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HIV-1 InfectionPhase 2NCT04295772

Doravirine/Islatravir (DOR/ISL) in Pediatric Participants With Human Immunodeficiency Virus Type 1 (HIV-1) Who Are <18 Years of Age and Weigh ≥35 kg (MK-8591A-028)

A Phase 2 study testing DOR/ISL in people with HIV-1 Infection, run by Merck Sharp & Dohme LLC at 17 sites in 5 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

This is a phase 2, single-group, multi-site, open-label study of an islatravir/doravirine (ISL/DOR, MK-8591A) fixed dose combination (FDC) for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in pediatric participants who are virologically suppressed (VS) on antiretroviral therapy (ART) for ≥3… Read more about this study

Who is it for?
Ages Up to 17 years
Conditions the study is for
HIV-1 Infection
What is being tested?
DOR/ISL
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
17 sitesin 5 countries
Study dates
26 Nov 2020to 25 Jan 2023
Phase
Phase 2
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 Up to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Is HIV-1 positive, is <18 years of age, and weighs ≥35 kg at screening.
  • VS Participants: Is HIV-1 positive at Screening with plasma HIV-1 RNA <50 copies/mL and has been receiving continuous, stable oral 2-drug or 3-drug combination ART ± PK booster with documented viral suppression for ≥3 months prior to providing documented informed consent/assent and has no history of prior virologic treatment failure on any past or current regimen.
  • TN Participants: Is HIV-1 positive at Screening with plasma HIV-1 RNA ≥500 copies/mL and is naive to ART defined as having received <=10 days of prior therapy with any antiretrovirals following HIV-1 diagnosis other than pre-exposure prophylaxis (PrEP) or potentially exposed person (PEP).
  • If female, is not pregnant or breastfeeding, and is either 1) not a woman of childbearing potential (WOCBP) or 2) is a WOCBP and is using acceptable contraception or is abstinent.

Who cannot join

  • Has HIV-2 infection.
  • Has hypersensitivity or other contraindication to any of the components of the study drugs as determined by the investigator.
  • Has an active diagnosis of hepatitis due to any cause, including active hepatitis B virus (HBV) infection (defined as hepatitis B surface antigen [HBsAg]-positive or HBV deoxyribonucleic acid [DNA] positive).
  • 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.
  • 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.
  • Is taking or is anticipated to require systemic immunosuppressive therapy, immune modulators, or any prohibited therapies from 45 days prior to Day 1 through the study treatment period.
Show all 11Show fewer
  • Is currently taking long-acting cabotegravir-rilpivirine.
  • Is currently participating in or has participated in an interventional 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 DOR/ISL (DOR resistance substitutions in reverse transcriptase: V106A/M, V108I, Y188L, H221Y, P225H, F227C/L, M230I/L, L234I, P236L, or Y318F; ISL resistance substitution in reverse transcriptase: M184V/I).
  • Has exclusionary laboratory values.
  • Is female and expecting to conceive or donate eggs at any time during the study.

Trial locations and contacts

17 sites in 5 countries.

17 sites in 5 countries

United States4 sites
  • Emory Children's Center ( Site 1805)

    Atlanta, Georgia, 30322

  • Johns Hopkins University ( Site 1800)

    Baltimore, Maryland, 21287

  • Duke University ( Site 1807)

    Durham, North Carolina, 27705

  • Children's National Medical Center ( Site 1816)

    Washington D.C., District of Columbia, 20010

Other trials in United States

Russia4 sites
  • Krasnoyarsk Regional Center for Prevention and Control of AIDS ( Site 1507)

    Krasnoyarsk, Krasnoyarsk Krai, 660049

  • Infectious Clinical Hospital #2 ( Site 1501)

    Moscow, Moscow, 105275

  • FGU Republican Clinical Infectious Hospital of Roszdrav ( Site 1500)

    Saint Petersburg, Sankt-Peterburg, 196645

  • Saratov Regional Clinical Center for Prophylaxis and Control of AIDS ( Site 1505)

    Saratov, Saratov Oblast, 410009

Other trials in Russia

South Africa4 sites
  • King Edward Hospital ( Site 1900)

    Durban, KwaZulu-Natal, 4001

  • Perinatal HIV Research Unit ( Site 1902)

    Johannesburg, Gauteng, 1864

  • Wits Reproductive Health and HIV Institute (WRHI) ( Site 1903)

    Johannesburg, Gauteng, 2000

  • Empilweni Services and Research Unit ( Site 1904)

    Johannesburg, Gauteng, 2093

Other trials in South Africa

Thailand3 sites
  • Chulalongkorn University ( Site 1602)

    Bangkok, Bangkok, 10330

  • Siriraj Hospital ( Site 1601)

    Bangkok, Bangkok, 10700

  • Research Institute for Health Sciences ( Site 1603)

    Chiang Mai, 50200

Other trials in Thailand

Italy2 sites
  • Azienda Ospedaliera Luigi Sacco ( Site 1300)

    Milan, 20157

  • IRCCS Ospedale Pediatrico Bambino Gesu ( Site 1301)

    Roma, 00165

Other trials in Italy

About this study

Official title: A Phase 2 Clinical Study to Evaluate the Pharmacokinetics, Safety, and Efficacy of Doravirine/Islatravir in Pediatric Participants With HIV-1 Infection Who Are Virologically Suppressed or Treatment-Naïve, Are Less Than 18 Years of Age, and Weigh Greater Than or Equal to 35 kg

This is a phase 2, single-group, multi-site, open-label study of an islatravir/doravirine (ISL/DOR, MK-8591A) fixed dose combination (FDC) for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in pediatric participants who are virologically suppressed (VS) on antiretroviral therapy (ART) for ≥3 months or are treatment-naive (TN). The primary purposes of the study are 1) to examine the steady-state pharmacokinetics (PK) of ISL in plasma; 2) the steady-state PK of ISL-triphosphate (ISL-TP) in peripheral blood mononuclear cells (PBMCs); and 3) to examine the safety and tolerability of ISL/DOR.

Read the detailed description

As of protocol amendment 03 (approved 08-Feb-2022), all participants have been discontinued from study therapy and will be switched to non-study antiretroviral therapy and monitored for safety. The present results cover data obtained through the cut-off date of 30-Mar-2022, and will be updated once monitoring is completed.

Conditions
HIV-1 Infection
Being tested
DOR/ISL

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, Doravirine/islatravir

    100 mg DOR/0.75 mg ISL FDC tablet taken once daily by mouth.

Study groups in NCT04295772
Study groupRoleWhat they receive
DOR/ISLExperimentalPediatric participants with HIV-1 infection receive DOR/ISL for 96 weeks.
Receives: Drug: DOR/ISL

What is being measured

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

  1. Area Under the Plasma Drug Concentration-time Curve From 0 to 24 Hours Post-dose (AUC0-24) of Islatravir (ISL)

    The AUC0-24 of ISL in plasma was determined at steady state.

    Measured: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28

  2. Maximum Plasma Concentration (Cmax) of ISL

    The Cmax of ISL in plasma was determined at steady state.

    Measured: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28

  3. Time to Reach Maximum Plasma Concentration (Tmax) of ISL

    The Tmax of ISL in plasma was determined at steady state.

    Measured: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28

  4. Apparent Plasma Terminal Half-life (t½) of ISL

    The t½ of ISL in plasma was determined at steady state.

    Measured: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28

  5. Apparent Total Clearance From Plasma (CL/F) of ISL

    The CL/F of ISL from plasma was determined at steady state.

    Measured: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28

  6. Apparent Volume of Distribution During Terminal Phase (Vz/F) of ISL

    The Vz/F of ISL was determined at steady state.

    Measured: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28

  7. AUC0-last of ISL-triphosphate (ISL-TP) in Peripheral Blood Mononuclear Cells (PBMCs)

    The AUC0-24 of ISL-TP in PBMCs was determined at steady state.

    Measured: Pre-dose, and 4 and 24 hours post-dose on Day 28

  8. Cmax of ISL-TP in PBMCs

    The Cmax of ISL-TP in PBMCs was determined at steady state.

    Measured: Pre-dose, and 4, and 24 hours post-dose on Day 28

  9. C24 of ISL-TP in PBMCs

    The C24 of ISL-TP in PBMCs was determined at steady state.

    Measured: 24 hours post-dose on Day 28

  10. Number of Participants Experiencing ≥1 Adverse Event (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.

    Measured: Up to 24 weeks

  11. Number of Participants Discontinuing From Study Treatment 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.

    Measured: Up to 24 weeks

Secondary outcomes (9)
  1. Percentage of Virologically Suppressed (VS) Participants With HIV-1 Ribonucleic Acid (RNA) ≥50 Copies/mL

    The percentage of VS participants with HIV-1 RNA ≥50 copies/mL was determined at the central laboratory with an Abbott Real Time Polymerase Chain Reaction (PCR) assay with a lower limit of detection (LLOD) of 40 copies/mL.

    Measured: Week 24

  2. Percentage of VS Participants With HIV-1 RNA <50 Copies/mL

    The percentage of VS participants with HIV-1 RNA <50 copies/mL will be determined at the central laboratory with an Abbott Real Time PCR assay with a LLOD of 40 copies/mL.

    Measured: Week 24

  3. Percentage of Treatment Naive (TN) Participants With HIV-1 RNA <50 Copies/mL

    The percentage of TN participants with HIV-1 RNA <50 copies/mL will be determined at the central laboratory with an Abbott Real Time PCR assay with a LLOD of 40 copies/mL.

    Measured: Week 24

  4. Change From Baseline in Cluster of Differentiation 4+ (CD4+) T-cells in VS Participants

    CD4+ T-cell counts were measured by a central laboratory. Negative and positive results represent a decrease and increase, respectively, from baseline CD4+ T-cell counts.

    Measured: Baseline (Day 1) and Week 24

  5. Change From Baseline in CD4+ T-cells in TN Participants

    CD4+ T-cell counts were measured by a central laboratory. Negative and positive results represent a decrease and increase, respectively, from baseline CD4+ T-cell counts.

    Measured: Baseline (Day 1) and Week 24

  6. Incidence of Viral Drug Resistance to DOR

    The number of participants with viral drug resistance to DOR was determined.

    Measured: Up to 24 weeks

  7. Incidence of Viral Drug Resistance to ISL

    The number of participants with viral drug resistance to ISL was determined.

    Measured: Up to 24 weeks

  8. Palatability of DOR/ISL Tablet

    The palatability of the DOR/ISL tablet (whole or split) was assessed with a modified 5-point facial hedonic scale. Responses ranged from 1 ("very bad") to 5 ("very good"). Data show the number of VS and TN participants responding at each score at the designated time points.

    Measured: Baseline (Day 1), Week 4, and Week 24

  9. Acceptability of DOR/ISL Tablet

    The acceptability of the DOR/ISL tablet (whole or split) was assessed. Acceptability was assessed by monitoring for refusing the tablet, throwing up or spitting out the tablet, and gagging on the tablet. Data show the number of VS and TN participants responding at each score at the designated time points.

    Measured: Baseline (Day 1), Week 4, and Week 24

Timeline

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

  1. First posted4 Mar 2020
  2. Study start26 Nov 2020
  3. Primary completion21 Dec 2021
  4. Study completion25 Jan 2023

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
42 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04295772
Sponsor's protocol ID
8591A-028
Other IDs
MK-8591A-028, 2019-003597-10, 2019
Status last verified
Jan 2024
First submitted
3 Mar 2020
Last updated
31 Jan 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing DOR/ISL in people with HIV-1 Infection, run by Merck Sharp & Dohme LLC at 17 sites in 5 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 4 inclusion and 11 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 31 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in United States, Russia, South Africa, Thailand, Italy. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 24 Feb 2023). 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?

Area Under the Plasma Drug Concentration-time Curve From 0 to 24 Hours Post-dose (AUC0-24) of Islatravir (ISL) (time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28). The study lists 11 primary outcomes in all. 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 31 Jan 2024; AzTrials last refreshed its copy on 8 Nov 2026.

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