Complete proof-of-concept Phase 2a dataset of investigational
HIV-1 Maturation Inhibitor presented at European AIDS Conference (EACS)
Bristol-Myers
Squibb Company (NYSE:BMY) today announced overall antiviral activity
and safety results from the three-part Phase 2a proof-of-concept study
of BMS-955176, a novel investigational therapy designed to prevent the
maturation of HIV-1. Presented today at the European AIDS Clinical
Society’s 15th European AIDS Conference (EACS) in Barcelona,
the study findings support the continued development of BMS-955176, an
investigational therapy from a potential new drug class that is designed
to attack the HIV-1 virus differently than other available treatments.
BMS-955176 is a second-generation maturation inhibitor designed to
inhibit one of the last steps of the HIV-1 viral lifecycle, which is
theorized to disrupt the “maturation” of new virus particles and cause
the release of immature HIV-1 particles that are unable to complete
their lifecycle. The overall results of the study demonstrate
BMS-955176’s antiretroviral activity against the HIV-1 virus as both
monotherapy and in combination with other antiretroviral medicines, and
across patient subtypes (B, C), including those infected with the HIV-1
virus with changes in a critical protein (“Gag polymorphisms”) that were
not responsive to a previously investigated maturation inhibitor. Please
refer to the “Study Design and Results” sections below for the specific
data presented.
“Life-long management of HIV-1 infection requires sequencing of
antiretroviral therapy to stay ahead of resistance and long-term
tolerability challenges, and there is a need for new options for
treatment-experienced patients,” said Douglas Manion, M.D., head of
Specialty Development, Bristol-Myers Squibb. “The overall findings of
this proof-of-concept study confirm that BMS-955176 should be studied
further in Phase 2b for patients in need of new antiretrovirals.”
Maturation is one of the final steps in the HIV-1 lifecycle and occurs
when the virus breaks connections between structural proteins. As a
result, these proteins then undergo changes that produce fully mature
infectious virus particles, which are released from cells with the
ability to infect new CD4+ T-cells. BMS-955176 is designed to inhibit
the last cleavage step in the HIV-1 maturation process, and thus
potentially block the virus from becoming mature and infectious.
Thirty-four million people are infected with HIV-1 globally, and
although the last twenty years have seen significant treatment advances,
drug resistance, tolerability, and the potential for drug-drug
interactions still present challenges. As the patient population ages
and patients are on treatment longer, those developing resistance to
existing regimens and classes, or who are unable to tolerate current
available treatments, is increasing. This shift is driving a need for
novel drug classes with innovative mechanisms of action and the
potential to address these evolving needs. Bristol-Myers Squibb, a
leader in the development of HIV-1 treatments for more than two decades,
is centering its current HIV-1-related research and development on
potential novel therapeutic options for treatment-experienced patients.
Today at EACS, Bristol-Myers Squibb presented new data from Part C of
the randomized, multi-part trial evaluating the antiviral activity and
safety of BMS-955176 administered as monotherapy in patients infected
with HIV-1 subtype C, a type of the virus that has a higher prevalence
of the naturally occurring changes in the Gag polyprotein (a critical
protein for viral replication). Taken together, data from all three
parts of the Phase 2a study support the further evaluation of BMS-955176
in broader global studies.
Part A Study Design & Results
Part A of the Phase 2a, randomized, multi-part trial evaluated
BMS-955176 antiviral activity, safety, and exposure-response during 10
days of monotherapy in 40 HIV-1, subtype B-infected patients with HIV-1
RNA ≥5000 c/mL and CD4+ T-cell counts ≥200 cells/µL. Patients were
randomized 1:1:1:1 to dose groups of 5, 10, 20 or 40 mg, and then 4:1 to
receive an oral suspension of BMS-955176 (n=48) or placebo once daily
(n=12) for 10 days. Twenty additional subjects were later randomized to
80 and 120 mg once-daily dose groups. The primary endpoint was change in
HIV-1 RNA from baseline to Day 11, and safety and exposure-response were
secondary endpoints. A summary of the data is below.
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BMS- 955176 5mg QD
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BMS- 955176 10mg QD
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BMS- 955176 20mg QD
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BMS- 955176 40mg QD
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BMS- 955176 80mg QD
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BMS- 955176 120mg QD
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Placebo
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N
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8
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8
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8
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8
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8
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8
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12
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Median change in HIV-1 RNA (log10
c/mL) on Day 11 (min, max)
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-0.15
(0.13,
-0.33)
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-0.74
(0.66, -1.16)
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-0.82
(0.08,
-1.94)
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-1.21
(-0.64,
-1.82)
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-1.35
(-0.93,
-1.73)
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-1.36
(-0.81,
-1.98)
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-0.03
(1.20,
-0.68)
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Maximum median change in HIV-1 RNA (log10
c/mL) on Day 24 (min, max)
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-0.50
(-0.22,
-0.78)
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-0.98
(-0.64, -1.76)
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-1.12
(-0.13,
-2.12)
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-1.70
(-0.93,
-1.88)
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-1.56
(-1.04,
-1.82)
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-1.65
(-0.83,
-2.07)
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-0.38
(0.56,
-1.46)
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There were no deaths, serious adverse events (SAEs), adverse events
(AEs) leading to discontinuation, grade 3–4 related AEs or clinically
relevant grade 2–4 laboratory abnormalities. With all reported AEs
except for G1-2 diarrhea in 4 subjects on BMS-955176, the same or
greater percentage of subjects on placebo reported AEs as compared to
subjects receiving BMS-955176. Subjects receiving placebo reported
headache (42%), abnormal dreams (25%), night sweats (8%), and diarrhea
(0%).
Part B Study Design & Results
In Part B of the trial, antiviral activity and safety of BMS-955176
administered with atazanavir ± ritonavir were evaluated and compared to
a standard of care regimen of atazanavir and ritonavir plus tenofovir
disoproxil fumarate/emtricitabine after 28 days of therapy. The study
included 28 HIV-1, subtype B-infected patients with HIV-1 RNA ≥5000 c/mL
and CD4+ T-cell counts ≥200 cells/µL who were randomized 2:2:2:1 to four
treatment groups: BMS-955176 40 mg plus atazanavir 400 mg; BMS-955176 40
mg plus atazanavir 300 mg and ritonavir 100 mg; BMS-955176 80 mg plus
atazanavir 400 mg; and a SOC control of atazanavir 300 mg and ritonavir
100 mg plus tenofovir disoproxyl fumarate 300 mg plus emtricitabine 200
mg in a fixed dose combination. Study endpoints included change in HIV-1
RNA from baseline to Day 28, change in HIV-1 RNA from baseline to the
end of the study (Day 42) and safety. A summary of the data is below.
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BMS-955176 (40mg QD)+ATV (400mg QD)
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BMS-955176 (40mg QD)+ATV (300mg QD)+RTV (100mg
QD)
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BMS-955176 (80mg QD)+ATV (400mg QD)
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Tenofovir disoproxil fumarate (300mg QD)+emtricitabine (200mg
QD) (fixed-dose combination) +ATV(300mg QD) +RTV
(100mg QD)
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N
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8
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8
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8
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4
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Median change in HIV-1 RNA (log10
c/mL) on Day 29 (min, max)
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-1.66
(-1.19, -2.04)
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-1.99
(-1.04, -3.32)
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-2.18
(-1.53, -2.68)
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-2.22
(-1.83, -2.84)
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Maximum median change in HIV-1
RNA (log10 c/mL) on Day 42 (min, max)
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-1.86
(-1.49, -2.37)
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-2.20
(-1.24, -3.52)
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-2.23
(-1.87, -2.68)
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-2.39
(-1.83, -3.04)
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There were no deaths, SAEs or AEs leading to discontinuation. In
addition, bilirubin levels were lower for patients receiving BMS-955176
plus unboosted atazanavir compared to patients receiving BMS-955176 40
mg plus boosted atazanavir or the standard of care. The most common AEs
(≥10%) across all treatment groups included increased bilirubin levels
(58%), headache (50%) and abnormal dreams (38%).
Part C Study Design & Results
Part C of the trial evaluated the antiviral activity and safety of
BMS-955176 administered as monotherapy for 10 days. The study included
19 treatment-naïve or treatment-experienced patients (who had not
previously received a protease inhibitor- or maturation
inhibitor-containing regimen) infected with HIV-1 subtype C with plasma
HIV-1 RNA ≥5,000 c/mL and CD4+ T-cell count ≥µL. Patients were
randomized to three dose groups: BMS-955176 40 mg (n=8), BMS-955176 120
mg (n=7), or placebo (n=4) once daily. The primary endpoint was the
change in HIV-1 RNA from baseline to Day 11. A summary of the data is
below.
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BMS-955176 40mg QD
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BMS-955176 120mg QD
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Placebo
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N
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8
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7
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4
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Median change in HIV-1 RNA (log10 c/mL)
on Day 11 (min, max)
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-1.21
(-0.93, -1.72)
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-1.03
(0.25,-1.88)
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0.001
(0.52, -1.21)
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Maximum median change in HIV-1 RNA (log10
c/mL) on Day 24 (min, max)
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-1.35
(-1.04, -2.03)
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-1.26
(-0.70, -2.02)
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-0.42
(0.22, -1.21)
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There were no deaths, SAEs or AEs leading to discontinuation of
treatment.
Two Phase 2b studies of BMS-955176 began in 2015 and are ongoing,
including a traditional dose-finding study in treatment-naive patients
and a study to evaluate an innovative nucleos(t)ide- and booster-sparing
regimen in treatment-experienced patients.
About Bristol Myers-Squibb’s HIV Portfolio
For more than 20 years, Bristol-Myers Squibb has focused on delivering
innovative medicines to help meet the needs of patients living with
HIV-1. Our goal is to help individuals living with HIV-1 to live longer
and healthier lives by achieving and maintaining viral suppression and
by managing challenges associated with treatment resistance. We are
investigating new ways to attack the HIV-1 virus - studies are ongoing
involving this HIV-1 maturation inhibitor and another novel
investigational therapy, an HIV-1 attachment inhibitor (BMS-663068).
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information, please
visit http://www.bms.com or
follow us on Twitter at http://twitter.com/bmsnews.
Bristol-Myers Squibb Forward Looking Statement
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding the research, development and commercialization of
pharmaceutical products. Such forward-looking statements are based on
current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that clinical trials of
BMS-955176 will support regulatory filings, or that BMS-955176 will
receive regulatory approval, or if approved, that it will become a
commercially successful product. Forward-looking statements in this
press release should be evaluated together with the many uncertainties
that affect Bristol-Myers Squibb's business, particularly those
identified in the cautionary factors discussion in Bristol-Myers
Squibb's Annual Report on Form 10-K for the year ended December 31,
2014, in our Quarterly Reports on Form 10-Q and our Current Reports on
Form 8-K. Bristol-Myers Squibb undertakes no obligation to publicly
update any forward-looking statement, whether as a result of new
information, future events or otherwise.
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