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This study is designed to evaluate the safety and efficacy of pomalidomide in HIV-1-infected individuals on ART and to determine the impact of pomalidomide on virological control in people living with HIV during an analytical treatment interruption.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pomalidomide | Active Comparator | This arm will receive pomalidomide 2 mg oral capsules |
|
| Placebo | Placebo Comparator | This arm will receive placebo (oral capsules with no active drug) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pomalidomide 2 mg | Drug | Participants will receive pomalidomide 2 mg/d concurrently with aspirin 75 mg for three cycles, each consisting of 21 days on and a minimum of 7 days off. |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of treatment, measured as the time from ART cessation until meeting ART restart criteria. | From ATI to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria | |
| Safety of treatment, measured by the number of treatment-emergent adverse events (AEs) of grade 3 or higher that are probably or definitely related to the study treatment. | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| Measure | Description | Time Frame |
|---|---|---|
| Safety, defined as all other treatment-emerging adverse events (AEs) | AEs are graded according to severity and assessed as either not related or possibly, probably or definitely related to study treatment. | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
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Documented HIV-1 infection
Age 18-70 years, both included.
Receiving combination ART for at least 1 year and being on the same ART regimen for at least 4 weeks at the screening visit
HIV-1 plasma RNA <50 copies/mL for >1 year and <20 copies/mL at screening. Episodes of a single HIV plasma RNA >50-500 copies/mL will not exclude participation if the subsequent HIV plasma RNA was <50 copies/mL
CD4+ T cell count >500 cells/uL at screening
Ability and willingness to provide informed consent and to continue ART throughout the study phase I and to discontinue ART at the commencement of study phase II.
All participants must agree not to participate in a conception process (e.g., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization, egg donation) during the study.
A female participant, may be eligible to enter and participate in the study if she:
Is of non-child-bearing potential defined as either:
Is of child-bearing potential with a negative pregnancy test at both Screening and Day 0 and agrees to use one of the following methods of contraception to avoid pregnancy:
A heterosexually active male participant, may be eligible to enter and participate in the study if he is:
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| Name | Affiliation | Role |
|---|---|---|
| Thomas A. Rasmussen, Associate professor, MD, PhD | University of Aarhus | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal Melbourne Hospital | Melbourne | Australia | ||||
| Aarhus University Hospital |
The participant data will be shared with collaborative researchers but in an anonymous form that cannot be traced to the individual participant, according to the General Data Protection Regulation (GDPR) of the European Union.
September 2024-September 2026
Since the study was approved in September 2024, there has been open access to the study protocol, the statistical analysis plan, and the informed consent form through the CTIS platform.
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| ID | Term |
|---|---|
| C467566 | pomalidomide |
| D001241 | Aspirin |
| ID | Term |
|---|---|
| D012459 | Salicylates |
| D062385 | Hydroxybenzoates |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
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Participants will be randomized 1:1 to pomalidomide 2 mg/d or matching placebo concurrent with aspirin 75 mg.
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| Placebo | Drug | Participants will receive placebo concurrently with aspirin 75 mg for three cycles, each consisting of 21 days on and a minimum of 7 days off. |
|
| Aspirin 75 mg | Drug | Auxiliary Medicinal Product |
|
| Rebound viral kinetics during the ATI, including plasma HIV-1 RNA copies/mL doubling times |
| From ATI to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| The proportion of participants maintaining HIV-1 RNA levels below 1,000 copies/mL at the end of the ATI. | From ATI to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| The proportion of participants who have not met ART restart criteria at the end of the ATI. | From ATI to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| The frequency of peripheral blood CD4+ T cells containing total and intact HIV-DNA while on suppressive ART | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| HIV-specific CD4+ responses | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| HIV-specific CD8+ T cell responses | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| The proportion of cells containing constitutive and inducible MS HIV-RNA | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| The level of CA-US HIV RNA in peripheral blood CD4+ T cells | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| Numbers of B cells, total lymphocytes, CD8+ T cells and CD4+ T cells including memory subsets | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| Proportions of B cells, total lymphocytes, CD8+ T cells and CD4+ T cells including memory subsets | From enrollment to the end of treatment at visit 18 or 16 weeks after meeting ART restart criteria |
| Aarhus |
| Denmark |
| D006841 |
| Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |