Lenacapavir for HIV Prevention
(PURPOSE 2 Trial)

Recruiting in Palo Alto (17 mi)

+102 other locations

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 3

Waitlist Available

Sponsor: Gilead Sciences

No Placebo Group

Pivotal Trial (Near Approval)

Prior Safety Data

Breakthrough Therapy

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial is testing lenacapavir, a drug that may help prevent HIV. It targets people who are at risk of getting HIV. The drug works by stopping the virus from making more copies of itself. Lenacapavir was developed by Gilead Sciences Inc. and has been approved for use in combination with other treatments.

Research Team

Gilead Study Director

Principal Investigator

Gilead Sciences

Eligibility Criteria

This trial is for individuals at risk of HIV infection who have had condomless receptive anal sex with male partners, used stimulants during sex recently, or had certain sexually transmitted infections. They must have a kidney function test result (eGFR) ≥ 60 mL/min and not previously taken long-acting PrEP or oral PrEP in the past 12 weeks.

Inclusion Criteria

I've had unprotected receptive anal sex with 2 or more partners in the last 3 months.

Negative local rapid fourth generation HIV-1/2 Ab/Ag, central fourth generation HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT)

My kidney function, measured by eGFR, is 60 mL/min or higher.

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Exclusion Criteria

Randomized Phase:

I have acute or chronic hepatitis A, B, or C.

I have received an HIV vaccine or broadly neutralizing antibody.

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Treatment Details

Interventions

F/TAF (Antiretroviral Therapy)
F/TDF (Antiretroviral Therapy)
Lenacapavir (Virus Therapy)

Trial OverviewThe study tests Lenacapavir's effectiveness in preventing HIV. Participants will receive either oral Lenacapavir, subcutaneous Lenacapavir, placebos, or other pre-exposure prophylaxis drugs like F/TDF (and F/TAF for US participants).

Participant Groups

4Treatment groups

Experimental Treatment

Group I: PK Tail PhaseExperimental Treatment2 Interventions

Participants who prematurely discontinue study drug during blinded phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase will transition to the PK Tail Phase. Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks to cover the PK tail and complete visits every 13 weeks (+/- 7 days). Upon unblinding, participants who were randomized to F/TDF in the Randomized Blinded Phase who decline to participate in the LEN OLE Phase will complete the ESDD visit, transition to local HIV prevention services, and return for a 30-day follow-up visit.

Group II: LEN Open-Label Extension (OLE) PhaseExperimental Treatment2 Interventions

Participants will be offered entry into the LEN OLE Phase, following the completion of primary analysis, if LEN demonstrates acceptable safety and efficacy in the Randomized Blinded Phase. Participants randomized to LEN will continue to receive SC LEN 927 mg, every 26 weeks (± 7 days), and have study visits every 13 weeks (± 7 days). Participants randomized to F/TDF will switch to SC LEN 927 mg on OLE Day 1, Week 26 and every 26 weeks thereafter. Participants will also receive oral LEN 600 mg on OLE Days 1 and 2. All participants in the LEN OLE Phase will complete the phase, once LEN becomes available or the sponsor decides to discontinue the study, whichever happens first. After completing the LEN OLE Phase or study discontinuation, participants will transition to local PrEP, including LEN or other options. If a participant exits early, they will complete an ESDD visit, be referred to local PrEP services if needed, and have a 30-day follow-up visit.

Group III: Blinded Phase: Placebo LEN + F/TDFExperimental Treatment3 Interventions

Participants will receive the following for approximately 52 weeks: * SC LEN placebo every 26 weeks * Oral F/TDF 200/300 mg once daily * PTM Oral LEN on Days 1 and 2 Participants will receive oral LEN placebo if SC injections are not available

Group IV: Blinded Phase: LEN + Placebo-to-match (PTM) F/TDFExperimental Treatment3 Interventions

Participants will receive the following for approximately 52 weeks: * Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks * Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily * Oral LEN 600 mg on Days 1 and 2 Participants will receive oral LEN if SC injections are not available