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Study of Lenacapavir for HIV Pre-Exposure Prophylaxis in People Who Are at Risk for HIV Infection (PURPOSE 2)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04925752
Recruitment Status : Active, not recruiting
First Posted : June 14, 2021
Last Update Posted : December 28, 2023
Sponsor:
Information provided by (Responsible Party):
Gilead Sciences

Brief Summary:
The goal of this clinical study is to test how well the study drug, lenacapavir (LEN), works in preventing the risk of HIV.

Condition or disease Intervention/treatment Phase
Pre-Exposure Prophylaxis of HIV Infection Drug: Oral Lenacapavir (LEN) Drug: F/TDF Drug: Sub-cutaneous (SC) Lenacapavir (LEN) Drug: Placebo SC LEN Drug: PTM F/TDF Drug: PTM Oral LEN Drug: F/TAF (for US participants only) Phase 3

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 3295 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 3, Double-Blind, Multicenter, Randomized Study to Evaluate the Efficacy and Safety of Subcutaneous Twice Yearly Long-Acting Lenacapavir for HIV Pre-Exposure Prophylaxis in Cisgender Men, Transgender Women, Transgender Men, and Gender Nonbinary People ≥ 16 Years of Age Who Have Sex With Male Partners and Are at Risk for HIV Infection
Actual Study Start Date : June 28, 2021
Estimated Primary Completion Date : January 2025
Estimated Study Completion Date : April 2027

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF

Participants will receive the following for at least 52 weeks:

  • Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks
  • Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily
  • Oral LEN 600 mg on Days 1 and 2

Participants will receive oral LEN if SC injections are not available

Drug: Oral Lenacapavir (LEN)
Tablets administered orally without regard to food
Other Name: GS-6207

Drug: Sub-cutaneous (SC) Lenacapavir (LEN)
Administered via SC injections
Other Name: GS-6207

Drug: PTM F/TDF
Tablets administered orally

Experimental: Blinded Phase: Placebo LEN + F/TDF

Participants will receive the following for at least 52 weeks:

  • SC LEN placebo every 26 weeks
  • Oral F/TDF 200/300 mg once daily
  • PTM Oral LEN on Days 1 and 2

Participants will receive oral LEN placebo if SC injections are not available

Drug: F/TDF
Tablets administered orally
Other Name: Truvada®

Drug: Placebo SC LEN
Administered via SC injections

Drug: PTM Oral LEN
Tablets administered orally

Experimental: LEN Open-Label Extension (OLE) Phase

After completion of the Blinded phase, participants will be offered entry into the LEN OLE Phase.

Participants randomized to LEN will continue to receive SC LEN 927 mg every 26 weeks for a total of 2 doses.

Participants randomized to F/TDF will receive SC LEN 927 mg on OLE Day 1, OLE Week 26, and will also receive oral LEN 600 mg on OLE Days 1 and 2.

Drug: Oral Lenacapavir (LEN)
Tablets administered orally without regard to food
Other Name: GS-6207

Drug: Sub-cutaneous (SC) Lenacapavir (LEN)
Administered via SC injections
Other Name: GS-6207

Experimental: PK Tail Phase

At the completion of the LEN OLE phase, participants will transition into the PK Tail phase.

Additionally, participants that prematurely discontinue the study drug during blinded phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase are also eligible to transition to the PK Tail Phase.

Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks beginning 26 weeks after the last injection of LEN.

Drug: F/TDF
Tablets administered orally
Other Name: Truvada®

Drug: F/TAF (for US participants only)
F/TAF tablets administered orally once daily




Primary Outcome Measures :
  1. Incidence Phase: Background HIV Incidence per 100-Person-Years (PY) [ Time Frame: At Screening ]
  2. Randomized Phase: Number of Participants with Diagnosis of HIV-1 Infection [ Time Frame: When all participants have completed a minimum of 52 weeks of follow-up in the study, or permanent discontinuation, whichever occurs first (maximum approximately 130 weeks) ]

Secondary Outcome Measures :
  1. Number of Participants with Diagnosis of HIV Among Participants While Adherent to Study Drug [ Time Frame: When all participants have completed a minimum of 52 weeks of follow-up in the study, or permanent discontinuation, whichever occurs first (maximum approximately 130 weeks) ]
  2. Percentage of Participants Experiencing Treatment-Emergent Adverse Events [ Time Frame: When all participants have completed a minimum of 52 weeks of follow-up in the study, or permanent discontinuation, whichever occurs first (maximum approximately 130 weeks) ]
  3. Percentage of Participants Experiencing Clinically Significant Laboratory Abnormalities [ Time Frame: When all participants have completed a minimum of 52 weeks of follow-up in the study, or permanent discontinuation, whichever occurs first (maximum approximately 130 weeks) ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   16 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Gender Based Eligibility:   Yes
Gender Eligibility Description:   Cisgender male, Transgender male, Transgender female, and Gender non-binary
Accepts Healthy Volunteers:   Yes
Criteria

Key Inclusion Criteria:

Incidence Phase

  • CGM, TGW, TGM, and GNB who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV infection.
  • HIV-1 status unknown at screening and no prior HIV-1 testing within the last 3 months.
  • Sexually active with ≥ 1 partner assigned male at birth (condomless receptive anal sex) in the last 12 months and 1 of the following:

    • Condomless receptive anal sex with ≥ 2 partners in the last 12 weeks.
    • History of syphilis, rectal gonorrhea, or rectal chlamydia in the last 24 weeks.
    • Self-reported use of stimulants with sex in the last 12 weeks.

Randomized Phase

  • Negative local rapid fourth generation HIV-1/2 Ab/Ag, central fourth generation HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT).
  • Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min at screening according to the Cockcroft-Gault formula for creatinine clearance (CLcr).

Key Exclusion Criteria:

Incidence Phase

  • Prior use of HIV PrEP (including F/TDF or F/TAF) or HIV postexposure prophylaxis (PEP) in the past 12 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir).
  • Prior recipient of an HIV vaccine or HIV broadly neutralizing antibody formulation.

Randomized Phase

  • Acute viral hepatitis A, B or C or evidence of chronic hepatitis B or C infection.
  • Severe hepatic impairment or a history of or current clinical decompensated liver cirrhosis.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04925752


Locations
Show Show 91 study locations
Sponsors and Collaborators
Gilead Sciences
Investigators
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Study Director: Gilead Study Director Gilead Sciences
Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Gilead Sciences
ClinicalTrials.gov Identifier: NCT04925752    
Other Study ID Numbers: GS-US-528-9023
DOH-27-102021-6681 ( Other Identifier: South African National Clinical Trial Registry )
First Posted: June 14, 2021    Key Record Dates
Last Update Posted: December 28, 2023
Last Verified: December 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Infections
Communicable Diseases
HIV Infections
Acquired Immunodeficiency Syndrome
Disease Attributes
Pathologic Processes
Blood-Borne Infections
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Genital Diseases
Urogenital Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Slow Virus Diseases
Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
Reverse Transcriptase Inhibitors
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antiviral Agents
Anti-Infective Agents
Anti-HIV Agents
Anti-Retroviral Agents