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Completed

NCT Number: NCT04433780

DORA: A Doravirine-based First-line Antiretroviral Therapy for Women of Reproductive Potential Living With HIV

This is a pilot study investigating the safety of Doravirine (DOR) in combination with Lamivudine (3TC) and Tenofovir Disoproxil Fumarate (TDF) administered over 48 weeks in women of reproductive potential living with HIV-1 switched from Efavirenz or Dolutegravir-based antiretroviral therapy on metabolic and neuropsychiatric outcomes.

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Key information

Conditions

Age range

18 year–49 year

Sex eligibility

Female

Study type

Interventional

Phase

Phase 3

Primary location

Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, Gauteng, South Africa

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About this study

This is a pilot, open label, single-arm, single centre, phase 3, switch study exploring the safety of of Doravirine (DOR) in combination with Lamivudine (3TC) and Tenofovir Disoproxil Fumarate (TDF) administered over 48 weeks in women of reproductive potential living with HIV-1 switched from Efavirenz or Dolutegravir-based antiretroviral therapy. The metabolic and neuropsychiatric outcomes among women (and their infants) in a representative African female population of reproductive potential will be investigated.

Approximately 100 women aged between 18 and 49 years old will be administered a once-daily, fixed-dose combination of doravirine 100 mg, lamivudine 300 mg, and tenofovir disoproxil fumarate 300 mg (DOR/3TC/TDF). The study includes screening and baseline visits, 4 study visits from Week 4 to Week 36, and an end of study visit at Week 48.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Females, aged 18-49 years and ≥ 40 kg
  • On a first-line EFV or DTG-containing regimen for at least six months and not more than 3 years
  • Plasma HIV-1 RNA < 50 copies/mL in last 60 days
  • Calculated creatinine clearance (CrCl) > 50 mL/min (Cockcroft-Gault formula)
  • Baseline weight measurement available at ART initiation.

Exclusion criteria

  • Virological failure on any other regimen
  • Women who are pregnant at the time of the screening or enrolment visits or have had a pregnancy gestation ≥ 28 weeks in the preceding 2 years
  • Active tuberculosis and/or are on antituberculosis therapy at the time of the screening or enrolment visits
  • Taking (and cannot discontinue) prohibited concomitant medications listed in protocol at least two weeks prior to the enrolment visit and for the duration of the study period (see potential drug interactions section for list).

Treatment and study plan

Doravirine/lamivudine/tenofovir disoproxil fumarate

Drug

DOR/3TC/TDF 100/300/300 mg once daily fixed-dose combination switched from either EFV/TDF/FTC or DTG/TDF/3TC

Other names: Delstrigo

Primary outcomes

  1. The proportion of participants with neuropsychiatric adverse events (AEs)

    Time frame: 48 weeks

    The proportion of participants with neuropsychiatric adverse events (AEs) in 3 pre-specified categories (dizziness, sleep disorders/ disturbances, and altered sensorium) at Week 48

  2. Changes in fasting lipids from baseline to Week 48

    Time frame: 48 weeks

    Changes in fasting lipids from baseline to Week 48 assessed using lipid profile blood test

  3. Changes in weight from baseline to Week 48

    Time frame: 48 weeks

    Changes in weight from baseline to Week 48 assessed

  4. Changes in body mass index from baseline to Week 48

    Time frame: 48 weeks

    Changes in body mass index from baseline to Week 48 assessed

  5. Changes in glucose from baseline to Week 48

    Time frame: 48 weeks

    Changes in glucose from baseline to Week 48 assessed using blood test

Secondary outcomes

  1. The proportion of participants with detectable plasma HIV-1 RNA levels (≥ 50 copies/mL)

    Time frame: At week 24, 48

    The proportion of participants with detectable plasma HIV-1 RNA levels (≥ 50 copies/mL) at weeks 24 and 48

  2. The proportion of participants with neuropsychiatric adverse events (AEs) in 3 pre-specified categories

    Time frame: 24 weeks

    The proportion of participants with neuropsychiatric adverse events (AEs) in 3 pre-specified categories (dizziness, sleep disorders/ disturbances, and altered sensorium) at Week 24

  3. Changes in glucose from baseline to week 24

    Time frame: 24 weeks

    Changes in glucose from baseline to Week 24 using blood test

  4. Changes in fasting lipids from baseline to week 24

    Time frame: 24 weeks

    Changes in fasting lipids from baseline to Week 24 using lipid profile blood test

  5. Changes in weight and from baseline to week 24

    Time frame: 24 weeks

    Changes in weight from baseline to Week 24

  6. Changes in body mass index from baseline to week 24

    Time frame: 24 weeks

    Changes in body mass index from baseline to Week 24

  7. The proportion of infants evaluated for HIV-positive tests using HIV DNA polymerase chain reaction test (PCR)

    Time frame: 48 weeks

    The proportion of infants evaluated for HIV-positive tests using HIV DNA polymerase chain reaction test (PCR)

  8. Changes in quality of life from baseline

    Time frame: At weeks 24, 48

    Changes in quality of life from baseline to Weeks 24 and 48 measured using a traditional clinical, validated quality of life questionairre. Higher scores mean a better outcome

  9. Median adherence by each adherence measure

    Time frame: At weeks 24, 48

    Median adherence by each adherence measure at Weeks 24 and 48 using a validated adherence questionairre

  10. Emergence of antiretroviral resistance mutations in participants with virological failure

    Time frame: 48 weeks

    Evaluating the number of antiretroviral resistance mutations that emerge in participants with virological failure

Sponsors and collaborators

Lead sponsor

Professor Francois Venter

Other

Registry information

Official study title

A Single Arm, Phase 3 Study, Exploring the Safety of Doravirine-based First-line Antiretroviral Therapy for Women of Reproductive Potential Living With HIV, a Pilot Switch Study Strategy in South Africa

Acronym: DORA

Important dates

Study start
2021
Primary completion
2023
Study completion
2023
First posted
Jun 16, 2020
Registry last updated
Aug 3, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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