Skip to main content
Erschienen in: Clinical Pharmacokinetics 6/2017

04.10.2016 | Original Research Article

A Two-Way Steady-State Pharmacokinetic Interaction Study of Doravirine (MK-1439) and Dolutegravir

verfasst von: Matt S. Anderson, Sauzanne Khalilieh, Ka Lai Yee, Rachael Liu, Li Fan, Matthew L. Rizk, Vedangi Shah, Azra Hussaini, Ivy Song, Lisa L. Ross, Joan R. Butterton

Erschienen in: Clinical Pharmacokinetics | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Doravirine, a non-nucleoside reverse-transcriptase inhibitor in development for the treatment of patients with human immunodeficiency virus-1 infection, has potential to be used concomitantly in antiretroviral therapy with dolutegravir, an integrase strand transfer inhibitor. The pharmacokinetic interactions between these drugs were therefore assessed.

Methods

Oral formulations of doravirine and dolutegravir were dosed both individually and concomitantly once daily in healthy adults. Twelve subjects (six were male), 23–42 years of age, were enrolled and 11 completed this phase I, open-label, three-period, fixed-sequence study per protocol; one subject was discontinued for a positive cotinine test at admission to period 2. In period 1, dolutegravir 50 mg was administered for 7 days. After a 7-day washout, doravirine 200 mg was dosed for 7 days in period 2, followed (without washout) by both doravirine and dolutegravir simultaneously for 7 days in period 3. Plasma samples were taken to determine dolutegravir and doravirine concentrations.

Results

The steady-state concentration 24 h post-dose (C24) of dolutegravir was not substantially altered by co-administration of doravirine multiple doses; area under the plasma concentration–time curve from dosing to 24 h post-dose (AUC0–24), maximum concentration (C max), and C24 geometric mean ratios were 1.36, 1.43, and 1.27, respectively. The pharmacokinetics of doravirine was not affected by multiple doses of dolutegravir (geometric mean ratios: 1.00, 0.98, and 1.06 for AUC0–24, C24, and C max, respectively). Both drugs were generally well tolerated.

Conclusion

The results of this study demonstrate that concomitant administration of doravirine and dolutegravir in healthy subjects causes no clinically significant alteration in the pharmacokinetic and safety profiles of the two drugs, thereby supporting further evaluation of co-administration of these agents for human immunodeficiency virus-1 treatment.
Literatur
2.
Zurück zum Zitat Izzedine H, Harris M, Perazella MA. The nephrotoxic effects of HAART. Nat Rev Nephrol. 2009;5:563–73.CrossRefPubMed Izzedine H, Harris M, Perazella MA. The nephrotoxic effects of HAART. Nat Rev Nephrol. 2009;5:563–73.CrossRefPubMed
3.
Zurück zum Zitat Bedimo R, Maalouf NM, Zhang S, et al. Osteoporotic fracture risk associated with cumulative exposure to tenofovir and other antiretroviral agents. AIDS. 2012;26:825–31.CrossRefPubMed Bedimo R, Maalouf NM, Zhang S, et al. Osteoporotic fracture risk associated with cumulative exposure to tenofovir and other antiretroviral agents. AIDS. 2012;26:825–31.CrossRefPubMed
4.
Zurück zum Zitat Montessori V, Press N, Harris M, et al. Adverse effects of antiretroviral therapy for HIV infection. CMAJ. 2004;170:229–38.PubMedPubMedCentral Montessori V, Press N, Harris M, et al. Adverse effects of antiretroviral therapy for HIV infection. CMAJ. 2004;170:229–38.PubMedPubMedCentral
5.
Zurück zum Zitat Nolan D, Mallal S. Complications associated with NRTI therapy: update on clinical features and possible pathogenic mechanisms. Antivir Ther. 2004;9:849–63.PubMed Nolan D, Mallal S. Complications associated with NRTI therapy: update on clinical features and possible pathogenic mechanisms. Antivir Ther. 2004;9:849–63.PubMed
6.
Zurück zum Zitat Margolis AM, Heverling H, Pham PA, et al. A review of the toxicity of HIV medications. J Med Toxicol. 2014;10:26–39.CrossRefPubMed Margolis AM, Heverling H, Pham PA, et al. A review of the toxicity of HIV medications. J Med Toxicol. 2014;10:26–39.CrossRefPubMed
7.
Zurück zum Zitat Conway B. The role of adherence to antiretroviral therapy in the management of HIV infection. J Acquir Immune Defic Syndr. 2007;45(Suppl 1):S14–8.CrossRefPubMed Conway B. The role of adherence to antiretroviral therapy in the management of HIV infection. J Acquir Immune Defic Syndr. 2007;45(Suppl 1):S14–8.CrossRefPubMed
8.
Zurück zum Zitat Aldir I, Horta A, Serrado M. Single-tablet regimens in HIV: does it really make a difference? Curr Med Res Opin. 2014;30:89–97.CrossRefPubMed Aldir I, Horta A, Serrado M. Single-tablet regimens in HIV: does it really make a difference? Curr Med Res Opin. 2014;30:89–97.CrossRefPubMed
9.
Zurück zum Zitat Fernandez-Montero JV, Vispo E, Soriano V. Emerging antiretroviral drugs. Expert Opin Pharmacother. 2014;15:211–9.CrossRefPubMed Fernandez-Montero JV, Vispo E, Soriano V. Emerging antiretroviral drugs. Expert Opin Pharmacother. 2014;15:211–9.CrossRefPubMed
11.
Zurück zum Zitat Keeshin SW, Feinberg J. Evaluation of dolutegravir safety for the treatment of HIV-1. Expert Opin Drug Saf. 2015;14:141–7.CrossRefPubMed Keeshin SW, Feinberg J. Evaluation of dolutegravir safety for the treatment of HIV-1. Expert Opin Drug Saf. 2015;14:141–7.CrossRefPubMed
12.
Zurück zum Zitat Eron JJ, Clotet B, Durant J, et al. Safety and efficacy of dolutegravir in treatment-experienced subjects with raltegravir-resistant HIV type 1 infection: 24-week results of the VIKING Study. J Infect Dis. 2013;207:740–8.CrossRefPubMed Eron JJ, Clotet B, Durant J, et al. Safety and efficacy of dolutegravir in treatment-experienced subjects with raltegravir-resistant HIV type 1 infection: 24-week results of the VIKING Study. J Infect Dis. 2013;207:740–8.CrossRefPubMed
13.
Zurück zum Zitat Castagna A, Maggiolo F, Penco G, et al. Dolutegravir in antiretroviral-experienced patients with raltegravir- and/or elvitegravir-resistant HIV-1: 24-week results of the phase III VIKING-3 study. J Infect Dis. 2014;210:354–62.CrossRefPubMedPubMedCentral Castagna A, Maggiolo F, Penco G, et al. Dolutegravir in antiretroviral-experienced patients with raltegravir- and/or elvitegravir-resistant HIV-1: 24-week results of the phase III VIKING-3 study. J Infect Dis. 2014;210:354–62.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Canducci F, Ceresola ER, Boeri E, et al. Cross-resistance profile of the novel integrase inhibitor dolutegravir (S/GSK1349572) using clonal viral variants selected in patients failing raltegravir. J Infect Dis. 2011;204:1811–5.CrossRefPubMed Canducci F, Ceresola ER, Boeri E, et al. Cross-resistance profile of the novel integrase inhibitor dolutegravir (S/GSK1349572) using clonal viral variants selected in patients failing raltegravir. J Infect Dis. 2011;204:1811–5.CrossRefPubMed
15.
Zurück zum Zitat Anderson MS, Gilmartin J, Cilissen C, et al. Safety, tolerability and pharmacokinetics of doravirine, a novel HIV non-nucleoside reverse transcriptase inhibitor, after single and multiple doses in healthy subjects. Antivir Ther. 2015;20:397–405.CrossRefPubMed Anderson MS, Gilmartin J, Cilissen C, et al. Safety, tolerability and pharmacokinetics of doravirine, a novel HIV non-nucleoside reverse transcriptase inhibitor, after single and multiple doses in healthy subjects. Antivir Ther. 2015;20:397–405.CrossRefPubMed
16.
Zurück zum Zitat Gatell JM, Raffi F, Plettenberg A, et al. Efficacy and safety of doravirine 100 mg QD vs efavirenz 600 mg QD with TDF/FTC in ART-naive HIV-infected patients: week 24 results. 8th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention, July 18-22, 2015, Vancouver, Canada. TUAB0104. http://www.natap.org/2015/IAS/IAS_22.htm. Accessed 22 Sept 2016. Gatell JM, Raffi F, Plettenberg A, et al. Efficacy and safety of doravirine 100 mg QD vs efavirenz 600 mg QD with TDF/FTC in ART-naive HIV-infected patients: week 24 results. 8th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention,  July 18-22, 2015, Vancouver, Canada. TUAB0104. http://​www.​natap.​org/​2015/​IAS/​IAS_​22.​htm. Accessed 22 Sept 2016.
17.
Zurück zum Zitat Feng M, Wang D, Grobler JA, et al. In vitro resistance selection with doravirine (MK-1439), a novel nonnucleoside reverse transcriptase inhibitor with distinct mutation development pathways. Antimicrob Agents Chemother. 2015;59:590–8.CrossRefPubMed Feng M, Wang D, Grobler JA, et al. In vitro resistance selection with doravirine (MK-1439), a novel nonnucleoside reverse transcriptase inhibitor with distinct mutation development pathways. Antimicrob Agents Chemother. 2015;59:590–8.CrossRefPubMed
18.
Zurück zum Zitat Gatell JM, Morales-Ramirez JO, Hagins DP, et al. Forty-eight-week efficacy and safety and early CNS tolerability of doravirine (MK-1439), a novel NNRTI, with TDF/FTC in ART-naive HIV-positive patients. J Int AIDS Soc. 2014;17(4 Suppl 3):19532.PubMedPubMedCentral Gatell JM, Morales-Ramirez JO, Hagins DP, et al. Forty-eight-week efficacy and safety and early CNS tolerability of doravirine (MK-1439), a novel NNRTI, with TDF/FTC in ART-naive HIV-positive patients. J Int AIDS Soc. 2014;17(4 Suppl 3):19532.PubMedPubMedCentral
19.
Zurück zum Zitat Kandel CE, Walmsley SL. Dolutegravir: a review of the pharmacology, efficacy, and safety in the treatment of HIV. Drug Des Develop Ther. 2015;9:3547–55.CrossRef Kandel CE, Walmsley SL. Dolutegravir: a review of the pharmacology, efficacy, and safety in the treatment of HIV. Drug Des Develop Ther. 2015;9:3547–55.CrossRef
21.
Zurück zum Zitat Schürmann D, Sobotha C, Gilmartin J, et al. A randomized, double-blind, placebo-controlled, short-term monotherapy study of doravirine in treatment-naive HIV-infected individuals. AIDS. 2016;30:57–63.PubMed Schürmann D, Sobotha C, Gilmartin J, et al. A randomized, double-blind, placebo-controlled, short-term monotherapy study of doravirine in treatment-naive HIV-infected individuals. AIDS. 2016;30:57–63.PubMed
22.
Zurück zum Zitat Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum likelihood. Biometrics. 1997;53:983–97.CrossRefPubMed Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum likelihood. Biometrics. 1997;53:983–97.CrossRefPubMed
23.
Zurück zum Zitat Molla A, Korneyeva M, Gao Q, et al. Ordered accumulation of mutations in HIV protease confers resistance to ritonavir. Nat Med. 1996;2:760–6.CrossRefPubMed Molla A, Korneyeva M, Gao Q, et al. Ordered accumulation of mutations in HIV protease confers resistance to ritonavir. Nat Med. 1996;2:760–6.CrossRefPubMed
24.
Zurück zum Zitat Yee KL, Chatterjee M, Dockendorf M, et al. Pharmacokinetics (PK) of doravirine and exposure-response analysis: efficacy and safety implications. In: 54th interscience conference on antimicrobial agents and chemotherapy (ICAAC), 5–9 Sept 2014, Washington, DC. http://www.natap.org/2014/ICAAC/ICAAC_04.htm. Accessed 28 Sept 2016. Yee KL, Chatterjee M, Dockendorf M, et al. Pharmacokinetics (PK) of doravirine and exposure-response analysis: efficacy and safety implications. In: 54th interscience conference on antimicrobial agents and chemotherapy (ICAAC), 5–9 Sept 2014, Washington, DC. http://​www.​natap.​org/​2014/​ICAAC/​ICAAC_​04.​htm. Accessed 28 Sept 2016.
25.
Zurück zum Zitat Xu Y, Li YF, Zhang D, et al. Characterizing class-specific exposure-viral load suppression response of HIV antiretrovirals using a model-based meta-analysis. Clin Transl Sci. 2016;9(4):192–200.CrossRefPubMed Xu Y, Li YF, Zhang D, et al. Characterizing class-specific exposure-viral load suppression response of HIV antiretrovirals using a model-based meta-analysis. Clin Transl Sci. 2016;9(4):192–200.CrossRefPubMed
27.
Zurück zum Zitat Song I, Borland J, Chen S, et al. Effect of food on the pharmacokinetics of the integrase inhibitor dolutegravir. Antimicrob Agents Chemother. 2012;56:1627–9.CrossRefPubMedPubMedCentral Song I, Borland J, Chen S, et al. Effect of food on the pharmacokinetics of the integrase inhibitor dolutegravir. Antimicrob Agents Chemother. 2012;56:1627–9.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Reese MJ, Savina PM, Generaux GT, et al. In vitro investigations into the roles of drug transporters and metabolizing enzymes in the disposition and drug interactions of dolutegravir, a HIV integrase inhibitor. Drug Metab Dispos. 2013;41:353–61.CrossRefPubMed Reese MJ, Savina PM, Generaux GT, et al. In vitro investigations into the roles of drug transporters and metabolizing enzymes in the disposition and drug interactions of dolutegravir, a HIV integrase inhibitor. Drug Metab Dispos. 2013;41:353–61.CrossRefPubMed
29.
Zurück zum Zitat Song I, Chen S, Piscitelli SC, Min S. Pharmacokinetics (PK) and PK-pharmacodynamic (PD) relationship of dolutegravir (DTG) in integrase inhibitor (INI)-naïve subjects. In: 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), September 10-13, 2013, Denver, CO. http://www.natap.org/2013/ICAAC/ICAAC_44.htm. Accessed 22 Sept 2016. Song I, Chen S, Piscitelli SC, Min S. Pharmacokinetics (PK) and PK-pharmacodynamic (PD) relationship of dolutegravir (DTG) in integrase inhibitor (INI)-naïve subjects. In: 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), September 10-13, 2013, Denver, CO. http://​www.​natap.​org/​2013/​ICAAC/​ICAAC_​44.​htm. Accessed 22 Sept 2016.
30.
Zurück zum Zitat Clotet B, Feinberg J, van LJ, et al. Once-daily dolutegravir versus darunavir plus ritonavir in antiretroviral-naive adults with HIV-1 infection (FLAMINGO): 48 week results from the randomised open-label phase 3b study. Lancet. 2014;383:2222–31.CrossRefPubMed Clotet B, Feinberg J, van LJ, et al. Once-daily dolutegravir versus darunavir plus ritonavir in antiretroviral-naive adults with HIV-1 infection (FLAMINGO): 48 week results from the randomised open-label phase 3b study. Lancet. 2014;383:2222–31.CrossRefPubMed
31.
Zurück zum Zitat Walmsley SL, Antela A, Clumeck N, et al. Dolutegravir plus abacavir-lamivudine for the treatment of HIV-1 infection. N Engl J Med. 2013;369:1807–18.CrossRefPubMed Walmsley SL, Antela A, Clumeck N, et al. Dolutegravir plus abacavir-lamivudine for the treatment of HIV-1 infection. N Engl J Med. 2013;369:1807–18.CrossRefPubMed
32.
Zurück zum Zitat Song I, Borland J, Min S, et al. Effects of etravirine alone and with ritonavir-boosted protease inhibitors on the pharmacokinetics of dolutegravir. Antimicrob Agents Chemother. 2011;55:3517–21.CrossRefPubMedPubMedCentral Song I, Borland J, Min S, et al. Effects of etravirine alone and with ritonavir-boosted protease inhibitors on the pharmacokinetics of dolutegravir. Antimicrob Agents Chemother. 2011;55:3517–21.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Dailly E, Allavena C, Gregoire M, et al. Influence of nevirapine administration on the pharmacokinetics of dolutegravir in patients infected with HIV-1. J Antimicrob Chemother. 2015;70:3307–10.PubMed Dailly E, Allavena C, Gregoire M, et al. Influence of nevirapine administration on the pharmacokinetics of dolutegravir in patients infected with HIV-1. J Antimicrob Chemother. 2015;70:3307–10.PubMed
34.
Zurück zum Zitat Cottrell ML, Hadzic T, Kashuba AD. Clinical pharmacokinetic, pharmacodynamic and drug-interaction profile of the integrase inhibitor dolutegravir. Clin Pharmacokinet. 2013;52:981–94.CrossRefPubMedPubMedCentral Cottrell ML, Hadzic T, Kashuba AD. Clinical pharmacokinetic, pharmacodynamic and drug-interaction profile of the integrase inhibitor dolutegravir. Clin Pharmacokinet. 2013;52:981–94.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Min S, Song I, Borland J, et al. Pharmacokinetics and safety of S/GSK1349572, a next-generation HIV integrase inhibitor, in healthy volunteers. Antimicrob Agents Chemother. 2010;54:254–8.CrossRefPubMed Min S, Song I, Borland J, et al. Pharmacokinetics and safety of S/GSK1349572, a next-generation HIV integrase inhibitor, in healthy volunteers. Antimicrob Agents Chemother. 2010;54:254–8.CrossRefPubMed
36.
Zurück zum Zitat van Lunzen J, Maggiolo F, Arribas JR, et al. Once daily dolutegravir (S/GSK1349572) in combination therapy in antiretroviral-naive adults with HIV: planned interim 48 week results from SPRING-1, a dose-ranging, randomised, phase 2b trial. Lancet Infect Dis. 2012;12:111–8.CrossRefPubMed van Lunzen J, Maggiolo F, Arribas JR, et al. Once daily dolutegravir (S/GSK1349572) in combination therapy in antiretroviral-naive adults with HIV: planned interim 48 week results from SPRING-1, a dose-ranging, randomised, phase 2b trial. Lancet Infect Dis. 2012;12:111–8.CrossRefPubMed
Metadaten
Titel
A Two-Way Steady-State Pharmacokinetic Interaction Study of Doravirine (MK-1439) and Dolutegravir
verfasst von
Matt S. Anderson
Sauzanne Khalilieh
Ka Lai Yee
Rachael Liu
Li Fan
Matthew L. Rizk
Vedangi Shah
Azra Hussaini
Ivy Song
Lisa L. Ross
Joan R. Butterton
Publikationsdatum
04.10.2016
Verlag
Springer International Publishing
Erschienen in
Clinical Pharmacokinetics / Ausgabe 6/2017
Print ISSN: 0312-5963
Elektronische ISSN: 1179-1926
DOI
https://doi.org/10.1007/s40262-016-0458-4

Weitere Artikel der Ausgabe 6/2017

Clinical Pharmacokinetics 6/2017 Zur Ausgabe