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Gilead Sciences (GILD) Reports Biktarvy Maintained High Efficacy w/no Cases of Treatment-Emergent Resistance Through 3-Yrs in Ph. 3 HIV Clinical Trials

November 6, 2019 6:56 AM

Gilead Sciences, Inc. (NASDAQ: GILD) today announced findings from two randomized, double-blind, active-controlled Phase 3 studies (Study 1489 and Study 1490) evaluating the safety and efficacy of Biktarvy® (bictegravir 50 mg/emtricitabine 200 mg/tenofovir alafenamide 25 mg tablets) compared with dolutegravir (DTG)-containing regimens for the treatment of HIV-1 infection in adults new to HIV therapy. In both studies, Biktarvy was well-tolerated and demonstrated high rates of virologic suppression through Week 144. These data are being presented at the 17th European AIDS Conference (EACS) in Basel, Switzerland.

“The findings presented today support the value of Biktarvy as an effective treatment that offers durable viral suppression and maintains a high barrier to resistance,” said Diana Brainard, MD, Senior Vice President, HIV and Emerging Viruses, Gilead Sciences. “These longer-term data reaffirm Biktarvy’s role as a first-line treatment option for appropriate adults who are living with HIV and are starting therapy.”

Biktarvy is indicated in the United States as a complete regimen for the treatment of HIV-1 infection in patients who have no antiretroviral treatment history or to replace the current antiretroviral regimen in those who are virologically suppressed on a stable antiretroviral regimen for at least three months with no history of treatment failure and no known substitutions associated with resistance to the individual components of Biktarvy. Biktarvy carries a Boxed Warning in its U.S. product label regarding the risk of post-treatment acute exacerbation of hepatitis B. See below for Important Safety Information.

Studies 1489 and 1490 randomized 1,274 treatment-naïve adults to receive Biktarvy or either dolutegravir/ abacavir/lamivudine (50/600/300 mg, DTG/ABC/3TC) (Study 1489) or DTG + emtricitabine/tenofovir alafenamide (50/200/25 mg, F/TAF) (Study 1490). The primary endpoint of both studies was virologic suppression, defined as the proportion of participants who were virologically suppressed (HIV-1 RNA levels <50 copies/mL) at Week 48. At the primary endpoint, noninferior efficacy was achieved in both studies and has been previously presented. At Week 144, non-inferiority was maintained from the primary endpoint measurement in both studies at Week 48, with a similar proportion of the Biktarvy group achieving virologic suppression (82 percent; n=518/634) as those taking DTG/ABC/3TC (84 percent; n=265/315) and DTG + F/TAF (84 percent; n=273/325). Across all treatment groups no participants developed treatment failure with treatment-emergent resistance.

“Developing new HIV treatment regimens that can be used in a wide range of people living with HIV is very important,” said Chloe Orkin, MBBCH, FRCP, Clinical Professor of HIV Medicine at Queen Mary University of London. “The three-year results from both Biktarvy studies provide further evidence that it is potent and effective, enabling people living with HIV to maintain an undetectable viral load over the long term.”

There were no discontinuations due to renal events and no cases of proximal renal tubulopathy or Fanconi syndrome in the Biktarvy treatment group. Similar reductions in median estimated glomerular filtration rate (eGFR) were observed across groups (-9.2 mL/min in patients taking Biktarvy vs. -11.7 mL/min in participants taking ABC/DTG/3TC vs. -11.0 mL/min in participants taking DTG + F/TAF) at Week 144. Study 1489 also assessed other laboratory markers of renal and bone safety in patients taking Biktarvy and DTG/ABC/3TC. Participants in both treatment arms demonstrated similar median changes in proteinuria and mean percentage changes in hip and spine bone mineral density (BMD) from baseline. Small, statistically significant differences in the median change from baseline favoring DTG/ABC/3TC were observed for LDL, HDL and total cholesterol to HDL ratio.

Biktarvy was well tolerated through Week 144. Discontinuations due to adverse events were low across all groups (1 percent (n=6/634) for Biktarvy vs. 2 percent (n=5/315) for DTG/ABC/3TC and 2 percent (n=6/325) for DTG + F/TAF). The proportion of drug-related adverse events (all grades) was 26 percent in the Biktarvy arm (n=165/634) vs. 42 percent (n=132/315) for DTG/ABC/3TC and 29 percent (n=94/325) for DTG + F/TAF). The incidence of drug-related nausea was 4 percent for Biktarvy vs. 18 percent for DTG/ABC/3TC and 5 percent for DTG + F/TAF (p<0.0001 for Biktarvy vs. DTG/ABC/3TC). The most commonly reported treatment-emergent adverse events (all grades) were diarrhea (19 percent for Biktarvy vs. 18 percent for DTG/ABC/3TC and 16 percent for DTG + F/TAF), headache (16 percent for Biktarvy vs. 18 percent for DTG/ABC/3TC and 18 percent for DTG + F/TAF) and nasopharyngitis (14 percent for Biktarvy vs.17 percent for DTG/ABC/3TC and 19 percent for DTG + F/TAF).

Study 1489 and Study 1490 are ongoing. Beyond Week 144, study participants will have the option to receive Biktarvy in an open-label extension for up to 96 weeks.

Biktarvy does not cure HIV infection or AIDS.

Important U.S. Safety Information and Indication for Biktarvy

BOXED WARNING: POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B

Contraindications

Warnings and precautions

Adverse reactions

Drug interactions

Dosage and administration

Pregnancy and lactation

INDICATION

Biktarvy is indicated as a complete regimen for the treatment of HIV-1 infection in adults and pediatric patients weighing at least 25 kg who have no antiretroviral (ARV) treatment history or to replace the current ARV regimen in those who are virologically suppressed (HIV-1 RNA <50 copies per mL) on a stable ARV regimen with no history of treatment failure and no known resistance to any component of Biktarvy.

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