Trial Outcomes & Findings for TMC125-TiDP35-C213: Safety and Antiviral Activity of Etravirine (TMC125) in Treatment-Experienced, HIV Infected Children and Adolescents (NCT NCT00665847)

NCT ID: NCT00665847

Last Updated: 2015-04-23

Results Overview

A treatment-emergent adverse event (TEAE) was defined as an event that occurred in the 48-week treatment period during which it emerged (i.e. started or worsened in severity, relation, or other attribute), and not in the subsequent study periods, even if the event continued to be present. Adverse events were graded from 1 to 4 in severity using the Division of Acquired Immunodeficiency Syndrome severity scale (grade 1 being less severe and grade 4 being more severe). ETR=etravirine/TMC125; OBR=optimized background regimen

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

103 participants

Primary outcome timeframe

48 weeks

Results posted on

2015-04-23

Participant Flow

In total, 41 investigators in 13 countries enrolled patients in study TMC125-C213. A total of 103 patients were documented as being enrolled in the study, however 2 patients were randomized in error. Therefore, 101 patients were enrolled and treated with etravirine (ETR) also known as TMC125 and included in the intent-to-treat (ITT) population.

Participant milestones

Participant milestones
Measure
TMC125
TMC125 dosed according to body weight (kg) from 100 mg to 200 mg twice a day
Overall Study
STARTED
101
Overall Study
COMPLETED
76
Overall Study
NOT COMPLETED
25

Reasons for withdrawal

Reasons for withdrawal
Measure
TMC125
TMC125 dosed according to body weight (kg) from 100 mg to 200 mg twice a day
Overall Study
Adverse Event
8
Overall Study
Withdrawal by Subject
2
Overall Study
Subject non-compliant
8
Overall Study
Subject reached a virologic endpoint
4
Overall Study
Resistance to TMC125
1
Overall Study
Subject ineligible to continue the trial
1
Overall Study
Switch to Commercial Medication
1

Baseline Characteristics

TMC125-TiDP35-C213: Safety and Antiviral Activity of Etravirine (TMC125) in Treatment-Experienced, HIV Infected Children and Adolescents

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
TMC125
n=101 Participants
TMC125 dosed according to body weight (kg) from 100 mg to 200 mg twice a day
Age, Continuous
12.2 years
STANDARD_DEVIATION 2.99 • n=5 Participants
Sex: Female, Male
Female
64 Participants
n=5 Participants
Sex: Female, Male
Male
37 Participants
n=5 Participants
Age Customized
>=6 to <12 years
41 participants
n=5 Participants
Age Customized
>=12 to <18 years
60 participants
n=5 Participants

PRIMARY outcome

Timeframe: 48 weeks

Population: The safety analysis was done on the intent-to-treat (ITT) population, which included all patients who received at least one dose of investigational medication.

A treatment-emergent adverse event (TEAE) was defined as an event that occurred in the 48-week treatment period during which it emerged (i.e. started or worsened in severity, relation, or other attribute), and not in the subsequent study periods, even if the event continued to be present. Adverse events were graded from 1 to 4 in severity using the Division of Acquired Immunodeficiency Syndrome severity scale (grade 1 being less severe and grade 4 being more severe). ETR=etravirine/TMC125; OBR=optimized background regimen

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs that were grade 3 or 4 in severity
14 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: Rash
23 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: hepatic events
0 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: cardiac events
0 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: bleeding events
0 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: pancreatic events
1 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: lipid-related events
6 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: neoplasms
1 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
Any TEAE
89 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs that were fatal
0 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs that were serious
5 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs leading to temporary ETR discontinuation
8 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs leading to permanent ETR discontinuation
8 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs possibly related to ETR
23 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs probably related to ETR
14 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs very likely related to ETR
3 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs at least possibly related to ETR
33 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs possibly related to OBR
27 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs probably related to OBR
12 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs very likely related to OBR
5 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs at least possibly related to OBR
36 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of at least grade 2 in severity
21 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of at least grade 3 in severity
3 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: Skin event
31 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: severe cutaneous reactions
7 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: angioedema
4 Patients
The Number of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: neuropsychiatric events
2 Patients

PRIMARY outcome

Timeframe: 48 weeks

Population: The safety analysis was done on the intent-to-treat (ITT) population, which included all patients who received at least one dose of investigational medication.

The percentage of patients with a treatment-emergent adverse event (TEAE) (defined as an event that occurred in the 48-week treatment period during which it emerged \[i.e. started or worsened in severity, relation, or other attribute\], and not in the subsequent study periods, even if the event continued to be present\] are provided below. Adverse events were graded from 1 to 4 in severity using the Division of Acquired Immunodeficiency Syndrome severity scale (grade 1 being less severe and grade 4 being more severe). ETR=etravirine/TMC125; OBR=optimized background regimen

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
Any TEAE
88.1 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs that were fatal
0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs that were serious
5.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs that were grade 3 or 4 in severity
13.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs leading to temporary ETR discontinuation
7.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs at least possibly related to OBR
35.6 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of at least grade 2 in severity
20.8 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of at least grade 3 in severity
3.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: Skin event
30.7 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: Rash
22.8 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: severe cutaneous reactions
6.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: pancreatic events
1.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs leading to permanent ETR discontinuation
7.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs possibly related to ETR
22.8 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs probably related to ETR
13.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs very likely related to ETR
3.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs at least possibly related to ETR
32.7 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs possibly related to OBR
26.7 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs probably related to OBR
11.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs very likely related to OBR
5.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: angioedema
4.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: neuropsychiatric events
2.0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: hepatic events
0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: cardiac events
0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: bleeding events
0 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: lipid-related events
5.9 Percentage of patients
The Percentage of Patients With Treatment-emergent Adverse Events (TEAEs)
TEAEs of interest: neoplasms
1.0 Percentage of patients

SECONDARY outcome

Timeframe: Weeks 4-48

Population: The intent-to-treat (ITT) population, i.e. all patients who had been enrolled and taken ETR at least once, regardless of their compliance with the protocol was used for this analysis. The table below shows results for "Overall (children and adolescents combined)."

The AUC12h is a Bayesian estimation based on a population pharmacokinetic model and sparse samples collected at each visit over the duration of trial. For each sparse sample taken, the time blood sample was recorded as well as the time of etravirine intake just prior to the time of blood sample.

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
Population Pharmacokinetic (PK) Estimates of Etravirine/TMC125 (ETR): Area Under the Plasma Concentration-time Curve Over 12 Hours at Steady-state (AUC12h)
5216 ng.h/mL
Standard Deviation 4305

SECONDARY outcome

Timeframe: Week 48

Population: The intent-to-treat (ITT) population, i.e. all patients who had been enrolled and taken ETR at least once, regardless of their compliance with the protocol was used for this analysis. The table below shows results for "Overall (children and adolescents combined)."

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
Population Pharmacokinetic (PK) Estimates of Etravirine/TMC125 (ETR): Trough Plasma Concentration (C0h)
346 ng/mL
Standard Deviation 342

SECONDARY outcome

Timeframe: Week 4

Population: The intent-to-treat (ITT) population, i.e. all patients who had been enrolled and taken Etravirine/TMC125 (ETR) at least once, regardless of their compliance with the protocol was used for this analysis.

Etravirine/TMC125 (ETR) Cmax was approximated for each individual using the median value of plasma ETR concentrations taken 4 hours postdose (± 1 hour), when available, on the day of the Week 4 visit as shown in the table below.

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
Population Pharmacokinetic (PK) Estimates of Etravirine/TMC125 (ETR): Maximum Plasma Concentration (Cmax)
589 ng/mL
Standard Deviation 486

SECONDARY outcome

Timeframe: Week 24

Population: The intent-to-treat (ITT) population, i.e. all patients who had been enrolled and taken Etravirine/TMC125 (ETR) at least once, regardless of their compliance with the protocol was used for this analysis.

Virologic response was defined as the percentage of patients with plasma viral load \< 50 copies/mL at Week 24 calculated according to the non-completer=failure (NC=F) imputation method.

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
Percentage of Patients With Virologic Response at Week 24
52.5 Percentage of Patients

SECONDARY outcome

Timeframe: Baseline, Week 48

Population: The intent-to-treat (ITT) population, i.e. all patients who had been enrolled and taken Etravirine/TMC125 (ETR) at least once, regardless of their compliance with the protocol was used for this analysis.

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
Change From Baseline in Human Immunodeficiency Virus - Type 1 (HIV-1) Ribonucleic Acid (RNA) in Plasma Over Time
-1.53 log10 copies/mL
Standard Error 0.132

SECONDARY outcome

Timeframe: Baseline, Week 48

Population: The intent-to-treat (ITT) population, i.e. all patients who had been enrolled and taken Etravirine/TMC125 (ETR) at least once, regardless of their compliance with the protocol was used for this analysis.

Outcome measures

Outcome measures
Measure
TMC125
n=101 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
The Change From Baseline in CD4 Cell Counts Over Time
156 10E6 cells/L
Standard Error 22.7

SECONDARY outcome

Timeframe: Baseline and Endpoint (up to Week 48)

Population: The patients in the intent-to-treat (ITT) population classified as virologic failures were used for this analysis.

Virologic failure (lack of response) was defined as: plasma viral load decline of \< 0.5 log10 from Baseline by Week 8 and/or plasma viral load decline of \<1.0 log10 from Baseline by Week 12. Virologic failure (loss of response) was defined as 2 consecutive measurements of plasma viral load \> 0.5 log10 above the nadir after a minimum of 12 weeks of treatment. The table below provides data for 41 viologic failures of which 30 had mutation data available. In the table below, only the 4 most frequently emerging mutations are presented (emerging in at least 3 patients).

Outcome measures

Outcome measures
Measure
TMC125
n=41 Participants
TMC125 dosed based on body weight (kg) from 100 mg to 200 mg twice a day
The Emergence of Non-nucleoside Reverse Transcriptase Inhibitor Resistance-associated Mutations (NNRTI RAMs) in Patients Classified as Virologic Failures
V90I
3 Patients
The Emergence of Non-nucleoside Reverse Transcriptase Inhibitor Resistance-associated Mutations (NNRTI RAMs) in Patients Classified as Virologic Failures
L100I
3 Patients
The Emergence of Non-nucleoside Reverse Transcriptase Inhibitor Resistance-associated Mutations (NNRTI RAMs) in Patients Classified as Virologic Failures
E138A
3 Patients
The Emergence of Non-nucleoside Reverse Transcriptase Inhibitor Resistance-associated Mutations (NNRTI RAMs) in Patients Classified as Virologic Failures
Y181C
8 Patients

Adverse Events

TMC125

Serious events: 5 serious events
Other events: 70 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
TMC125
n=101 participants at risk
TMC125 dosed according to body weight (kg) from 100 mg to 200 mg twice a day
Eye disorders
Ulcerative keratitis
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
General disorders
Drug resistance
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Injury, poisoning and procedural complications
Drug toxicity
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Injury, poisoning and procedural complications
Overdose
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Investigations
Immunoglobulins
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Investigations
Lymphocyte morphology abnormal
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Investigations
Weight decreased
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Social circumstances
Treatment noncompliance
0.99%
1/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.

Other adverse events

Other adverse events
Measure
TMC125
n=101 participants at risk
TMC125 dosed according to body weight (kg) from 100 mg to 200 mg twice a day
Eye disorders
Conjunctivitis
5.9%
6/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Gastrointestinal disorders
Diarrhoea
15.8%
16/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Gastrointestinal disorders
Nausea
9.9%
10/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Gastrointestinal disorders
Vomiting
10.9%
11/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
General disorders
Pyrexia
8.9%
9/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Infections and infestations
Bronchitis
8.9%
9/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Infections and infestations
Oral herpes
5.9%
6/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Infections and infestations
Pharyngitis
7.9%
8/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Infections and infestations
Rhinitis
5.9%
6/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Infections and infestations
Sinusitis
5.9%
6/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Infections and infestations
Upper respiratory tract infection
26.7%
27/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Nervous system disorders
Headache
8.9%
9/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Respiratory, thoracic and mediastinal disorders
Cough
12.9%
13/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
5.9%
6/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Skin and subcutaneous tissue disorders
Rash
10.9%
11/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.
Skin and subcutaneous tissue disorders
Rash maculo-papular
8.9%
9/101
Only subjects who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. subjects with Non-Serious Adverse Events.

Additional Information

Senior Director

Tibotec Pharmaceuticals, Ireland

Phone: 32 14 641 265

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60