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Non-nucleoside Reverse Transcriptase Inhibitor
Doravirine for HIV-Associated Weight Gain
Phase 4
Waitlist Available
Research Sponsored by Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
Ability to acquire NRTIs (TAF/FTC or TAF/3TC, and TDF/FTC or TDF/3TC) and INSTI through usual care for the duration of the study
Currently, on a BIC (bictegravir), DTG (dolutegravir), or RAL (raltegravir) +TAF/FTC (or TAF/3TC) regimen with ≥48 weeks INSTI+TAF/FTC (or TAF/3TC) dosing prior to study entry.
Must not have
Historical or current evidence of major mutations associated with any NNRTI resistance
Prior exposure to single-dose nevirapine for the prevention of parent-to-child transmission of HIV
Timeline
Screening 3 weeks
Treatment Varies
Follow Up at day 0, weeks 4, 12, 24, and 48
Awards & highlights
Summary
This trial is testing if changing HIV medications to doravirine or switching drug combinations can help patients who have gained weight on their current treatment. The study focuses on people with HIV who have experienced significant weight gain. Doravirine works by blocking a different part of the virus, which might help reduce weight gain and improve overall health. Doravirine is an alternative treatment option for individuals who do not tolerate efavirenz.
Who is the study for?
This trial is for adults with HIV who have experienced significant weight gain after starting an INSTI+TAF/FTC or TAF/3TC regimen. They must have been on this treatment for at least 48 weeks, have a BMI of ≥27.5 kg/m2, and show stable viral suppression with no major mutations associated with drug resistance.
What is being tested?
The study tests if switching to doravirine (a non-nucleoside reverse transcriptase inhibitor) from an INSTI-based regimen can reduce or stabilize weight within a year. It also examines changes in body composition, metabolic health, bone health, and the maintenance of HIV suppression.
What are the potential side effects?
Potential side effects may include typical reactions to antiretroviral therapy such as nausea, headaches, fatigue, possible liver enzyme elevations, and rare but serious risks like lactic acidosis or severe liver problems.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
I can get the required HIV medications for the study's duration.
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I've been on a specific HIV treatment regimen for at least 48 weeks.
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I have a confirmed HIV-1 diagnosis.
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I gained over 10% of my weight without a clear reason after starting or changing to INSTI-based ART.
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My HIV-1 levels have been undetectable for at least the past year.
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I have confirmed HIV-1 infection.
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I've been on a specific HIV treatment regimen for at least 48 weeks.
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I can get the required HIV medications for the study's duration.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
My tests show major mutations linked to NNRTI resistance.
Select...
I have taken nevirapine once to prevent passing HIV to my child.
Select...
I plan to have weight loss surgery or make major diet or exercise changes soon.
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I have been diagnosed with osteoporosis or osteopenia.
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I haven't been hospitalized or needed serious treatment in the last 30 days.
Select...
My HIV has specific mutations (K65R/E/N or M184V/I).
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ at day 0, weeks 4, 12, 24, and 48
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~at day 0, weeks 4, 12, 24, and 48
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Secondary study objectives
Occurrence of Grade ≥3 AEs or >10% reduction in CrCl as estimated by the CKD-EPI equation
Occurrence of confirmed plasma HIV-1 RNA >200 copies/mL
Occurrence of premature discontinuation of study treatment
Trial Design
3Treatment groups
Experimental Treatment
Group I: DOR 100 mg + TDF/FTC (or TDF/3TC, depending on location)Experimental Treatment3 Interventions
By mouth daily with or without food
Group II: DOR 100 mg + TAF/FTC (or TAF/3TC, depending on location)Experimental Treatment3 Interventions
By mouth daily with or without food
Group III: Continuation of entry INSTI+TAF/FTC (or TAF/3TC)Experimental Treatment3 Interventions
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Integrase strand transfer inhibitors
2020
N/A
~120
Tenofovir alafenamide/emtricitabine
2020
Completed Phase 1
~50
Research Highlights
Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
The most common treatments for HIV infection include non-nucleoside reverse transcriptase inhibitors (NNRTIs) like Doravirine, nucleoside reverse transcriptase inhibitors (NRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs). NNRTIs, such as Doravirine, work by binding to and inhibiting the reverse transcriptase enzyme, which is crucial for the HIV virus to replicate its genetic material.
NRTIs mimic the natural nucleotides used by reverse transcriptase, causing premature termination of the viral DNA chain. PIs inhibit the protease enzyme, preventing the virus from maturing and becoming infectious.
INSTIs block the integrase enzyme, which is necessary for the viral DNA to integrate into the host cell's genome. These treatments are vital for HIV patients as they reduce viral load, improve immune function, and decrease the risk of HIV-related complications and transmission.
Doravirine versus ritonavir-boosted darunavir in antiretroviral-naive adults with HIV-1 (DRIVE-FORWARD): 96-week results of a randomised, double-blind, non-inferiority, phase 3 trial.
Doravirine versus ritonavir-boosted darunavir in antiretroviral-naive adults with HIV-1 (DRIVE-FORWARD): 96-week results of a randomised, double-blind, non-inferiority, phase 3 trial.
Find a Location
Who is running the clinical trial?
Advancing Clinical Therapeutics Globally for HIV/AIDS and Other InfectionsLead Sponsor
99 Previous Clinical Trials
73,350 Total Patients Enrolled
AIDS Clinical Trials GroupLead Sponsor
100 Previous Clinical Trials
73,401 Total Patients Enrolled
National Institute of Allergy and Infectious Diseases (NIAID)NIH
3,311 Previous Clinical Trials
5,626,474 Total Patients Enrolled
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- My HIV-1 levels have been undetectable for at least the past year.It's okay if you missed taking your medication a few times in the past year, as long as the gaps were not more than a week long and you had no more than three of them.I started TAF/FTC or TAF/3TC at least 48 weeks before joining the study.The term "licensed" means that the kit used in the study has been approved by a government agency or certified by a reputable organization in the country where the study is taking place.I have confirmed HIV-1 infection.I can get the required HIV medications for the study's duration.If you test positive for HIV on the first test, you need to take a second test using a different method to confirm the result. This is required by the World Health Organization and the Centers for Disease Control and Prevention.I've been on a specific HIV treatment regimen for at least 48 weeks.My tests show major mutations linked to NNRTI resistance.I switched my HIV medication within the same class more than 24 weeks ago.I have taken nevirapine once to prevent passing HIV to my child.I have a confirmed HIV-1 diagnosis.I plan to start or stop taking medication for mental health, thyroid, or diabetes that affects weight.I plan to have weight loss surgery or make major diet or exercise changes soon.I have been diagnosed with osteoporosis or osteopenia.You currently use drugs or alcohol regularly, or have recently stopped using methamphetamine within the past 60 days. This may prevent you from following the study guidelines.I gained over 10% of my weight without a clear reason after starting or changing to INSTI-based ART.I am not planning to start or change any medications that could significantly affect my weight during the study.I have experienced severe kidney side effects from TDF.I haven't been hospitalized or needed serious treatment in the last 30 days.You have a body mass index (BMI) of 27.5 or higher.My HIV has specific mutations (K65R/E/N or M184V/I).I've been on a specific HIV treatment regimen for at least 48 weeks.The ability and willingness of the participant or their legal guardian/representative to provide informed consent is required.I can get the required HIV medications for the study's duration.I have been on a stable hormone dose for more than 12 weeks.
Research Study Groups:
This trial has the following groups:- Group 1: DOR 100 mg + TAF/FTC (or TAF/3TC, depending on location)
- Group 2: DOR 100 mg + TDF/FTC (or TDF/3TC, depending on location)
- Group 3: Continuation of entry INSTI+TAF/FTC (or TAF/3TC)
Awards:
This trial has 3 awards, including:- Drug Has Already Been Approved - The FDA has already approved this drug, and is just seeking more data.
- No Placebo-Only Group - All patients enrolled in this study will receive some form of active treatment.
- Pivotal Trial - The final step before approval, pivotal trials feature drugs that have already shown basic safety & efficacy.
Timeline:
This trial has the following timeline:- Screening: It may take up to 3 Weeks to process to see if you qualify in this trial.
- Treatment: The duration you will receive the treatment varies.
- Follow Ups: You may be asked to continue sharing information regarding the trial for 6 Months after you stop receiving the treatment.
Human Immunodeficiency Virus Infection Patient Testimony for trial: Trial Name: NCT04636437 — Phase 4
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