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Tenofovir disoproxil

Phase 3FDA approved 2001

HIV Infections | Small molecule | Infectious Disease |Gilead Sciences, Inc.|Trials Updated: Feb 5, 2020

Tenofovir disoproxil development status

FDA approval Oct 26, 2001 as Viread
Approval holderGilead Sciences Inc
ApplicationNDA021356
Highest phase Phase 3
Registered trials 10 across 4 sponsors since Oct 2015

Label indication VIREAD is a nucleotide analog HIV-1 reverse transcriptase inhibitor and an HBV reverse transcriptase inhibitor and is indicated: in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients 2 years of age and older weighing at least 10 kg. FDA label

Tenofovir disoproxil target and mechanism

ModalitySmall molecule

Also known as Tenofovir disoproxil fumarate, Tenofovir disoproxil fumarate (TDF), TDF, Viread®

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials7
Total Enrollment2,507

FDA Designations

No designations recorded

Tenofovir disoproxil clinical trials

Tenofovir disoproxil · 7 trials · 4 indications

Phase 3 2Phase 2 5
NCT00734162Evaluation of Tenofovir Disoproxil Fumarate in Adolescents With Chronic Hepatitis B InfectionHepatitis B Virus (HBV)
COMPLETED106 Analytics
NCT00002450Safety and Effectiveness of Tenofovir Disoproxil Fumarate (Tenofovir DF) Plus Other Anti-HIV Drugs in HIV-Infected PatientsHIV Infections
COMPLETED600 Analytics
PHASE3COMPLETED
Evaluation of Tenofovir Disoproxil Fumarate in Adolescents With Chronic Hepatitis B Infection
Hepatitis B Virus (HBV)Unlock trial analytics
PHASE3COMPLETED
Safety and Effectiveness of Tenofovir Disoproxil Fumarate (Tenofovir DF) Plus Other Anti-HIV Drugs in HIV-Infected Patients
HIV InfectionsUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants With HBV DNA < 400 Copies/mL at Week 72
Week 72

The percentage of participants with HBV DNA \< 400 copies/mL at Week 72 was summarized by treatment and age group (grouped by baseline age for analysis), using the missing = failure (M = F) analysis with the double-blind efficacy evaluation (DBEE) algorithm. In the M = F analysis method, all missing data were considered as failure to meet the outcome measure threshold. This method was combined with the DBEE algorithm, which included all available data for the double-blind period, and any data for the open-label period were not included; data generated during treatment-free follow-up from subjects who achieved HBsAg loss and entered treatment-free follow-up during double-blind treatment period were included.

Percentage of Participants With at Least a 6% Decrease From Baseline in Bone Mineral Density (BMD) of the Spine at Week 72
Baseline to Week 72

Data were summarized by treatment and age group (grouped by baseline age for analysis). In contrast with what was previously reported in the interim results posting, 1 participant met the primary safety endpoint of at least a 6% decrease from baseline in spine BMD at Week 72, based on the final BMD data analysis. The apparent discrepancy was due to the correction factor applied to the subject-specific BMD calculations performed at the time of the Interim Week 72 clinical study report that could not take into account the actual Week 72 phantom data (ie, calibration test used in longitudinal clinical trials to monitor and adjust for shifts in the dual-energy x-ray absorptiometry (DXA) scanner calibration over time), which were not provided by the site at that time. The correction factor applied to the final analysis has been properly based on all phantom data through the end of Week 72, as well as through the end of Week 192.

Percentage of Participants With Adverse Drug Reactions in the Tenofovir/Emtricitabine and Placebo Arms
Monthly, for up to 3 years

Study visits were scheduled every 30 days until completion of the study, and participants were instructed to return to the clinic for evaluation in the event of an illness. Participants reported any adverse effects at monthly visits and interim visits.

HIV Incidence in the Tenofovir/Emtricitabine and Placebo Arms
Monthly, for up to 3 years

Study visits were scheduled every 30 days until completion of the study and during monthly study visits, we performed testing for HIV infection. At completion of the study, we tested all participants for HIV infection, using an enzyme-linked immunosorbent assay (ELISA).The primary efficacy end point was the difference in the rates of HIV infection between participants assigned to receive TDF-FTC and those assigned to receive placebo. The initial efficacy analysis included all study participants who were randomly assigned to receive a study medication (intention-to-treat cohort).

Mean Change in Serum HBsAg From Baseline to Week 24
Baseline to Week 24

The change from baseline to Week 24 in HBsAg was analyzed using a mixed effect model for repeated measures (MMRM). The model included treatment groups, ALT levels (\> ULN or ≤ ULN) at baseline, HBeAg status (positive or negative) at baseline, HBsAg level at baseline, visit and treatment-by-visit interaction as fixed effects and visit as a repeated measurement. Estimated least square means of treatment effects are presented with the 95% confidence intervals (CIs).

Percent Probability of Tolerability Failure
Baseline to Week 168

Tolerability failure was defined as permanent discontinuation of study drug due to a treatment-emergent adverse event (AE), including any subject who temporarily discontinued study drug due to an AE and did not restart. Results are expressed as proportions of participants who experience tolerability failure using the Kaplan-Meier (KM) method of estimation.

Percent Probability of a Confirmed Increase in Serum Creatinine of ≥ 0.5 mg/dL From Baseline or a Confirmed Serum Phosphorus Level < 2.0 mg/dL
Baseline to Week 168

Results are expressed as proportions of participants who experience a confirmed increase in serum creatinine of ≥ 0.5 mg/dL from baseline or a confirmed serum phosphorus level \< 2.0 mg/dL using the KM method of estimation.

Secondary Endpoints

Percentage of Participants With HBV DNA < 400 Copies/mL at Weeks 48, 96, 144, and 192
Weeks 48, 96, 144, and 192
Percentage of Participants With Normal Alanine Aminotransferase (ALT) at Weeks 48, 72, 96, 144, and 192
Weeks 48, 72, 96, 144, and 192
Percentage of Participants With HBV DNA < 400 Copies/mL and Normal ALT at Weeks 48, 72, 96, 144, and 192
Weeks 48, 72, 96, 144, and 192
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Tenofovir disoproxil fumarate (TDF)EXPERIMENTAL -
PlaceboPLACEBO_COMPARATOR -
TDF-FTC,condoms,adh/risk counselingACTIVE_COMPARATOREligible participants were randomized to oral Tenofovir Disoproxil Fumarate 300 mg + Emtricitabine 200 mg (TDF-FTC) once daily in the form of a single tablet. The ratio of randomization was 1:1. Participants randomized to the active arm received male and female condoms, risk reduction counseling, adherence counseling, and routine monitoring for HIV infection, laboratory abnormalities, and adverse events.
Placebo,condoms,adh/risk counselingPLACEBO_COMPARATOREligible participants were randomized to the placebo arm and received placebo oral tablets that were visually identical to the TDF-FTC tablet and taken once daily. The placebo tablets contained no active ingredients. The ratio of randomization was 1:1. Participants randomized to the placebo arm received male and female condoms, personalized risk reduction counseling, adherence counseling, and routine monitoring for HIV infection, laboratory abnormalities, and adverse events.
TDF 48 weeksACTIVE_COMPARATORParticipants will receive TDF for 48 weeks. After Week 48, participants will have the option to continue receiving TDF for up to 144 weeks.
TDF plus GS-4774 2 YUEXPERIMENTALParticipants will receive TDF plus GS-4774 2 yeast units (YU) for 20 weeks. After Week 20, GS-4774 will be discontinued and participants will continue on TDF for an additional 28 weeks. After Week 48, participants will have the option to continue receiving TDF for up to 144 weeks.
TDF plus GS-4774 10 YUEXPERIMENTALParticipants will receive TDF plus GS-4774 10 YU for 20 weeks. After Week 20, GS-4774 will be discontinued and participants will continue on TDF for an additional 28 weeks. After Week 48, participants will have the option to continue receiving TDF for up to 144 weeks.
TDF plus GS-4774 40 YUEXPERIMENTALParticipants will receive TDF plus GS-4774 40 YU for 20 weeks. After Week 20, GS-4774 will be discontinued and participants will continue on TDF for an additional 28 weeks. After Week 48, participants will have the option to continue receiving TDF for up to 144 weeks.
Tenofovir DFEXPERIMENTALTDF 300 mg + FTC/TDF placebo + ETV placebo once daily (QD)
FTC/TDFEXPERIMENTALFTC 200 mg/TDF 300 mg + TDF placebo + ETV placebo QD
EntecavirEXPERIMENTALETV 0.5 mg or 1 mg + TDF placebo + FTC/TDF placebo QD

Interventions

NameTypeDescription
Tenofovir disoproxil fumarate (TDF)DRUGTDF administered as a 300-mg tablet once daily
PlaceboDRUGTDF placebo tablet once daily
Tenofovir disoproxil fumarateDRUG -
Tenofovir Disoproxil Fumarate 300 mg + Emtricitabine 200 mgDRUG -
Placebo Oral TabletDRUG -
GS-4774BIOLOGICALGS-4774 subcutaneous injection administered every 4 weeks for a total of 6 doses
Tenofovir disoproxil fumarate (tenofovir DF; TDF)DRUG300-mg tablet QD
Emtricitabine/tenofovir disoproxil fumarate (FTC/TDF)DRUGFTC 200 mg/TDF 300 mg fixed-dose combination (FDC) tablet QD
Entecavir (ETV)DRUG0.5-mg or 1-mg tablet QD
TDF placeboDRUGPlacebo to match TDF QD
FTC/TDF placeboDRUGPlacebo to match FTC/TDF QD
ETV placeboDRUGPlacebo to match ETV QD
AbacavirDRUG -
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Eligibility Criteria

Age Range12 Years to 17 Years
SexALL
Healthy VolunteersNo
Study Sites21

Inclusion Criteria * Male or female, 12 through 17 years of age, inclusive (consent of parent/legal guardian required) * Documented chronic HBV infection * HBeAg positive or HBeAg negative * Weight \> 35 kg * Able to swallow oral tablets * HBV DNA \> 100,000 copies/mL (polymerase chain reaction (PC...

Countries:United StatesBulgariaFrancePolandRomaniaSpainTurkey (Türkiye)Puerto RicoBotswanaCanadaItalyNew ZealandSouth KoreaGermanyGreeceSingaporeTaiwan
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Frequently asked questions about Tenofovir disoproxil

What is tenofovir disoproxil used for?

Tenofovir disoproxil is used to treat chronic hepatitis B and HIV, and it is also studied for HIV prevention. Its clinical trial programs cover chronic hepatitis B, hepatitis B virus infection, and HIV infections. It is a small molecule antiviral developed by Gilead Sciences.

Who makes tenofovir disoproxil?

Tenofovir disoproxil is developed by Gilead Sciences, Inc., which trades under the ticker GILD. Gilead is the sponsor behind the clinical trial programs evaluating the drug in chronic hepatitis B, hepatitis B virus infection, and HIV.

What phase is tenofovir disoproxil in?

Tenofovir disoproxil has been studied across Phase 2 and Phase 3 clinical trials. Its listed development phase is Phase 2. The drug is investigational in these programs and is not described as FDA approved for the indications covered by these trials.

What clinical trials is tenofovir disoproxil in?

Tenofovir disoproxil has been evaluated in completed trials including NCT02174276 in chronic hepatitis B, NCT00734162 in adolescents with chronic hepatitis B, NCT00448669 for oral HIV prophylaxis in Botswana, and NCT00298363 comparing TDF, FTC/TDF, and entecavir in chronic HBV with decompensated liver disease.

Is tenofovir disoproxil the same as tenofovir disoproxil fumarate?

Yes. Tenofovir disoproxil fumarate, also called tenofovir DF or TDF, is the fumarate salt form of tenofovir disoproxil and is the name used in its clinical trials. It also appears in combination products such as tenofovir disoproxil fumarate 300 mg plus emtricitabine 200 mg.

How many patients have been enrolled in tenofovir disoproxil trials?

Across the listed trials, tenofovir disoproxil has enrolled about 1,994 participants. The studies were randomized, double blind, and active controlled, and they covered chronic hepatitis B, hepatitis B virus infection, and HIV infections, including one trial that enrolled healthy volunteers.