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Ibalizumab Plus Optimized Background Regimen in Treatment-Experienced Patients With Multi-Drug Resistant HIV-1

Phase 3
Completed
Conditions
HIV
Interventions
Drug: Optimized Background Regimen
Registration Number
NCT02707861
Lead Sponsor
TaiMed Biologics Inc.
Brief Summary

Ibalizumab is a monoclonal antibody that works by blocking HIV entry into the immune system cells (CD4+ or T-cells) the virus typically infects. Ibalizumab is intended for use in combination with other anti-HIV drugs in people with multi-drug resistant HIV and limited treatment options. This study will collect further information on the safety and tolerability of intravenously administered (IV) ibalizumab combined with an optimized background regimen for treating multi-drug resistant HIV-1 infection, and will provide continuing access to ibalizumab for patients completing a prior ibalizumab clinical trial.

Detailed Description

Participants will enroll into one of two study cohorts. Cohort 1 will provide continued administration of IV ibalizumab for patients completing a prior ibalizumab clinical trial (TaiMed-sponsored or Investigator-Sponsored). Patients will continue to receive IV infusions of ibalizumab at the dosage assigned in the previous study - either 800 mg once every two weeks, or 2000 mg once every four weeks.

Cohort 2 will provide IV ibalizumab, 800 mg once every two weeks, for qualifying patients with multi-drug resistant HIV-1 and limited treatment options who have never previously received ibalizumab.

Participants may continue in this study for 48 weeks, or until ibalizumab becomes commercially available, whichever occurs first.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
79
Inclusion Criteria

(Cohort 1)

  • Currently receiving ibalizumab via other TaiMed-sponsored or investigator-Sponsored protocol
  • Are capable of understanding and have voluntarily signed the informed consent document

(Cohort 2)

  • 18 years of age or older
  • Are capable of understanding and have voluntarily signed the informed consent document
  • Have documented HIV-1 infection by official, signed, written history (e.g., laboratory report), otherwise an HIV-antibody test will be performed
  • Are able and willing to comply with all protocol requirements and procedures
  • Have a viral load >1,000 copies/mL and documented resistance to at least one antiretroviral medication from each of three classes of antiretroviral medications as measured by previous viral resistance testing (resistance testing is not provided by the study for qualification purposes)
  • Have a history of at least 6 months on antiretroviral treatment
  • Are receiving a failing antiretroviral regimen OR have failed and are off therapy
  • Have viral sensitivity/susceptibility to at least one antiretroviral agent, other than ibalizumab, as determined by previous resistance test performed within 6 months of screening and be willing and able to be treated with at least one agent to which the patient's viral isolate is fully sensitive/susceptible according to the resistance tests used for screening as a component of OBR
  • If sexually active, are willing to use an effective method of contraception during the study and for 30 days after the last administration of the study drug
Exclusion Criteria

(Cohort 1)

  • There are no Exclusion Criteria for patients meeting the Inclusion Criteria for Cohort 1

(Cohort 2)

  • Eligible for participation in other TaiMed-sponsored clinical trials of ibalizumab

  • Any significant diseases (other than HIV-1 infection) or clinically significant findings, including psychiatric and behavioral problems, determined from screening, medical history and/or physical examination that, in the investigator's opinion, would preclude the patient from participating in this study

  • Any significant acute illness within 1 week before the first administration of investigational medication on this study

  • Any active infection secondary to HIV requiring acute therapy; however, patients that require maintenance therapy (i.e., secondary prophylaxis for opportunistic infections) will be eligible for the study.

  • Any immunomodulating therapy (including interferon), systemic steroids, or systemic chemotherapy within 4 weeks before Day 0

  • Any prior exposure to ibalizumab (formerly TNX-355 and Hu5A8)

  • Any vaccination within 7 days before Day 0

  • Any female patient who either is pregnant, intends to become pregnant, or is currently breastfeeding

  • Any current alcohol or illicit drug use that, in the investigator's opinion, will interfere with the patient's ability to comply with the study schedule and protocol evaluations

  • Any previous clinically significant allergy or hypersensitivity to any excipient in the ibalizumab formulation

  • Any radiation therapy during the 28 days before first administration of investigational medication on this study

  • Any clinically significant Grade 3 or 4 laboratory abnormality according to the Division of AIDS (DAIDS) grading scale, except for the following asymptomatic Grade 3 events:

    • triglyceride elevation
    • total cholesterol elevation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cohort 2Optimized Background RegimenIV ibalizumab (combined with optimized background regimen): 800 mg once every two weeks for qualifying patients who have never received ibalizumab Administered for 48 weeks, or until ibalizumab becomes commercially available
Cohort 1Optimized Background RegimenIV ibalizumab (combined with optimized background regimen): 800 mg once every two weeks for patients receiving that dosage on prior, successfully completed ibalizumab clinical trial OR 2000 mg once every four weeks for patients receiving that dosage on prior, successfully completed ibalizumab clinical trial Administered for 48 weeks, or until ibalizumab becomes commercially available
Cohort 1ibalizumabIV ibalizumab (combined with optimized background regimen): 800 mg once every two weeks for patients receiving that dosage on prior, successfully completed ibalizumab clinical trial OR 2000 mg once every four weeks for patients receiving that dosage on prior, successfully completed ibalizumab clinical trial Administered for 48 weeks, or until ibalizumab becomes commercially available
Cohort 2ibalizumabIV ibalizumab (combined with optimized background regimen): 800 mg once every two weeks for qualifying patients who have never received ibalizumab Administered for 48 weeks, or until ibalizumab becomes commercially available
Primary Outcome Measures
NameTimeMethod
Effectiveness of Ibalizumab + OBR (Cohort 2 Only)7 days

Number of patients in Cohort 2 achieving at least a 0.5 log change from Baseline in viral load at Day 7 of the study

Safety and Tolerability of Ibalizumab + OBRThrough 48 weeks

Number of participants with Grade 3/4 adverse events possibly, probably, or definitely due to ibalizumab

Discontinuations Due to Adverse Events Related to Ibalizumab48 weeks

number of participants discontinuing ibalizumab treatment due to adverse events probably, possibly, or definitely related to ibalizumab

Secondary Outcome Measures
NameTimeMethod
Suppression to <400 Copies by Ibalizumab + OBR (Cohort 2 Only)48 weeks

Number of patients in Cohort 2 with HIV-1 RNA levels \<400 copies/mL at week 48

Effectiveness of Ibalizumab + OBR by 1.0 Log10 Decrease in Viral Load From Baseline (Cohort 2 Only)48 weeks

Number of patients in Cohort 2 achieving at least a 1.0 log10 decrease in viral load from Baseline measurement at all assessment time points

Suppression to <50 Copies With Ibalizumab + OBR (Cohort 2 Only)48 weeks

Number of patients in Cohort 2 with HIV-1 RNA levels \<50 copies/mL at week 48

Trial Locations

Locations (32)

Palmtree Clinical Research, Inc.

🇺🇸

Palm Springs, California, United States

Southern California Permanente Medical Group

🇺🇸

Los Angeles, California, United States

Charles R. Drew University of Medicine and Science, Clinical and Translational Research Center

🇺🇸

Los Angeles, California, United States

Anthony Mills MD Inc.

🇺🇸

Los Angeles, California, United States

Triple O Research Institute

🇺🇸

West Palm Beach, Florida, United States

AIDS Research Consortium of Atlanta

🇺🇸

Atlanta, Georgia, United States

Philadelphia FIGHT

🇺🇸

Philadelphia, Pennsylvania, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

Long Beach Education and Research Consultants

🇺🇸

Long Beach, California, United States

Ruane Clinical Research Institute Inc.

🇺🇸

Los Angeles, California, United States

ID Research Institute

🇺🇸

Springfield, Massachusetts, United States

Central West Clinical Research

🇺🇸

Saint Louis, Missouri, United States

National Institute of Allergy & Infectious Diseases

🇺🇸

Bethesda, Maryland, United States

Howard Brown Health Center

🇺🇸

Chicago, Illinois, United States

AIDS Healthcare Foundation - Manhattan Midtown HCC

🇺🇸

New York, New York, United States

Chelsea Village Medical

🇺🇸

New York, New York, United States

East Carolina University

🇺🇸

Greenville, North Carolina, United States

St. Hope Foundation Community Health Center

🇺🇸

Bellaire, Texas, United States

North Texas Infectious Disease Consultants

🇺🇸

Dallas, Texas, United States

Crofoot Research Center

🇺🇸

Houston, Texas, United States

St. Jude's Children's Research Hospital

🇺🇸

Memphis, Tennessee, United States

Clinical Research PR, Inc.

🇵🇷

San Juan, Puerto Rico

Research Access Network

🇺🇸

Houston, Texas, United States

eStudy Site

🇺🇸

San Francisco, California, United States

Kaiser Foundation Research Institute

🇺🇸

San Francisco, California, United States

AIDS Healthcare Foundation - South Beach

🇺🇸

Miami, Florida, United States

Georgetown University School of Medicine

🇺🇸

Washington, District of Columbia, United States

Orlando Immunology Center

🇺🇸

Orlando, Florida, United States

Gary Richmond, MD, PA

🇺🇸

Fort Lauderdale, Florida, United States

AIDS Healthcare Foundation - Kinder Medical Group

🇺🇸

Miami, Florida, United States

Jacobi Medical Center

🇺🇸

Bronx, New York, United States

University of Hawaii - John A. Burns School of Medicine

🇺🇸

Honolulu, Hawaii, United States

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