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HivPhase 1/2PETITE-DTGNCT05590325

Pharmacokinetics and Safety of DolutegravIr in Neonate

A Phase 1/2 study testing Dolutegravir in people with Hiv, run by Desmond Tutu TB Centre at 1 site in South Africa.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

A Phase I/II, open-label, single arm, two-stage trial to evaluate the single and multi-dose PK and safety of DTG in HIV-exposed neonates on ARV prophylaxis. HIV-exposed term neonates born mothers with HIV on DTG-based antiretroviral therapy with a birth weight ≥2000 g who are on ARV postnatal prophylaxis will be… Read more about this study

Who is it for?
Ages 1 day to 14 daysHealthy volunteers can take part
Conditions the study is for
Hiv
What is being tested?
Dolutegravir
Could I receive a placebo?
No, everyone receives an active treatment
How many people
56 participants
Where
1 siteSouth Africa
Study dates
12 Sep 2022to 31 Dec 2024
Phase
Phase 1/2
Are there results?
None posted in the registry

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 1 day to 14 days
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Stage 1: Inclusion Criteria
  • HIV-exposed neonate (pending HIV status) born to a woman within HIV on DTG-based ART
  • Birth weight of ≥2000 g and on standard of care ARV prophylaxis
  • Cohort Specific Inclusion Criteria in Stage 1 must be met at Study Entry:
  • Cohort 1A: Infant <14 days of life Cohort 1B: Infant ≤3 days of life
  • Stage 2: Inclusion Criteria
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  • Low risk* HIV-exposed neonate (pending HIV status) born to a virologically suppressed woman on DTG-based ART
  • Neonate born to a woman with a documented plasma HIV-1 RNA result <50 copies/mL in the 4 weeks prior to delivery or between delivery and infant study entry
  • Birth weight of ≥2000 g and on standard of care ARV prophylaxis
  • Cohort Specific Inclusion Criteria in Stage 2 must be met at Study Entry:
  • Cohort 2: Infant <7 days of life

Who cannot join

  • • Less than 37 weeks gestational age at birth
  • Known blood group incompatibilities which can result in hemolytic disease of the newborn (e.g., Rh-negative mother, presence of antibodies on neonatal red blood cells, etc.)
  • Total bilirubin values approaching an exchange transfusion as defined by local guidelines (Section 18.2)
  • Haemoglobin value of <13.0 g/dL
  • Platelet count of less than 50,000 cells/mm3)
  • Decreased total white blood cell count (Grade 3 and above)
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  • Creatinine value more than 1.3 the upper limit of normal (ULN) for gestational age and postnatal age (Grade 2 and above)
  • AST or ALT of more than 2.5 the ULN (Grade 2 and above)
  • Any other current Grade ≥3 event on the DAIDS toxicity table
  • Severe congenital abnormalities or critically ill neonates at discretion of the examining clinician
  • Receiving medicine(s) that can impact DTG pharmacokinetics (Section 8.7)
  • Participation in another clinical trial
  • HIV-infected neonates

Trial locations and contacts

1 site in 1 country.

Adrie Bekker, Prof contact

+27 (0)219389198

adrie@sun.ac.za

Tina Sachs, MSc contact

+27 (0)620474701

tsachs@sun.ca.za

South Africa1 site, 1 recruiting
  • Tygerberg Hospital

    Cape Town, Western Cape, 7505

    Adrie Beker, Prof

    Recruiting

Other trials in South Africa

About this study

Official title: Open Label, Single Arm, Two-stage Trial to Evaluate the Single and Multi-dose Pharmacokinetics and Safety of the Paediatric Dolutegravir (10 mg, Scored) Dispersible Tablet in HIV-exposed Neonates

A Phase I/II, open-label, single arm, two-stage trial to evaluate the single and multi-dose PK and safety of DTG in HIV-exposed neonates on ARV prophylaxis. HIV-exposed term neonates born mothers with HIV on DTG-based antiretroviral therapy with a birth weight ≥2000 g who are on ARV postnatal prophylaxis will be enrolled.

Read the detailed description

A Phase I/II, open-label, single arm, two-stage trial to evaluate the single and multi-dose PK and safety of DTG in HIV-exposed neonates on ARV prophylaxis. HIV-exposed term neonates born mothers with HIV on DTG-based antiretroviral therapy with a birth weight ≥2000 g who are on ARV postnatal prophylaxis will be enrolled.

Enrolment will be in two stages:

  • Stage 1 will assess a single 5 mg dose of the DTG-DT in two sequential cohorts: Cohort 1A (n=8) and Cohort 1B (n=8).
  • Stage 2 will assess multiple 5 mg doses of the DTG-DT and DTG-ODF in two parallel cohorts: Cohort 2A (n=20) and Cohort 2B (n=20).

Per national guidelines, all infants receive a birth HIV nucleic acid test (NAT). HIV NAT test results for the infant may or may not be available (HIV pending) at the time of study entry. HIV NAT results are typically available within 72 hours of the blood sample being taken and are checked and acted upon by the hospital HIV PMTCT service, as part of standard of care. If an HIV NAT result comes back positive whilst the neonate is on study, the neonate will not receive any further DTG doses, revert to standard of care antiretroviral therapy (ART), and be followed for safety for the duration of the study.

Primary Objectives:

  • To evaluate the pharmacokinetics of dolutegravir (DTG) during the first 28 days of life in HIV-exposed term neonates (born to a mother with HIV) following administration of DTG dispersible tablet (DTG-DT) and DTG oral dispersible film (DTG-ODF)
  • To determine the safety of DTG during the first 28 days of life in HIV-exposed term neonates following administration of DTG-DT and DTG-ODF

Secondary Objectives:

  • To quantitatively and qualitatively assess the acceptability of DTG-DT and DTG-ODF for the neonate, the caregiver and health workers

Primary endpoints:

  • DTG plasma pharmacokinetics parameters: area under the concentration time curve (AUC); maximum plasma concentration (Cmax), apparent clearance (CL/F), and trough concentration (Ctrough)
  • Occurrence of the following events: adverse events of Grade 3 or higher; treatment-related adverse events of Grade 3 or higher; any adverse events

Secondary endpoints:

  • Acceptability to caregivers and neonates of using DTG-DT will be measured by means of a questionnaire
Conditions
Hiv
Being tested
Dolutegravir
Keywords
HIV exposed, Neonates
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.

  • DolutegravirDrug

    Single dose of the DTG-DT in two sequential cohorts and multiple-doses of the DTG-DT or DTG-ODF in a two cohorts.

    Qualitative Acceptability will be collected from mothers and health workers in structured discussion guides.

Study groups in NCT05590325
Study groupRoleWhat they receive
single arm, two-stageExperimentalParticipants will be enrolled in two stages: * Stage 1 will assess a single dose of the DTG-DT in two sequential cohorts: Cohort 1A (n=8) and Cohort 1B (n=8). * Stage 2 will assess multiple-doses of the DTG-DT and the DTG-ODF in a single cohort: Cohort 2A (n=20) DTG-DT and Cohort 2B (n=20) DTG-ODF
Receives: Drug: Dolutegravir

What is being measured

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

  1. In Cohort 1, PK analysis will be performed to calculate the following parameter: Cmax

    Cmax will be taken directly from the observed concentration-time data.

    Measured: first 28 days of life

  2. In Cohort 1, PK analysis will be performed to calculate the following parameter: Clast,

    Clast will be taken directly from the observed concentration-time data.

    Measured: first 28 days of life

  3. In Cohort 1, PK analysis will be performed to calculate the following parameter: Tmax

    Tmax will be taken directly from the observed concentration-time data.

    Measured: first 28 days of life

  4. In Cohort 1, PK analysis will be performed to calculate the following parameter: C24

    C24 will be taken directly from the observed concentration-time data.

    Measured: first 28 days of life

  5. In Cohort 1, PK analysis will be performed to calculate the following parameter: AUC0-24

    AUC0-all will be determined using the linear-up log-down trapezoidal method. Total body clearance for extravascular administration will be calculated using Dose/ AUC0-infinity. Median (range), means (standard deviations), and geometric means with 95%CI for each PK parameter will be calculated separately for Cohorts 1A and 1B, as well as for Cohort 1A/1B together.

    Measured: first 28 days of life

  6. In Cohort 1, PK analysis will be performed to calculate the following parameter: AUC0-infinity

    AUC0-infinity will be determined using the linear-up log-down trapezoidal method. Total body clearance for extravascular administration will be calculated using Dose/ AUC0-infinity. Median (range), means (standard deviations), and geometric means with 95%CI for each PK parameter will be calculated separately for Cohorts 1A and 1B, as well as for Cohort 1A/1B together.

    Measured: first 28 days of life

  7. In Cohort 1, PK analysis will be performed to calculate the following parameter: Ratio AUC0-24 / AUC0-infinity

    Ratio AUC0-24 / AUC0-infinity will be determined using the linear-up log-down trapezoidal method. Total body clearance for extravascular administration will be calculated using Dose/ AUC0-infinity. Median (range), means (standard deviations), and geometric means with 95%CI for each PK parameter will be calculated separately for Cohorts 1A and 1B, as well as for Cohort 1A/1B together.concentration-time data.

    Measured: first 28 days of life

  8. Reporting adverse events of Grade 3 or higher; treatment-related adverse events of Grade 3 or higher; any adverse events neonates following administration of DTG dispersible tablet

    Using the DAIDS toxicity table and protocol specific safety criteria

    Measured: first 28 days of life

  9. In Cohorts 2A and 2B, both non-compartmental and population PK analyses will be performed using the following parameter: Cmax

    Population means and variances of Cmax for DTG will be estimated using nonlinear mixed-effects regression models. Subject covariates will be assessed to explain sources of inter-subject PK variability.

    Measured: first 28 days of life

  10. In Cohorts 2A and 2B, both non-compartmental and population PK analyses will be performed using the following parameter: AUC0-tau

    Population means and variances of AUC0-tau for DTG will be estimated using nonlinear mixed-effects regression models. Subject covariates will be assessed to explain sources of inter-subject PK variability. Changes in DTG drug exposures in neonates following multi-doses of DTG-DT and DTG-ODF during the first 28 days of life will be estimated using the final model.

    Measured: first 28 days of life

  11. In Cohorts 2A and 2B, both non-compartmental and population PK analyses will be performed using the following parameter: CTau

    Population means and variances of CTau for DTG will be estimated using nonlinear mixed-effects regression models. Subject covariates will be assessed to explain sources of inter-subject PK variability. Changes in DTG trough concentrations in neonates following multi-doses of DTG-DT and DTG-ODF during the first 28 days of life will be estimated using the final model.

    Measured: first 28 days of life

  12. In Cohorts 2A and 2B, both non-compartmental and population PK analyses will be performed using the following parameter: Tmax

    Population means and variances of Tmax for DTG will be estimated using nonlinear mixed-effects regression models. Subject covariates will be assessed to explain sources of inter-subject PK variability.

    Measured: first 28 days of life

Secondary outcomes (2)
  1. Acceptability to caregivers and neonates of using DTG-DT will be measured by means of a questionnaire

    key characteristics: Palatability, Swallowability, the device used to administer the dose, The complexity for the caregiver to prepare the dose correctly, Required dose, Need for a vehicle, Dosing frequency and duration of treatment, Selected administration devices, Primary container closure system, Actual mode of administration that reflects understanding of user instructions and feasibility of following them,

    Acceptability will be recorded by focusing on:

    Attitude of the child when presented with the formulation: facial expression, crying or smiling, reaction to drug intake, fighting drug intake, spitting out the suspension, Swallowability, i.e., ability to take the full dose, The way the caregiver prepares the dose

    Measured: first 28 days of life

  2. Qualitative acceptability data from mothers and health workers

    Data will be collected using a semi-structured discussion guide

    Measured: first 28 days of life

Timeline

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

  1. First posted21 Oct 2022
  2. Study start12 Sep 2022
  3. Primary completion30 Jun 2024 (estimated)
  4. Study completion31 Dec 2024 (estimated)

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 1/2
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Model description
Phase I/II, open-label, single arm, two-stage pharmacokinetic and safety study
Masking
None (open label)
Enrolment
56 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05590325
Sponsor's protocol ID
2019-36-SUN-MDR
Acronym
PETITE-DTG
Status last verified
Sep 2023
First submitted
6 Sep 2022
Last updated
18 Dec 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bekker A, Salvadori N, Rabie H, du Toit S, Than-In-At K, Groenewald M, Barnabas S, Ganger L, Luangcharoenkul T, Pingkarawat S, Capparelli EV, Owen A, Cressey R, Fry S, Le Roux G, Tawon Y, Kaewmalee J, Phitak T, Lallemant M, Cotton MF, Cressey TR. Safety and pharmacokinetics of dolutegravir dispersible tablets and oral films in term neonates exposed to HIV in South Africa (PETITE-DTG study): an open-label, randomised, phase 1/2 trial. Lancet HIV. 2025 Nov;12(11):e753-e762. doi: 10.1016/S2352-3018(25)00239-5. Epub 2025 Oct 8.

    PubMed 41075812
  • Cressey TR, Salvadori N, Rabie H, du Toit S, Than-In-At K, Groenewald M, Capparelli E, Owen A, Cressey R, Lallemant M, Cotton MF, Bekker A. Single Doses of Pediatric Dolutegravir Dispersible Tablets in Neonates Support Multidosing: PETITE-Dolutegravir Study. J Acquir Immune Defic Syndr. 2025 Jun 1;99(2):195-201. doi: 10.1097/QAI.0000000000003652.

    PubMed 39972540

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Dolutegravir in people with Hiv, run by Desmond Tutu TB Centre at 1 site in South Africa.

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 11 inclusion and 13 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: status not confirmed, as of the sponsor's last update on 18 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in South Africa. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

Results are not available in the source record.

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

Contact Adrie Bekker, Prof (+27 (0)219389198, adrie@sun.ac.za), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

In Cohort 1, PK analysis will be performed to calculate the following parameter: Cmax (time frame: first 28 days of life). The study lists 12 primary outcomes in all. 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 NCT05590325, 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 18 Dec 2023; AzTrials last refreshed its copy on 8 Nov 2026.

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