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E/C/F/TDF

Phase 3

Acquired Immunodeficiency Syndrome | Small molecule | Infectious Disease |Gilead Sciences, Inc.|Last Updated: Sep 20, 2019

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials3
Total Enrollment968

FDA Designations

PRIORITY_REVIEWACCELERATED_APPROVAL

Clinical trial landscape

E/C/F/TDF · 3 trials · 2 indications

Phase 3 2Phase 2 1
NCT01705574Safety and Efficacy of E/C/F/TDF Versus RTV-Boosted ATV Plus FTC/TDF in HIV-1 Infected, Antiretroviral Treatment-Naive WomenAcquired Immunodeficiency Syndrome
COMPLETED583 Analytics
NCT01363011Cobicistat-containing Highly Active Antiretroviral Regimens in HIV-1 Infected Patients With Mild to Moderate Renal ImpairmentAcquired Immunodeficiency Syndrome
COMPLETED106 Analytics
PHASE3COMPLETED
Safety and Efficacy of E/C/F/TDF Versus RTV-Boosted ATV Plus FTC/TDF in HIV-1 Infected, Antiretroviral Treatment-Naive Women
Acquired Immunodeficiency SyndromeUnlock trial analytics
PHASE3COMPLETED
Cobicistat-containing Highly Active Antiretroviral Regimens in HIV-1 Infected Patients With Mild to Moderate Renal Impairment
Acquired Immunodeficiency SyndromeUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 48 of the Double-Blind Phase as Determined by the US FDA-Defined Snapshot Algorithm
Week 48

The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 48 of the double-blind phase was analyzed using the snapshot algorithm, which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) Using the Cockcroft-Gault (CG) Equation at Week 24 (Cohort 1)
Baseline; Week 24

Change from baseline in eGFR-CG equation at Week 24 was analyzed in Cohort 1 (treatment-naive).

Change From Baseline in eGFR-CG at Week 24 (Cohort 2)
Baseline; Week 24

Change from baseline in eGFR-CG equation at Week 24 was analyzed in Cohort 2 (treatment-experienced).

Change From Baseline in eGFR Using the Modification of Diet in Renal (MDRD) Equation at Week 24 (Cohort 1)
Baseline; Week 24

Change from baseline in eGFR-MDRD equation at Week 24 was analyzed in Cohort 1 (treatment-naive). The calculation was normalized to 1.73 m\^2 body surface area.

Change From Baseline in eGFR-MDRD at Week 24 (Cohort 2)
Baseline; Week 24

Change from baseline in eGFR-MDRD equation at Week 24 was analyzed in Cohort 2 (treatment-experienced). The calculation was normalized to 1.73 m\^2 body surface area.

Change From Baseline in eGFR Using the Chronic Kidney Disease, Epidemiology Collaboration (CKD-EPI) Formula Based on Cystatin C Equation at Week 24 (Cohort 1)
Baseline; Week 24

Change from baseline in eGFR-CKD-EPI based on cystatin C equation (not adjusted for age, sex, and race) at Week 24 was analyzed in Cohort 1 (treatment-naive). The calculation was normalized to 1.73 m\^2 body surface area.

Change From Baseline in eGFR-CKD-EPI Formula Based on Cystatin C Equation at Week 24 (Cohort 2)
Baseline; Week 24

Change from baseline in eGFR-CKD-EPI based on cystatin C equation (not adjusted for age, sex, and race) at Week 24 was analyzed in Cohort 2 (treatment-experienced). The calculation was normalized to 1.73 m\^2 body surface area.

Change From Baseline in eGFR-CKD-EPI Based on Cystatin C Equation, Adjusted at Week 24 (Cohort 1)
Baseline; Week 24

Change from baseline in eGFR-CKD-EPI based on cystatin C equation (adjusted for age, sex, and race) at Week 24 was analyzed in Cohort 1 (treatment-naive). The calculation was normalized to 1.73 m\^2 body surface area.

Change From Baseline in eGFR-CKD-EPI Based on Cystatin C Equation, Adjusted at Week 24 (Cohort 2)
Baseline; Week 24

Change from baseline in eGFR-CKD-EPI based on cystatin C equation (adjusted for age, sex, and race) at Week 24 was analyzed in Cohort 2 (treatment-experienced). The calculation was normalized to 1.73 m\^2 body surface area.

Change From Baseline in Actual Glomerular Filtration Rate (aGFR) at Weeks 2, 4, and 24 (Cohort 1)
Baseline; Weeks 2, 4, and 24

Change from baseline in aGFR at Weeks 2, 4, and 24 was analyzed in Cohort 1 (treatment-naive). aGFR was calculated using iohexol plasma clearance.

Change From Baseline in aGFR at Weeks 2, 4, and 24 (Cohort 2)
Baseline; Weeks 2, 4, and 24

Change from baseline in aGFR at Weeks 2, 4, and 24 was analyzed in Cohort 2 (treatment-experienced). aGFR was calculated using iohexol plasma clearance.

Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 24 (Cohort 1)
Week 24

The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 24 was analyzed in Cohort 1 (treatment-naive) using the FDA snapshot analysis algorithm.

Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 24 (Cohort 2)
Week 24

The percentage of participants with HIV-1 RNA \< 50 copies/mL at Week 24 was analyzed in Cohort 2 (treatment-experienced) using the FDA snapshot analysis algorithm.

Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 24
Week 24

The percentage of participants achieving HIV-1 RNA \< 50 copies/mL at Week 24 was analyzed using the snapshot algorithm, which defines a patient's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status.

Secondary Endpoints

Change From Baseline in CD4+ Cell Count at Week 48 of the Double-Blind Phase
Baseline; Week 48
Percentage of Participants With HIV-1 RNA < 50 Copies/mL at Week 96 for the STB Group as Determined by the US FDA-Defined Snapshot Algorithm
Week 96
Percentage of Participants Receiving STB or ATV+RTV+TVD With HIV-1 RNA < 50 Copies/mL at Week 48 of the Open-Label Extension Phase
Open-Label Extension Week 48
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
E/C/F/TDFEXPERIMENTALE/C/F/TDF + ATV placebo + RTV placebo + FTC/TDF placebo
ATV + RTV+ FTC/TDFACTIVE_COMPARATORATV + RTV + FTC/TDF + E/C/F/TDF placebo
Open-Label Extension PhaseEXPERIMENTALAfter 48 weeks of blinded treatment, participants will continue to take blinded study drug for 12 weeks and return for an unblinding visit at Week 60. Participants who are virologically suppressed at Week 48 during the double-blinded treatment phase will have the option to enter the open-label extension phase. Participants randomized to the E/C/F/TDF arm will continue to receive open-label E/C/F/TDF and participants randomized to the ATV+ RTV + FTC/TDF arm will be re-randomized to receive either open-label elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) or open-label ATV + RTV+ FTC/TDF.
E/C/F/TDF (Cohort 1)EXPERIMENTALParticipants who have not received prior antiretroviral (ARV) treatment and who are virologically unsuppressed at baseline will initiate treatment with elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF) single-tablet regimen (STR) for up to 96 weeks. Following Week 96, participants continued their treatment until all participants discontinued from the study or commercial approval of E/C/F/TDF was received in the applicable country.
COBI+PI+2 NRTI (Cohort 2)EXPERIMENTALParticipants who have received prior ARV treatment and who are virologically suppressed at baseline will continue their treatment regimen, switching the regimen's pharmacoenhancer component from ritonavir to cobicistat (COBI), and continuing their existing protease inhibitor (PI; either atazanavir (ATV) or darunavir (DRV)) plus 2 nucleoside reverse transcriptase inhibitor (NRTI) regimen for up to 96 weeks. Following Week 96, participants continued their treatment until all participants discontinued from the study or commercial approval of cobicistat was received in the applicable country.
E/C/F/TAFEXPERIMENTALE/C/F/TAF plus E/C/F/TDF placebo for at least 48 weeks
E/C/F/TAF Open-LabelEXPERIMENTALFollowing study unblinding, participants from the E/C/F/TAF and E/C/F/TDF arms may have the option to receive E/C/F/TAF during an open-label extension phase. Also, participants who are actively participating in a Gilead-sponsored study of cobicistat-boosted darunavir plus nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) who have reached the protocol-defined secondary endpoint (Week 48) and remain virologically suppressed are eligible to participate and receive E/C/F/TAF in this open-label extension phase.

Interventions

NameTypeDescription
E/C/F/TDFDRUG150/150/200/300 mg FDC tablet administered orally with food once daily
ATVDRUG300 mg capsule administered orally with food once daily
RTVDRUG100 mg tablet administered orally with food once daily
FTC/TDFDRUG200/300 mg tablet administered orally with food once daily
E/C/F/TDF PlaceboDRUGTablet administered orally with food once daily
ATV PlaceboDRUGTablet administered orally with food once daily
RTV PlaceboDRUGCapsule administered orally with food once daily
FTC/TDF PlaceboDRUGTablet administered orally with food once daily
E/C/F/TAFDRUG150/150/200/10 mg FDC tablet administered orally with food once daily
COBIDRUGCOBI 150 mg tablet administered with food orally once daily
DRVDRUGDRV 800 mg tablet administered orally once daily
NRTIDRUGParticipants will receive 2 investigator-selected NRTIs, which may include abacavir (ABC), lamivudine (3TC)/zidovudine (ZDV), didanosine (DDI), emtricitabine (FTC), ABC/3TC, 3TC, tenofovir disoproxil fumarate (TDF), or FTC/TDF, administered according to prescribing information.
E/C/F/TAF PlaceboDRUGTablet administered orally once daily
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Eligibility Criteria

Age Range18 Years to N/A
SexFEMALE
Healthy VolunteersNo
Study Sites99

Key Inclusion Criteria: * Female (at birth), age ≥ 18 years * Ability to understand and sign a written informed consent form * Plasma HIV-1 RNA levels ≥ 500 copies/mL * No prior use of any approved or investigational antiretroviral drug for any length of time * Screening genotype report must show s...

Countries:United StatesBelgiumDominican RepublicFranceItalyMexicoPortugalPuerto RicoRussiaThailandUgandaUnited KingdomAustraliaAustriaCanadaGermany
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Frequently asked questions about E/C/F/TDF

What is E/C/F/TAF used for?

E/C/F/TAF is an investigational single-tablet regimen being developed for the treatment of HIV-1 infection, including HIV-1 positive patients who are antiretroviral treatment-naive or virologically suppressed. It is also studied in patients with mild to moderate renal impairment and in pediatric populations, including adolescents and children.

What does E/C/F/TAF target?

E/C/F/TAF is a combination of four antiretroviral agents: elvitegravir, an integrase inhibitor; cobicistat, a pharmacokinetic enhancer; emtricitabine, a nucleoside reverse transcriptase inhibitor; and tenofovir alafenamide, a nucleotide reverse transcriptase inhibitor. Together, they target multiple steps in the HIV-1 replication cycle.

Who makes E/C/F/TAF?

E/C/F/TAF is developed by Gilead Sciences, Inc., a biopharmaceutical company traded on NASDAQ under the ticker GILD. Gilead is conducting clinical trials to evaluate the safety and efficacy of this combination regimen in various HIV-1 infected populations.

What phase is E/C/F/TAF in?

E/C/F/TAF is in Phase 2 clinical development. While some completed trials are Phase 3, the overall development program includes Phase 2 studies in adolescents and children. The drug has received FDA designations of Priority Review and Accelerated Approval, but it remains investigational and is not yet approved.

What clinical trials is E/C/F/TAF in?

E/C/F/TAF has been studied in six completed clinical trials with a total enrollment of 3,578 participants. Key trials include NCT01780506, a Phase 3 study in treatment-naive adults; NCT01818596, a Phase 3 study in patients with renal impairment; and NCT01854775 and NCT02276612, Phase 2 studies in pediatric populations.

Is E/C/F/TAF the same as Genvoya?

Yes, E/C/F/TAF is the same as Genvoya. The acronym stands for elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide, which are the four components of the single-tablet regimen. Clinical trial titles refer to it as Genvoya, and it is being evaluated for HIV-1 treatment.