Browsing by Author "Agwu AL"

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Acceptability and tolerability of long-acting injectable cabotegravir or rilpivirine in the first cohort of virologically suppressed adolescents living with HIV (IMPAACT 2017/MOCHA): a secondary analysis of a phase 1/2, multicentre, open-label, non-comparative dose-finding study.
(2024-Apr) Lowenthal ED; Chapman J; Ohrenschall R; Calabrese K; Baltrusaitis K; Heckman B; Yin DE; Agwu AL; Harrington C; Van Solingen-Ristea RM; McCoig CC; Adeyeye A; Kneebone J; Chounta V; Smith-Anderson C; Camacho-Gonzalez A; D'Angelo J; Bearden A; Crauwels H; Huang J; Buisson S; Milligan R; Ward S; Bolton-Moore C; Gaur AH; Centre for Infectious Disease Research in Zambia/University of Alabama Birmingham, Lusaka, Zambia.; The Children's Hospital of Philadelphia, Division of General Pediatrics and Global Health Center, Philadelphia, PA, USA.; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; The Children's Hospital of Philadelphia, Division of General Pediatrics and Global Health Center, Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Departments of Pediatrics and Biostatistics, Epidemiology and Informatics, Philadelphia, PA, USA. Electronic address: lowenthale@chop.edu.; Frontier Science Foundation, Amherst, NY, USA.; Janssen Research and Development, Beerse, Belgium.; Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.; Emory University School of Medicine, Atlanta, GA, USA.; Northwestern University and Lurie Children's Hospital of Chicago, Chicago, IL, USA.; University of Pennsylvania School of Nursing, Philadelphia, PA, USA.; Johns Hopkins University School of Medicine, Baltimore, MD, USA.; St Jude Children's Research Hospital, Memphis, TN, USA.; National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS, National Institutes of Health (NIH), Rockville, MD, USA.; ViiV Healthcare, Madrid, Spain.; ViiV Healthcare, Research Triangle Park, NC, USA.; University of Colorado School of Medicine, Aurora, CO, USA.; FHI 360 IMPAACT Operations Center, Durham, NC, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Long-acting injectable cabotegravir and rilpivirine have demonstrated safety, acceptability, and efficacy in adults living with HIV-1. The IMPAACT 2017 study (MOCHA study) was the first to use these injectable formulations in adolescents (aged 12-17 years) living with HIV-1. Herein, we report acceptability and tolerability outcomes in cohort 1 of the study. METHODS: In this a secondary analysis of a phase 1/2, multicentre, open-label, non-comparative dose-finding study, with continuation of pre-study oral combination antiretroviral treatment (ART), 55 adolescents living with HIV-1 were enrolled to receive sequential doses of either long-acting cabotegravir or rilpivirine and 52 received at least two injections. Participants had a body weight greater than 35 kg and BMI less than 31·5 kg/m FINDINGS: Between March 19, 2019, and Nov 25, 2021, 55 participants were enrolled into cohort 1. Using the six-point face scale, 43 (83%) of participants at week 4 and 38 (73%) at week 8 reported that the injection caused "no hurt" or "hurts little bit", while only a single (2%) participant for each week rated the pain as one of the two highest pain levels. Quality of life was not diminished by the addition of one injectable antiretroviral. In-depth interviews revealed that parents and caregivers in the USA frequently had more hesitancy than adolescents about use of long-acting formulations, but parental acceptance was higher after their children received injections. INTERPRETATION: High acceptability and tolerability of long-acting cabotegravir or rilpivirine injections suggests that these are likely to be favoured treatment options for some adolescents living with HIV. FUNDING: National Institutes of Health and ViiV Healthcare.
Safety and pharmacokinetics of oral and long-acting injectable cabotegravir or long-acting injectable rilpivirine in virologically suppressed adolescents with HIV (IMPAACT 2017/MOCHA): a phase 1/2, multicentre, open-label, non-comparative, dose-finding study.
(2024-Apr) Gaur AH; Capparelli EV; Calabrese K; Baltrusaitis K; Marzinke MA; McCoig C; Van Solingen-Ristea RM; Mathiba SR; Adeyeye A; Moye JH; Heckman B; Lowenthal ED; Ward S; Milligan R; Samson P; Best BM; Harrington CM; Ford SL; Huang J; Crauwels H; Vandermeulen K; Agwu AL; Smith-Anderson C; Camacho-Gonzalez A; Ounchanum P; Kneebone JL; Townley E; Bolton Moore C; University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Janssen Research and Development, Beerse, Belgium.; Frontier Science Foundation, Boston, MA, USA.; FHI 360, Durham, NC, USA.; University of Colorado School of Medicine, Aurora, CO, USA.; Emory University School of Medicine-Children's Healthcare of Atlanta, Atlanta, GA, USA.; ViiV Healthcare, ResearchTriangle Park, NC, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Alabama, Birmingham, AL, USA.; ViiV Healthcare, Madrid, Spain.; Baragwanath Academic Hospital, Johannesburg, South Africa.; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Frontier Science Foundation, Amherst, NY, USA.; Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.; Johns Hopkins University School of Medicine, Baltimore, MD, USA.; University of California San Diego, La Jolla, CA, USA.; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA.; St Jude Children's Research Hospital, Memphis, TN, USA. Electronic address: aditya.gaur@stjude.org.; GlaxoSmithKline, Mississauga, ON, Canada.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Combined intramuscular long-acting cabotegravir and long-acting rilpivirine constitute the first long-acting combination antiretroviral therapy (ART) regimen approved for adults with HIV. The goal of the IMPAACT 2017 study (MOCHA [More Options for Children and Adolescents]) was to assess the safety and pharmacokinetics of these drugs in adolescents. METHODS: In this phase 1/2, multicentre, open-label, non-comparative, dose-finding study, virologically suppressed adolescents (aged 12-17 years; weight ≥35 kg; BMI ≤31·5 kg/m FINDINGS: Between March 19, 2019, and Nov 25, 2021, 55 participants were enrolled: 30 in cohort 1C and 25 in cohort 1R. At week 16, 28 (97%, 95% CI 82-100) of the 29 dose-evaluable participants in cohort 1C and 21 (91%; 72-99) of the 23 dose-evaluable participants in cohort 1R had reported at least one adverse event, with the most common being injection-site pain (nine [31%] in cohort 1C; nine [39%] in cohort 1R; none were severe). One (4%, 95% CI 0-22) participant in cohort 1R had an adverse event of grade 3 or higher, leading to treatment discontinuation, which was defined as acute rilpivirine-related allergic reaction (self-limiting generalised urticaria) after the first oral dose. No deaths or life-threatening events occurred. In cohort 1C, the week 2 median cabotegravir AUC INTERPRETATION: Study data support using long-acting cabotegravir or long-acting rilpivirine, given every 4 weeks or 8 weeks, per the adult dosing regimens, in virologically suppressed adolescents aged 12 years and older and weighing at least 35 kg. FUNDING: The National Institutes of Health and ViiV Healthcare.
Safety of combined long-acting injectable cabotegravir and long-acting injectable rilpivirine in virologically suppressed adolescents with HIV (IMPAACT 2017/MOCHA): a phase 1/2, multicentre, open-label, non-comparative, dose-finding study.
(2025-Mar) Moore CB; Baltrusaitis K; Best BM; Moye JH; Townley E; Violari A; Heckman B; Buisson S; Van Solingen-Ristea RM; Capparelli EV; Marzinke MA; Lowenthal ED; Ward S; Krotje C; Milligan R; Agwu AL; Huang J; Cheung SYA; McCoig C; Yin DE; Roberts G; Crauwels H; Van Eygen V; Zabih S; Masheto G; Ounchanum P; Aurpibul L; Korutaro V; Gaur AH; Center for Biostatistics in AIDS Research, Harvard T H Chan School of Public Health, Boston, MA, USA.; University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Janssen Research and Development, Beerse, Belgium.; St Jude Children's Research Hospital, Memphis, TN, USA.; SMG Pharma Safety GlaxoSmithKline, Middlesex, UK.; FHI 360, Durham, NC, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: carolyn.bolton@cidrz.org.; ViiV Healthcare, Madrid, Spain.; Certara, Radnor, PA, USA; GlaxoSmithKline, Collegeville, PA, USA.; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.; Frontier Science Foundation, Amherst, NY, USA.; Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.; Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Botswana Harvard Health Partnership, Gaborone, Botswana.; Baylor College of Medicine Children's Foundation Uganda, Kampala, Uganda.; Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg, South Africa.; University of California San Diego, La Jolla, CA, USA.; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.; University of California Los Angeles, Los Angeles, CA, USA.; GlaxoSmithKline, Mississauga, ON, Canada.; Frontier Science Foundation, Brookline, MA, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Long-acting cabotegravir and long-acting rilpivirine constitute a completely intramuscular antiretroviral therapy (ART) regimen for adults with HIV. We aimed to assess the safety, antiviral activity, and pharmacokinetics of oral cabotegravir and rilpivirine followed by a combination of long-acting cabotegravir and long-acting rilpivirine in virologically suppressed adolescents with HIV. METHODS: The IMPAACT 2017/MOCHA study is a phase 1/2, multicentre, open-label, non-comparative, dose-finding trial being conducted at 18 sites across Botswana, South Africa, Thailand, Uganda, and the USA. In cohort 2 of this study, adolescents (aged 12-18 years; weight ≥35 kg) with HIV and no serious comorbidities who were receiving stable combination ART with confirmed virological suppression and had either previously enrolled in the first cohort or had not previously participated in the study were eligible for inclusion. Participants stopped their background combination ART and received oral cabotegravir 30 mg once daily and oral rilpivirine 25 mg once daily orally for 4-6 weeks, followed by long-acting injectable cabotegravir 600 mg (3 mL) and long-acting injectable rilpivirine 900 mg (3 mL) intramuscularly at weeks 4 and 8, and every 8 weeks thereafter. The primary outcome was safety, including all adverse events, at week 24. Primary safety outcome measures were summarised as frequencies, percentages, and exact Clopper-Pearson 95% CIs in the evaluable analysis population, which included participants who were treated exclusively with the regimen and either completed all scheduled treatments or experienced severe adverse events, permanently discontinued the treatment, or died, whichever occurred first; and in the all-treated analysis population, which included all participants who received at least one dose of any study product. This study is registered with ClinicalTrials.gov (NCT3497676) and is ongoing. FINDINGS: Between July 26, 2021, and Aug 27, 2022, 44 (80·0%) of 55 adolescents who participated in cohort 1 and 100 (87·0%) of 115 screened study-naive adolescents were enrolled in cohort 2. 74 (51·4%) participants were female and 70 (48·6%) were male. Overall, 15 (10·8% [95% CI 6·2-17·2]) of all 139 participants in the evaluable analysis population had at least one adverse event of grade 3 or above by week 24. Among 142 participants who received at least one injection, 43 (30%) experienced at least one injection site reaction (ISR). All 106 ISRs were either grade 1 (98 [92·5%]) or grade 2 (eight [7·5%]), and 97 (91·5%) resolved within 7 days. No participant experienced a drug-related serious adverse event or prematurely discontinued treatment due to a drug-related adverse event. INTERPRETATION: Long-acting injectable cabotegravir and long-acting injectable rilpivirine, administered to adolescents at recommended adult dosages every 8 weeks, showed no unanticipated safety concerns in the 24 weeks following administration. FUNDING: National Institutes of Health, ViiV Healthcare, and Johnson & Johnson.