• A5364: A Phase I, Open-Label Study of the Safety and Ability of Broadly Neutralizing Antibodies 3BNC117-LS and 10-1074-LS in Combination to Durably Prevent Viral Relapse During a Monitored Analytical Treatment Interruption

    October 10, 2022 Alexis Sexton

    ACTG A5364: A Phase I, Open-Label Study of the Safety and Ability of Broadly Neutralizing Antibodies 3BNC117-LS and 10-1074-LS in Combination to Durably Prevent Viral Relapse During a Monitored Analytical Treatment Interruption

     

    Treatment Category: Experienced

     

    Study Description
    This is a Phase I, open-label, single-arm, multi-step study designed to evaluate the effects of the combination of long-acting broadly neutralizing antibodies (bNAbs) 3BNC117-LS and 10-1074-LS in participants living with HIV who discontinue anti-HIV therapy (ART) during a monitored analytical treatment interruption (ATI), which is an extended period of time when not taking regular ART to control HIV.

     

    Study Status: Open to Accrual

     

    Why is this study being done?

    • To see if it is safe to give people 10-1074-LS and 3BNC117-LS, and to see if these study drugs cause any side
    • To evaluate the efficacy of the study drugs in preventing the return of HIV levels in the blood after interrupting ART.

     

    Who can join?

    • People with HIV between 18 and 70 years old.
    • On stable ART with an undetectable viral load for at least 48 weeks prior to study entry.
    • Body weight between 110 and 250 lbs.
    • Participants who can become pregnant must agree to use two methods of contraception during the
    • Be willing to temporarily stop taking ART medications.

     

    What do I need to do in the study?

    After screening, eligible participants will undergo leukapheresis (a procedure in which blood is collected from a vein in one arm, processed through an attached machine, and then returned through a vein in the opposite arm), and will be asked if they are interested in optional procedures (flexible sigmoidoscopy with rectal biopsy and/or lumbar puncture to collect spinal fluid). Three additional leukapheresis procedures will be done during the study.

     

    At study entry, participants will receive an infusion of 3BNC117-LS and an infusion of 10-1074-LS, and will discontinue ART 2 days later.

     

    Stopping ART is not recommended in the context of standard clinical care and poses some level of risk to the participant and sexual partner(s). However, for this research study, participants will be monitored closely while they are not taking ART. They will have to start taking ART again if blood tests show that it is necessary. The ATI can last up to 24 weeks of frequent visits to see if ART should be restarted.

     

    Each participant will be followed for 72 weeks.

     

    What treatments or drugs are involved with this study?

    10-1074-LS and 3BNC117-LS are antibodies to HIV. Many antibodies are naturally made by the body and help fight diseases. 10-1074-LS and 3BNC117-LS are made in a laboratory. They are called “monoclonal antibodies,” which means that they are made up of many copies of one single antibody.

  • A5418:Study of Tecovirimat for Human Monkeypox Virus (STOMP)

    September 9, 2022 Alexis Sexton

    ACTG A5418: A Randomized, Placebo-Controlled, Double-Blinded Trial of the Safety and Efficacy of Tecovirimat for the Treatment of Human Monkeypox Virus Disease, Study of Tecovirimat for Human Monkeypox Virus (STOMP)

     

    Treatment Category: Monkeypox

    Study Description
    A5418 (STOMP) is a study of tecovirimat (also known as TPOXX) for the treatment of human monkeypox virus (HMPXV) disease.

    Study Status: Open

    Why is this study being done?

    • To see if tecovirimat is safe, and whether it helps treat monkeypox infection.

    Who can join?

    People with:

    • Laboratory-confirmed or presumptive monkeypox infection
    • Monkeypox illness of less than 14 days’ duration
    • At least one active (not yet scabbed) skin lesion, mouth lesion, or proctitis (inflammation of the lining of the rectum) with or without visible ulcers

    What do I need to do in the study?

    Participants will be randomly assigned (like flipping a coin) in a 2:1 ratio to receive tecovirimat OR placebo for tecovirimat for 14 days.

    People who are at higher risk for severe disease because of their age or their medical history will be assigned to receive open-label tecovirimat for 14 days.

    All participants will be followed through a combination of in-person visits, specimen collection, virtual assessments, and self-reports and photographs of symptoms for about 2 months.

    What treatments or drugs are involved with this study?

    Tecovirimat is a drug that may help to treat infections caused by pox viruses. Tecovirimat is approved by the Food and Drug Administration (FDA) to treat smallpox in adults and children, but its use in this study is considered investigational.

    Duration of Study

    57 days

     

     

    For more info: https://www.stomptpoxx.org/main

  • A5355: Phase II, Double-Blind, Randomized, Placebo-Controlled Trial to Evaluate the Safety and Immunogenicity of a Modified Vaccinia Ankara (MVA)-based Anti-Cytomegalovirus (CMV) Vaccine (Triplex®) in Adults with Both Human Immunodeficiency Virus (HIV)-1 and CMV Who Are on Potent Combination ART with Conserved Immune Function

    June 2, 2022 Alexis Sexton

    Brief Background and Description: Since the early days of the HIV epidemic cytomegalovirus (CMV) has been one of the most common and devastating opportunistic infections (OIs) experienced by people with HIV. CMV is a common virus that usually causes few, mild, or no symptoms and typically remains in the body for life; in people with weakened immune systems, however, CMV can cause more serious symptoms affecting the eyes, lungs, liver, esophagus, stomach, and intestines ). HIV and CMV can work together against our bodies’ defenses, making transmission of each virus easier. We would like to change this.

    In this study, you will be randomized to one of the study treatment arms. You will receive either Triplex® study vaccine or placebo by injection into the muscle of your shoulder 2 times; once when you enter the study and again about 4 weeks later.

    Purpose of this Study: The purpose of this study is to see if an investigational vaccine for CMV (called Triplex®) is safe when given to people with both HIV and CMV. This study will also collect information on the effectiveness of Triplex® to reduce inflammation and immune activation markers compared to a placebo. This will be the first time that this type of information will be collected. You should be aware that the current standard of care for individuals with both HIV and CMV includes effective treatment for HIV but does not include treatment of CMV with either medication or vaccination – unless there is evidence that the CMV is causing or contributing to illness.

    Requirements to Enter Study (things that must be true for you):

    • Living with HIV-1 and with cytomegalovirus (CMV).
    • Be between 18 and 65 years old.
    • On an anti-HIV medications that are controlling your HIV for at least the past year.
    • Agree to use contraception/birth control methods if capable of becoming pregnant or impregnating someone else.

    Exclusion Criteria (things that cannot be true about you):

    • Use of anti-CMV drugs within the past 2 weeks.
    • Currently have hepatitis B or hepatitis C
    • Currently have a sexually transmitted infection (such as, gonorrhea, syphilis, or chlamydia)
    • History of CMV disease and symptoms within the past 12 months.
    • Receipt of any vaccine (including for COVID-19) within the previous 4 weeks.
    • Recent serious illness or condition requiring hospitalization.
    • Breastfeeding or pregnant.
    • Historic or current evidence of resistance to the study medication or other medications in its class.

    Talk to your study staff for a complete list of inclusion/exclusion criteria. 

    Intervention:

    When you enter this study, you will be randomized (assigned by chance, as if by roll of dice) to one of two study groups. You will have double the chance of receiving Triplex® versus the placebo. You must continue to take your anti-HIV drugs throughout the study.

    Procedures:

    • Blood and urine tests at scheduled clinic visits for safety evaluations and other research testing.
    • Questionnaires asking for information on adherence to ART and use of other drugs.
    • For 4 weeks following each study injection you will complete a daily study diary (which is also known as a study vaccination report card); you will need to take and record your body temperature for the first 5 days each time.
    • At several of the clinic visits, saliva, rectal swabs, and/or genital fluid (semen or vaginal swab) will be collected.

    Duration of Study: About 2 years (96 weeks). In the first month of the study, you will have 2 study visits and 2 telephone contacts with clinic staff. After that, you will have 5 more visits over the next 16 months. After you have been on the study for about 2 years (about 4 months after your last study visit), your participation will end with a phone call from the clinic staff.

  • A5386: N-803 with or without bNAbs for HIV-1 control in participants living with HIV-1 on suppressive ART

    May 26, 2021 Alexis Sexton

    Full Title: A Phase 1 Clinical Trial of the Safety, Tolerability, and Efficacy of IL-15 Superagonist (N-803) with and without Combination Broadly Neutralizing Antibodies to Induce HIV-1 Control During Analytic Treatment Interruption

    Scientists are looking for ways to effectively clear HIV that rests in areas of the body where standard antiretroviral treatment (ART) is unable to reach. IL-15 superagonist (N-803) appears to reactivate HIV that is “asleep” and is also thought to increase the body’s natural immune response to HIV. Broadly neutralizing antibodies (bNAbs), such as 10-1074 and VRC07-523LS, have been shown to control growth of HIV in the blood and to increase the body’s immune response to HIV. N-803 alone or in combination with bNAbs may provide greater control of HIV than previous efforts.

    Purpose of this Study: This research study is trying to find out if N-803, VRC07-523LS, and 10-1074 are safe and effective at reactivating and targeting the latent cell pool of HIV RNA during an ATI (analytical treatment interruption). All participants will receive eight doses of N-803. Half of participants will also receive 10-1074 and VRC07-523LS. A year after starting study treatment, participants will stop ART for up to 24 weeks to see how well their immune systems control growth of HIV (analytic treatment interruption or ATI).  Participants will be followed closely to see if ART should be restarted. After restarting ART, participants will be followed for another 24 weeks.

    Major requirements for entering the study (things that must be true for you):

    • Living with HIV.
    • Have a low or undetectable viral load for at least 2 years.
    • Be willing to take a superagonist and broadly neutralizing antibodies and complete study related tests.
    • Agree to use contraception/birth control methods.
    • Be between 18 and 70 years old.
    • Be willing to temporarily stop taking antiretrovirals or ART.

    Events or conditions that would prevent you from participating (things that cannot be true about you):

    • Recent serious illness or condition requiring hospitalization.
    • Breastfeeding or pregnant.
    • Active Hepatitis B or C infection or history of AIDS-defining conditions.
    • Current CD4 cell count less than 500 or ever had a CD4 cell count less than 200.

    Talk to your study staff for a complete list of inclusion/exclusion criteria.

    Intervention:

    • Eight doses of N-803 given by needle under the skin; half of participants will receive two doses of 10-1074 and one dose of VRC07-523LS given intravenously (through a catheter in the vein).

    Procedures:

    • Blood and urine tests at scheduled clinic visits for safety evaluations and to check your immune function.
    • Leukapheresis (collection of immune cells through a catheter in the vein) (a procedure similar to donating platelets) will be completed twice.
    • Lymph node fine-needle aspirate (a type of biopsy using a needle) is an optional procedure which will be done prior to study entry and at Week 13.

    Duration of Study: Maximum of 2 years. Arm A will receive one dose of N-803 at Week 1 and then every 3 weeks for a total of eight doses. Arm B will receive one dose each of VRC07-523LS and 10-1074 at Step 1 entry, a dose of N-803 at Week 1 and then every 3 weeks for a total of eight doses, and a second dose of 10-1074 at Week 9. Follow-up visits will occur at Weeks 26, 32, 46 and 52. Week 52 also marks the beginning of the ATI, which can last up to 24 weeks of frequent visits. There will also be follow-up visits at 4, 12, and 24 weeks from the restart of ART.

  • A5391: Doravirine for Persons with Excessive Weight Gain on Integrase Inhibitors and Tenofovir Alafenamide (The Do IT Study)

    May 20, 2021 Alexis Sexton

    ACTG A5391: Doravirine for Obese Persons on Integrase Inhibitors and Tenofovir Alafenamide (The Do IT Study)

     

    Treatment Category:  Treatment Experienced

     

    Study Description

    Weight gain after starting HIV therapy is common, but recent studies have found that some people with HIV (PWH) who are taking an integrase inhibitor (INSTI) combined with a tenofovir alafenamide (TAF) regimen may gain more weight than people taking other drug combinations.  A rising number of PWH are overweight or obese, and a higher body mass index (BMI) increases the risk for diabetes, heart disease and stroke.

     

    This study will include PWH who have been virally suppressed on a regimen consisting of an integrase inhibitor (INSTI) and TAF/FTC or TAF/3TC, and have a BMI of 30 kg/m2 (the cut-off for obesity) or greater. This research study is trying to find out if they could gain less weight, or maybe lose weight, after switching to a regimen containing doravirine (DOR) with TAF/FTC (or TAF/3TC), or DOR with the related medication tenofovir disproxil (TDF/FTC [or TDF/3TC]) as compared to continuation of their current INSTI plus TAF regimen.

    Study Status 

    Why is this study being done?

     

    • To see if obese PWH on an INSTI-containing regimen can either reduce their rate of weight gain over time or even lose weight with a change to a different regimen.

     

    Who can join?

     

    • People living with HIV-1 who are at least 18 years of age
    • Currently on an Integrase Inhibitor (INSTI) containing regimen (bictegravir, dolutegravir or raltegravir) plus TAF/FTC (or TAF/3TC) for at least 48 weeks
    • HIV viral load less than 50 copies
    • Have a body mass index (BMI) at least 30 kg/m2.
    • No plans to undergo weight loss surgery or to start significant exercise, diet, or medications affecting weight (e.g., structured weight loss programs such as Weight Watchers)

     

    What do I need to do in the study?

     

    Participants will be randomized to one of three study groups:

    Group 1: DOR and continue taking TAF/FTC (or TAF/3TC)

    Group 2: DOR and switch TAF to TDF/FTC (or TDF/3TC)

    Group 3: Continue current INSTI+TAF/FTC (or TAF/3TC)

     

    Study procedures include blood and urine tests, questionnaires about adherence to medications, diet and exercise habits, and DEXA Scans to measure lean muscle, body fat and bone density.

     

    Duration of Study:

    Participants will be on study treatment for 48 weeks.  Follow-up visits occur at Weeks 4,12,24,36, and 48.

     

    What treatments or drugs are involved with this study?

    Doravirine, which is an FDA-approved antiretroviral drug for the treatment of HIV-1 and a member of the non-nucleoside reverse transcriptase inhibitor (NNRTI) medication class, will be provided by the study.

     

    NRTIs will need to be obtained by prescription from primary care provider.

     

     

  • A5300B/I2003B:Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Participants (PHOENIx)

    February 20, 2020 Alexis Sexton

    This trial is in household contacts (HHC) at high risk for developing multidrug resistant tuberculosis (MDR-TB) which is an infection that does not get better with standard treatment for TB.  HHC means any person that  lives with, has lived with, or shared housekeeping duties in a home or the same place with a person (an Index Case) who has pulmonary MDR-TB (a lung infection or pneumonia with TB) and started treatment for MDR-TB within the past 90 days. It is also for people who have spent more than 4 hours indoors with the index case, during the week before they started MDR-TB treatment.

    High-risk household contacts are those with HIV or an immune system problem not from HIV like cancer , latent TB infection (a history of TB infection in the past based on testing), and young children below the age of 5 years.

    Purpose of this Study: 

    Is to compare how safe and effective 26 weeks of Delamanid (DLM), a medicine used to treat TB,  is versus 26 weeks of isoniazid (INH), a standard medicine to treat or prevent TB,  for preventing infection with TB (latent TB) or confirmed or probable active infection with TB among participantshigh risk HHC (see above for description).

    Requirements to Enter Study:

    The Index Case must be an adult (18 years and older) with pulmonary MDR-TB who has started MDR-TB treatment within the past 90 days, who has one or more household contacts and gives site staff permission to call and visit the household contacts.

    The Household contact must be a High-Risk Contact:

    • Children up to 5 years of age regardless of standard tests for TB known as the tuberculin skin test (TST) or the interferon gamma release assay (IGRA), a blood test for TB, or HIV status.
    • Adults, adolescents, and children ≥5 years of age who are TST-positive (defined as a skin test bump ≥5 mm in size) and/or IGRA test-positive and whose HIV status is negative, indeterminate, or unknown and who are not immunosuppressed from another condition besides HIV.
    • Adults, adolescents, and children ≥5 years of age who are HIV-infected or are immunosuppressed without HIV (defined as receiving anti-tumor necrosis factor (TNF) treatment, or in chronic renal failure receiving dialysis, or being solid organ or hematologic transplant recipients), regardless of TST/IGRA

    Treatment:

    Household contacts will be randomly assigned (like a flip of a coin) one of two groups:

    Group A will receive:

    DLM daily for adults, adolescents, and children, given for 26 weeks

    Group B will receive:

    • INH daily for adults, adolescents, and children, given for 26 weeks
    • Pyridoxine (vitamin B6) daily for adults, adolescents, and children, given for 26 weeks

    All high-risk HHCs in the same HH will receive the same randomized regimen.

    Duration of Study:

    All participants will be in this study for 96 weeks.

    Document list:

    PHOENIxRFA-17May2022

    A5300B/I2003B V3 Final Protocol dated March 31, 2020

    A5300B/I2003B V3 Manual of Procedures dated May 6, 2022

    A5300B/I2003B V3 Lab Processing Chart dated May 3, 2022