Drug-Drug Interaction Study of Vesatolimod in Adults With HIV-1 Who Have Very Low or Undetectable Virus Levels
Human Immunodeficiency Virus Type 1 (HIV-1) Infection
About this trial
This is an interventional treatment trial for Human Immunodeficiency Virus Type 1 (HIV-1) Infection
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.
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
Experimental
Experimental
Vesatolimod (VES) + Cobicistat (COBI) + Voriconazole (VOR)
Vesatolimod (VES) + Rifabutin (RFB)
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.