Status:

COMPLETED

The Effect of Dolutegravir on Whole-body Insulin Sensitivity, Lipid and Endocrine Profile in Healthy Volunteers

Lead Sponsor:

Chelsea and Westminster NHS Foundation Trust

Conditions:

HIV-1-infection on Healthy Volunteers

Eligibility:

All Genders

18-60 years

Phase:

PHASE1

Brief Summary

This study will investigate changes in insulin resistance, lipid metabolism and endocrine profile in HIV-negative subjects exposed to dolutegravir (an antiretroviral drug used in HIV treatment) in ord...

Detailed Description

A randomised, crossover study investigating the difference in changes in insulin sensitivity (determined by peripheral glucose uptake using a euglycaemic clamp) with the administration of dolutegravir...

Eligibility Criteria

Inclusion

  • Inclusion Criteria
  • Willing and able to provide informed consent
  • Cis-Male and Cis-Female healthy subjects without underlying conditions
  • Subjects must have documented negative HIV serology by ELISA and P24 antigen and not receiving anti-HIV pre-exposure prophylaxis (PreP)
  • Subjects must be clinically well volunteers aged between 18 to 60 years with BMI \<30 kg/m2 but \>18 kg/m2
  • Healthy, as determined by the investigator or medically qualified designee based on a medical evaluation, including medical history, physical examination, laboratory tests, and cardiac evaluation (including ECG)
  • Non-fasting blood glucose, total cholesterol and triglycerides within normal limits
  • Subjects should have complete blood count (FBC) with normal differential and platelet count (detail below of specified normal range, table 1)
  • Table 1 - Compete FBC with normal differential \& platelets count ranges Test Male Normal Range Female Normal Range Haemoglobin (g/L) 130-168 114-150 White blood cell count (x109/L) 4.2-10.6 4.2-11.2 Neutrophil count (x109/L) 2.0 - 7.1 Lymphocyte count (x109/L) 1.1 - 3.6 Monocyte count (x109/L) 0.2 - 0.9 Eosinophil count (x109/L) 0.0 - 0.5 Basophil count (x109/L) 0.0 - 0.2
  • A female, may be eligible to enter and participate in the study if she:
  • is of non-child-bearing potential defined as either post-menopausal (12 months of spontaneous amenorrhea and ≥45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or,
  • is of child-bearing potential with a negative pregnancy test at both Screening and Day 1 and agrees to use one of the following methods of contraception to avoid pregnancy:
  • Complete abstinence from penile-vaginal intercourse. Abstinence is acceptable only as true abstinence when this is in line with the preferred and usual lifestyle of the participant;
  • Any intrauterine device with published data showing that the expected failure rate is \<1% per year (not all intrauterine devices meet this criterion, see Appendix 6\] for an example listing of approved intrauterine devices);
  • Male partner sterilization confirmed prior to the female subject's entry into the study, and this male is the sole partner for that subject;
  • Approved hormonal contraception (see Appendix 6\] for a listing of examples of approved hormonal contraception)\*;
  • Any other method with published data showing that the expected failure rate is \<1% per year
  • Men who have partners who are women of childbearing potential (WOCBP - definition in Appendix 6) must be using an adequate method of contraception to avoid pregnancy in their partner throughout the study and for a period of at least 4 weeks after the study;
  • Complete abstinence from penile-vaginal intercourse. Abstinence is acceptable only as true abstinence when this is in line with the preferred and usual lifestyle of the patient;
  • Double barrier method (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide);
  • Any intrauterine device (IUD) with published data showing that the expected failure rate is \<1% per year (not all IUDs meet this criterion, see Appendix 4 for an example listing of approved IUDs) plus male condom;
  • Sterilisation confirmed prior to the subject's entry into the study
  • Approved hormonal contraception used by female partner (see protocol appendix 4 for a listing of examples of approved hormonal contraception) plus male condom;
  • Any other method with published data showing that the expected failure rate is \<1% per year and not containing hormones plus male condom.
  • Any contraception method must be used consistently, in accordance with the approved product label and for at least four weeks after discontinuation of IMP (Appendix 6).
  • Any contraception method must be used consistently, in accordance with the approved product label and for at least 28 days prior to the first dose of study medication and 4 weeks after discontinuing the study medication.
  • 1.2 Exclusion Criteria
  • Subjects with a waist hip ratio \> 0.97 or BMI \> 30kg/m2 and BMI \<18 kg/m2 will be excluded
  • Acute or chronic hepatitis B infection (determined by positive hepatitis B surface antigen result at the screening visit)
  • Acute or chronic hepatitis C infection (determined by positive hepatitis C antibody result at the screening visit)
  • Diabetes mellitus, other metabolic syndrome or disease process in the opinion of the investigator likely to cause marked disturbance in glucose and lipid homeostasis including hypertension. Subject with HbA1c \>42 mmol/mol will be excluded.
  • History or presence of allergy to the dolutegravir
  • ALT or AST greater than or equal to 1.5 x Upper Limit of Normal (ULN) and total bilirubin greater than or equal to 1.5 x ULN excluded;
  • Pregnancy and breastfeeding women
  • Alcohol consumption \>10 units/week
  • Clinically relevant drug use (positive urine drug screen) or history of alcohol or drug use considered by the Investigator to be sufficient to hinder compliance with treatment, follow-up procedures or evaluation of adverse events. Smoking is permitted, but tobacco intake should remain consistent throughout the study.
  • Unable to refrain from the use of prescription (e.g., dofetilide) or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives prior to the baseline visit and throughout the study until the follow-up period, unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise participant safety.
  • This includes on-going therapy with any of the following
  • Metabolically active medications
  • Any lipid-lowering medication
  • Any testosterones treatments or supplements - Glucocorticoids including inhaled steroids except for 'as necessary' use
  • Beta-blockers
  • Thiazide diuretics and indapamide
  • Thyroid preparations
  • Psychotropic agents
  • Anabolic steroids
  • Megestrol acetate
  • Dofetilide (or pilsicainide)

Exclusion

    Key Trial Info

    Start Date :

    March 20 2022

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    January 10 2024

    Estimated Enrollment :

    16 Patients enrolled

    Trial Details

    Trial ID

    NCT04771754

    Start Date

    March 20 2022

    End Date

    January 10 2024

    Last Update

    December 2 2025

    Active Locations (1)

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    Arnold Xhikola

    London, United Kingdom, SW10 0XD