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HIV-1Phase 1NCT02217904

A Study of Islatravir (MK-8591) in Anti-Retroviral Therapy-Naive, Human Immunodeficiency Virus-1 Infected Participants (MK-8591-003)

A Phase 1 study testing 1 mg islatravir, 2 mg islatravir and 10 mg islatravir in people with HIV-1, run by Merck Sharp & Dohme LLC.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will evaluate the safety, tolerability, pharmacokinetics, and anti-retroviral therapy (ART) activity of islatravir (MK-8591) monotherapy in ART-naive, human immunodeficiency virus-1 (HIV-1) infected participants. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
HIV-1
What is being tested?
1 mg islatravir, 2 mg islatravir and 10 mg islatravir
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
No sites listed yet
Study dates
17 Sep 2015to 11 May 2017
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Non-pregnant, non-breast feeding, postmenopausal or surgically sterile female
  • Female with reproductive potential agrees to use (or have male partner use) two acceptable methods of birth control
  • Male agrees to use acceptable method of contraception during study and for 90 days after last dose of trial drug
  • Has stable baseline health, other than HIV infection
  • Has no significantly abnormal electrocardiogram
  • Is HIV-1 positive
Show all 12Show fewer
  • Have a screening plasma HIV-1 RNA ≥ 10,000 copies/mL within 30 days prior to the treatment phase of this study. For inclusion in Panel Islatravir Extended Observation, participants must also have a screening plasma HIV-1 RNA ≤ 25,000 copies/mL within 30 days prior to the treatment phase.
  • Is ART naive
  • Has not received any investigational agent or marketed ART within 30 days of trial drug administration
  • Is diagnosed with HIV-1 infection >= 3 months prior to screening
  • Is willing to receive no other ART during treatment phase of study
  • Has no evidence of mutations conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs)

Who cannot join

  • Is mentally or legally institutionalized/incapacitated, or has significant emotional problems, or has a history of clinically significant psychiatric disorder of the last 5 years
  • Has a history of clinically significant endocrine, gastrointestinal, cardiovascular, hematological, hepatic, immunological (outside of HIV-1 infection), renal, respiratory, genitourinary, major neurological abnormalities or diseases
  • Has a history of cancer (malignancy)
  • Has a history of significant multiple and/or severe allergies, or had an anaphylactic reaction to drugs or food
  • Is positive for hepatitis B surface antigen
  • Has a history of chronic Hepatitis C
Show all 11Show fewer
  • Had major surgery or lost 500 mL of blood with 4 weeks prior to screening visit
  • Has participated in another investigational trial within 4 weeks prior to dosing visit
  • Will use any medications, prescribed drugs, or herbal remedies 4 weeks prior to dosing of trial drug, up to the post-trial visit
  • Consumes excessive amounts of alcohol, caffeinated beverages, or tobacco products
  • Uses illicit drugs or has a history of drug abuse within the prior 2 years

About this study

Official title: A Single-Dose Clinical Trial to Study the Safety, Tolerability, Pharmacokinetics, and Anti-Retroviral Activity of MK-8591 Monotherapy in Anti-Retroviral Therapy (ART)-Naive, HIV-1 Infected Patients

This study will evaluate the safety, tolerability, pharmacokinetics, and anti-retroviral therapy (ART) activity of islatravir (MK-8591) monotherapy in ART-naive, human immunodeficiency virus-1 (HIV-1) infected participants. The primary hypothesis is that at a safe and tolerable dose of islatravir, the true mean difference in the plasma HIV-1 ribonucleic acid (RNA) reduction from baseline between islatravir and placebo is at least 0.5 log (base10) copies/mL.

Conditions
HIV-1
Being tested
1 mg islatravir, 2 mg islatravir, 10 mg islatravir, 30 mg islatravir, 0.5 mg islatravir

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 1 mg islatravirDrug

    Also called MK-8591

    Single oral dose of 1 mg islatravir administered following ≥8 hour fast

  • 2 mg islatravirDrug

    Also called MK-8591

    Single oral dose of 2 mg islatravir administered following ≥8 hour fast

  • 10 mg islatravirDrug

    Also called MK-8591

    Single oral dose of 10 mg islatravir administered following ≥8 hour fast

  • 30 mg islatravirDrug

    Also called MK-8591

    Single oral dose of 30 mg islatravir administered following ≥8 hour fast

  • 0.5 mg islatravirDrug

    Also called MK-8591

    Single oral dose of 0.5 mg islatravir administered following ≥8 hour fast

  • 0.25 mg islatravirDrug

    Also called MK-8591

    Single oral dose of 0.25 mg islatravir administered following ≥8 hour fast

Study groups in NCT02217904
Study groupRoleWhat they receive
Islatravir 1 mgExperimentalSingle oral dose of islatravir 1 mg
Receives: Drug: 1 mg islatravir
Islatravir 2 mgExperimentalSingle oral dose of islatravir 2 mg
Receives: Drug: 2 mg islatravir
Islatravir 10 mgExperimentalSingle oral dose of islatravir 10 mg
Receives: Drug: 10 mg islatravir
Islatravir 30 mgExperimentalSingle oral dose of islatravir 30 mg
Receives: Drug: 30 mg islatravir
Islatravir 0.5 mgExperimentalSingle oral dose of islatravir 0.5 mg
Receives: Drug: 0.5 mg islatravir
Islatravir 0.25 mgExperimentalSingle oral dose of islatravir 0.25 mg
Receives: Drug: 0.25 mg islatravir
Islatravir 30 mg Extended ObservationExperimentalSingle oral dose of 30 mg islatravir administered following >8 hour fast. Participants will be closely monitored for viral load for up to approximately 21 days prior to starting standard of care ART.
Receives: Drug: 30 mg islatravir

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in Plasma HIV-1 RNA at 168 Hours Post-Dose

    Plasma HIV-1 RNA was measured using the Roche COBAS Ampliprep/COBAS TaqMan HIV-1 test v.2.0, which has a linear range from 20 to 10,000,000 copies/mL. The lower limit of detection has 100% specificity at 20 copies/mL. Additionally, the test increases the probability of detection and expands coverage by targeting two highly conserved regions of the HIV-1 genome to compensate for the possibility of mutations or mismatches.

    Measured: Baseline and 168 hours (7 days) post-dose

  2. Number of Participants With One or More Adverse Events

    An adverse event (AE) is any untoward medical occurrence in a study participant administered a pharmaceutical product that does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not related to the medicinal product.

    Measured: Up to 21 days post-dose

Secondary outcomes (9)
  1. Area Under the Concentration-Time Curve of Islatravir Triphosphate in Peripheral Blood Mononuclear Cells From Time 0 to 168 Hours (AUC0-168hr)

    Blood was collected to measure intracellular islatravir triphosphate concentration in peripheral blood mononuclear cells and determine AUC0-168hr.

    Measured: 4, 12, 24, 96, 120, 144, and 168 hours after islatravir administration. Value at predose was inferred from plasma predose sample.

  2. Maximum Concentration (Cmax) of Islatravir Triphosphate in Peripheral Blood Mononuclear Cells

    Blood was collected to measure intracellular islatravir triphosphate concentration in peripheral blood mononuclear cells and determine Cmax.

    Measured: 4, 12, 24, 96, 120, 144, and 168 hours after islatravir administration. Value at predose was inferred from plasma predose sample.

  3. Concentration of Islatravir Triphosphate in Peripheral Blood Mononuclear Cells at 168 Hours Post-Dose (C168hr)

    Blood was collected to measure intracellular islatravir triphosphate concentration in peripheral blood mononuclear cells and determine C168hr.

    Measured: 168 hours after islatravir administration

  4. Time to Maximum Concentration (Tmax) of Islatravir Triphosphate in Peripheral Blood Mononuclear Cells

    Blood was collected to measure intracellular islatravir triphosphate concentration in peripheral blood mononuclear cells and determine TMax.

    Measured: 4, 12, 24, 96, 120, 144, and 168 hours after islatravir administration. Value at predose was inferred from plasma predose sample.

  5. Apparent Terminal Half-Life (t1/2) of Islatravir Triphosphate in Peripheral Blood Mononuclear Cells

    Blood was collected to measure intracellular islatravir triphosphate concentration in peripheral blood mononuclear cells and determine apparent terminal t1/2.

    Measured: 4, 12, 24, 96, 120, 144, and 168 hours after islatravir administration. Value at predose was inferred from plasma predose sample.

  6. Area Under the Plasma Concentration-Time Curve of Islatravir From Time 0 to 168 Hours (AUC0-168hr)

    Blood was collected for the determination of AUC0-168hr of islatravir in plasma.

    Measured: Predose and at 0.25, 0.5, 1, 2, 4, 8, 12, 24, 48, and 96 hours after islatravir administration. Value at 168 hours was extrapolated.

  7. Maximum Plasma Concentration (Cmax) of Islatravir

    Blood was collected for the determination of Cmax of islatravir in plasma.

    Measured: Predose and at 0.25, 0.5, 1, 2, 4, 8, 12, 24, 48, and 96 hours after islatravir administration

  8. Time to Maximum Plasma Concentration (Tmax) of Islatravir

    Blood was collected for the determination of Tmax of islatravir in plasma.

    Measured: Predose and at 0.25, 0.5, 1, 2, 4, 8, 12, 24, 48, and 96 hours after islatravir administration

  9. Apparent Terminal Half-Life (t1/2) of Islatravir in Plasma

    Blood was collected for the determination of apparent terminal t1/2 of islatravir in plasma.

    Measured: Predose and at 0.25, 0.5, 1, 2, 4, 8, 12, 24, 48, and 96 hours after islatravir administration

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Aug 2014 (estimated)
  2. Study start17 Sep 2015
  3. Primary completion11 May 2017
  4. Study completion11 May 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02217904
Sponsor's protocol ID
8591-003
Other IDs
2014-002192-28, MK-8591-003, 2014
Status last verified
Jul 2019
First submitted
13 Aug 2014
Last updated
12 Aug 2019
Data monitoring committee
No
Individual data sharing
Yes: https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf

Publications

  • Schurmann D, Rudd DJ, Zhang S, De Lepeleire I, Robberechts M, Friedman E, Keicher C, Huser A, Hofmann J, Grobler JA, Stoch SA, Iwamoto M, Matthews RP. Safety, pharmacokinetics, and antiretroviral activity of islatravir (ISL, MK-8591), a novel nucleoside reverse transcriptase translocation inhibitor, following single-dose administration to treatment-naive adults infected with HIV-1: an open-label, phase 1b, consecutive-panel trial. Lancet HIV. 2020 Mar;7(3):e164-e172. doi: 10.1016/S2352-3018(19)30372-8. Epub 2020 Jan 3.

    PubMed 31911147

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing 1 mg islatravir, 2 mg islatravir and 10 mg islatravir in people with HIV-1, run by Merck Sharp & Dohme LLC.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Dec 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Plasma HIV-1 RNA at 168 Hours Post-Dose (time frame: Baseline and 168 hours (7 days) post-dose). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02217904, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2019.

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