Pharmacodynamics, safety, and pharmacokinetics of BMS-663068, an oral HIV-1 attachment inhibitor in HIV-1-infected subjects

J Infect Dis. 2012 Oct 1;206(7):1002-11. doi: 10.1093/infdis/jis432. Epub 2012 Aug 14.

Abstract

Background: BMS-663068 is a prodrug of the small-molecule inhibitor BMS-626529, which inhibits human immunodeficiency virus type 1 (HIV-1) infection by binding to gp120 and interfering with the attachment of virus to CD4+ T-cells.

Methods: Fifty HIV-1-infected subjects were randomized to 1 of 5 regimen groups (600 mg BMS-663068 plus 100 mg ritonavir every 12 hours [Q12H], 1200 mg BMS-663068 plus 100 mg ritonavir every bedtime, 1200 mg BMS-663068 plus 100 mg ritonavir Q12H, 1200 mg BMS-663068 Q12H plus 100 mg ritonavir every morning, or 1200 mg BMS-663068 Q12H) for 8 days in this open-label, multiple-dose, parallel study. The study assessed the pharmacodynamics, pharmacokinetics, and safety of BMS-663068.

Results: The maximum median decrease in plasma HIV-1 RNA load from baseline ranged from 1.21 to 1.73 log(10) copies/mL. Plasma concentrations of BMS-626529 were not associated with an antiviral response, while low baseline inhibitory concentrations and the minimum and average steady-state BMS-626529 plasma concentrations, when adjusted by the baseline protein binding-adjusted 90% inhibitory concentration (inhibitory quotient), were linked with antiviral response. BMS-663068 was generally well tolerated.

Conclusions: Administration of BMS-663068 for 8 days with or without ritonavir resulted in substantial declines in plasma HIV-1 RNA levels and was generally well tolerated. Longer-term clinical trials of BMS-663068 as part of combination antiretroviral therapy are warranted. Clinical Trials Registration.NCT01009814.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Drug Therapy, Combination
  • Female
  • HIV Fusion Inhibitors / adverse effects
  • HIV Fusion Inhibitors / pharmacokinetics
  • HIV Fusion Inhibitors / therapeutic use*
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV Protease Inhibitors / therapeutic use
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • Humans
  • Inhibitory Concentration 50
  • Male
  • Middle Aged
  • Organophosphates / adverse effects
  • Organophosphates / pharmacokinetics
  • Organophosphates / therapeutic use*
  • Piperazines / adverse effects
  • Piperazines / pharmacokinetics
  • Piperazines / therapeutic use*
  • RNA, Viral / blood
  • Ritonavir / therapeutic use
  • Treatment Outcome
  • Viral Load / drug effects
  • Young Adult

Substances

  • HIV Fusion Inhibitors
  • HIV Protease Inhibitors
  • Organophosphates
  • Piperazines
  • RNA, Viral
  • fostemsavir
  • Ritonavir

Associated data

  • ClinicalTrials.gov/NCT01009814