Gilead and Merck Announce Phase 2 Data Showing a Treatment Switch to an Investigational Oral Once-Weekly Combination Regimen of Islatravir and Lenacapavir Maintained Viral Suppression in Adults at Week 48
Gilead Sciences (GILD) and Merck (MRK) announced positive Phase 2 data for their investigational oral once-weekly combination regimen of islatravir and lenacapavir for HIV treatment. The study showed that 94.2% of participants maintained viral suppression at Week 48 after switching from daily Biktarvy to the weekly regimen. Key findings include:
- Zero participants had a viral load ≥50 copies/mL at Week 48
- Treatment-related adverse events were experienced by 19.2% of participants in the islatravir + lenacapavir group
- No grade 3 or 4 treatment-related adverse events were reported
- The combination is advancing to Phase 3 trials
This investigational regimen has the potential to become the first weekly oral HIV treatment, offering a novel option for people living with HIV.
Gilead Sciences (GILD) e Merck (MRK) hanno annunciato dati positivi della Fase 2 per il loro regime combinato orale in sperimentazione, da assumere una volta a settimana, di islatravir e lenacapavir per il trattamento dell'HIV. Lo studio ha mostrato che il 94,2% dei partecipanti ha mantenuto la soppressione virale alla Settimana 48 dopo aver passato dal Biktarvy giornaliero al regime settimanale. I risultati chiave includono:
- Zero partecipanti avevano una carica virale ≥50 copie/mL alla Settimana 48
- Eventi avversi correlati al trattamento sono stati riportati dal 19,2% dei partecipanti nel gruppo islatravir + lenacapavir
- Non sono stati riportati eventi avversi correlati al trattamento di grado 3 o 4
- La combinazione sta avanzando verso gli studi di Fase 3
Questo regime sperimentale ha il potenziale di diventare il primo trattamento orale settimanale per l'HIV, offrendo un'opzione innovativa per le persone che convivono con l'HIV.
Gilead Sciences (GILD) y Merck (MRK) anunciaron datos positivos de la Fase 2 para su régimen combinado oral en investigación de islatravir y lenacapavir, que se toma una vez a la semana para el tratamiento del VIH. El estudio mostró que el 94.2% de los participantes mantuvieron la supresión viral en la Semana 48 después de cambiar del Biktarvy diario al régimen semanal. Los hallazgos clave incluyen:
- Ningún participante tuvo una carga viral ≥50 copias/mL en la Semana 48
- El 19.2% de los participantes del grupo de islatravir + lenacapavir experimentaron eventos adversos relacionados con el tratamiento
- No se reportaron eventos adversos relacionados con el tratamiento de grado 3 o 4
- La combinación avanza a ensayos de Fase 3
Este régimen en investigación tiene el potencial de convertirse en el primer tratamiento oral semanal para el VIH, ofreciendo una opción novedosa para las personas que viven con el VIH.
길리아드 사이언스(GILD)와 머크(MRK)는 HIV 치료를 위해 이슬라트라비르와 레나카파비르의 주 1회 복용 조합 요법에 대한 긍정적인 2상 데이터를 발표했습니다. 연구 결과, 참여자의 94.2%가 매일 비크타르비에서 주 요법으로 전환한 후 48주에서 바이러스 억제를 유지한 것으로 나타났습니다. 주요 발견은 다음과 같습니다:
- 48주차에 바이러스 농도가 ≥50 복제본/mL인 참가자는 제로였습니다.
- 이슬라트라비르 + 레나카파비르 그룹의 19.2%가 치료 관련 불만을 경험했습니다.
- 3등급 또는 4등급 치료 관련 불만은 보고되지 않았습니다.
- 이 조합은 3상 시험으로 진행됩니다.
이 실험적인 요법은 첫 번째 주간 경구 HIV 치료제가 될 가능성이 있으며, HIV와 함께 살아가는 사람들에게 새로운 옵션을 제공합니다.
Gilead Sciences (GILD) et Merck (MRK) ont annoncé des données positives de la Phase 2 pour leur schéma thérapeutique combiné oral en investigation, à prendre une fois par semaine, à base d'islatravir et de lenacapavir pour le traitement du VIH. L'étude a montré que 94,2 % des participants ont maintenu une suppression virale à la Semaine 48 après être passés de Biktarvy quotidien au traitement hebdomadaire. Les principales conclusions incluent :
- Aucun participant n'avait une charge virale ≥50 copies/mL à la Semaine 48
- Des événements indésirables liés au traitement ont été signalés par 19,2 % des participants dans le groupe islatravir + lenacapavir
- Aucun événement indésirable lié au traitement de grade 3 ou 4 n'a été rapporté
- La combinaison avance vers des essais de Phase 3
Ce régime expérimental a le potentiel de devenir le premier traitement oral hebdomadaire du VIH, offrant une option novatrice pour les personnes vivant avec le VIH.
Gilead Sciences (GILD) und Merck (MRK) haben positive Daten aus der Phase 2 für ihr investigatives, einmal wöchentlich einzunehmendes Kombinationsregime von Islatravir und Lenacapavir zur Behandlung von HIV veröffentlicht. Die Studie zeigte, dass 94,2 % der Teilnehmer die virale Suppression aufrechterhielten zu Woche 48, nachdem sie von der täglichen Anwendung von Biktarvy auf das wöchentliche Regime gewechselt hatten. Zu den wichtigsten Ergebnissen gehören:
- Es hatten keine Teilnehmer eine Viruslast ≥50 Kopien/mL in Woche 48
- 19,2 % der Teilnehmer in der Islatravir + Lenacapavir Gruppe erlebten behandlungsbezogene Nebenwirkungen
- Es wurden keine behandlungsbezogenen Nebenwirkungen der Grade 3 oder 4 gemeldet
- Die Kombination geht in die Phase-3-Studien
Dieses experimentelle Regime hat das Potenzial, die erste wöchentliche orale HIV-Behandlung zu werden und bietet eine neuartige Option für Menschen, die mit HIV leben.
- High rate of viral suppression maintained at Week 48 (94.2%)
- Zero participants had viral load ≥50 copies/mL at Week 48
- Potential to become the first weekly oral HIV treatment
- Advancing to Phase 3 clinical trials
- Comparable efficacy to daily Biktarvy regimen (94.2% vs 92.3%)
- 19.2% of participants experienced treatment-related adverse events
- Two participants (3.8%) discontinued due to adverse events (unrelated to the drug)
- Safety and efficacy not yet established, still investigational
Insights
This Phase 2 study demonstrates promising results for a novel once-weekly oral HIV treatment combining islatravir and lenacapavir. The 94.2% viral suppression rate at 48 weeks is impressive, matching the efficacy of daily Biktarvy (92.3%). The zero viral load ≥50 copies/mL in both groups is particularly noteworthy.
The safety profile appears favorable, with mostly mild adverse events and no Grade 3-4 treatment-related events. However, the 19.2% treatment-related adverse event rate for islatravir/lenacapavir versus 5.8% for Biktarvy warrants attention in larger studies.
If approved, this could be groundbreaking as the first weekly oral HIV treatment, potentially improving adherence and quality of life for patients. The advancement to Phase 3 trials signals confidence in the regimen's potential. This could reshape HIV treatment paradigms, offering a more convenient option for virologically suppressed patients.
This development represents significant potential for both Gilead and Merck in the highly competitive HIV treatment market. A weekly oral regimen could be a major differentiator, potentially capturing market share from daily treatments like Gilead's own Biktarvy.
For Gilead, this collaboration leverages their expertise in HIV while diversifying beyond Biktarvy, which faces patent expiration. For Merck, it's an opportunity to strengthen their position in HIV therapeutics.
The market impact could be substantial. If approved, this regimen could become a preferred option for many of the millions of people living with HIV globally. It could also command premium pricing as a novel, convenient therapy. However, the timeline to potential approval and market entry remains uncertain, pending Phase 3 results and regulatory review.
– Novel Investigational Combination Regimen is Advancing to Phase 3 and has the Potential to Become the First Weekly Oral HIV Treatment –
At 48 weeks, the novel investigational combination maintained a high rate (n=49;
“The future of HIV treatment is person-centered, with long-acting options tailored to help meet the needs and preferences of people affected by HIV,” said Jared Baeten, MD, PhD, Senior Vice President, Virology Therapeutic Area Head, Gilead Sciences. "There is no ‘one size fits all’ approach. The complexities of HIV care require putting people first in the development of biomedical innovations as we keep striving to offer options for all those living with HIV. These data presented at IDWeek demonstrate our commitment to continuous scientific discovery aimed at further transforming the HIV treatment landscape.”
In this open-label, active-controlled study (NCT05052996), virologically suppressed adults (n=104) on Biktarvy® (bictegravir 50 mg/emtricitabine 200 mg/tenofovir alafenamide 25 mg tablets, B/F/TAF) were randomly allocated in a 1:1 ratio to receive either oral islatravir 2 mg and lenacapavir 300 mg once a week (n=52) or to continue daily oral Biktarvy (n=52). The median age of participants was 40 years (20-76). Eighteen percent of participants were assigned female at birth,
The proportion of individuals with HIV-1 RNA <50 c/mL at Week 48 by FDA snapshot algorithm (a secondary endpoint), showed that participants who switched to treatment with once-weekly islatravir and lenacapavir (ISL + LEN) or continued Biktarvy maintained comparable high rates of HIV suppression at Week 48 (
Treatment-related-adverse events (TRAEs), as attributed by study investigator, were experienced by
“Daily single-tablet regimens have helped to transform HIV care but can be challenging for some people to maintain. Novel HIV treatment options that allow for less frequent oral dosing have the potential to help support adherence, and address stigma faced by some individuals taking daily oral therapy,” said Dr. Elizabeth Rhee, Vice President, Global Clinical Development, Merck Research Laboratories. “We are pleased to see these encouraging 48-week data for this once-weekly oral combination regimen and advance to phase 3 clinical trials in collaboration with Gilead.”
Along with these most recent study results, the potent antiviral activities, and pharmacokinetic profiles of islatravir and lenacapavir support their continued development as an investigational once-weekly oral combination regimen for use in people with HIV who are virologically suppressed. This investigational combination of weekly oral ISL 2 mg + LEN 300 mg is being further evaluated as a fixed-dose combination regimen in two Phase 3 studies (NCT06630286 and NCT06630299) in virologically suppressed people with HIV.
Islatravir in combination with lenacapavir is investigational and not approved anywhere globally. The safety and efficacy of the combination of islatravir and lenacapavir have not been established.
Lenacapavir is being studied in multiple ongoing early and late-stage development programs and has the potential to offer a diverse set of person-centric options for treatment that could uniquely fit into the lives of people with HIV. The use of lenacapavir for HIV treatment in virologically suppressed individuals is investigational and not approved anywhere globally.
Please see below for the
There is currently no cure for HIV or AIDS.
About Islatravir (MK-8591) and Merck’s HIV Research
Islatravir (MK-8591) is Merck’s investigational nucleoside reverse transcriptase translocation inhibitor (NRTTI) under evaluation in multiple ongoing early and late-stage clinical studies in combination with other antiretrovirals for the treatment of HIV-1. Studies with islatravir are designed to offer different dosing options as potential daily and once-weekly treatments. For an overview of Merck’s HIV treatment and prevention clinical development program, please click here.
About Lenacapavir
The multi-stage mechanism of action of lenacapavir, is distinguishable from other currently approved classes of antiviral agents. While most antivirals act on just one stage of viral replication, lenacapavir is designed to inhibit HIV at multiple stages of its lifecycle.
Lenacapavir is being evaluated as a potential long-acting option in multiple ongoing and planned early and late-stage clinical studies in Gilead’s HIV prevention and treatment research program. The goal is to offer both long-acting oral and injectable options with various dosing frequencies in combination with other antiretroviral agents for treatment or as a single agent for prevention. This approach aims to help address the individual needs and preferences of people with HIV and people who could benefit from pre-exposure prophylaxis (PrEP). The use of lenacapavir for HIV prevention is investigational and the safety and efficacy of lenacapavir for this use has not been established.
About Merck
At Merck, known as MSD outside of
Merck’s Commitment to HIV
For more than 35 years, Merck has been committed to scientific research and discovery in HIV leading to scientific breakthroughs that have helped change HIV treatment. Our work has been pioneering in the development of new options across multiple drug classes to help those impacted by HIV. Today, we are developing a series of antiviral options designed to help people manage HIV and protect people from HIV, with the goal of reducing the growing burden of infection worldwide. We want to ensure people are not defined by HIV and our work focuses on transformational innovations, collaborations with others in the global HIV community, and access initiatives aimed at the goal of helping to end the HIV epidemic for everyone.
About Gilead Sciences
Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis, COVID-19, cancer, and inflammation. Gilead operates in more than 35 countries worldwide, with headquarters in
About Gilead Sciences in HIV
For 35 years, Gilead has been a leading innovator in the field of HIV, driving advances in treatment, prevention and cure research. Gilead researchers have developed 12 HIV medications, including the first single-tablet regimen to treat HIV, the first antiretroviral for pre-exposure prophylaxis (PrEP) to help reduce new HIV infections, and the first long-acting injectable HIV treatment medication administered twice-yearly. Our advances in medical research have helped to transform HIV into a treatable, preventable, chronic condition for millions of people.
Gilead is committed to continued scientific innovation to provide solutions for the evolving needs of people affected by HIV around the world. Through partnerships, collaborations, and charitable giving, the company also aims to improve education, expand access and address barriers to care, with the goal of ending the HIV epidemic for everyone, everywhere. Gilead is recognized as one of the leading funders of HIV-related programs in a report released by Funders Concerned About AIDS.
IMPORTANT
Biktarvy is indicated as a complete regimen for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and pediatric patients weighing at least 14 kg who have no antiretroviral treatment history or to replace the current antiretroviral regimen in those who are virologically-suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen with no history of treatment failure and no known or suspected substitutions associated with resistance to bictegravir or tenofovir.
BOXED WARNING: POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B
- Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine (FTC) and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of BIKTARVY. Closely monitor hepatic function with both clinical and laboratory follow-up for at least several months in patients who are coinfected with HIV-1 and HBV and discontinue BIKTARVY. If appropriate, anti-hepatitis B therapy may be warranted.
Contraindications
- Coadministration: Do not use BIKTARVY with dofetilide or rifampin.
Warnings and precautions
- Drug interactions: See Contraindications and Drug Interactions sections. Consider the potential for drug interactions prior to and during BIKTARVY therapy and monitor for adverse reactions.
- Immune reconstitution syndrome, including the occurrence of autoimmune disorders with variable time to onset, has been reported.
- New onset or worsening renal impairment: Postmarketing cases of renal impairment, including acute renal failure, proximal renal tubulopathy (PRT), and Fanconi syndrome have been reported with tenofovir alafenamide (TAF)–containing products. Do not initiate BIKTARVY in patients with estimated creatinine clearance (CrCl) <30 mL/min except in virologically suppressed adults <15 mL/min who are receiving chronic hemodialysis. Patients with impaired renal function and/or taking nephrotoxic agents (including NSAIDs) are at increased risk of renal-related adverse reactions. Discontinue BIKTARVY in patients who develop clinically significant decreases in renal function or evidence of Fanconi syndrome. Renal monitoring: Prior to or when initiating BIKTARVY and during therapy, assess serum creatinine, CrCl, urine glucose, and urine protein in all patients as clinically appropriate. In patients with chronic kidney disease, assess serum phosphorus.
- Lactic acidosis and severe hepatomegaly with steatosis: Fatal cases have been reported with the use of nucleoside analogs, including FTC and TDF. Discontinue BIKTARVY if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity develop, including hepatomegaly and steatosis in the absence of marked transaminase elevations.
Adverse reactions
-
Most common adverse reactions (incidence ≥
5% ; all grades) in clinical studies through week 144 were diarrhea (6% ), nausea (6% ), and headache (5% ).
Drug interactions
- Prescribing information: Consult the full prescribing information for BIKTARVY for more information on Contraindications, Warnings, and potentially significant drug interactions, including clinical comments.
- Enzymes/transporters: Drugs that induce P-gp or induce both CYP3A and UGT1A1 can substantially decrease the concentration of components of BIKTARVY. Drugs that inhibit P-gp, BCRP, or inhibit both CYP3A and UGT1A1 may significantly increase the concentrations of components of BIKTARVY. BIKTARVY can increase the concentration of drugs that are substrates of OCT2 or MATE1.
- Drugs affecting renal function: Coadministration of BIKTARVY with drugs that reduce renal function or compete for active tubular secretion may increase concentrations of FTC and tenofovir and the risk of adverse reactions.
Dosage and administration
-
Dosage: Adult and pediatric patients weighing ≥25 kg: 1 tablet containing 50 mg bictegravir (
BIC ), 200 mg emtricitabine (FTC), and 25 mg tenofovir alafenamide (TAF) taken once daily with or without food. Pediatric patients weighing ≥14 kg to <25 kg: 1 tablet containing 30 mgBIC , 120 mg FTC, and 15 mg TAF taken once daily with or without food. For children unable to swallow a whole tablet, the tablet can be split and each part taken separately as long as all parts are ingested within approximately 10 minutes.
- Renal impairment: For patients weighing ≥25 kg, not recommended in patients with CrCl 15 to <30 mL/min, or <15 mL/min who are not receiving chronic hemodialysis, or <15 mL/min who are receiving chronic hemodialysis and have no antiretroviral treatment history. For patients weighing ≥14 kg to <25 kg, not recommended in patients with CrCl <30 mL/min.
- Hepatic impairment: Not recommended in patients with severe hepatic impairment.
- Prior to or when initiating: Test patients for HBV infection.
- Prior to or when initiating, and during treatment: As clinically appropriate, assess serum creatinine, CrCl, urine glucose, and urine protein in all patients. In patients with chronic kidney disease, assess serum phosphorus.
Pregnancy and lactation
-
Pregnancy: BIKTARVY is recommended in pregnant individuals who are virologically suppressed on a stable ARV regimen with no known substitutions associated with resistance to any of the individual components of BIKTARVY. Lower plasma exposures of BIKTARVY were observed during pregnancy; therefore, viral load should be monitored closely during pregnancy. An Antiretroviral Pregnancy Registry (APR) has been established. Available data from the APR for
BIC , FTC, or TAF show no difference in the rates of birth defects compared with a US reference population.
- Lactation: Individuals infected with HIV-1 should be informed of the potential risks of breastfeeding.
Gilead Forward-Looking Statements
This press release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that are subject to risks, uncertainties and other factors, including Gilead’s ability to initiate, progress or complete clinical trials or studies within currently anticipated timelines or at all, and the possibility of unfavorable results from ongoing and additional clinical trials or studies, including those involving lenacapavir; uncertainties relating to regulatory applications and related filing and approval timelines, including potential applications for indications currently under evaluation; the possibility that Gilead may make a strategic decision to discontinue development of these programs and, as a result, these programs may never be successfully commercialized for the indications currently under evaluation; and any assumptions underlying any of the foregoing. These and other risks, uncertainties and factors are described in detail in Gilead’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2024, as filed with the
Forward-Looking Statement of Merck & Co., Inc.,
This news release of Merck & Co., Inc.,
Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in
The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the company’s Annual Report on Form 10-K for the year ended December 31, 2023 and the company’s other filings with the Securities and Exchange Commission (SEC) available at the SEC’s Internet site (www.sec.gov).
Biktarvy, Gilead and the Gilead logo are registered trademarks of Gilead Sciences, Inc., or its related companies. All other marks are the property of their respective owners.
For more information about Gilead, please visit the company’s website at www.gilead.com, follow Gilead on X (@Gilead Sciences) and LinkedIn, or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000.
View source version on businesswire.com: https://www.businesswire.com/news/home/20241019252729/en/
Meaghan Smith, Media
public_affairs@gilead.com
Jacquie Ross, Investors
investor_relations@gilead.com
Julie Cunningham, Media
julie.cunningham@merck.com
Peter Dannenbaum, Investors
peter.dannenbaum@merck.com
Source: Gilead Sciences, Inc.
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