This is a phase 2, single-group, multi-site, open-label study of an islatravir/doravirine (ISL/DOR, MK-8591A) fixed dose combination (FDC) for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in pediatric participants who are virologically suppressed (VS) on antiretroviral therapy (ART) for ≥3 months or are treatment-naive (TN). The primary purposes of the study are 1) to examine the steady-state pharmacokinetics (PK) of ISL in plasma; 2) the steady-state PK of ISL-triphosphate (ISL-TP) in peripheral blood mononuclear cells (PBMCs); and 3) to examine the safety and tolerability of ISL/DOR.
As of protocol amendment 03 (approved 08-Feb-2022), all participants have been discontinued from study therapy and will be switched to non-study antiretroviral therapy and monitored for safety. The present results cover data obtained through the cut-off date of 30-Mar-2022, and will be updated once monitoring is completed.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
42
100 mg DOR/0.75 mg ISL FDC tablet taken once daily by mouth.
Children's National Medical Center ( Site 1816)
Washington D.C., District of Columbia, United States
Emory Children's Center ( Site 1805)
Atlanta, Georgia, United States
Johns Hopkins University ( Site 1800)
Baltimore, Maryland, United States
Duke University ( Site 1807)
Durham, North Carolina, United States
Azienda Ospedaliera Luigi Sacco ( Site 1300)
Milan, Italy
IRCCS Ospedale Pediatrico Bambino Gesu ( Site 1301)
Roma, Italy
Krasnoyarsk Regional Center for Prevention and Control of AIDS ( Site 1507)
Krasnoyarsk, Krasnoyarsk Krai, Russia
Infectious Clinical Hospital #2 ( Site 1501)
Moscow, Moscow, Russia
FGU Republican Clinical Infectious Hospital of Roszdrav ( Site 1500)
Saint Petersburg, Sankt-Peterburg, Russia
Saratov Regional Clinical Center for Prophylaxis and Control of AIDS ( Site 1505)
Saratov, Saratov Oblast, Russia
...and 7 more locations
Area Under the Plasma Drug Concentration-time Curve From 0 to 24 Hours Post-dose (AUC0-24) of Islatravir (ISL)
The AUC0-24 of ISL in plasma was determined at steady state.
Time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28
Maximum Plasma Concentration (Cmax) of ISL
The Cmax of ISL in plasma was determined at steady state.
Time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28
Time to Reach Maximum Plasma Concentration (Tmax) of ISL
The Tmax of ISL in plasma was determined at steady state.
Time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28
Apparent Plasma Terminal Half-life (t½) of ISL
The t½ of ISL in plasma was determined at steady state.
Time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28
Apparent Total Clearance From Plasma (CL/F) of ISL
The CL/F of ISL from plasma was determined at steady state.
Time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28
Apparent Volume of Distribution During Terminal Phase (Vz/F) of ISL
The Vz/F of ISL was determined at steady state.
Time frame: Pre-dose, and 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose on Day 28
AUC0-last of ISL-triphosphate (ISL-TP) in Peripheral Blood Mononuclear Cells (PBMCs)
The AUC0-24 of ISL-TP in PBMCs was determined at steady state.
Time frame: Pre-dose, and 4 and 24 hours post-dose on Day 28
Cmax of ISL-TP in PBMCs
The Cmax of ISL-TP in PBMCs was determined at steady state.
Time frame: Pre-dose, and 4, and 24 hours post-dose on Day 28
C24 of ISL-TP in PBMCs
The C24 of ISL-TP in PBMCs was determined at steady state.
Time frame: 24 hours post-dose on Day 28
Number of Participants Experiencing ≥1 Adverse Event (AE)
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
Time frame: Up to 24 weeks
Number of Participants Discontinuing From Study Treatment Due to an AE
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
Time frame: Up to 24 weeks
Percentage of Virologically Suppressed (VS) Participants With HIV-1 Ribonucleic Acid (RNA) ≥50 Copies/mL
The percentage of VS participants with HIV-1 RNA ≥50 copies/mL was determined at the central laboratory with an Abbott Real Time Polymerase Chain Reaction (PCR) assay with a lower limit of detection (LLOD) of 40 copies/mL.
Time frame: Week 24
Percentage of VS Participants With HIV-1 RNA <50 Copies/mL
The percentage of VS participants with HIV-1 RNA \<50 copies/mL will be determined at the central laboratory with an Abbott Real Time PCR assay with a LLOD of 40 copies/mL.
Time frame: Week 24
Percentage of Treatment Naive (TN) Participants With HIV-1 RNA <50 Copies/mL
The percentage of TN participants with HIV-1 RNA \<50 copies/mL will be determined at the central laboratory with an Abbott Real Time PCR assay with a LLOD of 40 copies/mL.
Time frame: Week 24
Change From Baseline in Cluster of Differentiation 4+ (CD4+) T-cells in VS Participants
CD4+ T-cell counts were measured by a central laboratory. Negative and positive results represent a decrease and increase, respectively, from baseline CD4+ T-cell counts.
Time frame: Baseline (Day 1) and Week 24
Change From Baseline in CD4+ T-cells in TN Participants
CD4+ T-cell counts were measured by a central laboratory. Negative and positive results represent a decrease and increase, respectively, from baseline CD4+ T-cell counts.
Time frame: Baseline (Day 1) and Week 24
Incidence of Viral Drug Resistance to DOR
The number of participants with viral drug resistance to DOR was determined.
Time frame: Up to 24 weeks
Incidence of Viral Drug Resistance to ISL
The number of participants with viral drug resistance to ISL was determined.
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Time frame: Up to 24 weeks
Palatability of DOR/ISL Tablet
The palatability of the DOR/ISL tablet (whole or split) was assessed with a modified 5-point facial hedonic scale. Responses ranged from 1 ("very bad") to 5 ("very good"). Data show the number of VS and TN participants responding at each score at the designated time points.
Time frame: Baseline (Day 1), Week 4, and Week 24
Acceptability of DOR/ISL Tablet
The acceptability of the DOR/ISL tablet (whole or split) was assessed. Acceptability was assessed by monitoring for refusing the tablet, throwing up or spitting out the tablet, and gagging on the tablet. Data show the number of VS and TN participants responding at each score at the designated time points.
Time frame: Baseline (Day 1), Week 4, and Week 24