Phase 2
Completed N=309
A Phase IIb Study to Evaluate a Long-Acting Intramuscular Regimen for Maintenance of Virologic Suppression (Following Induction With an Oral Regimen of GSK1265744 and Abacavir/Lamivudine) in Human Immunodeficiency Virus Type 1 (HIV-1) Infected, Antiretroviral Therapy-Naive Adult Subjects
Infection, Human Immunodeficiency Virus · HIV
Source: ClinicalTrials.gov NCT02120352 ↗
Enrolled (actual)
309
Serious AEs
14.1%
Results posted
Aug 2020
Primary outcomePrimary: Percentage of Participants With Plasma Human Immunodeficiency Virus-1 (HIV-1) Ribonucleic Acid (RNA) Level Below 50 Copies/Milliliter (c/mL) at Week 32 — 95; 94; 91 Percentage of participants
Summary
This study is a Phase IIb, randomized, multicentre, parallel group, open-label, study having an overall objective to evaluate the antiviral activity, tolerability, and safety of two intramuscular (IM) dosing regimens of GSK744 LA plus TMC278 LA, relative to GSK744 30 milligram (mg) plus Abacavir/Lamivudine (ABC/3TC) given orally once daily (QD), in HIV-1 infected antiretroviral-naïve subjects. GSK744 is the oral formulation of GSK1265744 (cabotegravir), GSK744 LA is the long acting injectable formulation of GSK1265744 and TMC278 LA is the long acting injectable formulation of TMC278.
The study will consist of three parts: an Induction Period, Maintenance Period and Extension Period. There is also a Long-Term Follow Up Period for subjects who withdraw from the study and have received at least one dose of GSK744 LA and / or TMC278 LA. In the Induction Period, eligible subjects will receive a combination of an oral regimen of 30 mg of GSK744 and 600/300 mg of ABC/3TC, once daily for 20 weeks. In the Maintenance Period, eligible subjects will be randomized 2:2:1 at Day 1 to receive an IM regimen of GSK744 LA 400 mg + TMC278 LA 600 mg every 4 weeks for 96 weeks (Q4W), an IM regimen of GSK744 LA 600 mg + TMC278 LA 900 mg every 8 weeks for 96 weeks (Q8W), or to continue on the oral Induction Period regimen of GSK744 30 mg + ABC/3TC once daily for 96 weeks (or 104 weeks if continuing on to the Extension Period). The Extension Period will allow for a collection of longer term efficacy and safety and tolerability data from subjects receiving GSK744 LA and TMC278 LA.
The study will involve sufficient subjects at screening in order to ensure a total of approximately 265 subjects at the beginning of the Induction Period and approximately 225 subjects randomized into the Maintenance Period.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Plasma Human Immunodeficiency Virus-1 (HIV-1) Ribonucleic Acid (RNA) Level Below 50 Copies/Milliliter (c/mL) at Week 32 |
95; 94; 91 | — |
| PRIMARY Number of Participants With Protocol Defined Virologic Failure (PDVF) Until Week 32 |
1; 0; 1 | — |
| PRIMARY Number of Participants With Any Serious Adverse Event (SAE) and Any Non-serious Adverse Event (Non-SAE) (Induction Period) |
246; 8 | — |
| PRIMARY Number of Participants With Any Serious Adverse Event (SAE) and Any Non-serious Adverse Event (Non-SAE) (Maintenance Period) |
115; 113; 52; 9; 8; 5 | — |
| PRIMARY Number of Participants With Post-Baseline Adverse Events by Maximum Toxicity Grade |
31; 25; 19; 67; 72; 29 | — |
| PRIMARY Number of Participants With Maximum Post-Baseline Emergent Toxicities for Clinical Chemistry Parameters |
94; 94; 44; 50; 42; 16 | — |
| PRIMARY Number of Participants With Maximum Post-Baseline Emergent Toxicities for Hematology Parameters |
23; 17; 7; 2; 4; 2 | — |
| PRIMARY Number of Participants With Post-Baseline Urinalysis Dipstick Results |
5; 6; 1; 3; 3; 2 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA <200 c/mL and <50 c/mL, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
0; 72; 90; 89; 92; 91 | — |
| SECONDARY Absolute Values of Plasma HIV-1 RNA, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
4.43; 1.71; 1.62; 1.63; 1.61; 1.60 | — |
| SECONDARY Change From Baseline in Plasma HIV-1 RNA, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
-2.72; -2.80; -2.79; -2.81; -2.82 | — |
| SECONDARY Absolute Values of Cluster of Differentiation 4+ (CD4+), for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
498.9; 630.5; 664.2; 702.3; 690.9 | — |
| SECONDARY Change From Baseline in CD4+, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
131.7; 164.5; 201.5; 188.7 | — |
| SECONDARY Number of Participants With AEs by Their Severity Grades, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
27; 15; 2; 1 | — |
| SECONDARY Number of Participants With Maximum Post-Baseline Emergent Toxicities for Hematology Parameters, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
26; 4; 1; 3 | — |
| SECONDARY Number of Participants With Maximum Post-Baseline Emergent Toxicities for Clinical Chemistry Parameters, for Oral Dose of CAB 30 mg Plus ABC/3TC (Induction Period) |
130; 50; 16; 5 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: ALT, ALP, AST and CK (Induction Period) |
0.4; -1.3; -0.5; 1.5; -1.2; -2.1 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter: Albumin (Induction Period) |
0.2; 0.7; 1.4; 1.7; 1.9 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Total Bilirubin and Creatinine (Induction Period) |
-0.6; -0.9; -1.0; -0.5; -0.3; 2.6 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: CO2, Chloride, Cholesterol, Glucose, Potassium, Sodium, Triglyceride and Urea (Induction Period) |
0.2; 0.3; 0.4; 0.1; -0.8; 0.2 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter: Lipase (Induction Period) |
3.3; 0.8; 2.8; 2.1; -1.2 | — |
| SECONDARY Change From Baseline in Hematology Parameters: Basophil, Eosinophils, Lymphocytes, Total Neutrophils, Monocytes, Platelets Count and White Blood Cells (WBC) Count (Induction Period) |
0.00; 0.00; 0.00; 0.00; 0.00; 0.01 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hematocrit (Induction Period) |
0.00; 0.00; 0.00; 0.00; 0.00 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hemoglobin (Induction Period) |
0.8; 2.0; 2.5; 3.3; 3.1 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Mean Corpuscle Volume (Induction Period) |
1.0; 2.1; 3.1; 4.0; 4.4 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Red Blood Cell Count (Induction Period) |
-0.05; -0.07; -0.10; -0.10; -0.14 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA Level <50 c/mL and <200 c/mL Over Week 96 (Maintenance Period) |
95; 99; 98; 97; 98; 93 | — |
| SECONDARY Number of Participants With Protocol Defined Virologic Failure at Week 32 and Week 48 (Maintenance Period) |
1; 0; 1; 2; 0; 1 | — |
| SECONDARY Absolute Value of Plasma HIV-1 RNA at Week 32 and Week 96 (Maintenance Period) |
1.60; 1.59; 1.61; 1.60; 1.59; 1.59 | — |
| SECONDARY Change From Baseline in Plasma HIV-1 RNA at Week 32 and Week 96 (Maintenance Period) |
-2.78; -2.88; -2.73; -2.77; -2.89; -2.77 | — |
| SECONDARY Absolute Value of CD4+ at Week 32 and Week 96 (Maintenance Period) |
752.3; 761.3; 891.3; 748.6; 750.0; 906.8 | — |
| SECONDARY Change From Baseline in CD4+ at Week 32 and Week 96 (Maintenance Period) |
264.4; 263.7; 346.1; 257.5; 270.6; 369.9 | — |
| SECONDARY Number of Participants With HIV-1 Disease Progression Over Week 32 and Week 96 (Maintenance Period) |
1; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With AEs by Their Severity Grades Over Week 32 (Maintenance Period) |
35; 29; 23; 65; 69; 22 | — |
| SECONDARY Number of Participants With AEs by Their Severity Grades Over Week 96 (Maintenance Period) |
23; 21; 24; 71; 74; 26 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: ALT, ALP, AST and CK at Week 32 and Week 96 (Maintenance Period) |
-2.4; -2.7; -5.0; -1.2; -3.8; -1.3 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter: Albumin at Week 32 and Week 96 (Maintenance Period) |
1.4; 0.9; 1.1; 1.0; 0.9; 0.2 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Total Bilirubin and Creatinine at Week 32 and Week 96 (Maintenance Period) |
0.8; 0.4; -0.6; 2.7; 3.8; 2.7 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Total CO2, Chloride, Cholesterol, Glucose, Potassium, Sodium, Triglyceride and Urea at Week 32 and Week 96 (Maintenance Period) |
-0.8; -1.5; -1.1; -0.2; -0.3; 0.1 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter: Lipase at Week 32 and Week 96 (Maintenance Period) |
-1.2; -4.4; -3.9; 3.5; -0.8; -2.3 | — |
| SECONDARY Change From Baseline in Hematology Parameters: Basophil, Eosinophils, Lymphocytes, Total Neutrophils, Monocytes, Platelet Count and WBC Count at Week 32 and Week 96 (Maintenance Period) |
0.00; -0.00; 0.00; 0.01; 0.23; -0.01 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hematocrit at Week 32 and Week 96 (Maintenance Period) |
0.01; 0.01; 0.01; 0.0114; 0.0134; 0.0124 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hemoglobin at Week 32 and Week 96 (Maintenance Period) |
2.0; 0.8; 1.7; 3.9; 4.3; 4.1 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Mean Corpuscle Volume at Week 32 and Week 96 (Maintenance Period) |
2.5; 2.3; 7.1; 0.1; 0.3; 5.3 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Red Blood Cell Count at Week 32 and Week 96 (Maintenance Period) |
0.03; 0.02; -0.20; 0.12; 0.14; -0.13 | — |
| SECONDARY Average Initial Concentration (C0) and Maximum Plasma Concentration (Cmax) of CAB LA (Q4W IM and Q8W IM Dosing) (Maintenance Period) |
1.43; 2.35; 3.55; 3.50 | — |
| SECONDARY Average Initial Concentration (C0) and Cmax of RPV LA (Q4W IM and Q8W IM Dosing) (Maintenance Period) |
49.3; 77.2; 104; 111 | — |
| SECONDARY Trough Concentration (Ctrough) of CAB LA (Q8W IM Dosing) Used for Assessment of Steady State (Maintenance Period) |
1.6902; 1.6051; 1.5330 | — |
| SECONDARY Ctrough of CAB LA (Q4W IM Dosing) Used for Assessment of Steady State (Maintenance Period) |
2.2703; 2.3861; 2.6342; 2.4365; 2.4715 | — |
| SECONDARY Ctrough of RPV LA (Q8W IM Dosing) Used for Assessment of Steady State (Maintenance Period) |
41.94; 47.97; 57.24 | — |
| SECONDARY Ctrough of RPV LA (Q4W IM Dosing) Used for Assessment of Steady State (Maintenance Period) |
66.92; 74.55; 76.84; 80.84; 90.34 | — |
| SECONDARY Pharmacodynamic Response (HIV-1 RNA<50 c/mL) in Relation With PK Parameter (AUC[0-tau]) of CAB LA and RPV LA at Week 32 (Maintenance Period) |
0.00; 0.00; 0.00; 0.00 | — |
| SECONDARY Pharmacodynamic Response (HIV-1 RNA<50 c/mL) in Relation With PK Parameter (Average C0) of CAB LA and RPV LA at Week 32 (Maintenance Period) |
0.64; 2.39; 0.39; 0.00; 0.01; -0.01 | — |
| SECONDARY Pharmacodynamic Response (HIV-1 RNA<50 c/mL) in Relation With PK Parameter (Cmax) of CAB LA and RPV LA at Week 32 (Maintenance Period) |
-0.01; 1.64; 0.00; 0.01 | — |
| SECONDARY Virologic Failure (From MSDF Algorithm) in Relation With PK Parameter (AUC[0-tau]) of CAB LA and RPV LA at Week 32 (Maintenance Period) |
-0.00; -0.00; 0.00; -0.00 | — |
| SECONDARY Virologic Failure (From MSDF Algorithm) in Relation With PK Parameter (Average C0) of CAB LA and RPV LA at Week 32 (Maintenance Period) |
-1.01; -2.39; -0.53; -0.00; -0.01; -0.01 | — |
| SECONDARY Virologic Failure (From MSDF Algorithm) in Relation With PK Parameter (Cmax) of CAB LA and RPV LA at Week 32 (Maintenance Period) |
-0.45; -1.64; -0.00; -0.01 | — |
| SECONDARY Number of Participants With Treatment-emergent Genotypic Resistance |
0; 0; 0; 0 | — |
| SECONDARY Number of Participants With Treatment-emergent Phenotypic Resistance |
1; 1; 0; 0; 0; 0 | — |
| SECONDARY Percentage of Participants With Plasma HIV-1 RNA Level <50 c/mL Over Week 32 by Subgroups (Maintenance Period) |
96; 92; 94; 88; 100; 71 | — |
| SECONDARY Percentage of Participants With Protocol Defined Virologic Failure (PDVF) at Week 32 by Subgroups(Maintenance Period) |
3; 1; 0; 13; 0; 29 | — |
| SECONDARY HIV Treatment Satisfaction Questionnaire - Status Version (HIVTSQ[s]) Total Score at Week 32 and Week 96 (Maintenance Period) |
68.4; 66.6; 65.1; 68.4; 67.0; 63.5 | — |
| SECONDARY HIV Treatment Satisfaction Questionnaire - Change Version (HIVTSQ[c]) Total Score at Week 32 (Maintenance Period) |
30.9; 28.9; 20.5 | — |
| SECONDARY Number of Participants With HIV Medication Questionnaire (HIVMQ) Item E and F Scores at Week 32 (Maintenance Period) |
80; 73; 16; 12; 14; 13 | — |
| SECONDARY Number of Participants With HIV Medication Questionnaire (HIVMQ) Item E and F Scores at Week 96 (Maintenance Period) |
18; 10; 3; 2; 1; 9 | — |
Eligibility Criteria
Inclusion Criteria
- Subjects screened for this study must be HIV-1 infected and >=18 years of age.
- A female subject is eligible to enter and participate in the study if she: is of non-child-bearing potential defined as either post-menopausal (12 months of spontaneous amenorrhea and >=45 years of age) or physically incapable of becoming pregnant with documented tubal ligation, hysterectomy or bilateral oophorectomy or; is of child-bearing potential with a negative pregnancy test at both Screening and first day of the Induction Period and agrees to use one of the following methods of contraception to avoid pregnancy 2 weeks prior to administration of IP, throughout the study, and for at least 2 weeks after discontinuation of all oral study medications and for at least 52 weeks after discontinuation of GSK744 LA and TMC278 LA: Complete abstinence from intercourse (where this is the subject's preferred and usual lifestyle); double barrier method (male condom/spermicide, male condom/diaphragm, diaphragm/spermicide); approved hormonal contraception; any intrauterine device (IUD) with published data showing that the expected failure rate is =1000 c/mL.
- CD4+ cell count >=200 cells/mm^3 (or higher as local guidelines dictate).
- ART-naive defined as having no more than 10 days of prior therapy with any antiretroviral agent following a diagnosis of HIV-1 infection. Any previous exposure to an HIV integrase inhibitor or non-nucleoside reverse transcriptase inhibitor will be exclusionary.
- French subjects: In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category.
Exclusion Criteria
- Women who are breastfeeding.
- Any evidence at screening of an active Center for Disease and Prevention Control (CDC) Category C disease, except cutaneous Kaposi's sarcoma not requiring systemic therapy.
- Subjects with known moderate to severe hepatic impairment.
- Any pre-existing physical or mental condition (including substance abuse disorder) which, in the opinion of the Investigator, may interfere with the subject's ability to comply with the dosing schedule and/or protocol evaluations or which may compromise the safety of the subject.
- Subject who, in the investigator's judgment, poses a significant suicide risk. Recent history of suicidal behavior and/or suicidal ideation may be considered as evidence of serious suicide risk.
- The subject has a tattoo or other dermatological condition overlying the gluteus region which may interfere with interpretation of injection site reactions.
- History of ongoing or clinically relevant hepatitis within the previous 6 months, including chronic Hepatitis B virus (HBV) infection (HBsAg positive). Asymptomatic individuals with chronic hepatitis C virus (HCV) infection will not be excluded, however Investigators must carefully assess if therapy specific for HCV infection is required; subjects who are anticipated to require such therapy during the randomized portion of the study must be excluded.
- History of liver cirrhosis with or without hepatitis viral co-infection.
- Ongoing or clinically relevant pancreatitis.
- History of the following cardiac diseases: myocardial infarction, congestive heart failure, documented hypertrophic cardiomyopathy, sustained ventricular tachycardia.
- Personal or known family history of prolonged QT syndrome.
- Any condition which, in the opinion of the Investigator, may interfere with the absorption, distribution, metabolism or excretion of the drug or render the subject unable to receive study medication.
- History or presence of allergy or intolerance to the study drugs or their components or drugs of their class. In addition, if heparin is used during PK sampling, subjects with a history of sensitivity to heparin or heparin-induced thrombocytopenia must not be enrolled.
- Current or anticipated need for chronic anti-coagulation.
- Any evidence of primary resistance based on the presence
Data sourced from ClinicalTrials.gov (NCT02120352). 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.