NCT06317051

Optimising Metabolic Management for People With Human Immunodeficiency Virus (HIV) on Integrase Based Antiretroviral Therapy (ART)

A Phase III/IV Factorial Randomized Double-blind Trial to Compare the Addition of Dapagliflozin vs Placebo and Rosuvastatin/Ezetimibe Versus Pitavastatin in Patients With HIV on Integrase Strand Transfer Inhibitor-based Antiretrovirals With Elevated Metabolic Risk

• Status: Active Not Recruiting
• Phase: Phase 3
• Study type: Interventional
• Enrollment: 300 (estimated)
• Sponsor: Kirby Institute · Other Government
• Sex: All
• Age: 40 Years – 75 Years
• Healthy volunteers: Not accepted

Summary

People with HIV are at a higher risk of cardiovascular diseases (CVD) due to the effects of the virus and its treatment. Integrase strand transfer inhibitors (INSTIs), a common HIV treatment, are associated with increased CVD risk and metabolic issues, such as weight gain and high blood pressure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, however, have been working well in reducing CVD events and hospitalizations due to heart failure, irrespective of diabetes presence. They also help in reducing weight and blood pressure. Pitavastatin has shown to work in lowering CVD events in people with HIV, but its availability is limited. This benefit is thought to be common to all statins, but this has not yet been confirmed. This study will examine the impact of dapagliflozin vs. placebo on metabolic parameters in people with HIV with high metabolic risk who are on INSTI-based ART.

Detailed description

This is a 2x2 factorial, randomised, placebo-controlled, double-blind, phase III/IV trial with two randomisations performed centrally via an on-line system, stratified by site. Participants will be randomised 1:1 to dapagliflozin 10mg vs. Placebo; this randomisation will be blinded. Participants will also be randomised 1:1 within each group to pitavastatin 4mg vs. rosuvastatin 10mg/ezetimibe 10mg; this randomisation will be open label. Therefore, participants will be randomised to one of 4 groups: 1. Dapagliflozin 10mg + pitavastatin 4mg 2. Dapagliflozin 10mg + rosuvastatin 10mg/ezetimibe 10mg 3. Placebo + pitavastatin 4mg 4. Placebo + rosuvastatin 10mg/ezetimibe 10mg With the following 2-arm randomised comparisons: * Primary analysis hypothesis: a+b vs c+d (dapagliflozin vs placebo) * Secondary analysis hypothesis: a+c vs b+d (pitavastatin vs rosuvastatin 10mg/ezetimibe 10mg) The study's primary and secondary endpoints described will assess both efficacy and safety/tolerability across randomisation arms. Follow up will continue to 48 weeks and endpoint measures will be obtained at 4, 12, 24, and 48 weeks. Primary endpoint is at 24 weeks. The total number of participants is 300, with 75 randomised to each of the groups as listed above.

Conditions

• HIV Infections
• Weight Gain

Interventions

Type	Name	Description
DRUG	Dapagliflozin 10mg Tab	Dapagliflozin will be administered as a comparator to the placebo to assess its effects on weight reduction
DRUG	Pitavastatin 4 Mg Oral Tablet	Pitavastatin tablets will be administered as a comparator to Rosuvastatin/Ezetimibe 10mg/10mg tablets to assess and compare their effects on LDL concentrations
DRUG	Rosuvastatin and Ezetimibe	Rosuvastatin/Ezetimibe 10mg/10mg tablets will be administered as a comparator to pitavastatin to assess and compare their effects on LDL concentrations
DRUG	Placebo	The placebo tablets are visually identical to the active drug tablets and will be administered as a comparator to Dapagliflozin.

Timeline

• Start date: 2024-12-16
• Primary completion: 2026-07-01
• Completion: 2026-12-01
• First posted: 2024-03-19
• Last updated: 2025-12-10

Locations

10 sites across 9 countries: Argentina, Australia, India, Malaysia, Nigeria, South Africa, Thailand, Uganda, Zimbabwe