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HIV Open-label Prevention Extension (HOPE).
A Phase 3B Open-Label Follow-on Trial to Assess the Continues Safety of and Adherence to a Vaginal ring Containing Dapivirine in Women
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HIV Open-label Prevention | Experimental | Following demonstration of safety and efficacy of the dapivirine vaginal ring in MTN-020, eligible MTN-020 participants will be offered enrollment into MTN-025, a trial designed to obtain additional safety and adherence data in women MTN-020:NCT01617096 MTN-025: NCT02858037 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dapivirine Vaginal Ring | Combination Product | Dapivirine Vaginal Ring, 25 ring given monthly for at least one year. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The Safety Profile Associated With the Open-label Use of the Dapivirine Vaginal Matrix Ring (25 mg) in Women | Number of participants Grade 2, Grade 3, and all serious Adverse Events. | 13 months |
| Adherence to the Open Label Use of the Dapivirine Vaginal Matrix Ring (25 mg) in Women | By measuring the residual levels of dapivirine in returned used vaginal rings. | 13 months |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of HIV-1 Infection | HIV-1 infection as measured by the protocol algorithm | 13 months |
| Number of Participant Who Acquired HIV-1 With HIV-1 Drug Resistance Associated Mutations. | HIV-1 drug resistance mutations among participants who acquire HIV-1, as measured by standard genotype analysis and more sensitive methods to detect low frequency drug-resistant variants |
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Inclusion Criteria:
Women must meet all of the following criteria to be eligible for inclusion in the study
Exclusion Criteria:
Women who meet any of the following criteria will be excluded from the study
Study product use permanently discontinued in response to an AE or safety related concern while taking part in the MTN-020 (ASPIRE) trial
Per participant report at Screening:
Per participant report at Enrollment, currently taking Post-Exposure Prophylaxis (PEP)
With the exception of MTN-020 (ASPIRE), participation in any other research study involving drugs, medical devices, vaginal products, or vaccines, within 60 days of enrollment
Is pregnant at Screening/Enrollment or planning to become pregnant in the participant's anticipated study participation period
Currently breastfeeding
Diagnosed with urinary tract infection (UTI), pelvic inflammatory disease (PID), STI or reproductive tract infection (RTI) requiring treatment per WHO guidelines
At Screening, has a clinically apparent Grade 3 pelvic exam finding (observed by study staff) as per the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events Version 1.0, December, 2004 (Clarification dated August 2009), Addendum 1-Female Genital Grading Table for Use in Microbicide Studies
Has any of the following laboratory abnormalities at Screening Visit:
Has any significant medical condition or other condition that, in the opinion of the IoR/designee, would preclude informed consent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives
-
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| Name | Affiliation | Role |
|---|---|---|
| John Steytler | International Partnership for Microbicides | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins University Research Project | Blantyre | Malawi | ||||
| Malawi Clinical Research Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33539762 | Derived | Baeten JM, Palanee-Phillips T, Mgodi NM, Mayo AJ, Szydlo DW, Ramjee G, Gati Mirembe B, Mhlanga F, Hunidzarira P, Mansoor LE, Siva S, Govender V, Makanani B, Naidoo L, Singh N, Nair G, Chinula L, Parikh UM, Mellors JW, Balan IC, Ngure K, van der Straten A, Scheckter R, Garcia M, Peda M, Patterson K, Livant E, Bunge K, Singh D, Jacobson C, Jiao Y, Hendrix CW, Chirenje ZM, Nakabiito C, Taha TE, Jones J, Torjesen K, Nel A, Rosenberg Z, Soto-Torres LE, Hillier SL, Brown ER; MTN-025/HOPE Study Team. Safety, uptake, and use of a dapivirine vaginal ring for HIV-1 prevention in African women (HOPE): an open-label, extension study. Lancet HIV. 2021 Feb;8(2):e87-e95. doi: 10.1016/S2352-3018(20)30304-0. | |
| 32920652 |
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Participants were recruited from RC cohorts of MTN-020 participants. Efforts were made by RCs to maintain contact with MTN-020 (ASPIRE) participants between the end of follow-up in MTN-020 and the initiation of the MTN-025 trial (HOPE) to provide MTN-020 trial results and information regarding the HOPE trial to participants.
MTN-025 was implemented as a follow-on trial to MTN-020, and the inclusion and exclusion criteria were used to ensure the appropriate selection of trial participants for MTN-025.
The Decliner Population were former MTN-020 participants who declined participation in the main MTN-025 trial, and who met the inclusion and exclusion criteria Women in the Decliner Population were invited to complete a single visit which consisted of behavioral assessments.
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| ID | Title | Description |
|---|---|---|
| FG000 | HIV Open-label Prevention | Following demonstration of safety and efficacy of the dapivirine vaginal ring in MTN-020, eligible MTN-020 participants will be offered enrollment into MTN-025, a trial designed to obtain additional safety and adherence data in women MTN-020: NCT01617096 MTN-025: NCT02858037 Dapivirine Vaginal Ring: Dapivirine Vaginal Ring, 25 ring given monthly for at least one year. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 11, 2016 | Jun 15, 2022 |
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Participants will receive a silicone elastomer vaginal matrix ring containing 25 mg of dapivirine to be replaced each month for a total period of 12 months of use.
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| 13 months |
| Lilongwe |
| Malawi |
| Medical Research Council of South Africa | Westville | Durban | 3630 | South Africa |
| WRHI Clinical Research Center | Johannesburg | Gauteng | South Africa |
| Verulam Clinical Research Center | Durban | KwaZulu-Natal | 4340 | South Africa |
| Botha's Hill Clinical Research Center | Durban | KwaZulu-Natal | South Africa |
| Chatsworth Clinical Research Center | Durban | KwaZulu-Natal | South Africa |
| Isipingo Clinical Research Center | Durban | KwaZulu-Natal | South Africa |
| Tongaat Clinical Research Center | Durban | KwaZulu-Natal | South Africa |
| Emavundleni Research Centre | Cape Town | Western Cape | 7750 | South Africa |
| eThekwini Clinical Research Center | Durban | 4001 | South Africa |
| Wits Reproductive Health and HIV Institute Research Centre | Johannesburg | South Africa |
| Makerere University - Johns Hopkins University Research Collaboration Clinical Research Center | Kampala | Uganda |
| MU-JHU Research Collaboration | Kampala | Uganda |
| Seke South Clinical Research Center | Harare | Zimbabwe |
| Spilhaus Clinical Research Center | Harare | Zimbabwe |
| Zengeza Clinical Research Center | Harare | Zimbabwe |
| Derived |
| Kutner BA, Giguere R, Lentz C, Kajura-Manyindo C, Dolezal C, Butheliezi S, Gwande M, Nampiira S, Ndlovu T, Mvinjelwa P, Mwenda W, Balan IC. Sharing Objective Measures of Adherence to a Vaginal Microbicide Promotes Candor About Actual Use and Bolsters Motivation to Prevent HIV. AIDS Behav. 2021 Mar;25(3):721-731. doi: 10.1007/s10461-020-03026-6. Epub 2020 Sep 12. |
| Exposed Primary Cohort |
|
| COMPLETED |
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| NOT COMPLETED |
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|
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| ID | Title | Description |
|---|---|---|
| BG000 | HIV Open-label Prevention | Following demonstration of safety and efficacy of the dapivirine vaginal ring in MTN-020, eligible MTN-020 participants will be offered enrollment into MTN-025, a trial designed to obtain additional safety and adherence data in women MTN-020:NCT01617096 MTN-025: NCT02858037 Dapivirine Vaginal Ring: Dapivirine Vaginal Ring, 25 ring given monthly for at least one year. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Years |
| ||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| |||||||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| |||||||||||||||||||||||
| Region of Enrollment | Number | participants |
| |||||||||||||||||||||||
| Marital Status | Count of Participants | Participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Safety Profile Associated With the Open-label Use of the Dapivirine Vaginal Matrix Ring (25 mg) in Women | Number of participants Grade 2, Grade 3, and all serious Adverse Events. | Exposed Primary Cohort - included all participants enrolled in the Main Trial Population | Posted | Count of Participants | Participants | 13 months |
|
|
| ||||||||||||||||||||||||||||||||||||
| Primary | Adherence to the Open Label Use of the Dapivirine Vaginal Matrix Ring (25 mg) in Women | By measuring the residual levels of dapivirine in returned used vaginal rings. | Exposed Human Immunodeficiency Virus Incidence and Adherence Cohort | Posted | Mean | Full Range | mg | 13 months |
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Incidence of HIV-1 Infection | HIV-1 infection as measured by the protocol algorithm | Exposed Human Immunodeficiency Virus Incidence and Adherence Cohort | Posted | Number | events per 100 person-years | 13 months |
|
| |||||||||||||||||||||||||||||||||||||
| Secondary | Number of Participant Who Acquired HIV-1 With HIV-1 Drug Resistance Associated Mutations. | HIV-1 drug resistance mutations among participants who acquire HIV-1, as measured by standard genotype analysis and more sensitive methods to detect low frequency drug-resistant variants | Virology Population - included all HIV-1 infected participants in the Exposed HIV Incidence and Adherence Cohort. | Posted | Count of Participants | Participants | 13 months |
|
|
13 months
Treatment-emergent Adverse Events in ≥ 2.0% of Overall Participants by System Organ Class and Preferred Term, Regardless of Severity and Causality - Exposed Primary Cohort
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | HIV Open-label Prevention | Following demonstration of safety and efficacy of the dapivirine vaginal ring in MTN-020, eligible MTN-020 participants will be offered enrollment into MTN-025, a trial designed to obtain additional safety and adherence data in women MTN-020: NCT01617096 MTN-025: NCT02858037 Dapivirine Vaginal Ring: Dapivirine Vaginal Ring, 25 ring given monthly for at least one year. | 1 | 1,368 | 19 | 1,368 | 844 | 1,368 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Gastrtitis | Gastrointestinal disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Pelvic Inflammatory Disease | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Pneummonia | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Respiratory Track Infection | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Subcutaneous abscess | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Animal Bite | Injury, poisoning and procedural complications | MedDRA (21.1) | Systematic Assessment |
| |
| Contusion | Injury, poisoning and procedural complications | MedDRA (21.1) | Systematic Assessment |
| |
| Head injury | Injury, poisoning and procedural complications | MedDRA (21.1) | Systematic Assessment |
| |
| Multiple injuries | Injury, poisoning and procedural complications | MedDRA (21.1) | Systematic Assessment |
| |
| Tendon injury | Injury, poisoning and procedural complications | MedDRA (21.1) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Optic neuritis | Nervous system disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Abortion spontaneous complete | Pregnancy, puerperium and perinatal conditions | MedDRA (21.1) | Systematic Assessment |
| |
| Premature labour | Pregnancy, puerperium and perinatal conditions | MedDRA (21.1) | Systematic Assessment |
| |
| Psychotic disorder | Psychiatric disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Acute kidney injury | Renal and urinary disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Endometriosis | Reproductive system and breast disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Pelvic pain | Reproductive system and breast disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA (21.1) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Bacteria vaginosis | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Genitourinary chlamydia infection | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Genitourinary tract gonococcal infection | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Malaria | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Urinary Tract Infection | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Vulvovaginal Candidiasis | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| Vulvovaginitis trichomonal | Infections and infestations | MedDRA (21.1) | Systematic Assessment |
| |
| ALT increased | Investigations | MedDRA (21.1) | Systematic Assessment |
| |
| AST increased | Investigations | MedDRA (21.1) | Systematic Assessment |
| |
| Metrorrhagia | Reproductive system and breast disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Pelvic pain | Reproductive system and breast disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Vaginal discharge | Reproductive system and breast disorders | MedDRA (21.1) | Systematic Assessment |
| |
| Vulvovaginal pruritus | Reproductive system and breast disorders | MedDRA (21.1) | Systematic Assessment |
|
Interpretation of the HIV-1 incidence rates is limited by the lack of a concurrent placebo group in MTN-025.
Dapivirine residual levels in returned used rings do not provide adherence information at the time of potential exposure to and infection with HIV, eg, if a participant temporarily removes the DVR during sexual intercourse.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr John Steytler | International Partnership for Microbicides | +27 21 860 2300 | jsteytler@ipmglobal.org |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | May 28, 2021 | Jun 14, 2022 | SAP_001.pdf |
| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| 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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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
|
| More than one race |
|
| Unknown or Not Reported |
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| Uganda |
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| Zimbabwe |
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| Title | Measurements |
|---|---|
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