The investigational product, ibalizumab, is a humanized IgG4 monoclonal antibody administered via intravenous infusion at 800 mg every 2 weeks or at 2000 mg every 4 weeks. In addition to study drug, all patients will receive an optimized background regimen (OBR), which is a standard-of-care regimen selected by the investigator prior to randomization that is comprised of 2-4 antiretroviral agents. These agents must have been approved by the local regulatory agency or be available through expanded-access programs for treatment of human immunodeficiency virus (HIV).
The primary objectives of this study are to: * Evaluate the dose-response relationship of antiviral activity of the ibalizumab dose regimens at Week 24 in order to determine the optimal dose and regimen. The primary evaluation of effectiveness will be based on the proportion of patients achieving undetectable viral loads at Week 24. * Evaluate the safety and tolerability of two dose regimens of ibalizumab for dose selection The secondary objectives of this study are to: * Evaluate changes from Baseline in viral load, CD4+ cell counts, and time to loss of virologic response (TLOVR) * Characterize HIV-1 sensitivity/susceptibility changes associated with ibalizumab administration in combination with OBR * Determine the presence and significance of anti-ibalizumab antibodies, if any (immunogenicity of ibalizumab) * Assess CD4 receptor density and occupancy * Determine the impact of ibalizumab on quality of life as assessed by patient-reported outcomes on questionnaires * Evaluate the pharmacokinetic profile of two dose regimens of ibalizumab at steady state
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
113
Ibalizumab 800 mg IV every 2 weeks
Ibalizumab 2000 mg IV every 4 weeks
AIDS Health Care Foundation - Research
Beverly Hills, California, United States
Living Hope Clinical Foundation
Long Beach, California, United States
Kaiser Permanente Medical Center
Los Angeles, California, United States
Quest Clinical Research
San Francisco, California, United States
Kaiser Permanente Medical Center Research Unit
San Francisco, California, United States
The Proportion of Patients Achieving Undetectable Viral Loads at Week 24.
For the primary efficacy analysis, "undetectable" was defined as having HIV-1 RNA below the limit of assay detection at \<50 copies/mL. The primary efficacy endpoint was analyzed using Fisher exact test. The primary analysis was performed using the ITT population and both the missing data equals treatment failure (MEF) and last observation carried forward (LOCF) methods. The more conservative MEF results are recorded here.
Time frame: 24 weeks
Mean Change From Baseline in Viral Load (log10) at Week 24/EOS
The mean change in HIV-1 RNA (log10) from the Baseline measurement was analyzed at Week 24/End of Study using a generalized linear model at each scheduled study visit.
Time frame: Week 24 / End of Study
Mean Change From Baseline in CD4+ T-Cell Count at Week 24/EOS
The mean change in CD4+ T-cell count from the Baseline measurement at Week 24/End of Study was summarized at each scheduled time point by treatment group.
Time frame: Week 24 / End of Study
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Kaiser Permanente of Colorado
Denver, Colorado, United States
National Jewish Medical & Research Center
Denver, Colorado, United States
Whitman-Walker Clinic
Washington D.C., District of Columbia, United States
South Florida Clinical Research
Atlantis, Florida, United States
University of Miami, Miller School of Medicine
Miami, Florida, United States
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