GlaxoSmithKline, Collegeville, PA, USA.
ViiV Healthcare, Branford, CT, USA.
Br J Clin Pharmacol. 2021 Sep;87(9):3501-3507. doi: 10.1111/bcp.14759. Epub 2021 Mar 4.
GSK3640254, a novel, next-generation maturation inhibitor effective against a range of HIV polymorphisms with no cross-resistance to current antiretroviral therapy, could potentially be coadministered with dolutegravir as a 2-drug regimen. In this phase I study, pharmacokinetics and tolerability of GSK3640254 plus dolutegravir were assessed.
Healthy participants received dolutegravir 50 mg once daily (QD) on Days 1-5 in period 1, GSK3640254 200 mg QD on Days 1-7 in period 2, and dolutegravir 50 mg plus GSK3640254 200 mg QD on Days 1-7 in period 3. All treatments were administered with a moderate-fat meal 30 minutes prior to dosing. Pharmacokinetics parameters were derived by noncompartmental methods, and geometric mean ratios (GMRs) and 90% confidence intervals (CIs) were derived using linear mixed effects models. Adverse events, laboratory measurements, electrocardiography and vital signs were monitored.
Sixteen participants completed the study. GMRs (90% CIs) for dolutegravir area under the plasma concentration-time curve from time 0 to the end of the dosing interval at steady state, maximum observed concentration and plasma concentration at the end of the dosing interval were 1.17 (1.118-1.233), 1.09 (1.044-1.138) and 1.24 (1.160-1.315), respectively. The GMRs (90% CIs) for GSK3640254 were 1.04 (0.992-1.094), 0.99 (0.923-1.065) and 0.10 (0.939-1.056), respectively. Dolutegravir plus GSK3640254 coadministration did not meaningfully alter steady-state exposure to dolutegravir or GSK3640254. No clinically significant trends in tolerability or safety were observed.
Coadministration of GSK3640254 with dolutegravir did not result in clinically significant drug interaction and was well tolerated.
GSK3640254 是一种新型的下一代成熟抑制剂,对多种 HIV 多态性有效,与当前的抗逆转录病毒疗法无交叉耐药性,有可能与多替拉韦联合作为二联疗法。在这项 I 期研究中,评估了 GSK3640254 加多替拉韦的药代动力学和耐受性。
健康参与者在第 1 周期第 1-5 天接受多替拉韦 50mg 每日 1 次(QD),在第 2 周期第 1-7 天接受 GSK3640254 200mg QD,在第 3 周期第 1-7 天接受多替拉韦 50mg 加 GSK3640254 200mg QD。所有治疗均在饭前 30 分钟给予中等脂肪餐。采用非房室模型法计算药代动力学参数,采用线性混合效应模型计算几何均数比值(GMR)及其 90%置信区间(CI)。监测不良事件、实验室检查、心电图和生命体征。
16 名参与者完成了研究。多替拉韦稳态时从 0 到终末给药间隔的药时曲线下面积、最大观测浓度和终末给药间隔时的浓度的 GMR(90%CI)分别为 1.17(1.118-1.233)、1.09(1.044-1.138)和 1.24(1.160-1.315)。GSK3640254 的 GMR(90%CI)分别为 1.04(0.992-1.094)、0.99(0.923-1.065)和 0.10(0.939-1.056)。多替拉韦加 GSK3640254 联合用药对多替拉韦或 GSK3640254 的稳态暴露无明显影响。未观察到耐受性或安全性的临床显著趋势。
GSK3640254 与多替拉韦联合用药不会导致临床显著的药物相互作用,且耐受性良好。