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A Long Term Safety Study Of Lersivirine For The Treatment Of HIV-1 Infection In Subjects Who Have Completed Treatment With Lersivirine In Studies A5271015 And A5271022

A Long Term Open-Label Extension Study Of Lersivirine For The Treatment Of HIV-1 Infection

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01254656
Enrollment
108
Registered
2010-12-06
Start date
2011-02-28
Completion date
2013-04-30
Last updated
2014-06-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

HIV-1

Brief summary

This is a study to assess long-term safety and efficacy of lersivirine in patients who have completed 96 weeks of treatment with lersivirine in studies A5271015 and A5271022.

Detailed description

The trial was terminated prematurely on January 29, 2013, due to the decision of the sponsor to discontinue development of lersivirine. The decision to terminate the trial was not based on any safety or efficacy concerns.

Interventions

Lersivirine 500 mg tablets PO taken once daily + tenofovir DF 300 mg/emtricitabine 200 mg tablets PO once daily

DRUGefavirenz

Efavirenz 600 mg tablets PO taken once daily + tenofovir DF 300 mg/emtricitabine 200 mg tablets PO once daily

DRUGetravirine

Etravirine 200 mg PO tablets + darunavir 600 mg tablets/ritonavir 100 mg tablets or capsules taken twice daily + 1 optimized NRTI

Sponsors

ViiV Healthcare
CollaboratorINDUSTRY
Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Patients must complete of 96 weeks of treatment with lersivirine (or comparator where required by local regulation) in one of the parent protocols (A5271015 or A5271022). * Patients must have had a viral load less than 50 copies/mL at Week 84 of the parent protocol. * For women who can have children, a negative urine pregnancy test at the Day 1 visit.

Exclusion criteria

* Patients with any Grade 4 Division of AIDS toxicity (except for lipids and asymptomatic glucose elevations will not be included in this trial. * Patients being treated with another investigational product or in another clinical trial, except the lersivirine parent protocols will not be included in this trial.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Plasma Human Immunodeficiency Virus - 1 (HIV-1) Ribonucleic Acid (RNA) Level <50 Copies/mL at 144 Weeks From Day 1 of the Parent Protocol144 Weeks from Day 1 of the parent protocolNumber of participants with HIV-1 RNA level \<50 copies/mL plasma was summarized at 48 weeks i.e. 144 weeks from Day 1 of the parent protocol. Roche Amplicor HIV-1 Monitor assay was used to measure the HIV-1 RNA level.

Secondary

MeasureTime frameDescription
Change From Baseline in CD4+ Lymphocyte Counts (Absolute) at 144 Weeks From Day 1 of the Parent Protocol144 Weeks from Day 1 of the parent protocolParticipant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 48 weeks (ie, 144 weeks from Day 1 of the parent protocol)
Change From Baseline in CD4+ Lymphocyte Counts (Percentage) at 144 Weeks From Day 1 of the Parent Protocol144 Weeks from Day 1 of the parent protocolParticipant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 48 weeks (ie, 144 weeks from Day 1 of the parent protocol)
Number of Participants With Plasma HIV-1 RNA Level <50 Copies/mL up to Week 208Up to Week 208Number of participants with HIV-1 RNA level \<50 copies/mL plasma was summarized at last visit. Abbott RealTime HIV-1 assay was used to measure the HIV-1 RNA level.
Change From Baseline in CD4+ Lymphocyte Counts (Percentage) at 192 Weeks From Day 1 of the Parent Protocol192 Weeks from Day 1 of the parent protocolParticipant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 192 weeks from Day 1 of the parent protocol.
Virology Analysis Participant Accountability From Week 96 Through Study TerminationWeek 96 through study terminationVirology analysis included virus susceptibility (phenotype and genotype)to a standard panel of approved antiretrovirals as determined by the Monogram Biosciences PhenoSense GT assay. Below analysis table included the following parameters: 1. protocol-defined treatment failure was defined as an increase in HIV-1 RNA to detectable levels (≥50 copies/mL) on 2 consecutive measurements, the second measurement taken no more than 14 days after the first measurement); 2. Treatment failure: treatment failure (both virologic and non-virologic) was defined as a subject who met the protocol-defined treatment failure criterion or discontinued from the study; 3. NRTI or NNRTI resistance mutations: nucleoside reverse transcriptase inhibitor or lersivirine-associated resistance-associated mutations (RAM) based on the International AIDS Society-USA (IAS-USA) RAM guidelines; 4. 'with result' meant an analyzed sample returned genotypic result or phenotypic result or both.
Change From Baseline in CD4+ Lymphocyte Counts (Absolute) at 192 Weeks From Day 1 of the Parent Protocol192 Weeks from Day 1 of the parent protocolParticipant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 192 weeks from Day 1 of the parent protocol.

Countries

Australia, Brazil, Canada, Italy, Mexico, Poland, South Africa, Switzerland, United Kingdom

Participant flow

Recruitment details

Participants who had completed 96 weeks of treatment with lersivirine in the A5271015 parent study were enrolled in this extension study. One participant from a second parent study (A5271022) was initially enrolled in Study A5271037, but later discontinued from A5271037.

Pre-assignment details

Participants were required to have plasma HIV-1 ribonucleic acid (RNA) \<50 copies/mL at Week 84 of the parent protocol. Of 108 participants screened in the parent protocol A5271015, 47, 43, and 18 participants from the lersivirine 500 mg, lersivirine 750 mg, and efavirenz 600 mg groups, respectively, were enrolled in Study A5271037.

Participants by arm

ArmCount
Lersivirine (LRV) 500 mg
Participants received LRV 500 mg orally once daily (QD). In addition participants received treatment with tenofovir disoproxil fumarate (TDF) 300 mg/emtricitabine (FTC) 200 mg orally QD
47
LRV 750 mg
Participants received LRV 750 mg orally QD. In addition participants received treatment with tenofovir disoproxil fumarate (TDF) 300 mg/emtricitabine (FTC) 200 mg orally QD
43
Efavirenz (EFV) 600 mg
Participants received EFV 600 mg orally QD. In addition participants received treatment with tenofovir disoproxil fumarate (TDF) 300 mg/emtricitabine (FTC) 200 mg orally QD
18
Total108

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event110
Overall StudyDeath010
Overall StudyDiscontinued due to termination of study403913
Overall StudyLack of Efficacy300
Overall StudyLost to Follow-up102
Overall StudyPregnancy002
Overall StudyWithdrawal by Subject221

Baseline characteristics

CharacteristicLRV 750 mgEfavirenz (EFV) 600 mgLersivirine (LRV) 500 mgTotal
Age, Continuous35.8 Years
STANDARD_DEVIATION 8.7
38.5 Years
STANDARD_DEVIATION 7.8
36.6 Years
STANDARD_DEVIATION 8.4
36.6 Years
STANDARD_DEVIATION 8.4
Age, Customized
18 - 44 Years
37 Participants14 Participants41 Participants92 Participants
Age, Customized
< 18 Years
0 Participants0 Participants0 Participants0 Participants
Age, Customized
45 - 64 Years
6 Participants4 Participants6 Participants16 Participants
Age, Customized
>= 65 Years
0 Participants0 Participants0 Participants0 Participants
Sex: Female, Male
Female
11 Participants8 Participants10 Participants29 Participants
Sex: Female, Male
Male
32 Participants10 Participants37 Participants79 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
30 / 4735 / 4315 / 18
serious
Total, serious adverse events
6 / 475 / 430 / 18

Outcome results

Primary

Number of Participants With Plasma Human Immunodeficiency Virus - 1 (HIV-1) Ribonucleic Acid (RNA) Level <50 Copies/mL at 144 Weeks From Day 1 of the Parent Protocol

Number of participants with HIV-1 RNA level \<50 copies/mL plasma was summarized at 48 weeks i.e. 144 weeks from Day 1 of the parent protocol. Roche Amplicor HIV-1 Monitor assay was used to measure the HIV-1 RNA level.

Time frame: 144 Weeks from Day 1 of the parent protocol

Population: All participants enrolled in this protocol constituted the analysis population associated with each of the parent protocols and all available data were used for efficacy analyses.

ArmMeasureValue (NUMBER)
Lersivirine (LRV) 500 mgNumber of Participants With Plasma Human Immunodeficiency Virus - 1 (HIV-1) Ribonucleic Acid (RNA) Level <50 Copies/mL at 144 Weeks From Day 1 of the Parent Protocol40 Participants
LRV 750 mgNumber of Participants With Plasma Human Immunodeficiency Virus - 1 (HIV-1) Ribonucleic Acid (RNA) Level <50 Copies/mL at 144 Weeks From Day 1 of the Parent Protocol40 Participants
Efavirenz (EFV) 600 mgNumber of Participants With Plasma Human Immunodeficiency Virus - 1 (HIV-1) Ribonucleic Acid (RNA) Level <50 Copies/mL at 144 Weeks From Day 1 of the Parent Protocol16 Participants
Secondary

Change From Baseline in CD4+ Lymphocyte Counts (Absolute) at 144 Weeks From Day 1 of the Parent Protocol

Participant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 48 weeks (ie, 144 weeks from Day 1 of the parent protocol)

Time frame: 144 Weeks from Day 1 of the parent protocol

Population: All participants enrolled in this protocol constituted the analysis population associated with each of the parent protocols and all available data were used for efficacy analyses. Last observation carried forward (LOCF) was used to impute missing values.

ArmMeasureValue (MEAN)Dispersion
Lersivirine (LRV) 500 mgChange From Baseline in CD4+ Lymphocyte Counts (Absolute) at 144 Weeks From Day 1 of the Parent Protocol293 cells/uLStandard Deviation 206
LRV 750 mgChange From Baseline in CD4+ Lymphocyte Counts (Absolute) at 144 Weeks From Day 1 of the Parent Protocol302 cells/uLStandard Deviation 163
Efavirenz (EFV) 600 mgChange From Baseline in CD4+ Lymphocyte Counts (Absolute) at 144 Weeks From Day 1 of the Parent Protocol303 cells/uLStandard Deviation 163
Secondary

Change From Baseline in CD4+ Lymphocyte Counts (Absolute) at 192 Weeks From Day 1 of the Parent Protocol

Participant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 192 weeks from Day 1 of the parent protocol.

Time frame: 192 Weeks from Day 1 of the parent protocol

Population: Analyses included all enrolled participants. Week 192 data are presented, as Week 208 had few participants. For participants who discontinued prematurely, LOCF was used to impute values for post discontinuation visits. Participants who discontinued due to termination of the program were not included in the analysis for the post termination visits.

ArmMeasureValue (MEAN)Dispersion
Lersivirine (LRV) 500 mgChange From Baseline in CD4+ Lymphocyte Counts (Absolute) at 192 Weeks From Day 1 of the Parent Protocol308 cells/uLStandard Deviation 191
LRV 750 mgChange From Baseline in CD4+ Lymphocyte Counts (Absolute) at 192 Weeks From Day 1 of the Parent Protocol304 cells/uLStandard Deviation 159
Efavirenz (EFV) 600 mgChange From Baseline in CD4+ Lymphocyte Counts (Absolute) at 192 Weeks From Day 1 of the Parent Protocol300 cells/uLStandard Deviation 220
Secondary

Change From Baseline in CD4+ Lymphocyte Counts (Percentage) at 144 Weeks From Day 1 of the Parent Protocol

Participant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 48 weeks (ie, 144 weeks from Day 1 of the parent protocol)

Time frame: 144 Weeks from Day 1 of the parent protocol

Population: All participants enrolled in this protocol constituted the analysis population associated with each of the parent protocols and all available data were used for efficacy analyses. LOCF was used to impute missing values.

ArmMeasureValue (MEAN)Dispersion
Lersivirine (LRV) 500 mgChange From Baseline in CD4+ Lymphocyte Counts (Percentage) at 144 Weeks From Day 1 of the Parent Protocol13 PercentageStandard Deviation 6
LRV 750 mgChange From Baseline in CD4+ Lymphocyte Counts (Percentage) at 144 Weeks From Day 1 of the Parent Protocol13 PercentageStandard Deviation 5
Efavirenz (EFV) 600 mgChange From Baseline in CD4+ Lymphocyte Counts (Percentage) at 144 Weeks From Day 1 of the Parent Protocol13 PercentageStandard Deviation 6
Secondary

Change From Baseline in CD4+ Lymphocyte Counts (Percentage) at 192 Weeks From Day 1 of the Parent Protocol

Participant's immunological status assessed by CD4+ lymphocyte count (absolute and percentage) at 192 weeks from Day 1 of the parent protocol.

Time frame: 192 Weeks from Day 1 of the parent protocol

Population: Analyses included all enrolled participants. Week 192 data are presented as Week 208 had few participants. For participants who discontinued prematurely, LOCF was used to impute values for post discontinuation visits. Participants who discontinued due to termination of the program were not included in the analysis for the post termination visits.

ArmMeasureValue (MEAN)Dispersion
Lersivirine (LRV) 500 mgChange From Baseline in CD4+ Lymphocyte Counts (Percentage) at 192 Weeks From Day 1 of the Parent Protocol13 PercentageStandard Deviation 6
LRV 750 mgChange From Baseline in CD4+ Lymphocyte Counts (Percentage) at 192 Weeks From Day 1 of the Parent Protocol15 PercentageStandard Deviation 6
Efavirenz (EFV) 600 mgChange From Baseline in CD4+ Lymphocyte Counts (Percentage) at 192 Weeks From Day 1 of the Parent Protocol12 PercentageStandard Deviation 6
Secondary

Number of Participants With Plasma HIV-1 RNA Level <50 Copies/mL up to Week 208

Number of participants with HIV-1 RNA level \<50 copies/mL plasma was summarized at last visit. Abbott RealTime HIV-1 assay was used to measure the HIV-1 RNA level.

Time frame: Up to Week 208

Population: Analyses included all enrolled participants. Last visit used the last available visit of each participant. Discontinued from study, lost to follow-up, or missing HIV-1 RNA level data at last visit were considered to have HIV-1 RNA levels \>=50 copies/mL. Participants discontinued due to program termination were not considered as discontinuations.

ArmMeasureValue (NUMBER)
Lersivirine (LRV) 500 mgNumber of Participants With Plasma HIV-1 RNA Level <50 Copies/mL up to Week 20839 Participants
LRV 750 mgNumber of Participants With Plasma HIV-1 RNA Level <50 Copies/mL up to Week 20838 Participants
Efavirenz (EFV) 600 mgNumber of Participants With Plasma HIV-1 RNA Level <50 Copies/mL up to Week 20813 Participants
Secondary

Virology Analysis Participant Accountability From Week 96 Through Study Termination

Virology analysis included virus susceptibility (phenotype and genotype)to a standard panel of approved antiretrovirals as determined by the Monogram Biosciences PhenoSense GT assay. Below analysis table included the following parameters: 1. protocol-defined treatment failure was defined as an increase in HIV-1 RNA to detectable levels (≥50 copies/mL) on 2 consecutive measurements, the second measurement taken no more than 14 days after the first measurement); 2. Treatment failure: treatment failure (both virologic and non-virologic) was defined as a subject who met the protocol-defined treatment failure criterion or discontinued from the study; 3. NRTI or NNRTI resistance mutations: nucleoside reverse transcriptase inhibitor or lersivirine-associated resistance-associated mutations (RAM) based on the International AIDS Society-USA (IAS-USA) RAM guidelines; 4. 'with result' meant an analyzed sample returned genotypic result or phenotypic result or both.

Time frame: Week 96 through study termination

Population: The virology analysis set included only evaluable participants i.e. those having samples with valid genotypic or phenotypic susceptibility testing results and HIV-1 RNA \>500 copies/mL. However, samples with observed emergence of resistance-associated mutations and HIV-1 RNA level ≤500 copies/mL or missing HIV-1 RNA level, were also noted.

ArmMeasureGroupValue (NUMBER)
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTreatment failure (TF)8 Participants
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationProtocol defined treatment failure4 Participants
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA >500 c/mL1 Participants
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA >500 c/mL with result1 Participants
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA <= 500 c/mL5 Participants
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA <= 500 c/mL with result2 Participants
Lersivirine (LRV) 500 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationNRTI or NNRTI resistance mutations0 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationNRTI or NNRTI resistance mutations0 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA >500 c/mL0 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA <= 500 c/mL with result1 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA >500 c/mL with result0 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA <= 500 c/mL2 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTreatment failure (TF)5 Participants
LRV 750 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationProtocol defined treatment failure3 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA <= 500 c/mL2 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationProtocol defined treatment failure0 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA >500 c/mL0 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTreatment failure (TF)5 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationNRTI or NNRTI resistance mutations0 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA >500 c/mL with result0 Participants
Efavirenz (EFV) 600 mgVirology Analysis Participant Accountability From Week 96 Through Study TerminationTF analysed - HIV-1 RNA <= 500 c/mL with result0 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026