Measured: Up to approximately 55 months
Percentage of Participants Who Discontinued Study Intervention Due to an AE
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who discontinued study intervention due to an AE is presented. Per protocol, pregnancy-related AEs collected for enrolled participants are reported separately and are presented in the AE module.
Measured: Up to approximately 40 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Jan 2020
- Study start18 Feb 2020
- Primary completion26 Aug 2021
- Study completion27 Feb 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for HIV InfectionStudies of the same condition, open and under way.
- More trials run by Merck Sharp & Dohme LLCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 643 participants (actual)
Sponsor and investigators
- Lead sponsor
- Merck Sharp & Dohme LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Merck Sharp & Dohme LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04223791
- Sponsor's protocol ID
- 8591A-018
- Other IDs
- MK-8591A-018, 205166, 2019-000587-23, 2019
- Status last verified
- Mar 2026
- First submitted
- 8 Jan 2020
- Last updated
- 27 Mar 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: https://trialstransparency.msdclinicaltrials.com/pdf/ProcedureAccessClinicalTrialData.pdf
Publications
Mills AM, Rizzardini G, Ramgopal MN, Osiyemi OO, Bogner JR, Hagins DP, Paredes R, Reynes J, Rockstroh JK, Carr A, Su FH, Klopfer SO, Eves K, Plank RM, Correll T, Fox MC. Switch to fixed-dose doravirine (100 mg) with islatravir (0.75 mg) once daily in virologically suppressed adults with HIV-1 on bictegravir, emtricitabine, and tenofovir alafenamide: 48-week results of a phase 3, randomised, controlled, double-blind, non-inferiority trial. Lancet HIV. 2024 Jun;11(6):e357-e368. doi: 10.1016/S2352-3018(24)00030-4. Epub 2024 May 8.
PubMed 38734016
Study at a glance
From the registry record, last updated by the sponsor on 27 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Randomized, Active-Controlled, Double-Blind Clinical Study to Evaluate a Switch to Doravirine/Islatravir (DOR/ISL) Once-Daily in Participants With HIV-1 Virologically Suppressed on Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF)
- ClinicalTrials.gov ID
- NCT04223791
- Acronym / sponsor ID
- 8591A-018
- Conditions
- HIV Infection
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 643 participants (actual)
- Lead sponsor
- Merck Sharp & Dohme LLCIndustry (pharma, biotech, devices)
- Study start
- 18 Feb 2020 (actual)
- Primary completion
- 26 Aug 2021 (actual)
- Study completion
- 27 Feb 2025 (actual)
- First posted
- 10 Jan 2020 (actual)
- Results
- Posted 22 Aug 2022
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will evaluate the safety and efficacy of a switch to Doravirine/Islatravir (DOR/ISL) (MK-8591A) (a fixed dose combination of doravirine 100 mg and islatravir 0.75 mg) in participants living with human immunodeficiency virus-1 (HIV-1) virologically suppressed on a regimen of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). The primary hypothesis is that a switch to DOR/ISL (MK-8591A) will be non-inferior to continued treatment with BIC/FTC/TAF as assessed by the proportion of participants with HIV-1 ribonucleic acid (RNA) ≥50 copies/mL at Week 48. Participants who benefit from their assigned intervention (as determined by investigator) will be able to continue treatment through a 24-week study extension.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| DOR/ISL | Experimental | Drug: DOR/ISL, Drug: Placebo to BIC/FTC/TAFParticipants with Human Immunodeficiency Virus-1 (HIV-1) that have been virologically suppressed for ≥3 consecutive months with no history of treatment failure who were previously treated with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) received a once daily (QD) fixed dose combination (FDC) of 100 mg doravirine (DOR)/0.75 mg islatravir (ISL) for 144 weeks; and a placebo to BIC/FTC/TAF for 96 weeks. At Week 144, participants who consent to enter the optional open-label study extension will continue to receive QD FDC of DOR/ISL (100 mg/0.75 mg) for an additional 24 weeks, up to Week 168. |
| BIC/FTC/TAF | Active comparator | Drug: BIC/FTC/TAF, Drug: Placebo to FDC DOR/ISLParticipants with Human Immunodeficiency Virus-1 (HIV-1) that have been virologically suppressed for ≥3 consecutive months with no history of treatment failure who were previously treated with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) received once daily (QD) 50 mg bictegravir (BIC), 200 mg emtricitabine (FTC), 25 mg tenofovir alafenamide (TAF) for 144 weeks, and placebo to fixed dose combination (FDC) DOR/ISL for 96 weeks. At Week 144, participants who consent to enter the optional open-label study extension will continue to receive QD BIC/FTC/TAF (50 mg/200 mg/25 mg) for an additional 24 weeks, up to Week 168. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Is HIV-1 positive with plasma Human Immunodeficiency Virus 1 (HIV-1) RNA <50 copies/mL at screening.
- Has been receiving bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) therapy with documented viral suppression (HIV-1 RNA <50 copies/mL) for ≥3 months prior to signing informed consent and has no history of prior virologic treatment failure on any past or current regimen.
- Females are eligible to participate if not pregnant or breastfeeding, and at least one of the following conditions applies: Is not a woman of childbearing potential (WOCBP); is a WOCBP and using an acceptable contraceptive method, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle; a WOCBP must have a negative highly sensitive pregnancy test ([urine or serum] as required by local regulations) within 24 hours before the first dose of study intervention; if a urine test cannot be confirmed as negative (e.g. an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
Key exclusion criteria (7 listed)
- Has HIV-2 infection.
- Has an active diagnosis of hepatitis due to any cause, including active Hepatitis B Virus (HBV) co-infection.
- Has a history of malignancy ≤5 years prior to signing informed consent except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or cutaneous Kaposi's sarcoma.
- Is taking or is anticipated to require systemic immunosuppressive therapy, immune modulators, or any prohibited therapies.
- Is currently participating in or has participated in a clinical study with an investigational compound or device from 45 days prior to Day 1 through the study treatment period.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| DOR/ISLAlso: MK-8591A100 mg DOR/ 0.75 ISL FDC single tablet taken orally once daily | Drug | DOR/ISL |
| BIC/FTC/TAF50 mg BIC, 200 mg FTC, and 25 mg TAF combined in a single tablet, taken orally once daily | Drug | BIC/FTC/TAF |
| Placebo to BIC/FTC/TAFPlacebo to BIC/FTC/TAF in a single tablet taken orally, once daily | Drug | DOR/ISL |
| Placebo to FDC DOR/ISLAlso: Placebo to MK-8591APlacebo to FDC DOR/ISL in a single tablet taken orally, once daily | Drug | BIC/FTC/TAF |
Primary outcome
Percentage of Participants With Human Immunodeficiency Virus 1 Ribonucleic Acid (HIV-1 RNA) ≥50 Copies/mL at Week 48
Time frame: Week 48
The Abbott RealTime polymerase chain reaction (PCR) assay with a reliable lower limit of quantification of 40 copies/mL was used to measure the HIV-1 RNA level in blood samples obtained at each visit. Per protocol, the primary outcome measure, the percentage of participants with HIV-1 RNA ≥50 copies/mL at Week 48, is presented using the Food and Drug Administration (FDA) Snapshot missing data approach. The percentage values were rounded to the nearest tenth digit.
Percentage of Participants With One or More Adverse Events (AEs) up to Week 48
Time frame: Up to 48 weeks
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who experienced an AE up to week 48 is presented.
Percentage of Participants Who Discontinued Study Intervention Due to an AE up to Week 48
Time frame: Up to 48 weeks
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants who discontinued study intervention due to an AE up to week 48 is presented.
19 secondary outcomes
Percentage of Participants With HIV-1 RNA ≥50 Copies/mL at Week 96
Time frame: Week 96
Percentage of Participants With HIV-1 RNA ≥50 Copies/mL at Week 144
Time frame: Week 144
Percentage of Participants With HIV-1 RNA <50 Copies/mL at Week 48
Time frame: Week 48
Percentage of Participants With HIV-1 RNA <40 Copies/mL at Week 48
Time frame: Week 48
Percentage of Participants With HIV-1 RNA <50 Copies/mL at Week 96
Time frame: Week 96
Percentage of Participants With HIV-1 RNA <40 Copies/mL at Week 96
Time frame: Week 96
Percentage of Participants With HIV-1 RNA <50 Copies/mL at Week 144
Time frame: Week 144
Percentage of Participants With HIV-1 RNA <40 Copies/mL at Week 144
Time frame: Week 144
Mean Change From Baseline in Cluster of Differentiation-positive (CD4+) T-cell Count at Week 48
Time frame: Baseline and Week 48
Mean Change From Baseline in CD4+ T-cell Count at Week 96
Time frame: Baseline and Week 96
Mean Change From Baseline in CD4+ T-cell Count at Week 144
Time frame: Baseline and Week 144
Number of Participants With Viral Drug Resistance-associated Substitutions at Week 48
Time frame: Week 48
Number of Participants With Evidence of Viral Drug Resistance-associated Substitutions at Week 96
Time frame: Week 96
Number of Participants With Evidence of Viral Drug Resistance-associated Substitutions at Week 144
Time frame: Week 144
Change From Baseline in Body Weight at Week 48
Time frame: Baseline and Week 48
Change From Baseline in Body Weight at Week 96
Time frame: Baseline and Week 96
Change From Baseline in Body Weight at Week 144
Time frame: Baseline and Week 144
Percentage of Participants With One or More AEs
Time frame: Up to approximately 55 months
Percentage of Participants Who Discontinued Study Intervention Due to an AE
Time frame: Up to approximately 40 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 38734016Mills AM, Rizzardini G, Ramgopal MN, Osiyemi OO, Bogner JR, Hagins DP, Paredes R, Reynes J, Rockstroh JK, Carr A, Su FH, Klopfer SO, Eves K, Plank RM, Correll T, Fox MC. Switch to fixed-dose doravirine (100 mg) with islatravir (0.75 mg) once daily in virologically suppressed adults with HIV-1 on bictegravir, emtricitabine, and tenofovir alafenamide: 48-week results of a phase 3, randomised, controlled, double-blind, non-inferiority trial. Lancet HIV. 2024 Jun;11(6):e357-e368. doi: 10.1016/S2352-3018(24)00030-4. Epub 2024 May 8.
- Merck Clinical Trials InformationLink provided by the sponsor.
- Plain Language SummaryLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. https://trialstransparency.msdclinicaltrials.com/pdf/ProcedureAccessClinicalTrialData.pdf
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
Merck Sharp & Dohme LLC
89 sites in 11 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing DOR/ISL and BIC/FTC/TAF in people with HIV Infection, run by Merck Sharp & Dohme LLC at 89 sites in 11 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 3 inclusion and 7 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 27 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 89 sites in United States, France, Germany, Spain, Australia and 6 more countries. 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?
Yes. Results are posted in the registry (first posted 22 Aug 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Percentage of Participants With Human Immunodeficiency Virus 1 Ribonucleic Acid (HIV-1 RNA) ≥50 Copies/mL at Week 48 (time frame: Week 48). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04223791, which also lists 1 linked publication.
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 27 Mar 2026.