Phase 2
Completed N=60
Evaluating the Safety and Tolerability of Ruxolitinib in Antiretroviral-Treated HIV-Infected Adults
Source: ClinicalTrials.gov NCT02475655 ↗Enrolled (actual)
60
Serious AEs
3.3%
Results posted
Apr 2019
Primary outcomePrimary: Percentage of Participants on the Ruxolitinib Arm Who Experienced Any Safety Milestone Events While On-Treatment — 2.5 percentage of participants
Summary
The purpose of this study was to evaluate the safety and tolerability of ruxolitinib in HIV-positive adults who were virologically suppressed and who were on antiretroviral therapy (ART).
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants on the Ruxolitinib Arm Who Experienced Any Safety Milestone Events While On-Treatment |
2.5 | — |
| PRIMARY Percentage of Participants Who Experienced Any Safety Milestones On-study From Entry to Week 5 |
2.5; 0 | 0.67 |
| PRIMARY Percentage of Participants Who Experienced Each Safety Milestone That Occurred On-study From Entry to Week 5 |
0; 0; 0; 0; 0; 0 | — |
| PRIMARY Number of Participants With Premature Discontinuation of Study Treatment in the Ruxolitinib Arm |
3 | — |
| PRIMARY Fold Change in the Level of Plasma Interleukin 6 (IL-6) From Baseline to Week 4/5 |
0.93; 1.10 | 0.18 |
| SECONDARY Percentage of Participants on the Ruxolitinib Arm Who Experienced Any Safety Milestone Events During Total Follow-up |
7.5 | — |
| SECONDARY Percentage of Participants Who Experienced Any Safety Milestones On-study From Entry to Week 12 |
7.5; 0 | 0.40 |
| SECONDARY Percentage of Participants Who Experienced Each Safety Milestone That Occurred On-study From Entry to Week 12 |
0; 0; 2.5; 0; 2.5; 0 | — |
| SECONDARY Number of Participants Who Experienced a Protocol-defined Reportable Adverse Event at Any Post-entry Time Point. |
10; 2 | — |
| SECONDARY Creatinine Clearance |
118.5; 134.5; 116.3; 130.2; 117.3; 130.9 | — |
| SECONDARY Change in Creatinine Clearance Values From Entry |
-2.16; -3.47; -1.17; -2.78; -0.71; -7.06 | 0.70 |
| SECONDARY Creatinine |
0.99; 0.92; 1.0; 0.95; 1.01; 0.95 | — |
| SECONDARY Change in Creatinine Values From Entry |
0.01; 0.03; 0.02; 0.03; -0.00; 0.07 | 0.58 |
| SECONDARY Absolute Neutrophil Count (ANC) |
3558; 2730; 3390; 3312; 3307; 3163 | — |
| SECONDARY Change in Absolute Neutrophil Count (ANC) Values From Entry |
-169; 510; -251; 400; 299; 265 | 0.018 sig |
| SECONDARY Hemoglobin |
14.3; 14.3; 14.0; 14.1; 13.6; 14.2 | — |
| SECONDARY Change in Hemoglobin Values From Entry |
-0.28; -0.15; -0.65; -0.10; -0.07; -0.08 | 0.45 |
| SECONDARY Platelet Count |
238508; 261868; 281525; 264492; 270943; 264155 | — |
| SECONDARY Change in Platelet Counts From Entry |
43018; 5264; 32435; 4603; 8815; 3439 | <0.001 sig |
| SECONDARY Aspartate Aminotransferase (AST) (SGOT) |
23.2; 23.1; 28.2; 23.5; 29.1; 21.2 | — |
| SECONDARY Change in Aspartate Aminotransferase (AST) (SGOT) Values From Entry |
5.01; 0.05; 5.89; -2.26; 1.48; -2.47 | 0.05 |
| SECONDARY Alanine Aminotransferase (ALT) (SGPT) |
24.3; 26.9; 28.5; 26.5; 30.6; 22.4 | — |
| SECONDARY Change in Alanine Aminotransferase (ALT) (SGPT) Values From Entry |
4.21; -0.68; 6.25; -4.74; 0.64; -4.00 | 0.020 sig |
| SECONDARY Fold Change in the Level of Plasma Interleukin 6 (IL-6) |
1.16; 1.06; 1.26; 0.92 | 0.56 |
| SECONDARY Fold Change in the Level of Soluble CD14 (sCD14) |
0.96; 1.08; 1.02; 1.08; 1.08; 1.02 | 0.07 |
| SECONDARY Change in CD4+ T Cell Count |
131.2; -10.9; 66.1; -8.19; 3.27; 42.2 | 0.007 sig |
| SECONDARY Number of Participants With Plasma HIV-1 RNA Level Above the Limit of Quantification |
1; 0; 0; 0; 2; 0 | — |
| SECONDARY Relative Risks of HIV-1 RNA by Single Copy Assay (SCA) < 0.4 Copies/mL |
1.20; 1.22; 0.82; 1.11; 0.75; 0.91 | 0.94 |
| SECONDARY Fold Change in the Level of Plasma Tumor Necrosis Factor Alpha (TNF Alpha) |
0.79; 0.90; 0.85; 0.92 | 0.11 |
| SECONDARY Fold Change in the Level of Plasma Interleukin 1 Beta (IL-1 Beta) |
0.96; 0.75; 1.24; 0.78 | 0.30 |
| SECONDARY Fold Change in the Level of Plasma Interleukin 7 (IL-7) |
1.04; 0.81; 1.23; 1.04 | 0.24 |
| SECONDARY Fold Change in the Level of Interleukin 1 Alpha (IL-1 Alpha) |
— | — |
| SECONDARY Fold Change in the Level of Interferon Gamma-induced Protein 10 (IP-10) |
— | — |
| SECONDARY Fold Change in the Level of Macrophage Colony-stimulating Factor |
— | — |
| SECONDARY Fold Change in the Level of Neopterin |
— | — |
| SECONDARY Fold Change in the Level of Plasma Interleukin 10 (IL-10) |
0.94; 0.82; 0.65; 0.67 | 0.56 |
| SECONDARY Fold Change in the Level of Plasma Interleukin 15 (IL-15) |
1.33; 0.99; 1.06; 0.98 | 0.002 sig |
| SECONDARY Fold Change in the Level of Plasma Interleukin 18 (IL-18) |
0.89; 0.95; 1.05; 1.02 | 0.40 |
| SECONDARY Fold Change in the Level of Plasma Transforming Growth Factor Beta 1 (TGF Beta-1) |
0.90; 0.60; 1.91; 0.93 | 0.028 sig |
| SECONDARY Fold Change in the Level of Plasma Transforming Growth Factor Beta 2 (TGF Beta-2) |
0.96; 0.69; 0.90; 0.94 | 0.031 sig |
| SECONDARY Fold Change in the Level of Plasma Transforming Growth Factor Beta 3 (TGF Beta-3) |
0.99; 0.63; 0.67; 0.99 | 0.43 |
| SECONDARY Change in (CD3+CD4+) CD38+HLADR+ |
-0.27; 0.08; 0.17; -0.10 | 0.038 sig |
| SECONDARY Change in (CD3+CD8+) CD38+HLADR+ |
-1.16; -0.28; 0.89; 0.03 | 0.05 |
| SECONDARY Change in (CD3+CD4+) CD25hi+ |
-1.50; 0.22; 0.08; -0.08 | <0.001 sig |
| SECONDARY Change in (CD3+CD8+) CD25+ |
-0.31; -0.31; -0.53; -0.38 | 0.98 |
| SECONDARY Change in (CD3+CD4+) CD127+ |
2.65; -0.84; -1.48; -0.19 | 0.001 sig |
| SECONDARY Change in (CD3+CD8+) CD127+ |
5.42; -1.12; -0.09; 0.11 | <0.001 sig |
| SECONDARY Change in (CD3+CD4+) Ki67+ |
-0.26; -0.19; 0.37; -0.39 | 0.82 |
| SECONDARY Change in (CD3+CD8+) Ki67+ |
-0.64; -0.65; 0.59; 0.04 | 0.98 |
| SECONDARY Change in (CD3+CD4+) Bcl2+ |
-3.77; -0.48; -0.67; 0.06 | <0.001 sig |
| SECONDARY Change in (CD3+CD8+) Bcl2+ |
-5.64; -0.24; -1.29; -0.06 | <0.001 sig |
| SECONDARY Change in (CD3+CD4+) a4b7+ |
-2.16; -0.62; -0.01; 0.38 | 0.26 |
| SECONDARY Change in (CD3+CD8+) a4b7+ |
0.01; -0.54; 0.91; 0.59 | 0.71 |
| SECONDARY Change in (CD3+CD4+) CX3CR1+ |
-1.55; -0.22; -0.21; -0.04 | 0.010 sig |
| SECONDARY Change in (CD3+CD8+) CX3CR1+ |
-4.31; -1.07; -0.39; -0.22 | 0.008 sig |
| SECONDARY Change in CD69 |
— | — |
| SECONDARY Change in PAR-1 |
— | — |
| SECONDARY Change in Classical Monocytes (CD14+CD16-) |
0.95; -0.43; 1.15; -1.06 | 0.47 |
| SECONDARY Change in Classical Monocytes (CD14+CD16-) Expressing CD163+ |
-1.16; 3.18; -5.05; 4.76 | 0.28 |
| SECONDARY Change in Classical Monocytes (CD14+CD16-) Expressing CCR2+ |
-1.24; -0.43; -0.84; 0.86 | 0.55 |
| SECONDARY Change in Classical Monocytes (CD14+CD16-) Expressing CX3CR1+ |
-1.72; -0.25; -0.62; 1.00 | 0.15 |
| SECONDARY Change in Inflammatory Monocytes (CD14+CD16+) |
-1.21; -0.36; -0.49; 0.22 | 0.39 |
| SECONDARY Change in Inflammatory Monocytes (CD14+CD16+) Expressing CD163+ |
-3.88; 2.14; -4.40; 2.00 | 0.10 |
| SECONDARY Change in Inflammatory Monocytes (CD14+CD16+) Expressing CCR2+ |
2.95; 2.67; -1.99; 2.11 | 0.95 |
| SECONDARY Change in Inflammatory Monocytes (CD14+CD16+) Expressing CX3CR1+ |
-4.38; -5.61; 0.58; -3.18 | 0.74 |
| SECONDARY Change in Patrolling Monocytes (CD14dimCD16+) |
0.20; 0.83; -0.70; 0.87 | 0.66 |
| SECONDARY Change in Patrolling Monocytes (CD14dimCD16+) Expressing CD163+ |
-4.05; 3.05; -1.09; 0.41 | 0.013 sig |
| SECONDARY Change in Patrolling Monocytes (CD14dimCD16+) Expressing CCR2+ |
0.02; 0.01; 0.04; 0.04 | 0.79 |
| SECONDARY Change in Patrolling Monocytes (CD14dimCD16+) Expressing CX3CR1+ |
-5.48; -2.64; -2.39; -2.42 | 0.43 |
| SECONDARY Fold Change in Cellular HIV-1 DNA |
1.16; 0.62; 1.18; 0.90 | 0.007 sig |
| SECONDARY Fold Change in Cellular HIV-1 Total RNA |
1.06; 0.87; 0.97; 0.95 | 0.32 |
| SECONDARY Percentage of Participants With Detectable CMV Shedding |
13; 5; 13; 10; 13; 11 | 0.40 |
| SECONDARY Ruxolitinib Systemic Clearance (CL/F) From 2-compartment Pharmacokinetic (PK) |
14.5 | — |
Eligibility Criteria
Inclusion Criteria
- HIV-1 infection
- CD4+ T cell count greater than 350 cells/mm^3 within 45 days prior to study entry
- Documented virologic suppression defined as HIV-1 RNA level below the limit of quantification (eg, less than 40, less than 50, or less than 75 copies/mL, depending on the assay) using an FDA-approved assay with a quantification limit of 75 copies/mL or lower for at least 48 weeks prior to study entry
- Screening HIV-1 RNA level below the limit of quantification
- Tuberculosis (TB) screening within 365 days of the screening visit diagnosed by tuberculin skin test or interferon gamma release assay
- Currently on continuous ART for at least 730 days prior to study entry, defined as continuous ART for the 730 days period, inclusive, prior to study entry with no ART interruption longer than 7 consecutive days. NOTE: The current regimen must include TDF/FTC, TAF/FTC, TDF+3TC, or ABC/3TC; plus a nonnucleoside reverse transcriptase inhibitor or integrase strand transfer inhibitor (NNRTI or INSTI, not containing cobicistat) for at least 60 days, inclusive, prior to study entry.
- The following laboratory values obtained within 45 days prior to entry:
- Absolute neutrophil count (ANC) greater than or equal to 1,000/mm^3
- Hemoglobin greater than 12.0 g/dL for men and greater than 11.0 g/dL for women
- Platelets greater than or equal to 140,000/mm^3
- Calculated creatinine clearance (CrCl) greater than or equal to 70 mL/min (by Cockcroft Gault equation)
- Aspartate aminotransferase (AST) (SGOT) less than or equal to 1.5x upper limit of normal (ULN)
- Alanine aminotransferase (ALT) (SGPT) less than or equal to 1.5x ULN
- Alkaline phosphatase less than or equal to 1.5x ULN
- For females of reproductive potential, a negative serum or urine pregnancy test with a sensitivity of 25 mIU/mL within 72 hours, inclusive, prior to study entry
- All participants must agree not to participate in a conception process (e.g., active attempt to become pregnant or to impregnate, sperm donation, in vitro fertilization)
- All participants of reproductive potential, who were participating in sexual activity that could lead to pregnancy, must agree to use at least one reliable method of contraception while receiving the study drugs and for 7 weeks after stopping the medications
- Ability and willingness of participant or legal representative to provide written informed consent and attend study visits as scheduled at a participating site
Exclusion Criteria
- A current or past history of progressive multifocal leukoencephalopathy
- Breastfeeding or pregnancy
- Use of strong inhibitors or inducers of CYP3A4 including a protease inhibitor, cobicistat or entry inhibitors as part of the current ART regimen or other concomitant therapy
- Known allergy/sensitivity or any hypersensitivity to components of study drug or their formulation
- Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements
- Acute or serious illness or infection requiring systemic treatment and/or hospitalization within 60 days prior to entry
- Vaccinations (other than influenza) less than or equal to 45 days prior to the study entry visit.
- Use of immunomodulators (e.g., interleukins, interferons, cyclosporine), systemic cytotoxic chemotherapy or investigational therapy less than or equal to 60 days prior to study entry
- Any current diagnosis or past history of a significant cardiovascular, respiratory, hepatic, gastrointestinal, endocrine, hematological, neurological, neuropsychiatric, psychiatric, or other serious illness that, in the opinion of the investigator, could constitute a risk when taking investigational product or could interfere with the interpretation of data or affect the participant's ability to participate in the study. Diagnoses that would lead to exclusion include, but were not limited to the following:
- CDC category C AIDS-indicator conditions
- NOTE A: Except HI
Data sourced from ClinicalTrials.gov (NCT02475655). 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.