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A Trial With TMC278-TIDP6-C222 for Continued TMC278 Access in Patients Infected With Human Immunodeficiency Virus-1

An Open-label Trial With TMC278 25 mg q.d. in Combination With a Background Regimen Containing 2 N(t)RTI's in HIV-1 Infected Subjects Who Participated in TMC278 Clinical Trials and Were Still Benefitting From Treatment With TMC278

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01266902
Enrollment
482
Registered
2010-12-24
Start date
2011-02-28
Completion date
2020-02-29
Last updated
2021-03-04

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

Conditions

HIV-1 Infection

Keywords

HIV-1 Infection, HIV-1, HIV, TMC278-TiDP6-C222, TMC278-C222, TMC278, Rilpivirine

Brief summary

The purpose of the study is to provide continued access to TMC278 in HIV-1 infected patients who were randomized and treated with TMC278 in the Phase IIb or Phase III trials.

Detailed description

This is a Phase III, open-label (all people know the identity of the drug), multicenter, roll-over trial to provide continued access to TMC278 to HIV-1 infected patients who were randomized (the study drug is assigned by chance) and treated with TMC278 in the Phase IIb (TMC278-C204 \[C204\]) or Phase III trials (i.e., TMC278-TiDP6-C209 \[C209\] or TMC278-TiDP6-C215 \[C215\]) and who continue to benefit from their antiretroviral treatment, according to the investigator. In addition, information on the long-term safety and tolerability, including resistance data in case of virologic failures, of oral doses of TMC278 25 mg once daily (q.d.) in combination with a background regimen containing 2 N(t)RTIs will be collected. Available efficacy data will also be collected. Approximately 750 HIV-1 infected individuals are expected to participate in this trial. The duration of participation in the study for an individual participant will be 2 to 3 years. The final/withdrawal visit of the Phase IIb or Phase III trials will be the first visit of this trial. Safety and tolerability will be evaluated throughout the trial. Visits and assessments performed should be based on the local, generally accepted standard of care, with visits occurring at least every 6 months. Oral tablets of TMC278 25 mg once daily (q.d.) should be administered together with a meal.

Interventions

DRUGRilpivirine

25 mg once daily

Sponsors

Janssen R&D Ireland
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Patients are HIV-1 infected and were previously randomized to receive TMC278 in a TMC278 clinical trial and completed the protocol-defined treatment period. * Patients continue to benefit from treatment with TMC278 in the opinion of the investigator. * Patient can comply with the current protocol requirements. * The patient's general medical condition, in the investigator's opinion, does not interfere with participation in the trial.

Exclusion criteria

* Use of disallowed concomitant therapy. * Females of childbearing potential who are pregnant, or without the use of effective birth control methods, or not willing to continue practicing these birth control methods during the trial and for at least 1 month after the end of the trial (or last intake of TMC278). * Non-vasectomized heterosexually active male patients without the use of effective birth control methods or not willing to continue practicing these birth control methods during the trial and for at least 1 month after the end of the trial (or after last intake of TMC278).

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Adverse Events (AEs)Up to 7 yearsAn AE can be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non investigational) product, whether or not related to that medicinal (investigational or non investigational) product.
Number of Participants With Grade 3/4 Events of Rash Irrespective of CausalityUp to 7 yearsNumber of participants with grade 3/4 events of rash irrespective of causality were assessed. A grade 3 rash defined as diffuse macular, maculopapular or morbilliform rash with vesicles or limited number of bullae or; rash with superficial ulcerations of mucous membranes limited to 1 anatomical site or; rash with at least one of the following: elevations in aspartate aminotransferase (AST)/alanine aminotransferase (ALT) more than 2\*baseline value and at least 5 times upper limit of normal; fever greater than (\>) 38 degree celsius or 100 degree fahrenheit; eosinophils \> 1000/millimeter (mm)\^3; serum sickness-like reaction. A grade 4 rash defined as the following: extensive or generalized bullous lesions or; Stevens-Johnsons Syndrome (SJS) or ulceration of mucous membrane involving 2 or more distinct mucosal sites or toxic epidermal necrolysis.

Secondary

MeasureTime frameDescription
Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Baseline up to weeks 96, 192, 288, 336The immunologic assessment was determined by change from baseline in CD4+ cell count for observed case approach.
Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Baseline up to weeks 96, 192, 288, 336Change from baseline in CD4+ cell count were reported for NC=F approach (participants who discontinued because RPV became commercially available or could be accessed through another source or because the participants switched to other local \[RPV-based\] treatment options or local standard of care, were censored at that time; other participants after discontinuation had their CD4+ values imputed with baseline value. Intermittently missing values were imputed with a last observation carried-forward approach).
Time to Virologic ReboundUp to Week 360Time to virologic rebound was time to (first) human immunodeficiency virus type1 (HIV-1) ribonucleic acid (RNA) greater than or equal to (\>=) 50 or \>=200 copies/milliliter (copies/mL). The mean survival time and its standard error were underestimated because the largest observation was censored and the estimation was restricted to the largest event time.
Number of Participants With AEs Related to Rilpivirine (RPV)Up to 7 yearsNumber of participants with AEs related to RPV were assessed. An AE can be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non investigational) product, whether or not related to that medicinal (investigational or non investigational) product.
Number of Participants With Serious Adverse Events (SAEs)Up to 7 yearsA SAE is any untoward medical occurrence that at any dose: results in death; is life threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect.
Time To Treatment FailureUp to Week 360Time to treatment failure was defined as time to virologic rebound (time to first HIV-1 RNA \>= 50 or \>= 200 copies/mL) or discontinuation for reason other than RPV having become commercially available in the participating country, whichever came first, calculated as the time (in days) from baseline until treatment failure. The mean survival time and its standard error were underestimated because the largest observation was censored and the estimation was restricted to the largest event time.

Countries

Argentina, Australia, Austria, Belgium, Canada, Chile, China, Denmark, France, Germany, Netherlands, Puerto Rico, Romania, Russia, South Africa, Spain, Sweden, Taiwan, Thailand, United Kingdom, United States

Participant flow

Pre-assignment details

Total of 482 participants were treated and 437 discontinued at data cut-off date (8 February 2018) because they switched to commercially available rilpivirine (RPV) (371 participants), as planned per protocol. Only 6 of the 482 participants discontinued as they reached a virologic endpoint. At last contact date of last participant under Protocol Amendment 3 (28 February 2020), out of 45 participants 37 switched to commercially available RPV and 6 were lost to follow-up.

Participants by arm

ArmCount
Rilpivirine (RPV) (TMC278-C204 [C204])
Participants who rolled over from trial C204 (NCT00110305) continued to receive RPV 25 milligrams (mg) once daily (qd) in combination with an investigator-selected background regimen consisting of 2 nucleos(t)ide reverse transcriptase inhibitors (N\[t\]RTI)s starting Day 1.
119
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])
Participants who rolled over from trial C209 (NCT00540449) and C215 (NCT00543725) continued to receive RPV 25 mg qd in combination with an investigator-selected background regimen consisting of 2 N(t)RTIs starting Day 1. In trial C209, the background regimen was fixed to tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) and in trial C215, the background regimen was selected by the investigator and contained either abacavir (ABC)/lamivudine (3TC), zidovudine (AZT)/3TC, or TDF/FTC.
363
Total482

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Period 1 (Main Study)Adverse Event3110
Period 1 (Main Study)Continued RPV treatment11340
Period 1 (Main Study)Investigator's decision/Participant's decision230
Period 1 (Main Study)Lack of Efficacy420
Period 1 (Main Study)Lost to Follow-up5120
Period 1 (Main Study)Subject non-compliant370
Period 1 (Main Study)Withdrawal by Subject2120
Period 2 (After Protocol Amendment 3)Adverse Event001
Period 2 (After Protocol Amendment 3)Lost to Follow-up006
Period 2 (After Protocol Amendment 3)Withdrawal by Subject001

Baseline characteristics

CharacteristicRPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])TotalRilpivirine (RPV) (TMC278-C204 [C204])
Age, Continuous39.9 years
STANDARD_DEVIATION 9.09
40.4 years
STANDARD_DEVIATION 8.91
42 years
STANDARD_DEVIATION 8.18
Race/Ethnicity, Customized
American Indian or Alaska Native
4 participants4 participants0 participants
Race/Ethnicity, Customized
Asian
58 participants101 participants43 participants
Race/Ethnicity, Customized
Black or African American
64 participants81 participants17 participants
Race/Ethnicity, Customized
Other
0 participants9 participants9 participants
Race/Ethnicity, Customized
White
237 participants287 participants50 participants
Region of Enrollment
ARGENTINA
16 participants35 participants19 participants
Region of Enrollment
AUSTRALIA
11 participants11 participants0 participants
Region of Enrollment
AUSTRIA
6 participants8 participants2 participants
Region of Enrollment
BELGIUM
13 participants13 participants0 participants
Region of Enrollment
CANADA
21 participants21 participants0 participants
Region of Enrollment
CHILE
12 participants12 participants0 participants
Region of Enrollment
CHINA
18 participants26 participants8 participants
Region of Enrollment
DENMARK
5 participants5 participants0 participants
Region of Enrollment
FRANCE
15 participants20 participants5 participants
Region of Enrollment
GERMANY
24 participants27 participants3 participants
Region of Enrollment
ITALY
10 participants10 participants0 participants
Region of Enrollment
NETHERLANDS
3 participants3 participants0 participants
Region of Enrollment
PUERTO RICO
0 participants7 participants7 participants
Region of Enrollment
ROMANIA
4 participants4 participants0 participants
Region of Enrollment
RUSSIAN FEDERATION
27 participants38 participants11 participants
Region of Enrollment
SOUTH AFRICA
35 participants48 participants13 participants
Region of Enrollment
SPAIN
14 participants14 participants0 participants
Region of Enrollment
SWEDEN
3 participants3 participants0 participants
Region of Enrollment
TAIWAN
2 participants2 participants0 participants
Region of Enrollment
THAILAND
31 participants65 participants34 participants
Region of Enrollment
UNITED KINGDOM
17 participants25 participants8 participants
Region of Enrollment
UNITED STATES
76 participants85 participants9 participants
Sex: Female, Male
Female
84 Participants125 Participants41 Participants
Sex: Female, Male
Male
279 Participants357 Participants78 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 1192 / 363
other
Total, other adverse events
25 / 11961 / 363
serious
Total, serious adverse events
9 / 11916 / 363

Outcome results

Primary

Number of Participants With Adverse Events (AEs)

An AE can be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non investigational) product, whether or not related to that medicinal (investigational or non investigational) product.

Time frame: Up to 7 years

Population: The intent-to-treat (ITT) population included all participants who have taken at least 1 dose of rilpivirine (RPV), regardless of their compliance with the protocol and adherence to the dosing regimens.

ArmMeasureValue (NUMBER)
Rilpivirine (RPV) (TMC278-C204 [C204])Number of Participants With Adverse Events (AEs)32 Participants
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Number of Participants With Adverse Events (AEs)70 Participants
Primary

Number of Participants With Grade 3/4 Events of Rash Irrespective of Causality

Number of participants with grade 3/4 events of rash irrespective of causality were assessed. A grade 3 rash defined as diffuse macular, maculopapular or morbilliform rash with vesicles or limited number of bullae or; rash with superficial ulcerations of mucous membranes limited to 1 anatomical site or; rash with at least one of the following: elevations in aspartate aminotransferase (AST)/alanine aminotransferase (ALT) more than 2\*baseline value and at least 5 times upper limit of normal; fever greater than (\>) 38 degree celsius or 100 degree fahrenheit; eosinophils \> 1000/millimeter (mm)\^3; serum sickness-like reaction. A grade 4 rash defined as the following: extensive or generalized bullous lesions or; Stevens-Johnsons Syndrome (SJS) or ulceration of mucous membrane involving 2 or more distinct mucosal sites or toxic epidermal necrolysis.

Time frame: Up to 7 years

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimens.

ArmMeasureValue (NUMBER)
Rilpivirine (RPV) (TMC278-C204 [C204])Number of Participants With Grade 3/4 Events of Rash Irrespective of Causality0 Participants
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Number of Participants With Grade 3/4 Events of Rash Irrespective of Causality0 Participants
Secondary

Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336

Change from baseline in CD4+ cell count were reported for NC=F approach (participants who discontinued because RPV became commercially available or could be accessed through another source or because the participants switched to other local \[RPV-based\] treatment options or local standard of care, were censored at that time; other participants after discontinuation had their CD4+ values imputed with baseline value. Intermittently missing values were imputed with a last observation carried-forward approach).

Time frame: Baseline up to weeks 96, 192, 288, 336

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimen. Here 'number of participants analyzed' signifies number of participants analyzed in this outcome measure. Here 'number analyzed' included all participants evaluable at specified timepoint categories.

ArmMeasureGroupValue (MEAN)Dispersion
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 9669.76 cells/mcLStandard Error 19.372
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 28892.12 cells/mcLStandard Error 22.809
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 192133.56 cells/mcLStandard Error 21.906
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 33670.69 cells/mcLStandard Error 23.558
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 33649.24 cells/mcLStandard Error 16.688
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 9642.19 cells/mcLStandard Error 11.525
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 19291.69 cells/mcLStandard Error 15.563
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in CD4+ Cell Count for Non-Completer Equals Failure (NC=F) Approach Until Week 336Week 28863.33 cells/mcLStandard Error 17.132
Secondary

Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336

The immunologic assessment was determined by change from baseline in CD4+ cell count for observed case approach.

Time frame: Baseline up to weeks 96, 192, 288, 336

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimen. Here 'number of participants analyzed' signifies number of participants analyzed in this outcome measure. Here 'number analyzed' included all participants evaluable at specified timepoint categories.

ArmMeasureGroupValue (MEAN)Dispersion
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 9672.63 cells/microliter (cells/mcL)Standard Error 20.581
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 192148.76 cells/microliter (cells/mcL)Standard Error 24.111
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 288122.29 cells/microliter (cells/mcL)Standard Error 29.628
Rilpivirine (RPV) (TMC278-C204 [C204])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 336161.73 cells/microliter (cells/mcL)Standard Error 39.851
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 33676.49 cells/microliter (cells/mcL)Standard Error 40.484
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 9655.91 cells/microliter (cells/mcL)Standard Error 13.425
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 288101.50 cells/microliter (cells/mcL)Standard Error 24.108
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Change From Baseline in Cluster of Differentiation 4 (CD4+) Cell Count for Observed Case Approach Until Week 336Week 192132.73 cells/microliter (cells/mcL)Standard Error 21.989
Secondary

Number of Participants With AEs Related to Rilpivirine (RPV)

Number of participants with AEs related to RPV were assessed. An AE can be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non investigational) product, whether or not related to that medicinal (investigational or non investigational) product.

Time frame: Up to 7 years

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimens.

ArmMeasureValue (NUMBER)
Rilpivirine (RPV) (TMC278-C204 [C204])Number of Participants With AEs Related to Rilpivirine (RPV)7 Participants
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Number of Participants With AEs Related to Rilpivirine (RPV)16 Participants
Secondary

Number of Participants With Serious Adverse Events (SAEs)

A SAE is any untoward medical occurrence that at any dose: results in death; is life threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect.

Time frame: Up to 7 years

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimens.

ArmMeasureValue (NUMBER)
Rilpivirine (RPV) (TMC278-C204 [C204])Number of Participants With Serious Adverse Events (SAEs)9 Participants
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Number of Participants With Serious Adverse Events (SAEs)14 Participants
Secondary

Time To Treatment Failure

Time to treatment failure was defined as time to virologic rebound (time to first HIV-1 RNA \>= 50 or \>= 200 copies/mL) or discontinuation for reason other than RPV having become commercially available in the participating country, whichever came first, calculated as the time (in days) from baseline until treatment failure. The mean survival time and its standard error were underestimated because the largest observation was censored and the estimation was restricted to the largest event time.

Time frame: Up to Week 360

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimen.

ArmMeasureGroupValue (MEAN)Dispersion
Rilpivirine (RPV) (TMC278-C204 [C204])Time To Treatment Failure>= 50 copies/mL1795.7 daysStandard Error 70.03
Rilpivirine (RPV) (TMC278-C204 [C204])Time To Treatment Failure>= 200 copies/mL1868.7 daysStandard Error 63.29
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Time To Treatment Failure>= 50 copies/mL1694.1 daysStandard Error 59.42
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Time To Treatment Failure>= 200 copies/mL1637.5 daysStandard Error 42.42
Secondary

Time to Virologic Rebound

Time to virologic rebound was time to (first) human immunodeficiency virus type1 (HIV-1) ribonucleic acid (RNA) greater than or equal to (\>=) 50 or \>=200 copies/milliliter (copies/mL). The mean survival time and its standard error were underestimated because the largest observation was censored and the estimation was restricted to the largest event time.

Time frame: Up to Week 360

Population: The ITT population included all participants who have taken at least 1 dose of RPV, regardless of their compliance with the protocol and adherence to the dosing regimens.

ArmMeasureGroupValue (MEAN)Dispersion
Rilpivirine (RPV) (TMC278-C204 [C204])Time to Virologic Rebound>= 50 copies/mL1670.6 daysStandard Error 51.32
Rilpivirine (RPV) (TMC278-C204 [C204])Time to Virologic Rebound>= 200 copies/mL1901.3 daysStandard Error 47.19
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Time to Virologic Rebound>= 50 copies/mL1939.3 daysStandard Error 52.43
RPV (TMC278-TiDP6-C209 [C209] and TMC278-TiDP6-C215 [C215])Time to Virologic Rebound>= 200 copies/mL1877.3 daysStandard Error 25.93

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