Albuvirtide in Combination With 3BNC117 in Virologically Suppressed Subjects With HIV-1 Infection

The Phase 2, Two Arms, One Site, Safety and Antiviral Activity of Combination Therapy With Albuvirtide and 3BNC117 in Virologically Suppressed Subjects With HIV-1 Infection After Analytical Treatment Interruption

This is a phase 2 study to evaluate the safety and tolerability of combination therapy with Albuvirtide (ABT) and 3BNC117 in virologically suppressed subjects with HIV-1 infection and explore the potential of viral suppression and viral reservoir clearance after analytical treatment interruption (ATI).

Study Overview

• Status: Unknown
• Conditions: HIV/AIDS
• Intervention / Treatment: Drug: Albuvirtide; Drug: 3BNC117

Detailed Description

This is an open-label, one site study, in which a total of 24 HIV-1 subjects who are virologically suppressed and stable on daily oral combination antiretroviral therapy will be enrolled.

All eligible patients will be switched from daily oral combination antiretroviral regimen to treatment of ABT and 3BNC117 for 14 weeks. There is a two-week overlap of the baseline oral antiretroviral therapy and the ABT-3BNC117 combination regimen at the beginning of the study treatment, and then the oral ART will be interrupted.

The patients will be monitored for viral rebound every two or four weeks following initiation of ABT-3BNC117 combination and will re-initiate an oral antiretroviral regimen if virological rebound is confirmed with plasma HIV-1 RNA levels above 200 copies/ml on two consecutive test.

Pharmacokinetics of ABT and 3BNC117 will be assessed in this study.

• Study Type: Interventional
• Enrollment (Anticipated): 24
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Cheng Yao; Email: yaocheng@frontierbiotech.com
• Study Contact Backup: Name: Xingxiang Xu; Phone Number: 025-69648410; Email: xxxu@frontierbiotech.com

Study Locations

• China
  • Beijing, China
    • Peking Union Medical College Hospital
    • Contact: Taisheng Li, M.D.; Email: litsh@263.net
    • Principal Investigator: Taisheng Li, M.D.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Males and females, age ≥18 years

2. For cohort 1: HIV-1 infected subjects initiated a stable combination antiretroviral therapy (ART) within 6 months of primary HIV infection (PHI), having the document evidence of initial diagnosis of HIV-1 infection and initiation of ART therapy within 6 months of PHI.

   For cohort 2: Chronically HIV-1 infected subjects initiated a stable combination antiretroviral therapy (ART) after 6 months of primary HIV infection (PHI), having the document evidence of initial diagnosis of HIV-1 infection and initiation of ART therapy after 6 months of PHI.

3. Plasma HIV-1 RNA <50 copies/mL for at least 12 months prior to Screening Visit. An exception for a recorded HIV-1 RNA "blip" (e.g., transient HIV-1 RNA >50 copies/mL) can be considered.
4. Plasma HIV-1 RNA <20 copies/mL at Screening Visit.
5. CD4 cell count >500 cells/µL.

6. Laboratory values at Screening of:

   1. Absolute neutrophil count (ANC) ≥0.75×10∧9/L;
   2. Hemoglobin (Hb) ≥105 g/L (male) or ≥95 g/L (female);
   3. Platelets ≥75×10∧9/L;
   4. Serum alanine transaminase (SGPT/ALT) < 2 x upper limit of normal (ULN)
   5. Serum aspartate transaminase (SGOT/AST) < 2 x ULN
   6. Bilirubin (total) <2.5 x ULN unless Gilbert's disease is present or subject is receiving atazanavir in the absence of other evidence of significant liver disease
   7. Creatinine ≤1.5 x ULN
7. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Principal Investigator.
8. Both male and female patients and their partners of childbearing potential must agree to use accepted methods of contraception.
9. Females of childbearing potential must have a negative serum pregnancy test at Screening visit and negative urine pregnancy test prior to receiving the first dose of study drug.
10. Subjects who have two or more potential alternative antiretroviral treatment regimens.
11. Willing and able to participate in all aspects of the study, including use of IV medication, completion of evaluations, attendance at scheduled clinic visits, and compliance with all protocol requirements as evidenced by providing written informed consent.

Exclusion Criteria:

1. Any active infection or malignancy requiring acute therapy.
2. Hepatitis B infection as manifest by the presence of Hepatitis B surface antigen (HBsAg).
3. Hepatitis C infection as manifest by positive anti-HCV antibody and positive HCV RNA assay at the time of screening.
4. Females who are pregnant, lactating, or breastfeeding, or who plan to become pregnant during the study
5. Unexplained fever or clinically significant illness within 1 week prior to the first study dose
6. Any vaccination within 2 weeks prior to the first study dose.
7. Subjects BMI<20 or >27 kg/m∧2 [BMI＝weight/height∧2].
8. History of Bleeding Disorder or patients on anti-coagulant therapy
9. Participation in an experimental drug trial(s) within 30 days of the Screening Visit
10. Any known allergy or antibodies to the study drug or excipients

11. Treatment with any of the following:

    1. Radiation or cytotoxic chemotherapy with 30 days prior to the screening visit
    2. Receipt of any fusion inhibitor and monoclonal antibody therapy of any kind in the past.
    3. Immunosuppressants within 60 days prior to the Screening Visit
    4. Immunomodulating agents (e.g., interleukins, interferons), hydroxyurea, or foscarnet within 60 days prior to the screening visit
    5. Oral or parenteral corticosteroids within 30 days prior to the Screening Visit. Subjects on chronic steroid therapy > 5 mg/day will be excluded with the following exception:
    6. Subjects on inhaled, nasal, or topical steroids will not be excluded
12. Any other clinical condition that, in the Investigator's judgment, would potentially compromise study compliance or the ability to evaluate safety/efficacy.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Early treatment of infection; HIV-1 infected subjects initiated a stable combination antiretroviral therapy (ART) within 6 months of primary HIV infection (PHI), and had plasma HIV-1 RNA <50 copies/mL for at least 12 months. Albuvirtide 0.32 g and 3BNC117 2 g every 2 weeks IV infusion for a total of 14 weeks.	Drug: Albuvirtide; Long-Acting HIV-1 Fusion Inhibitor (chemically modified peptide targeting HIV-1 gp41); Other Names: ABT; Drug: 3BNC117; Recombinant, fully human mAb of the IgG1κ isotype that specifically binds to HIV-1 gp120.
Experimental: Chronic period of infection treatment; Chronically HIV-1 infected subjects initiated a stable combination antiretroviral therapy (ART) after 6 months of primary HIV infection (PHI), and had plasma HIV-1 RNA <50 copies/mL for at least 12 months. Albuvirtide 0.32 g and 3BNC117 2 g every 2 weeks IV infusion for a total of 14 weeks.	Drug: Albuvirtide; Long-Acting HIV-1 Fusion Inhibitor (chemically modified peptide targeting HIV-1 gp41); Other Names: ABT; Drug: 3BNC117; Recombinant, fully human mAb of the IgG1κ isotype that specifically binds to HIV-1 gp120.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of participants (with sustained viral suppression at week 14) with HIV-1 RNA < 50 copies/mL at Week 26 (24 weeks after ATI)	Proportion of participants with HIV-1 RNA < 50 copies/mL at Week 26.	Week 26

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean time to virologic rebound (HIV-1 RNA≥200 copies/mL) after ATI	Mean time to virologic rebound	up to 48 weeks
Proportion of participants without experiencing virologic rebound (HIV-1 RNA<200 copies/mL) at Week 26 (24 weeks after ATI).	Proportion of participants without experiencing virologic rebound	Week 26
Proportion of participants with HIV-1 RNA < 50 copies/mL at Week 26 (24 weeks after ATI).	Proportion of participants with HIV-1 RNA < 50 copies/mL at Week 26	Week 26
Mean change in CD4 cell count after ATI	Mean change in CD4 cell count	up to 48 weeks
Mean change in CD4/CD8 ration after ATI	Mean change in CD4/CD8 ration	up to 48weeks
Frequency of emergence of new resistance mutations after virologic rebound	Frequency of emergence of new resistance mutations	up to 48 weeks
Mean time to achieving HIV-1 RNA < 50 copies/mL after experiencing virologic rebound	Mean time to achieving HIV-1 RNA < 50 copies/mL after experiencing virologic rebound	up to 48 weeks

Collaborators and Investigators

• Sponsor: Frontier Biotechnologies Inc.
• Investigators: Study Director: Cheng Yao, Frontier Biotechnologies Inc.

Study record dates

Study Major Dates

• Study Start (Anticipated): May 1, 2021
• Primary Completion (Anticipated): June 1, 2022
• Study Completion (Anticipated): December 1, 2022

Study Registration Dates

• First Submitted: March 22, 2021
• First Submitted That Met QC Criteria: March 24, 2021
• First Posted (Actual): March 26, 2021

Study Record Updates

• Last Update Posted (Actual): March 26, 2021
• Last Update Submitted That Met QC Criteria: March 24, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Blood-Borne Infections; Communicable Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases; HIV Infections; Infections; Acquired Immunodeficiency Syndrome
• Other Study ID Numbers: ABT-3BNC117_202

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No