Gilead to Present Latest Antiviral Research and Development Data at CROI 2022 Addressing Urgent Global Needs
Gilead Sciences (GILD) announced new data from its HIV and COVID-19 research programs, to be presented at CROI 2022 from February 12-16. Findings highlight the role of Veklury (remdesivir) in treating COVID-19 and showcase advancements in HIV treatment, including one-year results from the CALIBRATE and CAPELLA trials on lenacapavir. Gilead affirms its commitment to addressing unmet health needs through innovative research, especially amidst ongoing global health challenges.
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– Data Provide New Clinical Insights on Use of Veklury for Treatment of COVID-19 in Patient Populations with Unmet Needs –
– New Findings on Prevention, Treatment and Cure Research Demonstrate Commitment to Scientific Innovation in HIV –
“The HIV and COVID-19 pandemics continue to challenge the global community, requiring unprecedented coordination and collaboration of scientists, industry and community partners to accelerate antiviral research and development. At Gilead, we will keep applying our long-standing expertise in virology to bring forward person-centered innovation to help fulfill these urgent global needs,” said
Gilead is committed to continued scientific innovation to provide solutions for the evolving needs of people affected by HIV around the world, with the goal of ending the HIV epidemic for everyone, everywhere. At CROI 2022, Gilead will share new findings on HIV treatment and prevention strategies, as well as the latest updates from the company’s continued pursuit of an HIV cure.
HIV treatment research and development data include one-year results from the CALIBRATE and CAPELLA trials evaluating the efficacy and virologic suppression, in combination with other antiretrovirals, of investigational lenacapavir in treatment-naïve and heavily treatment-experienced people with multi-drug resistant HIV. Lenacapavir is Gilead’s potential first-in-class, long-acting HIV-1 capsid inhibitor in development for the treatment and prevention of HIV-1 infection. If approved, lenacapavir would be the only HIV-1 treatment option administered twice yearly.
The five-year cumulative outcomes of two Phase 3 trials (Study 1489 and Study 1490), evaluating Biktarvy® (bictegravir 50 mg/emtricitabine 200 mg/tenofovir alafenamide 25 mg tablets, B/F/TAF) in treatment-naïve people living with HIV (PLWH) will also be presented. These results demonstrate Biktarvy’s long-term safety and tolerability profile, and sustained efficacy with a high barrier to resistance in participants who initiated treatment with the guidelines-recommended, once-daily, single-tablet regimen.
Data presented from Gilead’s cure research program uncover insights to further the collective scientific knowledge on potential pathways to achieve a functional cure or long-term viral remission in the absence of antiretroviral therapy for PLWH.
Additionally, at CROI 2022, Gilead will present new prevention research using data from the DISCOVER trial to evaluate the performance of different recency assays to calculate the background HIV incidence, or how many new HIV infections are occurring in a region. Recency assays have been proposed as the primary methodology to evaluate the efficacy of novel PrEP agents in next-generation PrEP clinical trials.
Gilead will present data that support the role of Veklury® (remdesivir) in addressing the needs of adult and pediatric patients, both hospitalized and non-hospitalized, with COVID-19. New interim results will be presented from an ongoing Phase 2/3 trial evaluating the safety, tolerability and pharmacokinetics of Veklury in children hospitalized with COVID-19.
In addition, Gilead will present the Phase 3 PINETREE data investigating a three-day course of Veklury IV treatment for non-hospitalized patients with mild-to-moderate COVID-19 at high risk of disease progression. This research led to the recent FDA approval for use of Veklury in non-hospitalized patients and updated
Select accepted abstracts are as follows:
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Remdesivir in an outpatient setting improves biomarkers for progression of COVID-19 |
Safety of remdesivir vs. placebo in non-hospitalized patients with COVID-19 |
Population pharmacokinetics of remdesivir in pediatric COVID-19 patients |
Remdesivir treatment for COVID-19 in hospitalized children: CARAVAN interim results |
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Long acting lenacapavir in people with multi-drug resistant HIV-1: Week 52 results |
Lenacapavir as part of a combination regimen in treatment-naïve people with HIV: Week 54 results |
Absence of cross-resistance to lenacapavir in HIV entry inhibitor-resistant isolates |
Pharmacokinetics of lenacapavir, a novel, first-in-class, selective inhibitor of HIV-1 capsid function, in participants with severe renal impairment |
Evaluation of potential drug-drug interactions between islatravir and lenacapavir |
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Biktarvy (B/F/TAF) five-year outcomes in treatment-naïve adults |
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HIV envelope diversity and sensitivity to bNAbs across stages of acute and early HIV |
Viral and biomarker outcomes of an engineered bNAb in ART-suppressed participants |
Identification of predictive biomarkers for time-to-HIV-rebound in virologic controllers |
Immunogenicity and prophylactic efficacy of arenavirus based SIV (simian immunodeficiency virus) vaccine in macaques |
Therapeutic efficacy of combined active and passive immunization in SHIV+ macaques |
Efficacy of AD26/MVA + ENV + vesatolimod therapeutic vaccination in rhesus macaques |
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Evaluation of HIV-1 recency assays among prospectively-observed HIV-1 seroconversions |
Long-acting lenacapavir protects against intravenous challenge with simian-tropic HIV |
For more information, including a complete list of abstracts, please visit https://www.croiconference.org/croi-2022/
Please see below for the
Lenacapavir and vesatolimod are investigational compounds and are not approved anywhere globally. Their safety and efficacy have not been established.
There is currently no cure for HIV or AIDS.
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 substitutions associated with resistance to the individual components of Biktarvy.
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.
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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
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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.
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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
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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 mg BIC, 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 withCrCl <30 mL/min. - Hepatic impairment: Not recommended in patients with severe hepatic impairment.
- Prior to or when initiating: Test patients for HBV infection.
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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
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Pregnancy: There is insufficient human data on the use of BIKTARVY during pregnancy. Dolutegravir, another integrase inhibitor, has been associated with neural tube defects. Discuss the benefit-risk of using BIKTARVY during pregnancy and conception. An Antiretroviral Pregnancy Registry (APR) has been established. Available data from the APR for
FTC shows no difference in the rates of birth defects compared with a US reference population. - Lactation: Women infected with HIV-1 should be instructed not to breastfeed, due to the potential for HIV-1 transmission.
Veklury® (remdesivir 100 mg for injection) is indicated for the treatment of COVID-19 in adults and pediatric patients (12 years of age and older and weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, who are:
- Hospitalized, or
- Not hospitalized and have mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death.
Veklury should only be administered in settings in which health care providers have immediate access to medications to treat a severe infusion or hypersensitivity reaction, such as anaphylaxis, and the ability to activate the emergency medical system (EMS), as necessary. Veklury must be administered by intravenous infusion. Veklury is contraindicated in patients who are allergic to Veklury or any of its components. For more information, please see the
Contraindication
Veklury is contraindicated in patients with a history of clinically significant hypersensitivity reactions to Veklury or any of its components.
Warnings and precautions
- Hypersensitivity, including infusion-related and anaphylactic reactions: Hypersensitivity, including infusion-related and anaphylactic reactions, has been observed during and following administration of Veklury; most occurred within one hour. Monitor patients during infusion and observe for at least one hour after infusion is complete for signs and symptoms of hypersensitivity as clinically appropriate. Symptoms may include hypotension, hypertension, tachycardia, bradycardia, hypoxia, fever, dyspnea, wheezing, angioedema, rash, nausea, diaphoresis, and shivering. Slower infusion rates (maximum infusion time up to 120 minutes) can potentially prevent these reactions. If a severe infusion-related hypersensitivity reaction occurs, immediately discontinue Veklury and initiate appropriate treatment (see Contraindications).
- Increased risk of transaminase elevations: Transaminase elevations have been observed in healthy volunteers and in patients with COVID-19 who received Veklury; these elevations have also been reported as a clinical feature of COVID-19. Perform hepatic laboratory testing in all patients (see Dosage and administration). Consider discontinuing Veklury if ALT levels increase to >10x ULN. Discontinue Veklury if ALT elevation is accompanied by signs or symptoms of liver inflammation.
- Risk of reduced antiviral activity when coadministered with chloroquine or hydroxychloroquine: Coadministration of Veklury with chloroquine phosphate or hydroxychloroquine sulfate is not recommended based on data from cell culture experiments, demonstrating potential antagonism, which may lead to a decrease in antiviral activity of Veklury.
Adverse reactions
-
The most common adverse reaction (≥
5% all grades) was nausea. -
The most common lab abnormalities (≥
5% all grades) were increases in ALT and AST.
Drug interactions
- Drug interaction trials of Veklury and other concomitant medications have not been conducted in humans.
Dosage and administration
- Dosage: For adults and pediatric patients ≥12 years old and weighing ≥40 kg: 200 mg on Day 1, followed by once-daily maintenance doses of 100 mg from Day 2 administered only via intravenous infusion. Veklury should be initiated as soon as possible after diagnosis of symptomatic COVID-19.
-
Treatment duration:
- For hospitalized patients requiring invasive mechanical ventilation and/or ECMO, the recommended total treatment duration is 10 days.
- For hospitalized patients not requiring invasive mechanical ventilation and/or ECMO, the recommended treatment duration is 5 days. If a patient does not demonstrate clinical improvement, treatment may be extended for up to 5 additional days for a total treatment duration of up to 10 days.
- For non-hospitalized patients diagnosed with mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death, the recommended total treatment duration is 3 days.
- Testing prior to and during treatment: Perform eGFR, hepatic laboratory, and prothrombin time testing prior to initiating Veklury and during use as clinically appropriate.
- Renal impairment: Veklury is not recommended in individuals with eGFR <30 mL/min.
- Dose preparation and administration: See full Prescribing Information.
Pregnancy and lactation
- Pregnancy: A pregnancy registry has been established. There are insufficient human data on the use of Veklury during pregnancy. COVID-19 is associated with adverse maternal and fetal outcomes, including preeclampsia, eclampsia, preterm birth, premature rupture of membranes, venous thromboembolic disease, and fetal death.
- Lactation: It is not known whether Veklury can pass into breast milk. Breastfeeding individuals with COVID-19 should follow practices according to clinical guidelines to avoid exposing the infant to COVID-19.
About
Gilead operates in more than 35 countries worldwide, with headquarters in
Forward-Looking Statement
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, the risk that FDA may not remove clinical holds currently in place on a clinical trial and the possibility of unfavorable results from such ongoing and additional clinical trials, including those involving Veklury, Biktarvy, lenacapavir and vesatolimod; the possibility that Gilead may make a strategic decision to discontinue development of lenacapavir and vesatolimod and as a result, these compounds may never be successfully commercialized; Gilead’s ability to receive regulatory approvals in a timely manner or at all, including approvals of lenacapavir, and the risk that any such approvals, if granted, may have significant limitations on its use; the risk that physicians may not see the benefits of prescribing Gilead’s products, including Biktarvy and Veklury; 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
Biktarvy, Veklury, Gilead and the Gilead logo are registered trademarks of
For more information about Gilead, please visit the company’s website at www.gilead.com, follow Gilead on Twitter (@Gilead Sciences) or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000.
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