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Phase 2 Completed N=97 Treatment

Phase 2b, Open-label, Multicenter, Rollover Study to Assess Antiviral Activity and Safety of Long-acting (LA) Cabotegravir (CAB) Plus LA Rilpivirine (RPV), Administered Every 2 Months (Q2M), in Human Immunodeficiency Virus (HIV)-Positive Participants From the LATTE Study

Source: ClinicalTrials.gov NCT03639311 ↗
Enrolled (actual)
97
Serious AEs
9.7%
Results posted
Jan 2021
Primary outcomePrimary: Percentage of Participants With HIV-ribonucleic Acid (RNA) >=50 Copies Per Milliliter (c/mL) as Per Food and Drug Administration (FDA) Snapshot Algorithm at Month 12 [Maintenance Phase] — 0; 0 Percentage of participants

Summary

This study (POLAR), is designed to assess the antiviral activity and safety of CAB LA plus RPV LA, administered Q2M, in approximately 100 adult HIV-1 infected, antiretroviral therapy (ART) experienced participants. Participants will rollover from the NCT01641809 (LATTE) study, who have completed minimum duration of Week 312 and with demonstrated HIV-1 ribonucleic acid (RNA) suppression (less than [<]50 copies (c) per milliliter [mL]), while receiving a two-drug regimen consisting of once-daily oral CAB at 30 milligram (mg) plus RPV at 25 mg. The participants will be offered the option to switch to the LA, intramuscular injections of CAB LA plus RPV LA, Q2M or the oral fixed dose combination (FDC) of dolutegravir (DTG) plus RPV, for the continued maintenance of HIV-1 RNA suppression, known as the Maintenance Phase (From Day 1 to Commercial Approval). Duration of study will vary from country to country, until regimen receives regulatory approval and becomes commercially available. The study plans to enroll approximately 100 participants. Any participant who receives at least one dose of CAB LA and/or RPV LA and discontinues the CAB LA plus RPV LA regimen for any reason will enter a 52-week Long-Term Follow-Up (LTFU) phase. Those participants must remain on suppressive highly active antiretroviral therapy (HAART) for at least 52 weeks after the last dose of CAB LA and or RPV LA.

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants With HIV-ribonucleic Acid (RNA) >=50 Copies Per Milliliter (c/mL) as Per Food and Drug Administration (FDA) Snapshot Algorithm at Month 12 [Maintenance Phase]
0; 0
SECONDARY
Percentage of Participants With HIV-RNA <50 c/mL as Per FDA Snapshot Algorithm at Month 12 [Maintenance Phase]
98; 100
SECONDARY
Number of Participants With Protocol-defined Confirmed Virologic Failure up to End of Maintenance Phase
1; 0
SECONDARY
Percentage of Participants With HIV-RNA >=50 c/mL as Per FDA Snapshot Algorithm Over Time for CAB LA + RPV LA Q2M Arm up to Month 12 [Maintenance Phase]
0; 0; 1; 0; 0; 0
SECONDARY
Percentage of Participants With HIV-RNA >=50 c/mL as Per FDA Snapshot Algorithm Over Time for DTG + RPV up to Month 12 [Maintenance Phase]
0.0; 0.0; 0.0; 0.0; 0.0
SECONDARY
Absolute Values for HIV-1 RNA of CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
1.591; 1.590; 1.594; 1.590; 1.590; 1.594
SECONDARY
Absolute Values for HIV-1 RNA of DTG + RPV Arm up to Month 12 [Maintenance Phase]
1.590; 1.590; 1.590; 1.590; 1.590
SECONDARY
Change From Baseline in HIV-1 RNA for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-0.001; 0.003; -0.000; -0.001; 0.003; -0.001
SECONDARY
Change From Baseline in HIV-1 RNA for DTG + RPV Arm up to Month 12 [Maintenance Phase]
0.000; 0.000; 0.000; 0.000
SECONDARY
Absolute Values for Cluster of Differentiation 4 Plus (CD4+) for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
873.0; 868.1; 879.8; 1046.8; 857; 859.2
SECONDARY
Absolute Values for CD4+ for DTG + RPV Arm up to Month 12 [Maintenance Phase]
804.3; 780.3; 728.9; 777.0; 790.4
SECONDARY
Change From Baseline Values for CD4+ for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-4.9; 5.3; 100.2; -20.7; -19.4; 45.6
SECONDARY
Change From Baseline Values for CD4+ for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-24.0; -75.4; -27.3; -13.9
SECONDARY
Number of Participants With Non-serious Adverse Events (Non-SAEs >=5 Percent [%] Incidence) and Serious Adverse Events (SAEs) for CAB LA + RPV LA Q2M Arm
86; 10
SECONDARY
Number of Participants With Non-serious Adverse Events (Non-SAEs >=5 Percent [%] Incidence) and Serious Adverse Events (SAEs) for DTG + RPV Arm
3; 0
SECONDARY
Number of Participants With Severity of Adverse Events for CAB LA + RPV LA Q2M Arm
22; 53; 10; 4; 0
SECONDARY
Number of Participants With Severity of Adverse Events for DTG + RPV Arm
0; 3; 0; 0; 0
SECONDARY
Number of Participants With Maximum Post-Baseline Chemistry Toxicities for CAB LA + RPV LA Q2M Arm up to End of Maintenance Phase
15; 3; 3; 0; 12; 6
SECONDARY
Number of Participants With Maximum Post-Baseline Chemistry Toxicities for DTG + RPV Arm up to Month 12 [Maintenance Phase]
1; 0; 0; 0; 0; 0
SECONDARY
Number of Participants With Maximum Post-Baseline Hematology Toxicities for CAB LA + RPV LA Q2M Arm up to End of Maintenance Phase
2; 0; 0; 0
SECONDARY
Number of Participants With Maximum Post-Baseline Hematology Toxicities for DTG + RPV Arm up to Month 12 [Maintenance Phase]
0; 0; 0; 0
SECONDARY
Number of Participants Who Permanently Discontinued Treatment Due to Adverse Events for CAB LA + RPV LA Q2M Arm up to End of Maintenance Phase
1
SECONDARY
Number of Participants Who Permanently Discontinued Treatment Due to Adverse Events for DTG + RPV Arm up to Month 12 [Maintenance Phase]
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Aspartate Aminotransferase (AST) and Creatinine Kinase for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-1.1; -1.0; 0.0; 4.0; -7.5; -2.5
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: ALT, ALP, AST and Creatinine Kinase for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-0.7; -4.3; 1.7; -0.3; 1.4; 1.6
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Albumin for CAB LA + RPV LA Q2M Arm up to LTFU Phase
-0.8; -0.9; -0.8; -0.9; 2.0; -0.7
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Albumin for DTG+ RPV Arm up to Month 12 [Maintenance Phase]
-1.6; -1.4; -1.3; -2.6
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Bilirubin, Creatinine for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-1.0; -1.0; -1.0; -0.5; 2.0; -1.0
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Bilirubin, Creatinine for DTG+ RPV Arm up to Month 12 [Maintenance Phase]
-1.7; -1.4; -0.9; -1.4; 11.89; 8.36
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Carbon Dioxide, Chloride, Glucose, Phosphate, Potassium, Sodium and Urea for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-0.4; -0.1; -0.2; -0.7; 2.0; 0.3
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Carbon Dioxide, Chloride, Glucose, Phosphate, Potassium, Sodium and Urea for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-1.0; -1.7; -1.9; -1.9; 1.0; 1.7
SECONDARY
Change From Baseline in Clinical Chemistry Parameters: Cholesterol, High Density Lipoprotein, Cholesterol Direct, Low Density Lipoprotein Cholesterol Calculation, and Cholesterol Direct, Triglycerides for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
0.12; 0.13; 0.48; 0.00; 0.07; -0.87
SECONDARY
Absolute Values of Clinical Chemistry Parameters: Cholesterol, Direct HDL Cholesterol, LDL Calculation, Direct LDL Cholesterol and Triglycerides for DTG + RPV Arm at Baseline
4.88; 1.59; 2.29; 4.45; 1.52
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: GFR From Creatinine Adjusted Using CKD-EPI for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
1.9; 1.7; 1.4; 0.8; 0.4; -1.7
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: GFR From Creatinine Adjusted Using CKD-EPI for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-11.7; -7.4; -16.6; -7.3
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: GFR From Creatinine Adjusted BSA for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
0.03; 0.02; 0.01; 0.00; -0.02; 0.00
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: GFR From Creatinine Adjusted BSA for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-0.19; -0.12; -0.27; -0.12
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Lipase for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-0.1; 3.7; 24.5; -1.3; -2.9; -6.4
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Lipase for DTG + RPV Arm up to Month 12 [Maintenance Phase]
2.6; 4.4; 1.3; 26.0
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Total Cholesterol/ HDL Cholesterol Ratio for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
0.20; 0.05; 0.55; 0.11; -1.01; -0.48
SECONDARY
Change From Baseline in Clinical Chemistry Parameter: Total Cholesterol/ HDL Cholesterol Ratio for DTG + RPV Arm at Month 6 [Maintenance Phase]
0.55
SECONDARY
Change From Baseline in Hematology Parameters: Basophils, Eosinophils, Leukocytes, Lymphocytes, Monocytes, Neutrophils and Platelets for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-0.000; 0.009; 0.003; -0.003; 0.003; 0.003
SECONDARY
Change From Baseline in Hematology Parameters: Basophils, Eosinophils, Leukocytes, Lymphocytes, Monocytes, Neutrophils and Platelets for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-0.008; -0.010; -0.005; -0.010; -0.072; -0.057
SECONDARY
Change From Baseline in Hematology Parameter: Erythrocyte Mean Corpuscular Volume for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-1.07; -2.04; -1.42; -1.28; -2.91; -1.93
SECONDARY
Change From Baseline in Hematology Parameter: Erythrocyte Mean Corpuscular Volume for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-1.00; 0.14; 0.29; -0.14
SECONDARY
Change From Baseline in Hematology Parameter: Erythrocytes for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-0.064; -0.021; -0.085; -0.063; -0.034; -0.020
SECONDARY
Change From Baseline in Hematology Parameter: Erythrocytes for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-0.114; -0.171; -0.171; -0.143
SECONDARY
Change From Baseline in Hematology Parameter: Hematocrit for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-0.011; -0.012; -0.015; -0.011; -0.017; -0.011
SECONDARY
Change From Baseline in Hematology Parameter: Hematocrit for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-0.015; -0.013; -0.013; -0.013
SECONDARY
Change From Baseline in Hematology Parameter: Hemoglobin for CAB LA + RPV LA Q2M Arm up to End of LTFU Phase
-2.11; -1.57; -3.29; -3.19; -3.44; -2.30
SECONDARY
Change From Baseline in Hematology Parameter: Hemoglobin for DTG + RPV Arm up to Month 12 [Maintenance Phase]
-3.57; -4.29; -4.86; -4.57
SECONDARY
Urine Albumin/Creatinine Ratio and Urine Protein/Creatinine Ratio
0.7; 0.4; 7.6; 9.1
SECONDARY
Absolute Values of Urine Creatinine
14875.6; 12112.9
SECONDARY
Absolute Values of Urine Phosphate
18.2; 14.7
SECONDARY
Absolute Values of Urine Specific Gravity
1.0; 1.0
SECONDARY
Absolute Values of Urine Potential of Hydrogen (pH)
6.1; 6.5
SECONDARY
Number of Participants With Treatment Emergent Genotypic Resistance
SECONDARY
Number of Participants With Treatment Emergent Phenotypic Resistance
SECONDARY
Change From Baseline in HIV Dependent Quality of Life (HIVDQoL - Self-completion Questionnaire Designed to Measure QoL in People Living With HIV)
0.1; 0.4; 0.0; -0.1; 0.0; 0.3
SECONDARY
Change From Baseline in Total Treatment Satisfaction Score of HIV Treatment Satisfaction Status Questionnaire (HIVTSQs)
-0.19; 0.71; -0.42; 0.14
SECONDARY
Change From Baseline in Individual Item Score of HIVTSQs
-0.1; 0.0; -0.1; -0.1; -0.1; -0.3
SECONDARY
Change in Treatment Satisfaction Over Time Using the HIV Treatment Satisfaction Change Questionnaire (HIVTSQc)
28.0; 27.7

Eligibility Criteria

Inclusion Criteria

  • Aged 18 years or older (or >=19 where required by local regulatory agencies), at the time of signing the informed consent.
  • A female participant is eligible to participate if she is not pregnant (as confirmed by a negative urine human chorionic gonadotrophin [hCG] test at Day 1), not lactating, and at least with one of following conditions:

(a) Non-reproductive potential defined as: (i) Pre-menopausal females with one of the conditions as documented tubal ligation; Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion, Hysterectomy, Documented Bilateral Oophorectomy.

(ii) Postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) and estradiol levels consistent with menopause (refer to laboratory reference ranges for confirmatory levels)]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrolment.

(b) Reproductive potential and agrees to follow one of the options listed in the Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) from 30 days prior to the first dose of study medication, throughout the study, for at least 30 days after discontinuation of all oral study medications, and for at least 52 weeks after discontinuation of CAB LA and RPV LA.

  • The investigator is responsible for ensuring that participants understand how to properly use the methods of contraception.
  • Capable of giving signed informed consent.
  • Must have been on oral CAB 30 mg plus RPV 25 mg regimen through at minimum Week 300 of the LATTE study as per LATTE protocol dosing requirements and until Day 1 of the POLAR study. Any disruptions in dosing during LATTE must be discussed with the Medical Monitor for a final determination of eligibility.
  • Plasma HIV-1 RNA = 50 c/mL at Week 300 in LATTE, a single repeat to determine eligibility may be allowed ONLY after consultation with the medical monitor.

Exclusion Criteria

  • During the last 6 months of participation in LATTE, consecutive (2 or more sequential) plasma HIV-1 RNA measurements >=50 c/mL.
  • During the last 6 months of participation in LATTE, any HIV-1 RNA measurement >=200 c/mL.
  • Any evidence of a current Center for Disease Control and Prevention (CDC) Stage 3 disease [CDC, 2014], except cutaneous Kaposi's sarcoma not requiring systemic therapy.
  • Participants with moderate to severe hepatic impairment determined by Child-Pugh classification.
  • Any pre-existing physical or mental condition (including substance use disorder) which, in the opinion of the Investigator, may interfere with the participant's ability to comply with the dosing schedule and/or protocol evaluations or which may compromise the safety of the participant.
  • Participants determined by the Investigator to have a high risk of seizures, including participants with an unstable or poorly controlled seizure disorder. A participant with a prior history of seizure may be considered for enrolment if the Investigator believes the risk of seizure recurrence is low.
  • Participants who, in the investigator's judgment, pose a significant suicide risk. Participant's recent history of suicidal behavior and/or suicidal ideation should be considered when evaluating for suicide risk.
  • Participants has a tattoo or other dermatological condition overlying the gluteus region which may interfere with interpretation of injection site reactions.
  • Evidence of Hepatitis B virus (HBV) infection based on the results of testing for Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody (anti-HBc), Hepatitis B surface antibody (anti-HBs) and HBV DNA as follows
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03639311). 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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