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Drug-Drug Interaction Study of Vesatolimod in Adults With HIV-1 Who Have Very Low or Undetectable Virus Levels

Primary Purpose

Human Immunodeficiency Virus Type 1 (HIV-1) Infection

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Vesatolimod
Cobicistat
Voriconazole
Rifabutin
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Human Immunodeficiency Virus Type 1 (HIV-1) Infection

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • On an antiretroviral therapy (ART) regimen for at least 6 consecutive months, with no change in the ART regimen within 2 months prior to screening. Permitted ARTs are as follows:

    • Cohort 1: A regimen of (BIC, DTG, RAL, or DOR) plus Nucleoside Reverse Transcriptase Inhibitors (NRTIs). Examples of acceptable regimens include BIC/emtricitabine/tenofovir, DTG/ABC/3TC, DTG/3TC, DTG + emtricitabine/tenofovir, or DOR/3TC/tenofovir
    • Cohort 2: A DTG-based regimen is required (DTG/ABC/3TC), (DTG/3TC), or (DTG + NRTIs)
  • Plasma HIV-1 RNA levels less than 50 copies/mL at screening
  • Have normal hematologic function with an absolute neutrophil count greater than or equal to 1.5 × 10^9/L, platelets greater than or equal to 150 × 10^9/L; hemoglobin greater than or equal to 10.5 g/dL for females and greater than or equal to 11.5 g/dL for males
  • Clusters of differentiation (CD) 4 T cell count greater than or equal to 350 cells/μL
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to 2.5 x upper limit of normal (ULN) and total bilirubin less than or equal to 1.5 mg/dL, or normal direct bilirubin and creatinine less than or equal to 1.25 x ULN
  • Have a calculated creatinine clearance (CLcr) of at least 60 mL/min (using the Cockcroft-Gault method) based on serum creatinine and actual body weight as measured at screening and upon admission
  • Individuals assigned female at birth and of childbearing potential who engage in heterosexual intercourse must agree to use protocol-specified method(s) of contraception
  • Must be willing and able to comply with all study requirements and available to complete the study schedule of assessments
  • In the judgment of the investigator, be in good general health, based on review of the results from a screening visit

Key Exclusion Criteria:

  • Have received any study drug within 30 days prior to study dosing
  • Participation in any other clinical study (including observation studies) without prior approval from the sponsor is prohibited while participating in this study
  • Have current alcohol or substance abuse judged by the investigator to potentially interfere with individual compliance or individual safety, or a positive drug or alcohol test at screening or baseline
  • No Evidence of chronic hepatitis B virus (HBV) infection (defined as positive hepatitis B surface antigen [HBsAg] and/or positive HBV core antibody with positive reflex HBV DNA polymerase chain reaction (PCR)). Note: positive HBV core antibody with negative reflex HBV DNA PCR results are acceptable
  • No Evidence of active hepatitis C virus (HCV) infection (defined as positive hepatitis C antibody and HCV RNA above lower limit of quantitation). Note: positive anti-HCV antibody and negative HCV PCR results are acceptable
  • Acute febrile illness within 35 days prior to Day 1
  • Have been treated with systemic steroids, immunosuppressant therapies, or chemotherapeutic agents within 3 months prior to screening or is expected to receive these agents during the study
  • Received any vaccine or immunomodulatory medication within 4 weeks prior to screening. Elective vaccination (eg, flu shot, hepatitis A or B vaccine) during the course of the study will require prior approval from the sponsor

    • Coronavirus disease of 2019 (COVID-19) vaccinations are allowed, with the requirement that they should not be administered within 7 ± 2 days of receiving VES
  • Have a history of any of the following:

    • Significant serious skin disease, such as but not limited to rash, food allergy, eczema, psoriasis, or urticaria
    • Significant drug sensitivity or drug allergy (such as anaphylaxis or hepatoxicity)
    • Known hypersensitivity to the study drugs, their metabolites, or to formulation excipients
    • Autoimmune disease
    • Significant cardiac disease or a family history of long QT syndrome, or unexplained death in an otherwise healthy individual between the ages of 1 and 30 years
    • Syncope, palpitations, or unexplained dizziness
    • Implanted defibrillator or pacemaker
    • Liver disease, including Gilbert syndrome
    • Severe peptic ulcer disease requiring prolonged (≥ 6 months) medical treatment
    • Medical or surgical treatment that permanently altered gastric absorption (eg, gastric or intestinal surgery). A history of cholecystectomy is not exclusionary
  • Have any serious or active medical or psychiatric illness (including depression) that, in the opinion of the investigator, would interfere with individual treatment, assessment, or compliance with the protocol
  • For Cohort 1, individuals with CYP2C19 genotype of CYP2C19*2/*2, CYP2C19*2/*3, or CYP2C19*3/*3

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Sites / Locations

  • Collaborative Neuroscience Research, LLC.
  • Clinical Pharmacology of Miami, LLC.
  • Advanced Pharma, CR, LLC.
  • Triple O Research Institute, P.A.
  • Hassman Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Vesatolimod (VES) + Cobicistat (COBI) + Voriconazole (VOR)

Vesatolimod (VES) + Rifabutin (RFB)

Arm Description

Participants will receive: In Period 1 (duration 1 day): a single dose of VES 2 mg on Day 1 In Period 2 (duration 5 days): COBI 150 mg once daily on Days 1 to 5; a single dose of VES 2 mg will be coadministered on Day 2 In Period 3 (duration 6 days): a loading dose of VOR 400 mg twice daily on Day 1, then VOR 200 mg twice daily on Days 2 to 6; a single dose of VES 2 mg will be coadministered in the morning on Day 3 There will be a washout period of 7 to 14 days between treatments in Period 1 Day 1 and Period 2 Day 1 and a washout period of 14 to 21 days between treatments in Period 2 Day 5 and Period 3 Day 1. Participants should inform the site of any adverse event (AE) during the washout period.

Participants will receive: In Period 1 (duration 1 day): participants will receive a single dose of VES 6 mg on Day 1 In Period 2 (duration 9 days): participants will receive RFB 300 mg once daily on Days 1 to 9; a single dose of VES 6 mg will be coadministered on Day 6 There will be a washout period of 7 to 14 days between treatments in Period 1 Day 1 and Period 2 Day 1. Participants should inform the site of any AE during the washout period.

Outcomes

Primary Outcome Measures

Pharmacokinetic (PK) Parameter : AUClast of Vesatolimod (VES)
AUClast is defined as an area under the concentration versus time curve from time zero to the last quantifiable concentration.
PK Parameter : AUCinf of VES
AUCinf is defined as an area under the concentration versus time curve extrapolated to infinite time, calculated as AUClast + (Clast/Lambda z).
PK Parameter : Cmax of VES
Cmax is defined as the maximum observed concentration of drug.
PK Parameter : %AUCexp of VES
%AUCexp is defined as the percentage of AUC extrapolated between AUClast and AUCinf.
PK Parameter : Tmax of VES
Tmax is defined as the time (observed time point) of Cmax.
PK Parameter : Clast of VES
Clast is defined as the last observed quantifiable concentration of the drug.
PK Parameter : Tlast of VES
Tlast is defined as the time (observed time point) of Clast.
PK Parameter : Lambda z of VES
Lambda z is defined as the terminal elimination rate constant, estimated by linear regression of the terminal elimination phase of the log concentration of drug versus time curve of the drug.
PK Parameter : t1/2 of VES
t1/2 is defined as the terminal elimination half-life.
PK Parameter : CL/F of VES
CL/F is defined as an apparent oral clearance.
PK Parameter : Vz/F of VES
Vz/F is defined as an apparent volume of distribution of the drug.
Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs)
Percentage of Participants Experiencing Treatment-Emergent Graded Laboratory Abnormalities

Secondary Outcome Measures

Full Information

First Posted
July 11, 2022
Last Updated
May 5, 2023
Sponsor
Gilead Sciences
search

1. Study Identification

Unique Protocol Identification Number
NCT05458102
Brief Title
Drug-Drug Interaction Study of Vesatolimod in Adults With HIV-1 Who Have Very Low or Undetectable Virus Levels
Official Title
A Phase 1, Open-label, Multicohort Study to Evaluate the Impact of Inhibitors and Inducers of Cytochrome P450 Enzyme (CYP)3A and/or P-glycoprotein (P-gp) on the Pharmacokinetics (PK) of Vesatolimod (VES) in Virologically Suppressed Adults With HIV-1 on Antiretroviral Therapy (ART)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 19, 2022 (Actual)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
November 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this clinical study is to learn more about the impact of cobicistat (COBI) (P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), and strong cytochrome P450 enzyme [CYP]3A inhibitor), voriconazole (VOR) (strong CYP3A inhibitor), and rifabutin (RFB) (moderate CYP3A inducer) on the study drug, vesatolimod (VES), in people with HIV-1 on antiretroviral therapy (ART).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Human Immunodeficiency Virus Type 1 (HIV-1) Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Vesatolimod (VES) + Cobicistat (COBI) + Voriconazole (VOR)
Arm Type
Experimental
Arm Description
Participants will receive: In Period 1 (duration 1 day): a single dose of VES 2 mg on Day 1 In Period 2 (duration 5 days): COBI 150 mg once daily on Days 1 to 5; a single dose of VES 2 mg will be coadministered on Day 2 In Period 3 (duration 6 days): a loading dose of VOR 400 mg twice daily on Day 1, then VOR 200 mg twice daily on Days 2 to 6; a single dose of VES 2 mg will be coadministered in the morning on Day 3 There will be a washout period of 7 to 14 days between treatments in Period 1 Day 1 and Period 2 Day 1 and a washout period of 14 to 21 days between treatments in Period 2 Day 5 and Period 3 Day 1. Participants should inform the site of any adverse event (AE) during the washout period.
Arm Title
Vesatolimod (VES) + Rifabutin (RFB)
Arm Type
Experimental
Arm Description
Participants will receive: In Period 1 (duration 1 day): participants will receive a single dose of VES 6 mg on Day 1 In Period 2 (duration 9 days): participants will receive RFB 300 mg once daily on Days 1 to 9; a single dose of VES 6 mg will be coadministered on Day 6 There will be a washout period of 7 to 14 days between treatments in Period 1 Day 1 and Period 2 Day 1. Participants should inform the site of any AE during the washout period.
Intervention Type
Drug
Intervention Name(s)
Vesatolimod
Other Intervention Name(s)
GS-9620
Intervention Description
Administered orally
Intervention Type
Drug
Intervention Name(s)
Cobicistat
Other Intervention Name(s)
Tybost®
Intervention Description
Administered orally
Intervention Type
Drug
Intervention Name(s)
Voriconazole
Other Intervention Name(s)
Vfend®
Intervention Description
Administered orally
Intervention Type
Drug
Intervention Name(s)
Rifabutin
Other Intervention Name(s)
Mycobutin®
Intervention Description
Administered orally
Primary Outcome Measure Information:
Title
Pharmacokinetic (PK) Parameter : AUClast of Vesatolimod (VES)
Description
AUClast is defined as an area under the concentration versus time curve from time zero to the last quantifiable concentration.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : AUCinf of VES
Description
AUCinf is defined as an area under the concentration versus time curve extrapolated to infinite time, calculated as AUClast + (Clast/Lambda z).
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : Cmax of VES
Description
Cmax is defined as the maximum observed concentration of drug.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : %AUCexp of VES
Description
%AUCexp is defined as the percentage of AUC extrapolated between AUClast and AUCinf.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : Tmax of VES
Description
Tmax is defined as the time (observed time point) of Cmax.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : Clast of VES
Description
Clast is defined as the last observed quantifiable concentration of the drug.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : Tlast of VES
Description
Tlast is defined as the time (observed time point) of Clast.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : Lambda z of VES
Description
Lambda z is defined as the terminal elimination rate constant, estimated by linear regression of the terminal elimination phase of the log concentration of drug versus time curve of the drug.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : t1/2 of VES
Description
t1/2 is defined as the terminal elimination half-life.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : CL/F of VES
Description
CL/F is defined as an apparent oral clearance.
Time Frame
Predose up to 96 hours postdose
Title
PK Parameter : Vz/F of VES
Description
Vz/F is defined as an apparent volume of distribution of the drug.
Time Frame
Predose up to 96 hours postdose
Title
Percentage of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs)
Time Frame
First dose date up to Week 7 plus 30 days
Title
Percentage of Participants Experiencing Treatment-Emergent Graded Laboratory Abnormalities
Time Frame
First dose date up to Week 7 plus 30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: On an antiretroviral therapy (ART) regimen for at least 6 consecutive months, with no change in the ART regimen within 2 months prior to screening. Permitted ARTs are as follows: Cohort 1: A regimen of (BIC, DTG, RAL, or DOR) plus Nucleoside Reverse Transcriptase Inhibitors (NRTIs). Examples of acceptable regimens include BIC/emtricitabine/tenofovir, DTG/ABC/3TC, DTG/3TC, DTG + emtricitabine/tenofovir, or DOR/3TC/tenofovir Cohort 2: A DTG-based regimen is required (DTG/ABC/3TC), (DTG/3TC), or (DTG + NRTIs) Plasma HIV-1 RNA levels less than 50 copies/mL at screening Have normal hematologic function with an absolute neutrophil count greater than or equal to 1.5 × 10^9/L, platelets greater than or equal to 150 × 10^9/L; hemoglobin greater than or equal to 10.5 g/dL for females and greater than or equal to 11.5 g/dL for males Clusters of differentiation (CD) 4 T cell count greater than or equal to 350 cells/μL Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to 2.5 x upper limit of normal (ULN) and total bilirubin less than or equal to 1.5 mg/dL, or normal direct bilirubin and creatinine less than or equal to 1.25 x ULN Have a calculated creatinine clearance (CLcr) of at least 60 mL/min (using the Cockcroft-Gault method) based on serum creatinine and actual body weight as measured at screening and upon admission Individuals assigned female at birth and of childbearing potential who engage in heterosexual intercourse must agree to use protocol-specified method(s) of contraception Must be willing and able to comply with all study requirements and available to complete the study schedule of assessments In the judgment of the investigator, be in good general health, based on review of the results from a screening visit Key Exclusion Criteria: Have received any study drug within 30 days prior to study dosing Participation in any other clinical study (including observation studies) without prior approval from the sponsor is prohibited while participating in this study Have current alcohol or substance abuse judged by the investigator to potentially interfere with individual compliance or individual safety, or a positive drug or alcohol test at screening or baseline No Evidence of chronic hepatitis B virus (HBV) infection (defined as positive hepatitis B surface antigen [HBsAg] and/or positive HBV core antibody with positive reflex HBV DNA polymerase chain reaction (PCR)). Note: positive HBV core antibody with negative reflex HBV DNA PCR results are acceptable No Evidence of active hepatitis C virus (HCV) infection (defined as positive hepatitis C antibody and HCV RNA above lower limit of quantitation). Note: positive anti-HCV antibody and negative HCV PCR results are acceptable Acute febrile illness within 35 days prior to Day 1 Have been treated with systemic steroids, immunosuppressant therapies, or chemotherapeutic agents within 3 months prior to screening or is expected to receive these agents during the study Received any vaccine or immunomodulatory medication within 4 weeks prior to screening. Elective vaccination (eg, flu shot, hepatitis A or B vaccine) during the course of the study will require prior approval from the sponsor Coronavirus disease of 2019 (COVID-19) vaccinations are allowed, with the requirement that they should not be administered within 7 ± 2 days of receiving VES Have a history of any of the following: Significant serious skin disease, such as but not limited to rash, food allergy, eczema, psoriasis, or urticaria Significant drug sensitivity or drug allergy (such as anaphylaxis or hepatoxicity) Known hypersensitivity to the study drugs, their metabolites, or to formulation excipients Autoimmune disease Significant cardiac disease or a family history of long QT syndrome, or unexplained death in an otherwise healthy individual between the ages of 1 and 30 years Syncope, palpitations, or unexplained dizziness Implanted defibrillator or pacemaker Liver disease, including Gilbert syndrome Severe peptic ulcer disease requiring prolonged (≥ 6 months) medical treatment Medical or surgical treatment that permanently altered gastric absorption (eg, gastric or intestinal surgery). A history of cholecystectomy is not exclusionary Have any serious or active medical or psychiatric illness (including depression) that, in the opinion of the investigator, would interfere with individual treatment, assessment, or compliance with the protocol For Cohort 1, individuals with CYP2C19 genotype of CYP2C19*2/*2, CYP2C19*2/*3, or CYP2C19*3/*3 Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilead Study Director
Organizational Affiliation
Gilead Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Collaborative Neuroscience Research, LLC.
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Clinical Pharmacology of Miami, LLC.
City
Miami
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
Advanced Pharma, CR, LLC.
City
Miami
State/Province
Florida
ZIP/Postal Code
33147
Country
United States
Facility Name
Triple O Research Institute, P.A.
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33407
Country
United States
Facility Name
Hassman Research Institute
City
Marlton
State/Province
New Jersey
ZIP/Postal Code
08054
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.gileadclinicaltrials.com/study/?id=GS-US-382-1587
Description
Gilead Clinical Trials Website

Learn more about this trial

Drug-Drug Interaction Study of Vesatolimod in Adults With HIV-1 Who Have Very Low or Undetectable Virus Levels

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