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Human Immunodeficiency VirusPhase 2NCT02010593

Safety and Pharmacokinetics of Dapivirine Vaginal Ring in Post-menopausal Women

A Phase 2 study testing Dapivirine Vaginal Ring in people with Human Immunodeficiency Virus, run by International Partnership for Microbicides, Inc. at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study will evaluate the safety of the dapivirine vaginal ring when inserts once every 4 weeks in postmenopausal women over 12 weeks of product use. Read more about this study

Who is it for?
Ages 45 to 65 years, women onlyHealthy volunteers can take part
Conditions the study is for
Human Immunodeficiency Virus
What is being tested?
Dapivirine Vaginal Ring
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
96 participants
Where
3 sitesUnited States
Study dates
Dec 2013to Apr 2015
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 to 65 years
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 45 through 65 years (inclusive) at Screening, verified per site SOPs
  • Per participant report, postmenopausal at Screening, defined as amenorrhoeic for the past 12 months (minimum) or at least 6 months status post-bilateral oophorectomy
  • Follicle-stimulating hormone (FSH) level at 40 mIU/ml or higher at Screening
  • Able and willing to provide written informed consent to be screened for and enrolled in MTN-024/IPM 031
  • Able to communicate in spoken and written English
  • Able and willing to comply with all study procedural requirements
Show all 19Show fewer
  • Willing to only use study provided and/or approved vaginal products throughout the duration of study participation.
  • Willing to abstain from inserting study approved lubricant into the vagina for 72 hours prior to each visit
  • Willing to abstain from vaginal intercourse for 72 hours prior to each visit
  • In general good health as determined by the Investigator of Record (IoR)/designee at Screening and Enrollment
  • Able and willing to provide adequate locator information, as defined in site SOPs
  • HIV-uninfected based on testing performed at Screening (per protocol algorithm in Appendix II)
  • Per participant report at Screening and Enrollment, agrees to use male latex condoms for sexual intercourse
  • Per participant report at Screening and Enrollment, states a willingness to refrain from inserting any non-study vaginal products or objects into the vagina including, but not limited to spermicides, female condoms, diaphragms, topical or systemic hormone replacement therapy, including vaginal estrogens, and/or hormonal contraceptives, vaginal medications, menstrual cups, cervical caps (or any other vaginal barrier method), vaginal douches, lubricants and moisturizers, sex toys (vibrators, dildos, etc.), for the duration of the study participation.
  • Note: Use of study approved lubricant is permitted.
  • At Screening and Enrollment, agrees not to participate in other research studies involving drugs, medical devices, vaginal products, or vaccines for the duration of study participation
  • Participants in the biopsy subset must also meet the following criteria at Screening to be eligible for inclusion:
  • Willing to abstain from inserting anything into the vagina for 72 hours following the collection of biopsies, including abstaining from vaginal intercourse
  • Anatomy sufficient for the collection of cervical biopsies

Who cannot join

  • Per participant report at screening:
  • Plans to relocate away from the study site during study participation
  • Plans to travel away from the study site for more than 4 consecutive weeks during study participation
  • Pregnant at screening Note: A documented negative pregnancy test performed by study staff is required for inclusion; however a self-reported pregnancy is adequate for exclusion from the study.
  • Diagnosed with urinary tract infection (UTI) at Screening or Enrollment Note: Otherwise eligible participants diagnosed with UTI during screening are offered treatment and may be enrolled after completing treatment and all symptoms have resolved.
  • If treatment is completed and symptoms have resolved within 45 days of obtaining informed consent for screening, the participant may be enrolled.
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  • Diagnosed with pelvic inflammatory disease, an STI or reproductive tract infection (RTI) requiring treatment per current Centers for Disease Control and Prevention (CDC) guidelines at Screening or Enrollment Note: Otherwise eligible participants diagnosed during screening with pelvic inflammatory disease or STI/RTI requiring treatment per CDC guidelines - other than asymptomatic bacterial vaginosis (BV) and asymptomatic candidiasis - are offered treatment and may be enrolled after completing treatment and all symptoms have resolved. If treatment is completed and symptoms have resolved within 45 days of obtaining informed consent for screening, the participant may be enrolled. Genital warts requiring treatment also must be treated prior to Enrollment. Genital warts requiring therapy are defined as those that cause undue burden or discomfort to the participant, including bulky size, unacceptable appearance, or physical discomfort.
  • Has a clinically apparent Grade 2 or higher pelvic exam finding (observed by study staff) at Screening or Enrollment, as per the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events Version 1.0, December, 2004 (Clarification dated August 2009), Addendum 1-Female Genital Grading Table for Use in Microbicide Studies Note: Cervical bleeding associated with speculum insertion and/or specimen collection judged to be within the range of normal according to the clinical judgment of the Investigator of Record (IoR)/designee is considered expected non-menstrual bleeding and is not exclusionary.
  • Note: Otherwise eligible participants with exclusionary pelvic exam findings may be enrolled/randomized after the findings have improved to a non-exclusionary severity grading or resolved. If improvement to a non-exclusionary grade or resolution is documented within 45 days of providing informed consent for screening, the participant may be enrolled.
  • Participant report and/or clinical evidence of any of the following:
  • Known adverse reaction to any of the study products (ever)
  • Known adverse reaction to latex (ever)
  • Chronic and/or recurrent vaginal candidiasis
  • Topical or systemic hormone replacement therapy and/or hormonal contraception within the 6 months prior to Enrollment
  • Non-therapeutic injection drug use in the 12 months prior to Enrollment
  • Post-exposure prophylaxis (PEP) for HIV exposure within the 6 months prior to Enrollment
  • Pre-exposure prophylaxis (PrEP) for HIV prevention within the 6 months prior to Enrollment
  • Last pregnancy outcome 6 months or less prior to Enrollment
  • Gynecologic or genital procedure (e.g., tubal ligation, dilation and curettage, piercing) 90 days or less prior to Enrollment
  • Currently breastfeeding
  • At Screening, severe pelvic relaxation such that either the vaginal walls or the uterine cervix descend beyond the vaginal introitus with Valsalva maneuver
  • Participation in any other research study involving drugs, medical devices, vaginal products, or vaccines, in the 45 days prior to Enrollment
  • As determined by the IoR/designee, any significant uncontrolled active or chronic cardiovascular, renal, liver, hematologic, neurologic, gastrointestinal, psychiatric, endocrine, respiratory, immunologic disorder or infectious disease
  • Has any of the following laboratory abnormalities at Screening Visit:
  • Aspartate aminotransferase (AST) or alanine transaminase (ALT) Grade 1 or higher*
  • Creatinine Grade 2 or higher*
  • Hemoglobin Grade 2 or higher*
  • Platelet count Grade 1 or higher*
  • Pap result Grade 2 or higher** Note: Otherwise eligible participants with an exclusionary test may be re-tested during the screening process.
  • Note: Women with a documented normal result within the 12 months prior to Enrollment need not have a Pap smear during the screening period. Women with a Grade 1 abnormal Pap smear can be enrolled upon completion of the initial phase of evaluation if no current treatment is indicated (based on local standard of care for management of abnormal cervical cytology). Need for a repeat Pap within 6 months does not preclude Enrollment prior to that result becoming available. If the participant has had a hysterectomy for reasons not related to cervical dysplasia, a Pap smear need not be performed.
  • Has any other condition that, in the opinion of the IoR/designee, would preclude informed consent, make study participation unsafe, complicate the interpretation of study outcome data, or otherwise interfere with achieving the study objectives *Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events Version 1.0, December, 2004 (Clarification dated August 2009) **Female Genital Grading Table for Use in Microbicide Studies Addendum 1 to the Division of AIDS (DAIDS) Table for Grading Adult and Pediatric Adverse Events, Version 1.0, December 2004 (Clarification dated August 2009)

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Alabama CRS, 84519th Street South, BBRB 203A

    Birmingham, Alabama, 35294-2170

  • Case CRS, Case Western Reserve University, 2061 Cornell Road, Room 303

    Cleveland, Ohio, 44106

  • Magee Women's Hospital of UPMC

    Pittsburgh, Pennsylvania, 15213

Other trials in United States

About this study

Official title: Phase 2a Safety Study of a Vaginal Matrix Ring Containing Dapivirine in a Postmenopausal Female Population

This study will evaluate the safety of the dapivirine vaginal ring when inserts once every 4 weeks in postmenopausal women over 12 weeks of product use.

Read the detailed description

Dapivirine, a non-nucleoside reverse-transcriptase inhibitor (NNRTI), is a substituted diamino- pyrimidine (DAPY) derivative with potent antiviral activity against HIV-1. Dapivirine is chemically described as 4-[[4-[(2,4,6-trimethylphenyl)amino]-2- pyrimidinyl]amino]benzonitrile.6 The dapivirine matrix VR is a flexible ring containing 25 mg of drug substance dispersed in a platinum-catalyzed-cured silicone matrix. Dapivirine is known to be well-suited for delivery via VR, as evidenced by favorable safety and pharmacokinetic data to date described below.

Being tested
Dapivirine Vaginal Ring, Placebo Vaginal Ring
Medical subject headings
Acquired Immunodeficiency Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dapivirine Vaginal RingDrug

    Also called TMC-120

    Dapivirine, a non-nucleoside reverse-transcriptase inhibitor (NNRTI), is a substituted amino- pyrimidine (DAPY) derivative with potent antiviral activity against HIV-1. Dapivirine is chemically described as 4-[[4-[(2,4,6-trimethylphenyl)amino]-2- pyrimidinyl]amino]benzonitrile.6 The dapivirine matrix VR is a flexible ring containing 25 mg of drug substance dispersed in a platinum-catalyzed-cured silicone matrix. Dapivirine is known to be well-suited for delivery via VR

  • Placebo Vaginal RingDrug

    The placebo VR is a flexible, platinum-catalyzed-cured silicone matrix ring, identical to dapivirine Ring-004, containing no active drug.

Study groups in NCT02010593
Study groupRoleWhat they receive
Dapivirine Vaginal RingExperimentalSafety study of a vaginal ring containing Dapivirine in a postmenopausal female population
Receives: Drug: Dapivirine Vaginal Ring
PlaceboPlacebo comparatorThe placebo VR is a flexible, platinum-catalyzed-cured matrix ring, identical to Dapivirine Ring-004, containing no active-drug
Receives: Drug: Placebo Vaginal Ring

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety of Dapivirine (25 mg) Administered in a Silicone Elastomer Vaginal Matrix Ring in HIV-uninfected Postmenopausal Women, When Inserted Once Every 4 Weeks During 12 Weeks of Study Product Use

    Evidence of Grade 2 or higher genital, genitourinary and reproductive system AEs as defined by the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 1.0, Dec 2004 (Clarification dated August 2009), Addendum 1, (Female Genital Grading Table for Use in Microbicide Studies) judged to be related to study product.

    Evidence of Grade 3 or higher AEs as defined by the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Version 1.0, Dec 2004 (Clarification dated August 2009).

    DAIDS severity grades are defined as follows:

    • Grade 1 = mild
    • Grade 2 = moderate
    • Grade 3 = severe
    • Grade 4 = potentially life-threatening
    • Grade 5 = death

    Measured: over 12-week period of use

Secondary outcomes (4)
  1. The Percentage of Participants Who Find the Study Vaginal Ring to be as Acceptable

    To evaluate the acceptability, the percentage of participants who at their 12-Week Final Clinic Visit report via acceptability questionnaire that they prefer the ring at least as much as other HIV prevention methods.

    Measured: at 12-week visit

  2. Percentage of Women Who Were Adherent to Daily Study Product Use Based on Self-report Over the 12-week Study Product Use Period

    Adherence will be measured by the percentage of women who keep the VR inserted at all times in the vagina over the course of 12 weeks.

    A participant was considered adherent in one month (4 weeks) by self-reported data, only if the ring was never out during that month and the participant was not on product hold and did not terminate the clinical trial within that month.

    Measured: 12-week period of use

  3. Pharmacokinetics - The Intent is to Determine if the Plasma Dapivirine Concentrations Are Different in Postmenopausal Women Than in Pre-menopausal Adult Women After Placement of Dapivirine Vaginal Rings.

    The PK endpoint is a description of the end of period (28 day post ring insertion) plasma dapivirine concentrations at week 4, 8, and 12 which will be compared to the same results in a recently studied population of premenopausal adult women (MTN-013).

    Measured: a 12 week product use period

  4. Pharmacokinetics - The Intent is to Determine if the Vaginal Fluid Dapivirine Concentrations Are Different in Postmenopausal Women Than in Pre-menopausal Adult Women After Placement of Dapivirine Vaginal Rings.

    The PK endpoint is a description of the end of period (28 day post ring insertion) vaginal fluid dapivirine concentrations at week 4, 8, and 12 which will be compared to the same results in a recently studied population of premenopausal adult women (MTN-013).

    Measured: a 12 week product use period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Dec 2013 (estimated)
  2. Study startDec 2013
  3. Primary completionApr 2015
  4. Study completionApr 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
96 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02010593
Sponsor's protocol ID
MTN-024/IPM031
Other IDs
5UM1AI068633-07
Status last verified
Nov 2022
First submitted
14 Oct 2013
Last updated
3 Nov 2022
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Shapley-Quinn MK, Laborde N, Luecke E, Hoesley C, Salata RA, Johnson S, Nel A, Soto-Torres L, Chen BA, van der Straten A. Acceptability of the Dapivirine Vaginal Ring in Postmenopausal US Women. AIDS Patient Care STDS. 2022 Mar;36(3):97-105. doi: 10.1089/apc.2022.0002.

    PubMed 35289688
  • Chen BA, Zhang J, Gundacker HM, Hendrix CW, Hoesley CJ, Salata RA, Dezzutti CS, van der Straten A, Hall WB, Jacobson CE, Johnson S, McGowan I, Nel AM, Soto-Torres L, Marzinke MA; MTN-024/IPM 031 Protocol Team for the Microbicide Trials Network. Phase 2a Safety, Pharmacokinetics, and Acceptability of Dapivirine Vaginal Rings in US Postmenopausal Women. Clin Infect Dis. 2019 Mar 19;68(7):1144-1151. doi: 10.1093/cid/ciy654.

    PubMed 30289485

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dapivirine Vaginal Ring in people with Human Immunodeficiency Virus, run by International Partnership for Microbicides, Inc. at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 19 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 5 Oct 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety of Dapivirine (25 mg) Administered in a Silicone Elastomer Vaginal Matrix Ring in HIV-uninfected Postmenopausal Women, When Inserted Once Every 4 Weeks During 12 Weeks of Study Product Use (time frame: over 12-week period of use). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02010593, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2022.

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