Gilead
Releases 24 Week Data on "Quad" Pill containing
Elvitegravir and Experimental Boosting Agent GS 9350
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SUMMARY:
On January 6, Gilead Sciences announced
early data from a Phase 2 clinical trial
of its once-daily 4-drug "Quad"
coformulation consisting of the investigational
integrase inhibitor elvitegravir,
tenofovir
and emtricitabine
(the drugs in the Truvada
pill), and GS
9350, a new pharmaco-enhancer or "boosting"
agent used to raise blood levels of elvitegravir.
After 24 weeks, the Quad regimen was non-inferior
to Atripla
(the tenofovir/emtricitabine/efavirenz combination
pill), with similar proportions of treatment-naive
HIV patients achieving viral load < 50
copies/mL. Results from the ongoing study
will be presented at a conference early
this year. In a second Phase II study, GS
9350 was shown to boost the protease inhibitor
atazanavir
(Reyataz) as well as ritonavir,
currently the sole approved boosting agent.
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Below
is an excerpt from a Gilead press release describing
the studies and their findings.
Phase
II Clinical Trial of Gilead's Investigational
Integrase-Based, Once-Daily, Fixed-Dose
"Quad" Regimen Meets 24-Week Primary
Objective
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24-Week
Data from a Second Phase II Study Supports
GS 9350 as an Effective Boosting Agent |
Foster City, Calif., January 6, 2009 -- Business
Wire -- Gilead Sciences, Inc. (Nasdaq: GILD)
today announced that a Phase II clinical trial
of its investigational integrase inhibitor-based,
once-daily, fixed-dose "Quad" regimen
of elvitegravir, GS 9350 and Truvada (emtricitabine
and tenofovir disoproxil fumarate) for the
treatment of HIV-1 infection met its primary
objective. The ongoing study of 71 HIV-infected,
antiretroviral treatment-naive adults compares
the Quad with Atripla (efavirenz 600 mg/emtricitabine
200 mg/tenofovir disoproxil fumarate 300 mg).
Based on 24-week data, efficacy of the Quad
met the statistical criteria of non-inferiority
as compared to Atripla based on the proportion
of subjects with HIV RNA levels (viral load)
of less than 50 copies/mL. Discontinuation
rates due to adverse events were comparable
in both arms of the study. Full study results
will be submitted for presentation at a scientific
meeting in early 2010.
Elvitegravir is Gilead's investigational HIV
integrase inhibitor. GS 9350 is Gilead's investigational
pharmacoenhancing or "boosting"
agent, being developed to increase blood levels
of certain medicines, including elvitegravir,
and allows for once-daily dosing.
Gilead is also studying GS 9350 as a stand-alone
boosting agent for other antiretrovirals,
in particular, protease inhibitors. A Phase
II clinical trial evaluating the safety and
efficacy of GS 9350-boosted atazanavir compared
to ritonavir-boosted atazanavir, each in combination
with Truvada, is ongoing. The Phase II study
involves 79 HIV-infected, antiretroviral treatment-naive
adults. The study met its primary objective
of achieving HIV RNA levels (viral load) of
less than 50 copies/mL at 24 weeks of treatment.
GS 9350-boosted atazanavir and Truvada had
similar efficacy to ritonavir-boosted atazanavir
and Truvada. Discontinuation rates due to
adverse events were comparable in both arms
of the study. Ritonavir is currently the only
agent used to boost HIV therapy. Results from
this study will also be submitted for presentation
at a scientific meeting in early 2010.
About the Quad Phase
II Study
The Quad Phase II study is a double-blind,
multicenter, randomized, active-controlled
48-week clinical trial evaluating the safety
and efficacy of a fixed-dose regimen containing
elvitegravir, GS 9350 and Truvada versus Atripla,
each administered in HIV-infected treatment-naive
adults with HIV RNA levels (viral load) greater
than or equal to 5,000 copies/mL and CD4 cell
counts greater than 50 cells/mm3 (n=71). Entry
criteria required that patients did not have
nucleoside reverse transcriptase inhibitor,
non-nucleoside reverse transcriptase inhibitor
or primary protease inhibitor resistance mutations,
as defined by International AIDS Society-USA
guidelines, and no prior use of antiretroviral
treatments.
In the study, trial participants were randomized
2:1 to receive a once-daily tablet containing
elvitegravir 150 mg/GS 9350 150 mg/emtricitabine
200 mg/tenofovir disoproxil fumarate 300 mg
(n=48) or Atripla (efavirenz 600 mg/emtricitabine
200 mg/tenofovir disoproxil fumarate 300 mg)
(n=23).
The study is ongoing. Secondary endpoints
will include the proportion of patients with
HIV RNA levels (viral load) less than 50 copies/mL
at 48 weeks of treatment, and the safety and
tolerability of the two treatment regimens
through 48 weeks of treatment. After week
48, subjects will continue to take blinded
study drug until treatment assignments have
been unblinded, at which point all subjects
will be given the option to participate in
an open-label rollover extension and receive
the single-tablet regimen containing elvitegravir,
GS 9350 and Truvada.
Additional information about the study can
be found at www.clinicaltrials.gov.
About the GS 9350
Phase II Study
The GS 9350 Phase II study is a double-blind,
multicenter, randomized (2:1), active-controlled
48-week clinical trial evaluating the safety
and efficacy of GS 9350-boosted atazanavir
(n=50) compared to ritonavir-boosted atazanavir
(n=29), each in combination with Truvada,
in HIV-infected treatment-naive adults with
HIV RNA levels (viral load) greater than or
equal to 5,000 copies/mL and CD4 cell counts
greater than 50 cells/mm3. Entry criteria
required that patients did not have nucleoside
reverse transcriptase inhibitor, non-nucleoside
reverse transcriptase inhibitor or primary
protease inhibitor resistance mutations, as
defined by International AIDS Society-USA
guidelines, and no prior use of antiretroviral
treatments.
The study is ongoing. Secondary endpoints
will include the proportion of patients with
HIV RNA levels (viral load) less than 50 copies/mL
at 48 weeks of treatment, and the safety and
tolerability of the two treatment regimens
through 48 weeks of treatment. After week
48, subjects will continue to take blinded
study drug until treatment assignments have
been unblinded, at which point all subjects
will be given the option to participate in
an open-label rollover extension and receive
GS 9350-boosted atazanavir and Truvada.
Additional information about the study can
be found at www.clinicaltrials.gov.
About Elvitegravir
Elvitegravir is an HIV integrase inhibitor.
Unlike other classes of antiretroviral agents,
integrase inhibitors interfere with HIV replication
by blocking the ability of the virus to integrate
into the genetic material of human cells.
Elvitegravir, also known as GS 9137 or JTK
303, was licensed by Gilead from Japan Tobacco
Inc. (JT) in March 2005. Under the terms of
Gilead's agreement with JT, Gilead has exclusive
rights to develop and commercialize elvitegravir
in all countries of the world, excluding Japan,
where JT retains rights. Elvitegravir is an
investigational compound and has not yet been
determined safe or efficacious in humans.
About GS 9350
GS 9350 is Gilead's proprietary potent mechanism-based
inhibitor of cytochrome P450 3A (CYP3A), an
enzyme that metabolizes drugs in the body.
In addition to studying the agent as part
of an integrase-based fixed-dose regimen,
Gilead is also examining GS 9350's potential
stand-alone role in boosting commercially
available HIV protease inhibitors, which are
used in many HIV treatment regimens. GS 9350
is an investigational therapy and has not
yet been determined safe or efficacious in
humans.
About Gilead Sciences
Gilead Sciences is a biopharmaceutical company
that discovers, develops and commercializes
innovative therapeutics in areas of unmet
medical need. The company's mission is to
advance the care of patients suffering from
life-threatening diseases worldwide. Headquartered
in Foster City, California, Gilead has operations
in North America, Europe and Australia.
U.S.
full prescribing information for Truvada
is available at www.Truvada.com. |
U.S.
full prescribing information for Atripla
is available at www.Atripla.com.
|
U.S.
full prescribing information for Viread
is available at www.Viread.com.
|
U.S.
full prescribing information for Emtriva
is available at www.GileadHIV.com.
|
U.S.
full prescribing information for Hepsera
is available at www.Hepsera.com. |
|
1/08/10
Source
Gilead Sciences (via Business Wire). Phase II Clinical
Trial of Gilead's Investigational Integrase-Based,
Once-Daily, Fixed-Dose "Quad" Regimen Meets
24-Week Primary Objective. Press release. January
6, 2010.
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