The PROMISE trial compared open-label strategies and included sequential randomizations:
antepartum randomization (at 14 weeks of gestation or later) to one of three regimens, with
postpartum randomization (breast-feeding settings) at 6 to 14 days to maternal ART or infant
prophylaxis during breast-feeding and “maternal
health” randomization of women receiving ART
to continue or stop ART after breast-feeding cessation or birth (formula-feeding settings). Breastfeeding settings (enrollment started in April
2011) and formula-feeding settings (enrollment
started in July 2011) had separate protocols
(available at NEJM.org); the complete PROMISE
trial schema is shown in Figure S1A and S1B in
the Supplementary Appendix. At the November
2014 planned interim analysis, the prespecified
early stopping guideline for efficacy for the antepartum component was met, and the data and
safety monitoring board recommended releasing
the results.