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Last Updated: December 18, 2025

CLINICAL TRIALS PROFILE FOR BIKTARVY


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All Clinical Trials for BIKTARVY

Trial ID Title Status Sponsor Phase Start Date Summary
NCT03259698 ↗ Optimizing the Delivery of HIV nPEP Recruiting Canadian Institutes of Health Research (CIHR) Phase 2 2021-10-01 Despite decades of traditional prevention efforts based on behavior change and condom use, Ontario has seen over 700 new HIV infections annually over the past 10 years. Post-exposure prophylaxis (PEP) is one such approach, in which uninfected persons use 28 days of antiretroviral medications (ARVs) shortly after an HIV exposure to minimize the risk of acquiring HIV. PEP is highly efficacious, is considered a standard of care intervention based on medical and ethical grounds, and is supported by treatment guidelines. Yet several implementation challenges have limited its clinical and public health impact in Ontario, where no formal PEP policy exists. Our proposal seeks to optimize two aspects of delivering PEP for sexual exposures (nPEP). Results will inform the development of a standardized approach to nPEP both province-wide and elsewhere. Thus study has pragmatic, multicenter randomized controlled trial using a 2x2 factorial design to determine whether the proportion of nPEP patients that successfully complete follow-up: 1. is higher among those receiving mobile phone-based text messaging support than among those receiving standard care; and 2. is non-inferior among those receiving care from a sexual health clinic nurse compared to those receiving hospital-based physician care. The prospective, randomized, non-blinded, 2x2 factorial trial that will enroll 318 study participants in Toronto. In Intervention A, we will randomize half of study participants to a text messaging support service ('WelTel'), in which a trained, community-based counselor provides standardized weekly 'check-in' messages during their 12-week course of PEP follow-up. The other half will receive standard care, which does not include any form of active outreach or reminders outside of scheduled appointments. In Intervention B, we will randomize half of participants to receive nurse-led care for PEP follow-up at a local sexual health clinic; the other half will receive standard care by a hospital-based ID physician. The specific activities for each follow-up visit will be clearly defined in a medical directive. In keeping with Ontario legislation on medical directives, nurses will review cases with their authorizing physician or nurse practitioner on a routine basis.
NCT03259698 ↗ Optimizing the Delivery of HIV nPEP Recruiting CIHR Canadian HIV Trials Network Phase 2 2021-10-01 Despite decades of traditional prevention efforts based on behavior change and condom use, Ontario has seen over 700 new HIV infections annually over the past 10 years. Post-exposure prophylaxis (PEP) is one such approach, in which uninfected persons use 28 days of antiretroviral medications (ARVs) shortly after an HIV exposure to minimize the risk of acquiring HIV. PEP is highly efficacious, is considered a standard of care intervention based on medical and ethical grounds, and is supported by treatment guidelines. Yet several implementation challenges have limited its clinical and public health impact in Ontario, where no formal PEP policy exists. Our proposal seeks to optimize two aspects of delivering PEP for sexual exposures (nPEP). Results will inform the development of a standardized approach to nPEP both province-wide and elsewhere. Thus study has pragmatic, multicenter randomized controlled trial using a 2x2 factorial design to determine whether the proportion of nPEP patients that successfully complete follow-up: 1. is higher among those receiving mobile phone-based text messaging support than among those receiving standard care; and 2. is non-inferior among those receiving care from a sexual health clinic nurse compared to those receiving hospital-based physician care. The prospective, randomized, non-blinded, 2x2 factorial trial that will enroll 318 study participants in Toronto. In Intervention A, we will randomize half of study participants to a text messaging support service ('WelTel'), in which a trained, community-based counselor provides standardized weekly 'check-in' messages during their 12-week course of PEP follow-up. The other half will receive standard care, which does not include any form of active outreach or reminders outside of scheduled appointments. In Intervention B, we will randomize half of participants to receive nurse-led care for PEP follow-up at a local sexual health clinic; the other half will receive standard care by a hospital-based ID physician. The specific activities for each follow-up visit will be clearly defined in a medical directive. In keeping with Ontario legislation on medical directives, nurses will review cases with their authorizing physician or nurse practitioner on a routine basis.
NCT03259698 ↗ Optimizing the Delivery of HIV nPEP Recruiting St. Michael's Hospital, Toronto Phase 2 2021-10-01 Despite decades of traditional prevention efforts based on behavior change and condom use, Ontario has seen over 700 new HIV infections annually over the past 10 years. Post-exposure prophylaxis (PEP) is one such approach, in which uninfected persons use 28 days of antiretroviral medications (ARVs) shortly after an HIV exposure to minimize the risk of acquiring HIV. PEP is highly efficacious, is considered a standard of care intervention based on medical and ethical grounds, and is supported by treatment guidelines. Yet several implementation challenges have limited its clinical and public health impact in Ontario, where no formal PEP policy exists. Our proposal seeks to optimize two aspects of delivering PEP for sexual exposures (nPEP). Results will inform the development of a standardized approach to nPEP both province-wide and elsewhere. Thus study has pragmatic, multicenter randomized controlled trial using a 2x2 factorial design to determine whether the proportion of nPEP patients that successfully complete follow-up: 1. is higher among those receiving mobile phone-based text messaging support than among those receiving standard care; and 2. is non-inferior among those receiving care from a sexual health clinic nurse compared to those receiving hospital-based physician care. The prospective, randomized, non-blinded, 2x2 factorial trial that will enroll 318 study participants in Toronto. In Intervention A, we will randomize half of study participants to a text messaging support service ('WelTel'), in which a trained, community-based counselor provides standardized weekly 'check-in' messages during their 12-week course of PEP follow-up. The other half will receive standard care, which does not include any form of active outreach or reminders outside of scheduled appointments. In Intervention B, we will randomize half of participants to receive nurse-led care for PEP follow-up at a local sexual health clinic; the other half will receive standard care by a hospital-based ID physician. The specific activities for each follow-up visit will be clearly defined in a medical directive. In keeping with Ontario legislation on medical directives, nurses will review cases with their authorizing physician or nurse practitioner on a routine basis.
NCT03259698 ↗ Optimizing the Delivery of HIV nPEP Recruiting Unity Health Toronto Phase 2 2021-10-01 Despite decades of traditional prevention efforts based on behavior change and condom use, Ontario has seen over 700 new HIV infections annually over the past 10 years. Post-exposure prophylaxis (PEP) is one such approach, in which uninfected persons use 28 days of antiretroviral medications (ARVs) shortly after an HIV exposure to minimize the risk of acquiring HIV. PEP is highly efficacious, is considered a standard of care intervention based on medical and ethical grounds, and is supported by treatment guidelines. Yet several implementation challenges have limited its clinical and public health impact in Ontario, where no formal PEP policy exists. Our proposal seeks to optimize two aspects of delivering PEP for sexual exposures (nPEP). Results will inform the development of a standardized approach to nPEP both province-wide and elsewhere. Thus study has pragmatic, multicenter randomized controlled trial using a 2x2 factorial design to determine whether the proportion of nPEP patients that successfully complete follow-up: 1. is higher among those receiving mobile phone-based text messaging support than among those receiving standard care; and 2. is non-inferior among those receiving care from a sexual health clinic nurse compared to those receiving hospital-based physician care. The prospective, randomized, non-blinded, 2x2 factorial trial that will enroll 318 study participants in Toronto. In Intervention A, we will randomize half of study participants to a text messaging support service ('WelTel'), in which a trained, community-based counselor provides standardized weekly 'check-in' messages during their 12-week course of PEP follow-up. The other half will receive standard care, which does not include any form of active outreach or reminders outside of scheduled appointments. In Intervention B, we will randomize half of participants to receive nurse-led care for PEP follow-up at a local sexual health clinic; the other half will receive standard care by a hospital-based ID physician. The specific activities for each follow-up visit will be clearly defined in a medical directive. In keeping with Ontario legislation on medical directives, nurses will review cases with their authorizing physician or nurse practitioner on a routine basis.
NCT03499483 ↗ Biktarvy for Non-Occupational Post-Exposure Prophylaxis (nPEP) Recruiting Fenway Community Health Phase 4 2019-01-24 Study will evaluate the safety and tolerability of once daily Biktarvy for 28 days for prevention of HIV infection in HIV-1-seronegative adults after high-risk sexual contact. (non-occupational post exposure prophylaxis - nPEP)
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for BIKTARVY

Condition Name

Condition Name for BIKTARVY
Intervention Trials
HIV-1-infection 13
HIV Infections 7
Human Immunodeficiency Virus 5
Hiv 5
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Condition MeSH

Condition MeSH for BIKTARVY
Intervention Trials
HIV Infections 18
Acquired Immunodeficiency Syndrome 10
Infections 5
Communicable Diseases 4
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Clinical Trial Locations for BIKTARVY

Trials by Country

Trials by Country for BIKTARVY
Location Trials
United States 101
Canada 10
Italy 7
United Kingdom 6
Germany 6
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Trials by US State

Trials by US State for BIKTARVY
Location Trials
Georgia 7
California 7
New Jersey 6
New York 6
Florida 6
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Clinical Trial Progress for BIKTARVY

Clinical Trial Phase

Clinical Trial Phase for BIKTARVY
Clinical Trial Phase Trials
PHASE4 1
PHASE3 1
PHASE2 2
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Clinical Trial Status

Clinical Trial Status for BIKTARVY
Clinical Trial Phase Trials
Recruiting 17
Not yet recruiting 9
Completed 4
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Clinical Trial Sponsors for BIKTARVY

Sponsor Name

Sponsor Name for BIKTARVY
Sponsor Trials
Gilead Sciences 18
ViiV Healthcare 4
Chelsea and Westminster NHS Foundation Trust 3
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Sponsor Type

Sponsor Type for BIKTARVY
Sponsor Trials
Other 61
Industry 28
U.S. Fed 1
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Clinical Trials Update, Market Analysis, and Projection for BIKTARVY

Last updated: October 26, 2025

Introduction

BIKTARVY (bictegravir/emtricitabine/tenofovir alafenamide) is a fixed-dose combination antiretroviral therapy (ART) developed by Gilead Sciences for the treatment of HIV-1 infection. Since its approval, BIKTARVY has gained prominence as a preferred regimen due to its efficacy, safety profile, and convenience. This report provides a comprehensive update on ongoing and completed clinical trials, assesses the current market landscape, and projects future growth potential for BIKTARVY.


Clinical Trials Update

Approved Indications and Ongoing Studies

Since its initial approval by the FDA in 2018, BIKTARVY has primarily been indicated for the treatment of HIV-1 infection in adults and treatment-naïve patients. Its outstanding tolerability and simplified dosing regimen (once daily) have established its role in HIV management.

Completed Clinical Trials

  • GS-1489 (Clinical Trial NCT02579166): A Phase 3, randomized, non-inferiority trial comparing BIKTARVY with other ART regimens in treatment-naïve adults. Results confirmed non-inferiority, with comparable viral suppression rates and fewer adverse events.
  • GS-1484 (NCT03130545): A 48-week study evaluating the safety and efficacy in various patient populations, including women and ethnic minorities, supporting broad use.

Ongoing and Planned Trials

  • Upcoming Real-World Effectiveness Studies: Several post-marketing observational studies aim to assess long-term safety, durability, and resistance development in diverse populations.
  • Pediatric Trials: Gilead is conducting trials (NCT04070192) to evaluate the safety and pharmacokinetics of BIKTARVY in adolescents aged 12 to 17, with initial results promising.
  • Drug Resistance Monitoring: Trials continue to monitor the resistance profiles among patients failing BIKTARVY therapy, given the significance of resistance in HIV treatment.

Key Clinical Findings

  • BIKTARVY maintains high viral suppression (≥95%) in treatment-naïve adults.
  • The regimen demonstrates a favorable safety profile, with fewer discontinuations due to adverse events compared to older regimens.
  • No significant emergence of resistance has been reported in patients with adherence, aligning with its high genetic barrier to resistance.
  • Studies are ongoing to establish effectiveness and safety in special populations, such as pregnant women, adolescents, and patients with comorbidities.

Market Analysis

Current Market Landscape

The global HIV therapeutics market has experienced steady growth, driven by advancements in ART and increasing diagnosis rates. As of 2023, the market is estimated at approximately $30 billion, with key competitors including Gilead’s own Truvada (emtricitabine and tenofovir disoproxil fumarate), Dolutegravir-based regimens (e.g., Tivicay, Juluca), and generic formulations.

Positioning of BIKTARVY

  • Market Share: According to IQVIA data, BIKTARVY commands roughly 15-20% of the newly diagnosed and eligible HIV treatment segment.
  • Competitive Advantages: BIKTARVY’s once-daily dosing, high barrier to resistance, and favorable safety profile position it as a preferred initial regimen.
  • Reimbursement & Adoption: Payer coverage has expanded in North America and Europe, favoring its wider adoption in treatment guidelines (e.g., US DHHS, EACS).

Market Drivers

  • Growing diagnosis rates: Increased screening initiatives worldwide.
  • Desire for simplified regimens: Patient preference for single-pill, once-daily therapies.
  • Advancement in formulations: Ongoing efforts to improve tolerability and minimize adverse effects.
  • Policy shifts: National and international guidelines increasingly advocate for drugs with high tolerability and resistance profiles.

Market Challenges

  • Price and access barriers: High drug cost limits uptake in low-to-middle-income countries.
  • Resistance concerns: Emerging resistance in cases of poor adherence.
  • Generic competition: Once patents expire, generics will capture significant market share, especially in developing regions.

Market Projection and Future Outlook

Growth Forecast (2023-2030)

  • Compound Annual Growth Rate (CAGR): The HIV ART market is expected to grow at approximately 6-8% annually.
  • Market Penetration: BIKTARVY is projected to maintain or slightly increase its market share due to existing clinical advantages, with estimates suggesting a 20-25% slice of the market by 2030.
  • Global Expansion: Key growth opportunities lie in emerging markets like Africa, Southeast Asia, and Latin America, where Gilead is expanding access programs.

Key Trends Influencing Growth

  • Expansion into pediatric and adolescent populations: Gilead’s ongoing trials could widen indications and drive adoption in younger demographics.
  • Combination therapies: Development of fixed-dose combinations that incorporate BIKTARVY with other agents could boost market share.
  • Long-acting formulations: The advent of long-acting injectable HIV therapies (e.g., cabotegravir/rilpivirine) may influence oral therapy markets but are unlikely to replace BIKTARVY's niche in initial therapy.

Market Risks and Opportunities

  • Patent expirations: Patents expected to last until at least 2028, with generic versions potentially reducing prices.
  • Regulatory changes: International health policies favoring affordability could pressure drug prices.
  • New entrants: Next-generation integrase inhibitors like cabotegravir and bictegravir analogs could introduce competition.

Strategic Recommendations

  • Focused market expansion: Gilead should prioritize access programs in emerging markets to sustain growth.
  • Invest in pediatric trials: Rapid completion of adolescent trials can open new markets.
  • Enhance clinical data: Supporting real-world evidence and resistance studies can solidify BIKTARVY’s efficacy claims.
  • Innovate formulations: Long-acting injectables and multi-drug regimens incorporating BIKTARVY could extend its lifecycle.

Key Takeaways

  • Clinical efficacy and safety: BIKTARVY remains a cornerstone for initial HIV treatment, backed by robust clinical trial results.
  • Market positioning: Its favorable profile and convenience sustain a strong market presence amid competition.
  • Growth potential: Limited patent expiration risks and expansion into pediatric populations provide significant upside.
  • Challenges: Access barriers and emerging alternatives require strategic planning and continued innovation.
  • Future outlook: Steady growth expected, supported by proactive market expansion, real-world data, and potential pipeline developments.

FAQs

  1. What is the primary indication for BIKTARVY?
    BIKTARVY is approved for the treatment of HIV-1 infection in adults and treatment-naïve patients.

  2. How does BIKTARVY compare with other antiretroviral regimens?
    It offers comparable efficacy with a better safety and tolerability profile, combined with a convenient once-daily, single-pill formulation.

  3. Are there ongoing clinical trials for BIKTARVY in pediatric populations?
    Yes, Gilead is conducting trials to evaluate BIKTARVY in adolescents aged 12–17, with early data indicating promising safety and pharmacokinetic profiles.

  4. What are the main market drivers for BIKTARVY?
    The primary drivers include increased diagnosis rates, preference for simplified regimens, expanding guideline recommendations, and the drug’s clinical advantages.

  5. When is patent expiration expected for BIKTARVY?
    Patent protection extends into the late 2020s, with generic competition anticipated around 2028 or later, depending on jurisdiction.


References

  1. Gilead Sciences. "BIKTARVY (bictegravir/emtricitabine/tenofovir alafenamide) Prescribing Information." 2018.
  2. IQVIA. "Global HIV Pharmaceutical Market Analysis." 2023.
  3. US Food and Drug Administration. "FDA approval letter for BIKTARVY," 2018.
  4. International Antiviral Society-USA. "Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents," 2022.
  5. Gilead Sciences. "Clinical Trials Database." NCT04070192, NCT02579166, NCT03130545.

In conclusion, BIKTARVY’s clinical robustness and market positioning underscore its importance in the evolving landscape of HIV therapy. Strategic efforts combining clinical innovation and global access will determine its sustained growth trajectory in the coming decade.

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