Gilead Initiates Phase 3 Clinical Program for Tenofovir Alafenamide, a Novel Low-Dose Prodrug for the Treatment of HIV
-- Two Studies Will Compare a Tenofovir Alafenamide-Based Single
Tablet Regimen to Gilead’s Stribild
--
Gilead Sciences, Inc. (Nasdaq: GILD) today announced the initiation of
the first of two Phase 3 clinical trials (Study 104) evaluating a single
tablet regimen containing tenofovir alafenamide (TAF) for the treatment
of HIV-1 infection in treatment-naïve adults. TAF is a novel prodrug of
tenofovir, the active agent in Viread® (tenofovir
disoproxil fumarate). The Phase 3 studies will examine a once-daily
single tablet regimen of TAF 10 mg/elvitegravir 150 mg/cobicistat 150
mg/emtricitabine 200 mg compared to Gilead’s Stribild®
(elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/tenofovir
disoproxil fumarate 300 mg) among patients new to HIV therapy. The
second Phase 3 study (Study 111) will be initiated later this quarter.
“We are pleased to move TAF into Phase 3 clinical research,” said
Norbert Bischofberger, PhD, Executive Vice President, Research and
Development and Chief Scientific Officer, Gilead Sciences. “We believe
that TAF’s smaller milligram size has the potential to offer safety and
tolerability advantages over existing therapies, and may enable the
creation of new single tablet regimens for HIV.”
In October 2012, Gilead announced topline results from a Phase 2 study
comparing the TAF/elvitegravir/cobicistat/emtricitabine single tablet
regimen to Stribild. The study found that the TAF-based regimen met its
primary objective based on the proportion of patients with HIV RNA
(viral load) levels < 50 copies/mL at 24 weeks of therapy. In addition,
statistically significant differences in bone and renal safety were
observed between the two arms in favor of the TAF-containing regimen.
Both the type and frequency of laboratory abnormalities and adverse
events were otherwise comparable between study arms. Full results from
the Phase 2 study will be presented at an upcoming medical conference.
Stribild was approved by the U.S. Food and Drug Administration (FDA) in
August 2012 and is Gilead’s third single tablet regimen for HIV. A
marketing application for Stribild is currently pending in Europe.
About the TAF Phase 3 Studies
Study 104 and Study 111 are randomized, double-blind, 96-week clinical
trials among treatment-naïve HIV-1 infected adults with viral load
greater than or equal to 1,000 copies/mL. In each study, a total of 840
patients will be randomized (1:1) to receive a once-daily tablet
containing TAF 10 mg/elvitegravir 150 mg/cobicistat 150 mg/emtricitabine
200 mg (n=420) or Stribild (n=420).
The primary endpoint of the studies will be the proportion of patients
with viral load < 50 copies/mL at 48 weeks of treatment as determined by
the FDA-defined snapshot analysis. Secondary endpoints will include the
proportion of patients with viral load < 20 copies/mL and < 200
copies/mL at 48 and 96 weeks of therapy as defined by the FDA snapshot
analysis, the proportion of patients with viral load < 50 copies/mL at
week 48 as defined by the FDA Time to Loss of Virologic Response (TLOVR)
analysis, the proportion of patients with viral load < 50 copies/mL at
week 96 as defined by the FDA snapshot and TLOVR analyses, and change
from baseline in CD4+ cell count at weeks 48 and 96.
The studies will include patients with impaired renal function, i.e.,
those patients with an estimated glomerular filtration rate between 50
mL/mn and 90 mL/mn (according to the Cockcroft-Gault formula). Bone
mineral density will be assessed for all patients by DEXA scans at
baseline and every 24 weeks. After week 96, patients will continue to
take their blinded study drug until treatment assignments have been
unblinded, at which point all will be given the option to participate in
an open-label rollover extension and receive the TAF-based single tablet
regimen.
About Tenofovir Alafenamide
Tenofovir alafenamide (TAF) is a nucleotide reverse transcriptase
inhibitor (NtRTI). It is a novel prodrug of tenofovir, the active agent
in Viread® (tenofovir disoproxil fumarate), which is also an
NtRTI. Phase 1b dose-ranging studies identified a dose of TAF that is
ten times lower than Viread and provides greater antiviral efficacy. The
smaller milligram size of TAF may enable the development of new
fixed-dose combinations and single tablet regimens for HIV therapy that
are not feasible with Viread.
About Elvitegravir
Elvitegravir is a member of the integrase inhibitor class of
antiretroviral compounds. Integrase inhibitors interfere with HIV
replication by blocking the ability of the virus to integrate into the
genetic material of human cells. Elvitegravir was licensed by Gilead
from Japan Tobacco Inc. (JT) in March 2005. Under the terms of Gilead’s
agreement with JT, Gilead has exclusive rights to develop and
commercialize elvitegravir in all countries of the world, excluding
Japan, where JT retains rights. Gilead submitted a New Drug Application
(NDA) to FDA for elvitegravir as a standalone agent on June 27, 2012,
and the agency has set a target action date under the Prescription Drug
User Fee Act (PDUFA) of April 27, 2013.
About Cobicistat
Cobicistat is Gilead’s proprietary potent mechanism-based inhibitor of
cytochrome P450 3A (CYP3A), an enzyme that metabolizes drugs in the
body. Unlike ritonavir, cobicistat acts only as a pharmacoenhancing or
“boosting” agent and has no antiviral activity. Gilead submitted an NDA
to FDA for cobicistat as a standalone agent on June 28, 2012, and a
PDUFA date of April 28, 2013 has been set.
TAF-containing regimens and TAF, elvitegravir and cobicistat as single
agents are investigational products and their safety and efficacy have
not yet been established.
About Gilead Sciences
Gilead Sciences is a biopharmaceutical company that discovers, develops
and commercializes innovative therapeutics in areas of unmet medical
need. The company's mission is to advance the care of patients suffering
from life-threatening diseases worldwide. Headquartered in Foster City,
California, Gilead has operations in North America, Europe and Asia
Pacific.
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 risks
related to our ability to enroll patients in the clinical trials
involving TAF and the possibility of unfavorable results from these
clinical trials. In addition, Gilead may make a strategic decision to
discontinue development of TAF if, for example, Gilead believes
commercialization will be difficult relative to other opportunities in
its pipeline. There is also risk that Gilead may not be able to commence
the second clinical trial of TAF and file for regulatory approval of TAF
in the anticipated timelines. Further, Gilead may be unable to obtain
approvals from regulatory authorities for TAF, elvitegravir and/or
cobicistat, alone or in combination with other products. If marketing
approval is granted for any of these products, there may be significant
limitations on their use. As a result, these product candidates as
standalone agents or as part of single tablet regimens may never be
successfully commercialized. These risks, uncertainties and other
factors could cause actual results to differ materially from those
referred to in the forward-looking statements. The reader is cautioned
not to rely on these forward-looking statements. These and other risks
are described in detail in Gilead’s Quarterly Report on Form 10-Q for
the quarter ended September 30, 2012, as filed with the U.S. Securities
and Exchange Commission. All forward-looking statements are based on
information currently available to Gilead, and Gilead assumes no
obligation to update any such forward-looking statements.
U.S. full prescribing information for Emtriva, Stribild and Viread is
available at www.gilead.com.
Emtriva, Stribild and Viread are registered trademarks of Gilead
Sciences, Inc.
For more information on Gilead Sciences, please visit the company’s
website at www.gilead.com,
follow Gilead on Twitter (@GileadSciences)
or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000.
