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NCT01780506

Study to Evaluate the Safety and Efficacy of E/C/F/TAF (Genvoya®) Versus E/C/F/TDF (Stribild®) in HIV-1 Positive, Antiretroviral Treatment-Naive Adults

Completed Phase 3 Results posted Last updated 19 November 2018
What this trial tests

Phase 3 trial testing E/C/F/TAF in HIV in 872 participants. Completed in 6 September 2017.

Timeline
26 December 2012
Primary endpoint
26 August 2014
6 September 2017

Quick facts

Lead sponsorGilead Sciences
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment872
Start date26 December 2012
Primary completion26 August 2014
Estimated completion6 September 2017
Sites117 locations across Italy, Japan, Belgium, Austria, United Kingdom, Canada, Puerto Rico, Australia

Drugs / interventions tested

Conditions studied

Sponsor

Gilead Sciences — full company profile →

Who can join

18 and older, any sex, with HIV or HIV Infections. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 48 Primary · Week 48

The percentage of participants achieving HIV-1 RNA \< 50 copies/mL at Week 48 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

GroupValue95% CI
E/C/F/TAF93.1
E/C/F/TDF92.8
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Weeks 96 and 144 Secondary · Weeks 96 and 144

The percentage of participants achieving HIV-1 RNA \< 50 copies/mL at Weeks 96 and 144 were analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Week 96
GroupValue95% CI
E/C/F/TAF89.2
E/C/F/TDF88.2
Week 144
GroupValue95% CI
E/C/F/TAF86.9
E/C/F/TDF83.1
Percentage of Participants With HIV-1 RNA < 20 Copies/mL at Weeks 48, 96, and 144 Secondary · Weeks 48, 96. and 144

The percentage of participants achieving HIV-1 RNA \< 20 copies/mL at Weeks 48, 96, and 144 were analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Week 48
GroupValue95% CI
E/C/F/TAF86.4
E/C/F/TDF87.3
Week 96
GroupValue95% CI
E/C/F/TAF84.4
E/C/F/TDF83.6
Week 144
GroupValue95% CI
E/C/F/TAF84.6
E/C/F/TDF80.1
Change From Baseline in CD4+ Cell Count at Week 48 Secondary · Baseline; Week 48
GroupValue95% CI
E/C/F/TAF235± 183.1
E/C/F/TDF221± 178.9
Change From Baseline in CD4+ Cell Count at Week 96 Secondary · Baseline; Week 96
GroupValue95% CI
E/C/F/TAF285± 203.0
E/C/F/TDF271± 208.1
Change From Baseline in CD4+ Cell Count at Week 144 Secondary · Baseline; Week 144
GroupValue95% CI
E/C/F/TAF323± 213.1
E/C/F/TDF310± 207.2
Percent Change From Baseline in Hip Bone Mineral Density (BMD) at Week 48 Secondary · Baseline; Week 48

Hip BMD was assessed by dual energy x-ray absorptiometry (DXA) scan.

GroupValue95% CI
E/C/F/TAF-0.865± 3.2532
E/C/F/TDF-3.200± 3.1759
Percent Change From Baseline in Hip BMD at Week 96 Secondary · Baseline; Week 96

Hip BMD was assessed by DXA scan.

GroupValue95% CI
E/C/F/TAF-0.951± 3.8633
E/C/F/TDF-3.515± 3.9451
Percent Change From Baseline in Hip BMD at Week 144 Secondary · Baseline; Week 144

Hip BMD was assessed by DXA scan.

GroupValue95% CI
E/C/F/TAF-0.826± 4.6786
E/C/F/TDF-3.475± 4.1551
Percent Change From Baseline in Spine BMD at Week 48 Secondary · Baseline; Week 48

Spine BMD was assessed by DXA scan.

GroupValue95% CI
E/C/F/TAF-1.337± 3.0715
E/C/F/TDF-2.956± 3.3524
Percent Change From Baseline in Spine BMD at Week 96 Secondary · Baseline; Week 96

Spine BMD was assessed by DXA scan.

GroupValue95% CI
E/C/F/TAF-0.907± 4.0039
E/C/F/TDF-3.053± 3.9539
Percent Change From Baseline in Spine BMD at Week 144 Secondary · Baseline; Week 144

Spine BMD was assessed by DXA scan.

GroupValue95% CI
E/C/F/TAF-0.809± 4.5041
E/C/F/TDF-3.023± 4.3122

Adverse events — posted to ClinicalTrials.gov

Time frame: Double-Blind Phase: Up to a maximum of 194.1 weeks plus 30 days; Open-Label Phase: Up to a maximum of 48.3 weeks plus 30 days. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Double-Blind: E/C/F/TAF
Serious: 73/435 (17%)
Deaths:
Double-Blind: E/C/F/TDF
Serious: 65/432 (15%)
Deaths:
Open-Label: E/C/F/TAF to E/C/F/TAF
Serious: 0/90 (0%)
Deaths:
Open-Label: E/C/F/TDF to E/C/F/TAF
Serious: 1/94 (1%)
Deaths:

Serious adverse events (147 terms)

ReactionSystemDouble-Blind: E/C/F/TAFDouble-Blind: E/C/F/TDFOpen-Label: E/C/F/TAF to E…Open-Label: E/C/F/TDF to E…
AppendicitisInfections and infestations
Suicidal ideationPsychiatric disorders
CellulitisInfections and infestations
InfluenzaInfections and infestations
Meningitis viralInfections and infestations
Uterine leiomyomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Acute myocardial infarctionCardiac disorders
Abdominal painGastrointestinal disorders
Rectal haemorrhageGastrointestinal disorders
Acute hepatitis CInfections and infestations
Staphylococcal skin infectionInfections and infestations
Accidental overdoseInjury, poisoning and procedural complications
OsteoarthritisMusculoskeletal and connective tissue disorders
Suicide attemptPsychiatric disorders
AnaemiaBlood and lymphatic system disorders
Iron deficiency anaemiaBlood and lymphatic system disorders
LeukocytosisBlood and lymphatic system disorders
Cardiac arrestCardiac disorders
Cardiac failure congestiveCardiac disorders
TachycardiaCardiac disorders
Dermoid cystCongenital, familial and genetic disorders
Retinal detachmentEye disorders
Alcoholic pancreatitisGastrointestinal disorders
Anal fissureGastrointestinal disorders
ColitisGastrointestinal disorders
Other adverse events (36 terms — click to expand)

ReactionSystemDouble-Blind: E/C/F/TAFDouble-Blind: E/C/F/TDFOpen-Label: E/C/F/TAF to E…Open-Label: E/C/F/TDF to E…
DiarrhoeaGastrointestinal disorders
Upper respiratory tract infectionInfections and infestations
NauseaGastrointestinal disorders
Viral upper respiratory tract infectionInfections and infestations
HeadacheNervous system disorders
Back painMusculoskeletal and connective tissue disorders
CoughRespiratory, thoracic and mediastinal disorders
OsteopeniaMusculoskeletal and connective tissue disorders
SyphilisInfections and infestations
FatigueGeneral disorders
ArthralgiaMusculoskeletal and connective tissue disorders
InsomniaPsychiatric disorders
SinusitisInfections and infestations
BronchitisInfections and infestations
VomitingGastrointestinal disorders
DepressionPsychiatric disorders
RashSkin and subcutaneous tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
InfluenzaInfections and infestations
AnxietyPsychiatric disorders
PyrexiaGeneral disorders
Abdominal painGastrointestinal disorders
DizzinessNervous system disorders
FlatulenceGastrointestinal disorders
Anogenital wartsNeoplasms benign, malignant and unspecified (incl cysts and polyps)
GastroenteritisInfections and infestations
FolliculitisInfections and infestations
PharyngitisInfections and infestations
AcneSkin and subcutaneous tissue disorders
ConstipationGastrointestinal disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
HaemorrhoidsGastrointestinal disorders
HypertensionVascular disorders
Chlamydial infectionInfections and infestations
GonorrhoeaInfections and infestations

Most-reported serious reactions: Appendicitis, Suicidal ideation, Cellulitis, Influenza, Meningitis viral, Uterine leiomyoma, Acute myocardial infarction, Abdominal pain.

Data from ClinicalTrials.gov NCT01780506 adverse events section.

Sponsor's own description

The primary objective of this study is to evaluate the efficacy of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) fixed-dose combination (FDC) versus elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF) FDC in HIV-1 positive, antiretroviral treatment-naive adults.

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Tenofovir alafenamide versus tenofovir disoproxil fumarate, coformulated with elvitegravir, cobicistat, and emtricitabine, for initial treatment of HIV-1 infection: two randomised, double-blind, phase 3, non-inferiority trials.
    Sax PE, Wohl D, Yin MT, Post F, et al · · 2015 · cited 435× · PMID 25890673 · DOI 10.1016/s0140-6736(15)60616-x
  2. Approved HIV reverse transcriptase inhibitors in the past decade.
    Li G, Wang Y, De Clercq E. · · 2022 · cited 71× · PMID 35847492 · DOI 10.1016/j.apsb.2021.11.009
  3. Atherosclerotic Cardiovascular Disease Risk Profile of Tenofovir Alafenamide Versus Tenofovir Disoproxil Fumarate.
    Huhn GD, Shamblaw DJ, Baril JG, Hsue PY, et al · · 2020 · cited 39× · PMID 31950070 · DOI 10.1093/ofid/ofz472
  4. Lack of impact of pre-existing T97A HIV-1 integrase mutation on integrase strand transfer inhibitor resistance and treatment outcome.
    Abram ME, Abram ME, Ram RR, Margot NA, et al · · 2017 · cited 26× · PMID 28212411 · DOI 10.1371/journal.pone.0172206
  5. Equivalent Decline in Inflammation Markers with Tenofovir Disoproxil Fumarate vs. Tenofovir Alafenamide.
    Funderburg NT, McComsey GA, Kulkarni M, Bannerman T, et al · · 2016 · cited 21× · PMID 27742226 · DOI 10.1016/j.ebiom.2016.10.009
  6. Special Issue: Abstract Supplement HIV Glasgow 10-13 November 2024, Glasgow, UK/Virtual.
    · 2024 · cited 8× · PMID 39513741 · DOI 10.1002/jia2.26370
  7. In the Crowded HIV Market, There's Room for Innovation.
    Clark M, Gohil K. · · 2015 · PMID 25987826

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing