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Phase 1 Completed N=19 Treatment

Pharmacokinetic Study of Cabotegravir Long-acting in Healthy Adult Volunteers

Infection, Human Immunodeficiency Virus · HIV
Source: ClinicalTrials.gov NCT02478463 ↗
Enrolled (actual)
19
Serious AEs
5.6%
Results posted
Jun 2020
Primary outcomePrimary: Cabotegravir Concentration in Blood Plasma Following IM Administration — 0.0000; 0.2864; 3.2748; 5.1071 Micrograms per milliliter

Summary

Cabotegravir (CAB) long-acting (LA) is a promising candidate for human immunodeficiency virus (HIV) pre exposure prophylaxis (PrEP) due to its potent antiretroviral activity and infrequent dosing requirements. Currently, the CAB concentrations achieved in the anatomical sites associated with sexual HIV transmission following the proposed 600 milligram (mg) intramuscular (IM) PrEP dose are unknown. These data will enhance our understanding of CAB distribution to the anatomical mucosal tissue believed to be relevant to sexual HIV-1 transmission and supplement the data to support future PrEP clinical trial development. The primary objective is to determine the PK concentrations of CAB following LA administration in plasma and in vaginal tissue (VT), cervical tissue (CT), and cervicovaginal fluid (CVF) in healthy women and in rectal tissue (RT) and rectal fluid (RF) in healthy men and women following a single 600 mg IM dose. This will be a Phase 1, open label study in healthy subjects to assess the pharmacokinetics of CAB LA in the plasma and mucosal locations associated with sexual HIV-1 transmission: VT, CT, CVF, RT and RF. The study will consist of a screening period, a 28-day oral lead-in phase at a dose of 30 mg per day followed by a 14-42 day washout period, and a single dose of CAB LA 600 mg as an IM (intragluteal) injection with compartmental pharmacokinetic (PK) sampling for up to 12 weeks. Subjects will return for safety assessments and plasma PK sampling at Week 24 and Week 36 post-injection and undergo a follow-up/withdrawal visit at Week 52 post-injection.

Outcome Measures

OutcomeResultp-value
PRIMARY
Cabotegravir Concentration in Blood Plasma Following IM Administration
0.0000; 0.2864; 3.2748; 5.1071; 5.0433; 2.5583
PRIMARY
Cabotegravir Concentration in Vaginal Tissue Following IM Administration (Female Participants)
0.5286; 0.1809
PRIMARY
Cabotegravir Concentration in Cervical Tissue Following IM Administration (Female Participants)
0.8016; 0.9261; 0.4409; 0.1570; 0.0460
PRIMARY
Cabotegravir Concentration in Cervicovaginal Fluid Following IM Administration (Female Participants)
0.6604; 0.6175; 0.3209; 0.0905; 0.0901
PRIMARY
Cabotegravir Concentration in Rectal Tissue Following IM Administration
0.2824; 0.5146; 0.2620; 0.1037; 0.0348
PRIMARY
Cabotegravir Concentration in Rectal Fluid Following IM Administration
1.3868; 3.2046; 5.2674; 0.3233; 0.7901
SECONDARY
Ratio of Cabotegravir Concentration in Vaginal Tissue to Cabotegravir Concentration in Blood Plasma Following IM Administration (Female Participants)
0.128; 0.199
SECONDARY
Ratio of Cabotegravir Concentration in Cervical Tissue to Cabotegravir Concentration in Blood Plasma Following IM Administration (Female Participants)
0.203; 0.174; 0.139; 0.139; 0.101
SECONDARY
Ratio of Cabotegravir Concentration in Cervicovaginal Fluid to Cabotegravir Concentration in Blood Plasma Following IM Administration (Female Participants)
0.116; 0.124; 0.073; 0.057; 0.082
SECONDARY
Ratio of Cabotegravir Concentration in Cervical Tissue to Cabotegravir Concentration in Cervicovaginal Fluid Following IM Administration (Female Participants)
1.738; 1.405; 1.883; 2.785; 1.195
SECONDARY
Ratio of Cabotegravir Concentration in Vaginal Tissue to Cabotegravir Concentration in Cervicovaginal Fluid Following IM Administration (Female Participants)
1.095; 3.613
SECONDARY
Ratio of Cabotegravir Concentration in Rectal Tissue to Cabotegravir Concentration in Blood Plasma Following IM Administration
0.078; 0.105; 0.104; 0.096; 0.091
SECONDARY
Ratio of Cabotegravir Concentration in Rectal Fluid to Cabotegravir Concentration in Blood Plasma Following IM Administration
0.286; 0.581; 0.460; 0.302; 0.514
SECONDARY
Ratio of Cabotegravir Concentration in Rectal Tissue to Cabotegravir Concentration in Rectal Fluid Following IM Administration
0.271; 0.185; 0.230; 0.366; 0.093
SECONDARY
Maximum Observed Concentration (Cmax) of Cabotegravir in Blood Plasma Following IM Administration
5.04
SECONDARY
Cmax of Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
0.81
SECONDARY
Cmax of Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
0.55
SECONDARY
Cmax of Cabotegravir in Rectal Tissue Following IM Administration
0.50
SECONDARY
Cmax of Cabotegravir in Rectal Fluid Following IM Administration
3.27
SECONDARY
Area Under the Concentration Time Curve From Time Zero to Last Quantifiable Time Point (AUC[0-last]) for Cabotegravir in Blood Plasma Following IM Administration
3992.25
SECONDARY
AUC(0-last) for Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
522.73
SECONDARY
AUC(0-last) of Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
324.33
SECONDARY
AUC(0-last) for Cabotegravir in Rectal Tissue Following IM Administration
347.73
SECONDARY
AUC(0-last) for Cabotegravir in Rectal Fluid Following IM Administration
1841.23
SECONDARY
Area Under the Concentration Time Curve From Time Zero to Infinity (AUC[0-inf]) for Cabotegravir in Blood Plasma Following IM Administration
4172.17
SECONDARY
AUC(0-inf) for Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
695.72
SECONDARY
AUC(0-inf) for Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
399.07
SECONDARY
AUC(0-inf) for Cabotegravir in Rectal Tissue Following IM Administration
291.98
SECONDARY
AUC(0-inf) for Cabotegravir in Rectal Fluid Following IM Administration
850.05
SECONDARY
Area Under the Concentration Time Curve From Time Zero to Week (WK) 4 (AUC[0-WK4]) for Cabotegravir in Blood Plasma Following IM Administration
2141.91
SECONDARY
AUC(0-WK4) for Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
277.48
SECONDARY
AUC(0-WK4) for Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
203.32
SECONDARY
AUC(0-WK4) for Cabotegravir in Rectal Tissue Following IM Administration
206.28
SECONDARY
AUC(0-WK4) for Cabotegravir in Rectal Fluid Following IM Administration
1170.49
SECONDARY
Area Under the Concentration Time Curve From Time Zero to Week 8 (AUC[0-WK8]) for Cabotegravir in Blood Plasma Following IM Administration
3213.62
SECONDARY
AUC(0-WK8) for Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
364.74
SECONDARY
AUC(0-WK8) for Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
281.60
SECONDARY
AUC(0-WK8) for Cabotegravir in Rectal Tissue Following IM Administration
287.35
SECONDARY
AUC(0-WK8) for Cabotegravir in Rectal Fluid Following IM Administration
1575.54
SECONDARY
Area Under the Concentration Time Curve From Time Zero to Week 12 (AUC[0-WK12]) for Cabotegravir in Blood Plasma Following IM Administration
3639.01
SECONDARY
AUC(0-WK12) for Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
349.98
SECONDARY
AUC(0-WK12) for Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
380.92
SECONDARY
AUC(0-WK12) for Cabotegravir in Rectal Tissue Following IM Administration
323.91
SECONDARY
AUC(0-WK12) for Cabotegravir in Rectal Fluid Following IM Administration
1345.13
SECONDARY
Apparent Terminal Phase Half-life (t1/2) of Cabotegravir in Blood Plasma Following IM Administration
459.53
SECONDARY
t1/2 of Cabotegravir in Cervical Tissue Following IM Administration (Female Participants)
363.41
SECONDARY
t1/2 of Cabotegravir in Cervicovaginal Fluid Following IM Administration (Female Participants)
355.83
SECONDARY
t1/2 of Cabotegravir in Rectal Tissue Following IM Administration
567.48
SECONDARY
t1/2 of Cabotegravir in Rectal Fluid Following IM Administration
306.58
SECONDARY
Ratio of AUC(0-last) in Cervical Tissue to AUC(0-last) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.1215
SECONDARY
Ratio of AUC(0-last) in Rectal Tissue to AUC(0-last) in Blood Plasma for Cabotegravir Following IM Administration
0.0849
SECONDARY
Ratio of AUC(0-inf) in Cervical Tissue to AUC(0-inf) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.1943
SECONDARY
Ratio of AUC(0-inf) in Rectal Tissue to AUC(0-inf) in Blood Plasma for Cabotegravir Following IM Administration
0.0766
SECONDARY
Ratio of AUC(0-Wk4) in Cervical Tissue to AUC(0-Wk4) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.1553
SECONDARY
Ratio of AUC(0-Wk 4) in Rectal Tissue to AUC(0-Wk 4) in Blood Plasma for Cabotegravir Following IM Administration
0.1000
SECONDARY
Ratio of AUC(0-WK8) in Cervical Tissue to AUC(0-WK8) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.1492
SECONDARY
Ratio of AUC(0-WK8) in Rectal Tissue to AUC(0-WK8) in Blood Plasma for Cabotegravir Following IM Administration
0.1062
SECONDARY
Ratio of AUC(0-WK12) in Cervical Tissue to AUC(0-WK12) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.1230
SECONDARY
Ratio of AUC(0-WK12) in Rectal Tissue to AUC(0-WK12) in Blood Plasma for Cabotegravir Following IM Administration
0.1089
SECONDARY
Ratio of AUC(0-last) in Cervicovaginal Fluid to AUC(0-last) in Blood Plasma for Cabotegravir Following IM Administration-female Participants
0.0754
SECONDARY
Ratio of AUC(0-last) in Rectal Fluid to AUC(0-last) in Blood Plasma for Cabotegravir Following IM Administration
0.4445
SECONDARY
Ratio of AUC(0-inf) in Cervicovaginal Fluid to AUC(0-inf) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.0857
SECONDARY
Ratio of AUC(0-inf) in Rectal Fluid to AUC(0-inf) in Blood Plasma for Cabotegravir Following IM Administration
0.1949
SECONDARY
Ratio of AUC(0-WK4) in Cervicovaginal Fluid to AUC(0-WK4) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.1032
SECONDARY
Ratio of AUC(0-WK4) in Rectal Fluid to AUC(0-WK4) in Blood Plasma for Cabotegravir Following IM Administration
0.5452
SECONDARY
Ratio of AUC(0-WK8) in Cervicovaginal Fluid to AUC(0-WK8) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.0925
SECONDARY
Ratio of AUC(0-WK8) in Rectal Fluid to AUC(0-WK8) in Blood Plasma for Cabotegravir Following IM Administration
0.4845
SECONDARY
Ratio of AUC(0-WK12) in Cervicovaginal Fluid to AUC(0-WK12) in Blood Plasma for Cabotegravir Following IM Administration (Female Participants)
0.0867
SECONDARY
Ratio of AUC(0-WK12) in Rectal Fluid to AUC(0-WK12) in Blood Plasma for Cabotegravir Following IM Administration
0.3863
SECONDARY
Cabotegravir Concentration in Vaginal Tissue Following Oral Administration (Female Participants)
0.7477
SECONDARY
Cabotegravir Concentration in Cervical Tissue Following Oral Administration (Female Participants)
1.1009
SECONDARY
Cabotegravir Concentration in Cervicovaginal Fluid Following Oral Administration (Female Participants)
0.8959
SECONDARY
Cabotegravir Concentration in Rectal Tissue Following Oral Administration
0.6104
SECONDARY
Cabotegravir Concentration in Rectal Fluid Following Oral Administration
5.5457
SECONDARY
Cabotegravir Concentration in Blood Plasma Following Oral Administration
5.7313
SECONDARY
Number of Participants With Any Non-serious Adverse Event (Non-SAE) and Serious Adverse Events (SAE) Following Oral Administration of Cabotegravir
10; 0
SECONDARY
Number of Participants With Any Non-SAE and SAE Following IM Administration of Cabotegravir
17; 2
SECONDARY
Change From Baseline in Alanine Amino Transferase (ALT), Alkaline Phosphatase (ALP) and Aspartate Amino Transferase (AST) at Indicated Time Points (Oral Dose)
1.7; 3.5; -0.2; -0.4; -0.3; 1.1
SECONDARY
Change From Baseline in ALT, ALP and AST at Indicated Time Points (IM Dose)
-0.2; -0.8; -1.4; 2.1; 0.6; 1.3
SECONDARY
Change From Baseline in Creatine Kinase at Indicated Time Points (Oral Dose)
-19.9; -8.9
SECONDARY
Change From Baseline in Creatine Kinase at Indicated Time Points (IM Dose)
19.6; 22.2
SECONDARY
Change From Baseline in Creatinine, Direct Bilirubin and Total Bilirubin at Indicated Time Points (Oral Dose)
0.491; -0.491; -0.311; 0.428; -1.282; 0.000
SECONDARY
Change From Baseline in Creatinine, Direct Bilirubin and Total Bilirubin at Indicated Time Points (IM Dose)
-3.640; -5.525; -3.315; -0.171; 0.171; 0.190
SECONDARY
Change From Baseline in Albumin and Total Protein at Indicated Time Points (Oral Dose)
-0.6; -0.3; -1.7; -1.4
SECONDARY
Change From Baseline in Albumin and Total Protein at Indicated Time Points (IM Dose)
0.3; 0.3; 0.6; 0.2; -0.1; 0.5
SECONDARY
Change From Baseline in Calcium, Glucose, Potassium, Sodium and Urea Enzymatic Colorimetry at Indicated Time Points (Oral Dose)
-0.027722; -0.033267; 0.391654; 0.672288; -0.05; -0.04
SECONDARY
Change From Baseline in Calcium, Glucose, Potassium, Sodium and UEC at Indicated Time Points (IM Dose)
-0.002935; -0.003327; -0.001559; -0.111020; -0.003469; -0.149183
SECONDARY
Change From Baseline in Basophil Count, Eosinophil Count, Lymphocyte Count and Monocyte Count at Indicated Time Points (Oral Dose)
-0.30; -0.05; 0.000; 0.100; 0.500; 0.400
SECONDARY
Change From Baseline in Basophil Count, Eosinophil Count, Lymphocyte Count and Monocyte Count at Indicated Time Points (IM Dose)
0.03; 0.00; 0.000; 0.000; 0.073; -0.300
SECONDARY
Change From Baseline in Total Neutrophil Count at Indicated Time Points (Oral Dose)
-0.353; -0.565
SECONDARY
Change From Baseline in Total Neutrophil Count at Indicated Time Points (IM Dose)
0.539; 0.010; -0.076
SECONDARY
Change From Baseline in Platelet Count and White Blood Cell (WBC) Count at Indicated Time Points (Oral Dose)
39.0; -6.6; 8.7; 2.100; -0.056; -0.263
SECONDARY
Change From Baseline in Platelet Count and WBC Count at Indicated Time Points (IM Dose)
11.7; 12.0; 7.3; -0.053; -0.085; -0.159
SECONDARY
Change From Baseline in Hemoglobin and Mean Corpuscle Hemoglobin Concentration (MCHC) at Indicated Time Points (Oral Dose)
-6.0; -5.1; -3.6; -8.0; -1.2; 1.3
SECONDARY
Change From Baseline in Hemoglobin and MCHC at Indicated Time Points (IM Dose)
-0.8; 0.8; 1.4; 0.9; -0.8; 1.8
SECONDARY
Change From Baseline in Mean Corpuscle Hemoglobin (MCH) at Indicated Time Points (Oral Dose)
-0.90; -0.22; -0.01
SECONDARY
Change From Baseline in MCH at Indicated Time Points (IM Dose)
-0.15; -0.39; -0.36
SECONDARY
Change From Baseline in Mean Corpuscle Volume (MCV) at Indicated Time Points (Oral Dose)
-0.20; -0.40; -0.34
SECONDARY
Change From Baseline in MCV at Indicated Time Points (IM Dose)
-0.67; -1.03; -1.63
SECONDARY
Change From Baseline in Hematocrit at Indicated Time Points (Oral Dose)
-0.0060; -0.0135; -0.0122
SECONDARY
Change From Baseline in Hematocrit at Indicated Time Points (IM Dose)
-0.0034; 0.0030; 0.0025
SECONDARY
Change From Baseline in Red Blood Cell (RBC) Count at Indicated Time Points (Oral Dose)
-0.050; -0.126; -0.114
SECONDARY
Change From Baseline in RBC Count at Indicated Time Points (IM Dose)
-0.004; 0.087; 0.117
SECONDARY
Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) at Indicated Time Points (Oral Dose)
-1.3; -1.0; -0.9; 0.5
SECONDARY
Change From Baseline in SBP and DBP at Indicated Time Points (IM Dose)
0.1; -1.5; 3.2; 1.8; 0.9; -1.1
SECONDARY
Change From Baseline in Pulse Rate at Indicated Time Points (Oral Dose)
-1.0; 2.4
SECONDARY
Change From Baseline in Pulse Rate at Indicated Time Points (IM Dose)
-0.9; 6.2; 1.6; -0.6; -0.9; 1.3
SECONDARY
Change From Baseline in Body Temperature at Indicated Time Points (Oral Dose)
-0.2; -0.1
SECONDARY
Change From Baseline in Body Temperature at Indicated Time Points (IM Dose)
-0.0; 0.2; 0.0; -0.1; -0.0; 0.2
SECONDARY
Number of Participants With Abnormal Urinalysis Parameters Following Oral Administration of Cabotegravir
SECONDARY
Number of Participants With Abnormal Urinalysis Parameters Following IM Administration of Cabotegravir

Eligibility Criteria

Inclusion Criteria

  • Between 18 and 55 years of age inclusive, at the time of signing the informed consent.
  • Healthy as determined by the investigator or medically qualified designee based on a medical evaluation including medical history, physical examination, laboratory tests and cardiac monitoring.
  • A subject with a clinical abnormality or laboratory parameter(s) which is/are not specifically listed in the inclusion or exclusion criteria, outside the reference range for the population being studied may be included only if the investigator in consultation with the medical monitor agree and document that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures. A single repeat of a procedure or lab parameter is allowed to determine eligibility.
  • Body weight >= 40 kilogram (kg) and body mass index (BMI) within the range 18.5 to 35 kg /meter square (inclusive).
  • Male or female
  • A female subject is eligible to participate if she is pre-menopausal, has an intact uterus and cervix, AND is not pregnant (as confirmed by a negative human chorionic gonadotrophin [hCG] test), not lactating, and at least one of the following conditions applies: a) Non-reproductive potential defined as: Pre-menopausal females with one of the following: Documented tubal ligation, Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion, Documented Bilateral Oophorectomy. b)Reproductive potential and agrees to follow one of the options listed below in the GlaxoSmithKline (GSK) Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) requirements from 30 days prior to the first dose of study medication and until at least five terminal half-lives OR until any continuing pharmacologic effect has ended, whichever is longer (can be up to 66 weeks on study) after the last dose of study medication and completion of the follow-up visit. Female subjects desiring pregnancy or foresee that they might wish to become pregnant within 52 weeks of receiving a CAB LA injection must be excluded. All subjects participating in the study must be counseled on safe sexual practices including the use of effective barrier methods to minimize risk of HIV transmission.
  • Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.

Exclusion Criteria

  • Liver Function: ALT or AST > upper limit of normal (ULN)
  • Total bilirubin >ULN (isolated total bilirubin >ULN is acceptable if total bilirubin is fractionated and direct bilirubin 450 milliseconds (msec):

NOTES: The QTc is the QT interval corrected for heart rate according to Bazette's formula (QTcB), machine-read or manually over-read. QTcB will be used to determine eligibility for an individual subject. Exclusion criteria for screening electrocardiogram (ECG) (a single repeat is allowed for eligibility determination): Heart rate ( 100 beats per minute (bpm) for males and 100 bpm for females; QRS duration: >120 msec; QTc interval: >450 msec for males and females

  • The subject's systolic blood pressure is outside the range of 90-140 millimeter (mm) mercury (Hg), or diastolic blood pressure is outside the range of 45-90 mmHg.
  • History of clinically significant cardiovascular disease including:

Evidence of previous myocardial infarction (pathologic Q waves, S-T segment changes (except early repolarization); History/evidence of symptomatic arrhythmia, angina/ischemia, coronary artery bypass grafting (CABG) surgery or percutaneous transluminal coronary angioplasty (PCTA) or any clinically significant cardiac disease; Any conduction abnormality (including but not specific to left or right complete bundle branch block, AV block (2nd degree [type II] or higher), Wolf Parkinson White [WPW] syndrome); Sinus pauses > 3 seconds.

  • Any significant arrhythmia which, in the opinion of th
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02478463). 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.

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