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| Name | Class |
|---|---|
| Merck Sharp & Dohme LLC | INDUSTRY |
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Drug therapy for persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) co-infected with latent tuberculosis infection (LTBI) is complex. Anti-tuberculosis drugs used to treat LTBI often induce drug metabolizing enzymes that share the same metabolic pathway as antiretroviral drugs used for those living with HIV/AIDS. This study evaluates the drug-drug interaction (DDI) potential of an antiretroviral drug when co-administered with a common anti-tuberculosis regimen of drugs.
Rifapentine (RPT) and isoniazid (INH) given once weekly for 12 weeks is commonly used for treating LTBI in adults. For people living with HIV-1, the risks of LTBI is increased. Individuals living with HIV-1 are often on chronic antiretroviral drugs that prevent immunodeficiency and complications associated with infection. Unfortunately, antiretroviral drugs are subject to many DDIs especially with RPT which induces drug clearing enzymes.
Doravirine (DOR) is a newly approved non-nucleoside reverse transcriptase inhibitor indicated for the treatment of HIV-1 infection. Because RPT induces the metabolic pathway in which DOR is removed, there is concern that taking both concomitantly will result in an unwanted DDI leading to reduced DOR concentrations in the blood. Reduced levels will result in loss of efficacy for the drug and therefore not provide adequate viral suppression in those living with HIV. This study investigates the DDI potential of the once weekly regimen RPT and INH together with DOR in healthy volunteers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | Period 1: DOR twice-daily alone (Study days 1-4) and Period 2: DOR twice-daily with RPT and INH once-weekly (Study days 7-21) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Doravirine (DOR) | Drug | Non-nucleoside reverse transcriptase inhibitor indicated for the treatment of HIV-1 infection in adults in combination with other antiretroviral agents. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Doravirine Maximum Concentration (Cmax) | Doravirine maximum observed concentration during the dosing interval | Day 4 and 21 (Period 1 and 2): 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose |
| Doravirine Area Under the Plasma Concentration Versus Time Curve From 0 to 12 Hours (AUC0-12) | Doravirine area under the plasma-concentration time curve derived from plasma sampling during one dosing interval | Day 4 and 21 (Period 1 and 2): 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose |
| Doravirine Oral Clearance (CL/F) | Doravirine apparent oral clearance derived from plasma sampling | Day 4 and 21 (Period 1 and 2): 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Event | Safety and tolerability | Days 1-24 post-dose (period 1 and 2) and 31-34 post-dose (post-study) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Walter K Kraft, MD | Sidney Kimmel Medical College at Thomas Jefferson University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Thomas Jefferson University Clinical Research Unit | Philadelphia | Pennsylvania | 19107 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Study Particpants | Eleven healthy volunteers enrolled into the study. For period 1 (study days 1-4), participants will be given doravirine 100mg oral tablets dosed twice-daily on study days 1-4. For period 2 (study days 7-21), oral 100mg doravirine will be dosed twice-daily. Weight-based rifapentine and isoniazid (as recommended by the CDC) will be given orally once-weekly on study days 7, 14, and 21. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Period 1: Study Days 1-4 |
| |||||||||||||
| Period 2: Study Days 7-21 |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Study Particpants | Eleven healthy volunteers enrolled into the study. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Doravirine Maximum Concentration (Cmax) | Doravirine maximum observed concentration during the dosing interval | Posted | Geometric Mean | 95% Confidence Interval | ug/mL | Day 4 and 21 (Period 1 and 2): 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose |
|
Daily for the duration of the study and 7-10 days post-study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Period 1 | DOR twice-daily alone (Study days 1-4) Doravirine (DOR): Non-nucleoside reverse transcriptase inhibitor indicated for the treatment of HIV-1 infection in adults in combination with other antiretroviral agents. Rifapentine (RPT): Rifamycin anti-tuberculosis agent indicated for the treatment of latent and active tuberculosis infection. Isoniazid (INH): Anti-tuberculosis agent indicated for the treatment of latent and active tuberculosis infection. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea/vomiting | Gastrointestinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Walter K. Kraft | Thomas Jefferson University | 215 955-9077 | walter.kraft@jefferson.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 17, 2019 | Feb 11, 2020 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D055985 | Latent Tuberculosis |
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D014376 | Tuberculosis |
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
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| ID | Term |
|---|---|
| C000592662 | doravirine |
| C018421 | rifapentine |
| D007538 | Isoniazid |
| D016568 | Drugs, Generic |
| ID | Term |
|---|---|
| D006834 | Hydrazines |
| D009930 | Organic Chemicals |
| D007539 | Isonicotinic Acids |
| D000147 | Acids, Heterocyclic |
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|
| Rifapentine (RPT) | Drug | Rifamycin anti-tuberculosis agent indicated for the treatment of latent and active tuberculosis infection. |
|
|
| Isoniazid (INH) | Drug | Anti-tuberculosis agent indicated for the treatment of latent and active tuberculosis infection. |
|
|
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Weight | Mean | Standard Deviation | Kilogram |
|
DOR twice-daily with RPT/INH once-weekly (Study days 7-21) |
|
|
| Primary | Doravirine Area Under the Plasma Concentration Versus Time Curve From 0 to 12 Hours (AUC0-12) | Doravirine area under the plasma-concentration time curve derived from plasma sampling during one dosing interval | Posted | Geometric Mean | 95% Confidence Interval | hr x ug/mL | Day 4 and 21 (Period 1 and 2): 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose |
|
|
|
| Primary | Doravirine Oral Clearance (CL/F) | Doravirine apparent oral clearance derived from plasma sampling | Posted | Geometric Mean | Geometric Coefficient of Variation | L/hr | Day 4 and 21 (Period 1 and 2): 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours post-dose |
|
|
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| Secondary | Adverse Event | Safety and tolerability | Posted | Number | participants | Days 1-24 post-dose (period 1 and 2) and 31-34 post-dose (post-study) |
|
|
|
| 0 |
| 11 |
| 0 |
| 11 |
| 4 |
| 11 |
| EG001 | Period 2 | DOR twice-daily with RPT/INH once-weekly (Study days 7-21) | 0 | 11 | 0 | 11 | 6 | 11 |
| Dysuria | Renal and urinary disorders | Non-systematic Assessment |
|
| Fever | General disorders | Non-systematic Assessment |
|
| Headache | Nervous system disorders | Non-systematic Assessment |
|
| Chills | General disorders | Non-systematic Assessment |
|
| Catheter site pain and redness | General disorders | Non-systematic Assessment |
|
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| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D000085343 | Latent Infection |
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| D006571 |
| Heterocyclic Compounds |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D004364 | Pharmaceutical Preparations |
| Fever |
|
| Headache |
|
| Chills |
|
| Catheter site pain and redness |
|