ViiV Healthcare Announces Superior Efficacy of Dolutegravir Versus Lopinavir/Ritonavir in Second-line HIV Treatment in Resource-limited Settings
ViiV Healthcare Announces Superior Efficacy of Dolutegravir Versus Lopinavir/Ritonavir in Second-line HIV Treatment in Resource-limited Settings
PR69451
LONDON, July 25, 2017 /PRNewswire=KYODO JBN/ --
- DAWNING study modified to allow patients the opportunity to receive
dolutegravir-based regimens
ViiV Healthcare, the global specialist HIV company, majority owned by GSK, with
Pfizer Inc. and Shionogi Limited as shareholders, today announced positive
interim results from DAWNING. This is a non-inferiority study conducted to
compare second-line treatment of the protease inhibitor-sparing regimen of
dolutegravir and 2 nucleoside reverse transcriptase inhibitors (NRTIs), with a
current WHO-recommended regimen of lopinavir/ritonavir and 2 NRTIs in
HIV-1-infected adults. Results are being presented at the International AIDS
Society congress in Paris.
(Logo: http://photos.prnewswire.com/prnh/20160223/336449LOGO )
The study's Independent Data Monitoring Committee (IDMC) noted significant and
clinically-relevant differences between treatment arms in favour of
dolutegravir and recommended that the boosted lopinavir treatment arm be
discontinued. Participants receiving lopinavir/ritonavir were offered the
opportunity to switch to a regimen with dolutegravir as the core agent, if
considered appropriate by the investigator.
The primary endpoint was the proportion of patients with plasma HIV-1 RNA <50
copies per millilitre (c/mL) at week 48. The 24-week interim data showed an 82%
response rate in the dolutegravir arm versus 69% for lopinavir/ritonavir
(p<0.001). Key secondary endpoints include evaluation of the development of
viral resistance and measurements of safety and tolerability. No subjects in
the dolutegravir arm of the study failed treatment with either integrase or
nucleoside resistance. The safety data for dolutegravir at week 24 was
consistent with previous dolutegravir studies. Additional data from DAWNING
will be presented at future medical meetings.
John C Pottage, Jr, MD, Chief Scientific and Medical Officer, ViiV Healthcare,
commented "The initial results from DAWNING are important because they not only
provide information that may help guide second-line treatment decisions in
resource-limited settings, but also reaffirm the position of dolutegravir at
the core of HIV care. We are working with investigators to ensure that
dolutegravir can be provided to patients in the control arm and are looking
forward to sharing the 48-week results, as soon as they will be available."
Notes to editors
Tivicay is a registered trademark of the ViiV Healthcare group of companies.
For more information on the trials please visit: http://www.clinicaltrials.gov
About the DAWNING study
DAWNING is a phase IIIb, non-inferiority study conducted to compare a protease
inhibitor-sparing regimen of DTG and 2 NRTIs with a current WHO-recommended
regimen of LPV/RTV + 2 NRTIs in HIV-1 infected patients failing first-line
therapy of a NNRTI + 2 NRTIs (ClinicalTrials.gov: NCT02227238). The IDMC
performed periodic reviews of data to protect the ethical and safety interests
of patients.
Adult patients failing first-line therapy, with HIV-1 RNA ≥400
copies(c)/mL, were randomised (1:1, stratified by baseline plasma HIV-1 RNA and
number of fully active background NRTIs) to 52 weeks of open-label treatment
with DTG or LPV/RTV combined with an investigator-selected dual NRTI
background, including at least one fully active NRTI.
TIVICAY (dolutegravir) tablets
Professional Indication(s) and Important Safety Information
Indications and Usage
TIVICAY is a human immunodeficiency virus type 1 (HIV-1) integrase strand
transfer inhibitor (INSTI) indicated in combination with other antiretroviral
agents for the treatment of HIV-1 infection in adults and paediatric patients
weighing at least 30 kg
Limitations of use:
Use of TIVICAY in INSTI-experienced patients should be guided by the number and
type of baseline INSTI substitutions. The efficacy of TIVICAY 50 mg twice daily
is reduced in patients with an INSTI-resistance Q148 substitution plus 2 or
more additional INSTI-resistance substitutions including T66A, L74I/M,
E138A/K/T, G140S/A/C, Y143R/C/H, E157Q, G163S/E/K/Q, or G193E/R
Important Safety Information
Contraindications:
TIVICAY is contraindicated in patients:
With previous hypersensitivity reaction to dolutegravir
Receiving dofetilide (antiarrhythmic)
Hypersensitivity Reactions:
Hypersensitivity reactions have been reported and were characterized by rash,
constitutional findings, and sometimes organ dysfunction, including liver
injury. The events were reported in <1% of subjects receiving TIVICAY in phase
III clinical trials
Discontinue TIVICAY and other suspect agents immediately if signs or symptoms
of hypersensitivity reactions develop, as a delay in stopping treatment may
result in a life-threatening reaction. Monitor clinical status, including liver
aminotransferases, and initiate appropriate therapy if hypersensitivity
reaction is suspected
Effects on Serum Liver Biochemistries in Patients with Hepatitis B or C
Co-infection:
Patients with underlying hepatitis B or C may be at increased risk for
worsening or development of transaminase elevations with use of TIVICAY. In
some cases the elevations in transaminases were consistent with immune
reconstitution syndrome or hepatitis B reactivation, particularly in the
setting where anti-hepatitis therapy was withdrawn
Appropriate laboratory testing prior to initiating therapy and monitoring for
hepatotoxicity during therapy with TIVICAY are recommended in patients with
underlying hepatic disease such as hepatitis B or C
Fat Redistribution or accumulation has been observed in patients receiving
antiretroviral therapy.
Immune Reconstitution Syndrome, including the occurrence of autoimmune
disorders with variable time to onset, has been reported.
Adverse Reactions: The most commonly reported (≥2%) adverse reactions of
moderate to severe intensity in treatment-naïve adult subjects in any one trial
receiving TIVICAY in a combination regimen were insomnia (3%), fatigue (2%),
and headache (2%).
Drug Interactions:
Coadministration of TIVICAY with certain inducers of UGT1A and/or CYP3A may
reduce plasma concentrations of dolutegravir and require dose adjustments of
TIVICAY
Administer TIVICAY 2 hours before or 6 hours after taking polyvalent
cation-containing antacids or laxatives, sucralfate, oral supplements
containing iron or calcium, or buffered medications. Alternatively, TIVICAY and
supplements containing calcium or iron can be taken with food
Consult the full Prescribing Information for TIVICAY for more information on
potentially significant drug interactions, including clinical comments
Pregnancy: TIVICAY should be used during pregnancy only if the potential
benefit justifies the potential risk. An Antiretroviral Pregnancy Registry has
been established.
Nursing Mothers: Breastfeeding is not recommended due to the potential for HIV
transmission and the potential for adverse reactions in nursing infants.
About ViiV Healthcare
ViiV Healthcare is a global specialist HIV company established in November 2009
by GlaxoSmithKline (LSE: GSK) and Pfizer (NYSE: PFE) dedicated to delivering
advances in treatment and care for people living with HIV and for people who
are at risk of becoming infected with HIV. Shionogi joined in October 2012. The
company's aim is to take a deeper and broader interest in HIV/AIDS than any
company has done before and take a new approach to deliver effective and
innovative medicines for HIV treatment and prevention, as well as support
communities affected by HIV. For more information on the company, its
management, portfolio, pipeline, and commitment, please visit
http://www.viivhealthcare.com .
About GSK
GSK - one of the world's leading research-based pharmaceutical and healthcare
companies - is committed to improving the quality of human life by enabling
people to do more, feel better and live longer. For further information please
visit http://www.gsk.com.
Cautionary statement regarding forward-looking statements
GSK cautions investors that any forward-looking statements or projections made
by GSK, including those made in this announcement, are subject to risks and
uncertainties that may cause actual results to differ materially from those
projected. Such factors include, but are not limited to, those described under
Item 3.D 'Principal risks and uncertainties' in the company's Annual Report on
Form 20-F for 2016.
SOURCE: ViiV Healthcare
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