HIV-1-infectionPhase 3WISARDNCT05349838
Open-Label Multi-Centre Randomised Switch Study to Evaluate Virological Efficacy Over 96Weeks Of 2-Drug Therapy With Dolutegravir(DTG)/Rilpivirine(RPV) Fixed Dose Combination(FDC) in Antiretroviral Treatment-Experienced HIV-1 Infected Subjects Virologically Suppressed With NNRTI Mutation K103N
A Phase 3 study testing Dolutegravir & Rilpivirine 2 drug fixed dose combined therapy in people with HIV-1-infection, run by NEAT ID Foundation at 29 sites in 6 countries.
Trial summary
HIV-1 infected subjects that experience virological failure while on non nucleoside reverse-transcriptase inhibitors (NNRTIs), including those with the K103N mutation, are usually switched to a boosted Protease Inhibitor (PI)-based regimen or other antiretroviral (ARV) combinations. 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 & Rilpivirine 2 drug fixed dose combined therapy
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 140 participants
- Where
- 29 sitesin 6 countries
- Study dates
- 5 Nov 2018to 9 Nov 2022
- 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
- Patient volunteers who meet all of the following criteria are eligible for this trial:
- Is male or female aged 18 years or over.
- Has documented HIV-1 infection
- Is capable of giving informed consent
- Is willing to comply with the protocol requirements
- Virologically suppressed (plasma HIV-RNA <50 copies/mL for >24 weeks) and on a stable regimen.
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- Subjects are required to have a history of the K103N mutation (acquired or selected). Subjects who at any time have had the mutations 100I, 101E/P, 106A/M, 138K/G/Q, 181C/I/V, 188L, 190A/S/E/Q, 230L mutations are to be excluded. Other NNRTI region variants can be included. All PI and NRTI mutations are acceptable. Study sites may ask the coordinating centre for advice as required.
- Subjects must have never failed INSTI (2 x VL >200 >2 weeks apart) but current regimen can include Integrase Strand Transfer Inhibitor(INSTI).
- A female, may be eligible to enter and participate in the study if she:
- is of non-child-bearing potential defined as either post-menopausal (12 months of spontaneous amenorrhea without an alternative medical cause and ≥ 45 years of age) A high follicle stimulating hormone (FSH) level consistent with postmenopausal status may be used to confirm a post- menopausal state in women who are not using hormonal contraception) or hormonal replacement therapy at the discretion of the Principal Investigator. However, in the absence of 12 months of amenorrhea, a single FSH measurement alone is insufficient.
- OR physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or,
- OR is of child-bearing potential with a negative pregnancy test at Screening (\& baseline visit) and agrees to use one of the following methods of contraception to avoid pregnancy:
- True abstinence from penile-vaginal intercourse from 2 weeks prior to administration of IP, throughout the study, and for at least 2 weeks after discontinuation of all study medications (When this is in line with the preferred and usual lifestyle of the subject.) (Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), and withdrawal are not acceptable methods of contraception.
- Any intrauterine device (IUD) with published data showing that the expected failure rate is <1% per year (not all IUDs meet this criterion, see Appendix 3 for an example listing of approved IUDs).
- Male partner sterilization confirmed prior to the female subject's entry into the study, and this male is the sole partner for that subject;
- Approved hormonal contraception (see appendix 4 for a listing of examples of approved hormonal contraception);
- Any other method with published data showing that the expected failure rate is <1% per year.
- Any contraceptive method must be used consistently and for at least 2 weeks after discontinuation of Investigational Product (IP)
- If a heterosexually active male, he is using effective birth control methods and is willing to continue practising these birth control methods during the trial and until follow-up visit
- Subjects currently receiving DTG or RPV, but not both, can be included.
Who cannot join
- Patients meeting 1 or more of the following criteria cannot be selected:
- Infected with HIV-2
- Detectable HIV-1 RNA at screening (HIV-1 RNA measurement >=50 c/mL).
- Subjects requiring regular dosing doing with H2 or PPI antacid medications or a history of achlorhidria or drug known to interact with RPV or DTG.
- Use of medications which are associated with Torsades de Pointes
- Corrected QT interval (QTc [Bazett]) >450 milliseconds or QTc (Bazett) >480 milliseconds for participants with bundle branch block. The QTc is the QT interval corrected for heart rate according to Bazett's formula (QTcB).
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- Unstable health conditions (i.e. opportunistic infections, cancers, unstable liver disease etc).
- Any evidence of an active Centers for Disease Control and Prevention Category C disease. Exceptions include cutaneous Kaposi's sarcoma not requiring systemic therapy and historic CD4+ lymphocyte counts of <200 cells/millimeter3.
- History or presence of allergy to the study drugs or their components or drugs of their class;
- Ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma, or cervical intraepithelial neoplasia; other localized malignancies require agreement between the investigator and the Study medical monitor for inclusion of the subject prior to randomization;
- Any pre-existing physical or mental condition which, in the opinion of the Investigator, may interfere with the subject's ability to comply with the dosing schedule and/or protocol evaluations or which may compromise the safety of the participants. Subjects considered to pose a significant risk of suicide should be excluded.
- Any condition which, in the opinion of the Investigator, may interfere with the absorption, distribution, metabolism or excretion of the study drugs or render the subject unable to take oral medication;
- Using any concomitant therapy disallowed as per the reference safety information and product labelling for the study drugs. Specifically, co-administration with the following medicinal products is not allowed:
- dofetilide or pilsicainide;
- fampridine (also known as dalfampridine);
- carbamazepine, oxcarbazepine, phenobarbital, phenytoin;
- rifampicin, rifapentine;
- proton pump inhibitors, such as omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole; - systemic dexamethasone, except as a single dose treatment;
- St John's wort (Hypericum perforatum).
- Has acute viral hepatitis including, but not limited to, A, B, or C
- Active hepatitis B/ Hep B non-immune subjects who have failed vaccination (antibody concentration < 10 international units). (If local practice does not include vaccination of low risk patients, then the patients without HBsAb are not excluded - this must be clearly documented in the medical records and eCRF). (Note: subjects can be re screened if they receive vaccination and subsequently meet eligibility criteria)
- Evidence of Hepatitis B virus (HBV) infection based on the results of testing at Screening for Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody (anti-HBc), and Hepatitis B surface antibody (HBsAb) as follows: Participants positive for HBsAg are excluded; Participants positive for anti-HBc (negative HBsAg status) and negative for HBsAb are excluded. (if local practice does not include vaccination of low risk patients, then the patients without HBsAb are not excluded - this must be clearly documented in the medical records and eCRF. Note: Subject positive for anti-HBc (negative HBsAg status) and positive for HBsAb are immune to HBV and are not excluded.
- Participants with an anticipated need for any Hepatitis C virus (HCV) therapy during the Early Switch Phase and for interferon-based therapy for HCV throughout the entire study period.
- Any investigational drug within 30 days prior to the trial drug administration
- Any evidence of viral resistance different to the one described in the inclusion criteria i.e. not meeting inclusion criteria or having different mutation at K103.
- Dialysis or renal insufficiency (creatinine clearance < 50ml/min)
- History of decompensated liver disease (Alanine aminotransferase (ALT) ≥ 5 times the upper limit of normal (ULN), OR ALT ≥3xULN and bilirubin ≥1.5xULN (with >35% direct bilirubin)
- Unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice), cirrhosis, known biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones)
- Subjects with severe hepatic impairment (Class C) as determined by Child-Pugh classification (see appendix 4)
- Opportunistic infection within 4 weeks prior to first dose of DTG plus RPV.
- Clinical decision that a switch of antiretroviral therapy should be immediate
- Screening blood result with any grade 3/4 toxicity according to Division of AIDS (DAIDS) grading scale, except: asymptomatic grade 3 glucose, amylase or lipid elevation or asymptomatic grade 4 triglyceride elevation (re-test allowed). or unconjugated hyperbilirubinaemia due to atanazavir exposure.
- Any condition (including illicit drug use or alcohol abuse) or laboratory results which, in the investigator's opinion, interfere with assessments or completion of the trial.
- Women planning pregnancy or who are pregnant or breast feeding. (NB: See section 6.12 Withdrawal Criteria for guidance if pregnancy does occur).
- Females of childbearing potential and males must be willing to use a highly effective (acceptable effective contraceptive measures are only acceptable for IMP's with unlikely human teratogenicity / fetotoxicity in early pregnancy) method of contraception (hormonal method of birth control; true abstinence). Contraceptive methods that can achieve a failure rate of less than 1% per year when used consistently and correctly are considered as highly effective birth control methods (see Appendix 4). Such methods include:
- combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral intravaginal transdermal
- progesteron-only hormonal contraception associated with inhibition of ovulation oral injectable implantable
- Intrauterine device (IUD)
- Intrauterine hormone-releasing system ( IUS)
- bilateral tubal occlusion
- vasectomized partner
- true sexual abstinence
- (NB: See section 6.12 Withdrawal Criteria for guidance if pregnancy does occur).
- Hypersensitivity to the active substances or to any of the excipients listed below: List of excipients Tablet core • Mannitol (E421) • Magnesium stearate • Microcrystalline cellulose • Povidone (K29/32) • Sodium starch glycolate • Sodium stearyl fumarate • Lactose monohydrate • Croscarmellose sodium • Povidone (K30) • Polysorbate 20 • Silicified microcrystalline cellulose Tablet coating • Polyvinyl alcohol- part hydrolysed • Titanium dioxide (E171) • Macrogol • Talc • Iron oxide yellow (E172) Iron oxide red (E172)
Trial locations and contacts
29 sites in 6 countries.
29 sites in 6 countries
United Kingdom9 sites
Brighton & Sussex University NHS Trust
Brighton
North Bristol NHS Trust, Southmead Hospital
Bristol
Chelsea & Westminster Hospital
London
Kings College Hospital London
London
Mortimer Market Centre
London
Queen Elizabeth Hospital
London
Royal Free London NHS Foundation Trust
London
St Marys Hospital
London
The Royal London Hospital
London
Spain6 sites
Hospital General Universitario de Alicante
Alicante
Hospital Clínic de Barcelona
Barcelona
Hospital Universitari Vall d'Herbo
Barcelona
Infectious Diseases Unit Hospital de la Santa Creu i Sant Pau
Barcelona
Hospital General Universitario de Elche
Elche
Hospital Universitario La Paz, Madrid
Madrid
Italy5 sites
AAST delgi spedali civili di Brescia
Brescia
ASST FBF SACCO- I Division of Infectious Diseases 1
Milan
ASST FBF SACCO- I Division of Infectious Diseases 3
Milan
I.R.C.C.S San Raffaele Hospital
Milan
ASST GOM Niguarda Milano, Dep. Infectious Disease
Milan
Germany4 sites
University Bonn
Bonn
University Essen
Essen
Frankfurt University Hospital
Frankfurt
ICH Study Center, Hamburg
Hamburg
France3 sites
CHU Hotel Dieu
Nantes
Hospital Saint Louis
Paris
Pitié-salpêtrière Hospital
Paris
Belgium2 sites
Institute of Tropical Medecine
Antwerp
St Pierre University Hospital
Brussels
About this study
Official title: An Open-Label, Multi-Centre, Randomised, Switch Study to Evaluate the Virological Efficacy Over 96 Weeks Of 2-Drug Therapy With DTG/RPV FDC in Antiretroviral Treatment-Experienced HIV-1 Infected Subjects Virologically Suppressed With Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) Resistance Mutation K103N
HIV-1 infected subjects that experience virological failure while on non nucleoside reverse-transcriptase inhibitors (NNRTIs), including those with the K103N mutation, are usually switched to a boosted Protease Inhibitor (PI)-based regimen or other antiretroviral (ARV) combinations. The same is true for subjects who need to start antiretroviral therapy and have acquired virus that is already resistant to antiretrovirals. These "second line" combinations are often associated with numerous issues that can have a potential impact on the quality of life (QoL) of these patients. Therefore a simpler and better tolerated alternative second line treatment option would be a useful tool for the clinical management of these patients.
The aim of this study is to assess the efficacy and tolerability of a dual combined therapy of Dolutegravir (DTG) 50 mg Once Daily (OD) + Rilpivirine (RPV) 25 mg OD in virologically suppressed participants with previous virological failure with NNRTIs and having the clinically significant mutation K103N. The secondary objective of the study is to assess whether a simplification of the treatment in terms of pill burden, long term metabolic toxicity and potential for drug interactions improves the QOL of the participants. The study will also evaluate DTG \& RPV concentrations in the blood plus changes in cell associated virus.
In order to compare the first line treatment (boosted PI and/or other antiretroviral combinations) and the DTG+RPV combination, two thirds of study participants will be switched to DTG+RPV immediately and receive DTG+RPV for 96 weeks. The other third will be switched after 48 weeks of continuing on their first line treatment and receive DTG+RPV for 48 weeks. All participants will then be followed up for a further 30 days. Participants will be recruited from sites across Europe, and randomised onto either arm of the study. After randomisation, participants will attend approximately 10 visits over the course of two years.
- Conditions
- HIV-1-infection
- Being tested
- Dolutegravir & Rilpivirine 2 drug fixed dose combined therapy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dolutegravir & Rilpivirine 2 drug fixed dose combined therapyDrug
Also called Boosted protease inhibitors or other ARV regimen
Daily oral tablet
| Study group | Role | What they receive |
|---|---|---|
| DTG/RPV FDC Regimen | Experimental | One combined Dolutegravir 50mg /Rilpivirine 25mg FDC tablet taken orally once daily Receives: Drug: Dolutegravir & Rilpivirine 2 drug fixed dose combined therapy |
| Continued ART Regimen | Active comparator | Patients will continue the current boosted PI regimen (or other antiretroviral combination) for 48 weeks. Patients will then be switched to one combined Dolutegravir/Rilpivirine FDC tablet taken orally once daily for 48 weeks. Receives: Drug: Dolutegravir & Rilpivirine 2 drug fixed dose combined therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With and Without Virological Suppression
Virological Suppression is defined as <50 copies/ml HIV RNA
Measured: 48 weeks
Secondary outcomes (29)
Number of Participants With and Without Virological Suppression
Virological Suppression is defined as <50 copies/ml HIV RNA
Measured: week 96
Changes in Blood Cell Counts - Red Blood Cells
red blood cell count evaluation
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Blood Cell Counts - White Blood Cells
white blood cell count evaluation
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Blood Cell Counts - Platelets
platelet count evaluation
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Blood Cell Counts - Haemoglobin
Haemoglobin count evaluation
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in Sodium
Change from baseline in Sodium
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Liver Levels - Bilirubin
Liver level evaluation - bilirubin
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Liver Levels - Alanine Aminotransferase (ALT)
Liver level evaluation - ALT
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Renal Markers - Creatinine Clearance (Estimated Glomerular Filtration Rate(eGFR))
Renal markers evaluation- creatinine clearance (eGFR)
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in Glucose
Change from baseline in Glucose
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Renal Markers - Creatinine
Renal markers evaluation - creatinine
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Bone Markers - Alkaline Phosphatase
Bone markers evaluation - Alkaline phosphatase
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Fasting Lipids From Baseline - Total Cholesterol
Fasting lipids level evaluation - total cholesterol
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Fasting Lipids From Baseline - High Density Lipoprotein (HDL)
Fasting lipids level evaluation - HDL
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Quality of Life Health Status Score
Questionnaire (EQ-5D-3L) Mobility, Self-care, Usual activities, Pain/Discomfort and Anxiety/Depression are recorded on 3 point scale (tick boxes), which indicates the severity of problems the participant has with each of these activities. Patients will select No problems, Some problems or Extreme problems/Unable to perform. Patients also report their current Health State on a Scale from 1 to 100 on which the best state you can imagine is marked 100 and the worst state you can imagine is marked 0.
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Patient Satisfaction - HIV Treatment Satisfaction Questionnaire (HIVTSQs)
HIV Treatment Satisfaction Questionnaire (HIVTSQs) Answers are recorded on a scale from 0 to 6, with 0 being least satisfied and 6 being most satisfied.
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Number of Participants With Adverse Events - Baseline to Week 48
Adverse Events reports (AEs, SAEs and treatment discontinuation)
Measured: Baseline to week 48
Number of Drug Drug Interactions
Comparing the drug interaction outcomes between antiretroviral therapy and co-medications before and after the switch by using the www.hiv-druginteractions.org/ website (within the same study arm)
Measured: Baseline, week 24, week 48, week 96
Changes in Fasting Lipids From Baseline - Triglycerides
Fasting lipids level evaluation - triglycerides
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Fasting Lipids From Baseline - Low Density Lipoprotein (LDL)
Fasting lipids level evaluation - LDL
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Vital Signs From Baseline - Systolic Blood Pressure
Changes in Vital Signs from baseline - Systolic Blood Pressure
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Vital Signs From Baseline - Diastolic Blood Pressure
Changes in Vital Signs from baseline - Diastolic Blood Pressure
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Vital Signs From Baseline - Pulse Rate
Changes in Vital Signs from baseline - Pulse rate
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Pittsburgh Sleep Quality Index (PSQI)
The PSQI measures several different aspects of sleep, with seven component scores and one composite score. The component scores include questions on subjective sleep quality, sleep latency (i.e., how long it takes to fall asleep), sleep duration, habitual sleep efficiency (i.e., the percentage of time in bed that one is asleep), sleep disturbances, use of sleeping medication, and daytime dysfunction.
Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance to sleep. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Number of Participants With Adverse Events - Week 48 to Week 96
Adverse Events reports (AEs, SAEs and treatment discontinuation)
Measured: From Week 48 to week 96
Change From Baseline in CD4
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in CD8 Cell Count
Change from baseline to week 48, Change from week 48 to week 96; Change from baseline to week 96 in participants in the DTG/RPV FDC Regimen and Continued ART Regimen arms
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in Body Weight
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in BMI
Measured: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Apr 2022
- Study start5 Nov 2018
- Primary completion15 Nov 2021
- Study completion9 Nov 2022
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 (2)Papers the sponsor has linked to this study.
- Other trials for HIV-1-infectionStudies of the same condition, open and under way.
- 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
- None (open label)
- Enrolment
- 140 participants (actual)
Sponsor and investigators
- Lead sponsor
- NEAT ID Foundation
- Sponsor type
- University, hospital or other
- Collaborators
- ViiV Healthcare
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05349838
- Sponsor's protocol ID
- NEAT 33
- Other IDs
- 2017-004040-38, 2017
- Acronym
- WISARD
- Status last verified
- Nov 2024
- First submitted
- 2 May 2019
- Last updated
- 24 Dec 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Moyle G, Assoumou L, De Castro N, Post FA, Curran A, Rusconi S, De Wit S, Stephan C, Raffi F, Johnson M, Masia M, Vera J, Jones B, Fletcher C, Morris K, Pozniak A; for NEAT Foundation, WISARD study group. Durable efficacy of dolutegravir/rilpivirine switch in subjects with HIV RNA <50 copies/ml and history of K103N mutation. AIDS. 2026 Jul 1;40(7):885-893. doi: 10.1097/QAD.0000000000004451. Epub 2026 Jan 22.
PubMed 41587441Moyle G, Assoumou L, de Castro N, Post FA, Curran A, Rusconi S, De Wit S, Stephan C, Raffi F, Johnson M, Masia M, Vera J, Jones B, Grove R, Fletcher C, Duffy A, Morris K, Pozniak A; NEAT ID Foundation and the WISARD study group. Switching to dolutegravir plus rilpivirine versus maintaining current antiretroviral therapy regimen in virologically suppressed people with HIV-1 and the Lys103Asn (K103N) mutation: 48-week results from a randomised, open-label pilot clinical trial. Lancet HIV. 2024 Mar;11(3):e156-e166. doi: 10.1016/S2352-3018(23)00292-8.
PubMed 38417976
Study at a glance
From the registry record, last updated by the sponsor on 24 Dec 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Open-Label, Multi-Centre, Randomised, Switch Study to Evaluate the Virological Efficacy Over 96 Weeks Of 2-Drug Therapy With DTG/RPV FDC in Antiretroviral Treatment-Experienced HIV-1 Infected Subjects Virologically Suppressed With Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) Resistance Mutation K103N
- ClinicalTrials.gov ID
- NCT05349838
- Acronym / sponsor ID
- WISARD / NEAT 33
- Conditions
- HIV-1-infection
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 140 participants (actual)
- Lead sponsor
- NEAT ID FoundationUniversity, hospital or other
- Collaborators
- ViiV Healthcare
- Study start
- 5 Nov 2018 (actual)
- Primary completion
- 15 Nov 2021 (actual)
- Study completion
- 9 Nov 2022 (actual)
- First posted
- 27 Apr 2022 (actual)
- Results
- Posted 24 Dec 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
HIV-1 infected subjects that experience virological failure while on non nucleoside reverse-transcriptase inhibitors (NNRTIs), including those with the K103N mutation, are usually switched to a boosted Protease Inhibitor (PI)-based regimen or other antiretroviral (ARV) combinations. The same is true for subjects who need to start antiretroviral therapy and have acquired virus that is already resistant to antiretrovirals. These "second line" combinations are often associated with numerous issues that can have a potential impact on the quality of life (QoL) of these patients. Therefore a simpler and better tolerated alternative second line treatment option would be a useful tool for the clinical management of these patients.
The aim of this study is to assess the efficacy and tolerability of a dual combined therapy of Dolutegravir (DTG) 50 mg Once Daily (OD) + Rilpivirine (RPV) 25 mg OD in virologically suppressed participants with previous virological failure with NNRTIs and having the clinically significant mutation K103N. The secondary objective of the study is to assess whether a simplification of the treatment in terms of pill burden, long term metabolic toxicity and potential for drug interactions improves the QOL of the participants. The study will also evaluate DTG \& RPV concentrations in the blood plus changes in cell associated virus.
In order to compare the first line treatment (boosted PI and/or other antiretroviral combinations) and the DTG+RPV combination, two thirds of study participants will be switched to DTG+RPV immediately and receive DTG+RPV for 96 weeks. The other third will be switched after 48 weeks of continuing on their first line treatment and receive DTG+RPV for 48 weeks. All participants will then be followed up for a further 30 days. Participants will be recruited from sites across Europe, and randomised onto either arm of the study. After randomisation, participants will attend approximately 10 visits over the course of two years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| DTG/RPV FDC Regimen | Experimental | Drug: Dolutegravir & Rilpivirine 2 drug fixed dose combined therapyOne combined Dolutegravir 50mg /Rilpivirine 25mg FDC tablet taken orally once daily |
| Continued ART Regimen | Active comparator | Drug: Dolutegravir & Rilpivirine 2 drug fixed dose combined therapyPatients will continue the current boosted PI regimen (or other antiretroviral combination) for 48 weeks. Patients will then be switched to one combined Dolutegravir/Rilpivirine FDC tablet taken orally once daily for 48 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- Is male or female aged 18 years or over.
- Has documented HIV-1 infection
- Is capable of giving informed consent
- Is willing to comply with the protocol requirements
- Virologically suppressed (plasma HIV-RNA <50 copies/mL for >24 weeks) and on a stable regimen.
Key exclusion criteria (44 listed)
- Infected with HIV-2
- Detectable HIV-1 RNA at screening (HIV-1 RNA measurement >=50 c/mL).
- Subjects requiring regular dosing doing with H2 or PPI antacid medications or a history of achlorhidria or drug known to interact with RPV or DTG.
- Use of medications which are associated with Torsades de Pointes
- Corrected QT interval (QTc [Bazett]) >450 milliseconds or QTc (Bazett) >480 milliseconds for participants with bundle branch block. The QTc is the QT interval corrected for heart rate according to Bazett's formula (QTcB).
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 |
|---|---|---|
| Dolutegravir & Rilpivirine 2 drug fixed dose combined therapyAlso: Boosted protease inhibitors or other ARV regimenDaily oral tablet | Drug | Continued ART Regimen, DTG/RPV FDC Regimen |
Primary outcome
Number of Participants With and Without Virological Suppression
Time frame: 48 weeks
Virological Suppression is defined as <50 copies/ml HIV RNA
29 secondary outcomes
Number of Participants With and Without Virological Suppression
Time frame: week 96
Changes in Blood Cell Counts - Red Blood Cells
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Blood Cell Counts - White Blood Cells
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Blood Cell Counts - Platelets
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Blood Cell Counts - Haemoglobin
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in Sodium
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Liver Levels - Bilirubin
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Liver Levels - Alanine Aminotransferase (ALT)
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Renal Markers - Creatinine Clearance (Estimated Glomerular Filtration Rate(eGFR))
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in Glucose
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Renal Markers - Creatinine
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Bone Markers - Alkaline Phosphatase
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Fasting Lipids From Baseline - Total Cholesterol
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Fasting Lipids From Baseline - High Density Lipoprotein (HDL)
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Quality of Life Health Status Score
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Patient Satisfaction - HIV Treatment Satisfaction Questionnaire (HIVTSQs)
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Number of Participants With Adverse Events - Baseline to Week 48
Time frame: Baseline to week 48
Number of Drug Drug Interactions
Time frame: Baseline, week 24, week 48, week 96
Changes in Fasting Lipids From Baseline - Triglycerides
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Fasting Lipids From Baseline - Low Density Lipoprotein (LDL)
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Vital Signs From Baseline - Systolic Blood Pressure
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Vital Signs From Baseline - Diastolic Blood Pressure
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Vital Signs From Baseline - Pulse Rate
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Changes in Pittsburgh Sleep Quality Index (PSQI)
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Number of Participants With Adverse Events - Week 48 to Week 96
Time frame: From Week 48 to week 96
Change From Baseline in CD4
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in CD8 Cell Count
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in Body Weight
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Change From Baseline in BMI
Time frame: Changed assessed from baseline to week 48, week 48 to week 96, baseline to week 96
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Dec 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 41587441Moyle G, Assoumou L, De Castro N, Post FA, Curran A, Rusconi S, De Wit S, Stephan C, Raffi F, Johnson M, Masia M, Vera J, Jones B, Fletcher C, Morris K, Pozniak A; for NEAT Foundation, WISARD study group. Durable efficacy of dolutegravir/rilpivirine switch in subjects with HIV RNA <50 copies/ml and history of K103N mutation. AIDS. 2026 Jul 1;40(7):885-893. doi: 10.1097/QAD.0000000000004451. Epub 2026 Jan 22.
- Derived from this study: PubMed 38417976Moyle G, Assoumou L, de Castro N, Post FA, Curran A, Rusconi S, De Wit S, Stephan C, Raffi F, Johnson M, Masia M, Vera J, Jones B, Grove R, Fletcher C, Duffy A, Morris K, Pozniak A; NEAT ID Foundation and the WISARD study group. Switching to dolutegravir plus rilpivirine versus maintaining current antiretroviral therapy regimen in virologically suppressed people with HIV-1 and the Lys103Asn (K103N) mutation: 48-week results from a randomised, open-label pilot clinical trial. Lancet HIV. 2024 Mar;11(3):e156-e166. doi: 10.1016/S2352-3018(23)00292-8.
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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.
The record lists no contact. Use the official record to reach the sponsor.
29 sites in 6 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Dolutegravir & Rilpivirine 2 drug fixed dose combined therapy in people with HIV-1-infection, run by NEAT ID Foundation at 29 sites in 6 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 20 inclusion and 44 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 24 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 29 sites in United Kingdom, Spain, Italy, Germany, France and 1 more country. 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 24 Dec 2024). 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?
Number of Participants With and Without Virological Suppression (time frame: 48 weeks). 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 NCT05349838, which also lists 2 linked publications.
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 24 Dec 2024.