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| ID | Type | Description | Link |
|---|---|---|---|
| 2013-001402-28 | EudraCT Number | ||
| IS000883 | Other Identifier | Argentina: The National Registry of Health Research (ReNIS) |
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The goal of this clinical study is to learn more about the safety and dosing of study drugs, cobicistat-boosted Atazanavir (ATV/co), cobicistat-boosted darunavir (DRV/co) and emtricitabine/tenofovir alafenamide (F/TAF), in children (age ≥ 4 weeks to < 18 years) with HIV.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1: Part A and Part B | Experimental | Participants ages 12 to <18 years old will receive cobicistat 150 mg with either ATV or DRV plus background regimen (BR). The BR may contain additional antiretroviral agents except for the following disallowed agents: saquinavir, indinavir, nelfinavir, double protease inhibitor (PI) regimens, raltegravir, elvitegravir, efavirenz, nevirapine, delavirdine, maraviroc, etravirine, rilpivirine, dolutegravir, and investigational antiretroviral agents. |
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| Cohort 2 | Experimental | Participants aged 6 to <12 years old and ≥25 to <40kg will receive cobicistat 150 mg and F/TAF 200/25 mg with either ATV or DRV. |
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| Cohort 3 | Experimental | Participants age ≥ 2 years old will receive cobicistat 90 mg and F/TAF 120/15 mg with either ATV or DRV. |
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| Cohort 4 (Group 1) | Experimental | Participants age ≥ 4 weeks old weighing 14 to < 25 kg will receive cobicistat tablet for oral suspension (TOS) 90 mg, once daily and F/TAF TOS 120/15 mg, once daily with either ATV or DRV or lopinavir boosted by ritonavir (LPV/r). Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, minimum age and weight for DRV is ≥ 3 years and ≥ 15 kg; participants receiving LPV/r will not receive cobicistat TOS. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ATV | Drug | Capsules administered once daily according to dosing recommendations per product monograph |
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| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic (PK) Parameter: AUCtau of ATV, DRV, TAF, and TFV | AUCtau is defined as concentration of drug over time (the area under the concentration verses time curve over the dosing interval). AUCtau for ATV (Cohorts 1 Part A, 2, 3, and 4 [Groups 2 to 4]); DRV (Cohorts 1 Part A, 2, and 3); TAF (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 [Groups 1 to 3] taking F/TAF); and TFV (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 [Groups 1 to 3] taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
| Percentage of Participants Experiencing Treatment Emergent Adverse Events (AEs) Through Week 24 | First dose date up to Week 24 plus 30 days (Cumulative data through Week 24) | |
| Percentage of Participants Experiencing Treatment Emergent Laboratory Abnormalities Through Week 24 | First dose date up to Week 24 plus 30 days (Cumulative data through Week 24) |
| Measure | Description | Time Frame |
|---|---|---|
| PK Parameter: Ctau of ATV, DRV, COBI, FTC and TFV | Ctau is defined as the observed drug concentration at the end of the dosing interval. Ctau for ATV (cohorts 1, 2, 3, and 4 (Groups 2 to 4)), DRV (cohorts 1, 2, and 3), COBI (except Cohort 5), FTC and TFV (cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
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Key Inclusion Criteria:
HIV-1 infected, virologically suppressed males and females age ≥ 4 weeks to < 18 years (according to requirements of enrolling Cohort).
Body weight at screening ≥ 25 to < 40 kg (Cohort 2); ≥ 14 to < 25 kg (Cohort 3); ≥ 3 to < 25 kg (Cohort 4); ≥ 3 to < 14 kg (Cohort 5).
Stable antiretroviral (ARV) regimen for a minimum of 3 months prior to the screening visit.
Participants enrolled prior to implementation of Amendment 7: 2 nucleoside reverse transcriptase inhibitors (NRTIs) and ritonavir-boosted atazanavir (ATV/r) once daily or ritonavir-boosted darunavir (DRV/r) once daily or twice daily.
Participants enrolled after the implementation of Amendment 9:
Participants undergoing dose modifications to their ARV regimen for growth or switching medication formulations are considered to be on a stable ARV regimen.
Documented plasma human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) for ≥ 3 months preceding the screening visit:
Participants enrolled after the implementation of Amendment 9:
For virologically suppressed participants, unconfirmed virologic elevations of HIV-1 RNA ≥ 50 copies/mL (transient detectable viremia, or "blip") prior to screening are acceptable. If the lower limit of detection of the local HIV-1 RNA assay is < 50 copies/mL (eg, < 20 copies/mL), the plasma HIV-1 RNA level cannot exceed 50 copies/mL on 2 consecutive HIV-1 RNA tests.
Adequate renal function: Estimated glomerular filtration rate (eGFR) ≥ 90 mL/min/1.73m2 using the Schwartz formula. If ≥ 1 year old, eGFR greater than or equal to the minimum normal value for age using the Schwartz formula. If < 1 year old as follows:
Participants must not have documented or suspected resistance to applicable study drugs including emtricitabine (Emtriva®) (FTC), TFV, ATV, DRV, or LPV. Participants < 14 kg (Cohorts 4 (Groups 2 to 4) and 5 (Groups 1 to 3)) with M184V/I AND HIV-1 RNA < 50 copies/mL will be allowed.
Positive confirmatory HIV test (confirmatory nucleic acid-based testing if < 18 months of age).
Cohort 4 (Groups 2 to 4) and Cohort 5 (Groups 1 to 3): Last dose of nevirapine or efavirenz, if applicable, ≥ 14 days prior to enrollment.
Note: Other protocol defined Inclusion/Exclusion criteria do apply.
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| Name | Affiliation | Role |
|---|---|---|
| Gilead Study Director | Gilead Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pediatric Infectious Disease Associates | Long Beach | California | 90806 | United States | ||
| Peter Morton Medical Building |
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| Label | URL |
|---|---|
| Gilead Clinical Trials Website | View source |
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| Cohort 4 (Group 2) | Experimental | Participants age ≥ 4 weeks old weighing 10 to < 14 kg will receive cobicistat TOS 30 mg (twice daily) and F/TAF TOS 60/7.5 mg, once daily with either ATV or LPV/r. Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, respectively; participants receiving LPV/r will not receive cobicistat TOS. |
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| Cohort 4 (Group 3) | Experimental | Participants age ≥ 4 weeks old weighing 6 to < 10 kg will receive cobicistat TOS 30 mg (twice daily) and F/TAF TOS 30/3.75 mg, once daily with either ATV or LPV/r. Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, respectively; participants receiving LPV/r will not receive cobicistat TOS. |
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| Cohort 4 (Group 4) | Experimental | Participants age ≥ 4 weeks old weighing 3 to < 6 kg will receive cobicistat TOS 30 mg (twice daily) and F/TAF TOS 15/1.88 mg, once daily with either ATV or LPV/r. Minimum age and weight for ATV is ≥ 3 months and ≥ 5 kg, respectively; participants receiving LPV/r will not receive cobicistat TOS. |
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| Cohort 5 (Group 1) | Experimental | Participants ages ≥ 4 weeks old weighing ≥ 10 to < 14 kg will receive F/TAF TOS 60/7.5 mg, once daily with the third unboosted drug. |
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| Cohort 5 (Group 2) | Experimental | Participants ages ≥ 4 weeks old weighing ≥ 6 to < 10 kg will receive F/TAF TOS 30/3.75 mg, once daily with the third unboosted drug. |
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| Cohort 5 (Group 3) | Experimental | Participants ages ≥ 4 weeks old weighing ≥ 3 to < 6 kg will receive F/TAF TOS 15/1.88 mg, once daily with the third unboosted drug. |
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| DRV | Drug | Tablets administered once daily according to dosing recommendations per product monograph |
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| Cobicistat | Drug | Tablets administered orally once daily with food |
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| BR | Drug | Background Regimen (BR) include Food and Drug Administration (FDA)-approved nucleos(t)ide reverse transcriptase inhibitors (NRTIs) including zidovudine (ZDV), stavudine (d4T), didanosine (ddI), abacavir (ABC), tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), lamivudine (3TC), and emtricitabine (FTC). |
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| F/TAF | Drug | Tablets administered orally once daily |
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| LPV/r | Drug | Solution administered orally |
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| Third Unboosted Drug | Drug | ATV (administered orally), DRV (administered orally), and LPV/r (administered orally) would be general list but unspecified for sites. |
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| Cobicistat TOS | Drug | Tablets for oral suspension |
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| F/TAF TOS | Drug | Tablets for oral suspension |
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| PK Parameter: Cmax of ATV, DRV, COBI, TAF, FTC and TFV | Cmax is defined as the maximum observed concentration of drug. Cmax for ATV (Cohorts 1, 2, 3, and 4 [Groups 2 to 4]) and DRV (Cohorts 1, 2, and 3); for COBI (except Cohort 5); for TAF, FTC and TFV (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
| PK Parameter: CL/F of ATV, DRV, COBI, TAF, FTC and TFV | CL/F is defined as the apparent oral clearance following administration of the drug. CL/F for ATV (Cohorts 1, 2, 3, and 4 [Groups 2 to 4]) and DRV (Cohorts 1, 2, and 3); for COBI (except Cohort 5); for TAF, FTC and TFV (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
| PK Parameter: Vz/F of COBI, TAF, FTC and TFV | Vz/F is defined as the apparent volume of distribution of the drug. Vz/F for COBI (Except Cohort 5); for TAF (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF); for FTC and TFV (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
| PK Parameter: AUCtau of COBI and FTC | AUCtau is defined as concentration of drug over time (the area under the concentration verses time curve over the dosing interval). AUCtau for COBI (Except Cohort 5) and FTC will be reported. | Predose on Day 1, and postdose up to Week 48 |
| PK Parameter: AUClast of TAF, FTC and TFV | AUClast is defined as area under the concentration versus time curve from time zero to the last quantifiable concentration. AUClast for TAF (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF); for FTC and TFV (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
| PK Parameter: Clast of TAF | Clast is defined as the the last observed quantifiable concentration of the drug in plasma. Clast for TAF (Cohorts 2, 3, 4 [Groups 1 to 4] and 5 taking F/TAF) will be reported. | Predose on Day 1, and postdose up to Week 48 |
| Percentage of Participants Experiencing Treatment-emergent Adverse Events (TEAEs) | First dose date up to Week 48 plus 30 days (Cumulative data through Week 48) |
| Percentage of Participants Experiencing Clinically Significant Changes in Safety Laboratory Values | First dose date up to Week 48 plus 30 days (Cumulative data through Week 48) |
| Percentage of Participants with HIV-1 RNA < 50 Copies/mL at Week 24 and as Defined by the US FDA-defined Snapshot Algorithm | Week 24 |
| Percentage of Participants with HIV-1 RNA < 50 Copies/mL at Week 48 and as Defined by the US FDA-defined Snapshot Algorithm | Week 48 |
| Change from Baseline in CD4+ Cell Counts (cells/μL) at Week 24 | Baseline, Week 24 |
| Change from Baseline in CD4+ Cell Counts (cells/μL) at Week 48 | Baseline, Week 48 |
| Change from Baseline in Percentage of CD4+ Cells at Week 24 | Baseline, Week 24 |
| Change from Baseline in Percentage of CD4+ Cells at Week 48 | Baseline, Week 48 |
| Acceptability of COBI and F/TAF as Measured by Palatability Score | Week 48 |
| Los Angeles |
| California |
| 90095 |
| United States |
| University of Colorado Denver | Aurora | Colorado | 80045 | United States |
| The George Washington University | Washington D.C. | District of Columbia | 20010 | United States |
| University of South Florida | Tampa | Florida | 33606 | United States |
| St. Jude Children's Research Hospital | Memphis | Tennessee | 38105 | United States |
| University of Texas Health Science Center of Houston | Houston | Texas | 77030 | United States |
| Hospital General de Agudos Cosme Argerich | Buenos Aires | 1151 | Argentina |
| Helios Salud | Buenos Aires | C1141 ACG | Argentina |
| University of the Free State | Bloemfontein | 9300 | South Africa |
| University of Stellenbosch | Cape Town | 7505 | South Africa |
| King Edward VIII Hospital | Durban | 3629 | South Africa |
| Rahima Clinical Trials, a Division of Wits Health Consortium (Pty) Ltd | Johannesburg | 2093 | South Africa |
| The Aurum Institute: Pretoria Clinical Research Centre | Pretoria | 87 | South Africa |
| Perinatal HIV Research Unit | Soweto | 2013 | South Africa |
| HIV-NAT | Bangkok | 10330 | Thailand |
| Siriraj Hospital | Bangkok | 10700 | Thailand |
| Srinagarind Hospital | Khon Kaen | 40002 | Thailand |
| MU-JHU Research Collaboration/MU-JHU Care Ltd | Kampala | 256 | Uganda |
| SICRA-TASO Mulago National Referral Hospital | Kampala | Uganda |
| AMBSO Masaka Clinical Research Site | Masaka | Uganda |
| Imperial College Healthcare NHS Trust | London | W2 1NY | United Kingdom |
| University of Zimbabwe Clinical Research Centre | Harare | Zimbabwe |
| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| D015658 | HIV Infections |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D000069446 | Atazanavir Sulfate |
| D000069454 | Darunavir |
| D000069547 | Cobicistat |
| C000613801 | emtricitabine tenofovir alafenamide |
| ID | Term |
|---|---|
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D009842 | Oligopeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D002219 | Carbamates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D005663 | Furans |
| D013844 | Thiazoles |
| D001393 | Azoles |
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