Phase 3
Completed N=13
A Study of the Pharmacokinetics and Antiviral Activity of Dolutegravir in the Central Nervous System in HIV-1 Infected ART-naive Subjects
Infection, Human Immunodeficiency Virus
Source: ClinicalTrials.gov NCT01499199 ↗
Enrolled (actual)
13
Serious AEs
15.4%
Results posted
Nov 2013
Primary outcomePrimary: The Ratio of Total and Unbound DTG Concentrations Between Cerebrospinal Fluid (CSF) and Plasma at Week 2 and Week 16 — 0.516; 0.412 percentage
Summary
ING116070 is a Phase IIIb single-arm, open-label, multicenter study. The study will be conducted in approximately 14 HIV-1 infected antiretroviral therapy (ART)-naïve subjects. Subjects who fulfill eligibility requirements will receive dolutegravir (DTG) 50 mg once daily in combination with the fixed dose dual nucleoside reverse transcripatase inhibitor(NRTI) abacavir/lamivudine (ABC/3TC) for 96 weeks. One pair of pharmacokinetic (PK) samples in plasma and cerebral spinal fluid (CSF) (matching time) for determination of DTG concentration will be collected at Week 2 and Week 16. Samples for plasma HIV-1 RNA will be collected at Baseline and various time points throughout the study and samples for HIV-1 RNA levels in the CSF will be collected at Baseline, Week 2 and Week 16. Safety, additional measures of antiviral activity and development of viral resistance will also be evlauated. The primary analysis will take place after the last subject completes 16 weeks on therapy; additional analyses will be conducted after the last subject completes Weeks 2 and 96 (end of study).
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY The Ratio of Total and Unbound DTG Concentrations Between Cerebrospinal Fluid (CSF) and Plasma at Week 2 and Week 16 |
0.516; 0.412 | — |
| PRIMARY Total DTG Plasma Concentrations at Week 2 and Week 16 |
3.36; 3.21 | — |
| PRIMARY Unbound DTG Plasma Concentrations at Week 2 and Week 16 |
17.1; 23.9 | — |
| PRIMARY Plasma DTG Unbound Fraction at Week 2 and Week 16 |
0.488; 0.701 | — |
| PRIMARY DTG Concentrations in CSF at Weeks 2 and Week 16 |
18.2; 13.2 | — |
| SECONDARY Number of Participants With Plasma HIV-1 RNA <50 Copies Per Milliliter (c/mL) at Baseline and Weeks 2, 4, 8, 12, and 16 |
0; 4; 6; 8; 10; 10 | — |
| SECONDARY Absolute Values and Change From Baseline in Plasma Human Immunodeficiency Virus (HIV-1) Ribonucleic Acid (RNA) Levels at Weeks 2, 4, 8, 12, 16, 24, 36, 48, 60, 72, 84, and 96 |
4.73; 2.05; -2.53; 1.67; -3.04; 1.59 | — |
| SECONDARY Number of Participants With CSF HIV-1 RNA <50 Copies/Milliliter (c/mL) at Baseline, Week 2, and Week 16 |
1; 7; 11 | — |
| SECONDARY Absolute Values and Change From Baseline in CSF HIV-1 RNA Levels at Week 2 and Week 16 |
3.64; 0.98; -2.19; 0.00; -3.42 | — |
| SECONDARY Number of Participants With the Indicated Number of Copies of HIV-1 RNA in Both the CSF and Plasma at Baseline, Week 2, and Week 16 |
0; 1; 0; 12; 4; 3 | — |
| SECONDARY Pearson Correlation Between CSF DTG Concentration and Absolute Values and Change From Baseline (CFB) in CSF HIV-1 RNA at Week 2, Week 16, and Overall |
0.567; 0.007; -0.775; -0.354; 0.517; 0.106 | — |
| SECONDARY Absolute Values and Change From Baseline in Cluster of Differentiation 4+ (CD4+) Cell Counts at Weeks 4, 8, 12, 16, 24, 36, 48, 60, 72, 84, and 96 |
260; 578; 645; 589; 573; 634 | — |
| SECONDARY Absolute Values and Change From Baseline in Cluster of Differentiation 8+ (CD8+) Cell Counts at Weeks 4, 12, 16, 24, 48, and 96 |
757; 874; 865; 706; 876; 708 | — |
| SECONDARY Number of Participants With Post-Baseline HIV-1-associated Conditions, Including Recurrences |
0; 0; 0; 0 | — |
| SECONDARY The Numbers of Participants (Par.) With Clinical Adverse Events or Laboratory Abnormalities |
13; 12; 3; 0 | — |
| SECONDARY Number of Participants With Treatment-emergent Genotypic and Phenotypic Resistance to DTG and Other Antiretroviral Therapy (ART) |
0; 0 | — |
Eligibility Criteria
Inclusion Criteria
- HIV-1 infected adults at least 18 years of age. Females are eligible to enter and participate in the study if she is (1) of non-childbearing potential or (2) of childbearing potential with a negative pregnancy test at Screening and Day 1 and agrees to use protocol-defined methods of birthcontrol while on the study.
- HIV-1 infection as documented by Screening plasma HIV-1 RNA greater than or equal to 5000 copies/mL
- CD4+ cell count greater than or equal to 200 cells/mm3
- Antiretroviral-naive (less than or equal to 10 days of prior therapy with any antiretroviral agent following diagnosis of HIV-1 infection)
- Signed and dated written informed consent is obtained from the subject or the subject's legal representative prior to screening
- Documentation that the subject has been screened for, and is negative for the HLA-B*5701 allele
- Is willing to undergo serial lumbar punctures
Exclusion Criteria
- Relative or absolute contraindication to lumbar puncture, such as current coagulopathy, thrombocytopenia (platelets less than 50,000/microliter), hemophilia, or use of anticoagulant medication
- Moderate or severe cognitive impairment
- Women who are pregnant or breastfeeding
- Any evidence of an active Center for Disease Control and Prevention (CDC) Category C disease, except cutaneous Kaposi's sarcoma not requiring systemic therapy or historic CD4+ cell levels less than 200cells/mm3
- Subjects with any degree of hepatic impairment
- Positive for Hepatitis B at screening (+HbsAg), or an anticipated need for Hepatitis C virus (HCV) therapy during the study
- History or presence of allergy or intolerance to the study drugs or their components or drugs of their class
- History of malignancy within the past 5 years or ongoing malignancy other than cutaneous Kaposi's sarcoma, basal cell carcinoma, or resected, non-invasive cutaneous squamous cell carcinoma; other localized malignancies require agreement between the investigator and the Study medical monitor for inclusion of the subject
- Recent history (less than or equal to 3 months) of any upper or lower gastrointestinal bleed, with the exception of anal or rectal bleeding
- Treatment with an HIV-1 immunotherapeutic vaccine within 90 days of Screening
- Treatment with any of the following agents within 28 days of Screening: radiation therapy, cytotoxic chemotherapeutic agents, any immunomodulators that alter immune responses
- Treatment with any agent, except recognized ART as allowed above, with documented activity against HIV-1 in vitro within 28 days of first dose of IP
- Exposure to an experimental drug or experimental vaccine within either 28 days, 5 half-lives of the test agent, or twice the duration of the biological effect of the test agent, whichever is longer, prior to the first dose of IP
- Any evidence of primary viral resistance based on the presence of any major resistance-associated mutation in the Screening result or, if known, any historical resistance test result. Note: retests of Screening genotypes are not allowed
- Any verified Grade 4 laboratory abnormality (a single repeat test is allowed during the Screening period to verify a result). Any acute laboratory abnormality at Screening, which, in the opinion of the Investigator, would preclude the subject's participation in the study of an investigational compound is exclusionary
- Alanine aminotransferase (ALT) greater than 5 times the upper limit of normal (ULN)
- ALT greater than or equal to 3xULN and bilirubin greater than or equal to 1.5xULN (with greater than 35% direct bilirubin)
- Subject has creatinine clearance of less than 50 mL/min via Cockroft-Gault method
Data sourced from ClinicalTrials.gov (NCT01499199). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.