Pan African Clinical Trials Registry

South African Medical Research Council, South African Cochrane Centre
PO Box 19070, Tygerberg, 7505, South Africa
Telephone: +27 21 938 0506 / +27 21 938 0834 Fax: +27 21 938 0836
Email: pactradmin@mrc.ac.za Website: pactr.samrc.ac.za
Trial no.: PACTR202310819162115 Date of Approval: 19/10/2023
Trial Status: Registered in accordance with WHO and ICMJE standards
TRIAL DESCRIPTION
Public title A Phase I Randomized, Placebo-Controlled, Double-Blind Study to Assess Safety, Pharmacokinetics, and Modeled Pharmacodynamics of a Vaginal Insert Containing Tenofovir Alafenamide and Elvitegravir
Official scientific title A Phase I Randomized, Placebo-Controlled, Double-Blind Study to Assess Safety, Pharmacokinetics, and Modeled Pharmacodynamics of a Vaginal Insert Containing Tenofovir Alafenamide and Elvitegravir
Brief summary describing the background and objectives of the trial Background: Adolescent girls and young women (AGYW) bear the burden of the HIV-1 epidemic, with more than 59% of new infections occurring in women in sub-Saharan Africa (SSA). The daily dosing requirement and systemic side effects, primarily gastrointestinal (GI), have made it difficult, particularly for AGYW, to adhere to daily tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) for HIV-1 prevention. In SSA, adolescents and young people desire and even prefer on-demand HIV prevention options. Across multiple end-user studies a subset of women consistently indicate a preference for on-demand HIV and multipurpose prevention technologies (MPT) over daily use and even longer-acting products. Recent acceptability data from the contraceptive field, among AGYW in both high- and low-income countries, indicate that many prefer an on-demand, female controlled, peri-coital contraceptive, rather than a daily regimen or even a long-acting product. While there are several US Food and Drug Administration (FDA) approved antivirals to reduce HSV-2 shedding from an infected individual’s genital tract and reduce the duration of painful HSV-2 flare ups, there is no approved HSV-2 primary prevention product. HSV-2 is the most common cause of genital ulcers and is the most prevalent viral sexually transmitted infection (STI) in the US and world-wide, with an estimated 417 million people worldwide living with HSV-2. SSA is the most severely affected region of the world with up to 80% of sexually active women infected with HSV-2 by age 35 years. There are substantial data that HSV-2 and HIV1 infections are synergistic, with asymptomatic shedding of HSV-2 causing increased susceptibility to HIV-1 and increased shedding of HSV-2 among HIV-1 infected individuals. The development of an HIV-1 and HSV-2 primary prevention MPT would have a significant public health impact, especially for AGYW. The objectives of this study will be to examine the safety, Pharmacokinetics, modelled Pharmacodynamics, and acceptability of inserts containing the combination of Tenofovir Alafenamide (TAF) and Elvitegravir (EVG) applied vaginally in HIV-1 negative low-risk women aged 18 – 50 years.
Type of trial RCT
Acronym (If the trial has an acronym then please provide) MATRIX 001
Disease(s) or condition(s) being studied Infections and Infestations
Sub-Disease(s) or condition(s) being studied HIV/AIDS
Purpose of the trial Prevention
Anticipated trial start date 01/12/2023
Actual trial start date
Anticipated date of last follow up 30/11/2024
Actual Last follow-up date
Anticipated target sample size (number of participants) 20
Actual target sample size (number of participants)
Recruitment status Recruiting
Publication URL
Secondary Ids Issuing authority/Trial register
SERU 4778 KEMRI-SERU
STUDY DESIGN
Intervention assignment Allocation to intervention If randomised, describe how the allocation sequence was generated Describe how the allocation sequence/code was concealed from the person allocating the participants to the intervention arms Masking If masking / blinding was used
Factorial: participants randomly allocated to either no, one, some or all interventions simultaneously Randomised Simple randomization using a randomization table created by a computer software program Allocation was determined by the holder of the sequence who is situated off site Masking/blinding used Care giver/Provider,Participants
INTERVENTIONS
Intervention type Intervention name Dose Duration Intervention description Group size Nature of control
Experimental Group Tenofovir Alafenamide and Elvitegravir 20/16mg once a day 8 weeks Participants will be randomized (1:1) to apply either a placebo or TAF/EVG insert vaginally once daily for 3 consecutive days and every other day (QOD) for 14 days. 10
Control Group Placebo vaginal insert 0mg 8weeks Participants will be randomized (1:1) to apply either a placebo or TAF/EVG insert vaginally once daily for 3 consecutive days and every other day (QOD) for 14 days. 10 Placebo
ELIGIBILITY CRITERIA
List inclusion criteria List exclusion criteria Age Category Minimum age Maximum age Gender
1) Aged 18 to 50 years (inclusive) at Screening. 2) Assigned female sex at birth. 3) Able and willing to provide written informed consent to be screened for and enrolled in MATRIX-001 in one of the study languages (as specified in site SOP). 4) General good health (by volunteer history) without any evidence of clinically significant systemic disease (as determined by Investigator of Record [IoR] or designee). 5) Has had vaginal sex and has an intact uterus and cervix. 6) Has a regular and/or predictable bleeding pattern based on the opinion of the investigator, or is oligomenorrheic or amenorrhoeic. 7) HIV-uninfected based on testing performed at Screening and Enrollment (per protocol algorithms in Appendix II). 8) Negative urine pregnancy test at Screening and Enrollment. 9) Protected from pregnancy by an effective contraceptive method as confirmed by site SOP; effective methods include: • minimum of 3 months of use of a combined hormonal contraceptive method (except vaginal rings) • minimum of 6 months of use of a progestin only contraceptive method or copper IUD • Sterilization of participant or partner • Correct and consistent condom use (for US site only) • Abstinence from penile-vaginal intercourse (for US site only) 10) Participants over the age of 21 (inclusive) must have documentation of a Grade 0 Pap smear within the past 3 years prior to Enrollment, per the Female Genital Grading Table for Use in Microbicide Studies Addendum 1 (Dated November 2007) to the DAIDS Table for Grading Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, or Grade 1 Pap smear at Screening with no treatment required. 11) Normal cervicovaginal mucosa (as defined in MATRIX-001 Study Specific Procedures [SSP] manual). 12) Willing and able to comply with protocol requirements, including abstaining from vaginal activity and product use at specified times (see Section 6.7.2). 13) Per participant report, if in a relationship, must be in a mutually monogamo 1) Per participant report, intends to do any of the following during the study participation period: • Become pregnant. • Breastfeed. • Relocate away from the study site. • Travel away from the study site for a time period that would interfere with product resupply and/or study participation. 2) Currently breastfeeding. 3) Positive HIV test at Screening or Enrollment. 4) History of sensitivity/allergy to any component of the study product, topical anesthetic, cellulose based thrombogenic material, or to both silver nitrate and Monsel’s solution. 5) Positive test for Trichomonas vaginalis (TV), Neisseria gonorrhea (GC), Chlamydia trachomatis (CT), Treponema pallidum (Syphilis), or Hepatitis B surface antigen (HBsAg) at Screening or (per participant report) treated for GC, CT, TV, HBsAg or syphilis in the past 12 months. 6) Chronic or acute vulvar, vaginal or cervical symptoms (pain, irritation, spotting/bleeding other than what would be expected from contraceptive use, discharge, etc.). 7) Known bleeding/clotting disorder, including use of anti-coagulation. 8) Need for continued use of any contraindicated concomitant medications (as listed in Appendix III). 9) Participation in any other trial with use of an investigational drug/device within the last 30 days or planned participation in any other investigational trial with use of a drug/device during the study. 10) Participants who previously received an HIV vaccine or HIV broadly neutralizing antibody (bNAb) are not eligible. Individuals may be eligible if they participated in an HIV vaccine or bNAb study but have documentation that they did not receive active product (e.g., placebo recipients). 11) Prior use of PEP or oral PrEP (including FTC/TDF) in the past 4 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir). 12) Grade 2 or higher pelvic finding or laboratory abnormality, per the DAIDS Table for Grading Adult and Pediatric Adverse Events, Corrected Version 2.1 Adolescent: 13 Year-18 Year,Adult: 19 Year-44 Year,Middle Aged: 45 Year(s)-64 Year(s) 18 Year(s) 50 Year(s) Female
ETHICS APPROVAL
Has the study received appropriate ethics committee approval Date the study will be submitted for approval Date of approval Name of the ethics committee
Yes 14/09/2023 KEMRI SERU
Ethics Committee Address
Street address City Postal code Country
Off Raila Odinga Way, Nairobi 00200 Kenya
OUTCOMES
Type of outcome Outcome Timepoint(s) at which outcome measured
Primary Outcome Safety After initiation of the study product
Secondary Outcome Pharmacokinetics, Modeled in vitro Pharmacodynamics, Acceptability, Subclinical Safety and Vaginal Microbiome After study product initiation
RECRUITMENT CENTRES
Name of recruitment centre Street address City Postal code Country
KEMRI CCR PHRD OAU Road, Section 9 Thika Kenya
FUNDING SOURCES
Name of source Street address City Postal code Country
USAID 500 D Street Southwest Washington United States Minor Outlying Islands
SPONSORS
Sponsor level Name Street address City Postal code Country Nature of sponsor
Primary Sponsor CONRAD 601 Colley Ave Eastern Virginia United States Minor Outlying Islands Other Collaborative Groups
COLLABORATORS
Name Street address City Postal code Country
Eastern Virginia Medical School 601 Colley Ave Eastern Virginia United States Minor Outlying Islands
Centre for the AIDS Progrmme of Research in South Africa 3 Richards Road Durban South Africa
Kenya Medical Research Institute OAU Road Thika Kenya
CONTACT PEOPLE
Role Name Email Phone Street address
Principal Investigator Nelly Mugo rwamba@uw.edu +254733629665 OAU Road
City Postal code Country Position/Affiliation
Thika Kenya Senior Research Scientist
Role Name Email Phone Street address
Scientific Enquiries Kenneth Ngure kngure@pipsthika.org +254722362219 OAU Road
City Postal code Country Position/Affiliation
Thika Kenya Co Principal Investigator
Role Name Email Phone Street address
Public Enquiries Catherine Kiptinness catherine@pipsthika.org +254721323898 OAU Road
City Postal code Country Position/Affiliation
Thika Kenya Site Coordinator
REPORTING
Share IPD Description Additional Document Types Sharing Time Frame Key Access Criteria
Yes The Principal Investigators commit to share this data once the study is completed and published Study Protocol IPD will be shared after study completion and results published. IPD will be shared after study completion and results published.
URL Results Available Results Summary Result Posting Date First Journal Publication Date
No
Result Upload 1: Result Upload 2: Result Upload 3: Result Upload 4: Result Upload 5:
Result URL Hyperlinks Link To Protocol
Result URL Hyperlinks
Changes to trial information