Vicriviroc Demonstrates Potent and Sustained Viral Suppression in ACTG Phase II Clinical Study in Treatment-Experienced HIV Pat
2006年8月18日 - 6:00AM
PRニュース・ワイアー (英語)
First 24-Week Results with a CCR5 Receptor Antagonist Reported
TORONTO, Aug. 17 /PRNewswire-FirstCall/ -- Schering-Plough today
reported that results from an ongoing Phase II clinical trial
showed vicriviroc, its investigational CCR5 receptor antagonist,
demonstrated potent and sustained viral suppression after 24 weeks
of therapy in 118 treatment-experienced HIV patients, when
administered in once-daily doses in combination with an optimized
ritonavir-boosted protease inhibitor (PI)-containing antiretroviral
regimen. In the study, viral load decrease was significantly
greater for patients in each vicriviroc group compared to the
control group at day 14 and at week 24 (p less than 0.01), and was
not different between the vicriviroc groups (p greater than 0.05)
(ITT). Although there was no statistical difference in the viral
load reductions between the three vicriviroc arms, a higher rate of
virologic failure and emergence of X4 virus was observed at the
lowest dose of 5 mg. This is the first trial with a CCR5 receptor
antagonist for HIV to report 24-week treatment results. Researchers
from the NIH-sponsored Adult AIDS Clinical Trial Group (ACTG),
which is conducting the study, presented the data here today during
a late-breaker session at the XVI International AIDS Conference.
"We are encouraged by the durability of viral suppression observed
through 24 weeks in this study of patients with significantly
advanced HIV disease," said Roy Gulick, M.D., principal
investigator and associate professor, Weill Medical College of
Cornell University, New York. "The promise of new antiviral agents
with novel mechanisms of action and unique resistance profiles is
particularly important for treatment-experienced HIV patients, who
need new treatment options, and we look forward to the further
clinical evaluation of vicriviroc in combination with conventional
antiretroviral regimens." A total of 118 heavily
treatment-experienced HIV patients (median viral load 36,380
copies/ml and CD4 146 cells/uL) with R5-type virus taking
ritonavir-boosted PI-containing regimens were randomized in the
double-blind, 48-week study. Change in viral load after addition of
vicriviroc (5, 10 or 15 mg) dosed once daily (QD) or placebo was
measured at 14 days, and then at 12 and 24 weeks, after the
background antiretroviral regimen had been optimized at day 14. At
day 14, the primary endpoint of the study, the mean HIV-1 RNA
change from baseline (log10 copies/mL) for the vicriviroc 5, 10 and
15 mg QD arms were decreases of -0.87, -1.15 and -0.92,
respectively, compared to an increase of +0.06 for the placebo arm.
At week 24, the mean HIV-1 RNA change (log10 copies/mL) for
vicriviroc 5, 10 and 15 mg QD arms were declines of -1.51, -1.86
and -1.68, respectively, compared to a decrease of -0.29 for the
placebo arm. Mean CD4 cell counts increased at week 24 for the
vicriviroc 5, 10 and 15 QD mg arms by +84, +142 and +142
respectively, compared to a decrease of -9 for the placebo group.
Emergence of detectable X4-type virus was detected in 8 (27
percent), 3 (10 percent) and 2 (7 percent) of patients in the
vicriviroc 5, 10 and 15 QD mg arms, compared to 1 (4 percent) in
the placebo arm. Five of the 8 patients in the 5 mg QD arm
demonstrated the emergence of X4 virus prior to optimization of
their background regimen. The 5 mg QD dose of this trial was
discontinued early due to suboptimal efficacy (patients were
dose-escalated to 15 mg QD) and the study as a whole was unblinded
in March 2006 after recommendation from the Study Monitoring
Committee, based on reports of five malignancies (two Hodgkin's
disease, one with prior Hodgkin's disease; two non-Hodgkin's
disease, one with prior Hodgkin's disease; and one gastric
adenocarcinoma) among vicriviroc recipients. The ACTG (including an
independent safety monitoring committee) concluded causal
association between vicriviroc and the malignancies could not be
determined by this study. Coupled with evidence of significant
virologic activity and CD4 count increases, a decision was made to
continue the trial with the 10 and 15 mg doses. Open-label
follow-up of patients continues; the median length of study
treatment at the time of this analysis was more than 40 weeks for
the 10 and 15 mg vicriviroc treatment groups. VICTOR-E1 Trial
Initiated to Evaluate Higher Doses to Achieve Incremental Benefit
in Treatment-Experienced HIV Patients Based on the ACTG study
reported above and extensive pharmacokinetic and pharmacodynamic
data, Schering-Plough Research Institute has initiated a new Phase
II clinical trial of higher doses of vicriviroc in
treatment-experienced HIV patients, with the goal of achieving
incremental improvement in viral suppression. VICTOR-E1 (Vicriviroc
in Combination Treatment with Optimized Antiretroviral Treatment
Regimen in Experienced Subjects) will evaluate the safety and
efficacy of vicriviroc (20 mg and 30 mg once daily) compared to
placebo in combination with an optimized ritonavir-boosted,
protease inhibitor-containing antiretroviral regimen. The primary
objective of the study is to evaluate the antiviral activity of
vicriviroc as measured by the decline of viral load (log10
copies/mL) from baseline at 12 and 24 weeks. A total of 120
patients who are currently failing an antiretroviral treatment
regimen will be enrolled in the 48-week trial. The study is being
conducted at sites throughout Europe and North and South America.
For additional information on the ongoing VICTOR-E1 trial and trial
sites, please visit http://www.clinicaltrials.gov/. About
Vicriviroc Vicriviroc is an extracellular inhibitor of HIV
infection that is believed to block entry of infectious virions
into uninfected CD4 cells via antagonism of the CCR5 co-receptor.
Despite the availability of more than 25 antiretroviral agents, the
challenges of viral resistance and toxicities underscore the need
for new agents with novel mechanisms of action. VICTOR-E1 and other
vicriviroc studies in the drug's development program will further
evaluate its utility against HIV disease when used in combination
with antiretroviral drugs. Vicriviroc has been studied to date in
more than 650 patients in pharmacology or clinical trials. About
Schering-Plough Schering-Plough is a global science-based health
care company with leading prescription, consumer and animal health
products. Through internal research and collaborations with
partners, Schering-Plough discovers, develops, manufactures and
markets advanced drug therapies to meet important medical needs.
Schering-Plough's vision is to earn the trust of the physicians,
patients and customers served by its more than 32,000 people around
the world. The company is based in Kenilworth, N.J., and its Web
site is http://www.schering-plough.com/. SCHERING-PLOUGH DISCLOSURE
NOTICE: The information in this press release includes certain
"forward-looking statements" within the meaning of the Securities
Litigation Reform Act of 1995, including statements relating to the
timing of clinical trials and the potential market for vicriviroc.
Forward-looking statements relate to expectations or forecasts of
future events. Schering-Plough does not assume the obligation to
update any forward- looking statement. Many factors could cause
actual results to differ materially from Schering-Plough's
forward-looking statements, including market forces, economic
factors, product availability, patent and other intellectual
property protection, current and future branded, generic or
over-the-counter competition, the regulatory process, and any
developments following regulatory approval, among other
uncertainties. For further details about these and other factors
that may impact the forward-looking statements, see
Schering-Plough's Securities and Exchange Commission filings,
including Item 1A. Risk Factors in the Company's second quarter
2006 10-Q. 72-0806 DATASOURCE: Schering-Plough Corporation CONTACT:
Media Contact - Mary-Frances Faraji, +1-908-298-7109 (office),
+1-908-432-2404 (mobile); Investor Contact - Alex Kelly, or Robyn
Brown, +1-908-298-7436 Web site: http://www.schering-plough.com/
http://www.clinicaltrials.gov/ Company News On-Call:
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