Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Label indication PREZISTA, co-administered with ritonavir (PREZISTA/ritonavir), in combination with other antiretroviral agents, is indicated for the treatment of human immunodeficiency virus (HIV-1) infection in adult and pediatric patients 3 years of age and older [see Use in Specific Populations (8.4) and Clinical Studies (14) ] . FDA label
Also known as Darunavir (DRV)
Darunavir · 8 trials · 12 indications
Percentage of participants with a HIV-1 RNA \< 50 copies per mL were assessed using FDA snapshot approach which defines a participant's virologic response status using only the viral load at the predefined time point within an allowed window of time, along with study drug discontinuation status. The snapshot approach classified participants into 3 outcome categories: 1) virologic success (HIV RNA \< 20/50/200 copies per mL at Week 48), 2) virologic failure (HIV RNA greater than or equal to \[\>=\] 20/50/200 copies per mL at Week 48), 3) no viral load data in the Week 48 visit window (discontinued due to adverse event/death/other reason). The missing HIV-1 RNA is considered as non-response.
The percentage of participants who have plasma human immunodeficiency virus type-1 (HIV-1) ribonucleic acid (RNA) levels \<50 copies/milliliters \[mL\] after 48 weeks of follow-up. Switch = Failure is defined as switch in background nucleoside/nucleotide reverse transcriptase inhibitors (N\[t\]RTIs) not permitted by the trial protocol or plasma HIV-1 RNA assessment closest to target date of the analysis time point window (44-52 weeks) and next/confirmation of Plasma HIV-1 RNA in the analysis time point window above the threshold or discontinuation for any other reason.
Number of participants with early discontinuation from randomized HIV PEP for any reason other than confirmation of the negative HIV infection status of the index person in participants receiving HIV PEP for at least 28 days and a maximum of 30 days was assessed. Per protocol (PP) population included all participants in modified intention-to-treat (mITT \[defined as all participants who were assigned to receive randomized HIV PEP and were not discontinued due to confirmation of the negative HIV infection status of the index person\]) excluding participants with: No indication for HIV PEP; Initiation of PEP \>72 hours after injury; Discontinuation of HIV PEP due to confirmation of HIV negative status of index person and if index person bears resistant virus against HIV PEP components prescribed; incorrect HIV PEP; no intake of medication.
Adverse events (AEs): any untoward medical occurrence (any unfavorable and unintended sign \[including an abnormal laboratory finding\], symptom, or disease) that occurred in a participant administered a pharmaceutical product and which did not necessarily have causal relationship with study treatment. Serious adverse events (SAEs): any untoward medical occurrence at any dose resulted: death; was life threatening; requires inpatient hospitalization/prolongation of existing hospitalization; resulted in persistent/significant disability/incapacity or congenital anomaly/birth defect. Adult participants who received either DRV/rtv 800/100 mg once daily or DRV/rtv 600/100 mg twice daily per parent study were included in single arm and combined analysis was performed as planned in protocol because the 2 doses were extensively evaluated in their respective parent studies. Main purpose of this study was to provide continued access and not to compare the 2 doses.
Adverse events (AEs) were defined as any untoward medical occurrence (any unfavorable and unintended sign \[including an abnormal laboratory finding\], symptom, or disease) that occurred in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. Adult participants who received either DRV/rtv 800/100 mg once daily or DRV/rtv 600/100 mg twice daily per parent study were included in single arm and combined analysis was performed as planned in protocol because the 2 doses were extensively evaluated in their respective parent studies. Main purpose of this study was to provide continued access and not to compare the 2 doses.
Number of participants with adverse events possibly related to DRV/rtv treatment were reported. Adult participants who received either DRV/rtv 800/100 mg once daily or DRV/rtv 600/100 mg twice daily per parent study were included in single arm and combined analysis was performed as planned in protocol because the 2 doses were extensively evaluated in their respective parent studies. Main purpose of this study was to provide continued access and not to compare the 2 doses.
C0h is defined as the predose (trough) plasma concentration or concentration just prior to study drug administration.
The Cmin is the minimum observed plasma concentration.
The Cmax is the maximum observed plasma concentration.
The Tmax is defined as actual sampling time to reach maximum observed plasma concentration.
The AUC (0-12) is the area under the plasma concentration-time curve from time zero to 12 hours post dose. The selected arms were based on the dosing frequency (twice daily).
The AUC (0-24) is the area under the plasma concentration-time curve from time zero to 24 hours post dose. The selected arms were based on the dosing frequency (once daily).
Virological response is defined as the number of patients in the PP population with a plasma viral load \< 50 HIV RNA copies/ml at Week 48. Treatment failure was defined as two consecutive HIV RNA levels ≥ 50 copies/mL, or discontinuation of randomised treatment (known as TLOVR). In addition, any switch in background nucleoside reverse transcriptase inhibitors (NRTIs) equaled failure\* (referred to as a Switch Equals Failure analysis). \*Discontinuations and rechallenge with NRTIs are taken into account until Week 48
Brachial artery FMD is calculated as the percentage increase in brachial artery diameter with hyperemia (an increase in the quantity of blood flow to a body part) induced relative to the resting brachial artery diameter. Percentage of brachial artery diameter is measured as FMD diameter/basal diameter.
| Arm | Type | Description |
|---|---|---|
| Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide | EXPERIMENTAL | Subject will receive a single oral tablet containing darunavir (DRV) 800 milligram (mg)/ cobicistat (COBI) 150 mg/ emtricitabine (FTC) 200 mg/ tenofovir alafenamide (TAF) 10 mg (D/C/F/TAF fixed dose combination \[FDC\]) once daily along with DRV/COBI FDC-matching and FTC/TDF FDC-matching placebo tablets once daily up to Week 48 analysis unblinding visit (i.e. after last subject has reached Week 48). After Week 48 analysis unblinding visit, subjects will receive a single tablet containing D/C/F/TAF FDC once daily up to Week 96. |
| DRV/COBI fixed dose combination (FDC) and FTC/TDF FDC | ACTIVE_COMPARATOR | Subject will receive DRV 800 mg/COBI 150 mg FDC and FTC 200 mg/TDF 300 mg FDC along with D/C/F/TAF FDC-matching placebo tablet once daily up to Week 48 analysis unblinding (i.e. after last subject has reached Week 48). After Week 48 analysis unblinding, subjects will receive a single tablet containing D/C/F/TAF FDC once daily up to Week 96. |
| Darunavir monotherapy | EXPERIMENTAL | Darunavir (DRV) + ritonavir (rtv): 2 tablets DRV 400 mg should be taken together with 1 tablet rtv 100 mg within 30 minutes after a meal. Following the primary efficacy analysis after Week 48, patients who entered the study with a nadir CD4+ count of \<200 cells/μL will also receive 2 N\[t\]RTIs (ie, triple therapy) as soon as possible |
| Triple therapy containing darunavir | ACTIVE_COMPARATOR | Darunavir (DRV) + ritonavir (rtv) + 2 N\[t\]RTIs: 2 tablets DRV 400 mg should be taken together with 1 tablet rtv 100 mg within 30 minutes after a meal in combination with 2 N\[t\]RTIs (an investigator-selected dual combination of either abacavir (ABC), lamivudine (3TC), zidovudine (AZT), tenofovir disoproxil fumarate (TDF) or emtricitabine (FTC) |
| DRV/r with 2 NRTIs | EXPERIMENTAL | DRV/r 800/100 mg q.d. with 2 NRTIs: darunavir (800 mg) in combination with low-dose ritonavir (100 mg) administered once a day for at least 28 days and a maximum of 30 days along with 2 nucleoside/nucleotide analogue reverse transcriptase inhibitors (NRTIs). |
| Comparator standard of care HIV PEP | ACTIVE_COMPARATOR | Comparator standard of care HIV PEP (as per German-Austrian Guidelines): Administration of the standard of care HIV PEP (postexposure prophylaxis) consisting of 2 NRTIs plus third partner. |
| Continued Treatment with DRV in Combination with rtv | EXPERIMENTAL | HIV-1 infected children participants (aged less than \[\<\] 12 years) will continue to receive darunavir (DRV) 200 to 600 milligrams (mg) as oral suspension twice daily (BID) along with ritonavir (rtv) 32 to 100 mg as oral solution/suspension BID. HIV-1 infected adolescent participants (aged 12-17 years) will continue to receive DRV 200 to 600 mg as oral suspension BID along with rtv 32 to 100 mg as oral solution/suspension BID. Dosing for children and adolescent participants will be based on body weight (per parent study TMC114-TiDP29-C232). HIV-1 infected adult participants (aged greater than or equal to \[\>=\] 18 years) will continue to receive DRV 800 mg (2 tablets of 400 mg) orally every day (qd) along with rtv 100 mg tablet (per parent study TMC114-C211) or DRV 600 mg tablet orally BID along with rtv 100 mg tablet (per parent study TMC114-C214 or TMC114-TiDP31-C229). |
| Group 1: Darunavir 600 /Ritonavir 100 | EXPERIMENTAL | TMC114 (darunavir) Two 300 milligram (mg) or one 600 mg tablet twice daily up to 12 weeks postpartum / ritonavir one 100 mg tablet twice daily with darunavir up to 12 weeks postpartum. |
| Group 2: Darunavir 800/Ritonavir 100 | EXPERIMENTAL | TMC114 (darunavir) 800mg tablet once daily up to 12 weeks postpartum/ ritonavir one 100 mg tablet once daily with darunavir up to 12 weeks postpartum. |
| Group 3: Etravirine | EXPERIMENTAL | TMC125 (etravirine) 200 mg (1\*200 mg/2\*100 mg) tablets twice daily up to 12 weeks postpartum. |
| Group 4: Rilpivirine | EXPERIMENTAL | TMC278 (rilpivirine) One 25 mg tablet once daily up to 12 weeks postpartum. |
| Group 5: Darunavir 800/Cobicistat 150 | EXPERIMENTAL | Fixed dose combination (FDC) tablet of TMC114 (darunavir) 800 mg and cobicistat 150 mg once daily up to 12 weeks postpartum. |
| darunavir + 2 NRTI | EXPERIMENTAL | darunavir (DRV, TMC114) 800 mg qd (2 x 400 mg tablet) + 2 NRTI for 144 weeks |
| 005 | EXPERIMENTAL | Darunavir 400 mg tablet intake of 2 tablets once daily in combination with ritonavir |
| 006 | EXPERIMENTAL | Ritonavir Liquid formulation 80 mg/ml taken in combination with Darunavir |
| 007 | EXPERIMENTAL | Ritonavir 100 mg capsule to be taken once or twice daily in combination with Darunavir and following the Darunavir dosing schedule |
| 008 | EXPERIMENTAL | Ritonavir 100 mg tablet to be taken once or twice daily in combination with Darunavir and following the Darunavir dosing schedule |
| 001 | EXPERIMENTAL | Darunavir Oral suspension 100 mg/ml 20 mg/kg twice daily in combination with ritonavir for body weight between 10 and 20 kg |
| 002 | EXPERIMENTAL | Darunavir 375 mg composed via oral solution or various tablets twice daily in combination with ritonavir for body weight between 20 and 30 kg |
| 003 | EXPERIMENTAL | Darunavir 450 mg composed via oral solution or various tablets twice daily in combination with ritonavir for body weight between 30 and 40 kg |
| 004 | EXPERIMENTAL | Darunavir 600mg composed via oral solution or various tablets twice daily in combination with ritonavir for body weight as of 40 kg |
| 009 | EXPERIMENTAL | Ritonavir powder for oral suspension 10 mg/mL taken in combination with Darunavir. |
| Monotherapy | EXPERIMENTAL | Monotherapy: darunavir/ritonavir (DRV/r) will be administered for 48 weeks. |
| Combination therapy | EXPERIMENTAL | DRV/r along with 2 nucleoside reverse transcriptase inhibitors (NRTIs) will be administered for 48 weeks and whenever possible, participants should take these medications at the same time. Switch of NRTIs will be allowed in the event of suspected toxicity/intolerance, providing this change can be linked to a documented adverse event (AE)/serious AE. |
| Name | Type | Description |
|---|---|---|
| Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide FDC | DRUG | A tablet containing DRV 800 mg, COBI 150 mg, FTC 200 mg and TAF) 10 mg will be administered once daily. |
| DRV/COBI FDC | DRUG | A tablet containing DRV 800 mg and COBI 150 mg will be administered once daily. |
| FTC/TDF FDC | DRUG | A tablet containing FTC 200 mg and TDF 300 mg will be administered once daily. |
| D/C/F/TAF FDC - Matching Placebo | DRUG | Matching placebo of D/C/F/TAF FDC will be administered once daily. |
| FTC/TDF FDC Matching Placebo | DRUG | Matching placebo of FTC/TDF FDC will be administered once daily. |
| DRV/COBI FDC Matching Placebo | DRUG | Matching placebo of DRV/COBI FDC will be administered once daily. |
| Darunavir | DRUG | Darunavir (DRV): type = exact number, unit = mg, number = 800, form = tablet, route = oral use |
| Ritonavir | DRUG | ritonavir (rtv): type = exact number, unit = mg, number = 100, form = tablet, route = oral use |
| Darunavir/Ritonavir (DRV/r) | DRUG | Darunavir (DRV) type=exact number, unit=mg, number=800, form=tablet, route=oral use. Tablet is taken once a day, for 28 days; Ritonavir (r) type=exact number, unit=mg, number=100, form=tablet, route=oral use. Tablet is taken once a day, for at least 28 days and a maximum of 30 days. |
| Lopinavir in fixed combination with Ritonavir | DRUG | type=exact number, unit=mg, number=400/100, form=tablet, route=oral use. Tablet is taken once or twice a day, for at least 28 days and a maximum of 30 days. |
| Zidovudine | DRUG | type=exact number, unit=mg, number=250, form=tablet, route=oral use. Tablet is taken twice a day, for at least 28 days and a maximum of 30 days. |
| NRTIs | DRUG | The NRTIs (including tenofovir/emtricitabine \[Truvada\], lamivudine/zidovudine \[Combivir\]) will be administered as per the individual Summary of Product Characteristics (SmPCs) at the discretion of either the treating physician or Investigator. |
| Efavirenz | DRUG | type=exact number, unit=mg, number=600, form=tablet, route=oral use. Tablet is taken once a day, for at least 28 days and a maximum of 30 days. |
| Etravirine | DRUG | 200 mg (1\*200 mg/2\*100 mg) tablets twice daily up to 12 weeks postpartum. |
| Rilpivirine | DRUG | One 25 mg tablet once daily up to 12 weeks postpartum. |
| Darunavir/Cobicistat (FDC) | DRUG | Fixed dose combination (FDC) tablet of TMC114 (darunavir) 800 mg and cobicistat 150 mg once daily up to 12 weeks postpartum. |
| darunavir (DRV, TMC114) | DRUG | 800 mg qd (2 x 400 mg tablet) + 2 NRTI for 144 weeks |
| Darunavir(DRV) | DRUG | Oral administration of tablet DRV 800 mg (2 tablets of 400 mg) once daily at the same time, within 30 minutes after food for 48 weeks |
| 2 nucleoside reverse transcriptase inhibitors (NRTIs) | DRUG | 2 NRTIs will be administered as per the package inserts. |
Inclusion Criteria: * Subject must be antiretroviral (ARV) treatment-naive (never treated with an ARV including post-exposure prophylaxis and pre-exposure prophylaxis); no prior use of any approved or experimental anti- human immunodeficiency virus (anti-HIV) drug for any length of time * Screening...
Darunavir is used to treat HIV, including HIV-1 infection and human immunodeficiency virus infections. It is studied both as part of combination antiretroviral therapy in treatment-naive patients and as postexposure prophylaxis after potential HIV exposure. The darunavir/cobicistat/emtricitabine/tenofovir alafenamide fixed-dose combination is one studied regimen for HIV-1.
Darunavir is developed by Johnson & Johnson, which trades under the ticker JNJ. The company has sponsored Phase 3 trials of darunavir-based regimens, including the darunavir/cobicistat/emtricitabine/tenofovir alafenamide fixed-dose combination and darunavir/ritonavir combinations for HIV treatment and prevention.
Darunavir has been studied in Phase 3 clinical development, with completed Phase 3 trials in HIV and HIV-1 infection. It is an investigational small molecule in the infectious disease therapeutic area. Two Phase 3 studies are listed as completed, and no trials are currently active.
Darunavir has been evaluated in completed trials including NCT02431247, which compared darunavir/cobicistat/emtricitabine/tenofovir alafenamide fixed-dose combination against darunavir/cobicistat plus emtricitabine/tenofovir disoproxil fumarate in treatment-naive HIV-1 patients, and NCT01516970, which studied darunavir/ritonavir for HIV postexposure prophylaxis.
Across the listed darunavir trials, total enrollment is 725 patients in the largest study, NCT02431247, which was a Phase 3 trial in treatment-naive HIV-1 infected subjects. Other completed studies include NCT01516970 with 312 patients and NCT01448707 with 274 patients.